Zaditen
NAME OF THE MEDICINAL PRODUCT
Zaditen 0.25 mg/ml,eye drops, solution in single-dose containers.
QUALITATIVE AND QUANTITATIVE COMPOSITION
0.4 ml contains 0.138 mg ketotifen fumarate corresponding to 0.1 mg ketotifen.
Each drop contains 9.5 microgram ketotifen fumarate.
For the full list of excipients, see section 6.1.
PHARMACEUTICAL FORM
Eye drops, solution in single-dose containers.
Clear, colourless to faintly yellow solution.
CLINICAL PARTICULARS
Therapeutic indications
Symptomatic treatment of seasonal allergic conjunctivitis.
Posology and method of administration
Adults, elderly and children (age 3 and older): one drop of Zaditen into the conjunctival sac twice a day. The contents of a single-dose container are sufficient for one administration into both eyes.
The contents remain sterile until the original closure is broken. To avoid contamination do not touch any surface with the tip of the container.
The safety and efficacy of Zaditen in children below the age of 3 years have not yet been established.
Contraindications
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Special warnings and special precautions for use
No special warning.
Interaction with other medicinal products and other forms of interaction
If Zaditen is used concomitantly with other eye medications there must be an interval of at least 5 minutes between the medications.
The use of oral dosage forms of ketotifen may potentiate the effects of CNS depressants, antihistamines and alcohol. Although this has not been observed with Zaditen eye drops, the possibility of such effects cannot be excluded.
Fertility, pregnancy and lactation
Pregnancy
There are no adequate data from the use of ketotifen eye drops in pregnant women. Animal studies using maternally toxic oral doses showed increased pre- and postnatal mortality, but no teratogenicity. Systemic levels after ocular administration are much lower than after oral use. Caution should be exercised when prescribing to pregnant women.
Breast-feeding
Although animal data following oral administration show excretion into breast milk, topical administration to human is unlikely to produce detectable quantities in breast milk. Zaditen eye drops can be used during lactation.
Fertility
There is no data available on the effect of ketotifen fumarate on fertility in humans.
Effects on ability to drive and use machines
Any patient who experiences blurred vision or somnolence should not drive or operate machines.
Undesirable effects
Adverse reactions are ranked under heading of frequency, using the following convention: Very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000), not known (cannot be estimated from the available data).
Immune system disorders
Uncommon: Hypersensitivity
Nervous system disorders
Uncommon: Headache
Eye disorders
Common: Eye irritation, eye pain, punctate keratitis, punctate corneal epithelial erosion.
Uncommon: Vision blurred (during instillation), dry eye, eyelid disorder, conjunctivitis, photophobia, conjunctival haemorrhage.
Gastrointestinal disorders
Uncommon: Dry mouth
Skin and subcutaneous tissue disorders
Uncommon: Rash, eczema, urticaria
General disorders and administration site conditions
Uncommon: Somnolence
Adverse drug reactions from post marketing experience (Frequency not known): hypersensitivity reactions including local allergic reaction (mostly contact dermatitis, eye swelling, eyelid pruritis and oedema), systemic allergic reactions including facial swelling/oedema (in some cases associated with contact dermatitis) and exacerbation of pre-existing allergic conditions such as asthma and eczema.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation 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 reactions via the national reporting system listed in Appendix V.
Overdose
No case of overdose has been reported.
Oral ingestion of the contents of a single-dose container would be equivalent to 0.1 mg of ketotifen which is 5% of a recommended oral daily dose for a 3 year old child. Clinical results have shown no serious signs or symptoms after oral ingestion of up to 20 mg of ketotifen.
PHARMACOLOGICAL PROPERTIES
Pharmacodynamic properties
Pharmacotherapeutic group: Ophthalmologicals, other antiallergics
ATC code: S01GX08
Ketotifen is a histamine H1-receptor antagonist. In vivoanimal studies and in vitrostudies suggest the additional activities of mast cell stabilisation and inhibition of infiltration, activation and degranulation of eosinophils.
Pharmacokinetic properties
In a pharmacokinetic study conducted in 18 healthy volunteers with Zaditen eye drops, plasma levels of ketotifen after repeated ocular administration for 14 days were in most cases below the limit of quantitation (20 pg/ml).
After oral administration, ketotifen is eliminated biphasically, with an initial half life of 3 to 5 hours and a terminal half life of 21 hours. About 1% of the substance is excreted unchanged in the urine within 48 hours and 60 to 70% as metabolites. The main metabolite is a practically inactive ketotifen-N-glucuronide.
Preclinical safety data
Preclinical data reveal no special hazard which is considered relevant in connection with use of Zaditen eye drops in humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential and toxicity to reproduction.
PHARMACEUTICAL PARTICULARS
List of excipients
Glycerol (E422)
Sodium hydroxide (E524)
Water for injections
Incompatibilities
Not applicable.
Shelf‑life
In unopened blister/pouch: 2 years.
Opened blister/pouch: 28 days.
Single-dose containers stored without blister/pouch in the outer carton: 3 months.
After opening, the contents of a single-dose container should be used immediately.
Special precautions for storage
Do not store above 25°C.
Nature and contents of container
The container is a transparent LDPE single-dose container. Blocks of 5 single-dose containers are each packed in a blister made of PVC, aluminium, polyamide tray sealed with an aluminium foil cover and paper layer, or in a pouch made of polyethylene, aluminium and polyester.Carton boxes of 5, 10, 20, 30, 50and 60 single-dose containers.
Not all pack sizes may be marketed.
Special precautions for disposal and other handling
Single-dose containers must be discarded after use.
MARKETING AUTHORISATION HOLDER
<[To be completed nationally]>
MARKETING AUTHORISATION NUMBER(S)
<[To be completed nationally]>
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
2000-06-30/2010-06-30
DATE OF REVISION OF THE TEXT
9