Eagle Pharmaceuticals, Inc. (Nasdaq: EGRX) (“Eagle” or the
“Company”) today announced it has reached agreement on the terms of
a transfer of the entire issued and to be issued share capital of
Acacia Pharma Group plc (“Acacia Pharma”) (EURONEXT: ACPH) to Eagle
by way of a scheme of arrangement under Part 26 of the United
Kingdom’s Companies Act 2006 (the “Scheme”).
The terms of the proposed transaction value Acacia Pharma’s
existing issued and to be issued share capital at approximately
€94,700,000, or the equivalent of €0.90 per share. Each shareholder
of Acacia Pharma would receive, as consideration for each share of
Acacia Pharma held by such shareholder, €0.68 in cash and 0.0049
shares of common stock of Eagle. The terms of the proposed
transaction also provide for Eagle to guarantee approximately €25.0
million of debt within the Acacia Pharma group. In connection with
the proposed transaction, (i) the Company and Acacia Pharma entered
into a co-operation agreement (the “Cooperation Agreement”) on
March 27, 2022 and (ii) certain shareholders and directors owning
shares in the capital of Acacia delivered to the Company and Acacia
deeds of irrevocable undertaking.
The proposed transaction has been approved by the boards of
directors of both companies and is expected to close in late Q2
2022, subject to approval by Acacia Pharma’s shareholders and the
sanction of the High Court of England and Wales and customary
closing conditions for transactions of this type. There is no
assurance that the proposed transaction will be consummated on the
proposed terms or timing or at all.
The proposed transaction is expected to provide
Eagle with two currently marketed, acute care, hospital products
with the potential to disrupt the marketplace:
- BARHEMSYS® is the first and only
antiemetic approved by the FDA for rescue treatment of
postoperative nausea and vomiting (PONV) despite prophylaxis. Eagle
currently calls on healthcare providers and institutions
representing over 70% of the expected BARHEMSYS addressable market
opportunity.
- BARHEMSYS is also approved for the
treatment of PONV in patients who have not received prophylaxis and
for the prevention of PONV. The total estimated annual U.S.
addressable market for prophylaxis and rescue is $2.7 billion,
and
- BYFAVO® is indicated for the
induction and maintenance of procedural sedation in adults
undergoing procedures lasting 30 minutes or less, with an estimated
total addressable market in procedural sedation of more than $0.4
billion per year in the U.S.2
“We are delighted to announce that we have agreed to terms for
the proposed acquisition of Acacia Pharma. This will be a very
important acquisition for us, both financially and strategically.
In recent years, the pharmaceutical industry has witnessed slower
uptake of new products and longer ramp periods. In the face of
further challenges brought about by the COVID-19 pandemic, many
smaller underfunded companies experienced significant hurdles
launching products. We therefore believe that Eagle is well suited
to drive uptake of these two new products, building from Acacia
Pharma’s established foundation since its launch, through our
experienced and specialized hospital-based sales organization with
minimal additional infrastructure,” stated Scott Tarriff, President
and Chief Executive Officer of Eagle Pharmaceuticals.
“We have been extremely disciplined in managing our balance
sheet over the years, and we believe that the proposed acquisition
is a wise use of the cash we have generated. With these two
products, together with landiolol, which is on track for an NDA
submission to the FDA in May of this year, Eagle will potentially
have three NCEs going into their launch phase. We believe these
efforts will strengthen our leadership position in the hospital and
oncology space and establish a strong foundation for sustainable
long-term growth and bring value to our shareholders,” concluded
Tarriff.
“We believe that BARHEMSYS and BYFAVO address unmet clinical
needs and are nearing usage inflection points, with strong
formulary acceptance, and that with our longstanding relationships
in the hospital space, we can accelerate uptake and capture the
commercial potential of these assets. In doing so, we strive to
impact and improve the care of patients undergoing medical
treatments such as surgery and invasive procedures. Additionally,
their value to anesthesia providers, who are key users, is
important, facilitating precision medicine for patients. We see our
sales infrastructure as a strategic asset, and as we add to our
commercial product portfolio going forward, we plan to expand the
size of our salesforce over the next two years,” stated Michael
Moran, Executive Vice President and Chief Commercial Officer of
Eagle Pharmaceuticals.
