| Section 2 Qualitative and Quantitative Composition
The word recombinant has been deleted from the fifth paragraph. The text produced in a Chinese hamster ovary cell line by recombinant DNA technology has been added to the fifth paragraph, which now reads: Tenecteplase is a fibrin-specific plasminogen activator produced in a Chinese hamster ovary cell line by recombinant DNA technology.
Section 3 Pharmaceutical Form
The following text has been added as a second sentence to the second paragraph of this section: The reconstituted preparation is a clear and colourless to slightly yellow solution.
Section 4.1 Therapeutic Indications
The words in adults have been added to this section.
Section 4.2 Posology and Method of Administration
The text and other handling has been added to the sentence For details see section 6.6: Special precautions for disposal and other handling in the table in this section.
The sub heading Paediatric population has been added before the seventh paragraph of this section.
Section 4.3 Contraindications
A new first paragraph has been added to this section, commencing with the text Metalyse must not be administered …
The word Furthermore, has been added to the beginning of what is now the second paragraph of this section.
The following text has been deleted from the list of contraindications situations: Hypersensitivity to the active substance tenecteplase and to any of the excipients
Section 4.4 Special Warnings and Precautions for Use
The word special has been deleted from before the word precautions in this section’s header.
The word Hypersensitivity has been added to the sub-heading Hypersensitivity/Re-administration of this section. Text has been re-positioned (re antibody formation), added to (re anaphylactic reaction) and deleted from this section.
A new final sub-heading and paragraph regarding Paediatric population has been added to this section.
Section 4.5 Interaction with Other Medicinal Products and Other Forms of Interaction
The final paragraph of this section has been amended to read: Concomitant use of GPIIb/IIIa antagonists increases bleeding risk.
Section 4.6 Fertility, Pregnancy and Lactation
The word Fertility has been added to this section’s heading.
Pregnancy and Lactation sub-headings have been added before the first and second paragraphs respectively in this section.
A new final sub-heading and paragraph regarding Fertility has been added to this section.
Section 4.8 Undesirable Effects
A new second paragraph regarding adverse reaction frequencies and system organ classes has been added to this section.
A new Table 1 displaying the frequency of adverse reactions has been added to this section, replacing the previous listing of various undesirable effects disorders.
The words cardiac and myocardial have been added to and the words heart and re have been deleted from the list of common events reported as sequelae of myocardial infarction and/or thrombolytic administration in the penultimate paragraph of this section.
The words valve incompetence have been added to and the word insufficiency has been deleted from the list of uncommon events reported as sequelae of myocardial infarction and/or thrombolytic administration in the penultimate paragraph of this section.
Section 5.1 Pharmacodynamic Properties
The word Antithrombotic in the section sentence of this section has been un-italicised.
Section 5.2 Pharmacokinetic Properties
The typographical error labeled has been corrected to read labelled in the fourth sentence of the first paragraph of this section.
Section 6.3 Shelf-Life
The word up to have been deleted from before the text 24 hours in the Reconstituted solution paragraph of this section.
Section 6.5 Nature and Contents of Container
The text or 10 ml has been deleted from after the text with 8 ml from the 10 ml paragraph of this section.
Section 6.6 Special Precautions for Disposal and Other Handling
The text and other handling has been added to the heading of this section.
Section 8 Marketing Authorisation Number(s)
The header of this section has been updated from Number(s) in the community register of medicinal products to Marketing Authorisation Number.
The text (8,000 units) has been added to the number EU/1/00/169/005.
The text (10,000 units) has been added to the number EU/1/00/169/006.
Section 10 Date of Revision of the Text
The date has been updated from March 2007 to 04 June 2010.
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