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Pharmacy Guide

Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.

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CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection

⚠ This medicine appears to have been discontinued

The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.

If you were prescribed this medicine, other products containing Eptacog beta may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.

Active substance: Eptacog beta
Source: electronic medicines compendium (emc)
Official leaflet: Read the PIL on emc

What it is and what it is used for

for

CEVENFACTA contains the active substance eptacog beta (activated), a recombinant human coagulation Factor VIIa (rhFVIIa). CEVENFACTA is used in adults and adolescents (12 years of age or older) who were born with haemophilia A or B and who have developed inhibitors (antibodies). It is used for: the treatment of bleeding episodes, the management of bleeding during surgery. How CEVENFACTA works This medicine works by making the blood clot at the site of bleeding, when the body's own clotting factors are not working. 2.

What you need to know before you take it

e CEVENFACTA

Do not use CEVENFACTA if you are allergic to eptacog beta (activated), or any of the other ingredients of this medicine (listed in section 6), if you are allergic to rabbits or rabbit proteins. Warnings and precautions Before treatment with CEVENFACTA, tell your doctor:

  • If you have a history of atherosclerosis (when your arteries are narrowed by disease), coronary artery disease (heart disease due to narrowing of the blood vessels supplying the heart),

–

cerebrovascular disease (disease of the blood vessels supplying the brain), a crush injury, septicaemia (serious blood infection) or blood clots; If you have heart disease, heart failure, abnormal heart rhythms; If you had prior pulmonary (lungs) clots or heart surgery; If you have or have had any other medical condition.

Patients with known allergy to casein may be at a higher risk of hypersensitivity reactions. Should signs or symptoms of hypersensitivity occur, treatment should be discontinued and you should seek immediate medical attention. Symptoms may include hives (itchy swellings under the skin), itching, rash, difficulty breathing, swelling around the mouth and throat, tightness of the chest, wheezing, dizziness or fainting, and low blood pressure. Although the following conditions have not been observed, they may occur with CEVENFACTA:

  • Blood clots in arteries in the heart (which could lead to a heart attack or angina), in the brain (which could lead to a stroke), or in the lungs or deep veins. Symptoms may include swelling and pain in the arms, legs or abdomen, chest pain, shortness of breath, loss of feeling or movement, and altered consciousness or speech.
  • Hypersensitivity or anaphylactic reactions. Symptoms may include hives (itchy swellings under the skin), itching, rash, difficulty breathing, swelling around the mouth and throat, tightness of the chest, wheezing, dizziness or fainting, and low blood pressure.
  • Inhibitors (antibodies) which may cause bleeding problems. If any of these conditions apply to you, talk to your doctor before using CEVENFACTA. It is important to keep a record of the batch number of your CEVENFACTA. So, every time you get a new package of CEVENFACTA, note down the date and the batch number (which is on the packaging after Lot) and keep this information in a safe place. Adolescents The listed warnings and precautions apply both to adults and adolescents (12 years of age and older). Other medicines and CEVENFACTA Tell your doctor if you are taking, have recently taken or might take any other medicines. You should talk to your doctor before using CEVENFACTA if
  • you are taking or have recently taken another activated Factor VII, or activated or non-activated prothrombin complex concentrates,
  • you are taking or have recently taken Factor XIII, since the combination of these medicines with CEVENFACTA may increase the risk of thromboembolic events (formation of blood clots in the veins). You should talk to your doctor before using CEVENFACTA with these medicines. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine. Driving and using machines Dizziness might occur following administration of CEVENFACTA. You must avoid driving or using machines while experiencing this symptom. CEVENFACTA contains sodium This medicine contains less than 1 mmol sodium (23 mg) per injection, that is to say essentially 'sodium free'.

3.

