ANNEX I
SUMMARY OF PRODUCT CHARACTERISTICS
1.
Daronrix, suspension for injection in pre-filled syringe
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
This vaccine complies with the WHO recommendation and EU decision for the pandemic.
Excipients:
Thiomersal
50 micrograms
For a full list of excipients see section 6.1.
3.
Suspension for injection.
Turbid white suspension.
4.
Prophylaxis of influenza in an officially declared pandemic situation. Pandemic influenza vaccine
should be used in accordance with official guidance. (see sections 4.2 and 5.1)
Daronrix has been evaluated with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years following a 0, 21 day schedule.
Adults from the age of 18 to 60 years will receive two doses of Daronrix, the first administered at an
elected date, the second at least three weeks after the first dose for maximum efficacy.
No data have been generated with Daronrix below 18 years of age. Therefore health care providers
need to assess the benefits and potential risks of administering the vaccine in that population.
For pregnant women, see section 4.6.
2
For further information, see section 5.1.
Immunisation should be carried out by intramuscular injection.
History of an anaphylactic reaction (i.e. life-threatening) to any of the constituents or trace residues
(e.g. eggs, chicken protein, gentamicin sulphate) of this vaccine. However, in a pandemic situation, it
may be appropriate to give the vaccine, provided that facilities for resuscitation are immediately
available in case of need.
See section 4.4.
Caution is needed when administrating this vaccine to persons with a known hypersensitivity (other
than anaphylactic reaction) to the active substance, to any of the excipients, to thiomersal and to
residues e.g. eggs, chicken protein, gentamicin sulphate.
As with all injectable vaccines, appropriate medical treatment and supervision should always be
readily available in case of a rare anaphylactic event following the administration of the vaccine.
If the pandemic situation allows, immunisation shall be postponed in patients with severe febrile
illness or acute infection.
Daronrix should under no circumstances be administered intravascularly.
Antibody response in patients with endogenous or iatrogenic immunosuppression may be insufficient.
A protective immune response may not be elicited in all vaccinees (see section 5.1).
Daronrix should not be given at the same time as other vaccines. However, if co-administration with
another vaccine is indicated, immunisation should be carried out on separate limbs. It should be noted
that the adverse reactions may be intensified.
The immunological response may be diminished if the patient is undergoing immunosuppressant
treatment.
Following influenza vaccination, false positive results in serology tests using the ELISA method to
detect antibodies against HIV-1, Hepatitis C and especially HTLV-1 have been observed. The Western
Blot technique disproves the results. The transient false positive reactions could be due to the IgM
response by the vaccine.
No data have been generated with Daronrix in pregnant women. Therefore health care providers need
to assess the benefits and potential risks of administering the vaccine to pregnant women taking into
consideration official recommendations. Data from vaccinations with interpandemic trivalent vaccines
in pregnant women do not indicate that adverse foetal and maternal outcomes were attributable to the
vaccine.
Daronrix may be used during lactation.
3
The vaccine is unlikely to produce an effect on the ability to drive and use machines.
•
Clinical trials
Adverse reactions from clinical trials with different formulations (H5N1, H2N2 and H9N2) (N=941)
of the mock-up vaccine are listed here below (see section 5.1 for more information on mock-up
vaccines). Two hundred and one subjects received the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1).
The incidence of symptoms observed in subjects >60 years of age was lower as compared to the 18-60
years old population.
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)
Not known (cannot be estimated from the available data)
Infections and infestations
Uncommon: nasopharyngitis, rhinitis
Nervous system disorders
Very common: headache
Skin and subcutaneous tissue disorders
Common: sweating increase, ecchymosis
Musculoskeletal and connective tissue disorders
Common: myalgia, arthralgia
General disorders and administration site conditions
Very common: pain and redness at the site of injection, fatigue
Common: swelling and induration at the site of injection, shivering, fever
Uncommon: injection site pruritis
These reactions usually disappear within 1-2 days without treatment.
•
Post-marketing surveillance
From Post-marketing surveillance with interpandemic trivalent vaccines, the following adverse events
have been reported:
Uncommon
(≥1/1,000 to <1/100):
Generalised skin reactions including pruritus, urticaria or non-specific rash.
Rare
(≥1/10,000 to <1/1,000):
Neuralgia, paraesthesia, convulsions, transient thrombocytopenia.
Allergic reactions, in rare cases leading to shock, have been reported.
4
Very rare
(<1/10,000):
Vasculitis with transient renal involvement.
Neurological disorders, such as encephalomyelitis, neuritis and Guillain Barré syndrome.
This medicinal product contains thiomersal (an organomercuric compound) as a preservative and
therefore, it is possible that sensitisation reactions may occur (see section 4.4).
No case of overdose has been reported.
5.
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Influenza vaccines, ATC Code J07BB01.
This section describes the clinical experience with the mock-up vaccines following a two-dose
administration.
Mock-up vaccines contain influenza antigens that are different from those in the currently circulating
influenza viruses. These antigens can be considered as “novel” antigens and simulate a situation where
the target population for vaccination is immunologically naïve. Data obtained with the mock-up
vaccine will support a vaccination strategy that is likely to be used for the pandemic vaccine: clinical
immunogenicity, safety and reactogenicity data obtained with mock-up vaccines are relevant for the
pandemic vaccines.
A clinical study has evaluated the immunogenicity of the monovalent aluminium-adjuvanted whole
virus vaccine (A/H5N1) with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years (N=48) following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows:
anti-HA antibody
21 days after 1
st
dose
21 days after 2
nd
dose
Seroprotection rate*
50.0% (95% CI: 35.2;64.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion rate
47.9% (95% CI: 33.3;62.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion factor
6 (95% CI: 3.5;10.1)
12.4 (95% CI: 7.1;21.8)
* anti-HA ≥1:40
In this clinical study, the immunogenicity of the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1) with a haemagglutinin content of 27µg HA per dose in adults aged 18-60 years
(N=49) was also evaluated following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows 21 days after the first dose:
anti-HA antibody
21 days after 1
st
dose
Seroprotection rate*
73.5% (95% CI: 58.9;85.0)
Seroconversion rate
69.4% (95% CI: 54.6;81.7)
Seroconversion factor
14.5 (95% CI: 8.3;25.4)
5
* anti-HA ≥1:40
No clinical data have been generated in subjects below 18 years of age.
Although no clinical data have been generated with Daronrix in subjects >60 years of age, the
immunogenicity of a mock up formulation with different antigen doses of an aluminium-adjuvanted
whole virus vaccine (A/H9N2) administered at 0, 21 days was evaluated in a clinical trial in this
population. These results indicated that higher antigen content may be needed in subjects above 60
years of age as compared to an adult population (18-60 years) in order to ensure optimal protection.
The persistence of antibodies for the mock-up vaccines varies. With interpandemic trivalent vaccines,
it is usually 6 - 12 months, but for Daronrix no data are available yet with the H5N1 strain.
In a clinical study where a mock-up formulation of aluminium-adjuvanted whole virus vaccine
(AH9/N2) containing 3.8 µg HA was evaluated following a 0, 10 day schedule, it has been shown that
a faster onset of protection could be reached as compared to the recommended 0, 21 day schedule.
However data suggested that the duration of protection might be shorter. In circumstances when a fast
onset of protection is needed, a third dose might therefore be necessary to ensure duration of
protection.
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
The European Medicines Agency (EMEA) will review any new information which may become
available every year and this SPC will be updated as necessary.
5.2 Pharmacokinetic properties
Not applicable.
5.3 Preclinical safety data
Not applicable.
6.
6.1 List of excipients
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
For adjuvants, see section 2.
6.2 Incompatibilities
In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal
products.
6
6.3 Shelf-life
1 year.
6.4 Special precautions for storage
Store in a refrigerator (2°C – 8°C).
Do not freeze.
Store in the original package in order to protect from light.
6.5 Nature and contents of container
0.5 ml in pre-filled syringe (type I glass) with a plunger stopper (butyl) for 1 dose – pack sizes of 1
and 10 with or without needles.
Not all pack sizes may be marketed.
