Monday, October 3, 2016

Pabrinex Intravenous High Potency Injection





1. Name Of The Medicinal Product



Pabrinex Intravenous High Potency, Solution for injection


2. Qualitative And Quantitative Composition



Each presentation (carton) contains either 5ml or 10ml ampoules. Each pair of ampoules to be used in treatment is labelled Pabrinex No 1 and Pabrinex No 2.



























Each No 1 ampoule contains:

5ml ampoule

10ml ampoule

Thiamine Hydrochloride BP

250mg

500mg

Riboflavin (as Phosphate Sodium BP)

4mg

8mg

Pyridoxine Hydrochloride BP

50mg

100mg

Each No 2 ampoule contains:

5ml ampoule

10ml ampoule

Ascorbic Acid BP

500mg

1000mg

Nicotinamide BP

160mg

320mg

Anhydrous Glucose BP

1000mg

2000mg


For a full list of excipients, see section 6.1.



3. Pharmaceutical Form



Solution for injection



4. Clinical Particulars



4.1 Therapeutic Indications



Rapid therapy of severe depletion or malabsorption of the water soluble vitamins B and C, particularly in alcoholism, where a severe depletion of thiamine can lead to Wernicke's encephalopathy; after acute infections, post-operatively and in psychiatric states. Also used to maintain levels of vitamin B and C in patients on chronic intermittent haemodialysis.



4.2 Posology And Method Of Administration



Pabrinex is also available as an Intramuscular High Potency Injection. Therefore before administration, ensure that both the Summary of Product Characteristics and ampoule labels refer to the INTRAVENOUS injection.



1) The preferred method of administration of Pabrinex Intravenous High Potency is by drip infusion. Equal volumes of the contents of ampoules number 1 and 2 should be added to 50ml to 100ml physiological saline or glucose 5% and infused over 30 minutes (see “Special Precautions for Storage” section).



2) For a combined injection volume of not more than 10ml (e.g. the contents of one 5ml ampoule number 1 and one 5ml ampoule number 2) the contents of the ampoules are drawn up into a syringe to mix them just before use, then injected slowly, over a period of 10 minutes, into a vein.



Adults:


















Rapid therapy of severe depletion or malabsorption of the water soluble vitamins B and C, particularly in alcoholism, where a severe depletion of thiamine can lead to Wernicke's encephalopathy
  


10ml solution from Ampoule



Number 1



PLUS


10ml solution from Ampoule



Number 2




OR


  


15ml solution from Ampoule



Number 1



PLUS


15ml solution from Ampoule



Number 2




2 to 3 pairs of 5ml ampoules* (1 pair = ampoule 1 + ampoule 2) diluted with 50ml to 100ml infusion solution (physiological saline or glucose 5%) and administered over 30 minutes every 8 hours, or at the discretion of the physician.



* or equivalent volume of 5ml and/or 10ml ampoules


  










Psychosis following narcosis or E.C.T; toxicity from acute infections
  


5ml Ampoule Number 1



PLUS


5ml Ampoule Number 2




10ml of the mixed ampoules diluted with 50ml to 100ml infusion solution (physiological saline or glucose 5%) administered over 15 to 30 minutes twice daily for up to 7 days.


  










Haemodialysis
  


5ml Ampoule Number 1



PLUS


5ml Ampoule Number 2




10ml of the mixed ampoules diluted with 50ml to 100ml infusion solution (physiological saline or glucose 5%) administered over 15 to 30 minutes once every two weeks at the end of dialysis.


  


Elderly: as for adults.



Children: Pabrinex Intravenous High Potency is rarely indicated for administration to children, however suitable doses are as follows:











Under 6 years

quarter of the adult dose

6 - 10 years

third of the adult dose

10 - 14 years

half to two thirds of the adult dose

14 years and over

as for the adult dose


4.3 Contraindications



Known hypersensitivity to any of the active constituents or to the excipients.



