Empliciti: Uses, Side Effects and Dosage

What is EMPLICITI used for?

EMPLICITI (elotuzumab) is used with other medicines to treat adults with multiple myeloma, which is a cancer that affects a type of white blood cell called plasma cells. These cells divide out of control and collect in the bone marrow. This results in damage to the bones and kidneys. EMPLICITI is used when your disease has returned after you have had other types of treatment before.

It is not known if EMPLICITI is safe and effective in children younger than 18 years of age.

How does EMPLICITI work?

EMPLICITI contains the active substance elotuzumab which helps your immune system to attack and destroy cancer cells.

What are the ingredients in EMPLICITI?

The medicinal ingredient in EMPLICITI is elotuzumab.

The non-medicinal ingredients are citric acid, polysorbate 80, sodium citrate and sucrose.

EMPLICITI comes in the following dosage forms:

EMPLICITI comes in glass vials containing either 340 mg or 440 mg of elotuzumab powder for concentrate for solution for infusion. After reconstitution with sterile water for injection each vial of 340 mg delivers 300 mg of elotuzumab and each vial of 440 mg delivers 400 mg of elotuzumab.

Do not use EMPLICITI if:

If you are allergic to elotuzumab or any of the other ingredients of this medicine. Talk to your doctor if you are not sure.

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take EMPLICITI. Talk about any health conditions or problems you may have, including:

• Risk factors for developing blood clots such as: a family history of blood clots, age over 65, smoking, obesity or other reason.
• A history of pulmonary embolism (obstruction of a pulmonary artery by a blood clot)
• Abnormal liver function tests. Signs and symptoms may include eye or skin yellowing (jaundice), pain on the right side of your stomach area, or tiredness.
• Infection.

Other warnings you should know about:

Infusion reaction

Tell your doctor or nurse straight away if you develop signs of infusion reactions. These include fever, chills, and high blood pressure. These side effects mostly occur during or after the infusion of the first dose. You will be monitored for signs of such effects during and after the infusion.

Depending the seriousness of the infusion reactions, you may require additional treatment to prevent complications and reduce your symptoms, or your infusion may be interrupted. When the symptoms go away or improve, the infusion can be continued on a lower infusion rate and gradually increased if the symptoms do not recur. Your doctor may decide not to continue with EMPLICITI treatment if you have a strong infusion reaction.

Before each infusion of EMPLICITI, you will be given medicines to avoid infusion reaction.

Medicines given before each infusion

You must receive following medicines before each infusion of EMPLICITI to help reduce possible infusion reactions:

• medicines to reduce an allergic reaction (i.e. anti-histamines)
• medicines to reduce inflammation (i.e. dexamethasone)
• medicines to reduce pain and fever (i.e. acetaminophen)

Infections

EMPLICITI in combination with lenalidomide and dexamethasone may increase your risk of developing infections, which may be serious. Tell your healthcare provider if you have signs of an infection. The most frequent infections are nose, ears, sinuses, throat, lung and skin rash consisting of vesicles (shingles).

Second Primary Cancers

EMPLICITI in combination with lenalidomide and dexamethasone has been reported to increase the risk of developing new cancers. Discuss this risk with your healthcare provider before beginning on EMPLICITI in combinatio with lenalidomdie and dexamethasone.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

You should not use EMPLICITI if you are pregnant, unless your doctor specifically recommends it. The effects of EMPLICITI in pregnant women or its possible harm to an unborn baby are unknown.

• You must use effective contraception while you are being treated with EMPLICITI, if you are a woman who could become pregnant.
• If you become pregnant while using EMPLICITI, tell your doctor.

It is not known, whether elotuzumab gets into breast milk. A risk to the breast-fed infant cannot be excluded. Ask your doctor if you can breast-feed during or after treatment with EMPLICITI.

Changes in test results

EMPLICITI may cause changes in the results of tests carried out by your healthcare professional

EMPLICITI is used in combination with other drugs used to treat Multiple Myeloma.

Lenalidomide is expected to be harmful for an unborn baby. When EMPLICITI is given in combination with lenalidomide , you must also read the patient medication information of lenalidomide. When lenalidomide is used, you must follow the pregnancy prevention programme for lenalidomide.

Pediatrics (<18 years of age)

It is not known if EMPLICITI is safe and effective in children less than 18 years of age.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

How to take EMPLICITI:

Your healthcare provider will give you EMPLICITI as an intravenous infusion (IV infusion). An IV infusion is when medicine is slowly given directly into the bloodstream through a vein

Your EMPLICITI treatment schedule is divided into cycles that are 28 days (4 weeks) long. A cycle includes the number of days you are on treatment and also the time you spend resting in between treatments.

• For cycles 1 and 2 (28 days per cycle), you will receive EMPLICITI once every week.
• For cycles 3 and up (28 days per cycle), you will receive EMPLICITI once every 2 weeks.

Dosing Schedule of EMPLICITI with lenalidomide and dexamethasone

Before every EMPLICITI infusion, you will receive medicines to help reduce the chances of a reaction to the infusion.

EMPLICITI will be given as long as you continue to benefit from it. Make sure to go to all your infusion and follow-up appointments.

If you miss any appointments call your healthcare provider as soon as possible.

Usual dose:

The amount of EMPLICITI you will be given will be calculated based on your body weight. The recommended dose is 10 mg of elotuzumab per kilogram of your body weight.

Overdose:

As EMPLICITI will be given to you by a healthcare professional, it is unlikely you will be given too much. In the unlikely case of an overdose, your doctor will monitor you for side effects.

Missed Dose:

It is very important for you to keep all your appointments to receive EMPLICITI. If you miss an appointment, ask your healthcare professional when to schedule your next dose. EMPLICITI is used in combination with other multiple myeloma medicines. If any medicine in the regimen is delayed, interrupted, or discontinued, your doctor will decide how your treatment should be continued.

What are possible side effects from using EMPLICITI?

Like all medicines, this medicine can cause side effects, although not everybody gets them. Your doctor will discuss these with you and will explain the risks and benefits of your treatment.

EMPLICITI has been associated with infusion reactions. Tell your doctor or nurse straight away if you get any side effect. Below is a list of typical symptoms associated with infusion reactions:

• Fever
• Chills
• High blood pressure

Other symptoms may occur as well. Your doctor may consider reducing the infusion rate or interrupting the infusion of EMPLICITI to manage these symptoms.

The following side effects have been reported in clinical trials with elotuzumab:

Serious side effects and what to do about them

Tell your doctor immediately if you get any of the side effects listed above. Do not try to treat your symptoms with other medicines.

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional.

Reporting Side Effects

Storage:

It is unlikely that you will be asked to store EMPLICITI yourself. It will be stored in the hospital or clinic where it is given to you.

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the vial label and carton after EXP. The expiry date refers to the last day of that month.

Store in a refrigerator (2°C - 8°C) in the original package in order to protect from light. Do not freeze or shake.

After reconstitution, the reconstituted solution should be transferred from the vial to the infusion bag immediately.

After dilution, the EMPLICITI infusion must be completed within 24 hours of preparation of the infusion solution. The product should be used immediately. If not used immediately, the solution for infusion may be stored in the refrigerator (2 °C - 8 °C) for up to 24 hours.

Any unused medicine or waste material should be disposed of in accordance with local requirements.

If you want more information about EMPLICITI:

• Talk to your healthcare professional

• Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website; the manufacturer’s website at:

  http://www.bmscanada.ca

  or by contacting the sponsor, Bristol-Myers Squibb Canada at: 1-866-463-6267.

Last Revised: August 11, 2016