Proposed Transaction Rationale
- Opportunity for Eagle’s highly
skilled hospital-based salesforce to integrate and promote BYFAVO
and BARHEMSYS and to leverage longstanding relationships to realize
the full potential of these assets.
- Anticipated strong synergistic fit
with Eagle’s current and expanding portfolio of hospital products
and other expected cost synergies.
- Attractive opportunity to accelerate
Eagle’s existing growth strategy and further its advantage in acute
care.
- Commercial stage, NCE products with
long patent duration through 2031 would add complementary and
diversified revenue streams to Eagle.
- Eagle’s strong financial position
enables it to invest in this opportunity for potential significant
value creation.
- Compelling commercial opportunity in
both FDA-approved products:
- BARHEMSYS is the first and only
antiemetic approved for rescue treatment of PONV despite
prophylaxis and offers the potential for savings to hospitals and
ambulatory centers.
- BYFAVO addresses an unmet need in
procedural sedation by offering a fast-acting agent with a
favorable safety profile versus other current treatments.
- Expected to be earnings accretive
in 2024.
Product Descriptions and Potential Commercial
Opportunity
BARHEMSYS® (amisulpride for
injection)3 is the first and only FDA-approved product for PONV
rescue after failed prophylaxis4. It is a selective dopamine D2 /D3
antagonist with a broad, differentiated label. PONV is a common
complication of surgery, occurring in approximately 30% of all
surgical patients and 80% of high-risk patients. PONV is associated
with the use of anesthetic gases and opioid painkillers and is
particularly common following gynecological, abdominal, breast,
eye, and ear operations, especially those lasting an hour or more.
PONV can delay hospital discharge; result in re-admission after
in-patient procedures; and lead to day-case patients being admitted
to the hospital, all of which can result in significantly increased
healthcare costs.
By reducing these risks, BARHEMSYS® offers the potential for
significant economic savings to hospitals and ambulatory centers.
Approximately 70 million invasive surgical patients receive
antiemetic prophylaxis annually in the U.S. Approximately 10
million of these patients per year require PONV rescue treatment.
BARHEMSYS is the only drug with an FDA-approved indication to treat
patients who have failed PONV prophylaxis. It has an established
safety profile and efficacy demonstrated in controlled clinical
studies. BARHEMSYS® is nonsedating, a common complaint of standard
antiemetic agents. Patients experiencing PONV who were treated in a
pivotal clinical trial and failed prophylaxis were treated with
BARHEMSYS. These patients were observed to have shorter
post-anesthesia care (PACU) and hospital stays then patients who
were not. Please see Important Safety Information for BARHEMSYS,
below.
BYFAVO® (remimazolam for
injection)5 is a rapid onset/offset procedural sedative with an
established safety and efficacy profile. Additional benefits
include predictability and a readily available reversal agent.
Please see Important Safety Information, including boxed warning,
below.
BYFAVO has a compelling commercial opportunity, addressing a
clear unmet need. There has been no innovation in the sedation
space for over 20 years. Customers seek a fast onset,
titratability, and rapid recovery for quick discharge, and shorter
procedure times allow for increased procedural volumes. BYFAVO has
a broad label and potential health economic benefits and may enable
shorter procedure times and greater patient throughput. It is
indicated for procedural sedation in adults in procedures lasting
30 minutes or less and has a substantial clinical data package
demonstrating efficacy and safety in colonoscopies and
bronchoscopies, including the most challenging patients.