How to take it

CEVENFACTA

Treatment with this medicine should be initiated and supervised by a physician experienced in the treatment of haemophilia and/or bleeding disorders. CEVENFACTA comes as a powder that must be made up (reconstituted) with its solvent and injected into a vein (intravenous injection). See instructions for use guide at the end of this leaflet (section 7). When to treat yourself Injecting medicines requires special training. Do not attempt to self-inject unless you have been taught how to by your healthcare provider or haemophilia treatment centre. Many people with inhibitors learn to self-inject or inject with the help of a family member: once trained, you will need additional injection equipment along with your CEVENFACTA kit so that you can successfully treat your bleeding episodes at home. Be sure to collect all necessary injection equipment before preparing the medicine for injection. This additional injection equipment will be provided by your healthcare professional (e.g., your pharmacist or haemophilia treatment centre). CEVENFACTA may be injected at a haemophilia treatment centre, at your healthcare provider's office, or at home. Treating at the first sign of a bleed is important for bleed management. Start treatment of a bleed as early as possible, ideally within 2 hours.

  • In cases of a mild or moderate bleed (e.g., joint, superficial muscle, soft tissue, and mucous membranes), you should treat yourself as early as possible, ideally at home.
  • In case of a severe bleed (e.g., life or limb [arm or leg] threatening haemorrhage, intracranial [within the skull] or gastrointestinal [in the stomach or gut] haemorrhage) you should contact your doctor. Usually, severe bleeds are treated at the hospital and a dose of CEVENFACTA can be given on the way there. Do not treat yourself for longer than 24 hours without consulting your doctor.
  • Each time you use this medicine tell your healthcare provider as soon as possible.
  • If bleeding is not controlled within 24 hours, contact your healthcare provider or emergency services immediately. You will usually need hospital care. For instructions on reconstitution of the medicinal product before administration, follow the Instructions For Use guide at the end of this leaflet (section 7). Inject the solution into your vein over 2 minutes or less. Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. Dose Your healthcare provider will tell you how much CEVENFACTA to use, and when to use this medicine based on your weight, condition and type of bleed. Treatment of bleeding episodes Treatment with this medicine should be started as soon as a bleeding event occurs. Mild and moderate bleeding For mild to moderate bleeding episodes, treatment at home should not last longer than 24 hours. Continuing home treatment after 24 hours can only be considered after consultation with the haemophilia treatment centre.

Severe bleeding You should seek immediate medical care if signs or symptoms of severe bleeding occur at home. An initial dose can be administered on your way to the haemophilia treatment centre or your healthcare provider's office to avoid any treatment delay. Always use this medicine exactly as described in this leaflet or as your doctor has told you. Check with your doctor if you are not sure. Method of administration For instructions on reconstitution of the medicinal product before administration and instructions on administration, follow the Instructions For Use guide at the end of this leaflet (section 7). If you use more CEVENFACTA than you should If you use too much CEVENFACTA, get medical advice at once. If you forget to use CEVENFACTA, If you forget to use CEVENFACTA, talk to your doctor. If you have any further questions on the use of this medicine, ask your doctor. 4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Common side effects (may affect up to 1 in 10 people)

  • Dizziness
  • Headache
  • Injection site discomfort
  • Injection site bruising (haematoma)
  • Body temperature increased
  • Post procedural haematoma
  • Injection related reaction Reporting of side effects If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine. 5.

How to store it

CEVENFACTA

Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the label and the carton after EXP. The expiry date refers to the last day of that month. Store below 30 °C. Do not freeze. Keep the vial in the outer carton in order to protect from light. To reconstitute CEVENFACTA only use the material provided in the kit. After reconstitution, the product must be stored below 30 °C in the original vial and given within 4 hours. Do not freeze.

Any unused solution should be thrown away 4 hours after reconstitution. Do not use this medicine if you notice the liquid has particles or is cloudy after mixing. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. 6.

