Acarizax

Acarizax

Manufacturer:

Abbott

Distributor:

Abbott
Full Prescribing Info
Contents
Dermatophagoides pteronyssinus extract, Dermatophagoides farinae extract.
Description
Standardized allergen extract from the house dust mites Dermatophagoides pteronyssinus and Dermatophagoides farinae 12 SQ-HDM* per oral lyophilisate.
*SQ-HDM is the dose unit for Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax). SQ is a method for standardization on biological potency, major allergen content and complexity of the allergen extract. HDM is an abbreviation for house dust mite.
Action
Pharmacotherapeutic group: Allergen extracts, house dust mite. ATC code: V01AA03.
Pharmacology: Pharmacodynamics: Mechanism of action: Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is allergy immunotherapy. Allergy immunotherapy with allergen products is the repeated administration of allergens to allergic individuals with the purpose of modifying the immunological response to the allergen.
The immune system is the target for the pharmacodynamic effect of allergy immunotherapy, but the complete and exact mechanism of action regarding the clinical effect is not fully understood. Treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) has been demonstrated to induce an increase in house dust mite specific IgG4 and to induce a systemic antibody response that can compete with IgE in the binding of house dust mite allergens. This effect is observed already after 4 weeks of treatment.
Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) works by addressing the cause of house dust mite respiratory allergic disease, and clinical effect during treatment has been demonstrated for both upper and lower airways. The underlying protection provided by Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) leads to improvement in disease control and improved quality of life demonstrated through symptom relief, reduced need for other medications and a reduced risk for exacerbation.
Clinical efficacy in adults: The efficacy of treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) 12 SQ-HDM in house dust mite respiratory allergic disease was investigated in two double-blind, randomized, placebo-controlled trials with different endpoints and in different patient populations. Two thirds of the trial subjects were sensitized to more allergens than just house dust mite. Being sensitized to house dust mite only or to house dust mite and one or more other allergens did not impact the trial results. Supportive evidence from an allergen exposure chamber trial as well as a trial conducted with lower doses is also presented.
Allergic rhinitis: The MERIT trial (MT-06): The MERIT trial included 992 adults with moderate-to-severe house dust mite allergic rhinitis despite the use of rhinitis pharmacotherapy. Subjects were randomized to approximately 1 year of daily treatment with 12 SQ-HDM, 6 SQ-HDM or placebo and were given free access to standardized rhinitis pharmacotherapy. Subjects were seen by a specialist approximately every two months during the entire trial.
The primary endpoint was the average daily total combined rhinitis score (TCRS) evaluated during the last 8 weeks of treatment.
The TCRS was the sum of the rhinitis symptoms score and the rhinitis medication score. The rhinitis symptoms score evaluated 4 nasal symptoms (runny nose, blocked nose, itching nose, sneezing) daily on a 0-3 scale (no, mild, moderate, severe symptoms), i.e. range of scale is 0-12. The rhinitis medication score was the sum of the score for nasal steroid intake (2 points per puff, max. 4 puffs/day) and oral antihistamine intake (4 points/tablet, max. 1 tablet/day), i.e. range: 0-12. Thus the TCRS range is: 0-24.
Additional pre-defined key secondary endpoints were the total combined rhinoconjunctivitis score and rhinoconjunctivitis quality of life (RQLQ).
Post-hoc analyses of the days with a rhinitis exacerbation were also conducted to further illustrate the clinical relevance of the results.
A rhinitis exacerbation was defined as a day where the subject returned to the high level of symptoms required for trial inclusion: a rhinitis symptom score of at least 6 or at least 5 with one symptom rated severe.
See Figure 1:

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See Table 1:

