(surface antigen) Influvac QUALITATIVE AND QUANTITATIVE COMPOSITION Influenza virus surface antigens (hemagglutinin and neuraminidase) of the following strains*: - A/Michigan/45/2015 (H1N1)pdm09-like virus 15 micrograms HA ** - A/Hong Kong/4801/2014 (H3N2)-like virus 15 micrograms HA ** - B/Brisbane/60/2008-like virus 15 micrograms HA ** per 0.5 ml dose. * propagated in fertilized hens eggs from healthy chicken flocks ** hemagglutinin This vaccine complies with the World Health Organization (WHO) recommendation (southern hemisphere) and competent authority decision for the 2017 season. List of excipients Potassium chloride, potassium dihydrogen phosphate, disodium phosphate dihydrate, sodium chloride, calcium chloride dihydrate, magnesium chloride hexahydrate and water for injections. Inactivated Influenza Vaccine (surface antigen) (Influvac) may contain traces of eggs (such as ovalbumin, chicken proteins), formaldehyde, cetyltrimethylammonium bromide, polysorbate 80 or gentamicin, which are used during the manufacturing process (see section Contraindications). PHARMACEUTICAL FORM Suspension for injection in prefilled syringes, a colorless clear liquid, filled in single-dose syringes (glass, type I). CLINICAL PARTICULARS Therapeutic indications Prophylaxis of influenza; especially those who run an increased risk of associated complications. Inactivated Influenza Vaccine (surface antigen) (Influvac) is indicated in adults and children from 6 months of age. The use of Inactivated Influenza Vaccine (surface antigen) (Influvac) should be based on official recommendations. Vaccination is particularly recommended for the following categories of patients, depending on national immunization policies: - Persons aged 65 years, regardless their health condition. - Adults and children with chronic disorders of the pulmonary or cardiovascular systems, including asthma. - Adults and children with chronic metabolic diseases such as diabetes mellitus. - Adults and children with chronic renal dysfunction. - Adults and children with immunodeficiencies due to disease or immunosuppressant medication (e.g., cytostatics or corticosteroids) or radiotherapy. - Children and teenagers (6 months 18 years) who receive long-term acetylsalicylic acid containing medication, and might therefore be at risk for developing Reyes syndrome following an influenza infection. Posology and method of administration Posology Adults: 0.5 mL. Pediatric population Children from 36 months onwards: 0.5 mL. Children from 6 months to 35 months: Clinical data are limited. Dosages of 0.25 mL or 0.5 mL may be given, for detailed instructions on administering a 0.25 mL or 0.5 mL dose, see section Special precautions for disposal and other handling. The dose given should be in accordance with existing national recommendations. For children, who have not previously been vaccinated, a second dose should be given after an interval of at least 4 weeks. Children less than 6 months: the safety and efficacy of Inactivated Influenza Vaccine (surface antigen) (Influvac) in children less than 6 months have not been established. No data are available. Method of Administration Immunization should be carried out by intramuscular or deep subcutaneous injection. Precautions to be taken before handling or administrating the medicinal product: For instructions for preparation of the medicinal product before administration, see section Special precautions for disposal and other handling. Contraindications Hypersensitivity to the active substances, to any of the excipients listed in section List of excipients or to any component that may be present as traces such as eggs (ovalbumin, chicken proteins), formaldehyde, cetyltrimethylammonium bromide, polysorbate 80 or gentamicin. Immunization shall be postponed in patients/children with febrile illness or acute infection. Special warnings and precautions for use As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event following the administration of the vaccine. Inactivated Influenza Vaccine (surface antigen) (Influvac) should under no circumstances be administered intravascularly. Anxiety-related reactions, including vasovagal reactions (syncope), hyperventilation or stress- related reactions can occur following, or even before, any vaccination as a psychogenic response to the needle injection. This can be accompanied by several neurological signs such as transient visual disturbance, paresthesia and tonic-clonic limb movements during recovery. It is important that procedures are in place to avoid injury from faints. Antibody response in patients/children with endogenous or iatrogenic immunosuppression may be insufficient. Interference with serological testing: see section Interaction with other medicinal products and other forms of interaction. Interaction with other medicinal products and other forms of interaction Inactivated Influenza Vaccine (surface antigen) (Influvac) may be given at the same time as other vaccines. Immunization should be carried out on separate limbs. It should be noted that the adverse reactions may be intensified. The immunological response may be diminished if the patient/child is undergoing immunosuppressant treatment. Following influenza vaccination, false