Quest for the right Drug
ויואנס 30 מ"ג VYVANSE 30 MG (LISDEXAMFETAMINE DIMESYLATE)
תרופה במרשם
תרופה בסל
נרקוטיקה
ציטוטוקסיקה
צורת מתן:
פומי : PER OS
צורת מינון:
קפסולות : CAPSULES
עלון לרופא
מינוניםPosology התוויות
Indications תופעות לוואי
Adverse reactions התוויות נגד
Contraindications אינטראקציות
Interactions מינון יתר
Overdose הריון/הנקה
Pregnancy & Lactation אוכלוסיות מיוחדות
Special populations תכונות פרמקולוגיות
Pharmacological properties מידע רוקחי
Pharmaceutical particulars אזהרת שימוש
Special Warning עלון לרופא
Physicians Leaflet
Adverse reactions : תופעות לוואי
6 ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling: • Known hypersensitivity to amphetamine products or other ingredients of VYVANSE [see Contraindications (4)] • Hypertensive Crisis When Used Concomitantly with Monoamine Oxidase Inhibitors [see Contraindications (4) and Drug Interactions (7.1)] • Abuse,Misuse and Addiction[see Boxed Warning, Warnings and Precautions (5.1), and Drug Abuse and Dependence (9.2, 9.3)] • Risks to Patients with Serious Cardiac Disease[see Warnings and Precautions (5.2)] • Increase Blood Pressure and Heart Rate [see Warnings and Precautions (5.3)] • Psychiatric Adverse Reactions [see Warnings and Precautions (5.4)] • Long-Term Suppression of Growth in Pediatric Patients [see Warnings and Precautions (5.5)] • Peripheral Vasculopathy, including Raynaud's phenomenon [see Warnings and Precautions (5.6)] • Serotonin Syndrome [see Warnings and Precautions (5.7)] • Motor and Verbal Tics, and Worsening of Tourette’s Syndrome [see Warnings and Precautions (5.8)] 6.1 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 practice. Attention Deficit Hyperactivity Disorder The safety data in this section is based on data from the 4-week controlled parallel-group clinical studies of VYVANSE in pediatric and adult patients with ADHD [see Clinical Studies (14.1)]. Adverse Reactions Associated with Discontinuation of Treatment in ADHD Clinical Trials In the controlled trial in pediatric patients ages 6 to 12 years (Study 1), 8% (18/218) of VYVANSE- treated patients discontinued due to adverse reactions compared to 0% (0/72) of placebo-treated patients. The most frequently reported adverse reactions (1% or more and twice rate of placebo) were ECG voltage criteria for ventricular hypertrophy, tic, vomiting, psychomotor hyperactivity, insomnia, and rash [2 instances for each adverse reaction, i.e., 2/218 (1%)]. Less frequently reported adverse reactions (less than 1% or less than twice rate of placebo) included abdominal pain upper, dry mouth, weight decreased, dizziness, somnolence, logorrhea, chest pain, anger and hypertension. In the controlled trial in pediatric patients ages 13 to 17 years (Study 4), 3% (7/233) of VYVANSE- treated patients discontinued due to adverse reactions compared to 1% (1/77) of placebo-treated patients. The most frequently reported adverse reactions (1% or more and twice rate of placebo) were decreased appetite (2/233; 1%) and insomnia (2/233; 1%). Less frequently reported adverse reactions (less than 1% or less than twice rate of placebo) included irritability, dermatillomania, mood swings, and dyspnea. In the controlled adult trial (Study 7), 6% (21/358) of VYVANSE-treated patients discontinued due to adverse reactions compared to 2% (1/62) of placebo-treated patients. The most frequently reported adverse reactions (1% or more and twice rate of placebo) were insomnia (8/358; 2%), tachycardia (3/358; 1%), irritability (2/358; 1%), hypertension (4/358; 1%), headache (2/358; 1%), anxiety (2/358; 1%), and dyspnea (3/358; 1%). Less frequently reported adverse reactions (less than 1% or less than twice rate of