United States - English - NLM (National Library of Medicine)

e.r. squibb & sons, l.l.c. - nivolumab (unii: 31yo63lbsn) (nivolumab - unii:31yo63lbsn), relatlimab (unii: af75xof6w3) (relatlimab - unii:af75xof6w3) - opdualag™ is indicated for the treatment of adult and pediatric patients 12 years of age or older with unresectable or metastatic melanoma. none.       risk summary based on findings in animals and mechanism of action, opdualag can cause fetal harm when administered to a pregnant woman. administration of nivolumab to cynomolgus monkeys from the onset of organogenesis through delivery resulted in increased abortion and premature infant death (see data ). human igg4 is known to cross the placenta; therefore, nivolumab and relatlimab have the potential to be transmitted from the mother to the developing fetus. the effects of opdualag are likely to be greater during the second and third trimesters of pregnancy. there are no available data on opdualag in pregnant women to evaluate a drug-associated risk. advise the patient of the potential risk to a fetus. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. data animal data opdualag injection for intravenous use contains nivolumab and relatlimab [see description (11)] . nivolumab: one function of the pd-1/pd-l1 pathway is to preserve pregnancy by maintaining immune tolerance to the fetus. the effects of nivolumab on prenatal and postnatal development were evaluated in monkeys that received nivolumab twice weekly from the onset of organogenesis through delivery, at exposure levels of between 9 and 42 times higher than those observed at the clinical dose of 3 mg/kg (based on auc). nivolumab administration resulted in a non-dose-related increase in spontaneous abortion and increased neonatal death. in surviving infants (18 of 32 compared to 11 of 16 vehicle-exposed infants) of cynomolgus monkeys treated with nivolumab, there were no apparent malformations and no effects on neurobehavioral, immunological, or clinical pathology parameters throughout the 6-month postnatal period. relatlimab: there are no available animal data on relatlimab. the effects of a murine surrogate anti-lag-3 antibody was evaluated in mice using syngeneic and allogeneic breeding models. when anti-lag-3 antibodies were administered beginning on gestation day 6, there were no maternal or developmental effects in either syngeneic or allogeneic breedings. risk summary there are no data on the presence of nivolumab and relatlimab in human milk, the effects on the breastfed child, or the effects on milk production. because nivolumab and relatlimab may be excreted in human milk and because of the potential for serious adverse reactions in a breastfed child, advise patients not to breastfeed during treatment with opdualag and for at least 5 months after the last dose [see pharmacokinetics (12.3)] . opdualag can cause fetal harm when administered to a pregnant woman [see use in specific populations (8.1)] . pregnancy testing verify the pregnancy status of females of reproductive potential prior to initiating opdualag [see use in specific populations (8.1)] . contraception advise females of reproductive potential to use effective contraception during treatment and for at least 5 months following the last dose of opdualag [see clinical pharmacology (12.3)] . the safety and effectiveness of opdualag for the treatment of unresectable or metastatic melanoma have been established in pediatric patients 12 years of age or older who weigh at least 40 kg. use of opdualag for this indication is supported by evidence from an adequate and well-controlled study in adults and additional data analyses that suggest that nivolumab and relatlimab exposures in pediatric patients 12 years of age who weigh at least 40 kg are expected to result in similar safety and efficacy to that of adults. the pharmacokinetics of monoclonal antibodies and the course of unresectable or metastatic melanoma are sufficiently similar in adults and pediatric patients 12 years of age or older to allow extrapolation of data from adult patients to pediatric patients 12 years of age or older (who weigh at least 40 kg). a recommended dosage for pediatric patients 12 years of age or older who weigh less than 40 kg has not been established [see adverse reactions (6.1), clinical pharmacology (12.3), and clinical studies (14)] . the safety and effectiveness of opdualag have not been established in pediatric patients 12 years of age or older who weigh less than 40 kg, and pediatric patients younger than 12 years of age. of the 355 patients treated with opdualag in relativity-047, 47% of patients were 65 years or older, 29% were 65 to 74 years, 17% were 75 to 84 years, and 1.7% were 85 years and older. no overall differences in safety or effectiveness were observed between elderly patients and younger patients.