Contents of the pack and other information

What CEVENFACTA contains The active substance is recombinant coagulation factor VIIa (eptacog beta (activated)) The other excipients are: Powder: arginine hydrochloride, isoleucine, trisodium citrate dihydrate, glycine, lysine hydrochloride, polysorbate 80, hydrochloric acid (for pH adjustment). Solvent: water for injections. See section 2 "CEVENFACTA contains sodium". The powder for solution for injection contains: 1 mg/vial (corresponding to 45 KIU/vial), 2 mg/vial (corresponding to 90 KIU/vial), 5 mg/vial (corresponding to 225 KIU/vial). After reconstitution the solution concentration is approximately 1 mg/ mL (45 KIU/ mL) eptacog beta (activated). 1 KIU equals 1 000 IU (International Units). What CEVENFACTA looks like and contents of the pack The powder vial contains a white to off-white lyophilised powder and the prefilled syringe of solvent contains clear and colourless solution. The reconstituted solution should be clear to slightly opaque. Each CEVENFACTA pack contains:

  • 1 glass vial with powder for solution for injection,
  • 1 sterile vial adapter for reconstitution equipped with a 5 μm filter,
  • 1 prefilled syringe of water for injections,
  • 1 plunger rod and backstop. Pack sizes: 1 mg (45 KIU), 2 mg (90 KIU), and 5 mg (225 KIU). Marketing Authorisation Holder Laboratoire français du Fractionnement et des Biotechnologies Tour W 102 Terrasse Boieldieu 19ème Étage 92800 Puteaux France Manufacturer LFB Biotechnologies Zone d'activité de Courtabɶuf 3 Avenue des Tropiques 91940 Les Ulis France +33 1 69 82 70 10 For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder: United Kingdom LFB Biopharmaceuticals Ltd Suite 106, Spirella Building, Bridge Road, Letchworth Garden City, Hertfordshire, SG6 4ET Tel: +44 1462 55 8844

e-mail: [email protected] This leaflet was last revised in March 2025 Other sources of information ———————————————————————————————————————–INSTRUCTIONS FOR USE: READ THESE INSTRUCTIONS CAREFULLY BEFORE YOU START USING CEVENFACTA CEVENFACTA is supplied as a powder. Before injection it must be made up (reconstituted) with the solvent supplied in the syringe. The solvent is water for injections. The reconstituted CEVENFACTA must be injected into your vein (intravenous use only). This kit provides the equipment needed to reconstitute this medicine. Additional materials are needed to inject the medicine after reconstitution. These materials will be provided by your healthcare professional (e.g., your pharmacist or haemophilia treatment centre). Your doctor or your nurse will show you and/or your caregiver how to make up and inject CEVENFACTA. Do not use this kit without proper training by your healthcare provider or haemophilia treatment centre. Use a clean and germ-free (aseptic) technique when preparing and injecting the medicine. Your CEVENFACTA kit contains:

  • 1 glass vial with powder for solution for injection
  • 1 sterile vial adapter for reconstitution equipped with a 5 μm filter
  • 1 prefilled syringe of water for injections
  • 1 plunger rod and backstop

*NOTE: Your CEVENFACTA kit will contain only one vial adapter.

You will also need a sterile injection set (tubing and butterfly needle), a sterile plastic syringe, sterile alcohol swabs and a sharps container compliant with local applicable regulations and standards. These materials are not included in the CEVENFACTA package. These additional materials will be provided by your healthcare professional (e.g., your pharmacist or haemophilia treatment centre).

1) Collect equipment and prepare vial ➢ Take out the number of CEVENFACTA kits you need to fulfill your prescribed dose, a sterile injection set (not supplied) and an alcohol swab (not supplied). Do not use the kit if the tamper seal has been broken or you suspect the kit is contaminated. Use a new kit instead. ➢ Check the expiry date on the side of the kit (Fig. A). Do not use if the expiry date has passed.

➢ Check the name, strength and colour of the package to make sure it contains the correct product (1 mg package is yellow, 2 mg package is green and 5 mg package is purple).

➢ Clean a flat surface before starting the steps for reconstituting CEVENFACTA. ➢ Wash your hands with soap and water and dry using a clean towel or air dry (Fig. B).

➢ Take out the contents of one kit and one alcohol swab. Place items on the clean surface (Fig. C).

