Components:
Method of action:
Treatment option:
Medically reviewed by Oliinyk Elizabeth Ivanovna, PharmD. Last updated on 26.06.2023
Attention! Information on this page is intended only for medical professionals! Information is collected in open sources and may contain significant errors! Be careful and double-check all the information on this page!
Top 20 medicines with the same components:
Tapentadol
Powder and solvent for solution for injection.
White Powder.
Hereditary angioedema type I and II (HAE)
Treatment and pre-procedure prevention of acute episodes.
Treatment should be initiated under the supervision of a physician experienced in the treatment of C1-esterase inhibitor deficiency.
Posology
Adults
Treatment of acute angioedema attacks:
20 IU per kilogram body weight (20 IU/kg b.w.)
Pre-procedure prevention of angioedema attacks:
1000 IU less than 6 hours prior to a medical, dental, or surgical procedure.
Paediatric population
Treatment of acute angioedema attacks:
20 IU per kilogram body weight (20 IU/kg b.w.).
Pre-procedure prevention of angioedema attacks:
15 to 30 IU per kilogram body weight (15-30 IU/kg b.w.) less than 6 hours prior to a medical, dental, or surgical procedure. Dose should be selected taking into account clinical circumstances (e.g. type of procedure and disease severity).
Method of administration
< The reconstituted solution should be colourless and clear to slightly opalescent.The solution is to be administered by slow i.v. injection.
Tapentadol
In patients with known tendency towards allergies, antihistamines and corticosteroids should be administered prophylactically.
If allergic or anaphylactic-type reactions occur, the administration of Berinert has to be stopped immediately (e.g. discontinue injection/infusion) and an appropriate treatment has to be initiated. Therapeutic measures depend on the kind and severity of the undesirable effect. The current medical standards for shock treatment are to be observed.
Patients with laryngeal oedema require particularly careful monitoring with emergency treatment in stand-by.
Unlicensed use or treatment of Capillary Leak Syndrome (CLS) with Berinert (see also section "4.8 Undesirable effects") is not advised.
Berinert contains up to 486 mg sodium (approximately 21 mmol) per 100 ml solution. To be taken into consideration by patients on a controlled sodium diet.
Home treatment and self-administration
There are limited data on the use of this medicinal product in home treatment or self-administration. Potential risks associated with home treatment are related to the administration itself as well as the handling of adverse drug reactions, particularly hypersensitivity. The decision on the use of home treatment for an individual patient should be made by the treating physician, who should ensure that appropriate training is provided and the use reviewed at intervals.
Virus safety
Standard measures to prevent infections resulting from the use of medicinal products prepared from human blood or plasma include selection of donors, screening of individual donations and plasma pools for specific markers of infection and the inclusion of effective manufacturing steps for the inactivation/removal of viruses. Despite this, when medicinal products prepared from human blood or plasma are administered, the possibility of transmitting infective agents cannot be totally excluded. This also applies to unknown or emerging viruses and other pathogens.
The measures taken are considered effective for enveloped viruses such as HIV, HBV, HCV and for the non-enveloped viruses HAV and parvovirus B19.
Appropriate vaccination (hepatitis A and B) should be generally considered for patients in regular/repeated receipt of human plasma-derived products.
It is strongly recommended that every time Berinert is administered to a patient, the name and batch number of the product are recorded in order to maintain a link between the patient and the batch of the product.
No interaction studies have been performed.
Pregnancy
There are limited amount of data that indicate no increased risk from the use of Berinert in pregnant women. Berinert is a physiological component of human plasma. Therefore, no studies on reproduction and developmental toxicity have been performed in animals and no adverse effects on fertility, pre- and postnatal development are expected in humans.
Therefore, Berinert should be given to a pregnant woman only if clearly needed.
Breastfeeding
It is unknown whether Berinert is excreted in human milk, but due to its high molecular weight, the transfer of Berinert into breast milk seems unlikely. However, breastfeeding is questionable in women suffering from hereditary angioedema. A decision must be made whether to discontinue breastfeeding or to discontinue the Berinert therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.
Fertility
Berinert is a physiological component of human plasma. Therefore, no studies on reproduction and developmental toxicity have been performed in animals and no adverse effects on fertility, pre- and postnatal development are expected in humans.
Berinert has no or negligible influence on the ability to drive and use machines.
Berinert contains up to 486 mg sodium (approximately 21 mmol) per 100 ml solution. To be taken into consideration by patients on a controlled sodium diet.