placebo) included palpitations, diarrhea, nausea, decreased appetite, dizziness, agitation, depression, paranoia and restlessness. Adverse Reactions Occurring at an Incidence of ≥5% or More Among VYVANSE Treated Patients with ADHD in Clinical Trials The most common adverse reactions (incidence ≥5% and at a rate at least twice placebo) reported in pediatric patients ages 6 to 17 years, and/or adults were anorexia, anxiety, decreased appetite, decreased weight, diarrhea, dizziness, dry mouth, irritability, insomnia, nausea, upper abdominal pain, and vomiting. Adverse Reactions Occurring at an Incidence of 2% or More Among VYVANSE Treated Patients with ADHD in Clinical Trials Adverse reactions reported in the controlled trials in pediatric patients ages, 6 to 12 years (Study 1), pediatric patients ages 13 to 17 years (Study 4), and adult patients (Study 7) treated with VYVANSE or placebo are presented in Tables 1, 2, and 3 below. Table 1 Adverse Reactions Reported by 2% or More of Pediatric Patients Ages 6 to 12 Years with ADHD Taking VYVANSE and Greater than or Equal to Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 1) VYVANSE Placebo (n=218) (n=72) Decreased Appetite 39% 4% Insomnia 23% 3% Abdominal Pain Upper 12% 6% Irritability 10% 0% Vomiting 9% 4% Weight Decreased 9% 1% Nausea 6% 3% Dry Mouth 5% 0% Dizziness 5% 0% Affect lability 3% 0% Rash 3% 0% Pyrexia 2% 1% Somnolence 2% 1% Tic 2% 0% Anorexia 2% 0% Table 2 Adverse Reactions Reported by 2% or More of Pediatric Patients Ages 13 to 17 Years with ADHD Taking VYVANSE and Greater than or Equal to Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 4) VYVANSE Placebo (n=233) (n=77) Decreased Appetite 34% 3% Insomnia 13% 4% Weight Decreased 9% 0% Dry Mouth 4% 1% Palpitations 2% 1% Anorexia 2% 0% Tremor 2% 0% Table 3 Adverse Reactions Reported by 2% or More of Adult Patients with ADHD Taking VYVANSE and Greater than or Equal to Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 7) VYVANSE Placebo (n=358) (n=62) Decreased Appetite 27% 2% Insomnia 27% 8% Dry Mouth 26% 3% Diarrhea 7% 0% Nausea 7% 0% Anxiety 6% 0% Anorexia 5% 0% Feeling Jittery 4% 0% Agitation 3% 0% Increased Blood Pressure 3% 0% Hyperhidrosis 3% 0% Restlessness 3% 0% Decreased Weight 3% 0% Dyspnea 2% 0% Increased Heart Rate 2% 0% Tremor 2% 0% Palpitations 2% 0% In addition, in the adult population erectile dysfunction was observed in 2.6% of males on VYVANSE and 0% on placebo; decreased libido was observed in 1.4% of subjects on VYVANSE and 0% on placebo. Weight Loss and Slowing Growth Rate in Pediatric Patients with ADHD In a controlled trial of VYVANSE in pediatric patients ages 6 to 12 years (Study 1), mean weight loss from baseline after 4 weeks of therapy was -0.9, -1.9, and -2.5 pounds, respectively, for patients receiving 30 mg, 50 mg, and 70 mg of VYVANSE, compared to a 1 pound weight gain for patients receiving placebo. Higher doses were associated with greater weight loss with 4 weeks of treatment. Careful follow-up for weight in pediatric patients ages 6 to 12 years who received VYVANSE over 12 months suggests that consistently medicated pediatric patients (i.e. treatment for 7 days per week throughout the year) have a slowing in growth rate, measured by body weight as demonstrated by an age- and sex-normalized mean change from baseline in percentile, of -13.4 over 1 year (average percentiles at baseline and 12 months were 60.9 and 47.2, respectively). In a 4-week controlled trial of VYVANSE in pediatric patients ages 13 to 17 years, mean weight loss from baseline to endpoint was -2.7, -4.3, and -4.8 lbs., respectively, for patients receiving 30 mg, 50 mg, and 70 mg of VYVANSE, compared to a 2.0 