➢ Inspect all contents of the kit. Make sure each vial has a matching coloured syringe. Do not use the contents if they have been dropped or if they are damaged. Use a new kit instead. ➢ If not already at room temperature, bring the vial and the pre-filled syringe to room temperature. You can do this by holding them in your hands until they feel as warm as your hands. Do not warm the vial and pre-filled syringe in any other way. ➢ Remove the plastic cap from the vial (Fig. D). If the plastic cap is loose or missing, do not use the vial.

➢ Wipe the rubber stopper with an alcohol swab (Fig. E) and allow it to air dry for a few seconds to ensure that it is as germ free as possible.

➢ After cleaning with the swab, do not touch the rubber stopper with your fingers and do not allow it to touch any other object until you attach the vial adapter, as this can transfer germs. 2) Attach vial adapter ➢ Peel off the protective paper cover from the vial adapter package (Fig. F). If the protective paper cover is not fully sealed or if it is broken, do not use the vial adapter.

Do not take the vial adapter out of the protective cap with your fingers. If you touch the spike on the vial adapter, you may transfer germs from your fingers onto the spike. ➢ Place the vial on a clean flat surface and hold with one hand. Use your other hand to hold the plastic cover (with the vial adapter inside) directly over the vial and line up the spike of the adapter with the middle of the grey rubber stopper. ➢ Firmly press the plastic cover down so that the vial adapter spike breaks through the rubber stopper (you may hear/see it "snap" into place) (Fig. G).

➢ Lightly squeeze the plastic cover and lift it up to remove it from the vial adapter (Fig. H).

Do not touch the top of the vial adapter once you have removed plastic cover to avoid transferring germs from your fingers. NOTE: The 5 mg vial adapter may not sit flat against the vial, but it is fully functional. As mentioned previously, your CEVENFACTA kit will contain only one vial adapter: the one suitable for the vial included in the kit. 3) Attach pre-filled syringe and install the plunger rod ➢ Remove the syringe cap from the pre-filled syringe by holding the syringe body with one hand and using the other hand to unscrew the syringe cap (turn to the left) (Fig. I).

Do not touch the syringe tip under the syringe cap to avoid transferring germs from your fingers. Do not use the pre-filled syringe if the syringe cap is loose or missing.

➢ Hold the edges of the vial adapter and screw on the pre-filled syringe (turn to the right a few times) until it starts to tighten (Fig. J). Be careful not to overtighten as you will need to remove the syringe later.

➢ To attach the plunger rod onto the syringe, hold the wide top end of the plunger rod in one hand and the syringe body in your other hand. ➢ Insert the plunger rod into the syringe, then screw a few turns (turn to the right) so that the plunger rod is attached to the grey rubber stopper in the syringe (Fig. K).

4) Mix medicinal product in vial ➢ Very slowly push the plunger rod down to the bottom of the syringe, to transfer all of the liquid from the syringe into the vial (Fig. L). Do not push too quickly as it can result in excess foam in the vial.

➢ Swirl the vial gently or roll between hands until all powder is dissolved (Fig. M). Do not shake the vial as this creates foam.

➢ Check the mixed solution (Fig. N). It should be clear to slightly opaque. All powder should be dissolved with no particles floating in the liquid. Do not use the medicinal product if the liquid has particles or is cloudy after mixing. Start over with a new kit.

5) Remove empty syringe from vial adapter ➢ Without withdrawing any medicinal product back into the syringe, unscrew the syringe from the vial adapter (turn to the left) until it is completely detached (Fig. O).

➢ Throw out the empty syringe into an approved sharps container (Fig. P). Do not remove the vial adapter. Do not touch the luer lock top of the vial adapter. If you touch this top, you may transfer germs from your fingers.

6) Mix additional vial(s) and inject dose ➢ If your dose requires more than one vial, repeat the above steps with additional kits until you have reached your required dose. ➢ Withdraw the liquid medicinal product from the vial(s), using a sterile syringe provided by your pharmacy that is large enough to hold your prescribed dose.

