Treprostinil Tillomed 1 mg/ml solution for infusion

Patient Leaflet Updated 27-Feb-2024 | Tillomed Laboratories Ltd

Treprostinil Tillomed 1 mg/ml, 2.5 mg/ml, 5 mg/ml, 10 mg/ml solution for infusion

Package leaflet: Information for the user

Treprostinil Tillomed 1 mg/ml, 2.5 mg/ml, 5 mg/ml, 10 mg/ml solution for infusion

treprostinil

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
  • Keep this leaflet. You may need to read it again.
  • If you have any further questions, ask your doctor.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Treprostinil Tillomed is and what it is used for
2. What you need to know before you use Treprostinil Tillomed
3. How to use Treprostinil Tillomed
4. Possible side effects
5. How to store Treprostinil Tillomed
6. Contents of the pack and other information

1. What Treprostinil Tillomed is and what it is used for
What Treprostinil Tillomed is

The active ingredient of Treprostinil Tillomed is treprostinil.

Treprostinil belongs to a group of medicines which work in a similar way to the naturally occurring prostacyclins. Prostacyclins are hormone-like substances which reduce blood pressure by relaxing blood vessels, causing them to widen, which allows the blood to flow more easily. Prostacyclins can also have an influence in preventing blood from clotting.

What Treprostinil Tillomed is used to treat

Treprostinil Tillomed is used to treat idiopathic or heritable pulmonary arterial hypertension (PAH) in patients with moderate severity of the symptoms. Pulmonary arterial hypertension is a condition where your blood pressure is too high in the blood vessels between the heart and the lungs, causing shortness of breath, dizziness, tiredness, fainting, palpitations or abnormal heartbeat, dry cough, chest pain and swollen ankles or legs.

Treprostinil Tillomed is initially administered as a continuous subcutaneous (under the skin) infusion. Some patients may become unable to tolerate this because of local site pain and swelling. Your physician will decide whether Treprostinil Tillomed can be administered by continuous intravenous infusion directly into a vein with the insertion of a central venous tube (catheter) that is connected to an external pump. Your doctor will determine what is the best option for you.

How Treprostinil Tillomed works

Treprostinil Tillomed lowers blood pressure within the pulmonary artery, by improving blood flow and reducing the amount of work for the heart. Improved blood flow leads to an improved supply of oxygen to the body and reduced strain on the heart, causing it to function more effectively. Treprostinil improves the symptoms associated with PAH and the ability to exercise in patients who are limited in terms of activity.

2. What you need to know before you use Treprostinil Tillomed
Do not use Treprostinil Tillomed
  • if you are allergic (hypersensitive) to treprostinil or any of the other ingredients of this medicine (listed in section 6)
  • if you have been diagnosed with a disease called "pulmonary veno-occlusive disease".
    This is a disease in which the blood vessels that carry blood through your lungs become swollen and clogged, resulting in a higher pressure in the blood vessels between the heart and the lungs.
  • if you have severe liver disease
  • if you have a heart problem, for example:
    • a myocardial infarction (heart attack) within the last six months
    • severe changes in heart rate
    • severe coronary heart disease or unstable angina
    • a heart defect has been diagnosed such as a faulty heart valve that causes the heart to work poorly
    • any disease of the heart which is not being treated or not under close medical observation
  • if you are at a specific high risk of bleeding – for example, active stomach ulcers, injuries or other bleeding conditions
  • if you have had a stroke within the last 3 months or any other interruption of blood supply to the brain.

Warnings and precautions

Talk to your doctor before using Treprostinil Tillomed:

  • if you suffer from any liver disease
  • if you suffer from kidney disease
  • if you have been advised that you are medically obese (BMI greater than 30 kg/m2)
  • if you have Human Immunodeficiency Virus (HIV) infection
  • if you have high blood pressure in your liver veins (portal hypertension)
  • if you have a birth defect in your heart which affects the way your blood flows through it.

During your treatment with Treprostinil Tillomed, tell your doctor:

  • if your blood pressure decreases (hypotension)
  • if you experience a rapid increase in breathing difficulties or persistent cough (this can be related to congestion in the lungs or asthma or other condition), consult your doctor immediately
  • if you have excessive bleeding as treprostinil may increase the risk, by preventing your blood from clotting
  • if you develop a fever whilst receiving intravenous treprostinil or the intravenous infusion site becomes red, swollen and / or painful to touch, as this could be a sign of infection.

Other medicines and Treprostinil Tillomed

Tell your doctor if you are taking, have recently taken, or might take any other medicines.