6.6 Special precautions for disposal
The vaccine should be allowed to reach room temperature before use. Shake before use.
7.
GlaxoSmithKline Biologicals s.a.
rue de l'Institut 89
B-1330 Rixensart, Belgium
7
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
This vaccine complies with the WHO recommendation and EU decision for the pandemic.
Excipients:
Thiomersal
50 micrograms
For a full list of excipients see section 6.1.
3.
Suspension for injection.
Turbid white suspension.
4.
Prophylaxis of influenza in an officially declared pandemic situation. Pandemic influenza vaccine
should be used in accordance with official guidance. (see sections 4.2 and 5.1)
Daronrix has been evaluated with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years following a 0, 21 day schedule.
Adults from the age of 18 to 60 years will receive two doses of Daronrix, the first administered at an
elected date, the second at least three weeks after the first dose for maximum efficacy.
No data have been generated with Daronrix below 18 years of age. Therefore health care providers
need to assess the benefits and potential risks of administering the vaccine in that population.
For pregnant women, see section 4.6.
8
For further information, see section 5.1.
Immunisation should be carried out by intramuscular injection.
History of an anaphylactic reaction (i.e. life-threatening) to any of the constituents or trace residues
(e.g. eggs, chicken protein, gentamicin sulphate) of this vaccine. However, in a pandemic situation, it
may be appropriate to give the vaccine, provided that facilities for resuscitation are immediately
available in case of need.
See section 4.4.
Caution is needed when administrating this vaccine to persons with a known hypersensitivity (other
than anaphylactic reaction) to the active substance, to any of the excipients, to thiomersal and to
residues e.g. eggs, chicken protein, gentamicin sulphate.
As with all injectable vaccines, appropriate medical treatment and supervision should always be
readily available in case of a rare anaphylactic event following the administration of the vaccine.
If the pandemic situation allows, immunisation shall be postponed in patients with severe febrile
illness or acute infection.
Daronrix should under no circumstances be administered intravascularly.
Antibody response in patients with endogenous or iatrogenic immunosuppression may be insufficient.
A protective immune response may not be elicited in all vaccinees (see section 5.1).
Daronrix should not be given at the same time as other vaccines. However, if co-administration with
another vaccine is indicated, immunisation should be carried out on separate limbs. It should be noted
that the adverse reactions may be intensified.
The immunological response may be diminished if the patient is undergoing immunosuppressant
treatment.
Following influenza vaccination, false positive results in serology tests using the ELISA method to
detect antibodies against HIV-1, Hepatitis C and especially HTLV-1 have been observed. The Western
Blot technique disproves the results. The transient false positive reactions could be due to the IgM
response by the vaccine.
No data have been generated with Daronrix in pregnant women. Therefore health care providers need
to assess the benefits and potential risks of administering the vaccine to pregnant women taking into
consideration official recommendations. Data from vaccinations with interpandemic trivalent vaccines
in pregnant women do not indicate that adverse foetal and maternal outcomes were attributable to the
vaccine.
Daronrix may be used during lactation.
9
The vaccine is unlikely to produce an effect on the ability to drive and use machines.
•
Clinical trials
Adverse reactions from clinical trials with different formulations (H5N1, H2N2 and H9N2) (N=941)
of the mock-up vaccine are listed here below (see section 5.1 for more information on mock-up
vaccines). Two hundred and one subjects received the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1).
The incidence of symptoms observed in subjects >60 years of age was lower as compared to the 18-60
years old population.
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)
Not known (cannot be estimated from the available data)
Infections and infestations
Uncommon: nasopharyngitis, rhinitis
Nervous system disorders
Very common: headache
Skin and subcutaneous tissue disorders
Common: sweating increase, ecchymosis
Musculoskeletal and connective tissue disorders
Common: myalgia, arthralgia
General disorders and administration site conditions
Very common: pain and redness at the site of injection, fatigue
Common: swelling and induration at the site of injection, shivering, fever
Uncommon: injection site pruritis
These reactions usually disappear within 1-2 days without treatment.
•
Post-marketing surveillance
From Post-marketing surveillance with interpandemic trivalent vaccines, the following adverse events
have been reported:
Uncommon
(≥1/1,000 to <1/100):
Generalised skin reactions including pruritus, urticaria or non-specific rash.
Rare
(≥1/10,000 to <1/1,000):
Neuralgia, paraesthesia, convulsions, transient thrombocytopenia.
Allergic reactions, in rare cases leading to shock, have been reported.
10
Very rare
(<1/10,000):
Vasculitis with transient renal involvement.
Neurological disorders, such as encephalomyelitis, neuritis and Guillain Barré syndrome.
This medicinal product contains thiomersal (an organomercuric compound) as a preservative and
therefore, it is possible that sensitisation reactions may occur (see section 4.4).
No case of overdose has been reported.
5.
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Influenza vaccines, ATC Code J07BB01.
This section describes the clinical experience with the mock-up vaccines following a two-dose
administration.
Mock-up vaccines contain influenza antigens that are different from those in the currently circulating
influenza viruses. These antigens can be considered as “novel” antigens and simulate a situation where
the target population for vaccination is immunologically naïve. Data obtained with the mock-up
vaccine will support a vaccination strategy that is likely to be used for the pandemic vaccine: clinical
immunogenicity, safety and reactogenicity data obtained with mock-up vaccines are relevant for the
pandemic vaccines.
A clinical study has evaluated the immunogenicity of the monovalent aluminium-adjuvanted whole
virus vaccine (A/H5N1) with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years (N=48) following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows:
anti-HA antibody
21 days after 1
st
dose
21 days after 2
nd
dose
Seroprotection rate*
50.0% (95% CI: 35.2;64.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion rate
47.9% (95% CI: 33.3;62.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion factor
6 (95% CI: 3.5;10.1)
12.4 (95% CI: 7.1;21.8)
* anti-HA ≥1:40
In this clinical study, the immunogenicity of the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1) with a haemagglutinin content of 27µg HA per dose in adults aged 18-60 years
(N=49) was also evaluated following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows 21 days after the first dose:
anti-HA antibody
21 days after 1
st
dose
Seroprotection rate*
73.5% (95% CI: 58.9;85.0)
Seroconversion rate
69.4% (95% CI: 54.6;81.7)
Seroconversion factor
14.5 (95% CI: 8.3;25.4)
11
* anti-HA ≥1:40
No clinical data have been generated in subjects below 18 years of age.
Although no clinical data have been generated with Daronrix in subjects >60 years of age, the
immunogenicity of a mock up formulation with different antigen doses of an aluminium-adjuvanted
whole virus vaccine (A/H9N2) administered at 0, 21 days was evaluated in a clinical trial in this
population. These results indicated that higher antigen content may be needed in subjects above 60
years of age as compared to an adult population (18-60 years) in order to ensure optimal protection.
The persistence of antibodies for the mock-up vaccines varies. With interpandemic trivalent vaccines,
it is usually 6 - 12 months, but for Daronrix no data are available yet with the H5N1 strain.
In a clinical study where a mock-up formulation of aluminium-adjuvanted whole virus vaccine
(AH9/N2) containing 3.8 µg HA was evaluated following a 0, 10 day schedule, it has been shown that
a faster onset of protection could be reached as compared to the recommended 0, 21 day schedule.
However data suggested that the duration of protection might be shorter. In circumstances when a fast
onset of protection is needed, a third dose might therefore be necessary to ensure duration of
protection.
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
The European Medicines Agency (EMEA) will review any new information which may become
available every year and this SPC will be updated as necessary.
5.2 Pharmacokinetic properties
Not applicable.
5.3 Preclinical safety data
Not applicable.
6.
6.1 List of excipients
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
For adjuvants, see section 2.
6.2 Incompatibilities
In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal
products.
12
6.3 Shelf-life
1 year.
6.4 Special precautions for storage
Store in a refrigerator (2°C – 8°C).
Do not freeze.
Store in the original package in order to protect from light.