➢ CEVENFACTA must be administered within 4 hours of reconstitution (Fig. Q). Do not use if more than 4 hours have passed since reconstitution.

➢ CEVENFACTA can be given as an injection into your vein over the course of 2 minutes or less, according to the instructions given by your healthcare provider. 7) Throw out empty medicinal product vial(s) ➢ After reconstitution and injection, safely dispose of the vial with the vial adapter attached, the injection syringe, and any other waste materials into an approved sharps container (Fig. R). Do not throw out with ordinary household waste. Do not take the vial and vial adapter apart before disposal. Do not reuse any components of the kit.

Follow local applicable regulations and standards for proper disposal of the sharps container. Storage CEVENFACTA is supplied in a kit that should be stored below 30 °C. Do not open the kit contents until you are ready to use them. Do not freeze or store syringes containing reconstituted CEVENFACTA solution. Avoid exposure of the reconstituted CEVENFACTA solution to direct light. Important information CEVENFACTA is only for injection into a vein (intravenous administration). Do not inject in any other way such as below the skin (subcutaneously) or into a muscle (intramuscularly). Contact your doctor, nurse or pharmacist if you experience problems.

Frequently asked questions about CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection

How do I take CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection?

CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection comes as injection containing 1mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.

What is the active substance in CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection?

The active substance in CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection is eptacog beta.

Where does this information come from?

This leaflet reproduces the patient information leaflet approved for CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.

Can I get CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection without a prescription?

Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.

About this leaflet

The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.

Medical disclaimer: This page is for information only and does not replace advice from your doctor or pharmacist. Always read the leaflet supplied with your medicine. If you are unwell, call NHS 111; in an emergency, call 999.

Medicines with the same active substance: Eptacog beta (3 medicines)
See every medicine containing this substance, or browse the full A–Z of active substances.
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
Technical information intended for healthcare professionals (doctors and pharmacists). The Summary of Product Characteristics (SmPC) is the official document approved by the MHRA/EMA. It does not replace the patient leaflet or a doctor’s advice.

4.1. Therapeutic indications

CEVENFACTA is indicated in adults and adolescents (12 years of age and older) for the treatment of bleeding episodes and for the prevention of bleeding in those undergoing surgery or invasive procedures in the following patient groups:

• in patients with congenital haemophilia with high-responding inhibitors to coagulation factors VIII or IX (i.e. ≥5 Bethesda Units (BU));

• in patients with congenital haemophilia with low titre inhibitors (BU <5), but expected to have a high anamnestic response to factor VIII or factor IX administration or expected to be refractory to increased dosing of FVIII or FIX.

4.2. Posology and method of administration

Treatment should be initiated and supervised by a physician experienced in the treatment of haemophilia and/or bleeding disorders.

Posology

The dose and duration of treatment depend on the location and severity of the bleeding or the type of surgery/procedure, the need for urgent haemostasis, the frequency of administration, and the known patient responsiveness to FVIIa-containing bypassing agents during prior bleeding events.

The results of laboratory assessment(s) of coagulation (prothrombin time (PT)/international normalised ratio (INR), activated partial thromboplastin time (aPTT), FVII coagulation activity (Clotting time) (FVII:C)) do not necessarily correlate with or predict the haemostatic effectiveness of this medicinal product.

The dose, frequency, and duration of CEVENFACTA therapy should be based on the patient's clinical response and haemostasis evaluation.

Maximum tolerated doses have not been determined for this medicinal product and cumulative daily doses greater than 1 025 μg/kg have not been studied.

Treatment of bleeding episodes

Treatment with this medicinal product should be initiated as soon as a bleeding event occurs.

The recommended initial dose should be adjusted based on the criteria provided in Table 1.

For mild to moderate bleeding episodes, the duration of home therapy should not exceed 24 hours. Only after consultation with the haemophilia treatment centre can continued home treatment be considered.