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Supportive evidence - allergic rhinitis: A randomized, double-blind, placebo-controlled phase II trial was conducted in an allergen exposure chamber in 124 adults with house dust mite allergic rhinitis. Before each allergen challenge, subjects were washed out of all allergy pharmacotherapy. At the end-of-trial allergen challenge after 24 weeks of treatment with 12 SQ-HDM, 6 SQ-HDM or placebo, the mean rhinitis symptoms score was 7.45 [6.57;8.33] in the placebo group and 3.83 [2.94;4.72] in the 12 SQ-HDM group, corresponding to an absolute difference of 3.62 and a relative difference of 49% (95% confidence interval [35%;60%], p<0.001). The difference between 12 SQ-HDM and placebo was also statistically significant at 16 weeks (mean scores of 4.82 and 6.90, difference of 2.08 corresponding to 30%, 95% CI [17%;42%], p<0.001) and at 8 weeks (mean scores of 5.34 and 6.71, difference of 1.37 corresponding to 20%, 95% CI [7%;33%], p=0.007).
Allergic asthma: The MITRA trial (MT-04) The MITRA trial included 834 adults with house dust mite allergic asthma not well-controlled by daily use of inhaled corticosteroid (ICS) corresponding to 400-1200 μg budesonide. All subjects received 7-12 months' treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in addition to ICS and short-acting beta-agonist prior to ICS reduction. No titration phase to establish the lowest maintenance dose of ICS was conducted prior to randomization. Efficacy was assessed by time to first moderate or severe asthma exacerbation under ICS reduction over the last 6 months of 13-18 months of treatment.
The definition of a moderate asthma exacerbation was fulfilled if the subject experienced one or more of the 4 criteria as follows, and it led to change in treatment: Nocturnal awakening or increase in symptoms: nocturnal awakening(s) due to asthma requiring short-acting β2 agonist (SABA) for two consecutive nights or increase of ≥0.75 from baseline in daily symptom score on two consecutive days.
Increased SABA use: increase from baseline in occasions of SABA use on two consecutive days (minimum increase: 4 puffs/day).
Deterioration in lung function: ≥20% decrease in PEF from baseline on at least two consecutive mornings/evenings or ≥20% decrease in FEV1 from baseline.
Healthcare visit: visit to the emergency room / trial site for asthma treatment not requiring systemic corticosteroids.
A severe asthma exacerbation was defined as experiencing at least one of the two following: Need for systemic corticosteroids for ≥3 days.
Emergency room visit requiring systemic corticosteroids or hospitalization for ≥12h.
Post-hoc analyses of the asthma symptoms and symptomatic medication use in the last 4 weeks of the treatment period prior to reduction of inhaled corticosteroids were also conducted to investigate the effect of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) as add-on to inhaled corticosteroid. The analyses looked at asthma daytime and nocturnal symptom scores, nocturnal awakenings, and SABA intake. The post-hoc analyses showed numerical differences consistently in favour of 12 SQ-HDM over placebo for all parameters investigated during the last 4 weeks prior to inhaled corticosteroid reduction. The differences were only statistically significant for the asthma daytime symptom score (p=0.0450) and the odds for no nocturnal awakenings (p=0.0409).
See Figure 2:

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See Table 2:

