Information for professionals
1. NAME OF THE MEDICINAL PRODUCT IMUNOR
2. QUALITATIVE AND QUANTITATIVE COMPOSITION Transferendi factor suillus 10 mg in each vial
3. PHARMACEUTICAL FORM Oral lyophilizate Product description: Porous, white to off-white mass in the form of a cake or a dispersed powder. The powder can get adhered to the bottom or a stopper of the vial.
4. CLINICAL PARTICULARS 4.1 Therapeutic indications The active substance is a mixture of low-molecular peptides and nucleoprotein grafts with a low molecular mass (less than 12 000 D), including regulative products of T lymphocytes that are released, under physiological conditions, by immunocompetent cells during an immune response. The proportional composition of the low-molecular substance mixture is characterized by the absorbency ratio at 260 and 280 nm. A260------- higher or equal to 1.8 A280 IMUNOR is indicated for the treatment primarily in cases of a laboratory confirmed cellular immunity disorder (a decrease of the total T lymphocyte count, deviations from the number of CD4+ and CD8+ T lymphocyte subpopulations); furthermore, it is indicated in clinical cases of diseases known to be usually associated with impairment of cellular immunity. IMUNOR is also indicated to treat humoral immunity deficiencies with laboratory confirmed reduced levels of immunoglobulins and irregular findings of affected cellular immunity with a clinical picture of recurring infections of various locations. The following types of disease are especially concerned: Primary immunodeficiency: For instance, a common variable immune deficiency, particularly with manifestations of chronic and/or recurrent bacterial infections and a proof of impaired cellular immunity functions. Secondary immunodeficiency: Adjuvant therapy at the protracted recovery after some viral diseases; conditions after complicated surgical interventions performed under general anesthesia with symptoms of reduced immunocompetence; adjuvant therapy of malignant diseases at the phase after chemotherapy and radiotherapy with the symptomatology of the lowered immunity functions (recurring infections, sub-febrile conditions, fatigue, leucopenia); recovery after septic conditions; chronic and recurrent infections with a difficult response to current therapy; chronic fatigue syndrome – cases exhibiting reduced cell-immunity parameters; recurrent herpetic diseases (herpes simplex, herpes genitalis). IMUNOR has also produced good results in the treatment of some allergic diseases (asthma bronchiale) as a complementary therapy to the standard treatment (antihistaminic agents, prophylactic immunopharmaceuticals), or to the subsequent immunotherapy (auto-vaccines, hyposensitization). It is also used with good results at the treatment of superficial mycoses. IMMUNOR is indicated for the treatment of adults and children from 3 years of age.
4.2 Posology and method of administration
Dosage Route of administration
4.3 Contraindications
Hypersensitivity to the active substance.
4.4 Special warnings and precautions for use
No serious adverse drug reactions have been reported so far. The product can be administered to patients with renal insufficiency. IMUNOR treatment should be conducted under supervision of a clinical immunologist.
4.5 Interaction with other medicinal products and other forms of interaction
No interactions studies have been carried out.
4.6 Fertility, pregnancy and lactation
Pregnancy Lactation
4.7 Effects on ability to drive and use machines
IMUNOR has no or a negligible influence on the ability to drive or operate machines.
4.8 Undesirable effects
IMUNOR tolerance is generally very good. The following adverse drug reactions have been reported in sporadic cases: The adverse drug reactions are mostly of a transient character and they have led to a necessity of discontinuance of the treatment in exceptional cases only. No serious adverse drug reactions have been reported. Reporting of suspected adverse reactions address:
4.9 Overdose In view of the results of preclinical testing, the overdose has not been studied.
5. PHARMACOLOGICAL PROPERTIES 5.1 Pharmacodynamic properties Pharmacotherapeutic group: Immunostimulants, ATC code: L03AX Mode of action The mode of action of IMUNOR (transfer factor) is complex. The transfer effect on its own results in activation of non-competent lymphocytes and, thus, they are able to identify foreign antigens and react to them by proliferation and differentiation. At the same time, numerous non-specific alterations take place after IMUNOR administration.Pharmacodynamic effects The pharmacodynamic effects consist in activation of chemotaxis, the phagocyte activity of macrophages and polymorphonuclears, in an induction of the interferon and interleukin creation, in normalization of a number of total T lymphocytes and PHA-reacting lymphocytes, in activation of cyclic nucleotides (cGMT), in normalization of the blood picture constituents, in higher synthesis of nucleic acids, and in anti-inflammatory and antiedematous effects. The above mentioned activities do not result in exceeding the normalvalue parameters. Hence, IMUNOR seems to be a substance modulating the entire immune system; and in preclinical testing, the effect of IMUNOR did not differ markedly from the standard human transfer factor administered subcutaneously.Clinical safety and efficacy Based on results of clinical testing, it may be stated that IMUNOR administration resulted in an adjustment of both reduced and increased values of studied parameters (being outside the given physiological range) as ascertained at the start of the study. The values were modified during the study towards their physiological range. That is why a lower percentage of persons with out-of-limit values were recorded at the end of the study in majority of cases. IMUNOR administration has demonstrated a favorable influence on fatigue as well as sub-febrile temperatures going away, or a beneficial impact on the frequency and severity of course of infections. In vast majority of patients, the health state got improved thanks to IMUNOR.The product tolerance was very good. Only three out of 135 patients had to be excluded from the study owing to adverse drug reactions of higher intensity.
5.2 Pharmacokinetic properties
The pharmacokinetic study was not carried out for technical reasons. The product is a soluble ultra-filtered extract prepared of porcine peripheral blood leukocytes. The active substance is a mixture of low-molecular peptides and nucleoprotein grafts of low molecular mass (lower than 12 000 D), incl. regulative products of T lymphocytes released under physiological conditions by immunocompetent cells at an immune response. This mixture of substances could not be differentiated from substances proper to the organism using available methods.
5.3 Preclinical safety data No particular risk for humans has been revealed based on non-clinical data obtained from conventional studies of pharmacological safety, multiple dosage toxicity, genotoxicity, carcinogenicity, or reproduction and development toxicity studies. At preclinical testing of the transfer factor by the VÚFB (the Research Institute of Pharmacy and Biochemistry), safety of the factor was studied in a seven-day tolerance study on mice and rats. Furthermore, a special test was carried out investigating potential embryotoxicity of the product tested. IMUNOR is very well tolerated. The seven-day administration of the product to mice and rats, dosed daily 0.15 mg/kg and 7.5 mg/kg orally (i.e. an equivalent and in a fifty-fold multiple of the supposed clinical dose), did not induce any alteration indicating the product toxic influence on clinical, hematological or biochemical parameters studied. Neither pathological/anatomical, nor histological, nor ultra-structural examination indicated toxic effects of IMUNOR. No alterations indicating embryo-toxic activity of IMUNOR in the CHEST I and II test on a chicken embryo were confirmed. Neither mutagenic activity was ascertained.
6. PHARMACEUTICAL PARTICULARS 6.1 List of excipients None
6.2 Incompatibilities No compatibility studies are available. Therefore, this medicinal product must not be mingled with other medicinal products.
6.3 Shelf-life
In an intact package, the shelf-life is 18 months. After reconstitution according to instructions, the product must be consumed immediately.
6.4 Special precautions for storage
Store in a fridge at 2 - 8º C; the vials should be kept in their box to protect the product from light.
6.5 Nature and contents of container
A glass vial of 3 ml in each, closed with a lyophilization stopper and a plastic screw cap. The vials are packed 4 pieces in each paper folding box.
6.6 Special precautions for handling and disposal
Reconstitute the contents of the vial before administration by adding drinking water up to the neck of the vial and moderately shake. Since the powder can get adhered to the stopper, it is advisable to close the vial again after water addition and to shake it in order to achieve a perfect reconstitution of the powder in the water. Then drink the contents on an empty stomach; a light breakfast can be taken after half an hour thereafter. The unused medicinal product or its wastes must be disposed of in compliance with requirements of local legislation.
7. MARKETING AUTHORISATION HOLDER
ImunomedicA a.s., Chuderov 118, 400 02 Ústí n. Labem, Czech Republic
8. MARKETING AUTHORISATION NUMBER(S)
59/516/97-C
9. DATE OF FIRST AUTHORIZATION/RENEWAL OF THE AUTHORIZATION
Date of first authorization: 25.6.1997 Date of renewal of the authorization: 25.6.2014
10. DATE OF REVISION OF THE TEXT
19.5.2015 |
Documents to download
VPOIS & pharmacovigilance
Qualified Person for Pharmacovigilance (EU QPPV): PharmDr. Jan Kolouch email: safetyimunor@nextpvservices.com phone: +420 777 125 460 Contact person for a publicly accessible scientific service of the product MUDr. Dalibor Jílek, CSc. email: dalibor.jilek@cbox.cz |