What Extavia contains
- The active substance is interferon beta-1b. Each vial contains 300 microgram (9.6 million IU) interferon beta-1b per vial. After reconstitution, each millilitre contains 250 microgram (8 million IU) interferon beta-1b.
- The other ingredients are
- in the powder: mannitol and human albumin.
- in the solvent: sodium chloride, water for injections.
What Extavia looks like and contents of the pack
Extavia is a powder and solvent for solution for injection.
The powder is white to off-white.
The Extavia powder is provided in a 3-millilitre vial.
The solvent for Extavia is provided in a 1.2 ml pre-filled syringe and contains 1.2 ml sodium chloride 5.4 mg/ml (0.54% (w/v)) solution for injection.
Extavia is available in pack sizes of:
- 5 vials of interferon beta-1b and 5 pre-filled syringes containing solvent.
- 14 vials of interferon beta-1b and 14 pre-filled syringes containing solvent.
- 15 vials of interferon beta-1b and 15 pre-filled syringes containing solvent.
- 3-month multipack containing 42 (3x14) vials of interferon beta-1b and 42 (3x14) pre-filled syringes containing solvent.
- 3-month multipack containing 45 (3x15) vials of interferon beta-1b and 45 (3x15) pre-filled syringes containing solvent.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Novartis Europharm Limited
Wimblehurst Road
Horsham
West Sussex, RH12 5AB
United Kingdom
Manufacturer
Novartis Pharmaceuticals UK, Limited
Wimblehurst Road
Horsham
West Sussex, RH12 5AB
United Kingdom
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
BelgiëBelgiqueBelgien Novartis Pharma N.V. TélTel 32 2 246 16 11 LuxembourgLuxemburg Novartis Pharma GmbH TélTel 49 911 273 0
Novartis Pharma Services Inc. . 359 2 489 98 28 Magyarország Novartis Hungária Kft. Pharma Tel. 36 1 457 65 00
eská republika Novartis s.r.o. Tel 420 225 775 111 Malta Novartis Pharma Services Inc. Tel 356 2298 3217
Danmark Novartis Healthcare AS Tlf 45 39 16 84 00 Nederland Novartis Pharma B.V. Tel 31 26 37 82 111
Deutschland Novartis Pharma GmbH Tel 49 911 273 0 Norge Novartis Norge AS Tlf 47 23 05 20 00
Eesti Novartis Pharma Services Inc. Tel 372 66 30 810 Österreich Novartis Pharma GmbH Tel 43 1 86 6570
Novartis Hellas A.E.B.E. 30 210 281 17 12 Polska Novartis Poland Sp. z o.o. Tel. 48 22 550 8888
España Novartis Farmacéutica, S.A. Tel 34 93 306 42 00 Portugal Novartis Farma - Produtos Farmacêuticos, S.A. Tel 351 21 000 8600
France Novartis Pharma S.A.S. Tél 33 1 55 47 66 00 România Novartis Pharma Services Inc. Tel 40 21 31299 01
Ireland Novartis Ireland Limited Tel 353 1 260 12 55 Slovenija Novartis Pharma Services Inc. Tel 386 1 300 75 50
Ísland Vistor hf. Sími 354 535 7000 Slovenská republika Novartis Slovakia s.r.o. Tel 421 2 5542 5439
Italia Novartis Farma S.p.A. Tel 39 02 96 54 1 SuomiFinland Novartis Finland Oy PuhTel 358 010 6133 200
Novartis Pharma Services Inc. 357 22 690 690 Sverige Novartis Sverige AB Tel 46 8 732 32 00
Latvija Novartis Pharma Services Inc. Tel 371 67 887 070 United Kingdom Novartis Pharmaceuticals UK Ltd. Tel 44 1276 698370
Lietuva
Novartis Pharma Services Inc.
Tel: +370 5 269 16 50
This leaflet was last approved in
Annex: SELF-INJECTION PROCEDURE
The following instructions are intended to explain how to prepare Extavia for administration and how to inject Extavia yourself. Please read the instructions carefully and follow them step by step. Your doctor or his/her assistant will help you to learn the process of self-administration. Do not attempt to inject yourself until you are sure that you understand how to prepare the injection solution and give the injection to yourself.
PART I: STEP BY STEP INSTRUCTIONS
The instructions include the following main steps:
A) General advice
B) Getting ready to inject
C) Reconstituting the solution, step by step
D) Drawing up the injection
E) Making the injection manually (to make an injection with an auto-injector, refer to the instructions for use provided with the auto-injector)
F) Quick review of the process
A) General advice
- Getting off to a good start!
You will find that within a few weeks your treatment will become a natural part of your routine. As you get started, you may find the following tips helpful:
- Set up a permanent storage area in a convenient location out of the reach of children so that your Extavia and other supplies are always easy to find. For details on storage conditions see section 5 of the leaflet, ?How to store Extavia?.