6.5 Nature and contents of container
0.5 ml in ampoule (type I glass) for 1 dose – pack size of 100
6.6 Special precautions for disposal
The vaccine should be allowed to reach room temperature before use. Shake before use.
7.
GlaxoSmithKline Biologicals s.a.
rue de l'Institut 89
B-1330 Rixensart, Belgium
9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
13
1.
Daronrix, suspension for injection in multidose container
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
This vaccine complies with the WHO recommendation and EU decision for the pandemic situation.
This is a multidose container. See section 6.5 for the number of doses per vial.
Excipients:
Thiomersal
50 micrograms
For a full list of excipients see section 6.1.
3.
Suspension for injection.
Turbid white suspension.
4.
Prophylaxis of influenza in an officially declared pandemic situation. Pandemic influenza vaccine
should be used in accordance with official guidance. (see sections 4.2 and 5.1)
Daronrix has been evaluated with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years following a 0, 21 day schedule.
Adults from the age of 18 to 60 years will receive two doses of Daronrix, the first administered at an
elected date, the second at least three weeks after the first dose for maximum efficacy.
No data have been generated with Daronrix below 18 years of age. Therefore health care providers
need to assess the benefits and potential risks of administering the vaccine in that population.
14
For pregnant women, see section 4.6.
For further information, see section 5.1.
Immunisation should be carried out by intramuscular injection.
History of an anaphylactic reaction (i.e. life-threatening) to any of the constituents or trace residues
(e.g. eggs, chicken protein, gentamicin sulphate) of this vaccine. However, in a pandemic situation, it
may be appropriate to give the vaccine, provided that facilities for resuscitation are immediately
available in case of need.
See section 4.4.
Caution is needed when administrating this vaccine to persons with a known hypersensitivity (other
than anaphylactic reaction) to the active substance, to any of the excipients, to thiomersal and to
residues e.g. eggs, chicken protein, gentamicin sulphate.
As with all injectable vaccines, appropriate medical treatment and supervision should always be
readily available in case of a rare anaphylactic event following the administration of the vaccine.
If the pandemic situation allows, immunisation shall be postponed in patients with severe febrile
illness or acute infection.
Daronrix should under no circumstances be administered intravascularly.
Antibody response in patients with endogenous or iatrogenic immunosuppression may be insufficient.
A protective immune response may not be elicited in all vaccinees (see section 5.1).
Daronrix should not be given at the same time as other vaccines. However, if co-administration with
another vaccine is indicated, immunisation should be carried out on separate limbs. It should be noted
that the adverse reactions may be intensified.
The immunological response may be diminished if the patient is undergoing immunosuppressant
treatment.
Following influenza vaccination, false positive results in serology tests using the ELISA method to
detect antibodies against HIV-1, Hepatitis C and especially HTLV-1 have been observed. The Western
Blot technique disproves the results. The transient false positive reactions could be due to the IgM
response by the vaccine.
No data have been generated with Daronrix in pregnant women. Therefore health care providers need
to assess the benefits and potential risks of administering the vaccine to pregnant women taking into
consideration official recommendations. Data from vaccinations with interpandemic trivalent vaccines
in pregnant women do not indicate that adverse foetal and maternal outcomes were attributable to the
vaccine.
15
Daronrix may be used during lactation.
The vaccine is unlikely to produce an effect on the ability to drive and use machines.
•
Clinical trials
Adverse reactions from clinical trials with different formulations (H5N1, H2N2 and H9N2) (N=941)
of the mock-up vaccine are listed here below (see section 5.1 for more information on mock-up
vaccines). Two hundred and one subjects received the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1).
The incidence of symptoms observed in subjects >60 years of age was lower as compared to the 18-60
years old population.
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)
Not known (cannot be estimated from the available data)
Infections and infestations
Uncommon: nasopharyngitis, rhinitis
Nervous system disorders
Very common: headache
Skin and subcutaneous tissue disorders
Common: sweating increase, ecchymosis
Musculoskeletal and connective tissue disorders
Common: myalgia, arthralgia
General disorders and administration site conditions
Very common: pain and redness at the site of injection, fatigue
Common: swelling and induration at the site of injection, shivering, fever
Uncommon: injection site pruritis
These reactions usually disappear within 1-2 days without treatment.
•
Post-marketing surveillance
From Post-marketing surveillance with interpandemic trivalent vaccines, the following adverse events
have been reported:
Uncommon
(≥1/1,000 to <1/100):
Generalised skin reactions including pruritus, urticaria or non-specific rash.
Rare
(≥1/10,000 to <1/1,000):
16
Neuralgia, paraesthesia, convulsions, transient thrombocytopenia.
Allergic reactions, in rare cases leading to shock, have been reported.
Very rare
(<1/10,000):
Vasculitis with transient renal involvement.
Neurological disorders, such as encephalomyelitis, neuritis and Guillain Barré syndrome.
This medicinal product contains thiomersal (an organomercuric compound) as a preservative and
therefore, it is possible that sensitisation reactions may occur (see section 4.4).
No case of overdose has been reported.
5.
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Influenza vaccines, ATC Code J07BB01.
This section describes the clinical experience with the mock-up vaccines following a two-dose
administration.
Mock-up vaccines contain influenza antigens that are different from those in the currently circulating
influenza viruses. These antigens can be considered as “novel” antigens and simulate a situation where
the target population for vaccination is immunologically naïve. Data obtained with the mock-up
vaccine will support a vaccination strategy that is likely to be used for the pandemic vaccine: clinical
immunogenicity, safety and reactogenicity data obtained with mock-up vaccines are relevant for the
pandemic vaccines.
A clinical study has evaluated the immunogenicity of the monovalent aluminium-adjuvanted whole
virus vaccine (A/H5N1) with a haemagglutinin content of 15 µg HA per dose in adults aged 18-60
years (N=48) following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows:
anti-HA antibody
21 days after 1
st
dose
21 days after 2
nd
dose
Seroprotection rate*
50.0% (95% CI: 35.2;64.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion rate
47.9% (95% CI: 33.3;62.8)
70.8% (95% CI: 55.9;83.0)
Seroconversion factor
6 (95% CI: 3.5;10.1)
12.4 (95% CI: 7.1;21.8)
* anti-HA ≥1:40
In this clinical study, the immunogenicity of the monovalent aluminium-adjuvanted whole virus
vaccine (A/H5N1) with a haemagglutinin content of 27µg HA per dose in adults aged 18-60 years
(N=49) was also evaluated following a 0, 21 day schedule.
The seroprotection rate, the seroconversion rate and seroconversion factor for anti-HA antibody were
as follows 21 days after the first dose:
anti-HA antibody
21 days after 1
st
dose
Seroprotection rate*
73.5% (95% CI: 58.9;85.0)
17
Seroconversion rate
69.4% (95% CI: 54.6;81.7)
Seroconversion factor
14.5 (95% CI: 8.3;25.4)
* anti-HA ≥1:40
No clinical data have been generated in subjects below 18 years of age.
Although no clinical data have been generated with Daronrix in subjects >60 years of age, the
immunogenicity of a mock up formulation with different antigen doses of an aluminium-adjuvanted
whole virus vaccine (A/H9N2) administered at 0, 21 days was evaluated in a clinical trial in this
population. These results indicated that higher antigen content may be needed in subjects above 60
years of age as compared to an adult population (18-60 years) in order to ensure optimal protection.
The persistence of antibodies for the mock-up vaccines varies. With interpandemic trivalent vaccines,
it is usually 6 - 12 months, but for Daronrix no data are available yet with the H5N1 strain.
In a clinical study where a mock-up formulation of aluminium-adjuvanted whole virus vaccine
(AH9/N2) containing 3.8 µg HA was evaluated following a 0, 10 day schedule, it has been shown that
a faster onset of protection could be reached as compared to the recommended 0, 21 day schedule.
However data suggested that the duration of protection might be shorter. In circumstances when a fast
onset of protection is needed, a third dose might therefore be necessary to ensure duration of
protection.
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
The European Medicines Agency (EMEA) will review any new information which may become
available every year and this SPC will be updated as necessary.
5.2 Pharmacokinetic properties
Not applicable.