Australia - English - Department of Health (Therapeutic Goods Administration)

pfizer australia pty ltd - conjugated estrogens, quantity: 0.45 mg; bazedoxifene acetate, quantity: 22.56 mg (equivalent: bazedoxifene, qty 20 mg) - tablet, modified release - excipient ingredients: lactose monohydrate; hypromellose; microcrystalline cellulose; hyprolose; macrogol 400; magnesium stearate; sucrose palmitate; ascorbic acid; powdered cellulose; calcium phosphate; sucrose; propylene glycol; purified water; isopropyl alcohol; iron oxide black; titanium dioxide; iron oxide red; polydextrose; povidone; hyetellose; maltitol solution; poloxamer - duavive is indicated for treatment of moderate to severe vasomotor symptoms associated with menopause in women with a uterus.,- duavive should be used for the shortest duration consistent with treatment goals and risks for the individual woman.,- experience in women older than 65 years is limited.

Australia - English - Department of Health (Therapeutic Goods Administration)

bristol-myers squibb australia pty ltd - nivolumab, quantity: 255.6 mg; relatlimab, quantity: 85.2 mg - injection, concentrated - excipient ingredients: histidine hydrochloride monohydrate; water for injections; pentetic acid; sucrose; polysorbate 80; histidine - opdualag is indicated for the treatment of patients with unresectable or metastatic melanoma who are at least 12 years old.

European Union - English - EMA (European Medicines Agency)

covis pharma europe b.v. - aclidinium bromide, formoterol fumarate dihydrate - pulmonary disease, chronic obstructive - drugs for obstructive airway diseases, - duaklir genuair is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (copd).

European Union - English - EMA (European Medicines Agency)

pfizer europe ma eeig - oestrogens conjugated, bazedoxifene - postmenopause - conjugated estrogens and bazedoxifene - duavive is indicated for:treatment of oestrogen deficiency symptoms in postmenopausal women with a uterus (with at least 12 months since the last menses) for whom treatment with progestin-containing therapy is not appropriate.the experience treating women older than 65 years is limited.

United States - English - NLM (National Library of Medicine)

u.s. pharmaceuticals - estrogens, conjugated (unii: iu5qr144qx) (estrogens, conjugated - unii:iu5qr144qx), bazedoxifene acetate (unii: j70472ud3d) (bazedoxifene - unii:q16tt9c5bk) - estrogens, conjugated 0.45 mg - duavee is indicated in women with a uterus for: duavee is contraindicated in women with any of the following conditions: risk summary duavee is contraindicated for use in pregnant women and is not indicated for use in females of reproductive potential [see contraindications (4), warnings and precautions (5.15)]. conjugated estrogens (ce) there are no data with the use of conjugated estrogens in pregnant women; however, epidemiologic studies and meta-analyses have not found an increased risk of genital and non-genital birth defects (including cardiac anomalies and limb-reduction defects) following exposure to combined hormonal contraceptives before conception or during early pregnancy. bazedoxifene there are no available data on bazedoxifene use in pregnant women to inform a drug associated risk of adverse developmental outcomes. animal studies have shown that oral bazedoxifene administered during the period of organogenesis to pregnant rats or rabbits at 0.3 and 2 times, respectively, the exposure at the maxi

United States - English - NLM (National Library of Medicine)