Terms of the Proposed Transaction and
Financing
The terms of the proposed transaction value Acacia Pharma’s
existing issued and to be issued share capital at approximately
€94.7 million. The cash consideration payable by Eagle under the
terms of the transaction would be approximately €71.6 million. The
cash consideration payable by Eagle under the terms of the proposed
transaction is expected to be financed by existing cash resources
of Eagle. The remaining approximately €23.2 million consideration
payable by Eagle is expected to be paid in shares of Eagle common
stock. The terms of the proposed transaction also provide for Eagle
to guarantee approximately €25.0 million of debt within the Acacia
Pharma group
Conditions to Closing and Anticipated
Timing
The Scheme is expected to become effective between the middle of
May 2022 and June 30th, 2022, and is subject to closing conditions
including, among other things, obtaining the requisite approval of
Acacia Pharma’s shareholders and the sanction of the High Court of
England and Wales by June 30, 2022, which date may be extended by
mutual agreement of the parties. There is no assurance that the
proposed transaction will be consummated on the proposed terms or
timing or at all.
Advisors
Cooley (UK) LLP is acting as legal advisor and William Blair
& Company, L.L.C. is acting as exclusive financial advisor to
Eagle Pharmaceuticals in connection with the proposed transaction.
Locust Walk served as a transaction advisor to Eagle
Pharmaceuticals. NautaDutilh BV is acting as legal advisor to Eagle
Pharmaceuticals in connection with Belgian law. Sullivan &
Cromwell LLP is acting as legal advisor and Greenhill & Co.
International LLP and Jefferies International Limited are acting as
co-financial advisors to Acacia Pharma in connection with the
proposed transaction. Eubelius CVBA is acting as legal advisor to
Acacia Pharma in connection with Belgian law and its listing on
Euronext Brussels.
Conference Call
As previously announced, Eagle management will host an investor
conference call to discuss the proposed transaction as follows:
Date: |
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Thursday, March 31, 2022 |
Time: |
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8:30am ET |
Toll Free (U.S.): |
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800-909-7113 |
International: |
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203-518-9544 |
Webcast Live and Replay: |
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www.eagleus.com, under the “Investor + News” section |
A replay of the conference call will be available for one week
after the call's completion by dialing Toll Free Phone 800-839-5637
(US) or 402-220-2562 (International) and entering conference call
ID Conference ID: EGRX0331. The webcast will be archived for 30
days at the aforementioned URL.
About Acacia Pharma
Acacia Pharma is a hospital pharmaceutical company focused on
the development and commercialization of new products aimed at
improving the care of patients undergoing significant treatments
such as surgery, other invasive procedures, or cancer
chemotherapy.
Acacia Pharma is a public company limited by shares,
incorporated in England and is listed on the Euronext Brussels
exchange under the ISIN code GB00BYWF9Y76 and ticker symbol
ACPH.
Acacia Pharma has its U.S. headquarters in
Indianapolis, IN and its R&D operations are centered in
Cambridge, UK.
About Eagle Pharmaceuticals, Inc.
Eagle is a fully integrated pharmaceutical company with research
and development, clinical, manufacturing and commercial expertise.
Eagle is committed to developing innovative medicines that result
in meaningful improvements in patients’ lives. Eagle’s
commercialized products include vasopressin injection, PEMFEXY™,
RYANODEX®, BENDEKA®, BELRAPZO®, TREAKISYM (Japan), and its oncology
and CNS/metabolic critical care pipeline includes product
candidates with the potential to address underserved therapeutic
areas across multiple disease states. Additional information is
available on Eagle’s website at www.eagleus.com.
Further Information
This announcement is for information purposes only and is not
intended to and does not constitute, or form part of, an offer,
invitation or the solicitation of an offer to purchase, otherwise
acquire, subscribe for, sell or otherwise dispose of any
securities, or the solicitation of any vote or approval in any
jurisdiction, pursuant to the proposed transaction or otherwise,
nor the announcement of a forthcoming solicitation of any offer to
acquire or dispose of securities or of any vote or approval, nor
shall there be any sale, issuance or transfer of securities of
Acacia Pharma or Eagle in any jurisdiction. The information
contained in this announcement should not be construed to
constitute any form of advice or recommendation, including but not
limited to investment, tax, legal or other advice, and should not
be relied upon as the basis for any decision or action.