5.3 Preclinical safety data
Not applicable.
6.
6.1 List of excipients
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
For adjuvants, see section 2.
6.2 Incompatibilities
18
In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal
products.
6.3 Shelf-life
1 year.
6.4 Special precautions for storage
Store in a refrigerator (2°C – 8°C).
Do not freeze.
Store in the original package in order to protect from light.
6.5 Nature and contents of container
5 ml in ampoule (type I glass) for 10 doses – pack size of 50
5 ml in vial (type I glass) for 10 doses – pack size of 50
10 ml in vial (type I glass) for 20 doses – pack size of 50
Not all pack sizes may be marketed.
6.6 Special precautions for disposal
The vaccine should be allowed to reach room temperature before use. Shake before use.
7.
GlaxoSmithKline Biologicals s.a.
rue de l'Institut 89
B-1330 Rixensart, Belgium
9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
19
ANNEX II
A. MANUFACTURER OF THE BIOLOGICAL ACTIVE
SUBSTANCE AND MANUFACTURING AUTHORISATION
HOLDER RESPONSIBLE FOR BATCH RELEASE
B. CONDITIONS OF THE MARKETING AUTHORISATION
20
A. MANUFACTURER OF THE BIOLOGICAL ACTIVE SUBSTANCE AND
MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH
RELEASE
Name and address of the manufacturer of the biological active substance
Sächsisches Serumwerk Dresden (SSW)
Zirkusstraße 40
D-01069 Dresden
Germany
Name and address of the manufacturer responsible for batch release
Sächsisches Serumwerk Dresden (SSW)
Zirkusstraβe 40
D-01069 Dresden
Germany
B. CONDITIONS OF THE MARKETING AUTHORISATION
•
Medicinal product subject to medical prescription.
Daronrix can only be marketed when there is an official WHO/EU declaration of an influenza
pandemic, on the condition that the Marketing Authorisation Holder for Daronrix takes due account of
the officially declared pandemic strain.
•
CONDITIONS OR RESTRICTIONS WITH REGARD TO THE SAFE AND
EFFECTIVE USE OF THE MEDICINAL PRODUCT
Not applicable
•
OTHER CONDITIONS
Official batch release
: in accordance with Article 114 Directive 2001/83/EC as amended, the official
batch release will be undertaken by a state laboratory or a laboratory designated for that purpose.
Pharmacovigilance system
The MAH must ensure that the system of pharmacovigilance is in place and functioning before the
product is placed on the market and for as long as the marketed product remains in use.
The MAH commits to performing the studies and pharmacovigilance activities detailed in the
Pharmacovigilance Plan.
PSUR submission during the influenza pandemic:
During a pandemic situation, the frequency of submission of periodic safety update reports
specified in Article 24 of Regulation (EC) No 726/2004 will not be adequate for the safety
monitoring of a pandemic vaccine for which high levels of exposure are expected within a
short period of time. Such situation requires rapid notification of safety information that may
have the greatest implications for risk-benefit balance in a pandemic. Prompt analysis of
21
cumulative safety information, in light of extent of exposure, will be crucial for regulatory
decisions and protection of the population to be vaccinated. In addition, duration a pandemic,
resources needed for an in-depth evaluation of Periodic Safety Update Reports in the format as
defined in Volume 9a of the Rules Governing Medicinal Product in the European Union may
not be adequate for a rapid identification of a new safety issue.
In consequence, as soon as the pandemic is declared (Phase 6 of the WHO global Influenza
preparedness plan) and the pandemic vaccine is used, the MAH shall submit periodic safety
update reports with periodicity and format defined as follows:
Frequency of submission
-
The clock will start from the first Monday after shipment of the first batch of vaccine.
-
First data-lock point is 14 days later.
-
Report submission is no later than day 22 (i.e. the following Monday).
-
Reporting to be fortnightly for the first 3 months of the pandemic.
-
Periodicity will be reviewed by the MAH and the (Co-)Rapporteur at 3 monthly
intervals.
Format
The report shall include the following Tables of aggregate data using the agreed templates:
1.
Fatal and/or life-threatening reactions – for each Preferred Term (PT), including the
proportion of fatal reports
2.
Adverse Events of Special Interest (PTs)
3.
Serious unexpected reactions (PTs)
4.
All events occurring in the following age groups: 6-23 months, 2-8 years, 8-17 years,
18-60 years, >60 years
All events occurring in pregnant women
5.
All events reported by patients that have been entered into the database by data-lock
point
6.
A cumulative overview of all events reported during the period, stratified according to
type of reporter (patient or health care professional), seriousness, expectedness, and
whether spontaneous or solicited.
Presentation of data will take into consideration the following recommendations:
-
Serious expected reactions will be reviewed by the MAH as part of their signal detection
procedures and will only form part of the report if an issue of concern arises.
-
All tables will be based on number of events (presented on PT level, sorted by System
Organ Class [SOC]) and not number of cases.
-
Tables 1 to 4 will be based on events reported from healthcare professionals only.
-
In Tables 1 to 5, numbers will be provided for events received during the reporting period
and cumulatively.
-
All tables will be based on generic and not product-specific data. Product-specific data
can be evaluated during signal work-up.
-
A measure of relative reporting rate of signals for each reported PT should be provided if
possible (e.g. Proportional reporting ratio [PRR], Information Component [IC)] or the
Empirical Bayesian Geometric Mean [EBMG]; this is not mandatory as all MAHs do not
yet have this capability.
-
No line listings are required – these can be provided in signal evaluation reports as
necessary.
A short summary shall also be provided with the periodic safety update reports, in which any
area of concern should be highlighted, signal work-up prioritised (if the event of multiple
signals) and appropriate timelines for submission of a full signal evaluation report provided.
All signal evaluation reports should be provided, including those that were subsequently not
identified as being signals.
22
A summary of vaccine distribution shall be included and provide details of the number of
doses of vaccine distributed in:
i)
EU member states for the reporting period by batch number,
ii)
EU member states cumulatively and
iii)
the rest of the world
Risk Management plan
An updated Risk Management Plan should be provided as per the CHMP Guideline on Risk
Management Systems for medicinal products for human use.
C. SPECIFIC OBLIGATIONS TO BE FULFILLED BY THE MARKETING
AUTHORISATION HOLDER
The Marketing Authorisation Holder shall complete the following programme of studies within the
specified time frame, the results of which shall form the basis of the annual reassessment of the
benefit/risk profile.
Clinical
During the pandemic, the applicant will collect clinical safety
and effectiveness data of the pandemic vaccine and submit
this information to the CHMP for evaluation.
Depending on
and after
implementation
of vaccine
when first
pandemic will
take place.
Pharmacovigilance
During the pandemic, the applicant will conduct a
prospective cohort study as identified in the
Pharmacovigilance plan.
Depending on
and after
implementation
of vaccine
when first
pandemic will
take place.
23
ANNEX III
LABELLING AND PACKAGE LEAFLET
24
A. LABELLING
25
PARTICULARS TO APPEAR ON THE OUTER PACKAGING
MONODOSE PRESENTATION
PREFILLED SYRINGE X 1 AND X 10 WITH AND WITHOUT NEEDLE
1.
Daronrix, suspension for injection in a prefilled syringe.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
STATEMENT OF ACTIVE SUBSTANCE(S)
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
3.
LIST OF EXCIPIENTS
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
4.
Suspension for injection
Prefilled syringe
1 dose
1 dose (0.5 ml)
Prefilled syringe
Needle
10 x 1 dose
1 dose (0.5 ml)
5.
METHOD AND ROUTE(S) OF ADMINISTRATION
Read the package leaflet before use
26
0.05 milligrams Al
3+
and aluminium hydroxide, hydrated
Intramuscular use
Shake before use
6.
SPECIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT
OF THE REACH AND SIGHT OF CHILDREN
Keep out of the reach and sight of children.
7.
OTHER SPECIAL WARNING(S), IF NECESSARY
8.
EXPIRY DATE
EXP: MM/YYYY
9.
