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Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion

⚠ 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 Avibactam sodium, Aztreonam may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.

Active substance: Avibactam sodium, Aztreonam
Source: electronic medicines compendium (emc)
Official leaflet: Read the PIL on emc

What it is and what it is used for

for

What Emblaveo is Emblaveo is an antibiotic medicine that contains two active substances aztreonam and avibactam. • Aztreonam belongs to the group of antibiotics called "monobactams". It can kill certain types of bacteria (so-called Gram-negative bacteria). • Avibactam is a "beta-lactamase inhibitor" that helps aztreonam kill some bacteria that it cannot kill on its own. What Emblaveo is used for Emblaveo is used in adults to treat: • complicated bacterial infections of the abdomen (stomach and gut), where the infection has spread into abdominal cavity (space within the abdomen). • hospital-acquired pneumonia (a bacterial infection of the lungs that is picked up in hospitals), including ventilator-associated pneumonia (pneumonia that develops in patients on a machine called a ventilator to help them breathe). • complicated (difficult to treat as it has spread to other parts of the body or the patient has other conditions) urinary tract infections, including pyelonephritis (kidney infection). • infections caused by Gram-negative bacteria that other antibiotics may not be able to kill. 2.

What you need to know before you take it

Emblaveo

You should not be given Emblaveo if: • you are allergic to aztreonam, avibactam or any of the other ingredients of this medicine (listed in section 6). • you have ever had a severe allergic reaction (swelling of the face, hands, feet, lips, tongue or throat; or difficulty swallowing or breathing; or a severe skin reaction) to other antibiotics belonging to the penicillin, cephalosporin, or carbapenem groups. Warnings and precautions Talk to your doctor or nurse before using Emblaveo if: • you have ever had any allergic reaction (even if only a skin rash) to other antibiotics. Signs of allergic reaction include itching, a rash on the skin or difficulty in breathing. 1

•

• •

you have kidney problems or if you are taking medicines that affect your kidney function, such as other antibiotics known as aminoglycosides (streptomycin, neomycin, gentamicin). If your kidney function is impaired, your doctor may give you a lower dose of Emblaveo and may want to perform regular blood tests during treatment to check your kidney function. In addition, you may be at higher risk of developing serious side effects that affect the nervous system such as encephalopathy (a disorder of the brain that may be caused by disease, injury, medicines or chemicals) due to increased blood levels of Emblaveo unless the dose is reduced. Symptoms of encephalopathy include confusion, seizures and altered mental function (see Section 3: If you use more Emblaveo than you should). you have any liver problems. Your doctor may want to perform regular blood tests during treatment to check your liver since increases in liver enzymes have been observed with Emblaveo. you are taking medicines known as anticoagulants (a medicine that prevents the blood from clotting). Emblaveo can affect blood clotting. Your doctor will monitor your blood levels to check if your dose of anticoagulant needs to be changed during treatment with Emblaveo.

Talk to your doctor if after starting treatment with Emblaveo, you experience: • severe, prolonged, or bloody diarrhoea. This may be a sign of an inflammation of the large bowel. It may be necessary to interrupt the treatment with Emblaveo and start specific treatment for the diarrhoea (see section 4: Possible side effects). • other infections. There is a small possibility that you may get a different infection caused by another bacteria during or after treatment with Emblaveo. Lab tests Tell your doctor that you are taking Emblaveo if you are going to have any tests. This is because you may get an abnormal result with a test called direct or indirect Coombs test. This test looks for antibodies that fight against your red blood cells. Children and adolescents Emblaveo should not be used in paediatric or adolescent patients aged under 18 years. This is because it is not known if the medicine is safe to use in this age group. Other medicines and Emblaveo Tell your doctor if you are using, have recently used or might use any other medicines. Talk to your doctor before using Emblaveo if you are taking any of the following medicines: • a medicine for gout called probenecid Pregnancy and breast-feeding 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. This medicine may harm your unborn child. It should only be used during pregnancy if the doctor considers it necessary and only if the benefit for the mother outweighs the risk for the child. This medicine may pass into breast milk. If you are breast-feeding a decision must be made whether you should discontinue breast-feeding or abstain from treatment with this medicine, taking into account the benefit of breast-feeding for the child and the benefit of treatment for the woman. Driving and using machines Emblaveo may cause side effects, such as dizziness, which can affect your ability to drive and use machines. Do not drive or use tools or machines if you experience side effects such as dizziness (see section 4: Possible side effects). Emblaveo contains sodium 2

This medicine contains approximately 44.6 mg sodium (main component of cooking/table salt) in each vial. This is equivalent to 2.2% of the recommended maximum daily dietary intake for sodium for an adult. 3.