If signs or symptoms of severe bleeding occur in the home setting, immediate medical care should be sought by patients. In the meantime, to avoid any treatment delay, an initial dose can be administered at home.

In all situations, if an adequate haemostatic response is not achieved (e.g., within 24 hours of the first administration of CEVENFACTA for mild and moderate bleeding episodes), alternative therapies should be considered.

Table 1: Dosing for the treatment of bleeding episodes

Type of bleeding

Dosing regimen recommendation

Duration of therapy

Mild and moderate

Joint, superficial muscle, soft tissue, and mucous membranes.

75 μg/kg repeated every 3 hours until haemostasis is achieved.

or

Initial dose of 225 μg/kg. If haemostasis is not achieved within 9 hours, additional 75 μg/kg doses may be administered every 3 hours as needed to achieve haemostasis.

The following factors should be considered when choosing the initial dose of this medicinal product:

• The severity and site of bleeding and need for urgent haemostasis

• Frequency of administration

• Known patient responsiveness to FVIIa- containing bypassing agents during prior bleeding events

Continue therapy to support healing and prevent recurrent haemorrhage after haemostasis to maintain the haemostatic plug.

The site and severity of bleeding should determine therapy duration.

Severe

Life or limb threatening haemorrhage, iliopsoas and deep muscle with neurovascular injury, retroperitoneum, intracranial, or gastrointestinal.

225 μg/kg initially, followed if necessary 6 hours later with 75 μg/kg every 2 hours until haemostasis is achieved.

Subsequent dosing:

After achieving haemostasis, the decision for dosing should be based on the clinical assessment and the type of bleeding bearing in mind relevant warning and precautions (see section 4.4).

Continue therapy to support healing and prevent recurrent haemorrhage.

The site and severity of bleeding and the use of other procoagulant therapies should determine therapy duration.

There was limited experience with severe bleedings in the PerSept 1 clinical study.

Prevention of bleeding during surgical or invasive procedures

CEVENFACTA dosing for the prevention of bleeding during surgical or invasive procedures (perioperative management) is provided in Table 2.

Table 2: Dosing for perioperative management of bleeding

Type of surgical procedure

Dosing regimen recommendation

Duration of therapy

Minor

Including uncomplicated tooth extraction, peripheral central catheter insertion, Port-a-Cath placement, etc.

Initial dose:

75 μg/kg immediately before surgery or start of invasive procedure; then

Subsequent doses:

75 μg/kg repeated every 2 hours for the first 48 hours following the initial dose.

Most minor procedures should be treated for 48 hours to achieve haemostasis.

At the discretion of the clinician, this medicinal product may be administered less frequently than every 2 hours and/or for less than 48 hours.

Major

Pre-operative and operative doses:

200 μg/kg immediately before the surgery, followed by 75 μg/kg every 2 hours for the duration of the surgery

The following post-operative doses may be administered:

• First 48 hours: 75 μg/kg every 2 hours

• Days 3-4: 75 μg/kg every 2 to 4 hours

• Days 5-6: 75 μg/kg every 2 to 6 hours

• Days 7-10: 75 μg/kg every 2 to 8 hours

• Day 11 onwards: 75 μg/kg every 2 to 12 hours

The dose and dosing intervals may be adjusted by the healthcare provider based on the clinical assessment and known patient responsiveness to FVIIa-containing bypassing agents.

Following the surgery, CEVENFACTA (75 μg/kg) is also recommended prior to drain or suture removal or physical therapy.

This medicinal product should be administered for a minimum of 5 postoperative days (120 hours) and for as long as necessary to achieve haemostasis and support wound healing.

Close follow-up is important for early detection of potential postoperative bleeding events that may require adjustment of the dosing intervals.

Special population

The dosing regimen in elderly patients and in patients with renal or hepatic impairment has not yet been established (see sections 4.4 and 5.2).

Paediatric population

The efficacy of CEVENFACTA in children <12 years has not been established. Currently available data are described in sections 4.8 and 5.1 but no recommendation on a posology can be made.

