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DELZICOL(mesalamine delayed-release capsules)
2017-03-31 07:04:06 来源: 作者: 【 】 浏览:526次 评论:0
  • HIGHLIGHTS OF PRESCRIBING INFORMATION
    These highlights do not include all the information needed to use DELZICOL ® safely and effectively. See full prescribing information for DELZICOL.
    DELZICOL ® (mesalamine) delayed-release capsules, for oral use
    Initial U.S. Approval: 1987
    RECENT MAJOR CHANGES
     Indications and Usage, Treatment of Mildly to Moderately Active Ulcerative Colitis (1.1)  04/2014
     Dosage and Administration, Dosage for Treatment of Mildly to Moderately Active Ulcerative Colitis (2.1)  04/2014
     Dosage and Administration, Dosage for Treatment of Mildly to Moderately Active Ulcerative Colitis (2.1)  10/2014
     Dosage and Administration, Dosage for Maintenance of Remission of Ulcerative Colitis (2.2)  10/2014
     Dosage and Administration, Important Administration Instructions (2.3)  04/2014
     Dosage and Administration, Testing Prior to DELZICOL Administration (2.4)  04/2014
    INDICATIONS AND USAGE

    DELZICOL is an aminosalicylate indicated for:

    • Treatment of mildly to moderately active ulcerative colitis in patients 12 years of age and older (1.1)
    • Maintenance of remission of ulcerative colitis in adults (1.2)
    DOSAGE AND ADMINISTRATION
    • For the treatment of mildly to moderately active ulcerative colitis (2.1)
      ºAdults: 800 mg three times daily with or without food (2.4 grams/day) for 6 weeks
      º Pediatric Patients 12 years or older: Total daily dose is weight-based up to a maximum of 2.4 grams/day with or without food (see table below); twice daily dosing for 6 weeks

    Weight Group
    (kg)

    Daily Dose
    (mg/kg/day)

    Maximum Daily Dose
    (grams/day)

    17 to < 33

    36 to 71

    1.2

    33 to < 54

    37 to 61

    2.0

    54 to 90

    27 to 44

    2.4

    • For the maintenance of remission of ulcerative colitis in adults, 1.6 g daily, in divided doses (2.2)
    • Do not open, crush, break, or chew the capsules. Swallow whole with water (2.3)
    • Two DELZICOL 400 mg capsules should not be substituted with one mesalamine delayed-release 800 mg tablet (2.3)
    • Assess children for the ability to swallow capsules (2.3)
    • Recommend that renal function be eva luated prior to initiation of DELZICOL (2.4, 5.1)
    DOSAGE FORMS AND STRENGTHS

    Delayed-release capsules: 400 mg (3)
    CONTRAINDICATIONS
    Patients with known hypersensitivity to salicylates or aminosalicylates or to any of the ingredients of DELZICOL capsules (4, 5.3)
    WARNINGS AND PRECAUTIONS

    • Renal Impairment (for example, minimal change nephropathy, acute and chronic interstitial nephritis, renal failure): Assess renal function at beginning of treatment and periodically during treatment (5.1)

    • Mesalamine-induced Acute Intolerance Syndrome: Has been reported. Observe patients closely for worsening of these symptoms while on treatment (5.2)

    • Hypersensitivity Reactions: Use caution when treating patients who are hypersensitive to sulfasalazine. Mesalamine-induced cardiac hypersensitivity reactions (myocarditis and pericarditis) have been reported (5.3)

    • Hepatic Failure: Has been reported in patients with pre-existing liver disease. Use caution when treating patients with liver disease (5.4)

    • Prolonged Gastric Retention in Patients with Upper Gastrointestinal Obstruction: May lead to a delay in onset of action (5.5)

    ADVERSE REACTIONS

    The most common adverse reactions (observed in greater than or equal to 5% of adults in clinical trials) were abdominal pain, eructation, pain, back pain, rash, dyspepsia, rhinitis, flu syndrome, asthenia, flatulence, vomiting, fever, arthralgia, constipation, and gastrointestinal bleeding (6.1)
    Adverse reactions in children were similar (6.1)
    To report SUSPECTED ADVERSE REACTIONS, contact Warner Chilcott at 1-800-521-8813 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch

