YARGESA Hard capsule Ref.[27913] Active ingredients: Miglustat

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2021  Publisher: Piramal Critical Care Limited, Suite 4, Ground Floor, Heathrow Boulevard East Wing, 280 Bath Road, West Drayton, UB7 0DQ, United Kingdom

4.1. Therapeutic indications

Yargesa is indicated for the oral treatment of adult patients with mild to moderate type 1 Gaucher disease. Yargesa may be used only in the treatment of patients for whom enzyme replacement therapy is unsuitable (see sections 4.4 and 5.1).

Yargesa is indicated for the treatment of progressive neurological manifestations in adult patients and paediatric patients with Niemann-Pick type C disease (see sections 4.4, and 5.1).

4.2. Posology and method of administration

Therapy should be directed by physicians who are knowledgeable in the management of Gaucher disease or Niemann-Pick type C disease, as appropriate.

Posology

Dosage in type 1 Gaucher disease

Adult

The recommended starting dose for the treatment of adult patients with Type 1 Gaucher disease is 100 mg three times a day.

Temporary dose reduction to 100 mg once or twice a day may be necessary in some patients because of diarrhoea.

Paediatric population

The efficacy of Yargesa in children and adolescents aged 0-17 years with type 1 Gaucher disease has not been established. No data are available.

Dosage in Niemann-Pick type C disease

Adult

The recommended dose for the treatment of adult patients with Niemann-Pick type C disease is 200 mg three times a day.

Paediatric population

The recommended dose for the treatment of adolescent patients (12 years of age and above) with Niemann-Pick type C disease is 200 mg three times a day.

Dosing in patients under the age of 12 years should be adjusted on the basis of body surface area as illustrated below:

Body surface area (m²) Recommended dose
>1.25200 mg three times a day
>0.88-1.25200 mg twice a day
>0.73-0.88100 mg three times a day
>0.47-0.73100 mg twice a day
≤ 0.47100 mg once a day

Temporary dose reduction may be necessary in some patients because of diarrhoea.

The benefit to the patient of treatment with Yargesa should be evaluated on a regular basis (see section 4.4). There is limited experience with the use of Yargesa in Niemann-Pick type C disease patients under the age of 4 years.

Special populations

Elderly

There is no experience with the use of Yargesa in patients over the age of 70.

Renal Impairment

Pharmacokinetic data indicate increased systemic exposure to miglustat in patients with renal impairment. In patients with an adjusted creatinine clearance of 50-70 ml/min/1.73 m², administration should commence at a dose of 100 mg twice daily in patients with type 1 Gaucher disease and at a dose of 200 mg twice daily (adjusted for body surface area in patients below the age of 12) in patients with Niemann-Pick type C disease.

In patients with an adjusted creatinine clearance of 30-50 ml/min/1.73 m², administration should commence at a dose of 100 mg once daily in patients with type 1 Gaucher disease and at a dose of 100 mg twice daily (adjusted for body surface area in patients below the age of 12) in patients with Niemann-Pick type C disease. Use in patients with severe renal impairment (creatinine clearance <30 ml/min/1.73 m²) is not recommended (see sections 4.4 and 5.2).

Hepatic Impairment

Yargesa has not been evaluated in patients with hepatic impairment.

Method of Administration

Yargesa can be taken with or without food.

4.9. Overdose

Symptoms

No acute symptoms of overdose have been identified. Miglustat has been administered at doses of up to 3000 mg/day for up to six months in HIV positive patients during clinical trials. Adverse events observed included granulocytopenia, dizziness and paraesthesia. Leukopenia and neutropenia have also been observed in a similar group of patients receiving 800 mg/day or higher dose.

Management

In case of overdose general medical care is recommended.

6.3. Shelf life

4 years.

6.4. Special precautions for storage

This medicinal product does not require any special storage conditions.

6.5. Nature and contents of container

PVC and polychlorotrifluoroethylene (PCTFE) blister sealed with aluminium foil containing 21 capsules.

Pack size: 84 × 1 capsules.

6.6. Special precautions for disposal and other handling

No special requirements.

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