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Azelaic Acid
Azelaic Acid (FINACEA) Topical Foam 15% National Drug Monograph August 2016 VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives The purpose of VA PBM Services drug monographs is to provide a focused drug review for making formulary decisions. Updates will be made when new clinical data warrant additional formulary discussion. Documents will be placed in the Archive section when the information is deemed to be no longer current. FDA Approval Information Description/Mechanism of Azelaic acid is a naturally occurring C9-dicarboxylic acid that is found in plants Action (such as whole grain cereals), animals and humans. Azelaic acid has antiinflammatory, antioxidative and antikeratinizing effects. In rosacea skin, azelaic acid decreases cathelicidin levels and kallikrein 5 (KLK5) activity and possibly inhibits toll-like receptor 2 (TLR2) expression.1 A 15% gel formulation has been marketed for rosacea, and 20% cream has been available for acne vulgaris. The newer foam formulation consists of an oil- in-water emulsion and was designed to have a higher lipid content than the gel for dry and sensitive skin. Indication(s) Under Review Topical treatment of inflammatory papules and pustules of mild to moderate in This Document rosacea. Dosage Form(s) Under Foam, 15% Review REMS REMS No REMS Postmarketing Requirements See Other Considerations for additional REMS information Pregnancy Rating Category B Executive Summary Efficacy There have been no head-to-head trials comparing the foam and gel formulations of azelaic acid in terms of safety, tolerability and efficacy in the treatment of papulopustular (PP) rosacea.. In two major randomized clinical trials, azelaic acid foam produced small benefits over vehicle foam in achieving Investigator’s Global Assessment (IGA) treatment success (NNTs of 9.2 and 11.5) and in reducing inflammatory lesion counts. -
Quarterly Review
Tropical Gastroenterology 2008.29;4:187–193 Quarterly Have hematopoietic growth factors made an Review impact on the management of liver disease? Pankaj Tyagi and Kaushal Madan ABSTRACT Department of Gastroenterology, It is clear that the major indication for the use of hematopoietic growth factors in hepatology GB Pant Hospital & Department of is to counteract the adverse effects of interferons (neutropenia and thrombocytopenia) and Medical Hepatology, ribavirin (hemolytic anaemia) during the treatment of hepatitis C infection. This is important Institute of Liver and Biliary Sciences, because the probability of SVR depends on proper adherence to therapy (at least 80% of the New Delhi requisite dose maintained for at least 80% of the requisite duration) and proper adherence can only be achieved if the side effects are reduced to a minimum. Even though the studies Correspondence: Dr. Kaushal Madan have demonstrated beyond doubt that the use of hematopoietic growth factors does indeed Email: [email protected] reduce the incidence and severity of these adverse effects and helps the patients to complete the course of therapy, the data on improvement of SVR is still limited. There is only one study of darbepoetin and filgrastim showing the beneficial effect on SVR. Even among the hematological side effects, possibly the only significant effect which limits the use of optimal HCV therapy is the hemolytic anaemia induced by ribavirin. The other two main side effects, i.e. neutropenia and thrombocytopenia are not clinically problematic. The use of such growth factors would be particularly effective if patients who have advanced liver disease or cirrhosis are able to receive adequate anti-viral therapy as has been demonstrated in the study of eltrombopag among HCV cirrhotics. -
An Approach to the Patient with a Dry Mouth