wyeth pharmaceuticals llc, a subsidiary of pfizer inc. - estrogens, conjugated (unii: iu5qr144qx) (estrogens, conjugated - unii:iu5qr144qx), bazedoxifene acetate (unii: j70472ud3d) (bazedoxifene - unii:q16tt9c5bk) - estrogens, conjugated 0.45 mg - duavee is indicated in women with a uterus for: duavee is contraindicated in women with any of the following conditions: risk summary duavee is contraindicated for use in pregnant women and is not indicated for use in females of reproductive potential [see contraindications (4), warnings and precautions (5.15)]. conjugated estrogens (ce) there are no data with the use of conjugated estrogens in pregnant women; however, epidemiologic studies and meta-analyses have not found an increased risk of genital and non-genital birth defects (including cardiac anomalies and limb-reduction defects) following exposure to combined hormonal contraceptives before conception or during early pregnancy. bazedoxifene there are no available data on bazedoxifene use in pregnant women to inform a drug associated risk of adverse developmental outcomes. animal studies have shown that oral bazedoxifene administered during the period of organogenesis to pregnant rats or rabbits at 0.3 and 2 times, respectively, the exposure at the maximum recommended dose, can cause fetal harm [see data]. based on mechanism of action, bazedoxifene may block the important functions that estrogen has during all stages of pregnancy [see clinical pharmacology (12.1)] . data animal data bazedoxifene administration of bazedoxifene to rats at maternally toxic dosages ≥1 mg/kg/day (≥ 0.3 times the human area under the curve (auc) at the 20 mg dose) resulted in reduced numbers of live fetuses and/or reductions in fetal body weights. no fetal developmental anomalies were observed. in studies conducted with pregnant rabbits treated with bazedoxifene, abortion and an increased incidence of heart (ventricular septal defect) and skeletal system (ossification delays, misshapen or misaligned bones, primarily of the spine and skull) anomalies in the fetuses were present at maternally toxic dosages of ≥ 0.5 mg/kg/day (≥ 2 times the human auc at the 20 mg dose). risk summary duavee is not indicated for use in females of reproductive potential [see warnings and precautions (5.15)] . conjugated estrogens estrogens are present in human milk and can reduce milk production in breast-feeding females. this reduction can occur at any time but is less likely to occur once breast-feeding is well-established. bazedoxifene there are no data on the presence of bazedoxifene in either human or animal breast milk, the effect on the breastfed infant, or the effects on milk production. based on mechanism of action, bazedoxifene may block the important functions that estrogen has in mammary tissue during lactation [see clinical pharmacology (12.1)]. infertility bazedoxifene based on animal data, bazedoxifene administration may adversely affect female fertility. however, clinical fertility studies with bazedoxifene have not been conducted [see nonclinical toxicology (13.1)] . duavee is not indicated for use in children [see indications and usage (1)] . duavee is not recommended for use in women greater than 75 years of age [see dosage and administration (2.7) and clinical pharmacology 12.3)] . of the total number of women in phase 3 clinical studies who received duavee, 4.60% (n=224) were 65 years and over. duavee was not studied in women aged 75 and over. no overall differences in safety or effectiveness were observed between women 65–74 years of age and younger women, and other reported clinical experience has not identified differences in responses between the elderly and younger women, but greater sensitivity of some older women cannot be ruled out. an increased risk of probable dementia in women over 65 years of age was reported in the women's health initiative memory ancillary studies of the women's health initiative using daily conjugated estrogens (0.625 mg) [see clinical studies (14.6)]. duavee is not recommended for use in patients with renal impairment [see dosage and administration (2.6) and clinical pharmacology (12.3)]. the pharmacokinetics, safety, and efficacy of duavee have not been evaluated in women with renal impairment. duavee is contraindicated in patients with hepatic impairment [see contraindications (4) and clinical pharmacology (12.3)]. the pharmacokinetics, safety, and efficacy of duavee have not been evaluated in women with hepatic impairment. in a pharmacokinetics study of bazedoxifene 20 mg alone, the cmax and auc of bazedoxifene increased 67% and 143%, respectively, in women with mild hepatic impairment (child pugh class a), compared to healthy women. the cmax and auc of bazedoxifene increased 32% and 109%, respectively, in women with moderate hepatic impairment (child pugh class b). the cmax and auc of bazedoxifene increased 20% and 268%, respectively, in women with severe hepatic impairment (child pugh class c). no pharmacokinetic studies with conjugated estrogens were conducted in women with hepatic impairment. following duavee administration, the systemic exposures of conjugated estrogens and bazedoxifene were lower in obese subjects, compared to non-obese subjects [see pharmacokinetics (12.3)] . a single dose of duavee (conjugated estrogens 0.45 mg/bazedoxifene 20 mg) was administered to 12 obese bmi ≥ 30 [mean (sd) = 32.7 (2.7) kg/m2 ] and 12 non-obese bmi < 30 [mean (sd) 25.3 (2.6) kg/m2 ] postmenopausal women. in obese subjects, systemic exposures of total estrone, total equilin, and bazedoxifene were 2%, 32%, and 13% lower, respectively, compared to non-obese subjects. a greater reduction in bazedoxifene exposure compared to conjugated estrogens may be associated with decreased protection from endometrial hyperplasia. monitor and evaluate women with postmenopausal or unexplained genital bleeding for possible endometrial hyperplasia or malignancy [see warnings and precautions (5.3)] .

