Drugplain

Orfadin 20 mg/1

Nitisinone · CAPSULE · SWEDISH ORPHAN BIOVITRUM AB (PUBL)

No Recall History
Plain English

Orfadin is a capsule containing nitisinone at 20 mg/1, taken oral. Manufactured by SWEDISH ORPHAN BIOVITRUM AB (PUBL).

Key Facts

Brand Name
Orfadin
Generic Name
Nitisinone
NDC Code (Product)
66658-120
Manufacturer
SWEDISH ORPHAN BIOVITRUM AB (PUBL)
Strength
20 mg/1
Dosage Form
CAPSULE
Route
ORAL
Marketing Status
Application #
NDA021232
Drug Class
4-Hydroxyphenyl-Pyruvate Dioxygenase Inhibitor [EPC]
Marketing Start
07/01/2016

Recall History

No Recall History

Side Effects Reported to FDA

FDA FAERS database · These are reported events, not confirmed side effects

amino acid level increased128 reports
liver transplant117 reports
hepatocellular carcinoma61 reports
alpha 1 foetoprotein increased52 reports
treatment noncompliance49 reports
cataract47 reports
hepatic failure44 reports
hepatic cirrhosis37 reports
death36 reports
lenticular opacities34 reports

Full Prescribing Information

Source: FDA Drug Label (SPL)For healthcare professionals

Indications & Usage

1 INDICATIONS AND USAGE ORFADIN ® is indicated for the treatment of adult and pediatric patients with hereditary tyrosinemia type 1 (HT-1) in combination with dietary restriction of tyrosine and phenylalanine. ORFADIN is a hydroxy-phenylpyruvate dioxygenase inhibitor indicated for the treatment of adult and pediatric patients with hereditary tyrosinemia type 1 (HT-1) in combination with dietary restriction of tyrosine and phenylalanine. ( 1 )

Dosage & Administration

2 DOSAGE AND ADMINISTRATION Recommended Dosage ( 2.1 ) : The recommended starting dosage is 0.5 mg/kg orally twice daily. In patients 5 years of age and older who have undetectable serum and urine succinylacetone concentrations after a minimum of 4 weeks on a stable dosage of nitisinone, the total daily dose may be given once daily. Titrate the dosage based on biochemical and/or clinical response, as described in the full prescribing information. The maximum total daily dosage is 2 mg/kg orally. Preparation and Administration Instructions ( 2.2 ) : For instructions on preparing, measuring and administering the oral suspension, see the full prescribing information. Maintain dietary restriction of tyrosine and phenylalanine Take ORFADIN capsules at least one hour before, or two hours after a meal For patients who have difficulties swallowing capsules and who are intolerant to the oral suspension, the capsules may be opened and the contents suspended in a small amount of water, formula or apple sauce immediately before use. Take ORFADIN oral suspension without regard to meals. 2.1 Dosage Starting Dosage The recommended starting dosage of ORFADIN is 0.5 mg/kg administered orally twice

Contraindications

4 CONTRAINDICATIONS None. None ( 4 )

Drug Interactions

7 DRUG INTERACTIONS Nitisinone is a moderate CYP2C9 inhibitor, a weak CYP2E1 inducer and an inhibitor of OAT1/OAT3. Table 2 includes drugs with clinically important drug interactions when administered concomitantly with ORFADIN and instructions for preventing or managing them. Table 2: Clinically Relevant Interactions Affecting Co-Administered Drugs Sensitive CYP2C9 Substrates (e.g., celecoxib, tolbutamide) or CYP2C9 Substrates with a Narrow Therapeutic Index (e.g., phenytoin, warfarin) Clinical Impact Increased exposure of the co-administered drugs metabolized by CYP2C9. [see Clinical Pharmacology ( 12.3 )] Intervention Reduce the dosage of the co-administered drugs metabolized by CYP2C9 drug by half. Additional dosage adjustments may be needed to maintain therapeutic drug concentrations for narrow therapeutic index drugs. See prescribing information for those drugs. OAT1/OAT3 Substrates (e.g., adefovir, ganciclovir, methotrexate) Clinical Impact Increased exposure of the interacting drug [see Clinical Pharmacology ( 12.3 )] Intervention Monitor for potential adverse reactions related to the co-administered drug. CYP2C9 Substrates : Increased systemic exposure of these co-administ

Adverse Reactions

6 ADVERSE REACTIONS Most common adverse reactions (>1%) are elevated tyrosine levels, thrombocytopenia, leukopenia, conjunctivitis, corneal opacity, keratitis, photophobia, eye pain, blepharitis, cataracts, granulocytopenia, epistaxis, pruritus, exfoliative dermatitis, dry skin, maculopapular rash and alopecia. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Swedish Orphan Biovitrum at 1-866-773-5274 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. ORFADIN was studied in one open-label, uncontrolled study of 207 patients with HT-1, ages 0 to 22 years at enrollment (median age 9 months), who were diagnosed with HT-1 by the presence of succinylacetone in the urine or plasma. The starting dose of ORFADIN was 0.3 to 0.5 mg/kg twice daily, and the dose was increased in some patients to 1 mg/kg twice daily based on weight, biochemical, and enzyme markers. The recommended starting d

Frequently Asked Questions

What is Orfadin used for?

Orfadin contains Nitisinone. It is a capsule taken oral. Consult your doctor for specific uses.

Is Orfadin a controlled substance?

Orfadin is not classified as a controlled substance by the DEA.

What is the generic name for Orfadin?

The generic name for Orfadin is Nitisinone. There are 9 other brand versions of Nitisinone.

What is the NDC code for Orfadin 20 mg/1?

The NDC (National Drug Code) for Orfadin 20 mg/1 is 66658-120, listed by SWEDISH ORPHAN BIOVITRUM AB (PUBL).

Product NDC

66658-120

Package NDC

66658-120-60

Not medical advice. Always consult your doctor or pharmacist before making any medication decisions.

Data from openFDA · Public domain (CC0 1.0)