SPECIAL STORAGE CONDITIONS
Store in a refrigerator
Do not freeze
Store in the original package in order to protect from light
10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS
OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF
APPROPRIATE
Dispose of in accordance with local regulations.
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart, Belgium
EU/0/00/000/000
13. BATCH NUMBER
Lot:
14. GENERAL CLASSIFICATION FOR SUPPLY
Medicinal product subject to medical prescription.
27
15. INSTRUCTIONS ON USE
16. INFORMATION IN BRAILLE
28
PARTICULARS TO APPEAR ON THE OUTER PACKAGING
AMPOULE X 100
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
STATEMENT OF ACTIVE SUBSTANCE(S)
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
3.
LIST OF EXCIPIENTS
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
4.
Ampoule
100 x 1 dose
1 dose (0.5 ml)
5.
METHOD AND ROUTE(S) OF ADMINISTRATION
Read the package leaflet before use
Intramuscular use
Shake before use
6.
SPECIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT
OF THE REACH AND SIGHT OF CHILDREN
29
Keep out of the reach and sight of children.
7.
OTHER SPECIAL WARNING(S), IF NECESSARY
8.
EXPIRY DATE
EXP: MM/YYYY
9.
SPECIAL STORAGE CONDITIONS
Store in a refrigerator
Do not freeze
Store in the original package in order to protect from light
10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS
OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF
APPROPRIATE
Dispose of in accordance with local regulations.
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart, Belgium
EU/0/00/000/000
13. BATCH NUMBER
Lot:
14. GENERAL CLASSIFICATION FOR SUPPLY
Medicinal product subject to medical prescription.
15. INSTRUCTIONS ON USE
16. INFORMATION IN BRAILLE
30
PARTICULARS TO APPEAR ON THE OUTER PACKAGING
MULTIDOSE PRESENTATION
VIAL (10 DOSES) X 50
VIAL (20 DOSES) X 50
AMPOULE (10 DOSES) X 50
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
2.
STATEMENT OF ACTIVE SUBSTANCE(S)
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
3.
LIST OF EXCIPIENTS
Sodium chloride
Disodium phosphate dodecahydrate
Potassium dihydrogen phosphate
Potassium chloride
Magnesium chloride hexahydrate
Thiomersal
Water for injections
4.
Suspension for injection
Vial
50 x 10 doses
1 dose (0.5 ml)
Vial
50 x 20 doses
1 dose (0.5 ml)
Ampoule
50 x 10 doses
1 dose (0.5 ml)
31
5.
METHOD AND ROUTE(S) OF ADMINISTRATION
Read the package leaflet before use
Intramuscular use
Shake before use
6.
SPECIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT
OF THE REACH AND SIGHT OF CHILDREN
Keep out of the reach and sight of children.
7.
OTHER SPECIAL WARNING(S), IF NECESSARY
8.
EXPIRY DATE
EXP: MM/YYYY
9.
SPECIAL STORAGE CONDITIONS
Store in a refrigerator
Do not freeze
Store in the original package in order to protect from light
10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS
OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF
APPROPRIATE
Dispose of in accordance with local regulations.
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart, Belgium
EU/0/00/000/000
13. BATCH NUMBER
Lot:
32
14. GENERAL CLASSIFICATION FOR SUPPLY
Medicinal product subject to medical prescription.
15. INSTRUCTIONS ON USE
16. INFORMATION IN BRAILLE
33
MINIMUM PARTICULARS TO APPEAR ON SMALL IMMEDIATE PACKAGING UNITS
MONODOSE PRESENTATION
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
I.M.
2.
METHOD OF ADMINISTRATION
3.
EXPIRY DATE
EXP
4.
BATCH NUMBER
Lot
5.
CONTENTS BY WEIGHT, BY VOLUME OR BY UNIT
1 dose (0.5 ml)
6.
OTHER
34
MINIMUM PARTICULARS TO APPEAR ON SMALL IMMEDIATE PACKAGING UNITS
MULTIDOSE (10 DOSES) PRESENTATION
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
I.M.
2.
METHOD OF ADMINISTRATION
3.
EXPIRY DATE
EXP
4.
BATCH NUMBER
Lot
5.
CONTENTS BY WEIGHT, BY VOLUME OR BY UNIT
10 doses (5 ml)
6.
OTHER
35
MINIMUM PARTICULARS TO APPEAR ON SMALL IMMEDIATE PACKAGING UNITS
MULTIDOSE (20 DOSES) PRESENTATION
1.
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
I.M.
2.
METHOD OF ADMINISTRATION
3.
EXPIRY DATE
EXP
4.
BATCH NUMBER
Lot
5.
CONTENTS BY WEIGHT, BY VOLUME OR BY UNIT
20 doses (10 ml)
6.
OTHER
36
B. PACKAGE LEAFLET
37
PACKAGE LEAFLET: INFORMATION FOR THE USER
Daronrix, suspension for injection in pre-filled syringe
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
Read all of this leaflet carefully before you start receiving this vaccine.
-
Keep this leaflet. You may need to read it again.
-
This vaccine has been prescribed for you. Do not pass it on to others.
-
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
In this leaflet
:
1. What Daronrix is and what it is used for
2. Before you receive Daronrix
3. How Daronrix is given
4. Possible side effects
5.
How to store Daronrix
6.
Further information
1.
WHAT DARONRIX IS AND WHAT IT IS USED FOR
Daronrix is a vaccine used in adults aged 18 to 60 years to prevent influenza (flu) in an officially
declared pandemic. The vaccine works by causing the body to produce its own protection (antibodies)
against the disease.
Pandemic flu is a type of influenza that occurs every few decades and which spreads rapidly to affect
most countries and regions around the world. The symptoms of pandemic flu are similar to those of
“ordinary” flu but are usually more severe.
2.
BEFORE YOU RECEIVE DARONRIX
Daronrix should not be given:
•
if you have previously had any allergic reaction to Daronrix, or any ingredient (including eggs,
chicken protein, gentamicin sulphate (antibiotic)) contained in this vaccine. The active
substances and other ingredients in Daronrix are listed at the end of the leaflet. Signs of an
allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or
tongue. However, in a pandemic situation, it may be appropriate to give the vaccine, provided
that facilities for resuscitation are immediately available in case of need.
Take special care with Daronrix:
•
if you have a severe infection with a high temperature (over 38°C). A minor infection such as a
cold should not be a problem, but talk to your doctor first.
Using other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including
medicines obtained without a prescription or have recently received any other vaccine.
If you take any medicines that reduce immunity to infections or have any other type of treatment (such
as radiotherapy) that affects the immune system, Daronrix can still be given but your response to the
vaccine may be poor.
38
-
If you have any further questions, ask your doctor or pharmacist.
Pregnancy and breast-feeding
There is no information on the use of Daronrix in pregnant women. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are pregnant. Please tell your doctor if you
are pregnant.
Daronrix may be used during lactation.
Driving and using machines
After administration of Daronrix, it is unlikely that side effects would unable you to drive or use
machines.
Important information about some of the ingredients of Daronrix
Thiomersal (preservative) is present in this product, and it is possible that you may experience an
allergic reaction.
3.
HOW IS DARONRIX GIVEN
Adults from the age of 18 to 60 years will receive two injections of Daronrix, the first injection will be
administered at an elected date, the second at least three weeks after the first injection.
There is no information on the use of Daronrix below 18 years of age. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are below the age of 18 years.
The doctor will give Daronrix as an injection into your upper arm muscle.
The vaccine should never be given into a vein.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4.
POSSIBLE SIDE EFFECTS
Like all medicines, Daronrix can cause side effects, although not everybody gets them.
♦
Very common (more than 1 per 10 doses of vaccine):
•
Headache
•
Fatigue
•
Pain and redness at the injection site
♦
Common (less than 1 per 10 but more than 1 per 100 doses of vaccine):
•
Increased sweating, bruising
•
Aching muscles, joint pain
•
Swelling at the injection site, hard lump
•
Shivering, fever
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Sore nose and throat and discomfort when swallowing, runny nose
•
Itching at the injection site
These reactions usually disappear within 1-2 days without treatment.