How to take it

Emblaveo

Emblaveo will be given to you by a doctor or a nurse. How much to use Emblaveo is given as a drip directly into a vein ('intravenous infusion'). The usual dose is one vial (containing 1.5 g aztreonam and 0.5 g avibactam) every 6 hours. The first dose is higher (2 g aztreonam and 0.67 g avibactam). The infusion will last 3 hours. A course of treatment usually lasts from 5 to up to 14 days, depending on the type of infection you have and how you respond to treatment. People with kidney problems If you have kidney problems your doctor may lower your dose and increase the time between the doses. This is because Emblaveo is removed from your body by the kidneys. If your kidney function is impaired your blood levels of Emblaveo may be increased. If you are given more Emblaveo than you should be given Emblaveo will be given to you by a doctor or a nurse, so it is unlikely you will be given too much of this medicine. However, if you have side effects or think you have been given too much Emblaveo, tell your doctor or nurse straight away. You must tell your doctor if you experience confusion, altered mental function, movement problems, or seizure. If a dose of Emblaveo has been forgotten If you think you have missed a dose, tell your doctor or nurse straight away. If you have any further questions on the use of this medicine, ask your doctor or nurse. 4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Serious side effects Tell your doctor straight away if you notice any of the following serious side effects – you may need urgent medical treatment: • Swelling of the face, lips, eyes, tongue, and/or throat, hives and with difficulty in swallowing or breathing. These may be signs of an allergic reaction or angioedema which may be life-threatening. • Severe, persistent, or bloody diarrhoea (which may be associated with stomach pain or fever). This may occur during or after treatment with antibiotics and can be a sign of serious bowel inflammation. If this happens do not take medicines that stop or slow bowel movement. • Sudden onset of a severe rash or blistering or peeling skin, possibly accompanied by a high fever or joint pain (these may be signs of more serious medical conditions such as toxic epidermal necrolysis, dermatitis exfoliative, erythema multiforme). These serious side effects are uncommon (may affect up to 1 in 100 people). Other side effects Tell your doctor or nurse if you notice any of the following side effects: Common: (may affect up to 1 in 10 people) 3

• • • • • • • • • • • • •

Decrease in the number of red blood cells – shown in blood tests Change in the number of some types of blood cells (called "platelets") – shown in blood tests Confusion Dizziness Diarrhoea Feeling sick (nausea) or being sick (vomiting) Stomach pain Increase in certain liver enzymes – shown in blood tests Rash Inflammation of a vein Inflammation of a vein associated with a blood clot Pain or swelling at the site of the injection Fever

Uncommon: (may affect up to 1 in 100 people) • Increase in the number of some types of white blood cells (called "eosinophils" and "leucocytes") – shown in blood tests • Difficulty falling and staying asleep • Encephalopathy (a condition that affects the brain and causes altered mental state and confusion) • Headache • Reduced sensation to touch, pain and temperature in the mouth • Taste disturbance • Extra heartbeats • Bleeding • Reduced blood pressure • Reddening of the face • Excessive contraction of the airway muscles causing breathing difficulty • Stomach bleeding • Mouth ulcers • Increase in the levels of some substances in your blood (gamma-glutamyltransferase, blood alkaline phosphatase, creatinine) • Itching • purple patches like bruising, small red spots • Excessive sweating • Chest pain • Weakness Rare: (may affect up to 1 in 1,000 people) • Fungal infections of the vagina • Low levels of blood cells (pancytopenia) • Significant decrease in the type of white blood cells (called "neutrophils") used to fight infection – shown in blood tests • Lengthening of the time it takes for a cut to stop bleeding • Spontaneous bruising • Abnormal result with a test called direct or indirect Coombs test. This test looks for antibodies that fight against your red blood cells. • Seizure • Sensations like numbness, tingling, pins and needles • Double vision • A spinning sensation • Ringing or buzzing in the ears • Difficulty breathing • Breath sounds abnormal (wheezing) 4

