What it is and what it is used for

for

Fyremadel contains the active substance ganirelix and belongs to a group of medicines called "antigonadotrophin-releasing hormones" which act against the actions of the natural gonadotrophin releasing hormone (GnRH). GnRH regulates the release of gonadotrophins (luteinising hormone (LH) and follicle stimulating hormone (FSH)). Gonadotrophins play an important role in human fertility and reproduction. In women, FSH is needed for the growth and development of follicles in the ovaries. Follicles are small round sacs that contain the egg cells. LH is needed to release the mature egg cells from the follicles and ovaries (i.e. ovulation). Fyremadel inhibits the action of GnRH, resulting in suppression of the release of especially LH. Fyremadel is used for In women undergoing assisted reproduction techniques, including in vitro fertilisation (IVF) and other methods, occasionally ovulation may occur too early causing a significant reduction in the chance of getting pregnant. Fyremadel is used to prevent the premature LH surge that might cause such a premature release of egg cells. In clinical studies ganirelix was used with recombinant follicle stimulating hormone (FSH) or corifollitropin alfa, a follicle stimulant with a long duration of action. 2.

What you need to know before you take it

e Fyremadel

Do not use Fyremadel if you are allergic to ganirelix or any of the other ingredients of this medicine (listed in section 6) if you are hypersensitive to gonadotrophin releasing hormone (GnRH) or a GnRH analogue if you have a moderate or severe kidney or liver disease if you are pregnant or breast-feeding.

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Warnings and precautions Talk to your doctor, pharmacist or nurse before using Fyremadel if you have an active allergic condition, please tell your doctor. Your doctor will decide, depending on the severity, if additional monitoring is required during treatment. Cases of allergic reactions have been reported, as early as with the first dose. allergic reactions, both generalised and local, including hives (urticaria), swelling of the face, lips, tongue and/or throat that may cause difficulty in breathing and/or swallowing (angioedema and/or anaphylaxis) have been reported (see also section 4.) If you have an allergic reaction, stop taking Fyremadel and seek immediate medical assistance. latex allergy, the needle cover contains dry natural rubber/latex which comes into contact with the needle and may cause allergic reactions. during or following hormonal stimulation of the ovaries, ovarian hyperstimulation syndrome may develop. This syndrome is related to the stimulation procedure with gonadotrophins. Please refer to the Package Leaflet of the gonadotrophin-containing medicine prescribed for you. the incidence of congenital malformations after assisted reproduction techniques may be slightly higher than after spontaneous conceptions. This slightly higher incidence is thought to be related to characteristics of the patients undergoing fertility treatment (e.g. age of the woman, sperm characteristics) and to the higher incidence of multiple gestations after assisted reproduction techniques. The incidence of congenital malformations after assisted reproduction techniques using Fyremadel is not different from that after using other GnRH analogues in the course of assisted reproduction techniques. there is a slightly increased risk of pregnancy outside of the uterus (an ectopic pregnancy) in women with damaged fallopian tubes. the efficacy and safety of Fyremadel has not been established in women weighing less than 50 kg or more than 90 kg. Ask your doctor for further information. Children and adolescents There is no relevant use of Fyremadel in children or adolescents. Other medicines and Fyremadel Tell your doctor or pharmacist if you are taking, have recently taken or might take, any other medicines. Pregnancy, breast-feeding and fertility Fyremadel should be used during controlled ovarian stimulation for assisted reproduction techniques (ART). Do not use Fyremadel during 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 or pharmacist for advice before taking this medicine. Driving and using machines The effects of Fyremadel on ability to drive and use machines have not been studied. Fyremadel 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

Fyremadel

Fyremadel is used as part of the treatment for assisted reproduction techniques (ART) including in vitro fertilisation (IVF). You will be giving yourself the injections and so your doctor will explain what you have to do. Always use this medicine exactly as your doctor or pharmacist has told you. If you have not understood the instructions check with your doctor or pharmacist.