Please tell your doctor if you are taking:

  • medicines used to treat high blood pressure (antihypertensive drugs or other vasodilators)
  • drugs used to increase the rate of urination (diuretics) including furosemide
  • medicines that stop blood clotting (anticoagulants) such as warfarin, heparin or nitric oxide-based products
  • any Non-Steroidal Anti-Inflammatory Drugs (NSAID) (e.g. acetylsalicylic acid, ibuprofen)
  • medicines that may increase or decrease the effect of treprostinil (e.g. gemfibrozil, rifampicin, trimethoprim, deferasirox, phenytoin, carbamazepine, phenobarbital, St. John’s Wort) as your doctor may need to adjust your dose of treprostinil.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Treprostinil is not recommended if you are pregnant, planning to become pregnant, or think that you might be pregnant, unless considered essential by your doctor. The safety of this medicine for use during pregnancy has not been established.

Treprostinil is not recommended for use in breastfeeding, unless considered essential by your doctor. You are advised to stop breastfeeding if treprostinil is prescribed for you, because it is not known whether this medicine passes into breast milk.

Contraception is strongly recommended during treatment with treprostinil.

Driving and using machines

Treprostinil may induce low blood pressure with dizziness or fainting. In such a case do not drive or operate machinery and ask your doctor for advice.

Treprostinil Tillomed contains sodium

Treprostinil Tillomed 1 mg/ml solution for infusion

This medicine contains 74.16 mg sodium (main component of cooking/table salt) in each 20 ml vial. This is equivalent to 3.71% of the recommended maximum daily dietary intake of sodium for an adult.

Treprostinil Tillomed 2.5 mg/ml solution for infusion

This medicine contains 75.08 mg sodium (main component of cooking/table salt) in each 20 ml vial. This is equivalent to 3.75% of the recommended maximum daily dietary intake of sodium for an adult.

Treprostinil Tillomed 5 mg/ml solution for infusion

This medicine contains 78.16 mg sodium (main component of cooking/table salt) in each 20 ml vial. This is equivalent to 3.91% of the recommended maximum daily dietary intake of sodium for an adult.

Treprostinil Tillomed 10 mg/ml solution for infusion

This medicine contains 75 mg sodium (main component of cooking/table salt) in each 20 ml vial. This is equivalent to 3.75% of the recommended maximum daily dietary intake of sodium for an adult.

3. How to use Treprostinil Tillomed

Always use this medicine exactly as your doctor has told you. You should check with your doctor if you are not sure.

Treprostinil Tillomed is administered as a continuous infusion, either:

  • subcutaneously (under the skin) via a small tube (cannula) which is located in your abdomen or thigh; or,
  • intravenously via a tube (catheter) that is usually located in your neck, chest or groin.

In both cases, treprostinil is pushed through the tubing by a portable pump placed out of your body (external).

Before you leave the hospital or clinic, the doctor will tell you how to prepare treprostinil and at what rate the pump should deliver your treprostinil.

Flushing of the infusion line whilst connected may cause accidental overdose.

Information on how to use the pump correctly and what to do if it stops working should also be given to you. The information should also tell you whom to contact in an emergency.

Treprostinil is diluted only when administered with a continuous intravenous infusion:

For intravenous infusion with external portable pump: You must only dilute your treprostinil solution with either Sterile Water for Injection or 0.9% Sodium Chloride Injection (as provided by your doctor).

Adult patients

Treprostinil Tillomed is available as 1 mg/ml, 2.5 mg/ml, 5 mg/ml or 10 mg/ml solution for infusion. Your doctor will determine the infusion rate and dose appropriate for your condition.

Overweight Patients

If you are overweight (weigh 30% or more than your ideal body weight) your doctor will determine the initial and subsequent doses based on your ideal body weight. Please also refer to Section 2 "Warnings and Precautions".

Older people

Your doctor will determine the infusion rate and dose appropriate for your condition.

Children and adolescents

Limited data are available for children and adolescents.

Dosage adjustment

The infusion rate can be reduced or increased on an individual basis under medical supervision only.

The aim of adjusting the infusion rate is to establish an effective maintenance rate which improves symptoms of PAH while minimising any undesirable effects.

If your symptoms increase or if you need complete rest, or are confined to your bed or chair, or if any physical activity brings on discomfort and your symptoms occur at rest, do not increase your dose without medical advice. Treprostinil may no longer be sufficient to treat your disease and another treatment may be required.

How can blood stream infections during treatment with intravenous treprostinil be prevented?

As with any long-term intravenous treatment, there is a risk of getting blood stream infections. Your doctor will train you on how to avoid this.

If you use more Treprostinil Tillomed than you should

If you accidentally overdose on treprostinil, you may experience nausea, vomiting, diarrhoea, low blood pressure (dizziness, light-headedness or fainting), skin flushes and/or headaches.

If any of these effects become severe then you should contact your doctor or hospital immediately. Your doctor may reduce or discontinue the infusion until your symptoms have disappeared. Treprostinil Tillomed solution for infusion will then be reintroduced at a dose level recommended by your doctor.

If you stop using Treprostinil Tillomed

Always use Treprostinil Tillomed as directed by your doctor or hospital specialist. Do not stop using treprostinil unless your doctor has advised you to.

Abrupt withdrawal or sudden reductions in the dose of treprostinil may cause the pulmonary arterial hypertension to return with the potential for rapid and severe deterioration in your condition.