• • • • • • • •

Sneezing Blocked nose (nasal congestion) Bad breath Inflammation of the liver Yellowing of the skin and eyes Muscle pain Breast tenderness Feeling generally unwell

Not known: (cannot be estimated from the available data) • Superinfection (a new infection that occurs after you are treated for your current infection) Sudden chest pain, which may be a sign of a potentially serious allergic reaction called Kounis syndrome has been noted with other medicines of the same type. If this happens talk to a doctor or nurse immediately. Reporting of side effects If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: 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

Emblaveo

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 vial label and carton after "EXP". The expiry date refers to the last day of that month. Store in a refrigerator (2 °C – 8 °C). Store in the original package in order to protect from light. 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 Emblaveo contains

  • The active substances are aztreonam and avibactam. Each vial contains 1.5 g aztreonam and avibactam sodium equivalent to 0.5 g avibactam (see section 2: Emblaveo contains sodium).
  • The other ingredient is arginine. What Emblaveo looks like and contents of the pack Emblaveo is a white to slightly yellow powder for concentrate for solution for infusion in a glass vial with a rubber stopper and aluminium seal with flip-off cap. It is available in packs containing 10 vials. Marketing Authorisation Holder Pfizer Limited Ramsgate Road Sandwich, Kent CT13 9NJ United Kingdom Manufacturer Pfizer Service Company BV 5

Hermeslaan 11 1932 Zaventem Belgium For any information about this medicine, please contact: Medical Information, Pfizer Ltd, Walton Oaks, Dorking Road, Tadworth, Surrey, KT20 7NS. Telephone 01304 616161. This leaflet was last revised in 11/2025. Ref: EB 2_0 ———————————————————————————————————————–The following information is intended for healthcare professionals only: Important: Please refer to the Summary of Product Characteristics before prescribing. This medicinal product must not be mixed with other medicinal products except sodium chloride (0.9%) solution for injection, glucose (5%) solution for injection, or Lactated Ringer's solution as mentioned below. The powder must be reconstituted with sterile water for injections and the resulting concentrate must then be immediately diluted prior to use. The reconstituted solution is a clear, colourless to yellow solution and is free of visible particles. Emblaveo (aztreonam/avibactam) is a combination product; each vial contains 1.5 g of aztreonam and 0.5 g of avibactam in a fixed 3:1 ratio. Standard aseptic techniques should be used for solution preparation and administration. Doses must be prepared in an appropriately sized infusion bag. Parenteral medicinal products should be inspected visually for particulate matter prior to administration. Each vial is for single use only. The total time interval between starting reconstitution and completing preparation of the intravenous infusion should not exceed 30 minutes. Instructions for preparing adult doses in an INFUSION BAG: NOTE: The following procedure describes the steps to prepare an infusion solution with a final concentration of 1.5-40 mg/mL of aztreonam and 0.50-13.3 mg/mL of avibactam. All calculations should be completed prior to initiating these steps. 1. Prepare the reconstituted solution (131.2 mg/mL of aztreonam and 43.7 mg/mL of avibactam): a) Insert the needle through the vial closure and inject 10 mL of sterile water for injections. b) Withdraw the needle and shake the vial gently to give a clear, colourless to yellow solution free of visible particles. 2. Prepare the final solution for infusion (final concentration must be 1.5-40 mg/mL of aztreonam and 0.50-13.3 mg/mL of avibactam): Infusion bag: Further dilute the reconstituted solution by transferring an appropriately calculated volume of the reconstituted solution to an infusion bag containing any of the following: sodium chloride (0.9%) solution for injection, glucose (5%) solution for injection, or Lactated Ringer's solution.

6

Refer to Table 1 below. Table 1.