MedicineToday 2014; 15(4): 30-37 PEER REVIEWED FEATURE 2 CPD POINTS An approach to the patient with a dry mouth Key points • The subjective complaint of ELHAM AFLAKI MD; TAHEREH ERFANI MD; NICHOLAS MANOLIOS MB BS(Hons), PhD, MD, FRACP, FRCPA; xerostomia needs to be MARK SCHIFTER FFD, RCSI(Oral Med), FRACDS(Oral Med) differentiated from true salivary hypofunction. Dry mouth is a common and disabling problem. After exclusion of treatable • Salivary hypofunction can significantly reduce quality causes, treatment is symptomatic to prevent the consequences of salivary of life through its adverse hypofunction, such as tooth decay and infection of the oral mucosa. effects on taste, mastication, swallowing, cleansing of the erostomia, or the subjective feeling of neuropathic-induced orofacial dysaesthesia) mouth, killing of microbes a dry mouth, is a common complaint. and psychological and psychiatric disorders, and speech. It is often a consequence of salivary such as anxiety and depression. • Salivary hypofunction is a hypofunction (hyposalivation), in substantive risk factor for X which there is objective evidence of reduced NORMAL SALIVA PRODUCTION dental caries, oral mucosal salivary output or qualitative changes in saliva. Under normal physiological conditions, the disease and infection, Typically, patients complain of oral dryness salivary glands produce 1000 to 1500 mL of particularly oral candidiasis. only when salivary secretion is reduced by more saliva daily as an ultrafiltrate from the circu- • Patients should be than half.1 As saliva has a crucial role in taste lating plasma. Therefore, simple dehydration investigated for contributory perception, mastication, swallowing, cleansing reduces saliva production. The parotid glands and underlying causes, of the mouth, killing of microbes and speech, are the major source of serous saliva (60 to 65% which include drugs and abnormalities in saliva production can signif- of total saliva volume), producing the stimu- rheumatological diseases. -
WITHOUTUS010307409B2 (12 ) United States Patent ( 10 ) Patent No
WITHOUTUS010307409B2 (12 ) United States Patent ( 10 ) Patent No. : US 10 , 307 ,409 B2 Chase et al. (45 ) Date of Patent: Jun . 4 , 2019 ( 54 ) MUSCARINIC COMBINATIONS AND THEIR (52 ) U . S . CI. USE FOR COMBATING CPC . .. .. A61K 31/ 4439 (2013 . 01 ) ; A61K 9 /0056 HYPOCHOLINERGIC DISORDERS OF THE (2013 . 01 ) ; A61K 9 / 7023 ( 2013 . 01 ) ; A61K CENTRAL NERVOUS SYSTEM 31 / 166 ( 2013 . 01 ) ; A61K 31 / 216 ( 2013 . 01 ) ; A61K 31 /4178 ( 2013 .01 ) ; A61K 31/ 439 (71 ) Applicant: Chase Pharmaceuticals Corporation , ( 2013 .01 ) ; A61K 31 /44 (2013 . 01 ) ; A61K Washington , DC (US ) 31/ 454 (2013 .01 ) ; A61K 31/ 4725 ( 2013 .01 ) ; A61K 31 /517 (2013 .01 ) ; A61K 45 / 06 ( 72 ) Inventors : Thomas N . Chase , Washington , DC (2013 . 01 ) (US ) ; Kathleen E . Clarence -Smith , ( 58 ) Field of Classification Search Washington , DC (US ) CPC .. A61K 31/ 167 ; A61K 31/ 216 ; A61K 31/ 439 ; A61K 31 /454 ; A61K 31 /4439 ; A61K (73 ) Assignee : Chase Pharmaceuticals Corporation , 31 /4175 ; A61K 31 /4725 Washington , DC (US ) See application file for complete search history. ( * ) Notice : Subject to any disclaimer, the term of this (56 ) References Cited patent is extended or adjusted under 35 U . S . C . 154 (b ) by 0 days . U . S . PATENT DOCUMENTS 5 ,534 ,520 A 7 / 1996 Fisher et al. ( 21) Appl . No. : 15 /260 , 996 2008 /0306103 Al 12 /2008 Fisher et al. 2011/ 0021503 A1* 1/ 2011 Chase . .. A61K 31/ 27 ( 22 ) Filed : Sep . 9 , 2016 514 / 215 2011/ 0071135 A1 * 3 / 2011 Chase . .. .. .. A61K 31/ 166 (65 ) Prior Publication Data 514 / 215 2011 /0245294 Al 10 / 2011 Paborji et al. -
Information for the User ZYTIGA 500 Mg Film-Coated Tablets Abiraterone
Package leaflet: Information for the user ZYTIGA 500 mg film-coated tablets abiraterone acetate Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet: 1. What ZYTIGA is and what it is used for 2. What you need to know before you take ZYTIGA 3. How to take ZYTIGA 4. Possible side effects 5. How to store ZYTIGA 6. Contents of the pack and other information 1. What ZYTIGA is and what it is used for ZYTIGA contains a medicine called abiraterone acetate. It is used to treat prostate cancer in adult men that has spread to other parts of the body. ZYTIGA stops your body from making testosterone; this can slow the growth of prostate cancer. When ZYTIGA is prescribed for the early stage of disease where it is still responding to hormone therapy, it is used with a treatment that lowers testosterone (androgen deprivation therapy ). When you take this medicine your doctor will also prescribe another medicine called prednisone or prednisolone. This is to lower your chances of getting high blood pressure, having too much water in your body (fluid retention), or having reduced levels of a chemical known as potassium in your blood. -
