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DIV/ERW/US/703/01 IMPORTANTDRUGINFORMATION February6,2017 Subject: ERWINAZE®Batch180K-NoticeofSpecialHandlingInstructions ForIntramuscularAdministrationOnly Usea5-micronfilterneedleforpreparationofvialsofERWINAZE® (asparaginaseErwiniachrysanthemi)fromBATCH180K DearHealthCareProvider: ThepurposeofthisletteristoalertyouthatERWINAZE(asparaginaseErwiniachrysanthemi) fromBatch180Kshouldbeadministeredintramuscularlyonlyandthatyouwillneedtousea5micronfilterneedletowithdrawthereconstitutedERWINAZEproductfromthevials.Thisis becauseparticulatematterwasobservedinsomevialsfromthisbatch.Becauseofthecritical necessityofthisdrug,JazzPharmaceuticalsisaskinghealthcareproviderstotakethese necessarystepsforpatientsafety. DuringroutinevisualinspectionsofERWINAZEBatch180K,particulatematterwasobservedin somevials.Theseaffectedvialsweresetasideandnotreleased.However,thereremainsa possibilitythatsomeofthereleasedvialsmaycontainparticulatematter,which,ifpresentin reconstitutedERWINAZE,mayposeasafetyrisktopatients. Inordertominimizethepotentialriskofadverseevents,healthcareprovidersshould administervialsfromBatch180Kbyintramuscularadministrationonly,notbyintravenous administration.Additionally,healthcareprovidersshouldcontinuetouseastandard5-micron filterneedletowithdrawthereconstitutedERWINAZEproductfromthevial,andthendiscard thefilterneedleandreplaceitwithanappropriateneedlepriortoadministration. PleasefollowtheinstructionsbelowpriortowithdrawingthereconstitutedERWINAZEproduct fromthevialsandadministeringittopatients. Page1of5 DIV/ERW/US/703/01 • • • • • • Priortoreconstitution,carefullyinspecteachvial.Ifyouobserveparticulatematter anywhereinthevial,quarantinethevial.Ifyoudonotobserveparticulatematterin thevials,reconstitutetheproductassetforthbelow. FollowallrecommendedstepsforreconstitutionofERWINAZEinaccordancewiththe PrescribingInformation. Carefullyinspect reconstitutedproduct. Intheeventthatyoudiscover visible particulatematterinthereconstitutedproduct,donotadministertothepatientand quarantinethevial. Ifnovisibleparticulatematterisseeninthereconstitutedproduct,useastandard5micronfilterneedletowithdrawthereconstitutedproductfromthevial.Seefilter needlemanufacturer’sinstructionsorusageguidelinesforproperuseoffilterneedle. Discardthefilterneedleandreplacewithanappropriateneedlepriortopatient administration.DonottransfertoanIVinfusionbag.Administerintramuscularlyonly. Ifyouseeparticulatematteranywhereinthevial,donotadministertothepatientand quarantinethevial.ContactJazzPharmaceuticalsMedicalInformationat 1-800-520-5568toreporttheissueandtodiscussappropriateresolution. Thefollowinglabel,attachedtothecarton,canidentifyvialsfromERWINAZEBatch180K: FORINTRAMUSCULARADMINISTRATIONONLY REQUIRES5-MICRONFILTERNEEDLEFORPREPARATION SEEINCLUDEDIMPORTANTDRUGINFORMATIONLETTER VialsfromERWINAZEBatch180Kcanalsobeidentifiedbynumberingontheindividualvial labels.Vialsfromtheaffectedbatchwillhaveoneofthefollowinglotnumbers:180K117, 180K217,180K317,or180K417. Pleaseensureyourstaffandanyproviderinyourinstitutionwhomaybeinvolvedinthe reconstitutionandadministrationofERWINAZEreceivesacopyofthisletterandspecifically reviewstheUpdatedInstructionsforPreparationappendedtothisletter.Pleasepayspecial