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TGA Product Information safety updates 31 January

TGA

When new safety information for medicines is identified, the Therapeutic Goods Administration (TGA) works with the sponsors to update Product Information (PI) to ensure that health professionals and consumers have access to this information. New safety information can be identified through the TGA’s ongoing safety monitoring activities or uncovered and submitted by sponsors themselves. Please see below details of some medicines that have recently had safety related updates to their PI.

The TGA monitors the safety of medicines marketed in Australia using:

  • and Periodic Safety Update Reports (PSURs)
  • reviews of literature
  • sharing of information with other regulatory agencies
  • sharing of information with Australian state and territory health authorities.

Changes to the PI that result from TGA safety monitoring activities may:

  • narrow indications
  • add or modify specific sections, such as:
    • contraindications
    • warnings or precautions
    • use in fertility, pregnancy and lactation
    • use in special populations
    • adverse effects.

It is important for prescribers and other health professionals to be aware of safety-related PI changes, as they may require you to take actions or do things differently, such as:

  • counsel patients on identified risks
  • undertake special monitoring or precautions
  • in some instances select alternate medications.

Significant PI changes are often supported by distribution of a Dear Health Care Professional Letter on the issue, which are produced by the medicine’s sponsor and sent directly to health professionals.

We will publish a Medicines Safety Update (MSU) article detailing recent safety-related PI updates each month, although this may not include all safety-related updates. We will continue to publish MSU articles for critical safety issues or topics of special interest.

The below medicines are generally innovator brands (generic brands may be included in some circumstances). Generic brands containing the same active ingredients as the medicines below are required to align with the safety information in the innovator’s PI and will be updated accordingly.

To view the full PI for each listing, click on the name of the product in the ‘Brand/trade name’ column. A ‘Summary table of changes’ appears at the end of the PI. If the TGA has published any further risk communication, such as a safety alert or stand-alone MSU article, it will be linked to in the ‘Safety issue’ column.

Table: Details of safety-related PI updates

Active ingredients

Brand name

Sponsor

PI updates

Date of approval

brentuximab

Takeda Pharmaceuticals Australia Pty Ltd

4.4 – Special warnings and precautions of use

  • Expanded precaution about severe cutaneous adverse reactions (SCARs) to include drug reaction with eosinophilia and systemic symptoms (DRESS)

4.8 – Adverse effects (undesirable effects)

  • DRESS

22 December 2022

calcium chloride dihydrate, glucose monohydrate, magnesium chloride hexahydrate, sodium bicarbonate and sodium chloride (and potassium chloride for Multibic 4)

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Fresenius Medical Care Australia Pty Ltd

4.4 – Special warnings and precautions for use

  • Risks associated with hypo/ hypernatraemia

2 December 2022

clostridium botulinum type A toxin – haemagglutinin complex

Ipsen Pty Ltd

4.4 – Special warnings and precautions for use

  • Dry eye and excessive muscle weakness or atrophy

4.8 – Adverse effects (undesirable effects)

  • Dizziness, facial paresis, eyelid ptosis, hypersensitivity, hypoaesthesia and muscle atrophy

20 December 2022

dexamethasone

Aspen Pharmacare Australia Pty Ltd

4.8 – Adverse effects (Undesirable effects)

  • Hiccups

23 December 2022

esomeprazole

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AstraZeneca Pty Ltd

4.4 – Special warnings and precautions of use

4.8 – Adverse effects (Undesirable effects)

  • Hypomagnesaemia and potential to cause hypocalcaemia and/ or hypokalaemia

16 December 2022

foscarnet sodium

Link Medical Products Pty Ltd T/A Link Pharmaceuticals

4.4 – Special warnings and precautions for use

  • Barium content in glass bottles, and related potential adverse effects

12 December 2022

galantamine

Janssen-Cilag Pty Ltd

4.4 – Special warnings and precautions for use

  • Prolongation of QT interval and torsades de pointes

4.5 – Interactions with other medicines and other forms of interactions

  • Potential interaction with medicines that may cause torsades de pointes

09 December 2022

infliximab

Janssen-Cilag Pty Ltd

4.4 – Special warnings and precautions for use

4.5 – Interactions with other medicines and other forms of interactions

  • Updated live vaccine recommendation for infants exposed in utero or via breast milk