Home treatment and self-administration
There are limited data on the use of this medicinal product in home treatment or self-administration. Potential risks associated with home treatment are related to the administration itself as well as the handling of adverse drug reactions, particularly hypersensitivity. The decision on the use of home treatment for an individual patient should be made by the treating physician, who should ensure that appropriate training is provided and the use reviewed at intervals.
Virus safety
Standard measures to prevent infections resulting from the use of medicinal products prepared from human blood or plasma include selection of donors, screening of individual donations and plasma pools for specific markers of infection and the inclusion of effective manufacturing steps for the inactivation/removal of viruses. Despite this, when medicinal products prepared from human blood or plasma are administered, the possibility of transmitting infective agents cannot be totally excluded. This also applies to unknown or emerging viruses and other pathogens.
The measures taken are considered effective for enveloped viruses such as HIV, HBV, HCV and for the non-enveloped viruses HAV and parvovirus B19.
Appropriate vaccination (hepatitis A and B) should be generally considered for patients in regular/repeated receipt of human plasma-derived products.
It is strongly recommended that every time Berinert is administered to a patient, the name and batch number of the product are recorded in order to maintain a link between the patient and the batch of the product.
4.5 Interaction with other medicinal products and other forms of interactionNo interaction studies have been performed.
4.6 Fertility, pregnancy and lactationPregnancy
There are limited amount of data that indicate no increased risk from the use of Berinert in pregnant women. Berinert is a physiological component of human plasma. Therefore, no studies on reproduction and developmental toxicity have been performed in animals and no adverse effects on fertility, pre- and postnatal development are expected in humans.
Therefore, Berinert should be given to a pregnant woman only if clearly needed.
Breastfeeding
It is unknown whether Berinert is excreted in human milk, but due to its high molecular weight, the transfer of Berinert into breast milk seems unlikely. However, breastfeeding is questionable in women suffering from hereditary angioedema. A decision must be made whether to discontinue breastfeeding or to discontinue the Berinert therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.
Fertility
Berinert is a physiological component of human plasma. Therefore, no studies on reproduction and developmental toxicity have been performed in animals and no adverse effects on fertility, pre- and postnatal development are expected in humans.
4.7 Effects on ability to drive and use machinesBerinert has no or negligible influence on the ability to drive and use machines.
4.8 Undesirable effectsThe following adverse reactions are based on post marketing experience as well as scientific literature. The following standard categories of frequency are used:
| Very common: | > | 1/10 |
| Common: | > | 1/100 to < 1/10 |
| Uncommon: | > | 1/1,000 to < 1/100 |
| Rare: | > | 1/10,000 to < 1/1,000 |
| Very rare: | < | 1/10,000 (including reported single cases) |
Undesired reactions with Berinert are rare.
| Organ class | Very common | Common | Uncommon | Rare | Very rare | ||||||||||||||||||
| Vascular disorders | Development of thrombosis* | ||||||||||||||||||||||
| General disorders and administration site conditions | Rise in temperature, reactions at the injection side | ||||||||||||||||||||||
| Immune system disorders | Allergic or anaphylactic-type reactions (e.g. tachycardia, hyper- or hypotension, flushing, hives, dyspnoea, headache, dizziness, nausea) | Shock Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the UK Yellow Card Scheme. Website: www.mhra.gov.uk/yellowcard Overdose
No case of overdose has been reported. Pharmacodynamic properties
Pharmacotherapeutic group: C1-inhibitor, plasma derived ATC code: B06AC01 C1-esterase inhibitor is a plasma glycoprotein with a molecular weight of 105 kD and a carbohydrate moiety of 40 %. Its concentration in human plasma ranges around 240 mg/l. Besides its occurrence in human plasma, also the placenta, the liver cells, monocytes and platelets contain C1-esterase inhibitor. C1-esterase inhibitor belongs to the serine-protease-inhibitor-(serpin)-system of human plasma as do also other proteins like antithrombin III, alpha-2-antiplasmin, alpha-1-antitrypsin and others. Under physiological conditions C1-esterase inhibitor blocks the classical pathway of the complement system by inactivating the enzymatic active components C1s and C1r. The active enzyme forms a complex with the inhibitor in a stoichiometry of 1:1. Furthermore, C1-esterase inhibitor represents the most important inhibitor of the contact activation of coagulation by inhibiting factor XIIa and its fragments. In addition, it serves, besides alpha-2-macroglobulin, as the main inhibitor of plasma kallikrein. The therapeutic effect of Berinert in hereditary angioedema is induced by the substitution of the deficient C1-esterase inhibitor activity. Pharmacokinetic properties