4.4 Special Warnings And Precautions For Use



Although potentially serious allergic adverse reactions such as anaphylactic shock may occur rarely during, or shortly after, parenteral administration of Pabrinex, such rare occurrence of serious allergic reactions should not preclude the use of Pabrinex in patients who need treatment by this route of administration particularly those at risk of Wernicke's encephalopathy - for whom treatment with parenteral thiamine is essential. Initial warning signs of a reaction to Pabrinex are sneezing or mild asthma and those treating patients need to note that the administration of further injections to such patients may give rise to anaphylactic shock. Facilities for treating anaphylactic reactions should be available whenever Pabrinex Intravenous High Potency is administered. To minimise the risk of such events with Pabrinex Intravenous High Potency, the preferred mode of administration is by infusion over a period of 30 minutes.



This medicine is for injection into a vein only and should not be given by any other route



Care should be taken to ensure that the route of administration used (intramuscular or intravenous) is that intended – reports of unintentional administration by the wrong route have been received; these incidents have not been associated with serious adverse reactions.



4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction



The content of pyridoxine may interfere with the effects of concurrent levodopa therapy.



4.6 Pregnancy And Lactation



No adverse effects have been noted at recommended doses when used as clinically indicated.



However animal studies are insufficient with respect to effects on pregnancy/ and-or/ embryonal/foetal development/ and-or/ parturition/ and-or/ postnatal development (see section 5.3). The potential risk for humans is unknown.



Caution should be exercised when prescribing to pregnant women.



4.7 Effects On Ability To Drive And Use Machines



No studies on the effects on the ability to drive and use machines have been performed. However given the nature of the product, no effects are anticipated.



4.8 Undesirable Effects



Occasionally, hypotension and mild paraesthesia from continued high doses of thiamine; occasionally mild ache at local site of injection.



4.9 Overdose



In the unlikely event of overdosage, treatment is symptomatic and supportive.



5. Pharmacological Properties



5.1 Pharmacodynamic Properties



Pabrinex Intravenous High Potency contains vitamins B1, B2, B6, nicotinamide, vitamin C and glucose.



ATC code: A11EB



5.2 Pharmacokinetic Properties



Not supplied.



5.3 Preclinical Safety Data



There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the Summary of Product Characteristics.



6. Pharmaceutical Particulars



6.1 List Of Excipients



Edetic acid



Sodium hydroxide



Water for Injections



6.2 Incompatibilities



If it is necessary to administer Pabrinex Intravenous High Potency in infusion, it is recommended that Pabrinex IV HP is administered in physiological saline or glucose 5%.



6.3 Shelf Life



24 months.



6.4 Special Precautions For Storage



Do not store above 25°C. Keep the container in the outer carton. Do not freeze.



Storage of diluted Pabrinex Intravenous High Potency



The stability of Pabrinex Intravenous High Potency in intravenous infusion fluids, at room temperature, is as follows:
















Intravenous infusion fluid




In the light




Glucose 5%




7 hours




Physiological saline (sodium chloride 0.9%)




7 hours




Glucose 4.3% with sodium chloride 0.18%




4 hours




Glucose 5% with potassium chloride 0.3%




4 hours




Sodium lactate M/6




7 hours



Although no further specific data are available, the solutions are expected to be stable for longer periods when protected from light. Store diluted solutions at 2°C to 8°C if not used immediately. Do not freeze.



6.5 Nature And Contents Of Container



Pabrinex Intravenous High Potency is supplied in pairs of amber glass ampoules of 5ml or 10ml. Pack sizes contain ten pairs of 5ml or five pairs of 10ml ampoules.



6.6 Special Precautions For Disposal And Other Handling



In common with all parenteral products each ampoule should be visually inspected prior to administration and should not be used if particulates are present.



7. Marketing Authorisation Holder



Archimedes Pharma UK Limited



250 South Oak Way



Green Park



Reading



Berkshire



RG2 6UG



UK



8. Marketing Authorisation Number(S)



PL 12406/0003



9. Date Of First Authorisation/Renewal Of The Authorisation



Date of first authorisation: October 1993



Date of the latest renewal: October 2003



10. Date Of Revision Of The Text



22 July 2010




No comments:

Post a Comment