Shortage of Erwinase for Injection and Replacement with UK Labelled Stock
- Starting date:
- February 27, 2018
- Type of communication:
- Dear Healthcare Professional Letter
- Subcategory:
- Biologic/vaccine
- Source of recall:
- Health Canada
- Issue:
- Supply, Important Safety Information
- Audience:
- Healthcare Professionals
- Identification number:
- RA-66062
Audiences
Healthcare professionals (medical oncologists, haematologists, oncology nurses, pharmacists), chiefs of medicine in hospitals, hospital pharmacy chiefs, cancer clinics.
Key messages
- To help manage the impact of the ongoing shortage of ERWINASE, some previously unreleased UK-labelled ERWINASE vials are now being made available.
- The newly released vials carry Batch numbers CAMR-183aG117, CAMR-184aG117 and CAMR-185aG117. These vials should be used with a standard 5-micron filter needle due to the presence of particulate matter.
- If particulate matter is observed elsewhere other than on the underside of the stopper (e.g., on or in the product) before or after reconstitution, do not administer the product and retain for collection.
- Healthcare professionals are reminded that there are some differences between the currently approved Canadian and UK labelling (see Tables 1 and 2). Healthcare professionals should refer to the ERWINASE Canadian Product Monograph for prescribing information.
Issue
During routine visual inspection of ERWINASE Batches CAMR-183, CAMR-184 and CAMR-185, particulate matter was observed bound to the stopper and/or present on the lyophilized cake of some vials. The global supply of ERWINASE has been affected by this ongoing issue with particulate matter. To help manage the impact of the ongoing shortage of ERWINASE, Health Canada has not objected to the importation and release of 60 packs of UK-labelled product from the global Batches CAMR-183a, CAMR-184a, CAMR-185a, sub-lots CAMR-183aG117, CAMR-184aG117, and CAMR-185aG117 as an interim measure. A standard 5-micron filter needle should be used to withdraw the reconstituted product from the UK-labelled product prior to administration.
Products affected
ERWINASE (Erwinia L-asparaginase) Batches CAMR-183a, sub-lot CAMR-183aG117; CAMR-184a, sub-lot CAMR-184aG117; and CAMR-185a, sub-lot CAMR-185aG117.
Background information
ERWINASE (Erwinia L-asparaginase) is indicated in the therapy of patients with acute lymphocytic leukemia (ALL) where it is used primarily in combination with other antineoplastic agents to induce remission in children and adults with this disease. It may also be used to treat patients who have developed hypersensitivity (but not anaphylaxis) to L-asparaginase derived from E. coli. ERWINASE should not be used as the sole agent for induction unless combination therapy is considered inappropriate.
During routine visual inspection of ERWINASE Batches CAMR-183, CAMR-184 and CAMR-185, particulate matter was observed bound to the stopper and/or present on the lyophilized cake of some vials. These vials were identified and segregated and were not released. The remaining vials in the batch were released with special handling instructions to use a standard 5-micron filter needle post-reconstitution.
Jazz Pharmaceuticals is experiencing an immediate shortage of ERWINASE due to an ongoing manufacturing issue that has delayed the scheduled release of an additional batch of the product. To reduce the length of the potential product outage, vials of ERWINASE from Batches CAMR-183a, CAMR-184a and CAMR-185a that were previously segregated due to the presence of visible particulate matter on the stopper will now be made available for use with a standard 5-micron filter needle. These vials have gone through an additional round of inspection in order to remove all vials except those with black particulate matter on the underside of the stopper. These vials will be released under batch numbers CAMR-183aG117, CAMR-184aG117 and CAMR-185aG117.
It is anticipated that new supply of ERWINASE will be available approximately mid-March 2018.
Who is affected
Information for health care professionals
The UK-labelled ERWINASE product is from the global batch and is the same as the Canadian product with respect to composition.
