1. Name Of The Medicinal Product
Soluprick SQ Grass Pollen Phleum pratense (Timothy Grass), 10 HEP, Solution for skin prick test, 2 ml per vial
2. Qualitative And Quantitative Composition
Soluprick SQ Grass Pollen is a glycerinated preparation containing standardised allergen extracts dissolved in equal parts of buffered saline and sterile glycerol.
Active ingredients:
The active ingredient is a partly purified pollen allergen extract which contains the relevant allergen. The active ingredient is standardised with respect to the content of major allergen and the biological activity is controlled by a total potency assay. The potency is expressed in HEP (Histamine Equivalent in Prick testing). The biological activity of Soluprick SQ Grass Pollen is related to the reaction in the skin of an allergic patient measured relative to a histamine dihydrochloride solution.
For a full list of excipients, see section 6.1
3. Pharmaceutical Form
Solution for a skin prick test (SPT)
4. Clinical Particulars
4.1 Therapeutic Indications
Soluprick SQ Grass Pollen is used in the diagnosis of specific IgE mediated allergic diseases.
4.2 Posology And Method Of Administration
Dosage:
Soluprick SQ Grass Pollen 10 HEP is recommended as the optimal biological potency of the allergen when taking into account the meaning of high sensitivity related to high specificity. The potency is expressed in HEP (Histamine Equivalent in Prick testing) which is related to the allergenic activity of the allergen product in the skin of the allergic patient.
ALK Positive con-trol (histamine dihydrochloride 10 mg/ml) is used as reference and ALK Negative control (Saline solution) is used to evaluate unspecific reactions.
When performing a SPT the amount of solution introduced into the superficial layer of the skin is extremely low, approxi-mately 3 x 10-3 µl. (S. Dreborg, Allergy no. 10, Vol 44, 1989)
Skin prick test technique
- The SPT is preferably performed on the volar side of the forearm. Alternatively the test can be performed on the back of the patient.
- The skin must be dry and clean and may be disinfected with 70% alcohol.
- Each test preparation and the controls are applied in droplets on the skin in an appropriate distance from each other (a numbered tape can be used).
- The superficial layer of the skin is pierced with an ALK Lancet perpendicular to the skin through the droplet. Hold it for 1 second and draw back the lancet. For each test preparation and control a new sterile, disposable ALK Lancet is used. The positive control is applied last.
- The droplets are wiped off with a tissue. Do not mix the preparations by sweeping!
- Start to read the reaction of the preparations after 15 minutes beginning with the positive control. A positive reaction is a pale weal (oedema) with a red flare (erythema). To record the weal in the patient's report: mark the contour of the weal with a pen, stick transparent tape over the weal. Press and transfer the tape to the report. The flare can be recorded likewise.
Size of the weal
The mean weal diameter of the allergen product (Da) and of the histamine
control (Dh) is calculated as D = (Dl + dp )/2, where Dl is the longest diameter
and dp is the diameter midortogonal to Dl.
Interpretation of results
- Reactions of the allergen product can be graded in relation to the histamine control reaction. This relation is called the skin index (SI).
SI = Da/Dh
0 | : negative reaction |
+ | : SI < 0.5 |
++ | : 0.5 < SI < 1.0 |
+++ | : 1.0 < SI < 2.0 |
++++ | : 2.0 < SI |
4.3 Contraindications
In extremely rare cases allergic reactions may occur and therefore, a SPT should be avoided when patients are treated with beta-blockers. Recovery from an anaphylactic reaction through the action of adrenaline may be hindered by beta-blockers since these drugs might influence an effective anti-anaphylactic treatment. Therapy with beta-blockers has to be considered an absolute contra-indication.
4.4 Special Warnings And Precautions For Use
Any diseases seriously affecting the patient's general condition; skin lesions in the area used for the testing; dermatographism; dermatitis. Atopic eczema may hamper the reliability of the test.