In line with the European Medicines Agency recommendations, there is no relevant use of CEVENFACTA for the treatment of congenital haemophilia in the paediatric population from birth to less than 6 months.

Method of administration

For instructions on reconstitution of the medicinal product before administration, see section 6.6.

Administer the solution as an intravenous bolus injection over 2 minutes or less.

4.3. Contraindications

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

Hypersensitivity to rabbits or rabbit proteins.

4.4. Special warnings and precautions for use

Traceability

In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.

Thrombosis

There is limited information about the safety of this medicinal product in patients with a history of arterial or venous thromboembolic disease, because such patients were excluded from CEVENFACTA clinical studies. Such reactions have been reported in clinical studies and post-marketing surveillance with eptacog alfa and aPCC/PCC (activated or non-activated prothrombin complex).

The following patients may be at an increased risk of thromboembolic events with use of this medicinal product:

• History of congenital or acquired haemophilia receiving concomitant treatment with aPCC/PCC or other haemostatic agents (see section 4.5);

• History of atherosclerosis, coronary artery disease, cerebrovascular disease, crush injury, septicaemia, or thromboembolism.

Patients receiving this medicinal product should be monitored for the development of signs and symptoms of activation of the coagulation system or thrombosis. When there is laboratory confirmation of intravascular coagulation or presence of clinical thrombosis, the dose of this medicinal product should be reduced or treatment should be stopped, depending on the patient's condition.

Hypersensitivity reactions

Hypersensitivity reactions, including anaphylaxis, may occur with this medicinal product. Symptoms may include hives, itching, rash, difficulty breathing, swelling around the mouth and throat, tightness of the chest, wheezing, dizziness or fainting, and low blood pressure. In the event of hypersensitivity reactions, patients should discontinue treatment and seek immediate medical attention.

Patients with known IgE-based hypersensitivity to casein may be at a higher risk of hypersensitivity reactions. Should signs or symptoms of hypersensitivity occur, treatment should be discontinued. Subsequent treatment with this medicinal product should be based on a thorough assessment of the risks and benefits.

Neutralising antibodies

Neutralising antibodies may occur with the use of this medicinal product. If treatment with this medicinal product does not result in adequate haemostasis, then the development of neutralising antibodies should be suspected as the possible cause and, as clinically indicated, testing should be performed.

Neutralising antibodies to other Factor VIIa-containing products have been observed in congenital Factor VII-deficient patients, an unapproved indication for eptacog beta (activated).

Elderly

The safety and efficacy of this medicinal product have not yet been established in elderly patients. No data are available.

Patients with renal or hepatic impairment

The safety and efficacy of this medicinal product have not yet been established in patients with renal or hepatic impairment. No data are available.

Sodium content

This medicinal product contains less than 1 mmol sodium (23 mg) per injection, that is to say essentially 'sodium free'.

4.5. Interaction with other medicinal products and other forms of interaction

No interaction studies have been conducted with this medicinal product.

Clinical experience with pharmacologic use of other FVIIa-containing products indicates an elevated risk of thrombotic events when used simultaneously with activated prothrombin complex concentrates (see section 4.4).

Based on a non-clinical study with eptacog alfa it is also not recommended to combine rFVIIa and rFXIII. There are no clinical data available on the interaction between rFVIIa and rFXIII.

4.6. Fertility, pregnancy and lactation

Pregnancy

There are no data on the use of eptacog beta (activated) in pregnant women.

As a precautionary measure, it is preferable to avoid the use of this medicinal product during pregnancy.

Breast-feeding

It is unknown whether eptacog beta (activated) is excreted in human milk. No studies have been conducted to assess the impact of eptacog beta (activated) on milk production or its presence in breast milk. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from CEVENFACTA therapy taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.

Fertility

Animal studies do not indicate direct or indirect harmful effect on male fertility. No fertility data are available in humans. Thus, the effect of eptacog beta (activated) on male and female fertility is unknown.

