Cerliponase alfa (intracerebroventricular route)


    Brand Name

    US Brand Name

    Brineura


    Description

    Cerliponase alfa injection is used to treat neuronal ceroid lipofuscinosis type 2 (CLN2) or tripeptidyl peptidase 1 (TPP1) deficiency. It helps slow down the loss of walking ability in children.

    This medicine is to be given only by or under the direct supervision of your doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of cerliponase alfa injection in children. Use is not recommended in children younger than 37 weeks post-menstrual age or weighing less than 2.5 kilograms (kg). Children younger than 3 years of age may have an increased risk for allergic reactions to this medicine compared to children 3 years of age and older.

    Geriatric

    No information is available on the relationship of age to the effects of cerliponase alfa injection in geriatric patients.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Acute intraventricular access device problems (eg, leakage, extravasation of fluid, failure) or
    • Infection (eg, meningitis) or
    • Infection on or around the device insertion site (eg, cellulitis), acute or uncorrected or
    • Ventriculoperitoneal shunt (a medical device that relieves pressure on the brain)—Should not be used in patients with these conditions.
    • Bradycardia (slow heartbeat), history of or
    • Heart disease, history of or
    • Heart rhythm problems, history of or
    • Hypotension (low blood pressure), history of—Use with caution. May make these conditions worse.

    Proper Use

    A doctor or other trained health professional will give you this medicine in a medical facility. It is injected into the cerebrospinal fluid using an infusion pump system through a tube placed inside your head.

    Your doctor may also give you other medicines (eg, allergy medicines, fever medicines, steroids) 30 to 60 minutes before you receive cerliponase alfa injection to help prevent unwanted effects.

    Missed Dose

    Call your doctor or pharmacist for instructions.


    Precautions

    It is very important that your doctor check your or your child's progress closely and at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

    This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you or your child start to have a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of the hands, face, or mouth after receiving this medicine.

    This medicine may increase your risk of infections in your brain or nerves (eg, meningitis) or on or around the device insertion site on your head (eg, cellulitis). If you have fever, headache, nausea, vomiting, and a stiff neck or back, or pain, redness, or swelling at the insertion site while receiving this medicine, check with your doctor right away.

    This medicine may worsen the condition of patients with a history of heart disease or heart rhythm problems. Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme tiredness or weakness, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, troubled breathing, or weight gain. You might also feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat.

    This medicine may cause infusion-related reactions. Check with your doctor right away if you have back pain, chest tightness, chills, fever, flushing, headache, nausea and vomiting, trouble breathing, or weakness.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Blurred vision
    • chest pain, discomfort, or tightness
    • chills
    • fever
    • headache
    • hives, itching, skin rash
    • hoarseness
    • itching, pain, redness, or swelling at the insertion site
    • joint pain, stiffness, or swelling
    • lightheadedness, dizziness, or fainting
    • redness of the skin
    • seizures
    • slow, fast, or irregular heartbeat
    • swelling of the eyelids, face, lips, hands, or feet
    • trouble breathing
    • trouble swallowing
    • unusual bruising
    • unusual tiredness
    • vomiting

    Incidence not known

    • Back pain
    • confusion
    • drowsiness
    • general feeling of illness
    • flushing
    • nausea
    • severe headache
    • stiff neck or back
    • weakness

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Collection of blood under the skin
    • deep, dark purple bruise
    • increased body temperature
    • irritability
    • jitteriness
    • sweating

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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