- Try to give yourself the injection at the same time each day. This makes it easier to remember and easier to plan a block of time when you will not be interrupted. Please refer to section 3 of the leaflet, ?How to use Extavia?, for further details on how to use Extavia.
- Prepare each dose only when you are ready for an injection. After mixing Extavia, you should administer the injection immediately (if Extavia is not used immediately, see section 5 of the leaflet, ?How to store Extavia?).
- Important tips to keep in mind
- Be consistent - use Extavia as described in section 3 of the leaflet, ?How to use Extavia?. Always double-check your dosage.
- Keep your syringes and syringe disposal unit out of the reach of children; lock the supplies if possible.
- Never re-use syringes or needles.
- Always use a sterile (aseptic) technique as described in here.
- Always place the used syringes in the proper disposal unit.
B) Getting ready to inject
- Choosing an injection site
Before preparing your injection, decide where you are going to inject. You should inject Extavia into the fatty layer between the skin and muscle (that is, subcutaneously, about 8 to 12 mm under the skin). The best places for injections are where the skin is loose and soft, and away from joints, nerves, bones, for example the abdomen, arm, thigh or buttocks.
Important: Do not use any area where you can feel lumps, bumps, firm knots, pain or an area that is discoloured, indented, scabbed, or where the skin is broken. Talk to your doctor or healthcare professional about these or any other unusual conditions you may find.
You should rotate the injection site at every injection. If some areas are too difficult for you to reach, you may need a family member or friend to help you with these injections. Follow the sequence described in the schedule at the end of the Annex (see II) Rotating injection sites) and you will come back to your first injection site area after 8 injections (16 days). This will give each injection site a chance to fully recover before receiving another injection.
Please refer to the rotation schedule at the end of this Annex to learn how to choose an injection site. An example of a medication record is also included. This should give you an idea of how you can keep track of your injection sites and dates.
You will need the medicine:
- 1 Extavia vial (with powder for solution for injection)
- 1 pre-filled syringe of solvent for Extavia (sodium chloride solution (0.54% (w/v))
To reconstitute and inject your medicine you will need the following components:
- a needle suitable for reconstitution
- 30-gauge needle for injection
- alcohol wipes You will also need a disposal unit for used syringes and needles.
Alternatively, you can use an application kit for the administration of Extavia (supplied separately from your medicine), which contains vial adapters for reconstituting your medicine, 30-gauge needles for injecting your medicine and alcohol wipes, as well as instructions on how to use these components.
The 30-gauge needles provided with the application kit for the administration of Extavia can be used either for manual injection OR with an ExtaviJect 30G auto-injector.
For skin disinfection use an appropriate disinfectant.
C) Reconstituting the solution, step by step
1 - Wash your hands thoroughly with soap and water before beginning this process.
2 - Open the Extavia vial and put it on the table. It is best to use your thumb rather than your nail as it could break.
3 - Clean the top of the vial with an alcohol wipe, moving the wipe in one direction only. Leave the wipe on top of the vial.
4 ? Take out the pre-filled solvent syringe from its package. Remove the tip cap from the pre-filled syringe by twisting it off. Be careful not to touch the exposed end of the syringe. Do not push the plunger.
5 - Take the needle suitable for reconstitution out of its wrapping and place it firmly onto the tip (nozzle) of the syringe. Remove the needle guard from the needle. Do not touch the needle.
6 - Holding the Extavia vial on a stable surface, slowly insert the needle of the syringe (containing 1.2 ml of liquid) all the way through the stopper of the vial.
7 - Push the plunger down slowly, directing the needle toward the side of the vial to allow the liquid to run down the inside of the vial.
Injecting solvent directly onto the powder will cause excess foaming.
Transfer all the solvent to the vial. Release the plunger.
8 - After the solvent in the syringe has been completely injected into the Extavia vial, hold the vial between your thumb, forefinger and middle finger with the needle and syringe resting against your hand and swirl the vial gently to completely dissolve the powder of Extavia.
Do not shake the vial.
9 - Examine the solution carefully. It should be clear and contain no particles. If the solution is discoloured or contains particles, discard it and start again with a syringe and vial out of your package.
If foam is present ?- which can happen if the vial is shaken or swirled too vigorously ? let the vial sit undisturbed until the foam settles.
D) Drawing up the solution for injection
10 - In order to redraw the solution back into the syringe, turn the syringe-vial-assembly, needle pointing upwards. Redraw the needle a little bit back within the vial so that the needle tip rests at the lowest point of the vial.
Keep the needle tip in the liquid, and slowly pull the plunger back all the way to withdraw the solution into the syringe.
11 - Any excessive air rises to the top of the solution. Remove the air bubbles by gently tapping the syringe and pushing the plunger to the 1 ml mark, or to the volume prescribed by your doctor.