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Supportive evidence - allergic asthma: In a double-blind, randomized, placebo-controlled phase II trial, 604 subjects ≥14 years old with house dust mite allergic asthma controlled by inhaled corticosteroids (100-800 μg budesonide) and a clinical history of house dust mite allergic rhinitis were randomized to approximately 1 year of treatment with 1, 3 or 6 SQ-HDM or placebo. At the 4-week end-of trial efficacy evaluation period, the mean change from baseline in the daily ICS dose was 207.6 μg budesonide in the 6 SQ-HDM group and 126.3 μg in the placebo group corresponding to an absolute difference of 81 μg budesonide per day (95% confidence interval [27;136], p=0.004. Relative mean and median ICS reductions from baseline were 42% and 50% for 6 SQ-HDM and 15% and 25% for placebo. In a post-hoc analysis of a subgroup (N=108) of subjects with lower asthma control and ICS ≥400 μg budesonide, the mean change from baseline in the daily ICS dose was 384.4 μg budesonide in the 6 SQ-HDM group and 57.8 μg in the placebo group corresponding to an absolute difference between 6 SQ-HDM and placebo of 327 μg budesonide per day (95% CI [182;471], p<0.0001, post-hoc analysis).
Pediatric population: Allergic rhinitis: Children 5-11 years of age: Clinical experience in treatment of allergic rhinitis with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children <12 years of age has not been established.
Adolescents 12-17 years of age The efficacy of treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) 12 SQ-HDM in house dust mite allergic rhinitis in adolescents was investigated in two doubleblind, randomized, placebo-controlled trials (P001 and TO-203-3-2). In these studies a proportion of the subjects were adolescents.
The P001 trial included 189 adolescents (of 1482 subjects randomized in total) with moderate-to-severe house dust mite allergic rhinitis/rhinoconjunctivitis with or without asthma. Subjects were randomized to approximately 1 year of daily treatment with 12 SQ-HDM or placebo and were given free access to standardized rhinitis pharmacotherapy.
The primary endpoint was the average daily total combined rhinitis score (TCRS) evaluated during the last 8 weeks of treatment.
After 1 year of treatment with 12 SQ-HDM, an absolute difference in medians of 1.0 (95% confidence interval [0.1; 2.0]) and a relative difference of 22% (p=0.024) compared to placebo was found in the adolescent group.
The TO-203-3-2 trial included 278 adolescents (of 851 subjects randomized in total) with moderate-to-severe persistent house dust mite allergic rhinitis. Subjects were randomized to approximately 1 year of daily treatment with 12 SQ-HDM, 6 SQ-HDM, or placebo and were given free access to standardized rhinitis pharmacotherapy.
The primary endpoint was the average daily TCRS evaluated during the last 8 weeks of treatment.
At the end-of-trial after 1 year of treatment with 12 SQ-HDM, an absolute difference in means of 1.0 (95% confidence interval [0.1; 1.9], p=0.037) and a relative difference of 20% compared to placebo was found in the adolescent group.
See Table 3:
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Allergic asthma: Pediatric population 5-17 years of age: Clinical experience in treatment of allergic asthma with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children <18 years of age has not been established.
The European Medicines Agency has waived the obligation to submit the results of studies with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children under the age of 5 in house dust mite respiratory allergy (treatment of allergic rhinitis, prevention of asthma, treatment of asthma).
The European Medicines Agency has deferred the obligation to submit the results of further studies with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children 5 years or older in house dust mite respiratory allergy (treatment of allergic rhinitis, prevention of asthma, treatment of asthma).
Elderly population: Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not indicated in patients >65 years of age (see Dosage & Administration). Limited safety and tolerability data exist for elderly patients >65 years of age.
Long-term treatment: International treatment guidelines refer to a treatment period of 3 years for allergy immunotherapy to achieve disease modification. Efficacy data is available for 18 months of treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) from the MITRA trial. Long-term efficacy has not been established.
Pharmacokinetics: No clinical studies investigating the pharmacokinetic profile and metabolism of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) have been conducted. The effect of allergy immunotherapy is mediated through immunological mechanisms, and there is limited information available on the pharmacokinetic properties.
The active molecules of an allergen extract are composed primarily of proteins. For sublingually administered allergy immunotherapy products, studies have shown that no passive absorption of the allergen through the oral mucosa occurs. Evidence points towards the allergen being taken up through the oral mucosa by dendritic cells, in particular Langerhans cells. Allergen which is not absorbed in this manner is expected to be hydrolyzed to amino acids and small polypeptides in the lumen of the gastrointestinal tract.
There is no evidence to suggest that the allergens present in Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) are absorbed into the vascular system after sublingual administration to any significant extent.
Toxicology: Preclinical safety data: Conventional studies of general toxicology and toxicity to reproduction in mice have revealed no special hazards to humans.
Indications/Uses
Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is indicated in adult patients (18-65 years) diagnosed by clinical history and a positive test of house dust mite sensitization (skin prick test and/or specific IgE) with at least one of the following conditions: persistent moderate to severe house dust mite allergic rhinitis despite use of symptom-relieving medication; house dust mite allergic asthma not well controlled by inhaled corticosteroids and associated with mild to severe house dust mite allergic rhinitis. Patients' asthma status should be carefully evaluated before the initiation of treatment (see Contraindications).
Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is indicated in adolescents (12-17 years) diagnosed by clinical history and a positive test of house dust mite sensitization (skin prick test and/or specific IgE) with persistent moderate to severe house dust mite allergic rhinitis despite use of symptom-relieving medication.
Dosage/Direction for Use
Posology: The recommended dose for adults and adolescents (12-17 years) is one oral lyophilisate (12 SQ-HDM) daily.
Onset of the clinical effect is to be expected 8-14 weeks after initiation. International treatment guidelines refer to a treatment period of 3 years for allergy immunotherapy to achieve disease modification. Efficacy data is available for 18 months of treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in adults; no data is available for 3 years of treatment (see Pharmacology: Pharmacodynamics under Actions). If no improvement is observed during the first year of treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) there is no indication for continuing treatment.
Pediatric population: Allergic rhinitis: The posology is the same for adults and adolescents (12-17 years). Clinical experience in treatment of allergic rhinitis with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children <12 years of age has not been established. Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not intended for treatment of allergic rhinitis in children <12 years of age. Currently available data are described in Pharmacology: Pharmacodynamics under Actions.
Allergic asthma: Clinical experience in treatment of allergic asthma with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children <18 years of age has not been established. Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not intended for treatment of allergic asthma in children <18 years of age.
Elderly population: Clinical experience on immunotherapy with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in adults >65 years of age has not been established. Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not intended for use in adults >65 years of age (see Pharmacology: Pharmacodynamics under Actions).
Method of administration: Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) treatment should be initiated by physicians with experience in treatment of allergic diseases.
It is recommended that the first oral lyophilisate is taken under medical supervision and that the patient is monitored for at least half an hour, to enable discussion and possible treatment of any immediate side effects.
Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is an oral lyophilisate. The oral lyophilisate should be taken with dry fingers from the blister unit immediately after opening the blister and placed under the tongue, where it will disperse. Swallowing should be avoided for approximately 1 minute. Food and beverage should not be taken for the following 5 minutes.
If treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is interrupted for a period up to 7 days, treatment can be resumed by the patient. If the treatment is interrupted for more than 7 days it is recommended to contact a physician before resuming the treatment.
Overdosage
In phase I studies adult patients with house dust mite allergy were exposed to doses up to 32 SQ-HDM. No data are available in adolescents regarding exposure to doses above the recommended daily dose of 12 SQ- HDM.
If doses higher than the recommended daily dose are taken, the risk of side effects increases, including the risk of systemic allergic reactions or severe local allergic reactions. In case of severe reactions such as angioedema, difficulty in swallowing, difficulty in breathing, changes in voice, or feeling of fullness in the throat, immediate medical evaluation is needed. These reactions should be treated with relevant symptomatic medication.
Contraindications
Hypersensitivity to any of the excipients.
Patients with FEV1 < 70% of predicted value (after adequate pharmacological treatment) at initiation of treatment.
Patients who have experienced a severe asthma exacerbation within the last 3 months.
In patients with asthma and experiencing an acute respiratory tract infection, initiation of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) treatment should be postponed until the infection has resolved.
Patients with active or poorly controlled autoimmune diseases, immune defects, immunodeficiencies, immunosuppression or malignant neoplastic diseases with current disease relevance.
Patients with acute severe oral inflammation or oral wounds (see Precautions).
Special Precautions
Asthma: Asthma is a known risk factor for severe systemic allergic reactions.
Patients should be advised that Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not intended to treat acute asthma exacerbations. In the event of an acute asthma exacerbation, a short-acting bronchodilator should be used. If patients find short-acting bronchodilator treatment ineffective or they need more inhalations than usual, medical attention must be sought.
Patients must be informed of the need to seek medical attention immediately if their asthma deteriorates suddenly.
Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) should initially be used as add on therapy and not as a substitute of pre-existing asthma medication. Abrupt discontinuation of asthma controller medication after initiation of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) treatment is not recommended. Reductions in asthma controller medication should be performed gradually under the supervision of a physician according to asthma management guidelines.
Severe systemic allergic reactions: Treatment should be discontinued and a physician should be contacted immediately in case of severe systemic allergic reactions, severe asthma exacerbation, angioedema, difficulty in swallowing, difficulty in breathing, changes in voice, hypotension or feeling of fullness in the throat. The onset of systemic symptoms may include flushing, pruritus, sense of heat, general discomfort and agitation/anxiety.
One option for treating severe systemic allergic reactions is adrenaline. The effects of adrenaline may be potentiated in patients treated with tricyclic antidepressants, mono amino oxidase inhibitors (MAOIs) and/or COMT inhibitors with possible fatal consequences. The effects of adrenaline may be reduced in patients treated with beta-blockers.
Patients with cardiac disease may be at increased risk in case of systemic allergic reactions. Clinical experience in treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) of patients with cardiac disease is limited.
This should be taken into consideration prior to initiating allergy immunotherapy.
Initiation of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in patients who have previously had a systemic allergic reaction to subcutaneous house dust mite immunotherapy should be carefully considered, and measures to treat potential reactions should be available. This is based on post-marketing experience from a corresponding sublingual tablet product for grass pollen immunotherapy which indicates that the risk of a severe allergic reaction may be increased for patients who have previously experienced a systemic allergic reaction to subcutaneous grass pollen immunotherapy.
Oral inflammation: In patients with severe oral inflammation (e.g. oral lichen planus, mouth ulcers or thrush), oral wounds or following oral surgery, including dental extraction, or following tooth loss, initiation of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) treatment should be postponed and ongoing treatment should be temporarily interrupted to allow healing of the oral cavity.
Local Allergic Reactions: When treated with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) the patient is exposed to the allergen that causes the allergic symptoms. Therefore, local allergic reactions are to be expected during the treatment period. These reactions are usually mild or moderate; however, more severe oropharyngeal reactions may occur. If the patient experiences significant local adverse reactions from the treatment, anti-allergic medication (e.g. antihistamines) should be considered.
Eosinophilic esophagitis: Isolated cases of eosinophilic esophagitis have been reported in association with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) treatment. In patients with severe or persisting gastro-esophageal symptoms such as dysphagia or dyspepsia, medical attention must be sought.
Autoimmune diseases in remission: Limited data is available on treatment with allergy immunotherapy in patients with autoimmune diseases in remission. Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) should therefore be prescribed with caution in these patients.
Food allergy: Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) may contain trace amounts of fish protein. Available data have not indicated an increased risk of allergic reactions in patients with fish allergy.
Effects on ability to drive and use machines: Treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) has no or negligible influence on the ability to drive or use machines.
Use In Pregnancy & Lactation
Pregnancy: There is no data on the clinical experience for the use of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in pregnant women. Animal studies do not indicate increased risk to the fetus. Treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) should not be initiated during pregnancy. If pregnancy occurs during treatment, the treatment may continue after evaluation of the general condition (including lung function) of the patient and reactions to previous administration of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax). In patients with pre-existing asthma close supervision during pregnancy is recommended.
Lactation: No clinical data are available for the use of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) during lactation. No effects on the breastfed infants are anticipated.
Fertility: There is no clinical data with respect to fertility for the use of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax). In a repeat dose toxicity study in mice no effects were observed in the reproductive organs of both genders.
Adverse Reactions
Summary of the safety profile: Subjects taking Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) should primarily expect mild to moderate local allergic reactions to occur within the first few days and subsiding again with continued treatment (1-3 months) (see Precautions). For the majority of events, the reaction should be expected to start within 5 minutes after intake of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) on each day of occurrence and abate after minutes to hours. More severe oropharyngeal allergic reactions may occur (see Precautions).
Isolated cases of severe acute worsening of asthma symptoms have been reported. Patients with known risk factors should not initiate treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) (see Contraindications).
Tabulated list of adverse reactions: The following table of adverse reactions is based on data from placebo-controlled clinical trials investigating Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in adult and adolescent patients with house dust mite allergic rhinitis and/or allergic asthma and spontaneous reporting.
Adverse reactions are divided into groups according to the MedDRA convention frequencies: 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). (See Table 4.)