39
Other side effects which have occurred in the days or weeks after vaccination with ordinary flu
vaccines include:
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Generalised skin reactions such as itching, hives or rash
♦
Rare (less than 1 per 1000 but more than 1 per 10,000 doses of vaccine):
•
Severe stabbing or throbbing pain along one or more nerves
•
Pins and needles
•
Fits
•
Low blood platelet count
•
Allergic reactions leading to a dangerous decrease of blood pressure, which, if untreated,
may lead to collapse, coma and death
♦
Very rare (less than 1 per 10,000 doses of vaccine):
•
Narrowing or blockage of blood vessels with kidney problems
•
Inflammation of the brain and spinal column
•
Painful swelling in the arms or legs
•
Temporary inflammation of the nerves, causing pain, weakness and paralysis in the
extremities and often progressing to the chest and face.
Do not be alarmed by this list of possible side effects. It is possible that you have no side effects from
vaccination.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please
tell your doctor or pharmacist.
5.
HOW TO STORE DARONRIX
Keep out of the reach and sight of children.
Do not use Daronrix after the expiry date which is stated on the carton. The expiry date refers to the
last day of that month.
Store in a refrigerator (2°C - 8°C).
Store in the original package in order to protect from light.
Do not freeze.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These measures will help to protect the environment.
6.
FURTHER INFORMATION
What Daronrix contains
-
The active substances are:
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent
to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
40
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
-
The other ingredients are: sodium chloride, disodium phosphate dodecahydrate, potassium
dihydrogen phosphate, potassium chloride, magnesium chloride hexahydrate, thiomersal, water
for injections
What Daronrix looks like and contents of the pack
Daronrix is a white, slightly milky liquid and is presented in a pre-filled syringe (0.5 ml) for 1 dose in
pack sizes of 1 and 10 with or without needles
Not all pack sizes may be marketed.
Marketing Authorisation Holder
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart
Belgium
Manufacturer
Sächsisches Serumwerk Dresden (SSW)
Zirkusstraße 40
D-01069 Dresden
Germany
For any information about this medicine, please contact the local representative of the Marketing
Authorisation Holder:
België/Belgique/Belgien
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
Luxembourg/Luxemburg
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
България
ГлаксоСмитКлайн ЕООД
Тел.: + 359 2 953 10 34
Magyarország
GlaxoSmithKline Kft.
Tel.: + 36-1-2255300
Česká republika
GlaxoSmithKline s.r.o.
Tel: + 420 2 22 00 11 11
gsk.czmail@gsk.com
Malta
GlaxoSmithKline Malta
Tel: + 356 21 238131
Danmark
GlaxoSmithKline Pharma A/S
Tlf: + 45 36 35 91 00
info@glaxosmithkline.dk
Nederland
GlaxoSmithKline BV
Tel: + 31 (0)30 69 38 100
nlinfo@gsk.com
Deutschland
GlaxoSmithKline GmbH & Co. KG
Tel: + 49 (0)89 360448701
produkt.info@gsk.com
Norge
GlaxoSmithKline AS
Tlf: + 47 22 70 20 00
firmapost@gsk.no
41
0.05 milligrams Al
3+
and aluminium hydroxide, hydrated
Eesti
GlaxoSmithKline Eesti OÜ
Tel: +372 667 6900
estonia@gsk.com
Österreich
GlaxoSmithKline Pharma GmbH.
Tel: + 43 1 970 75-0
at.info@gsk.com
Ελλάδα
GlaxoSmithKline A.E.B.E
Tηλ: + 30 210 68 82 100
Polska
GSK Commercial Sp. z o.o.
Tel.: + 48 (22) 576 9000
España
GlaxoSmithKline, S.A.
Tel: + 34 902 202 700
es-ci@gsk.com
Portugal
Smith Kline & French Portuguesa, Produtos
Farmacêuticos, Lda.
Tel: + 351 21 412 95 00
France
Laboratoire GlaxoSmithKline
Tél: + 33 (0) 1 39 17 84 44
diam@gsk.com
Ireland
GlaxoSmithKline (Ireland) Ltd
Tel: + 353 (0)1 4955000
Slovenija
GlaxoSmithKline d.o.o.
Tel: + 386 (0) 1 280 25 00
medical.x.si@gsk.com
Ísland
GlaxoSmithKline ehf.
Sími: +354-530 3700
Slovenská republika
GlaxoSmithKline Slovakia s.r.o.
Tel: + 421 (0)2 49 10 33 11
recepcia.sk@gsk.com
Italia
GlaxoSmithKline S.p.A.
Tel:+ 39 04 59 21 81 11
Suomi/Finland
GlaxoSmithKline Oy
Puh/Tel: + 358 10 30 30 30
Finland.tuoteinfo@gsk.com
Κύπρος
GlaxoSmithKline Cyprus Ltd
Τηλ: + 357 22 89 95 01
Latvija
GlaxoSmithKline Latvia SIA
Tel: + 371 7312687
lv-epasts@gsk.com
United Kingdom
GlaxoSmithKline UK
Tel: + 44 (0)808 100 9997
customercontactuk@gsk.com
Lietuva
GlaxoSmithKline Lietuva UAB
Tel. +370 5 264 90 00
info.lt@gsk.com
This leaflet was last approved in
{MM/YYYY}.
42
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
The European Medicines Agency (EMEA) will review any new information on the medicine every
year and this leaflet will be updated as necessary.
Detailed information on this medicine is available on the European Medicines Agency (EMEA) web
site:
http://www.emea.europa.eu/
43
PACKAGE LEAFLET: INFORMATION FOR THE USER
Daronrix, suspension for injection.
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
Read all of this leaflet carefully before you start receiving this vaccine.
-
Keep this leaflet. You may need to read it again.
-
This vaccine has been prescribed for you. Do not pass it on to others.
-
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
In this leaflet
:
1. What Daronrix is and what it is used for
2. Before you receive Daronrix
3. How Daronrix is given
4. Possible side effects
6.
How to store Daronrix
6.
Further information
1.
WHAT DARONRIX IS AND WHAT IT IS USED FOR
Daronrix is a vaccine used in adults aged 18 to 60 years to prevent influenza (flu) in an officially
declared pandemic. The vaccine works by causing the body to produce its own protection (antibodies)
against the disease.
Pandemic flu is a type of influenza that occurs every few decades and which spreads rapidly to affect
most countries and regions around the world. The symptoms of pandemic flu are similar to those of
“ordinary” flu but are usually more severe.
2.
BEFORE YOU RECEIVE DARONRIX
Daronrix should not be given:
•
if you have previously had any allergic reaction to Daronrix, or any ingredient (including eggs,
chicken protein, gentamicin sulphate (antibiotic)) contained in this vaccine. The active
substances and other ingredients in Daronrix are listed at the end of the leaflet. Signs of an
allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or
tongue. However, in a pandemic situation, it may be appropriate to give the vaccine, provided
that facilities for resuscitation are immediately available in case of need.
Take special care with Daronrix:
•
if you have a severe infection with a high temperature (over 38°C). A minor infection such as a
cold should not be a problem, but talk to your doctor first.
Using other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including
medicines obtained without a prescription or have recently received any other vaccine.
If you take any medicines that reduce immunity to infections or have any other type of treatment (such
as radiotherapy) that affects the immune system, Daronrix can still be given but your response to the
vaccine may be poor.
44
-
If you have any further questions, ask your doctor or pharmacist.
Pregnancy and breast-feeding
There is no information on the use of Daronrix in pregnant women. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are pregnant. Please tell your doctor if you
are pregnant.
Daronrix may be used during lactation.
Driving and using machines
After administration of Daronrix, it is unlikely that side effects would unable you to drive or use
machines.
Important information about some of the ingredients of Daronrix
Thiomersal (preservative) is present in this product, and it is possible that you may experience an
allergic reaction.
3.
HOW IS DARONRIX GIVEN
Adults from the age of 18 to 60 years will receive two injections of Daronrix, the first injection will be
administered at an elected date, the second at least three weeks after the first injection.