Managing Adverse Effects and Complications in Completing Treatment for Hepatitis C Virus Infection
HCV Treatment Complications Volume 20 Issue 4 October/November 2012 Perspective Managing Adverse Effects and Complications in Completing Treatment for Hepatitis C Virus Infection The addition of direct-acting antivirals (DAAs) to hepatitis C virus (HCV) Psychiatric Complications treatment regimens has made treatment more effective and patient Depression is the most common psy- management more complex. Shepherding patients through a full course of chiatric complication encountered in HCV therapy requires motivation and involvement on the part of the patient HCV patients, with mild to moderate and the physician. Indeed, physician inexperience and lack of confidence in depression found in as much as 80% of guiding patients through the challenges of treatment appears to be a primary patients. Bipolar disorder and schizo- reason for early discontinuation of therapy. Among the many complications phrenia are also not infrequently en- of HCV treatment that must be managed efficiently and effectively are countered. depression and other psychiatric disorders; hematologic abnormalities There is little evidence to support including DAA- and ribavirin-associated anemia and peginterferon alfa- a benefit of preemptive antidepres- associated neutropenia and thrombocytopenia; rash and drug eruptions, sant therapy in all patients undergo- including telaprevir-associated rash; and weight loss. Practical considerations ing HCV treatment, though a recent in management of these common complications are offered. This article randomized trial of HCV patients -
(CD-P-PH/PHO) Report Classification/Justifica
COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of medicines belonging to the ATC group D07A (Corticosteroids, Plain) Table of Contents Page INTRODUCTION 4 DISCLAIMER 6 GLOSSARY OF TERMS USED IN THIS DOCUMENT 7 ACTIVE SUBSTANCES Methylprednisolone (ATC: D07AA01) 8 Hydrocortisone (ATC: D07AA02) 9 Prednisolone (ATC: D07AA03) 11 Clobetasone (ATC: D07AB01) 13 Hydrocortisone butyrate (ATC: D07AB02) 16 Flumetasone (ATC: D07AB03) 18 Fluocortin (ATC: D07AB04) 21 Fluperolone (ATC: D07AB05) 22 Fluorometholone (ATC: D07AB06) 23 Fluprednidene (ATC: D07AB07) 24 Desonide (ATC: D07AB08) 25 Triamcinolone (ATC: D07AB09) 27 Alclometasone (ATC: D07AB10) 29 Hydrocortisone buteprate (ATC: D07AB11) 31 Dexamethasone (ATC: D07AB19) 32 Clocortolone (ATC: D07AB21) 34 Combinations of Corticosteroids (ATC: D07AB30) 35 Betamethasone (ATC: D07AC01) 36 Fluclorolone (ATC: D07AC02) 39 Desoximetasone (ATC: D07AC03) 40 Fluocinolone Acetonide (ATC: D07AC04) 43 Fluocortolone (ATC: D07AC05) 46 2 Diflucortolone (ATC: D07AC06) 47 Fludroxycortide (ATC: D07AC07) 50 Fluocinonide (ATC: D07AC08) 51 Budesonide (ATC: D07AC09) 54 Diflorasone (ATC: D07AC10) 55 Amcinonide (ATC: D07AC11) 56 Halometasone (ATC: D07AC12) 57 Mometasone (ATC: D07AC13) 58 Methylprednisolone Aceponate (ATC: D07AC14) 62 Beclometasone (ATC: D07AC15) 65 Hydrocortisone Aceponate (ATC: D07AC16) 68 Fluticasone (ATC: D07AC17) 69 Prednicarbate (ATC: D07AC18) 73 Difluprednate (ATC: D07AC19) 76 Ulobetasol (ATC: D07AC21) 77 Clobetasol (ATC: D07AD01) 78 Halcinonide (ATC: D07AD02) 81 LIST OF AUTHORS 82 3 INTRODUCTION The availability of medicines with or without a medical prescription has implications on patient safety, accessibility of medicines to patients and responsible management of healthcare expenditure. The decision on prescription status and related supply conditions is a core competency of national health authorities. -
Abiraterone Acetate for Chemotherapy-Naive