attentiontotheupdatesinsteps#1-#7thatincludeobservationofparticulatematterandthe useofa5-micronfilterneedletowithdrawthereconstitutedERWINAZE,andintramuscular administrationonly. Page2of5 DIV/ERW/US/703/01 FurtherInformation PleaseseeaccompanyingFullPrescribingInformationforERWINAZE. Formoreinformation,visitwww.erwinaze.comorcall1-800-520-5568. Callforreporting Healthcareprovidersshouldreportproductqualityproblemsandallsuspectedadverseevents associatedwiththeuseofERWINAZE.Ifyoubecomeawareofapatientexperiencingan adverseeventwhiletakingERWINAZEorproductqualityproblemswithERWINAZE,please contactJazzPharmaceuticals,Inc.at1-800-520-5568. Adverseeventsorqualityproblems experiencedwiththeuseofthisproductmayalsobereportedtotheFDA’sMedWatchAdverse EventReportingProgrameitheronline,orregularmail,orbyfax: • CompleteandsubmitthereportOnline:www.fda.gov/medwatch/report.htm • RegularmailorFax:Downloadformwww.fda.gov/MedWatch/getforms.htmorcall1800-332-1088torequestareportingform,thencompleteandreturntotheaddresson thepre-addressedform,orsubmitbyfaxto1-800-FDA-0178. Sincerely, NoamFrey,MDMBA VicePresident,MedicalAffairs JazzPharmaceuticals,Inc. Page3of5 DIV/ERW/US/703/01 UpdatedInstructionsforPreparation:ERWINAZEBatch180KVial PreparationandHandlingInstructions 1. 2. Carefullyinspecteachvial.Ifyouobserveparticulatematter,quarantinethevial.Ifyou donotobserveparticulatematter,reconstitutetheproductasfollows. Reconstitutethecontentsofeachvialbyslowlyinjecting1or2mLofpreservative freesterilesodiumchloride(0.9%)injection(USP)againsttheinnervialwall. 3. Donotforcefullyinjectsolutionforreconstitutiondirectlyontoorintothepowder. Whenreconstitutedwith1mLtheresultantconcentrationis10,000International UnitspermL.Whenreconstitutedwith2mLtheresultantconcentrationis5,000 InternationalUnitspermL. 4. Dissolvecontentsbygentlemixingorswirling.Donotshakeorinvertvial. 5. 6. Whenreconstituted,ERWINAZEshouldbeaclear,colorlesssolution.Inspectthe solutionafterreconstitutionforanyvisibleparticlesorproteinaggregates,ifyou observeparticulatematterinthereconstitutedproduct,quarantinethevial. Calculatethedoseneededandthevolumeneededtoobtainthecalculateddose. 7. Withdrawthevolumecontainingthecalculateddosefromthevialusinga5-micron filterneedle(accordingtothefilterneedlemanufacturer’sinstructions)intoa polypropylenesyringewithin15minutesofreconstitution.Discardthefilterneedle andreplacewithanappropriateneedlepriortoadministration. 8. Ifapartialvialisused,donotsaveorreusetheunuseddrugforlateradministration. Discardunusedportions. 9. Donotfreezeorrefrigeratereconstitutedsolutionandadministerwithin4hoursor discard[seePrescribingInformation-HowSupplied/StorageandHandling(16)]. Page4of5 DIV/ERW/US/703/01 10. Ifyouseeparticulatematteranywhereotheronthantheundersideofthestopper (pre-orpost-reconstitution),donotadministertothepatientandquarantinethe vial.ContactJazzPharmaceuticalsMedicalInformation at1-800-520-5568toreport theissueandtodiscussappropriateresolution. AdministrationInstructionsforERWINAZEBatch180K ERWINAZEsolutionmaybeadministeredbyintramuscularinjectiononly.Donotadministerby intravenousinfusion. • Forintramuscularuse,limitthevolumeofreconstitutedERWINAZEatasingleinjection site to 2 mL; if reconstituted dose to be administered is greater than 2 mL, use multiple injectionsites. Page5of5