The proposed transaction will be implemented solely pursuant to
the terms of a Scheme Document (the “Scheme Document”), which will
contain the full terms and conditions of the proposed transaction,
including details of how to vote in respect of the proposed
transaction.
This announcement does not constitute a prospectus or a
prospectus-equivalent document.
Forward-Looking Statements
This press release contains forward-looking
information within the meaning of the Private Securities Litigation
Reform Act of 1995, as amended, and other securities laws.
Forward-looking statements are statements that are not historical
facts. Words and phrases such as “anticipated,” “forward,” “will,”
“would,” “may,” “remain,” “potential,” “prepare,” “expected,”
“believe,” “plan,” “near future,” “belief,” “guidance,”
“opportunity,” “estimate,” and similar expressions are intended to
identify forward-looking statements. These statements include, but
are not limited to, statements regarding future events such as: the
strategic fit of BARHEMSYS and BYFAVO with Eagle’s specialized
hospital-based salesforce; statements regarding the addressable
market size and commercial potential for BARHEMSYS and BYFAVO and
other products or product candidates; the expected structure,
anticipated synergies, terms, timing and closing of the proposed
transaction; Eagle’s marketing, product development, partnering and
growth strategy, including relating to the commercialization of
BARHEMSYS and BYFAVO, and the ability of Acacia Pharma’s technology
and know-how to help Eagle achieve its strategy; the expectation
that the addition of BARHEMSYS and BYFAVO will be accretive to
Eagle, and the timing thereof; the expected sources of financing
for the proposed transaction; the ability of Eagle to expand the
application of the Acacia Pharma products; the timing, scope or
likelihood and timing of regulatory filings and approvals from the
FDA for the Company’s product candidates, including landiolol; the
ability of BARHEMSYS and BYFAVO to address unmet clinical needs;
the ability of BARHEMSYS to offer significant economic savings to
hospitals and ambulatory centers; the ability of BYFAVO to offer
potential health economic benefits and enable shorter procedure
times and greater patient throughput; the ability of the proposed
transaction to create shareholder value; and the ability of the
Company’s executive team to execute on the Company’s strategy and
build stockholder value. All of such statements are subject to
certain risks and uncertainties, many of which are difficult to
predict and generally beyond the Company's control, that could
cause actual results to differ materially from those expressed in,
or implied or projected by, the forward-looking information and
statements. Such risks and uncertainties include, but are not
limited to: the risk that the transaction described above is not
consummated or that the benefits of the transaction are not
realized; the impacts of the COVID-19 pandemic and geopolitical
events such as the conflict in Ukraine, including disruption or
impact in the sales of the Company's marketed products,
interruptions or other adverse effects to clinical trials, delays
in regulatory review, manufacturing and supply chain interruptions,
adverse effects on healthcare systems, disruption in the operations
of the Company's third party partners and disruption of the global
economy, and the overall impact of the COVID-19 pandemic or other
events on the Company's business, financial condition and results
of operations; whether the Company will incur unforeseen expenses
or liabilities or other market factors; whether the Company will
successfully implement its development plan for its product
candidates; delay in or failure to obtain regulatory approval of
the Company's or its partners’ product candidates; whether the
Company can successfully market and commercialize its product
candidates; the success of the Company's relationships with its
partners; the availability and pricing of third party sourced
products and materials; the outcome of litigation involving any of
its products or that may have an impact on any of the Company’s
products; successful compliance with the FDA and other governmental
regulations applicable to product approvals, manufacturing
facilities, products and/or businesses; general economic
conditions, including the potential adverse effects of public
health issues, including the COVID-19 pandemic and geopolitical
events, on economic activity and the performance of the financial
markets generally; the strength and enforceability of the Company's
intellectual property rights or the rights of third parties;
competition from other pharmaceutical and biotechnology companies
and the potential for competition from generic entrants into the
market; the risks inherent in the early stages of drug development
and in conducting clinical trials; the outcome of Acacia Pharma's
shareholder vote, the High Court and other closing conditions; and
factors in addition to the foregoing that may impact the Company’s
expectations, including among other things, any potential business
development transactions, acquisitions, restructurings or legal
settlements, in addition to any unanticipated factors, that may
cause the Company’s actual results and outcomes to materially
differ; and those risks and uncertainties identified in the “Risk
Factors” section of the Company's Annual Report on Form 10-K for
the year ended December 31, 2021, filed with the Securities and
Exchange Commission (the “SEC”) on March 8, 2022, and its other
subsequent filings with the SEC. Readers are cautioned not to place
undue reliance on these forward-looking statements. All
forward-looking statements contained in this press release speak
only as of the date on which they were made. Except to the extent
required by law, the Company undertakes no obligation to update
such statements to reflect events that occur or circumstances that
exist after the date on which they were made.