Fan et al. BMC Urology (2018) 18:110 https://doi.org/10.1186/s12894-018-0416-6 RESEARCHARTICLE Open Access Abiraterone acetate for chemotherapy- naive metastatic castration-resistant prostate cancer: a single-centre prospective study of efficacy, safety, and prognostic factors Liancheng Fan†, Baijun Dong†, Chenfei Chi†, Yanqing Wang†, Yiming Gong†, Jianjun Sha, Jiahua Pan, Xun Shangguan, Yiran Huang, Lixin Zhou* and Wei Xue* Abstract Background: To evaluate the efficacy and safety of abiraterone acetate (AA) plus prednisone compared with prednisone alone in Asian patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC), and to identify predictive factors. Methods: We reviewed the medical records of 60 patients with chemotherapy-naive mCRPC at Renji Hospital who were treated with AA plus prednisone (n = 43) or prednisone alone (n = 17). All patients were assessed for prostate- specific antigen (PSA) response, PSA progression-free survival (PSA PFS), radiographic progression-free survival (rPFS), and overall survival (OS). The ability of several parameters to predict PSA PFS, rPFS, and OS was studied. Results: The median follow-up time was 14.0 months (range 7.0–18.5 months), at which time 19 death events had been reported: 11 in the AA + prednisone group and 8 in the prednisone group. The AA + prednisone group had significantly longer median PSA PFS (10.3 vs 3.0 months, P < 0.001), rPFS (13.9 vs 3.9 months, P < 0.001), and OS (23. 3 vs 17.5 months, P = 0.016) than the prednisone-alone group. The most frequently reported grade 3 or 4 adverse event in both the AA + prednisone and prednisone-alone groups was elevated alanine aminotransferase level in 5 of 43 patients (11.6%) and 2 of 17 patients (11.8%), respectively. -
A Note on Medical Management of Uveitis Apurupa Nedunuri Department of Pharmacology, Osmania University, Hyderabad, India
OPEN ACCESS Freely available online e Journal of Pharmacovigilance ISSN: 2329-6887 Mini Review A Note on Medical Management of Uveitis Apurupa Nedunuri Department of Pharmacology, Osmania University, Hyderabad, India ABSTRACT Uveitis is a moving illness to treat. Corticosteroids have been utilized in the treatment of uveitis for a long time. Immunosuppressives are acquiring force lately in the treatment of uveitis. In this article we present an outline of current treatment of uveitis and the significant discoveries and advances in medications and visual medication conveyance frameworks in the treatment of uveitis. Keywords: Corticosteroids; Immunosuppressives; Medical Management; Uveitis. INTRODUCTION prednisolone acetic acid derivation is multiple times less powerful on a molar premise than betamethasone or dexamethasone, the Uveitis is a potentially sight threatening disease. It may occur due entrance into the cornea of prednisolone acetic acid derivation is to an infection or may be due to an autoimmune etiology. Specific significantly more than betamethasone or dexamethasone. Dosing antimicrobial therapies with or without corticosteroids are used recurrence and the time span the medicine stays in contact with in cases of infectious uveitis. Several drugs are available for the visual surface additionally impacts adequacy. Suspensions have a management of non-infectious uveitis including corticosteroids, immunosuppressive agents, and more recently biologics. The more serious level of calming impact. treatment of uveitis is evolving -
Clinical Rx Forum Volume 4 Issue 1
In This Issue Clevidipine for Hypertensive Urgency and Emergency From the Department of Pharmacy Tramadol: No Longer the Codeine Alternative January/February Issue 2016 Volume 4, Issue 1 FDA Medication Safety Alert: Risk of VTE with TestClevidipine for Hypertensive Urgency and Emergency osterone By: Gretchen D’Arcangelo, Pharm.D. Marcia J. Wyman, Pharm.D., BCPS Introduction: Hypertensive emergen- istration (FDA) for the reduction of BP Drug Information Pharmacist cies are deLined by potentially life- when oral therapy is not feasible Editor threatening elevations in blood pres- or desirable. 3 sure (BP) greater than 180/120 mmHg Mandy C. Leonard, Pharm.D., BCPS Pharmacokinetics: Following IV ad- System Director, Drug Use Policy and and are also paired with organ dysfunc- 1 ministration, clevidipine is rapidly me- Formulary Management tion. Hypertensive urgencies, on the Editor other hand, do not have the characteris- tabolized by blood and tissue esterases tic organ dysfunction present. These giving it a very quick onset of action Meghan K. Lehmann, Pharm.D., BCPS hypertensive crises are said to account and short half-life. 3 Its pharmacologic Drug Information Specialist effect starts within 2 to 4 minutes with Editor for up to 3% of emergency department admissions, with about three-fourths of a duration of action of up to 15 minutes. Marigel Constantiner, MSc, BCPS, CGP, CPh those admissions due to hypertensive EfLicacy and Safety: Patients undergo- Drug Information Specialist emergencies. 2 In patients with either Associate Editor ing cardiac surgery diagnosed with hy- hypertensive urgency or emergency, pertension in the past 6 months were immediate BP reduction should be at- Christopher Snyder, B.S., R.Ph. -