Preparation of Emblaveo for adult doses in an INFUSION BAG

Total dose (aztreonam/avibactam)

Volume to withdraw from reconstituted vial(s)

Final volume after dilution in infusion baga,b

2000 mg/667 mg

15.2 mL

50 mL to 250 mL

1500 mg/500 mg

11.4 mL

50 mL to 250 mL

1350 mg/450 mg

10.3 mL

50 mL to 250 mL

750 mg/250 mg

5.7 mL

50 mL to 250 mL

675 mg/225 mg

5.1 mL Volume (mL) calculated based on dose required: Dose (mg aztreonam) ÷ 131.2 mg/mL aztreonam Or Dose (mg avibactam) ÷ 43.7 mg/mL avibactam

50 mL to 250 mL

All other doses

a b

Volume (mL) will vary based on infusion bag size availability and preferred final concentration (must be 1.5-40 mg/mL of aztreonam and 0.50-13.3 mg/mL of avibactam)

Dilute to final aztreonam concentration of 1.5-40 mg/mL (final avibactam concentration of 0.50-13.3 mg/mL) for in-use stability up to 24 hours at 2 °C – 8 °C, followed by up to 12 hours up to 30 °C for infusion bags containing sodium chloride (0.9%) solution for injection or Lactated Ringer's solution. Dilute to final aztreonam concentration of 1.5-40 mg/mL (final avibactam concentration of 0.50-13.3 mg/mL) for in-use stability up to 24 hours at 2 °C – 8 °C, followed by up to 6 hours up to 30 °C for infusion bags containing glucose (5%) solution for injection.

From a microbiological point of view, the medicinal product should be used immediately, unless reconstitution and dilution have taken place in controlled and validated aseptic conditions. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and must not exceed those stated above. Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

7

Frequently asked questions about Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion

How do I take Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion?

Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion comes as infusion containing 1.5g / 0.5g. 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 Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion?

The active substance in Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion is avibactam sodium, aztreonam.

Where does this information come from?

This leaflet reproduces the patient information leaflet approved for Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion, 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 Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion 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: Avibactam sodium, aztreonam (1 medicine)
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

Emblaveo is indicated for the treatment of the following infections in adult patients (see sections 4.4 and 5.1):

• Complicated intra-abdominal infection (cIAI)

• Hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP)

• Complicated urinary tract infection (cUTI), including pyelonephritis

Emblaveo is also indicated for the treatment of infections due to aerobic Gram-negative organisms in adult patients with limited treatment options (see sections 4.2, 4.4, and 5.1).

Consideration should be given to official guidance on the appropriate use of antibacterial agents.

4.2. Posology and method of administration

It is recommended that Emblaveo should be used to treat infections due to aerobic Gram‑negative organisms in adult patients with limited treatment options only after consultation with a physician with appropriate experience in the management of infectious diseases.

Posology

Dose in adults with estimated creatinine clearance (CrCL) > 50 mL/min

Table 1 shows the recommended intravenous dose for patients with a creatinine clearance (CrCL) > 50 mL/min. A single loading dose is followed by maintenance doses beginning at the next dosing interval.

Table 1. Recommended intravenous dose by type of infection in adult patients with CrCLa > 50 mL/min

Type of infection

Dose of aztreonam‑avibactam

Infusion time

Dosing interval

Duration of treatment

Loading

Maintenance

cIAIb

2 g/0.67 g

1.5 g/0.5 g

3 hours

Every 6 hours

5-10 days

HAP, including VAP

2 g/0.67 g

1.5 g/0.5 g

3 hours

Every 6 hours

7-14 days

cUTI, including pyelonephritis

2 g/0.67 g

1.5 g/0.5 g

3 hours

Every 6 hours

5-10 days

Infections due to aerobic Gram-negative organisms in patients with limited treatment options

2 g/0.67 g

1.5 g/0.5 g

3 hours

Every 6 hours

Duration in accordance with the site of infection and may continue for up to 14 days

a Calculated using the Cockcroft-Gault formula.

b To be used in combination with metronidazole when anaerobic pathogens are known or suspected to be contributing to the infectious process.

Special populations

Elderly

No dosage adjustment is required in elderly patients based on age (see section 5.2).

Renal impairment

No dosage adjustment is required in patients with mild renal impairment (estimated CrCL > 50 to ≤ 80 mL/min).

