"By Matt McMillen
WebMD Health News
Reviewed by Brunilda Nazario, MD
April 9, 2015 -- Spring is finally here, and with it comes tree pollen. For people with allergies, that could spell misery. But despite the hars"...
(SIN-rise) (C1 Esterase Inhibitor [Human]) Freeze Dried Powder
This leaflet summarizes important information about CINRYZE. Please read it carefully before using CINRYZE and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider, and it does not include all of the important information about CINRYZE. If you have any questions after reading this, ask your healthcare provider.
Do not attempt to self-administer unless you have been taught how by your healthcare provider.
What is CINRYZE?
CINRYZE is an injectable medicine that is used to help prevent swelling and/or painful attacks in teenagers and adults with Hereditary Angioedema (HAE). HAE is caused by the decreased functioning of a protein called C1 esterase inhibitor, that is present in your blood and helps control inflammation (swelling) and parts of the immune system. CINRYZE contains C1 esterase inhibitor. Before you can inject CINRYZE into your vein (intravenous injection), you must dissolve the CINRYZE powder using Sterile Water for Injection, USP. You can get supplies, including Sterile Water for Injection, USP from your pharmacist.
Who should not use CINRYZE?
You should not use CINRYZE if you have had life-threatening immediate hypersensitivity reactions, including anaphylaxis to the product.
What should I tell my healthcare provider before using CINRYZE?
Tell your healthcare provider about all of your medical conditions, including if you
- have an indwelling catheter/access device in one of your veins.
- have a history of blood clots, heart disease, or stroke.
- are taking birth control pills or androgens.
- are pregnant or planning to become pregnant. It is not known if CINRYZE can harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known if CINRYZE passes into your milk and if it can harm your baby.
Tell your healthcare provider and pharmacist about all of the medicines you take, including all prescription and nonprescription medicines such as over-the-counter medicines, supplements, or herbal remedies.
What are the possible side effects of CINRYZE?
Allergic reactions may occur with CINRYZE. Call your healthcare provider or get emergency support services right away if you have any of the following symptoms:
- difficulty breathing
- chest tightness
- turning blue (look at lips and gums)
- fast heartbeat
- swelling of the face
Serious blood clots may occur with CINRYZE. Call your healthcare provider or get emergency support services right away if you have any of the following symptoms:
- pain and/or swelling of an arm or leg with warmth over the affected area
- discoloration of an arm or leg
- unexplained shortness of breath
- chest pain or discomfort that worsens on deep breathing
- unexplained rapid heart rate
- numbness or weakness on one side of the body
The most common side effects seen with CINRYZE were headache, nausea, rash, and vomiting.
These are not all the possible side effects of CINRYZE.
Tell your healthcare provider about any side effect that bothers you or that does not go away. You can also report side effects to Shire Medical Information at 1-866-888-0660 or the FDA at 1-800-FDA-1088.
You can ask your healthcare provider for information that is written for healthcare providers.
How should I store CINRYZE?
Do not freeze CINRYZE.
Store CINRYZE in a refrigerator or at room temperature between 36° to 77°F (2° to 25°C).
Keep CINRYZE in the original carton to protect it from light.
Do not use CINRYZE after the expiration date on the vial.
What else should I know about CINRYZE?
Medicines are sometimes prescribed for purposes other than those listed here. Do not use CINRYZE for a condition for which it is not prescribed. Do not share CINRYZE with other people, even if they have the same symptoms that you have.
Because CINRYZE is made from human blood, it may carry a risk of transmitting infectious agents, e.g. viruses, and, theoretically, the Creutzfeldt-Jakob (CJD) agent.
This leaflet summarizes the most important information about CINRYZE. If you would like more information, talk to your healthcare provider. You can ask your healthcare provider or pharmacist for information about CINRYZE that was written for healthcare professionals.
Instructions for Use
Do not attempt to self-administer unless you have been taught how by your healthcare provider.
See the step-by-step instructions for injecting CINRYZE at the end of this leaflet. You should always follow the specific instructions given by your healthcare provider. The steps listed below are general guidelines for using CINRYZE. If you are unsure of the steps, please call your healthcare provider or pharmacist before using.
Call your healthcare provider right away if swelling is not controlled after using CINRYZE.
Your healthcare provider will prescribe the dose that you should take.
Call your healthcare provider if you take too much CINRYZE.
Call your healthcare provider if you miss a dose of CINRYZE.
Talk to your healthcare provider before traveling. You should plan to bring enough CINRYZE for your treatment during this time.
Preparation of CINRYZE
Always wash your hands before doing the following steps. Try to keep everything clean and germ-free while you are reconstituting CINRYZE. Once you open the vials, you should finish preparing CINRYZE as soon as possible. This will help to keep them germ-free.
CINRYZE IS A FREEZE-DRIED POWDER THAT IS SUPPLIED IN A VACUUM-SEALED VIAL.
Note: Two vials of CINRYZE are required for each dose. You should reconstitute both vials according to steps 1 through 6.
