Coagulation factor ix (recombinant)

Preparation and Reconstitution The procedures below are provided as general recommendations for the preparation and reconstitution of IXINITY. Before starting reconstitution and administration you will need the following items that are included in each kit of IXINITY: One (or more) vial(s) of IXINITY 250, 500, 1000, 1500, 2000, or 3000 IU powder One (or more) 10 mL syringe(s), pre-filled with 5 mL of Sterile Water for Injection (pre-filled syringe) with plunger rod attached One sterile vial adapter with filter In addition, you will need the following items that are not included in the kit: One sterile LUER-LOK™ syringe (administration syringe); additional or larger syringes may be required if pooling multiple vials Sterile alcohol swabs Sterile infusion set Sterile gauze pad Sterile bandage Always work on a clean surface and wash your hands before performing the following procedures: Use aseptic technique during reconstitution procedure.

Allow IXINITY and the pre-filled syringe to reach room temperature before use. Remove cap from the vial (See Figure A ). Peel back the cover of the vial adapter package (leave the vial adapter in the package). Figure A Place the administration syringe, if using, and vial adapter on a clean flat work surface. Twist off the cap of the pre-filled syringe and place it on the clean flat surface (See Figure B ).

Figure B Wipe the top of the IXINITY vial with an alcohol swab (or similar germicidal solution) and allow it to dry. Place on a clean, flat surface. Firmly hold the package containing the vial adapter on a clean, flat surface. Connect the pre-filled syringe to the vial adapter by pushing the syringe tip down onto the LUER-LOK in the center of the vial adapter, and screw until the syringe is secured (See Figure C ).

Figure C Carefully lift up the combined syringe-and-vial-adapter and remove it from the plastic package (See Figure D ). Figure D With one hand, continue to hold the combined syringe-and-vial-adapter. With the other hand, hold the IXINITY vial tightly on a clean, flat surface. In a continuous motion, place the vial adapter over the IXINITY vial; firmly push the filter spike of the vial adapter through the center of IXINITY vial’s rubber circle until the clear plastic cap snaps onto the IXINITY vial (See Figure E ).

Push the plunger down to complete the transfer of all liquid from the syringe to the IXINITY vial. Figure E With the syringe and the vial still attached, gently swirl, in a circular motion, the IXINITY vial until the product is fully dissolved/reconstituted (See Figure F ). Figure F Remove the pre-filled syringe (now empty) from the vial adapter by turning it counterclockwise until it is completely detached (See Figure G ).

Figure G Remove the administration syringe from its packaging. Leave the vial adapter attached to the vial and attach the administration syringe to the vial adapter by turning clockwise until it is securely attached (See Figure H ). Figure H Keeping the administration syringe plunger pressed, turn the IXINITY vial upside down.

Draw the solution from the vial through the filter spike in the vial adapter by pulling the plunger back slowly until all solution is transferred into the administration syringe (See Figure I ). Figure I Keep the administration syringe plunger facing downwards and prevent it from moving. With one hand hold the vial-and-vial-adapter, and with the other hand firmly grasp the barrel of the administration syringe and unscrew the syringe from the vial adapter (See Figure J ).

Figure J If only dosing with a single vial, proceed to administer IXINITY via intravenous infusion; otherwise proceed to Pooling Instructions. POOLING INSTRUCTIONS 1. If two or more vials are required to achieve the required dose, remove the pre-filled syringe from the vial adapter on the reconstituted second vial by turning it counterclockwise until it is completely detached. 2.

Leave the vial adapter attached to the vial and attach the administration syringe containing the reconstituted IXINITY from the first vial by turning it clockwise until it is securely in place. 3. Turn the IXINITY vial upside down and slowly pull on the plunger rod to draw the solution into the administration syringe (see Figure I ). 4.

Continue with remaining vials, if required. Once pooling is complete, proceed to administer IXINITY via intravenous infusion. After reconstitution of the lyophilized powder, all dosage strengths should yield a clear, colorless solution without visible particles. Discard if visible particulate matter or discoloration is observed.

Infuse reconstituted solution immediately or within 3 hours of storage at room temperature after reconstitution. Do not refrigerate after reconstitution. Do not touch the syringe tip or the inside of the cap. Place the syringe containing the IXINITY solution on the clean surface, making sure that the tip does not touch anything.

Figure A Figure B Figure C Figure D Figure E Figure F Figure G Figure H Figure I Figure J

Administration For intravenous use after reconstitution only. Inspect parenteral drug products visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not mix IXINITY with other medicinal products for infusion. Attach the administration syringe containing the reconstituted IXINITY solution to a sterile infusion set.

Adapt the infusion rate to the comfort level of each patient, not exceeding 10 mL per minute. Record the name and batch number of the product in the patient record. Dispose of any unused product or waste material in accordance with local requirements.