Summary of adverse reactions The following adverse reactions have been attributed to BIAMSUN liposomal based on clinical trial data and post-marketing experience. The frequency is based on analysis from pooled clinical trials of 688 BIAMSUN liposomal treated patients; the frequency of adverse reactions identified from post- marketing experience is not known.
Adverse reactions are listed below by body system organ class using MedDRA and are sorted by frequency. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
Frequencies are defined as:
Very common (≥ 1/10) Common (≥ 1/100 to < 1/10) Uncommon (≥ 1/1,000 to < 1/100) Very rare (<1/10,000), Not known (cannot be estimated from the available data) Blood and lymphatic system disorders Uncommon: thrombocytopenia Not known: anaemia Immune system disorders Uncommon: anaphylactoid reaction Not known: anaphylactic reactions, hypersensitivity Metabolism and nutrition disorders Very common: hypokalaemia Common: hyponatraemia, hypocalcaemia, hypomagnesaemia, hyperglycaemia, hyperkalaemia Nervous system disorders Common: headache Uncommon: convulsion Cardiac disorders Common: tachycardia Not known: cardiac arrest, arrhythmia Vascular disorders Common: hypotension, vasodilatation, flushing Respiratory, thoracic and mediastinal disorders Common: dyspnoea Uncommon: bronchospasm Gastrointestinal disorders Very common: nausea, vomiting Common: diarrhoea, abdominal pain Hepatobiliary disorders Common: abnormal liver function tests, hyperbilirubinaemia, increased alkaline phosphatase Skin and subcutaneous disorders Common: rash Not known: angioneurotic oedema Musculoskeletal and connective tissue disorders Common: back pain Not Known: rhabdomyolysis (associated with hypokalaemia), musculoskeletal pain (described as arthralgia or bone pain) Renal and urinary disorders Common: increased creatinine, increased blood urea Not known: renal failure, renal insufficiency General disorders and administration site conditions Very Common: rigors, pyrexia, Common: chest pain Description of selected adverse reactions Infusion-related reactions Fever and chills/rigors are the most frequent infusion-related reactions expected to occur during BIAMSUN liposomal administration.
Less frequent infusion-related reactions may consist of one or more of the following symptoms: chest tightness or pain, dyspnoea, bronchospasm, flushing, tachycardia, hypotension and musculoskeletal pain (described as arthralgia, back pain, or bone pain).
These resolve rapidly on stopping the infusion and may not occur with every subsequent dose or when slower infusion rates (over 2 hours) are used. In addition, infusion-related reactions may also be prevented by the use of premedication.
4). In two double-blind, comparative studies, BIAMSUN liposomal treated patients experienced a significantly lower incidence of infusion-related reactions, as compared to patients treated with conventional amphotericin B or amphotericin B lipid complex.
In pooled study data from randomised, controlled clinical trials comparing Amphotericin B liposomal with conventional amphotericin B therapy in greater than 1,000 patients, reported adverse reactions were considerably less severe and less frequent in BIAMSUN liposomal treated patients as compared with conventional amphotericin B treated patients.
A randomized phase III study assessed a single 10 mg/kg dose of Amphotericin B SUN Pharma liposomal with a backbone of 14 days flucytosine and fluconazole, compared to the control group (1-week conventional amphotericin B plus flucytosine followed by 1 week of fluconazole) in the treatment of HIV associated cryptococcal meningitis.
The Amphotericin B SUN Pharma liposomal treated patients experienced fewer grade 3 or 4 adverse events compared to the control group. The safety profile observed in this patient population was consistent with the overall safety profile for Amphotericin B SUN Pharma liposomal.
Renal toxicity Nephrotoxicity occurs to some degree with conventional amphotericin B in most patients receiving the product intravenously. 0 times baseline measurement), was approximately half that for conventional amphotericin B. 0 times baseline measurement) was approximately half that for Amphotericin B lipid complex.
g. used in Beckman Coulter analyzers including the Synchron LX20). This assay is intended for the quantitative determination of inorganic phosphorus in human serum, plasma or urine samples. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
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