Investor Relations for Eagle Pharmaceuticals,
Inc.:
Lisa M.
Wilson In-Site
Communications, Inc. T: 212-452-2793 E: lwilson@insitecony.com
Important Safety Information for
BARHEMSYS® (amisulpride)
Injection
Contraindication
BARHEMSYS is contraindicated in patients with known
hypersensitivity to amisulpride.
QT Prolongation
BARHEMSYS causes dose- and concentration-dependent prolongation
of the QT interval. The recommended dosage is 5 mg or 10 mg as a
single intravenous (IV) dose infused over 1 to 2 minutes.
Avoid BARHEMSYS in patients with congenital long QT syndrome and
in patients taking droperidol.
Electrocardiogram (ECG) monitoring is recommended in patients
with pre-existing arrhythmias/cardiac conduction disorders,
electrolyte abnormalities (e.g., hypokalemia or hypomagnesemia),
congestive heart failure, and in patients taking other medicinal
products (e.g., ondansetron) or with other medical conditions known
to prolong the QT interval.
Adverse Reactions
Common adverse reactions reported in ≥ 2% of adult patients who
received BARHEMSYS 5 mg (n=748) and at a higher rate than placebo
(n=741) in clinical trials for the prevention of PONV were: chills
(4% vs. 3%), hypokalemia (4% vs. 2%), procedural hypotension (3%
vs. 2%), and abdominal distention (2% vs. 1%).
Serum prolactin concentrations were measured in one prophylaxis
study where 5% (9/176) of BARHEMSYS-treated patients had increased
blood prolactin reported as an adverse reaction compared with 1%
(1/166) of placebo-treated patients.
The most common adverse reaction, reported in ≥ 2% of adult
patients who received BARHEMSYS 10 mg (n=418) and at a higher rate
than placebo (n=416), in clinical trials for the treatment of PONV
was infusion site pain (6% vs. 4%).
Use in Specific Populations
Lactation
Amisulpride is present in human milk. There are no reports of
adverse effects on the breastfed child and no information on the
effects of amisulpride on milk production.
BARHEMSYS may result in an increase in serum prolactin levels,
which may lead to a reversible increase in maternal milk
production. In a clinical trial, serum prolactin concentrations in
females (n=112) increased from a mean of 10 ng/mL at baseline to 32
ng/mL after BARHEMSYS treatment and from 10 ng/mL to 19 ng/mL in
males (n=61). No clinical consequences due to elevated prolactin
levels were reported.
To minimize exposure to a breastfed infant, lactating women may
consider interrupting breastfeeding and pumping and discarding
breast milk for 48 hours after receiving a dose of BARHEMSYS.
Pediatric Use
Safety and effectiveness in pediatric patients have not been
established.
Geriatric Use
No overall differences in safety or effectiveness were observed
between these patients and younger patients, and other reported
clinical experience has not identified differences in responses
between the elderly and younger patients, but greater sensitivity
of some older individuals cannot be ruled out.