M2021: Pharmacogenetic Testing
Pharmacogenetic Testing Policy Number: AHS – M2021 – Pharmacogenetic Prior Policy Name and Number, as applicable: Testing • M2021 – Cytochrome P450 Initial Presentation Date: 06/16/2021 Revision Date: N/A I. Policy Description Pharmacogenetics is defined as the study of variability in drug response due to heredity (Nebert, 1999). Cytochrome (CYP) P450 enzymes are a class of enzymes essential in the synthesis and breakdown metabolism of various molecules and chemicals. Found primarily in the liver, these enzymes are also essential for the metabolism of many medications. CYP P450 are essential to produce many biochemical building blocks, such as cholesterol, fatty acids, and bile acids. Additional cytochrome P450 are involved in the metabolism of drugs, carcinogens, and internal substances, such as toxins formed within cells. Mutations in CYP P450 genes can result in the inability to properly metabolize medications and other substances, leading to increased levels of toxic substances in the body. Approximately 58 CYP genes are in humans (Bains, 2013; Tantisira & Weiss, 2019). Thiopurine methyltransferase (TPMT) is an enzyme that methylates azathioprine, mercaptopurine and thioguanine into active thioguanine nucleotide metabolites. Azathioprine and mercaptopurine are used for treatment of nonmalignant immunologic disorders; mercaptopurine is used for treatment of lymphoid malignancies; and thioguanine is used for treatment of myeloid leukemias (Relling et al., 2011). Dihydropyrimidine dehydrogenase (DPD), encoded by the gene DPYD, is a rate-limiting enzyme responsible for fluoropyrimidine catabolism. The fluoropyrimidines (5-fluorouracil and capecitabine) are drugs used in the treatment of solid tumors, such as colorectal, breast, and aerodigestive tract tumors (Amstutz et al., 2018). A variety of cell surface proteins, such as antigen-presenting molecules and other proteins, are encoded by the human leukocyte antigen genes (HLAs). -
Changes to the Highmark Drug Formularies
AUGUST 2020 JULY/AUGUST 2020 UPDATE CHANGES TO THE HIGHMARK DRUG FORMULARIES Following is the update to the Highmark Drug Formularies and pharmaceutical management procedures for July/August 2020. The formularies and pharmaceutical management procedures are updated on a bimonthly basis, and the following changes reflect the decisions made in June 2020 by our Pharmacy and Therapeutics Committee. These updates are effective on the dates noted throughout this document. Please reference the guide below to navigate this communication: Section I. Highmark Commercial and Healthcare Reform Formularies A. Changes to the Highmark Comprehensive Formulary and the Highmark Comprehensive Healthcare Reform Formulary B. Changes to the Highmark Progressive Formulary and the Highmark Progressive Healthcare Reform Formulary C. Changes to the Highmark Healthcare Reform Essential Formulary D. Changes to the Highmark Core Formulary E. Changes to the Highmark National Select Formulary F. Updates to the Pharmacy Utilization Management Programs 1. Prior Authorization Program 2. Managed Prescription Drug Coverage (MRxC) Program 3. Formulary Program 4. Quantity Level Limit (QLL) Programs Section II. Highmark Medicare Part D Formularies A. Changes to the Highmark Medicare Part D 5-Tier Incentive Formulary B. Changes to the Highmark Medicare Part D 5-Tier Closed Formulary C. Additions to the Specialty Tier D. Updates to the Pharmacy Utilization Management Programs 1. Prior Authorization Program 2. Managed Prescription Drug Coverage (MRxC) Program 3. Quantity Level Limit (QLL) Program As an added convenience, you can also search our drug formularies and view utilization management policies on the Provider Resource Center (accessible via NaviNet® or our website). Click the Pharmacy Program/Formularies link from the menu on the left.