positive results in serology tests using the ELISA method to detect antibodies against HIV1, Hepatitis C and especially HTLV1 have been observed. The Western Blot technique disproves the false-positive ELISA test results. The transient false-positive reactions could be due to the IgM response by the vaccine. Fertility, pregnancy and lactation Pregnancy Inactivated influenza vaccines can be used in all stages of pregnancy. Larger datasets on safety are available for the second and third trimester, compared with the first trimester; however, data from worldwide use of influenza vaccine do not indicate any adverse fetal and maternal outcomes attributable to the vaccine. Breastfeeding Inactivated Influenza Vaccine (surface antigen) (Influvac) may be used during breastfeeding. Fertility No fertility data are available. 1108461
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Effects on ability to drive and use machines Inactivated Influenza Vaccine (surface antigen) (Influvac) has no or negligible influence on the ability to drive and use machines. Undesirable effects ADVERSE REACTIONS OBSERVED FROM CLINICAL TRIALS The safety of trivalent inactivated influenza vaccines is assessed in open label, uncontrolled clinical trials performed as annual update requirement, including at least 50 adults aged 18 - 60 years of age and at least 50 elderly aged 61 years or older. Safety evaluation is performed during the first 3 days following vaccination. The following undesirable effects have been observed during clinical trials with the following frequencies: very common (1/10); common (1/100, <1/10); uncommon (1/1,000, <1/100) Tabulated list of adverse reactions: Organ class Very common Common Uncommon 1/10 1/100, <1/10 1/1,000, <1/100 Nervous system disorders Headache* Skin and subcutaneous Sweating* tissue disorders Musculoskeletal and Myalgia, connective tissue disorders arthralgia* General disorders and fever, malaise, administration site shivering, fatigue conditions Local reactions: redness, swelling, pain, ecchymosis, induration* * These reactions usually disappear within 1-2 days without treatment ADVERSE REACTIONS REPORTED FROM POST-MARKETING SURVEILLANCE Adverse reactions reported from post marketing surveillance are, next to the reactions which have also been observed during the clinical trials, the following: Blood and lymphatic system disorders: Transient thrombocytopenia, transient lymphadenopathy Immune system disorders: Allergic reactions, in rare cases leading to shock, angioedema Nervous system disorders: Neuralgia, paresthesia, febrile convulsions, neurological disorders, such as encephalomyelitis, neuritis and Guillain Barr syndrome. Vascular disorders: Vasculitis associated in very rare cases with transient renal involvement Skin and subcutaneous tissue disorders: Generalized skin reactions including pruritus, urticaria or non-specific rash Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorization of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse. For suspected adverse drug reaction, report to the FDA: www.fda.gov.ph. Seek medical attention immediately at the first sign of any adverse drug reaction. Overdose Overdosage is unlikely to have any untoward effect. PHARMACOLOGICAL PROPERTIES Pharmacodynamic properties Pharmacotherapeutic group: Influenza vaccine, ATC Code: J07BB02. Seroprotection is generally obtained within 2 to 3 weeks. The duration of post-vaccinal immunity to homologous strains or to strains closely related to the vaccine strains varies but is usually 6-12 months. Pharmacokinetic properties Not applicable. Preclinical safety data Not applicable. PHARMACEUTICAL PARTICULARS Incompatibilities In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products. Shelf life 1 year Special precautions for storage Store at temperatures between 2C - 8C. (Refrigerate. Do not freeze.) Store in the original package in order to protect from light. Nature and contents of container 0.5 mL suspension for injection in prefilled syringe with / without needle (glass, type I), pack of 1. Special precautions for disposal and other handling The vaccine should be allowed to reach room temperature before use. Shake before use. Inspect visually prior to administration. For the administration of a 0.25 mL dose from a single dose 0.5 mL syringe, push the front side of the plunger exactly to the edge of the mark so that half of the volume is eliminated; a volume of 0.25 mL of the vaccine remains in the syringe, suitable for administration. See also section Posology and method of administration. Any unused product or waste material should be disposed of in accordance with local requirements. Caution Foods, Drugs, Devices and Cosmetics Act prohibits dispensing without prescription. Registration Number: BR-901 Date of First Authorization: 10 March 2014 Manufactured by Abbott Biologicals B.V. Veerweg 12, 8121 AA Olst The Netherlands Imported by Abbott Laboratories Venice Corporate Center 8 Turin St., Mckinley Town Center Fort Bonifacio, Taguig City, Philippines Distributed by Zuellig Pharma Corporation Km. 14 West Service Road SH cor. Edison Ave. Sun Valley, Paraaque City, Philippines Date of Revision of Package Insert: 18 Mar 2016 SOLID1000609529 v1.0 1108461