Renal Impairment
Avoid BARHEMSYS in patients with severe renal impairment
(estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73
m2). The pharmacokinetics of amisulpride in patients with severe
renal impairment have not been adequately studied in clinical
trials. Amisulpride is known to be substantially excreted by the
kidneys, and patients with severe renal impairment may have
increased systemic exposure and an increased risk of adverse
reactions.
No dosage adjustment is necessary in patients with mild to
moderate renal impairment
(eGFR ≥ 30 mL/min/1.73 m2).
Drug Interactions
- BARHEMSYS causes
dose- and concentration-dependent QT prolongation. To avoid
potential additive effects, avoid use of BARHEMSYS in patients
taking droperidol.
- ECG monitoring is
recommended in patients taking other drugs known to prolong the QT
interval (e.g., ondansetron).
- Reciprocal
antagonism of effects occurs between dopamine agonists (e.g.,
levodopa) and BARHEMSYS. Avoid using levodopa with BARHEMSYS.
Important Safety Information for
BYFAVO™ (remimazolam)
Injection
Indications
BYFAVO is a benzodiazepine indicated for the induction and
maintenance of procedural sedation in adults undergoing procedures
lasting 30 minutes or less.
Important Safety Information
WARNING: PERSONNEL AND EQUIPMENT FOR MONITORING AND
RESUSCITATION AND RISKS FROM CONCOMITANT USE WITH OPIOID
ANALGESICS
Personnel and Equipment for Monitoring and
Resuscitation
- Only
personnel trained in the administration of procedural sedation, and
not involved in the conduct of the diagnostic or therapeutic
procedure, should administer BYFAVO.
-
Administering personnel must be trained in the detection
and management of airway obstruction, hypoventilation, and apnea,
including the maintenance of a patent airway, supportive
ventilation, and cardiovascular resuscitation.
- BYFAVO has
been associated with hypoxia, bradycardia, and hypotension.
Continuously monitor vital signs during sedation and during the
recovery period.
-
Resuscitative drugs, and age- and size-appropriate
equipment for bag-valve-mask–assisted ventilation must be
immediately available during administration of
BYFAVO.
Risks From Concomitant Use With Opioid Analgesics and
Other Sedative-Hypnotics
Concomitant use of benzodiazepines, including BYFAVO,
and opioid analgesics may result in profound sedation, respiratory
depression, coma, and death. The sedative effect of intravenous
BYFAVO can be accentuated by concomitantly administered CNS
depressant medications, including other benzodiazepines and
propofol. Continuously monitor patients for respiratory depression
and depth of sedation.
Contraindication
BYFAVO is contraindicated in patients with a history of severe
hypersensitivity reaction to dextran 40 or products containing
dextran 40.
Personnel and Equipment for Monitoring and
Resuscitation
Clinically notable hypoxia, bradycardia, and hypotension were
observed in Phase 3 studies of BYFAVO. Continuously monitor vital
signs during sedation and through the recovery period. Only
personnel trained in the administration of procedural sedation, and
not involved in the conduct of the diagnostic or therapeutic
procedure, should administer BYFAVO. Administering personnel must
be trained in the detection and management of airway obstruction,
hypoventilation, and apnea, including the maintenance of a patent
airway, supportive ventilation, and cardiovascular resuscitation.
Resuscitative drugs, and age- and size-appropriate equipment for
bag-valve-mask–assisted ventilation must be immediately available
during administration of BYFAVO. Consider the potential for
worsened cardiorespiratory depression prior to using BYFAVO
concomitantly with other drugs that have the same potential (e.g.,
opioid analgesics or other sedative-hypnotics). Administer
supplemental oxygen to sedated patients through the recovery
period. A benzodiazepine reversal agent (flumazenil) should be
immediately available during administration of BYFAVO.