pound weight gain for patients receiving placebo. Careful follow-up of weight and height in pediatric patients ages 7 to 10 years who were randomized to either methylphenidate or non-medication treatment groups over 14 months, as well as in naturalistic subgroups of newly methylphenidate-treated and non-medication treated pediatric patients over 36 months (to the ages of 10 to 13 years), suggests that consistently medicated pediatric patients ages 7 to 13 years (i.e. treatment for 7 days per week throughout the year) have a temporary slowing in growth rate (on average, a total of about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years), without evidence of growth rebound during this period of development. In a controlled trial of amphetamine (d- to l-enantiomer ratio of 3:1) in pediatric patients ages 13 to 17 years, mean weight change from baseline within the initial 4 weeks of therapy was -1.1 pounds and -2.8 pounds, respectively, for patients receiving 10 mg and 20 mg of amphetamine. Higher doses were associated with greater weight loss within the initial 4 weeks of treatment [see Warnings and Precautions (5.5)]. Weight Loss in Adults with ADHD In the controlled adult trial (Study 7), mean weight loss after 4 weeks of therapy was 2.8 pounds, 3.1 pounds, and 4.3 pounds, for patients receiving final doses of 30 mg, 50 mg, and 70 mg of VYVANSE, respectively, compared to a mean weight gain of 0.5 pounds for patients receiving placebo. Binge Eating Disorder The safety data in this section is based on data from two 12 week parallel group, flexible-dose, placebo- controlled studies in adults with BED [see Clinical Studies 14.2]. Patients with cardiovascular risk factors other than obesity and smoking were excluded. Adverse Reactions Associated with Discontinuation of Treatment in BED Clinical Trials In controlled trials of patients ages 18 to 55 years, 5.1% (19/373) of VYVANSE-treated patients discontinued due to adverse reactions compared to 2.4% (9/372) of placebo-treated patients. No single adverse reaction led to discontinuation in 1% or more of VYVANSE-treated patients. Less commonly reported adverse reactions (less than 1% or less than twice rate of placebo) included increased heart rate, headache, abdominal pain upper, dyspnea, rash, insomnia, irritability, feeling jittery and anxiety. Adverse Reactions Occurring at an Incidence of 5% or More and At Least Twice Placebo Among VYVANSE Treated Patients with BED in Clinical Trials The most common adverse reactions (incidence ≥5% and at a rate at least twice placebo) reported in adults were dry mouth, insomnia, decreased appetite, increased heart rate, constipation, feeling jittery, and anxiety. Adverse Reactions Occurring at an Incidence of 2% or More and At Least Twice Placebo Among VYVANSE Treated Patients with BED in Clinical Trials Adverse reactions reported in the pooled controlled trials in adult patients (Study 11 and 12) treated with VYVANSE or placebo are presented in Table 4 below. Table 4 Adverse Reactions Reported by 2% or More of Adult Patients with BED Taking VYVANSE and Greater than or Equal to Twice the Incidence in Patients Taking Placebo in 12-Week Clinical Trials (Study 11 and 12) VYVANSE Placebo (N=373) (N=372) Dry Mouth 36% 7% 1 Insomnia 20% 8% Decreased Appetite 8% 2% 2 Increased Heart Rate 7% 1% Feeling Jittery 6% 1% Constipation 6% 1% Anxiety 5% 1% Diarrhea 4% 2% Decreased Weight 4% 0% Hyperhidrosis 4% 0% Vomiting 2% 1% Gastroenteritis 2% 1% Paresthesia 2% 1% Pruritus 2% 1% Upper Abdominal Pain 2% 0% Energy Increased 2% 0% Urinary Tract Infection 2% 0% Nightmare 2% 0% Restlessness 2% 0% Oropharyngeal Pain 2% 0% 1 Includes all preferred terms containing the word “insomnia.” 