4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction
Concomitant treatment with antiallergic symptomatics may affect the result of the test.
It is recommended that patients who are going to have a skin prick test performed discontinue treatment with:
|
|
|
|
Corticosteroids in doses lower than 30 mg of prednisone/prednisolone per day for up to one week do not reduce the response to skin tests.
Oral low dose glucocorticoids (doses less than 10 mg of prednisolone per day) need not to be discontinued prior to skin testing.
4.6 Pregnancy And Lactation
Pregnancy is not an absolute contraindication for skin testing. Skin prick testing with Soluprick may be performed during lactation.
4.7 Effects On Ability To Drive And Use Machines
None
4.8 Undesirable Effects
Undesirable effects occurring are related to the fact allergenic material is applied. The local reaction is an integrated part of the diagnosis, and the following type of reactions related directly to the patient's allergy might occur.
Local reactions
The weal is continuously spreading and pseudopodia may be formed during the first 15-20 minutes after application. Note that in some cases a late reaction (6-24 hours after) may occur after application of the allergen in the form of a diffuse swelling.
Systemic reaction
In rare cases a general reaction may develop which can be treated with relevant symptomatics.
Anaphylactic reaction
Although never reported a theoretical possibility exists of development of an anaphylactic reaction after a few seconds or minutes. For this reason an emergency kit with a ready for use adrenaline syringe must always be available.
4.9 Overdose
Not relevant
5. Pharmacological Properties
5.1 Pharmacodynamic Properties
Soluprick SQ Grass Pollen is used for specific diagnosis by skin prick testing. The preparation is mixtures of molecules with high molecular weight compounds.
The allergenic substance of the preparation can react with the immune system of an allergic patient provided IgE antibodies to the corresponding allergen are released. An immediate allergic reaction will occur within 10-20 minutes, characterised by a weal and flare.
This reaction is mainly caused by binding the allergen to specific IgE attached to mast cells, resulting in release of vaso-active agents like histamine. Some patients also develop a late phase reaction, i.e. a diffuse swelling and redness, starting 2 to 3 hours after the allergen piercing, peaking at 6-12 hours and disappearing within 12-24 hours.
Lymphocytes are involved in the late phase response; the exact mechanism has not yet been elucidated.
5.2 Pharmacokinetic Properties
Neither the doses applied in a SPT - in terms of weight less than 0.1 µg - nor the route of administration indicate that Soluprick SQ Grass Pollen is used to acquire a clinical effect after systemic absorption.
No attempt has been made to account for the fate of the individual components.
5.3 Preclinical Safety Data
No toxicological studies have been performed. However, long term clinical experience confirms that nonallergic reactions are hardly of any significance.
6. Pharmaceutical Particulars
6.1 List Of Excipients
Disodium phosphate, dihydrate
Sodium dihydrogen phosphate, dihydrate
Phenol
Sodium chloride
Glycerol
Water for Injections
The sodium content of Soluprick SQ Grass Pollen is less than 1 mmol sodium (23 mg) per dose; therefore it is essentially “sodium free”
6.2 Incompatibilities
None known. In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products.
6.3 Shelf Life
Shelf life of medicinal product as packaged for sale: 3 years
Shelf life after opening the container: 6 months
6.4 Special Precautions For Storage
Store in a refrigerator at 2-8 °C
Do not freeze. Store in original packaging in order to protect from light.
6.5 Nature And Contents Of Container
Vial (type I glass) with a halobutyl rubber stopper and a screw cap (polypropylene).
6.6 Special Precautions For Disposal And Other Handling
No special requirements.
7. Marketing Authorisation Holder
ALK-Abelló A/S
Bøge Allé 6-8
DK-2970 Hørsholm
Denmark
8. Marketing Authorisation Number(S)
PL 10085/31
9. Date Of First Authorisation/Renewal Of The Authorisation
09/07/2007
10. Date Of Revision Of The Text
09/07/2007
No comments:
Post a Comment