Table 2 shows the recommended dose adjustments for patients with estimated creatinine clearance ≤ 50 mL/min. A single loading dose is followed by maintenance doses beginning at the next dosing interval.

Table 2. Recommended doses for patients with estimated CrCL ≤ 50 mL/min

Estimated CrCL (mL/min)a

Dose of aztreonam‑avibactamb

Infusion time

Dosing interval

Loading

Maintenance

> 30 to ≤ 50

2 g/0.67 g

0.75 g/0.25 g

3 hours

Every 6 hours

> 15 to ≤ 30

1.35 g/0.45 g

0.675 g/0.225 g

3 hours

Every 8 hours

≤ 15 mL/min, on intermittent haemodialysisc,d

1 g/0.33 g

0.675 g/0.225 g

3 hours

Every 12 hours

a Calculated using the Cockcroft-Gault formula.

b Dose recommendations are based on PK modelling and simulation.

c Both aztreonam and avibactam are removed by haemodialysis; on haemodialysis days Emblaveo should be administered after the haemodialysis session.

d Aztreonam-avibactam should not be used in patients with CrCL ≤ 15 mL/min unless haemodialysis or another form of renal replacement therapy is initiated.

In patients with renal impairment, close monitoring of estimated creatinine clearance is advised (see sections 4.4 and 5.2).

There are insufficient data to make dosing adjustment recommendations for patients undergoing renal replacement therapy other than haemodialysis (e.g. continuous veno-venous hemofiltration or peritoneal dialysis). Patients receiving continuous renal replacement therapy (CRRT) need a higher dose than patients on haemodialysis. For patients receiving continuous renal replacement therapy, the dose should be adjusted guided by the CRRT clearance (CLCRRT in mL/min).

Hepatic impairment

No dosage adjustment is required in patients with hepatic impairment (see section 5.2).

Paediatric population

The safety and efficacy of Emblaveo in paediatric patients < 18 years of age have not yet been established. No data are available.

Method of administration

Intravenous use.

Emblaveo is administered by intravenous infusion over 3 hours.

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

4.3. Contraindications

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

Severe hypersensitivity (e.g. anaphylactic reaction, severe skin reaction) to any other type of beta‑lactam antibacterial agent (e.g. penicillins, cephalosporins or carbapenems).

4.4. Special warnings and precautions for use

Hypersensitivity reactions

Prior to treatment, it should be established if the patient has a history of hypersensitivity reactions to aztreonam or other beta-lactam medicinal products. Emblaveo is contraindicated in patients who have a history of severe hypersensitivity reactions to any beta-lactam agent (see section 4.3). In addition, caution should be exercised when administering aztreonam/avibactam to patients with a history of any other type of hypersensitivity reaction to other beta-lactam medicinal products. In case of severe hypersensitivity reactions, Emblaveo must be discontinued immediately and adequate emergency measures must be initiated.

Renal impairment

In patients with renal impairment, close monitoring is recommended during treatment with Emblaveo. Aztreonam and avibactam are predominantly eliminated via the kidneys, therefore the dose should be reduced according to the degree of renal impairment (see section 4.2). There have been some reports of neurological sequelae with aztreonam (e.g. encephalopathy, confusion, epilepsy, impaired consciousness, movement disorders) in patients with renal impairment and in association with beta‑lactam overdose (see section 4.9).

Concomitant treatment with nephrotoxic products (e.g. aminoglycosides) may adversely affect renal function. CrCL should be monitored in patients with changing renal function and the dose of Emblaveo adjusted accordingly (see section 4.2).

Hepatic impairment

Elevated liver enzymes have been observed with Emblaveo (see section 4.8). In patients with hepatic impairment, close monitoring is recommended during treatment with Emblaveo.

Limitations of the clinical data

The use of aztreonam-avibactam to treat patients with cIAI, HAP including VAP and cUTI including pyelonephritis, is based on experience with aztreonam alone, pharmacokinetic-pharmacodynamic analyses of aztreonam-avibactam, and on limited data from the randomised clinical study of 422 adults with cIAI or HAP/VAP.