    DRUG INTERACTIONS
    • Nephrotoxic agents including NSAIDs: Renal reactions have been reported (7.1)
    • Azathioprine or 6-mercaptopurine: Blood disorders have been reported (7.2)
    USE IN SPECIFIC POPULATIONS
    • Renal Impairment: Use DELZICOL with caution in patients with a history of renal disease (5.1, 7.1, 8.6)
    • Geriatric Patients: Monitor blood cell counts in geriatric patients (8.5)
    See 17 for PATIENT COUNSELING INFORMATION.

    Revised: 12/2014

  • FULL PRESCRIBING INFORMATION: CONTENTS*

    1 INDICATIONS AND USAGE

    1.1 Treatment of Mildly to Moderately Active Ulcerative Colitis

    1.2 Maintenance of Remission of Ulcerative Colitis in Adults

    2 DOSAGE AND ADMINISTRATION

    2.1 Dosage for Treatment of Mildly to Moderately Active Ulcerative Colitis

    2.2 Dosage for Maintenance of Remission of Ulcerative Colitis in Adults

    2.3 Important Administration Instructions

    2.4 Testing Prior to DELZICOL Administration

    3 DOSAGE FORMS AND STRENGTHS

    4 CONTRAINDICATIONS

    5 WARNINGS AND PRECAUTIONS

    5.1 Renal Impairment

    5.2 Mesalamine-Induced Acute Intolerance Syndrome

    5.3 Hypersensitivity Reactions

    5.4 Hepatic Failure

    5.5 Prolonged Gastric Retention in Patients with Upper Gastrointestinal Obstruction

    6 ADVERSE REACTIONS

     6.1 Clinical Trials Experience

    6.2 Postmarketing Experience

    7 DRUG INTERACTIONS

    7.1 Nephrotoxic Agents, Including Non-Steroidal Anti-Inflammatory Drugs

    7.2 Azathioprine or 6-mercaptopurine

    8 USE IN SPECIFIC POPULATIONS

    8.1 Pregnancy

    8.3 Nursing Mothers

    8.4 Pediatric Use

    8.5 Geriatric Use

    8.6 Renal Impairment

    10 OVERDOSAGE

    11 DESCRIPTION

    12 CLINICAL PHARMACOLOGY

    12.1 Mechanism of Action

    12.3 Pharmacokinetics

    13 NONCLINICAL TOXICOLOGY

    13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

    13.2 Animal Toxicology and/or Pharmacology

    14 CLINICAL STUDIES

    14.1 Treatment of Mildly to Moderately Active Ulcerative Colitis

    14.2 Maintenance of Remission of Ulcerative Colitis

    16 HOW SUPPLIED/STORAGE AND HANDLING

    17 PATIENT COUNSELING INFORMATION

    *
    Sections or subsections omitted from the full prescribing information are not listed.
  • 1 INDICATIONS AND USAGE

     

    1.1 Treatment of Mildly to Moderately Active Ulcerative Colitis
    DELZICOL® (mesalamine) delayed-release capsules are indicated for the treatment of mildly to moderately active ulcerative colitis in patients 12 years of age and older.

    1.2 Maintenance of Remission of Ulcerative Colitis in Adults

    ​DELZICOL® (mesalamine) delayed-release tablets are indicated for the maintenance of remission of ulcerative colitis in adults. The safety and effectiveness of DELZICOL for the maintenance of remission of ulcerative colitis in pediatric patients have not been established.

  • 2 DOSAGE AND ADMINISTRATION

     

    2.1 Dosage for Treatment of Mildly to Moderately Active Ulcerative Colitis
    Adults
    For adults, the recommended dosage of DELZICOL is two 400 mg capsules to be taken three times daily (total daily dose of 2.4 grams), for a duration of 6 weeks [see Clinical Studies (14.1)]. 