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Stage 1 Ovarian stimulation with follicle stimulating hormone (FSH) or corifollitropin may start at day 2 or 3 of your period. Stage 2 The content of the syringe Fyremadel (0.25 mg) should be injected just under the skin once daily, starting on day 5 or day 6 of stimulation. Based on your ovarian response, your doctor may decide to start on another day. Fyremadel and FSH should be administered approximately at the same time. However, the preparations should not be mixed and different injection sites must be used. Daily treatment with Fyremadel should be continued up to the day that sufficient follicles of adequate size are present. Stage 3 Final maturation of the egg cells in the follicles can be induced by administering human chorionic gonadotrophin (hCG). The time between two Fyremadel injections as well as the time between the last Fyremadel injection and hCG injection should not exceed 30 hours, as otherwise a premature ovulation (i.e. release of egg cells) may occur. Therefore, if you have been injecting Fyremadel in the morning you must also have Fyremadel on the day when you will receive the hCG treatment to trigger ovulation. If you have been injecting Fyremadel in the afternoon the last Fyremadel injection should be given in the afternoon prior to the day of triggering ovulation. Instructions for use Injection site Fyremadel is supplied in pre-filled syringes which contain one dose. The contents should be injected slowly, just under the skin, preferably in the upper leg. Inspect the solution before use. Do not use if the solution contains particles or is not clear. If you administer the injections yourself or have it done by your partner, follow the instructions below carefully. Do not mix Fyremadel with any other medicines.

Preparing the injection site Wash your hands thoroughly with soap and water. Swab the injection site with a disinfectant (for example alcohol) to remove any surface bacteria. Clean about 5 cm (two inches) around the point where the needle will go in and let the disinfectant dry for at least one minute before proceeding.

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Inserting the needle Remove the needle cover. Pinch up a large area of skin between finger and thumb. Insert the needle at the base of the pinched-up skin at an angle of 45° to the skin surface. Use a different place for each injection.

Checking the correct needle position Gently draw back the plunger of the syringe to check if the needle is positioned correctly. If any blood is drawn into the syringe it means the needle tip has penetrated a blood vessel. If this happens, do not continue with the injection of Fyremadel. Remove the syringe, cover the injection site with a swab containing disinfectant and apply pressure; bleeding should stop in a minute or two. Do not use this syringe and dispose of it properly. Start again with a new syringe. Injecting the solution Once the needle has been correctly placed, depress the plunger slowly and steadily, so the solution is correctly injected and the skin tissues are not damaged. Removing the syringe Pull the syringe out quickly and apply pressure to the site with a swab containing disinfectant. Use the pre-filled syringe only once.

Precautions for Prefilled Syringe Usage This product is contained in a syringe with a thin needle. Hold the prefilled syringe in the centre of the glass barrel while removing from its tray to avoid bending or damage to the needle. Do not use the prefilled syringe if any unusual or bent needle is observed: Inspect the syringe and needle carefully before use. If the needle appears bent or damaged, do not use the syringe. Contact your healthcare provider or pharmacist.

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Do not open the needle cover and replace it back on the needle: Once the needle cover is removed, do not attempt to place it back on the needle. This action may potentially damage or bend the needle, leading to improper administration or injury.

Ensure the bevel of the needle is in upward direction (not upside down): When administering the injection, ensure the bevel of the needle is facing up to avoid pain or bending. This positioning ensures a smooth insertion and safe injection process.

If you use more Fyremadel than you should Contact your doctor. If you forget to use Fyremadel If you realise that you forgot a dose, administer it as soon as possible. Do not inject a double dose to make up for a forgotten dose. If you are more than 6 hours late (so the time between two injections is longer than 30 hours) administer the dose as soon as possible and contact your doctor for further advice. If you stop using Fyremadel Do not stop using Fyremadel unless advised to by your doctor, as this may affect the outcome of your treatment. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse. 4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. Very common (may affect more than 1 in 10 women) local skin reactions at the site of injection (predominantly redness, with or without swelling). The local reaction normally disappears within 4 hours of administration. Uncommon (may affect up to 1 in 100 women) headache nausea malaise (general feeling of being sick, feeling bad). Very rare (may affect up to 1 in 10,000 women) Notif 61(3)

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allergic reactions have been observed, as early as with the first dose.