4.7. Effects on ability to drive and use machines

The active substance eptacog beta (activated) may have a minor influence on the ability to drive and use machines. Dizziness may occur following administration of the active substance eptacog beta (see section 4.8).

4.8. Undesirable effects

Summary of the safety profile

A total of 103 patients received at least one dose of eptacog beta (activated). The overall safety population used for the integrated analysis (see Table 3) comprised 75 unique patients, in four clinical studies, exposed to 3 418 injections in a total of 1 117 treatment episodes. The most frequently reported adverse reactions were infusion site discomfort (1.3%), infusion site haematoma (1.3%), post-procedural haematoma (1.3%), infusion-related reaction (1.3%), body temperature increased (1.3%), dizziness (1.3%) and headache (1.3%). Twenty-eight (28) other patients received a single intravenous bolus dose of eptacog beta (activated) in a fifth clinical study (Study LFB-FVIIA-009-19): a summary of the safety data from study LFB-FVIIA-009-19 is presented hereafter.

Paediatric population

Of the 75 patients included in the integrated analysis of safety, 34 were adolescents and children: 13 (17%) were aged <6 years, 15 (20%) were from 6 to less than 12 years and 6 (8%) were < 18 years.

The frequency, type, and severity of adverse reactions in children are expected to be the same as in adults.

Tabulated list of adverse reactions

In this section, the following categories of frequency have been used: 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). Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness.

Table 3 lists the adverse reactions.

Table 3: Adverse reactions from pooled clinical studies

System Organ Class

Adverse Reactions (Preferred Term)

Frequency

Nervous system disorders

Dizziness

Common

Headache

Common

General disorders and administration site conditions

Injection site discomfort

Common

Injection site haematoma

Common

Investigations

Body temperature increased

Common

Injury, poisoning and procedural complications

Post-procedural haematoma

Common

Injection related reaction

Common

In study LFB-FVIIa-009-19, only one mild episode of headache (in the 75 µg/kg group) was assessed as related to eptacog beta (activated) and was resolved by the end of the study. There was no SAE.

Overall, the safety data from Study 009-19 did not alter the CEVENFACTA safety profile described above.

Description of selected adverse reactions

Immunogenicity

In the pooled safety data for the three pivotal PerSept clinical studies, 5 out of 60 patients had a positive screening assay for anti-CEVENFACTA antibodies at baseline (prior to exposure to this medicinal product) and at follow-up visits. Two patients had transient anti-CEVENFACTA antibodies with an additional confirmatory test for anti-CEVENFACTA antibodies; these were confirmed as non-neutralising antibodies.

No patient developed anti-rabbit milk protein antibodies during treatment with this medicinal product. Still, as with all therapeutic proteins, there is the potential for immunogenicity.

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 Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

4.9. Overdose

There is no experience of overdose in clinical studies.

The dosing schedule should not be intentionally increased above the recommended doses due to the absence of information on the additional risk that may be incurred.

🇷🇴 Known in Romania as

Medicines sold in Romania with the same active substance: Cunoscut în România ca

⚠ Not the same combination. This medicine contains Eptacog beta. The products below do not contain exactly the same set of active substances — they are not direct substitutes.

  • NOVOSEVEN 1 mg (50 KUI) prescription partial — not the same combinationEPTACOG ALFA ACTIVATUM · injection / infusion

Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →

🇵🇱 Known in Poland as

Medicines sold in Poland with the same active substance: W Polsce znany jako

⚠ Not the same combination. This medicine contains Eptacog beta. The products below do not contain exactly the same set of active substances — they are not direct substitutes.

  • NovoSeven partial — not the same combinationEptacogum alfa (activatum). Czynnik VII krzepnięcia krwi, rekombinowany, aktywowany · injection / infusion

Some of these do not contain exactly the same active substances — check each one. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →

💬 Ask about this leaflet

Ask anything about CEVENFACTA 1 mg (45 KIU) powder and solvent for solution for injection. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.

Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.

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