QUTENZA Cutaneous patch Ref.[6296] Active ingredients: Capsaicin

Source: European Medicines Agency (EU)  Revision Year: 2017  Publisher: Grünenthal GmbH, Zieglerstraße 6, 52078, Aachen, Germany

Therapeutic indications

Qutenza is indicated for the treatment of peripheral neuropathic pain in adults either alone or in combination with other medicinal products for pain.

Posology and method of administration

The Qutenza cutaneous patch should be applied by a physician or by a health care professional under the supervision of a physician.

Posology

Qutenza should be applied to the most painful skin areas (using up to a maximum of 4 patches). The painful area should be determined by the physician and marked on the skin. Qutenza must be applied to intact, non-irritated, dry skin, and allowed to remain in place for 30 minutes for the feet (e.g. HIVassociated neuropathy, painful diabetic peripheral neuropathy) and 60 minutes for other locations (e.g. postherpetic neuralgia). Qutenza treatments may be repeated every 90 days, as warranted by the persistence or return of pain.

The treatment area may be pre-treated with a topical anaesthetic or the patient may be administered an oral analgesic prior to application of Qutenza to reduce potential application related discomfort. The topical anaesthetic should be applied to cover the entire Qutenza treatment area and surrounding 1 to 2 cm. The topical anaesthetic or oral analgesic should be used in accordance with the medicinal product’s instructions for use. In clinical trials, patients were pre-treated with topical lidocaine (4%), lidocaine (2.5%)/prilocaine (2.5%) or with 50 mg of tramadol. The anaesthetic cream should be removed prior to applying Qutenza and the skin washed and dried thoroughly.

Renal and/or hepatic impairment

No dose adjustment is required for patients with renal or hepatic impairment.

Paediatric population

The safety and efficacy of Qutenza in children from birth to 18 years has not been established. No data are available.

Method of administration

Cutaneous use only.

Precautions to be taken before handling or administering the medicinal product

Nitrile gloves should be worn at all times while handling Qutenza and cleaning treatment areas. Latex gloves should NOT be worn as they do not provide adequate protection. Use of a mask and protective glasses is recommended , particularly during application and removal of the patch.

These precautions should be taken to avoid unintentional contact with the patches or other materials that have come in contact with the treated areas. This may result in transient erythema and burning sensation (with mucous membranes being particularly susceptible), eye pain, eye and throat irritation and cough.

Patches should not be held near eyes or mucous membranes.

If necessary, hairs in the affected area should be clipped to promote patch adherence (do not shave). The treatment area(s) should be gently washed with soap and water. Following hair removal and washing, the skin should be thoroughly dried.

Instructions for use

Qutenza is a single use patch and can be cut to match the size and shape of the treatment area. Qutenza should be cut prior to removal of the release liner. The release liner should NOT be removed until just prior to application. There is a diagonal cut in the release liner to aid in its removal. A section of the release liner should be peeled and folded and the adhesive side of the printed patch placed on the treatment area. The patch should be held in place. The release liner should slowly and carefully be peeled from underneath with one hand while the patch should simultaneously be smoothed onto the skin with the other to ensure that there is complete contact between the patch and the skin, with no air bubbles and no moisture.

When treating feet, Qutenza patches can be wrapped around the dorsal, lateral and plantar surfaces of each foot to completely cover the treatment area.

To ensure Qutenza maintains contact to the treatment area, stretchable socks or rolled gauze may be used.

The Qutenza patches should be removed gently and slowly by rolling them inward to minimize the risk of aerosolisation of capsaicin. After removal of Qutenza, cleansing gel should be applied liberally to the treatment area and left on for at least one minute. Cleansing gel should be wiped off with dry gauze to remove any remaining capsaicin from the skin. After the cleansing gel has been wiped off, the area should be gently washed with soap and water.

Acute pain during and following the procedure should be treated with local cooling (such as a cool compress) and oral analgesics (e.g. short-acting opioids).

For instructions on handling and disposal of the treatment materials see section 6.6.

Overdose

No case of overdose has been reported. Qutenza is required to be administered by a physician or under the supervision of a physician. Therefore, overdosing is unlikely to occur. Overdose may be associated with severe application site reactions, e.g. application site pain, application site erythema, application site pruritus. In case of suspected overdose, the patches should be removed gently, cleansing gel should be applied for one minute and then wiped off with dry gauze and the area should be gently washed with soap and water. Supportive measures should be taken as clinically needed. There is no antidote to capsaicin.

Shelf life

Shelf life: 4 years.

After opening sachet: apply Qutenza within 2 hours.

Special precautions for storage

Qutenza cutaneous patch: Store flat in the original sachet and carton. Store below 25°C.

Cleansing gel: Store below 25°C.

Nature and contents of container

The Qutenza patch is stored in a paper coated aluminium foil sachet with acrylnitrile-acrylic acid copolymer heat seal layer.

Qutenza is available in a kit containing one or two individually sealed Qutenza patches and a 50 g tube of cleansing gel.

Not all pack sizes may be marketed.

Special precautions for disposal and other handling

Health care professionals should wear nitrile gloves when handling patches and cleansing treatment areas. The use of a mask and protective glasses is recommended, see section 4.2.

Used and unused patches and all other materials that have been in contact with the treated area should be disposed of immediately after use by sealing them in a polyethylene medical waste bag and placing in an appropriate medical waste container.

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