If you have any further questions on the use of this product, ask your doctor.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Very common side effects (may affect more than 1 in 10 people)

  • widening of blood vessels with flushing of the skin
  • pain or tenderness around the infusion site
  • skin discolouration or bruising around the infusion site
  • headaches
  • skin rashes
  • nausea
  • diarrhoea
  • jaw pain

Common side effects (may affect up to 1 in 10 people)

  • dizziness
  • being sick (vomiting)
  • light-headedness or fainting due to low blood pressure
  • itching or redness of the skin
  • swelling of feet, ankles, legs or fluid retention
  • bleeding episodes such as nose bleeds, coughing up blood, blood in the urine, bleeding from the gums, blood in the faeces
  • joint pain (arthralgia)
  • muscle pain (myalgia)
  • pain in the legs and/or arms

Other possible side-effects

Not known (frequency cannot be estimated from the available data)

  • infection at the infusion site
  • abscess at the infusion site
  • a decrease of blood clotting cells (platelets) in the blood (thrombocytopenia)
  • bleeding at the infusion site
  • bone pain
  • skin rashes with discolouration or raised bumps (maculopapular rashes)
  • tissue infection under the skin (cellulitis)
  • too much pumping of blood from the heart leading to shortness of breath, fatigue, swelling of the legs and abdomen due to fluid build-up, persistent cough

Additional side-effects associated with the intravenous route of administration

  • inflammation of the vein (thrombophlebitis)
  • blood stream bacterial infection (bacteraemia)* (refer to Section 3)
  • septicaemia (severe blood bacterial infection)

*life-threatening or fatal cases of blood stream bacterial infection have been reported

Reporting of side effects

If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Treprostinil Tillomed

Keep this medicine out of the sight and reach of children.

This medicinal product does not require any special storage conditions.

Do not use this medicine after the expiry date, which is stated on the carton and vial after ‘EXP’. The expiry date refers to the last day of that month.

Do not use Treprostinil Tillomed if you notice any damage to the vial, discolouration or other signs of deterioration.

A treprostinil vial must be used or discarded within 30 days after first opening.

During continuous subcutaneous infusion, a single reservoir (syringe) of undiluted treprostinil must be used within 72 hours.

During continuous intravenous infusion using external portable pumps, a single reservoir (syringe) of diluted treprostinil must be used within 24 hours.

Any remaining diluted solution should be discarded.

For instructions on use please refer to Section 3 "How to use Treprostinil Tillomed".

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use.These measures will help to protect the environment.

6. Contents of the pack and other information
What Treprostinil Tillomed contains

The active substance is treprostinil 1 mg/ml, 2.5 mg/ml, 5 mg/ml, 10 mg/ml.

The other ingredients in Treprostinil Tillomed are:

Sodium chloride, metacresol, sodium citrate, sodium hydroxide, hydrochloric acid; concentrated, water for injection.

What Treprostinil Tillomed looks like and contents of the pack

Treprostinil Tillomed 1 mg/ml solution for infusion

Clear colourless to slightly yellow solution, practically free from visible particles filled in 20 ml clear glass vial stoppered with 20 mm dark grey bromobutyl rubber stopper with four marks equally spaced 90° apart and with ring at the centre and sealed with 20 mm yellow matte finish flip-off seal.

Treprostinil Tillomed 2.5 mg/ml solution for infusion

Clear colourless to slightly yellow solution, practically free from visible particles filled in 20 ml clear glass vial stoppered with 20 mm dark grey bromobutyl rubber stopper with four marks equally spaced 90° apart and with ring at the centre and sealed with 20 mm blue matte finish flip-off seal.

Treprostinil Tillomed 5 mg/ml solution for infusion

Clear colourless to slightly yellow solution, practically free from visible particles filled in 20 ml clear glass vial stoppered with 20 mm dark grey bromobutyl rubber stopper with four marks equally spaced 90° apart and with ring at the centre and sealed with 20 mm green matte finish flip-off seal.

Treprostinil Tillomed 10 mg/ml solution for infusion

Clear colourless to slightly yellow solution, practically free from visible particles filled in 20 ml clear glass vial stoppered with 20 mm dark grey bromobutyl rubber stopper with four marks equally spaced 90° apart and with ring at the centre and sealed with 20 mm red matte finish flip-off seal.

The vials are packaged in an outer carton.

Pack size: 1 vial/pack

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

Tillomed Laboratories Limited
220 Butterfield, Great Marlings
Luton
LU2 8DL
United Kingdom

Manufacturer

MIAS Pharma Limited
Suite 2
Stafford House
Strand Road
Portmarnock
Co. Dublin
Ireland

Tillomed Laboratories Limited
220 Butterfield
Great Marlings
Luton
LU2 8DL
United Kingdom

This leaflet was last revised in 11/2023

Company Contact Details
Tillomed Laboratories Ltd
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Telephone

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