United States - English - NLM (National Library of Medicine)

u.s. pharmaceuticals - estrogens, conjugated (unii: iu5qr144qx) (estrogens, conjugated - unii:iu5qr144qx), bazedoxifene acetate (unii: j70472ud3d) (bazedoxifene - unii:q16tt9c5bk) - estrogens, conjugated 0.45 mg - duavee is indicated in women with a uterus for: - use duavee for the shortest duration consistent with treatment goals and risks for the individual woman. postmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary. - when prescribing solely for the prevention of postmenopausal osteoporosis, therapy should only be considered for women at significant risk of osteoporosis and non-estrogen medication should be carefully considered. duavee is contraindicated in women with any of the following conditions: - undiagnosed abnormal uterine bleeding - known, suspected, or past history of breast cancer - known or suspected estrogen-dependent neoplasia - active deep venous thrombosis, pulmonary embolism, or history of these conditions - active arterial thromboembolic disease (for example, stroke, myocardial infarction) or history of these conditions - hypersensitivity (for example, anaphylaxis, angioedema) to estrogens, bazedoxifene, or any ingredients -

United States - English - NLM (National Library of Medicine)

circassia pharmaceuticals inc. - aclidinium bromide (unii: uqw7uf9n91) (aclidinium - unii:k17vy42f6c), formoterol fumarate (unii: w34shf8j2k) (formoterol - unii:5zz84gcw8b) - duaklir pressair is a combination of aclidinium bromide (an anticholinergic) and formoterol fumarate (a laba) indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (copd). limitations of use : duaklir pressair is not indicated for the relief of acute bronchospasm or for the treatment of asthma [see warnings and precautions (5.1, 5.4)] . use of a long-acting beta2 -adrenergic agonist (laba), including formoterol fumarate, one of the active ingredients in duaklir pressair, without an inhaled corticosteroid is contraindicated in patients with asthma [see warnings and precautions (5.1)] . duaklir pressair is not indicated for the treatment of asthma. duaklir pressair is contraindicated in patients with: risk summary there are no adequate and well-controlled studies of duaklir pressair or its individual components, formoterol fumarate or aclidinium bromide, in pregnant women to inform drug-associated risks. no adverse developmental effects were seen w

United States - English - NLM (National Library of Medicine)

astrazeneca pharmaceuticals lp - aclidinium bromide (unii: uqw7uf9n91) (aclidinium - unii:k17vy42f6c), formoterol fumarate (unii: w34shf8j2k) (formoterol - unii:5zz84gcw8b) - duaklir pressair is a combination of aclidinium bromide (an anticholinergic) and formoterol fumarate (a laba) indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (copd). limitations of use: duaklir pressair is not indicated for the relief of acute bronchospasm or for the treatment of asthma [see warnings and precautions (5.1, 5.4)] . use of a long-acting beta2 -adrenergic agonist (laba), including formoterol fumarate, one of the active ingredients in duaklir pressair, without an inhaled corticosteroid is contraindicated in patients with asthma [see warnings and precautions (5.1)] . duaklir pressair is not indicated for the treatment of asthma. duaklir pressair is contraindicated in patients with: risk summary there are no adequate and well-controlled studies of duaklir pressair or its individual components, formoterol fumarate or aclidinium bromide, in pregnant women to inform drug-associated risks. no adverse developmental effects were seen with inhalation administr