The Educational Health Care Professional’s Kit shall contain the following elements: • Brief background on lenalidomide and its licensed indication • Posology • The need to avoid foetal exposure due to teratogenicity of lenalidomide in animals and the expected teratogenic effect of lenalidomide in humans including a summary of the interim results of study CC-5013-TOX-004 • Obligations of the health care professional in relation to the prescribing of Revlimid o Need to provide comprehensive advice and counselling to patients o That patients should be capable of complying with the requirements for the safe use of Revlimid o Need to provide patients with appropriate patient educational brochure and patient card • Safety advice relevant to all patients o Description and management of neutropenia and thrombocytopenia including incidence rates from clinical trials o Description and management of thromboembolic risk including incidence rates from clinical trials o Use in patients with hepatic and/or renal impairment o Disposal of unwanted medicine o Local country specific arrangements for a prescription for Revlimid to be dispensed o Description of risk of hypothyroidism o Explanation of unknown risk of neuropathy with long term use • Description of the PPP and categorisation of patients based on sex and childbearing potential o Algorithm for implementation of PPP o Definition of women of childbearing potential (WCBP) and actions the physician should take if unsure • Safety advice for women of childbearing potential o The need to avoid foetal exposure o Description of the PPP o Need for adequate contraception (even if woman has amenorrhoea) and definition of adequate contraception o Pregnancy test regime Advice on suitable tests Before commencing treatment During treatment based on method of contraception After finishing treatment o Need to stop Revlimid immediately upon suspicion of pregnancy o Need to tell treating doctor immediately upon suspicion of pregnancy • Safety advice for men o The need to avoid foetal exposure o The need to use condoms if sexual partner is a WCBP (even if man has had a vasectomy) During Revlimid treatment For one week following final dose. o That if his partner becomes pregnant whilst he is taking Revlimid or shortly after he has stopped taking Revlimid he should inform his treating doctor immediately • Requirements in the event of pregnancy o Instructions to stop Revlimid immediately upon suspicion of pregnancy o Need to refer to physician specialised or experienced in dealing with teratology and its diagnosis for evaluation and advice o Local contact details for reporting of any suspected pregnancy 64 o Pregnancy reporting form • Check list for physicians ensuring that patients receive the appropriate counselling concerning the treatment, contraceptive methods and pregnancy prevention appropriate for their sex and childbearing status • Adverse event reporting forms
Tervishoiuspetsialisti infopaketis on järgmine teave: • Lühike taustateave lenalidomiidi ja selle heakskiidetud näidustuste kohta • Annustamine • Looteekspositsiooni vältimise vajadus lenalidomiidi teratogeensuse tõttu loomadele ning lenalidomiidi eeldatava teratogeense toime tõttu inimestele, k. a uuringu CC- 5013- TOX- 004 vahetulemuste kokkuvõte • Tervishoiuspetsialisti kohustused Revlimidi välja kirjutamisel o patsientide asjatundlik teavitamine ja nõustamine o veendumine, et patsient on suuteline järgmina Revlimidi ohutu kasutamise nõudeid o patsiendi varustamine vastava õppematerjali ja patsiendikaardiga • Ohutusteave kõigi patsientide osas o neutropeenia ja trombotsütopeenia kirjeldus ja ravijuhised, k. a kliinilistes uuringutes ilmnenud esinemissagedused o trombembooliariski kirjeldus ja ravijuhised, k. a kliinilistes uuringutes ilmnenud esinemissagedused o kasutamine maksa - ja/ või neerukahjustusega patsientidel o mittevajaliku ravimi hävitamine o vastava riigi erinõuded Revlimidi välja kirjutamisel o hüpotüreoidismiohu kirjeldus o selgitus neuropaatia teadmata riski kohta ravimi pikaajalisel kasutamisel • Raseduse ennetusprogrammi (PPP) kirjeldus ja patsientide rühmitamine soo ja fertiilsuse põhjal o PPP järgimiseks vajalik algoritm o fertiilses eas naise definitsioon ja arsti käitumine, kui fertiilsus ei ole teada • Ohutusteave fertiilsetele naistele o looteekspositsiooni vältimise vajadus o raseduse ennetusprogrammi (PPP) kirjeldus o tõhusa rasestumisvastast meetodi kasutamise vajadus (ka amenorröaga naistel) ja tõhusa rasestumisvastase meetodi määratlus o rasedustestid teave testide sobivuse kohta ravieelne testimine testimine ravi ajal vastavalt kasutatavale rasestumisvastasele meetodile ravijärgne testimine o Revlimidiravi viivitamatu lõpetamise nõue raseduse kahtlusel o raseduse kahtlusel arsti viivitamatu teavitamise vajadus • Ohutusteave meestele o looteekspositsiooni vältimise vajadus o kondoomi kasutamise vajadus vahekorras fertiilses eas naispartneriga, isegi juhul, kui mehele on tehtud vasektoomia Revlimidiravi ajal nädala jooksul pärast viimast annust o vajadus teavitada raviarsti viivitamatult partneri rasestumisest mehe Revlimidiravi ajal või lühikest aega pärast ravi • Nõuded rasestumise korral o Revlimidiravi viivitamatu lõpetamine raseduse kahtlusel o patsiendi suunamine hindamiseks ja nõustamiseks teratoloogiaspetsialisti juurde o piirkondlikud kontaktandmed raseduse kahtlusest teatamiseks o rasedusest teavitamise vorm • Kontroll- loend arstile, et tagada ravi, rasestumisvastaste meetodite ja raseduse ennetamise alane nõustamine vastavalt soole ja fertiilsele staatusele • Kõrvaltoimetest teavitamise vorm