The product is to be administered intravenously and is immediately available in the plasma with a plasma concentration corresponding to the administered dose. The pharmacokinetic properties of Berinert have been investigated in two studies. A phase I study conducted in 15 healthy, adult subjects provided PK data that was used to assess the relative bioavailability of Berinert 1500 and Berinert 500. Comparable bioavailability of the two presentations of Berinert was demonstrated. For C1-INH antigen concentrations the Cmax and AUC0-last geometric mean ratios (90% CIs) were 1.02 (0.99, 1.04) and 1.02 (0.99, 1.05) respectively. Half-life was estimated in a subset of subjects using non-compartmental PK analyses. The mean half-life of Berinert 1500 and Berinert 500 was 87.7 hours and 91.4 hours, respectively. Pharmacokinetic properties have been investigated in patients with hereditary angioedema (34 patients > 18 years, 6 patients < 18 years). These included 15 patients under prophylactic treatment (with frequent/severe attacks), as well as 25 patients with less frequent/mild attacks and "on demand" treatment. The data were generated in an attack-free interval. The median in-vivo recovery (IVR) was 86.7 % (range: 54.0 - 254.1 %). The IVR for children was slightly higher (98.2 %, range: 69.2 - 106.8 %)) than for adults (82.5 %, range: 54.0 - 254.1 %). Patients with severe attacks had a higher IVR (101.4 %) compared to patients with mild attacks (75.8 %, range: 57.2 - 195.9 %). The median increase in activity was 2.3 %/IU/kg b.w. (range: 1.4 - 6.9 %/IU/kg b.w.). No significant differences were seen between adults and children. Patients with severe attacks showed a slightly higher increase in activity than patients with mild attacks (2.9, range: 1.4 - 6.9 vs. 2.1, range: 1.5 - 5.1 %/IU/kg b.w.). The maximum concentration of C1-esterase inhibitor activity in plasma was reached within 0.8 hours after administration of Berinert without significant differences between the patient groups. The median half-life was 36.1 hours. It was slightly shorter in children than in adults (32.9 vs. 36.1 hours) and in patients with severe attacks than in patients with mild attacks (30.9 vs. 37.0). Pharmacotherapeutic group
C1-inhibitor, plasma derived
List of excipients
Powder: Glycine Sodium chloride Sodium citrate Solvent: Water for injections Incompatibilities
In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products and diluents in the syringe/infusion set. Shelf life
36 months After reconstitution, the physico-chemical stability has been demonstrated for 48 hours at room temperature (max 25°C). From a microbiological point of view and as Berinert contains no preservative, the reconstituted product should be used immediately. If it is not administered immediately, storage shall not exceed 8 hours at room temperature. The reconstituted product should only be stored in the vial. Special precautions for storage
Tapentadol Nature and contents of container
Immediate containers: Powder (1500 IU) in a vial (Type I glass) with a stopper (bromobutyl rubber), seal (aluminium) and flip-off cap (plastic). 3 ml of solvent in a vial (Type I glass) with a stopper (chlorobutyl rubber), seal (aluminium) and flip-off cap (plastic). Presentation Box containing: 1 vial with powder 1 solvent vial (3 ml) 1 filter transfer device 20/20 Administration set (inner box): 1 disposable 5 ml syringe 1 venipuncture set 2 alcohol swabs 1 plaster Not all pack sizes may be marketed. Special precautions for disposal and other handling
Any unused medicinal product or waste material should be disposed of in accordance with local requirements. Method of administration General instructions - The solution should be colourless and clear to slightly opalescent. After filtering/withdrawal (see below) reconstituted product should be inspected visually for particulate matter and discoloration prior to administration. - Do not use solutions that are cloudy or have deposits. - Reconstitution and withdrawal must be carried out under aseptic conditions. Use the syringe provided with the product. Reconstitution Bring the solvent to room temperature. Ensure product and solvent vial flip caps are removed and the stoppers are treated with an antiseptic solution and allowed to dry prior to opening the Mix2Vial package.
Withdrawal and application
Marketing authorisation holder
CSL Behring GmbH Emil-von-Behring-Strasse 76 35041 Marburg Germany Marketing authorisation number(s)
PL 15036/0035 Date of first authorisation/renewal of the authorisation
22 January 2015 Date of revision of the text
25 August 2017 Available in countries |