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Description of selected adverse reactions: If the patient experiences significant adverse reactions from the treatment, anti-allergic medication should be considered.
Cases of systemic allergic reactions, including anaphylactic reactions have been reported post marketing and are considered a class effect. The medical supervision at first oral lyophilisate intake is therefore an important precaution (see Dosage & Administration). In some cases the serious systemic allergic reaction has occurred at doses subsequent to the initial dose.
In case of acute worsening in asthma symptoms or severe systemic allergic reactions, angioedema, difficulty in swallowing, difficulty in breathing, changes in voice, hypotension or feeling of fullness in the throat a physician should be contacted immediately. Hypertensive crisis has been reported following respiratory distress shortly after intake of Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax). In such cases treatment should be discontinued permanently or until otherwise advised by the physician.
Isolated cases of eosinophilic esophagitis have been reported (see Precautions).
Pediatric population: Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) is not indicated in children <12 years of age (see Dosage & Administration). Only limited data fromchildren 5-11 years of age are available and no data on treatment with Dermatophagoides pteronyssinus extract and Dermatophagoides farinae extract (Acarizax) in children <5 years of age exist. Reported adverse reactions in adolescents have been similar in frequency, type and severity as in adults.
Drug Interactions
No interaction trials have been conducted in humans and no potential drug interactions have been identified from any source. Concomitant therapy with symptomatic anti-allergic medications may increase the tolerance level of the patient to immunotherapy. This should be considered at discontinuation of such medications.
Caution For Usage
Incompatibilities: Not applicable
Storage
Store at temperatures not exceeding 30°C.
Shelf life: 3 years
ATC Classification
V01AA03 - house dust mites ; Belongs to the class of allergen extracts. Used as antigenic substances capable of producing immediate-type hypersensitivity.
Presentation/Packing
Oral lyophilisate tab 12 SQ-HDM (white to off-white freeze-dried debossed) x 30's.
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