1. Let the vial of CINRYZE and the vial of Sterile Water for Injection, USP (diluent) reach room temperature.
2. Remove the cap from the vial of CINRYZE and Sterile Water for Injection, USP (diluent) vial to show the center part of the rubber stopper.
3. Wipe the top of each vial with an alcohol wipe or swab, and allow it to dry. Do not blow on the stopper to dry it faster. Place each vial on a flat surface. After cleaning, do not touch the rubber stopper with your hand or allow it to touch any surface.
4. Note: Diluent vial must be penetrated before the CINRYZE vial to prevent loss of vacuum. Remove the protective covering from the top of the Mix2Vial transfer device package. Do not remove the device from the package. Place the Sterile Water for Injection, USP (diluent) vial on a flat surface, and place the blue end of the Mix2Vial transfer device over it, pushing down until the spike penetrates the rubber stopper and the device snaps in place. Mix2Vial transfer device must be positioned completely upright before penetrating the rubber stopper. Remove the plastic package and discard it. Take care not to touch the exposed end of the device.
5. Place the vial of CINRYZE on a flat surface. Turn the diluent vial containing 5 mL Sterile Water for Injection, USP, upside-down and insert the clear end of the Mix2Vial transfer device into the vial of CINRYZE, pushing down until the spike penetrates the rubber stopper and the device snaps in place. The Mix2Vial transfer device must be positioned completely upright before penetrating the rubber stopper. The Sterile Water for Injection, USP, will automatically flow into the vial of CINRYZE because the vacuum in the vial will draw the Sterile Water for Injection, USP, into the vial of CINRYZE. If this does not happen, do not use the product.
6. Once all the Sterile Water for Injection, USP, is in the CINRYZE vial, gently swirl (do not shake) the vial of CINRYZE until all the powder is dissolved. Disconnect the Sterile Water for Injection, USP vial by turning it counterclockwise. Do not remove the clear end of the Mix2Vial transfer device from the vial of CINRYZE.
Look at the final solution before using it to make sure that CINRYZE is completely dissolved. The solution should be clear with no evidence of cloudiness. Reconstituted solution should be colorless to slightly blue. Do not use if solution is cloudy or otherwise discolored and call Shire Medical Information at 1-866-888-0660 for further instructions.
One vial of dissolved CINRYZE contains 5 mL of C1 esterase inhibitor at a concentration of 100 Units/mL. Prepare two vials of CINRYZE for one dose. Repeat steps 1-6 using a new Mix2Vial transfer device. Do not reuse the Mix2Vial transfer device. CINRYZE should be administered within 3 hours of reconstitution.
7. Utilizing a sterile, disposable 10mL syringe, draw back the plunger to allow approximately 5mL of air into the syringe. Use of a silicone-free syringe is recommended.
8. Attach the syringe onto the clear end of the Mix2Vial transfer device by turning it clockwise.
9. Turn the vial of CINRYZE upside down, inject air into the vial. Slowly pull as much dissolved CINRYZE as possible into the syringe. While holding the vial upside down, detach the syringe from the vial by turning it counterclockwise and releasing it from the Mix2Vial transfer device. Remove any air bubbles by gently tapping the syringe with your finger and slowly pushing the air out of the syringe.
Repeat steps 7-9 above with a second vial of CINRYZE to make one complete dose of 10 mL.
10. Dispose of the vials with the Mix2Vial transfer device attached to them.
CINRYZE should be administered at room temperature promptly after preparation in the syringe. SELF ADMINISTRATION (Intravenous Injection)
Your healthcare provider will teach you how to safely administer CINRYZE. It is important that CINRYZE is injected directly into a superficial vein and not injected into surrounding tissues and not injected into an artery. Once you learn how to self-administer, you can follow the instructions in this insert.
1. Attach a needle or infusion set with a winged adapter to the syringe containing the dissolved CINRYZE solution. Fill the tubing with dissolved CINRYZE by gently pushing the plunger of the syringe. Be careful not to spill the dissolved CINRYZE. This process replaces the air in the tubing with dissolved CINRYZE.
2. Apply a tourniquet and prepare the injection site by wiping the skin well with an alcohol swab.
3. As instructed by your healthcare provider:
- Insert the butterfly needle of the infusion set tubing into your vein.
- Remove the tourniquet.
- Make sure that the needle is in a vein.
- Inject the dissolved CINRYZE product slowly over ten minutes (approximately 1mL/min).
4. After infusing CINRYZE, remove the infusion set and discard. Cover infusion site with an adhesive bandage. The amount of drug product left in the infusion set will not affect your treatment. Dispose of all unused solution, the empty vials, and the used needles and syringe in an appropriate container used for throwing away waste that might hurt others if not handled properly.
It is a good idea to record the lot number from the CINRYZE vial label every time you use CINRYZE.
This Patient Package Insert has been approved by the U.S. Food and Drug Administration.
Last reviewed on RxList: 12/2/2014
This monograph has been modified to include the generic and brand name in many instances.
Additional Cinryze Information
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