Altreno

2 DOSAGE AND ADMINISTRATION Apply a thin layer of ALTRENO to the affected areas once daily. Avoid the eyes, mouth, paranasal creases, and mucous membranes. ALTRENO is for topical use only. Not for ophthalmic, oral, or intravaginal use.

• Apply a thin layer of ALTRENO to affected areas once daily. Avoid eyes, mouth, paranasal creases, and mucous membranes. ( 2 ) • Not for ophthalmic, oral, or intravaginal use. ( 2 )

6 ADVERSE REACTIONS • The most common adverse reactions occurring in ≥1% of subjects and greater than vehicle were dryness, pain, erythema, irritation and exfoliation (all at the application site). gov/medwatch. 1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

In 2 randomized, double-blind, vehicle-controlled trials, subjects age 9 years and older applied ALTRENO or vehicle once daily for 12 weeks. The majority of subjects were White (74%) and female (55%). Approximately 47% were Hispanic/Latino and 45% were younger than 18 years of age.

Adverse reactions reported by ≥1% of subjects treated with ALTRENO and more frequently than vehicle are summarized in Table 1.

Table 1:

Adverse Reactions Reported by ≥1% of Subjects Treated with ALTRENO and More Frequently than Vehicle Adverse Reactions n (%) ALTRENO N=767 Vehicle N=783 Application site dryness 29 (4) 1 (<1) Application site pain Application site pain defined as application site stinging, burning or pain.

25 (3) 3 (<1) Application site erythema 12 (2) 1 (<1) Application site irritation 7 (1) 1 (<1) Application site exfoliation 6 (1) 3 (<1) Skin irritation was evaluated by active assessment of erythema, scaling, hypopigmentation, hyperpigmentation, itching, burning and stinging.

The percentage of subjects who were assessed to have these signs and symptoms at any post baseline visit are summarized in Table 2.

Table 2:

Application Site Tolerability Reactions at Any Post Baseline Visit ALTRENO N=760 Mild/Mod/Severe Vehicle N=782 Mild/Mod/Severe Erythema 51% 44% Scaling 49% 30% Hypopigmentation 12% 10% Hyperpigmentation 35% 35% Itching 35% 28% Burning 30% 14% Stinging 21% 8%

5 WARNINGS AND PRECAUTIONS • Skin Irritation: Dryness, pain, erythema, irritation and exfoliation may occur with use of ALTRENO. 1 ) • Ultraviolet Light and Environmental Exposure: Minimize exposure to sunlight and sunlamps. Use sunscreen and protective clothing when sun exposure cannot be avoided.

2 ) • Fish Allergies: Use ALTRENO with caution if allergic to fish due to potential for allergenicity to fish protein. Advise patients to contact their healthcare provider if they develop pruritus or urticaria. 1 Skin Irritation Patients using ALTRENO may experience application site dryness, pain, erythema, irritation, and exfoliation.

Depending upon the severity of these adverse reactions, instruct patients to use a moisturizer, reduce the frequency of the application of ALTRENO, or discontinue use. Avoid application of ALTRENO to eczematous or sunburned skin. 2 Ultraviolet Light and Environmental Exposure Minimize unprotected exposure to ultraviolet light including sunlight and sunlamps during the use of ALTRENO.

Warn patients who normally experience high levels of sun exposure and those with inherent sensitivity to sun to exercise caution. Use sunscreen products and protective clothing over treated areas when sun exposure cannot be avoided.

3 Fish Allergies ALTRENO contains soluble fish proteins. Use with caution in patients with known sensitivity or allergy to fish. Advise patients to contact their healthcare provider if they develop pruritus or urticaria.

4 CONTRAINDICATIONS None. None. ( 4 )