    Pediatrics
    For pediatric patients 12 years of age and older, the recommended total daily dose of DELZICOL is weight-based (up to maximum of 2.4 grams/day). DELZICOL capsules are to be taken twice daily with or without food for a duration of 6 weeks [see Clinical Studies (14.1)]. 

    Pediatric Dosage by Weight

     Weight Group
    (kg)

     Daily Dose
    (mg/kg/day)
     Maximum Daily Dose
    (grams/day)
     17 to < 33  36 to 71  1.2
     33 to < 54  37 to 61  2.0
     54 to 90  27 to 44  2.4

    2.2 Dosage for Maintenance of Remission of Ulcerative Colitis in Adults
    For the maintenance of remission of ulcerative colitis, the recommended dose of DELZICOL in adults is 1.6 g daily with or without food in divided doses [see Clinical Studies (14.2)].

    2.3 Important Administration Instructions
    Do not open, crush, break, or chew the capsules. Swallow whole with water.
    Before prescribing DELZICOL capsules, children should be assessed for the ability to swallow capsules
    Two DELZICOL 400 mg capsules should not be substituted with one mesalamine delayed-release 800 mg tablet.

    2.4 Testing Prior to DELZICOL Administration
    eva luate renal function prior to initiation of DELZICOL [see Warnings and Precautions (5.1)].

  • 3 DOSAGE FORMS AND STRENGTHS

    DELZICOL (mesalamine) delayed-release capsules are red capsules containing 400 mg mesalamine and imprinted with “WC 400mg” in white.

  • 4 CONTRAINDICATIONS

    DELZICOL is contraindicated in patients with known hypersensitivity to salicylates or aminosalicylates or to any of the ingredients of DELZICOL [see Warnings and Precautions (5.3), Adverse Reactions (6.2), and Description (11)].

  • 5 WARNINGS AND PRECAUTIONS

     

    5.1 Renal Impairment

    Renal impairment, including minimal change nephropathy, acute and chronic interstitial nephritis, and renal failure, has been reported in patients taking products such as DELZICOL that contain mesalamine or are converted to mesalamine.

    It is recommended that patients have an eva luation of renal function prior to initiation of DELZICOL and periodically while on therapy.

    Prescribers should carefully eva luate the risks and benefits when using DELZICOL in patients with known renal impairment or history of renal disease [see Drug Interactions (7.1) and Nonclinical Toxicology (13.2)].

    5.2 Mesalamine-Induced Acute Intolerance Syndrome

    Mesalamine has been associated with an acute intolerance syndrome that may be difficult to distinguish from an exacerbation of ulcerative colitis. Although the exact frequency of occurrence has not been determined, it has occurred in 3% of controlled clinical trials of mesalamine or sulfasalazine. Symptoms include cramping, abdominal pain, bloody diarrhea, and sometimes fever, headache, and rash. Observe patients closely for worsening of these symptoms while on treatment. If acute intolerance syndrome is suspected, promptly discontinue treatment with DELZICOL.

    5.3 Hypersensitivity Reactions

    Some patients who have experienced a hypersensitivity reaction to sulfasalazine may have a similar reaction to DELZICOL or to other compounds that contain or are converted to mesalamine.

    Mesalamine-induced cardiac hypersensitivity reactions (myocarditis and pericarditis) have been reported with DELZICOL and other mesalamine medications. Caution should be taken in prescribing this medicine to patients with conditions predisposing them to the development of myocarditis or pericarditis.

    5.4 Hepatic Failure

    There have been reports of hepatic failure in patients with pre-existing liver disease who have been administered mesalamine. Caution should be exercised when administering DELZICOL to patients with liver disease.

    5.5 Prolonged Gastric Retention in Patients with Upper Gastrointestinal Obstruction

    Organic or functional obstruction in the upper gastrointestinal tract may cause prolonged gastric retention of DELZICOL which would delay release of mesalamine in the colon.

  • 6 ADVERSE REACTIONS
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