The following differences between the currently approved Canadian and UK labelling should be noted:
Section of the label | UK | Canada |
---|---|---|
Name of Product |
Erwinase® 10,000 Units Lyophilisate for solution for injection 10,000 Units /vial |
Erwinase® 10 000 U. Sterile freeze-dried powder |
Crisantaspase (asparaginase from Erwinia chrysanthemi, Erwinia L-asparaginase) | Erwinia L-asparaginase | |
Reconstitution | Reconstitute before use. | Dissolve in 1 or 2 mL of Sodium chloride Injection, USP. |
Marketing Authorization Holder |
Porton Biopharma Limited Porton Down Salisbury SP4 0JG |
Jazz Pharmaceuticals France SAS |
Excipients |
Sodium Chloride, Glucose Monohydrate |
Not reported on the vial label |
Distributor/Local Representative | Jazz Pharmaceuticals UK Ltd. |
CGF Pharmatech Inc. Montreal Canada |
MA number | PL44403/002 | DIN 02237815 |
Others | No other information on vial label | Refer to the enclosed information leaflet |
Section | UK | Canada |
---|---|---|
All | English only | French Translation |
Name of Product |
Erwinase® 10,000 Units Lyophilisate for solution for injection |
Erwinase® 10 000 U. Sterile freeze-dried powder Antileukemic |
Crisantaspase (asparaginase from Erwinia chrysanthemi, Erwinia L-asparaginase) | Erwinia L-asparaginase for injection | |
Each vial contains: 10,000 Units crisantaspase |
Each vial contains: Erwinia L-asparaginase 10,000 Units |
|
Marketing Authorization Holder (MAH) |
Porton Biopharma Limited Porton Down Salisbury SP4 0JG |
Jazz Pharmaceuticals France SAS Lyon, France, 69006 |
Excipients |
Sodium Chloride, Glucose Monohydrate |
Glucose 5 mg; Sodium chloride 0.5 mg |
Reconstitution | Reconstitute before use. |
Dissolve in 1 or 2 mL of Sodium chloride Injection USP. Gently agitate to dissolve. Use only if clear. |
Distributor/Local Representative | Jazz Pharmaceuticals UK Ltd. | CGF Pharmatech Inc. Montreal Quebec, H4T 1A7 |
MA number | PL44403/002 | DIN 02237815 |
Others |
Contains no preservative. For dosage and directions for use see package insert. |
For complete prescribing information, including Dosage and Administration, please refer to the ERWINASE Canadian Product Monograph (CPM), which is provided with the UK labelled ERWINASE product, rather than the enclosed UK labelling information. The UK product will be accompanied by this risk communication and the Canadian Product Monograph.
Similarly to the Canadian product, UK-labelled ERWINASE should be reconstituted in 1 to 2 mL of sodium chloride (0.9%) solution for injection. Vials with visible particulate matter anywhere, other than on the underside of the stopper (e.g., on or in the product), before or after reconstitution, should be retained for collection.
Before reconstitution, carefully inspect each vial. If you observe particulate matter anywhere other than on the underside of the stopper (e.g., on or in the product), do not administer the product and retain for collection. If you do not observe particulate matter anywhere, other than on the underside of the stopper, reconstitute the product as usual.
After reconstitution, carefully inspect the reconstituted product. If you discover particulate matter after reconstitution, do not administer the product and retain for collection. If there is no visible particulate matter in the product after reconstitution, as an additional precaution, use a standard 5-micron filter needle to withdraw the reconstituted UK-labelled product from the vial prior to administration. A study has demonstrated that filtration through a 5-micron filter needle after reconstitution has no effect on ERWINASE activity.1
In the event that you discover particulate matter, pre- or post- reconstitution, please notify the Jazz Pharmaceuticals Customer Services department and retain the vial for collection.
Action taken by Health Canada
To help manage the impact of the ongoing shortage of ERWINASE, Health Canada, per the conditions agreed upon by Jazz Pharmaceuticals, had not objected to importation and release of UK-labelled ERWINASE. Health Canada will continue to monitor the situation.
Report health or safety concerns
Managing marketed health product-related side effects depends on health care professionals and consumers reporting them. Any serious or unexpected side effects in patients receiving ERWINASE should be reported to Jazz Pharmaceuticals or Health Canada.
Jazz Pharmaceuticals
E-mail: DrugSafetyUK@jazzpharma.com
Telephone: 1-800-520-5568 or 1-866-343-0344 (CGF Pharmatech)
You can report any suspected adverse reactions associated with the use of health products to Health Canada by:
- Calling toll-free at 1-866-234-2345; or
- Visiting MedEffect Canada's Web page on Adverse Reaction Reporting for information on how to report online, by mail or by fax.
For other health product inquiries related to this communication, contact Health Canada at:
Regulatory Operations and Regions Branch
E-mail: dcviu_uvcem@hc-sc.gc.ca
Telephone: 1-800-267-9675
Original signed by
Dr Kelvin Tan
Vice President Medical Affairs
Jazz Pharmaceuticals
Reference
1. Health Canada has the data on file, 29 Apr 2016
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