If too much solution goes into the vial along with the air bubbles, pull the plunger back a little to withdraw the solution back from the vial into the syringe. Do this until all the air is gone and there is 1 ml of reconstituted solution in the syringe.
12 - Disconnect the syringe and the needle. Leave the needle in the vial.
13 - Take the 30-gauge needle out of its wrapping and place it firmly onto the tip (nozzle) of the syringe.
14 - Dispose of the vial and the remaining unused portion of the solution into the disposal unit.
15 - You are now ready to inject.
If, for some reason, you are not able to inject Extavia immediately, you can keep the reconstituted solution in the syringe in a refrigerator for up to 3 hours before using. Make sure the needle cap is fixed properly while the syringe is stored in the fridge. Do not freeze the solution, and do not wait longer than 3 hours to inject it. If more than 3 hours pass, discard the medicine and prepare a new injection. When you use the solution, warm it up in your hands before injecting to avoid pain.
E) Making the injection manually (to make an injection with an auto-injector, refer to the instructions for use provided with the auto-injector)
1 - Choose an area for the injection (see advice at the start and the diagrams at the end of this Annex), and make a note of it in your medication record.
2 - Use an alcohol swab to clean the skin at the injection site. Let the skin air-dry. Throw the swab away. For skin disinfection use an appropriate disinfectant. 3 - Remove the cap from the needle by pulling and not twisting it.
4 - Gently pinch the skin together around the disinfected injection site to raise it up a little. 5 - Holding the syringe like a pencil or a dart, push the needle straight into the skin at a 90 angle with a quick, firm motion. 6 - Inject the medicine using a slow, steady push on the plunger. Push the plunger all the way in until the syringe is empty.
7 - Discard the syringe in the disposal unit.
F) Quick review of the process
1. Take out the contents needed (1 vial, 1 pre-filled syringe, 2 alcohol wipes, needle suitable for reconstitution, 30-gauge needle for injection).
2. Take off the cap from the vial and clean the rubber stopper with an alcohol wipe.
3. Unwrap the needle suitable for reconstitution and fix it to the syringe from which you removed the tip cap before.
4. Transfer the solvent from the syringe to the vial by pushing the plunger in all the way.
5. Turn the syringe-vial-assembly over, then withdraw plunger to redraw the solution.
6. Disconnect syringe and needle, leave the needle in the vial and discard both.
7. Unwrap the 30-gauge needle and connect it to the syringe.
8. Remove needle cap just before injection - you are now ready to inject.
NOTE: The injection should be administered immediately after mixing (if the injection is delayed, refrigerate the solution and inject it within 3 hours). Do not freeze.
PART II ROTATING INJECTION SITES
You need to choose a new site for each injection to allow the area time to recover and help prevent infection. Advice on which areas to choose is given in the first part of this Annex. It is a good idea to know where you plan to inject before you prepare your syringe. The schedule shown in the diagram below will help you to vary the sites appropriately. For example, give the first injection into the right side of the abdomen, choose the left side for the second injection, then move to the right thigh for the third, and so on through the diagram until all suitable areas of the body have been used. Keep a record of where and when you last gave yourself an injection. One way to do that is to note the injection site on the enclosed medication record card.
By following this schedule, you will come back to your first area (e.g. the right side of the abdomen) after 8 injections (16 days). This is called a Rotation Cycle. On our example schedule each area is split again into 6 injection sites (which adds up to 48 injection sites altogether), left, right, upper, middle and lower part of each area. If you come back to an area after one Rotation Cycle choose the most distant injection site within this area. If an area becomes sore, talk to your doctor or nurse about choosing other injection sites.
Rotation Schedule
To help you rotate the injection sites appropriately we recommend that you keep a record of the date and location of your injection. You can use the following rotation schedule.
Work through each rotation cycle in turn. Each cycle will be 8 injections (16 days), given in area 1 through to area 8 in turn. By following this sequence, you will give each area a chance to recover before receiving another injection.
Rotation Cycle 1 Rotation Cycle 2 Rotation Cycle 3 Rotation Cycle 4 Rotation Cycle 5 Rotation Cycle 6 Upper left section of each area Lower right section of each area Middle left section of each area Upper right section of each area Lower left section of each area Middle right section of each area
PART III: EXTAVIAMedication record
Instructions for keeping track of your injection sites and dates
- Start with your first injection (or your last injection if you are not a new Extavia user).
- Select an injection site. If you have already been using Extavia start with the area that has not been used during the last rotation cycle, i.e. the past 16 days).
- After your injection, fill in the used injection site and date in the table in your injection record (See the example: Keeping track of your injection sites and dates).
ROTATION SCHEDULE:
AREA 1 AREA 2 AREA 3 AREA 4 10 15 cm from groin AREA 5 AREA 6 AREA 8 AREA 7
EXAMPLE OF A MEDICATION RECORD: