Conestat alfa

FDA label, Pharming Healthcare Inc., intravenous, effective 2020-04-30. Full label on DailyMed

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From MedlinePlus, U.S. National Library of Medicine

Quoted from the FDA label. Product labels differ by manufacturer and change over time; confirm against the label for the product you are using.

Dosing in kidney impairment

This label has no separate kidney-impairment dosing section. Check warnings and clinical pharmacology in the full label.

Preparation and administration

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Preparation and Handling Store RUCONEST in the original carton and protect from light prior to reconstitution. Do not use after expiration date on the product vial label. Water for Injection is not included in the RUCONEST package. Use aseptic technique to reconstitute, mix the solution, and to combine the reconstituted solution from more than one vial ( see Reconstitution [ 2.3 ] and Administration [ 2.4 ]).

Do not mix or administer RUCONEST with other medicinal products or solutions. Discard all partially used vials after treatment.

Reconstitution Each package contains one single-use vial of RUCONEST. To reconstitute, the following are also required: Sterile Water for Injection (diluent) - At least 14 mL per vial of RUCONEST requiring reconstitution. Antiseptic wipe Syringe Commercially available vial adapter and syringe luer lock or large bore needle.

If using a syringe with vial adapter, use a new vial adapter for each vial of RUCONEST and diluent. The procedures below are provided as general guidelines for the reconstitution and administration of RUCONEST. Ensure that the RUCONEST vial and diluent vial are at room temperature. Remove the flip caps from the RUCONEST and diluent vials.

Treat the vial stoppers with the antiseptic wipe and allow to dry. Using the syringe/needle or syringe/vial adapter, withdraw 14 mL of sterile water for injection from the diluent vial. Remove the syringe and transfer the diluent to the RUCONEST vial. Add the diluent slowly to avoid forceful impact on the powder. Swirl the vial slowly to mix and avoid foaming.

Repeat this procedure using another 14 mL of diluent and a second vial of RUCONEST. If the same patient is to receive more than one vial, the contents of multiple vials may be pooled into a single administration device (i.e., syringe). Inspect RUCONEST visually for particulate matter and discoloration after reconstitution and prior to administration.

The reconstituted solution should be colorless, clear, and free from visible particles. Do not use if the solution is cloudy, colored, or contains particulates. RUCONEST vial is for single-use only. Use the reconstituted product immediately, or within 8 hours stored at 36ºF - 46ºF (2º - 8ºC). Discard partially used vials.

Do not freeze the reconstituted solution.

Administration Do not mix RUCONEST with other medicinal products. Administer RUCONEST by a separate infusion line. Use aseptic technique when administering RUCONEST. Follow recommended venipuncture guidelines for initiating intravenous therapy. Administer RUCONEST by slow intravenous injection over approximately 5 minutes.

For self-administration, provide the patient with instructions and training for intravenous injection outside of a clinic setting so patients may self-administer RUCONEST upon recognition of symptoms of an HAE attack [see Patient Counseling Information]. After administration, immediately discard any unused product and all used disposable supplies in accordance with local requirements.

Body weight RUCONEST Dose for Intravenous Injection Volume (mL) of Reconstituted Solution (150 U/mL) to be Administered
< 84 kg 50 U per kg Body weight in kg divided by 3
≥ 84 kg 4200 U (2 vials) 28 mL
Table 1. Recommended dose of RUCONEST for an acute attack
Body Weight RUCONEST Dose for Intravenous Injection Volume (mL) of Reconstituted Solution (150 U/mL) to be Administered
< 84 kg 50 U per kg Body weight in kg divided by 3
≥ 84 kg 4200 U (2 vials) 28 mL

Contraindications

4 CONTRAINDICATIONS RUCONEST is contraindicated in patients with a history of allergy to rabbits or rabbit-derived products. RUCONEST is contraindicated in patients with a history of life-threatening immediate hypersensitivity reactions to C1 esterase inhibitor preparations, including anaphylaxis. Known or suspected allergy to rabbits and rabbit-derived products. ( 4 ) History of immediate hypersensitivity reactions, including anaphylaxis, to C1 esterase inhibitor preparations. ( 4 )

Pregnancy and lactation

Pregnancy

8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies of RUCONEST in pregnant women. In the U.S. general population, regardless of drug exposure, available data suggest that major birth defects occur in 2 to 4% of the general population and miscarriage occurs in 15 to 20% of clinically recognized pregnancies. Data Human Data Limited available postmarketing safety data with RUCONEST use in pregnant women do not indicate any adverse effects in this population.

In a retrospective case collection study, 14 pregnant women aged 17 to 37 years with HAE received RUCONEST at 50 U/kg (max 4200 U) via intravenous administration for treatment of acute atttacks or for prophylaxis during pregnancy. For all 14 women in this study, delivery at full term with the births of healthy babies occurred without complications. No adverse events related to RUCONEST treatment were reported during the pregnancy period. 1,2 However these data cannot definitely establish the absence of any risk because of the small sample size and non-randomized study design.

Animal Data Embryo toxicity with 625 U/kg of RUCONEST (12.5 times the human dose) was tested after intravenous dosing of pregnant rats in a segment II (embryofetal toxicity) study design. There were no significant outcomes from this study. Dosing of pregnant rabbits with 625 U/kg during organogenesis showed no drug-related adverse effects on either the developing fetuses or mothers [see Animal Toxicology and/or Pharmacology (13.2)].

For breastfeeding, also see LactMed (National Library of Medicine), which summarizes milk levels and infant effects.

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