4.8 – Adverse effects (undesirable effects)

  • Orbital apex syndrome

6 December 2022

interferon beta-1b

Bayer Australia Ltd

4.4 – Special warnings and precautions for use

4.8 – Adverse effects (undesirable effects)

  • Infection site infection

13 December 2022

iodixanol

GE Healthcare Australia Pty Ltd

4.4 – Special warnings and precautions for use

  • Added/ updated warnings related to bronchospasm in asthmatic patients, risk of contrast encephalopathy, thyroid function, use in paediatric patients

4.8 – Adverse effects (undesirable effects)

7 December 2022

latanoprost

Aspen Pharmacare Australia Pty Ltd

4.8 – Adverse effects (undesirable effects)

  • Nausea and vomiting

7 December 2022

lithium

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Aspen Pharmacare Australia Pty Ltd

4.5 – Interactions with other medicines and other forms of interactions

  • SGLT2 inhibitors may increase renal excretion of lithium and decrease blood lithium levels

21 December 2022

parecoxib (as sodium)

Pfizer Australia Pty Ltd

4.3 Contraindications

  • Pregnant patients in their third trimester or in breastfeeding

4.6 – Fertility, pregnancy and lactation

  • Known risks associated with use on NSAIDS in pregnancy or lactation

19 December 2022

piroxicam

Pfizer Australia Pty Ltd

4.3 Contraindications

  • Updated to include Pregnant patients in their third trimester or in breastfeeding

4.6 – Fertility, pregnancy and lactation

  • Expanded warnings about use in pregnancy and potential adverse effects to the fetus

19 December 2022

pregabalin

Viatris Pty Ltd

4.4 – Special warnings and precautions for use

  • Avoiding use in pregnancy and using contraception during treatment

4.6 – Fertility, pregnancy and lactation

  • Change to pregnancy category D
  • Major congenital malformations

4.8 – Adverse effects (undesirable effects)

  • Parkinsonism, bullous dermatitis, dermatitis exfoliative and Stevens-Johnson syndrome

13 December 2022

rivaroxaban

Bayer Australia Ltd

4.8 – Adverse effects (undesirable effects)

  • Eosinophilic pneumonia

7 December 2022

ropinirole

Arrow Pharma Pty Ltd

4.3 – Contraindications

4.4 – Special warnings and precautions for use

4.5 – Interactions with other medicines and other forms of interactions

4.6 – Fertility, pregnancy and lactation

4.7 – Effects on ability to drive and use machines

4.8 – Adverse effects (undesirable effects)

  • Updated to align with overseas product information

2 December 2022

sotalol

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Arrow Pharma Pty Ltd

4.3 – Contraindications

4.4 – Special warnings and precautions for use

4.5 – Interactions with other medicines and other forms of interactions

4.6 – Fertility, pregnancy and lactation

4.7 – Effects on ability to drive and use machines

4.8 – Adverse effects (undesirable effects)

  • Updated to align with overseas product information

9 December 2022

temsirolimus

Pfizer Australia Pty Ltd

4.4 – Special warnings and precautions for use

  • Excipients – ethanol absolute and propylene glycol

12 December 2022

triptorelin (as embonate)

Ipsen Pty Ltd

4.4 – Special warnings and precautions for use

4.8 – Adverse effects (undesirable effects)

  • Pseudotumour cerebri and benign intracranial hypertension

15 December 2022

warfarin

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Viatris Pty Ltd

4.4 – Special warnings and precautions for use

  • Anticoagulant-related nephropathy and recommended close monitoring (including renal function) in patients with supratherapeutic INR and haematuria

4.8 – Adverse effects (undesirable effects)

  • Anticoagulant-related nephropathy and haematuria

16 December 2022

Disclaimer

Medicines Safety Update is aimed at health professionals. It is intended to provide practical information to health professionals on medicine safety, including emerging safety issues. The information in Medicines Safety Update is necessarily general and is not intended to be a substitute for a health professional’s judgment in each case, taking into account the individual circumstances of their patients. Reasonable care has been taken to ensure that the information is accurate and complete at the time of publication. The Australian Government gives no warranty that the information in this document is accurate or complete, and shall not be liable for any loss whatsoever due to negligence or otherwise arising from the use of or reliance on this document.

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