The use of aztreonam-avibactam to treat infections due to aerobic Gram-negative organism in patients with limited treatment options is based on pharmacokinetic/pharmacodynamic analysis for aztreonam‑avibactam and on limited data from the randomised clinical study of 422 adults with cIAI or HAP/VAP (of which 17 patients with carbapenem-resistant [meropenem-resistant] organisms were treated with Emblaveo), and the randomised clinical study of 15 adults (of which 12 patients were treated with Emblaveo) with serious infections due to metallo‑β‑lactamase (MBL)-producing Gram‑negative bacteria (see section 5.1).

Spectrum of activity of aztreonam-avibactam

Aztreonam has little or no activity against the majority of Acinetobacter spp., Gram-positive organisms and anaerobes (see sections 4.2 and 5.1). Additional antibacterial medicinal products should be used when these pathogens are known or suspected to be contributing to the infectious process.

The inhibitory spectrum of avibactam includes many of the enzymes that inactivate aztreonam, including Ambler class A β-lactamases and class C β-lactamases. Avibactam does not inhibit class B enzymes (metallo-β-lactamases) and is not able to inhibit many of the class D enzymes. Aztreonam is generally stable to hydrolysis by class B enzymes (see section 5.1).

Clostridioides difficile-associated diarrhoea

Clostridioides (C.) difficile-associated diarrhoea (CDAD) and pseudomembranous colitis have been reported with aztreonam and may range in severity from mild to life-threatening. This diagnosis should be considered in patients who present with diarrhoea during or subsequent to the administration of Emblaveo (see section 4.8). Discontinuation of therapy with Emblaveo and administration of specific treatment for C. difficile should be considered. Medicinal products that inhibit peristalsis should not be given.

Non-susceptible organisms

The use of Emblaveo may result in overgrowth of non-susceptible organisms, which may require interruption of treatment or other appropriate measures.

Prolongation of prothrombin time/increased activity of oral anticoagulants

Prolongation of prothrombin time has been reported in patients receiving aztreonam (see section 4.8). Appropriate monitoring should be undertaken when oral anticoagulants are prescribed concomitantly and adjustments in their dose may be necessary to maintain the desired level of anticoagulation.

Interference with serological testing

A positive direct or indirect Coombs test (direct or indirect antiglobulin test) may develop during treatment with aztreonam (see section 4.8).

Sodium

This medicinal product contains approximately 44.6 mg sodium per vial, equivalent to 2.2% of the WHO recommended maximum daily intake (RDI) of 2 g sodium for an adult.

Emblaveo may be diluted with sodium-containing solutions (see section 6.6) and this should be considered in relation to the total sodium from all sources that will be administered to the patient.

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

In vitro, aztreonam and avibactam are substrates of organic anion transporters OAT1 and OAT3 which might contribute to the active uptake from the blood compartment and, thereby, renal excretion. Probenecid (a potent OAT inhibitor) inhibits uptake of avibactam by 56% to 70% in vitro and, therefore, has the potential to alter the elimination of avibactam when co-administered. Since a clinical interaction study of aztreonam-avibactam and probenecid has not been conducted, co-dosing with probenecid is not recommended.

Aztreonam is not metabolized by cytochrome P450 enzymes. In vitro, avibactam showed no significant inhibition of cytochrome P450 enzymes and no cytochrome P450 induction in the clinically relevant exposure range. Avibactam does not inhibit the major renal or hepatic transporters in vitro in the clinically relevant exposure range; therefore, the drug-drug interaction potential via these mechanisms is considered low.

4.6. Fertility, pregnancy and lactation

Pregnancy

There are no or limited amount of data from the use of aztreonam or avibactam in pregnant women. Animal studies with aztreonam do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see section 5.3). Animal studies with avibactam have shown reproductive toxicity without evidence of teratogenic effects (see section 5.3).

Aztreonam/avibactam should only be used during pregnancy when clearly indicated and only if the benefit for the mother outweighs the risk for the child.

Breast-feeding

Aztreonam is excreted in human milk in concentrations that are less than 1% of those in simultaneously obtained maternal serum. It is unknown whether avibactam is excreted in human milk. A risk to the breastfed child cannot be excluded.

A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from aztreonam/avibactam therapy taking into account the benefit of breast‑feeding for the child and the benefit of therapy for the woman.

