Givosiran (subcutaneous route)


    Brand Name

    US Brand Name

    Givlaari


    Description

    Givosiran injection is used to treat patients with acute hepatic porphyria.

    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 have not been performed on the relationship of age to the effects of givosiran injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies on the relationship of age to the effects of givosiran injection have not been performed in the geriatric population. However, no geriatric-specific problems have been documented to date.

    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. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Alosetron
    • Atomoxetine
    • Caffeine
    • Desipramine
    • Dextromethorphan
    • Duloxetine
    • Eliglustat
    • Metoprolol
    • Nebivolol
    • Perphenazine
    • Ramelteon
    • Tacrine
    • Tasimelteon
    • Theophylline
    • Thioridazine
    • Tizanidine
    • Tolterodine
    • Venlafaxine

    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:

    • Blood problems (eg, increased homocysteine in the blood)—Use with caution. May make this condition worse.
    • Kidney disease, severe or
    • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A nurse or other trained health professional will give you this medicine in a hospital or clinic. It is given as a shot under your skin.

    Missed Dose

    This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.


    Precautions

    Your doctor will check your progress closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. 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 provider right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

    Check with your provider right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

    Check with your provider right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

    Call your provider right away if you have redness, burning, swelling, or pain at the injection site.

    This medicine may increase homocysteine (an amino acid) levels in your blood. You may receive vitamin supplements (eg, vitamin B6 supplement) to treat this blood problem.

    This medicine may cause pancreatitis (swelling of the pancreas). Check with your provider right away if you have bloating, chills, constipation, dark urine, fast heartbeat, fever, indigestion, loss of appetite, nausea, pains in the stomach, side or abdomen, possibly radiating to the back, vomiting, or yellow eyes or skin.

    Do not take other medicines unless they have been discussed with your provider. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    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

    • Agitation
    • blood in the urine
    • coma
    • confusion
    • dark urine
    • decreased urine output
    • depression
    • dizziness
    • headache
    • irritability
    • lethargy
    • loss of appetite
    • muscle twitching
    • nausea or vomiting
    • rapid weight gain
    • seizures
    • stomach pain
    • stupor
    • swelling of the face, ankles, or hands
    • unusual tiredness or weakness
    • yellow eyes or skin

    Rare

    • Chest tightness
    • cough
    • difficulty swallowing
    • dizziness
    • fast heartbeat
    • hives, itching, or skin rash
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • trouble breathing

    Incidence not known

    • Bloating
    • chills
    • constipation
    • fever
    • indigestion
    • pains in the stomach, side, or abdomen, possibly radiating to the back

    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

    • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

    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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