2 Includes the preferred terms heart rate increased and tachycardia. 6.2 Postmarketing Experience The following adverse reactions have been identified during post -approval use of VYVANSE. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events are as follows: cardiomyopathy, mydriasis, diplopia, difficulties with visual accommodation, blurred vision, eosinophilic hepatitis, anaphylactic reaction, hypersensitivity, dyskinesia, dysgeusia,motor and verbal tics, bruxism, depression, dermatillomania, alopecia, aggression, Stevens-Johnson Syndrome, chest pain, angioedema, urticaria, seizures, libido changes, frequent or prolonged erections, constipation, rhabdomyolysis and intestinal ischemia. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Any suspected adverse events should be reported to the Ministry of Health according to the National Regulation by using an online form https://sideeffects.health.gov.il/
פרטי מסגרת הכללה בסל
א. הפרעת קשב וריכוז ADHD (Attention deficit hyperactivity disorder) בילדים כקו טיפול מתקדם לאחר מיצוי טיפול ב-Methylphenidate.מיצוי טיפול יוגדר כתגובה לא מספקת לטיפול בקו הראשון על פי הערכה קלינית שתתבצע על פי מדד ADHD RS IV (כישלון טיפולי יוגדר כציון מעל 28)Jain et al, Child and Adolescent Psychiatry and Mental Health 2011; 5: 35 או תופעות לוואי קשות בטיפול בקו הראשון - על פי שיקול דעתו של הרופא.במהלך מחלתו יהיה החולה זכאי לתרופה לאחת מהתרופות הבאות – Atomoxetine, Dextroamphetamine saccharate + Amphetamine aspartate + monohydrate dextroamphetamine sulfate + Amphetamine sulfate, Lisdexamfetamineהטיפול לא יינתן בשילוב עם Dextroamphetamine saccharate + Amphetamine aspartate + monohydrate dextroamphetamine sulfate + Amphetamine sulfateהתחלת הטיפול בתרופה ייעשה לפי מרשם של רופא מומחה בנוירולוגיה ילדים או רופא מומחה בפסיכיאטריה ילדים. ב. הפרעת קשב וריכוז במבוגרים עד גיל 28 שנים.ג. מבוגרים עם הפרעת אכילה בולמוסית (Binge eating disorder), בדרגה בינונית עד קשה, אשר מיצו טיפול פסיכולוגי התנהגותי וטיפול תרופתי, כגון תרופות ממשפחת ה-SSRIs.התחלת הטיפול בתרופה תיעשה על פי המלצת רופא מומחה בפסיכיאטריה.
מסגרת הכללה בסל
התוויות הכלולות במסגרת הסל
התוויה | תאריך הכללה | תחום קליני | Class Effect | מצב מחלה |
---|---|---|---|---|
א. הפרעת קשב וריכוז ADHD (Attention deficit hyperactivity disorder) בילדים כקו טיפול מתקדם לאחר מיצוי טיפול ב-Methylphenidate. מיצוי טיפול יוגדר כתגובה לא מספקת לטיפול בקו הראשון על פי הערכה קלינית שתתבצע על פי מדד ADHD RS IV (כישלון טיפולי יוגדר כציון מעל 28) Jain et al, Child and Adolescent Psychiatry and Mental Health 2011; 5: 35 או תופעות לוואי קשות בטיפול בקו הראשון - על פי שיקול דעתו של הרופא. במהלך מחלתו יהיה החולה זכאי לתרופה לאחת מהתרופות הבאות – Atomoxetine, Dextroamphetamine saccharate + Amphetamine aspartate + monohydrate dextroamphetamine sulfate + Amphetamine sulfate, Lisdexamfetamine הטיפול לא יינתן בשילוב עם Dextroamphetamine saccharate + Amphetamine aspartate + monohydrate dextroamphetamine sulfate + Amphetamine sulfate התחלת הטיפול בתרופה ייעשה לפי מרשם של רופא מומחה בנוירולוגיה ילדים או רופא מומחה בפסיכיאטריה ילדים. | 01/08/2024 | נוירולוגיה | ADHD (Attention deficit hyperactivity disorder) | |
מבוגרים עם הפרעת אכילה בולמוסית (Binge eating disorder), בדרגה בינונית עד קשה, אשר מיצו טיפול פסיכולוגי התנהגותי וטיפול תרופתי, כגון תרופות ממשפחת ה-SSRIs. התחלת הטיפול בתרופה תיעשה על פי המלצת רופא מומחה בפסיכיאטריה | 01/08/2024 | נוירולוגיה | הפרעת אכילה בולמוסית (Binge eating disorder), | |
הפרעת קשב וריכוז במבוגרים עד גיל 28 שנים. | 01/08/2024 | נוירולוגיה | הפרעת קשב וריכוז ADHD (Attention deficit hyperactivity disorder) |
שימוש לפי פנקס קופ''ח כללית 1994
לא צוין
תאריך הכללה מקורי בסל
01/08/2024
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