Fertility

No human data on the effect of aztreonam/avibactam on fertility are available. Animal studies with aztreonam or avibactam do not indicate harmful effects with respect to fertility (see section 5.3).

4.7. Effects on ability to drive and use machines

Undesirable effects may occur (e.g. dizziness) which may have a minor influence on the ability to drive or use machines (see section 4.8).

4.8. Undesirable effects

Summary of the safety profile

The most common adverse drug reactions (ADRs) in patients treated with aztreonam/avibactam (ATM-AVI) were anaemia (6.9%), diarrhoea (6.2%), alanine aminotransferase (ALT) increased (6.2%), and aspartate aminotransferase (AST) increased (5.2%).

Tabulated list of adverse reactions

The following ADRs have been reported with aztreonam alone and/or identified during Phase 2 and Phase 3 clinical trials with Emblaveo (N = 305).

The ADRs listed in the table below are presented by System Organ Class (SOC) and frequency categories, defined using the following convention: 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), or frequency not known (cannot be estimated from the available data). Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness.

Table 3. Frequency of adverse drug reactions presented by system organ class

System Organ Class

Common

≥ 1/100 to < 1/10

Uncommon

≥ 1/1,000 to < 1/100

Rare

≥ 1/10,000 to < 1/1,000

Frequency not known (cannot be estimated from the available data)

Infections and infestations

Vulvovaginal candidiasis

Vaginal infection

Superinfection

Blood and lymphatic system disorders

Anaemia

Thrombocytosis

Thrombocytopenia

Eosinophil count increased

Leukocytosis

Pancytopenia

Neutropenia

Prothrombin time prolonged

Activated partial thromboplastin time prolonged

Coombs test positive

Coombs direct test positive

Coombs indirect test positive

Immune system disorders

Anaphylactic reaction

Drug hypersensitivity

Psychiatric disorders

Confusional state

Insomnia

Nervous system disorders

Dizziness

Encephalopathy

Headache

Hypoaesthesia oral

Dysgeusia

Seizure

Paraesthesia

Eye disorders

Diplopia

Ear and labyrinth disorders

Vertigo

Tinnitus

Cardiac disorders

Extrasystoles

Vascular disorders

Haemorrhage

Hypotension

Flushing

Respiratory, thoracic and mediastinal disorders

Bronchospasm

Dyspnoea

Wheezing

Sneezing

Nasal congestion

Gastrointestinal disorders

Diarrhoea

Nausea

Vomiting

Abdominal pain

Clostridium difficile colitis

Gastrointestinal haemorrhage

Mouth ulceration

Pseudomembranous colitis

Breath odour

Hepatobiliary disorders

Aspartate aminotransferase increased

Alanine aminotransferase increased

Transaminases increased

Gamma-glutamyltransferase increased

Blood alkaline phosphatase increased

Hepatitis

Jaundice

Skin and subcutaneous tissue disorders

Rash

Angioedema

Toxic epidermal necrolysis

Dermatitis exfoliative

Erythema multiforme

Purpura

Urticaria

Petechiae

Pruritus

Hyperhidrosis

Musculoskeletal and connective tissue disorders

Myalgia

Renal and urinary disorders

Blood creatinine increased

Reproductive system and breast disorders

Breast tenderness

General disorders and administration site conditions

Phlebitis

Thrombophlebitis

Infusion site extravasation

Injection site pain

Pyrexia

Chest discomfort

Asthenia

Malaise

Kounis syndrome

Acute coronary syndrome associated with an allergic reaction (Kounis syndrome) has been reported with other beta-lactam antibiotics.

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

4.9. Overdose

Overdose can cause encephalopathy, confusion, epilepsy, impaired consciousness, and movement disorders particularly in patients with renal impairment (see section 4.4).

If necessary, aztreonam and avibactam may be partially removed by haemodialysis.

During a 4-hour haemodialysis session, 38% of the aztreonam dose and 55% of the avibactam dose is removed.

🇷🇴 Known in Romania as

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

  • EMBLAVEO 1,5 g/0,5 g prescriptionAZTREONAMUM+AVIBACTAMUM · injection / infusion

Same active substance. 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

  • EmblaveoAztreonamum + Avibactamum · injection / infusion

Same active substance. 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 Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion. 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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