There is no information on the use of Daronrix below 18 years of age. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are below the age of 18 years.
The doctor will give Daronrix as an injection into your upper arm muscle.
The vaccine should never be given into a vein.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4.
POSSIBLE SIDE EFFECTS
Like all medicines, Daronrix can cause side effects, although not everybody gets them.
♦
Very common (more than 1 per 10 doses of vaccine):
•
Headache
•
Fatigue
•
Pain and redness at the injection site
♦
Common (less than 1 per 10 but more than 1 per 100 doses of vaccine):
•
Increased sweating, bruising
•
Aching muscles, joint pain
•
Swelling at the injection site, hard lump
•
Shivering, fever
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Sore nose and throat and discomfort when swallowing, runny nose
•
Itching at the injection site
These reactions usually disappear within 1-2 days without treatment.
45
Other side effects which have occurred in the days or weeks after vaccination with ordinary flu
vaccines include:
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Generalised skin reactions such as itching, hives or rash
♦
Rare (less than 1 per 1000 but more than 1 per 10,000 doses of vaccine):
•
Severe stabbing or throbbing pain along one or more nerves
•
Pins and needles
•
Fits
•
Low blood platelet count
•
Allergic reactions leading to a dangerous decrease of blood pressure, which, if untreated,
may lead to collapse, coma and death
♦
Very rare (less than 1 per 10,000 doses of vaccine):
•
Narrowing or blockage of blood vessels with kidney problems
•
Inflammation of the brain and spinal column
•
Painful swelling in the arms or legs
•
Temporary inflammation of the nerves, causing pain, weakness and paralysis in the
extremities and often progressing to the chest and face.
Do not be alarmed by this list of possible side effects. It is possible that you have no side effects from
vaccination.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please
tell your doctor or pharmacist.
5.
HOW TO STORE DARONRIX
Keep out of the reach and sight of children.
Do not use Daronrix after the expiry date which is stated on the carton. The expiry date refers to the
last day of that month.
Store in a refrigerator (2°C - 8°C).
Store in the original package in order to protect from light.
Do not freeze.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These measures will help to protect the environment.
6.
FURTHER INFORMATION
What Daronrix contains
-
The active substances are:
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent
to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
46
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxide, hydrated
0.05 milligrams Al
3+
-
The other ingredients are: sodium chloride, disodium phosphate dodecahydrate, potassium
dihydrogen phosphate, potassium chloride, magnesium chloride hexahydrate, thiomersal, water
for injections
What Daronrix looks like and contents of the pack
Daronrix is a white, slightly milky liquid and is presented as follows in an ampoule (0.5 ml) for 1 dose
in a pack of 100
Marketing Authorisation Holder
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart
Belgium
Manufacturer
Sächsisches Serumwerk Dresden (SSW)
Zirkusstraße 40
D-01069 Dresden
Germany
For any information about this medicine, please contact the local representative of the Marketing
Authorisation Holder:
België/Belgique/Belgien
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
Luxembourg/Luxemburg
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
България
ГлаксоСмитКлайн ЕООД
Тел.: + 359 2 953 10 34
Magyarország
GlaxoSmithKline Kft.
Tel.: + 36-1-2255300
Česká republika
GlaxoSmithKline s.r.o.
Tel: + 420 2 22 00 11 11
gsk.czmail@gsk.com
Malta
GlaxoSmithKline Malta
Tel: + 356 21 238131
Danmark
GlaxoSmithKline Pharma A/S
Tlf: + 45 36 35 91 00
info@glaxosmithkline.dk
Nederland
GlaxoSmithKline BV
Tel: + 31 (0)30 69 38 100
nlinfo@gsk.com
Deutschland
GlaxoSmithKline GmbH & Co. KG
Tel: + 49 (0)89 360448701
produkt.info@gsk.com
Norge
GlaxoSmithKline AS
Tlf: + 47 22 70 20 00
firmapost@gsk.no
47
Eesti
GlaxoSmithKline Eesti OÜ
Tel: +372 667 6900
estonia@gsk.com
Österreich
GlaxoSmithKline Pharma GmbH.
Tel: + 43 1 970 75-0
at.info@gsk.com
Ελλάδα
GlaxoSmithKline A.E.B.E
Tηλ: + 30 210 68 82 100
Polska
GSK Commercial Sp. z o.o.
Tel.: + 48 (22) 576 9000
España
GlaxoSmithKline, S.A.
Tel: + 34 902 202 700
es-ci@gsk.com
Portugal
Smith Kline & French Portuguesa, Produtos
Farmacêuticos, Lda.
Tel: + 351 21 412 95 00
France
Laboratoire GlaxoSmithKline
Tél: + 33 (0) 1 39 17 84 44
diam@gsk.com
Ireland
GlaxoSmithKline (Ireland) Ltd
Tel: + 353 (0)1 4955000
Slovenija
GlaxoSmithKline d.o.o.
Tel: + 386 (0) 1 280 25 00
medical.x.si@gsk.com
Ísland
GlaxoSmithKline ehf.
Sími: +354-530 3700
Slovenská republika
GlaxoSmithKline Slovakia s.r.o.
Tel: + 421 (0)2 49 10 33 11
recepcia.sk@gsk.com
Italia
GlaxoSmithKline S.p.A.
Tel:+ 39 04 59 21 81 11
Suomi/Finland
GlaxoSmithKline Oy
Puh/Tel: + 358 10 30 30 30
Finland.tuoteinfo@gsk.com
Κύπρος
GlaxoSmithKline Cyprus Ltd
Τηλ: + 357 22 89 95 01
Latvija
GlaxoSmithKline Latvia SIA
Tel: + 371 7312687
lv-epasts@gsk.com
United Kingdom
GlaxoSmithKline UK
Tel: + 44 (0)808 100 9997
customercontactuk@gsk.com
Lietuva
GlaxoSmithKline Lietuva UAB
Tel. +370 5 264 90 00
info.lt@gsk.com
This leaflet was last approved in
{MM/YYYY}.
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
48
The European Medicines Agency (EMEA) will review any new information on the medicine every
year and this leaflet will be updated as necessary.
Detailed information on this medicine is available on the European Medicines Agency (EMEA) web
49
PACKAGE LEAFLET: INFORMATION FOR THE USER
Daronrix, suspension for injection in multidose container
Pandemic influenza vaccine (whole virion, inactivated, adjuvanted)
Read all of this leaflet carefully before you start receiving this vaccine.
-
Keep this leaflet. You may need to read it again.
-
This vaccine has been prescribed for you. Do not pass it on to others.
-
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet,
please tell your doctor or pharmacist.
In this leaflet
:
1. What Daronrix is and what it is used for
2. Before you receive Daronrix
3. How Daronrix is given
4. Possible side effects
7.
How to store Daronrix
6.
Further information
1.
WHAT DARONRIX IS AND WHAT IT IS USED FOR
Daronrix is a vaccine used in adults aged 18 to 60 years to prevent influenza (flu) in an officially
declared pandemic. The vaccine works by causing the body to produce its own protection (antibodies)
against the disease.
Pandemic flu is a type of influenza that occurs every few decades and which spreads rapidly to affect
most countries and regions around the world. The symptoms of pandemic flu are similar to those of
“ordinary” flu but are usually more severe.
2.
BEFORE YOU RECEIVE DARONRIX
Daronrix should not be given:
•
if you have previously had any allergic reaction to Daronrix, or any ingredient (including eggs,
chicken protein, gentamicin sulphate (antibiotic)) contained in this vaccine. The active
substances and other ingredients in Daronrix are listed at the end of the leaflet. Signs of an
allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or
tongue. However, in a pandemic situation, it may be appropriate to give the vaccine, provided
that facilities for resuscitation are immediately available in case of need.
Take special care with Daronrix:
•
if you have a severe infection with a high temperature (over 38°C). A minor infection such as a
cold should not be a problem, but talk to your doctor first.
Using other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including
medicines obtained without a prescription or have recently received any other vaccine.
If you take any medicines that reduce immunity to infections or have any other type of treatment (such
as radiotherapy) that affects the immune system, Daronrix can still be given but your response to the
vaccine may be poor.