Risks From Concomitant Use With Opioid Analgesics and
Other Sedative-Hypnotics
Concomitant use of BYFAVO and opioid analgesics may result in
profound sedation, respiratory depression, coma, and death. The
sedative effect of IV BYFAVO can be accentuated when administered
with other CNS depressant medications (eg, other benzodiazepines
and propofol). Titrate the dose of BYFAVO when administered with
opioid analgesics and sedative-hypnotics to the desired clinical
response. Continuously monitor sedated patients for hypotension,
airway obstruction, hypoventilation, apnea, and oxygen
desaturation. These cardiorespiratory effects may be more likely to
occur in patients with obstructive sleep apnea, the elderly, and
ASA-PS class III or IV patients.
Hypersensitivity Reactions
BYFAVO contains dextran 40, which can cause hypersensitivity
reactions, including rash, urticaria, pruritus, and anaphylaxis.
BYFAVO is contraindicated in patients with a history of severe
hypersensitivity reaction to dextran 40 or products containing
dextran 40.
Neonatal Sedation
Use of benzodiazepines during the later stages of pregnancy can
result in sedation (respiratory depression, lethargy, hypotonia) in
the neonate. Observe newborns for signs of sedation and manage
accordingly.
Pediatric Neurotoxicity
Published animal studies demonstrate that anesthetic and
sedation drugs that block NMDA receptors and/or potentiate GABA
activity increase neuronal apoptosis in the developing brain and
result in long-term cognitive deficits when used for longer than 3
hours. The clinical significance of this is not clear. However, the
window of vulnerability to these changes is believed to correlate
with exposures in the third trimester of gestation through the
first several months of life but may extend out to approximately 3
years of age in humans.
Anesthetic and sedation drugs are a necessary part of the care
of children needing surgery, other procedures, or tests that cannot
be delayed, and no specific medications have been shown to be safer
than any other. Decisions regarding the timing of any elective
procedures requiring anesthesia should take into consideration the
benefits of the procedure weighed against the potential risks.
Adverse Reactions
The most common adverse reactions reported in >10% of
patients (N=630) receiving BYFAVO 5-30 mg (total dose) and
undergoing colonoscopy (two studies) or bronchoscopy (one study)
were: hypotension, hypertension, diastolic hypertension, systolic
hypertension, hypoxia, and diastolic hypotension.
Use in Specific Populations
Pregnancy
There are no data on the specific effects of BYFAVO on
pregnancy. Benzodiazepines cross the placenta and may produce
respiratory depression and sedation in neonates. Monitor neonates
exposed to benzodiazepines during pregnancy and labor for signs of
sedation and respiratory depression.
Lactation
Monitor infants exposed to BYFAVO through breast milk for
sedation, respiratory depression, and feeding problems. A lactating
woman may consider interrupting breastfeeding and pumping and
discarding breast milk during treatment and for 5 hours after
BYFAVO administration.
Pediatric Use
Safety and effectiveness in pediatric patients have not been
established. BYFAVO should not be used in patients less than 18
years of age.
Geriatric Use
No overall differences in safety or effectiveness were observed
between these subjects and younger subjects. However, there is a
potential for greater sensitivity (eg, faster onset, oversedation,
confusion) in some older individuals. Administer supplemental doses
of BYFAVO slowly to achieve the level of sedation required and
monitor all patients closely for cardiorespiratory
complications.
Hepatic Impairment
In patients with severe hepatic impairment, the dose of BYFAVO
should be carefully titrated to effect. Depending on the overall
status of the patient, lower frequency of supplemental doses may be
needed to achieve the level of sedation required for the procedure.
All patients should be monitored for sedation-related
cardiorespiratory complications.
Abuse and Dependence
BYFAVO is a federally controlled substance (CIV) because it
contains remimazolam which has the potential for abuse and physical
dependence.
_____________________________________
1 These estimates are the result of market research performed by
or for Eagle Pharmaceuticals.2 These estimates are the result of
market research performed by or for Eagle Pharmaceuticals.3
https://bynder.acaciapharma.com/m/5d7c2cd0d58865f7/original/Barhemsys-Prescribing-Information.pdf4
FDA labels for other recommended treatments do not include
treatment after failed prophylaxis.5
https://bynder.acaciapharma.com/m/403e8c343b2922de/original/Byfavo-PI.pdf
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