• rash
• facial swelling
• difficulty breathing (dyspnoea)
• swelling of face, lips, tongue and/or throat that may cause difficulty in breathing and/or swallowing (angioedema and/or anaphylaxis)
• hives (urticaria).

In addition, side effects are reported which are known to occur with controlled ovarian hyperstimulation treatment, e.g.: abdominal pain ovarian hyperstimulation syndrome (OHSS). (OHSS happens when your ovaries overreact to the fertility medicines you're taking.) ectopic pregnancy (when the embryo develops outside the womb) miscarriage (see the patient information leaflet of the FSH-containing preparation you are treated with). Worsening of a pre-existing rash (eczema) has been reported in one subject after the first ganirelix dose. 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

Fyremadel

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 carton and on the label after 'EXP'. The expiry date refers to the last day of that month. This medicinal product does not require any special storage conditions. Inspect the syringe before use. Use only syringes with clear, particle-free solutions and from undamaged containers. 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 Fyremadel contains The active substance is ganirelix. Each pre-filled syringe contains 0.25 mg ganirelix (as acetate) in 0.5 ml aqueous solution. The other ingredients are acetic acid, glacial (E260), mannitol (E421) and water for injection. The pH (a measurement of the acidity) may have been adjusted with sodium hydroxide and acetic acid, glacial. What Fyremadel looks like and contents of the pack Fyremadel is a clear and colourless aqueous solution for injection. The solution is ready for use and intended for subcutaneous administration. The needle cover contains dry natural rubber/latex which comes into contact with the needle.

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Fyremadel is available in packs of 1 or 5 pre-filled syringes with injection needles (27 G). Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder Sun Pharmaceutical Industries Europe B.V. Polarisavenue 87 2132 JH Hoofddorp The Netherlands Manufacturer Sun Pharmaceutical Industries Europe B.V. Polarisavenue 87 2132 JH Hoofddorp The Netherlands This medicinal product is authorised in the Member states of the EEA under the following names: Austria: Ganirelix Astro 0,25 mg/0,5 ml Injektionslösung in einer Fertigspritze Belgium: Fyremadel, 0,25 mg/0,5 ml oplossing voor injectie in een voorgevulde spuit Fyremadel 0,25 mg/0,5 mL, solution injectable en seringue préremplie Fyremadel 0,25 mg/0,5 ml Injektionslösung in einer Fertigspritze Denmark: Fyremadel 0,25 mg/0,5 ml injektionsvæske, opløsning, i fyldt injektionssprøjte Finland: Fyremadel 0,25 mg/0,5 ml injektioneste, liuos, esitäytetty ruisku France: Fyremadel 0,25 mg/0,5 ml solution injectable en seringue pré-remplie Greece: Fyremadel 0,25 mg/0,5 ml ενέσιμο διάλυμα σε προγεμισμένη σύριγγα Germany: Fyremadel 0,25 mg/0,5 ml Injektionslösung in einer Fertigspritze Italy: Fyremadel 0,25 mg/0,5 ml soluzione iniettabile in siringa preriempita Poland: Fyremadel 0,25 mg/0,5 ml roztwór do wstrzykiwań w ampułko strzykawce Portugal: Fyremadel 0,25 mg/0,5 ml solução injetável em seringa pré-cheia The Netherlands: Fyremadel 0,25 mg/0,5 ml oplossing voor injectie in voorgevulde spuit Norway: Fyremadel 0,25 mg/0,5 ml injeksjonsvæske, oppløsning, i ferdigfylt sprøyte Spain: Fyremadel 0,25 mg/0,5 ml solución inyectable en jeringa precargada EFG Slovakia: Fyremadel 0,25 mg/0,5 ml injekčný roztok v naplnenej injekčnej striekačke Sweden: Fyremadel 0,25 mg/0,5 ml injektionsvätska, lösning, förfylld spruta United Kingdom: Fyremadel 0.25 mg/0.5 ml solution for injection in pre-filled syringe This leaflet was last revised in September, 2025.

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