50
-
If you have any further questions, ask your doctor or pharmacist.
Pregnancy and breast-feeding
There is no information on the use of Daronrix in pregnant women. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are pregnant. Please tell your doctor if you
are pregnant.
Daronrix may be used during lactation.
Driving and using machines
After administration of Daronrix, it is unlikely that side effects would unable you to drive or use
machines.
Important information about some of the ingredients of Daronrix
Thiomersal (preservative) is present in this product, and it is possible that you may experience an
allergic reaction.
3.
HOW IS DARONRIX GIVEN
Adults from the age of 18 to 60 years will receive two injections of Daronrix, the first injection will be
administered at an elected date, the second at least three weeks after the first injection.
There is no information on the use of Daronrix below 18 years of age. Your doctor needs to assess the
benefits and potential risks of giving you the vaccine if you are below the age of 18 years.
The doctor will give Daronrix as an injection into your upper arm muscle.
The vaccine should never be given into a vein.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4.
POSSIBLE SIDE EFFECTS
Like all medicines, Daronrix can cause side effects, although not everybody gets them.
♦
Very common (more than 1 per 10 doses of vaccine):
•
Headache
•
Fatigue
•
Pain and redness at the injection site
♦
Common (less than 1 per 10 but more than 1 per 100 doses of vaccine):
•
Increased sweating, bruising
•
Aching muscles, joint pain
•
Swelling at the injection site, hard lump
•
Shivering, fever
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Sore nose and throat and discomfort when swallowing, runny nose
•
Itching at the injection site
These reactions usually disappear within 1-2 days without treatment.
51
Other side effects which have occurred in the days or weeks after vaccination with ordinary flu
vaccines include:
♦
Uncommon (less than 1 per 100 but more than 1 per 1000 doses of vaccine):
•
Generalised skin reactions such as itching, hives or rash
♦
Rare (less than 1 per 1000 but more than 1 per 10,000 doses of vaccine):
•
Severe stabbing or throbbing pain along one or more nerves
•
Pins and needles
•
Fits
•
Low blood platelet count
•
Allergic reactions leading to a dangerous decrease of blood pressure, which, if untreated,
may lead to collapse, coma and death
♦
Very rare (less than 1 per 10,000 doses of vaccine):
•
Narrowing or blockage of blood vessels with kidney problems
•
Inflammation of the brain and spinal column
•
Painful swelling in the arms or legs
•
Temporary inflammation of the nerves, causing pain, weakness and paralysis in the
extremities and often progressing to the chest and face.
Do not be alarmed by this list of possible side effects. It is possible that you have no side effects from
vaccination.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please
tell your doctor or pharmacist.
5.
HOW TO STORE DARONRIX
Keep out of the reach and sight of children.
Do not use Daronrix after the expiry date which is stated on the carton. The expiry date refers to the
last day of that month.
Store in a refrigerator (2°C - 8°C).
Store in the original package in order to protect from light.
Do not freeze.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to
dispose of medicines no longer required. These measures will help to protect the environment.
6.
FURTHER INFORMATION
What Daronrix contains
-
The active substances are:
Whole virion influenza vaccine of pandemic strain, inactivated, containing antigen
*
equivalent
to:
A/Vietnam/1194/2004 (H5N1)
***
15 micrograms
**
per 0.5 ml dose
52
*
propagated in eggs
**
haemagglutinin
***
adjuvanted by aluminium phosphate
0.45 milligrams Al
3+
and aluminium hydroxyde, hydrated
0.05 milligrams Al
3+
-
The other ingredients are: sodium chloride, disodium phosphate dodecahydrate, potassium
dihydrogen phosphate, potassium chloride, magnesium chloride hexahydrate, thiomersal, water
for injections
What Daronrix looks like and contents of the pack
Daronrix is a white, slightly milky liquid and is presented as follows:
- in an ampoule (5 ml) for 10 doses in a pack of 50
- in a vial (5 ml) for 10 doses in a pack of 50
- in a vial (10 ml) for 20 doses in a pack of 50
Not all pack sizes may be marketed.
Marketing Authorisation Holder
GlaxoSmithKline Biologicals s.a.
Rue de l’Institut 89
B-1330 Rixensart
Belgium
Manufacturer
Sächsisches Serumwerk Dresden (SSW)
Zirkusstraße 40
D-01069 Dresden
Germany
For any information about thismedicine, please contact the local representative of the Marketing
Authorisation Holder:
België/Belgique/Belgien
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
Luxembourg/Luxemburg
GlaxoSmithKline s.a./n.v.
Tél/Tel: + 32 2 656 21 11
България
ГлаксоСмитКлайн ЕООД
Тел.: + 359 2 953 10 34
Magyarország
GlaxoSmithKline Kft.
Tel.: + 36-1-2255300
Česká republika
GlaxoSmithKline s.r.o.
Tel: + 420 2 22 00 11 11
gsk.czmail@gsk.com
Malta
GlaxoSmithKline Malta
Tel: + 356 21 238131
Danmark
GlaxoSmithKline Pharma A/S
Tlf: + 45 36 35 91 00
info@glaxosmithkline.dk
Nederland
GlaxoSmithKline BV
Tel: + 31 (0)30 69 38 100
nlinfo@gsk.com
53
Deutschland
GlaxoSmithKline GmbH & Co. KG
Tel: + 49 (0)89 360448701
produkt.info@gsk.com
Norge
GlaxoSmithKline AS
Tlf: + 47 22 70 20 00
firmapost@gsk.no
Eesti
GlaxoSmithKline Eesti OÜ
Tel: +372 667 6900
estonia@gsk.com
Österreich
GlaxoSmithKline Pharma GmbH.
Tel: + 43 1 970 75-0
at.info@gsk.com
Ελλάδα
GlaxoSmithKline A.E.B.E
Tηλ: + 30 210 68 82 100
Polska
GSK Commercial Sp. z o.o.
Tel.: + 48 (22) 576 9000
España
GlaxoSmithKline, S.A.
Tel: + 34 902 202 700
es-ci@gsk.com
Portugal
Smith Kline & French Portuguesa, Produtos
Farmacêuticos, Lda.
Tel: + 351 21 412 95 00
France
Laboratoire GlaxoSmithKline
Tél: + 33 (0) 1 39 17 84 44
diam@gsk.com
Ireland
GlaxoSmithKline (Ireland) Ltd
Tel: + 353 (0)1 4955000
Slovenija
GlaxoSmithKline d.o.o.
Tel: + 386 (0) 1 280 25 00
medical.x.si@gsk.com
Ísland
GlaxoSmithKline ehf.
Sími: +354-530 3700
Slovenská republika
GlaxoSmithKline Slovakia s.r.o.
Tel: + 421 (0)2 49 10 33 11
recepcia.sk@gsk.com
Italia
GlaxoSmithKline S.p.A.
Tel:+ 39 04 59 21 81 11
Suomi/Finland
GlaxoSmithKline Oy
Puh/Tel: + 358 10 30 30 30
Finland.tuoteinfo@gsk.com
Κύπρος
GlaxoSmithKline Cyprus Ltd
Τηλ: + 357 22 89 95 01
Latvija
GlaxoSmithKline Latvia SIA
Tel: + 371 7312687
lv-epasts@gsk.com
United Kingdom
GlaxoSmithKline UK
Tel: + 44 (0)808 100 9997
customercontactuk@gsk.com
Lietuva
GlaxoSmithKline Lietuva UAB
Tel. +370 5 264 90 00
info.lt@gsk.com
54
This leaflet was last approved in
{MM/YYYY}.
Daronrix has been authorised under “Exceptional Circumstances”.
This means that for scientific reasons, it has not been possible to obtain complete information on this
medicinal product.
The European Medicines Agency (EMEA) will review any new information on the medicine every
year and this leaflet will be updated as necessary.
Detailed information on this medicine is available on the European Medicines Agency (EMEA) web
55
Source: European Medicines Agency
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- If you wish to link to this page, you can do so by referring to the URL address below this line.
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