Zarzio

filgrastim

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This is a summary of the European public assessment report (EPAR). It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the studies performed, to reach its recommendations on how to use the medicine.

If you need more information about your medical condition or your treatment, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist. If you want more information on the basis of the CHMP recommendations, read the scientific discussion (also part of the EPAR).

What is Zarzio?

Zarzio is a solution for injection or infusion (drip into a vein) in a prefilled syringe. It contains the active substance filgrastim (30 or 48 million units).

Zarzio is a ‘biosimilar medicine'. This means that Zarzio is similar to a biological medicine that is already authorised in the European Union (EU) and contains the same active substance (also known as the ‘reference medicine’). The reference medicine for Zarzio is Neupogen. 

What is Zarzio used for?

Zarzio is used to stimulate the production of white blood cells in the following situations:

  • to reduce the duration of neutropenia (low levels of neutrophils, a type of white blood cell) and the occurrence of febrile neutropenia (neutropenia with fever) in patients receiving chemotherapy (cancer treatment) that is cytotoxic (cell-killing);
  • to reduce the duration of neutropenia in patients undergoing treatment to destroy the bone marrow cells before a bone-marrow transplant (such as in some patients with leukaemia) if they are at a risk of long-term, severe neutropenia;
  • to increase levels of neutrophils and reduce the risk of infections in patients with neutropenia who have a history of severe, repeated infections;
  • to treat persistent neutropenia in patients with advanced human-immunodeficiency-virus (HIV) infection, to reduce the risk of bacterial infections when other treatments are not appropriate.

Zarzio can also be used in people who are about to donate blood stem cells for transplant, to help release these cells from the bone marrow. The medicine can only be obtained with a prescription.

How is Zarzio used?

Zarzio is given by injection under the skin or infusion into a vein. How it is given, the dose and the duration of treatment depend on why it is being used, the patient’s body weight and the response to treatment. Zarzio is usually given in a specialised treatment centre, although patients who receive it by injection under the skin may inject themselves once they have been trained appropriately. For more information, see the package leaflet.

How does Zarzio work?

The active substance in Zarzio, filgrastim, is very similar to a human protein called granulocyte colony stimulating factor (G-CSF). Filgrastim is produced by a method known as ‘recombinant DNA technology’: it is made by a bacterium that has received a gene (DNA), which makes it able to produce filgrastim. The replacement acts in the same way as naturally produced G-CSF by encouraging the bone marrow to produce more white blood cells.

How has Zarzio been studied?

Zarzio was studied to show that it is comparable to the reference medicine, Neupogen.

Four studies looked at the levels of neutrophils in the blood in a total of 146 healthy volunteers who received Zarzio or Neupogen. The studies looked at the effects of single and repeated administration of various doses of the medicines, either injected under the skin or infused into a vein. The main measure in these studies was the neutrophil count over the first 10 days of treatment.

What benefit has Zarzio shown during the studies?

Zarzio and Neupogen brought about similar increases in blood neutrophil counts in healthy volunteers over the course of the studies. This was considered sufficient to demonstrate that the benefits of Zarzio are comparable to those of the reference medicine.

What is the risk associated with Zarzio?

The most common side effect with Zarzio (seen in more than 1 patient in 10) is musculoskeletal pain (pain in the muscles and bones). Other side effects may be seen in more than 1 patient in 10, depending on the condition that Zarzio is being used for. For the full list of all side effects reported with Zarzio, see the package leaflet.

Zarzio should not be used in people who may be hypersensitive (allergic) to filgrastim or any of the other ingredients.

Why has Zarzio been approved?

The Committee for Medicinal Products for Human Use (CHMP) decided that, in accordance with EU requirements, Zarzio has been shown to have a comparable quality, safety and efficacy profile to Neupogen. Therefore, the CHMP’s view was that, as for Neupogen, the benefit outweighs the identified risk. The Committee recommended that Zarzio be given marketing authorisation.

Other information about Zarzio

The European Commission granted a marketing authorisation valid throughout the EU for Zarzio to Sandoz GmbH on 6 February 2009.

Name Language First published Last updated
Zarzio : EPAR - Summary for the public BG = bălgarski 2009-02-16  
Zarzio : EPAR - Summary for the public ES = español 2009-02-16  
Zarzio : EPAR - Summary for the public CS = čeština 2009-02-16  
Zarzio : EPAR - Summary for the public DA = dansk 2009-02-16  
Zarzio : EPAR - Summary for the public DE = Deutsch 2009-02-16  
Zarzio : EPAR - Summary for the public ET = eesti keel 2009-02-16  
Zarzio : EPAR - Summary for the public EL = elliniká 2009-02-16  
Zarzio : EPAR - Summary for the public EN = English 2009-02-16  
Zarzio : EPAR - Summary for the public FR = français 2009-02-16  
Zarzio : EPAR - Summary for the public IT = italiano 2009-02-16  
Zarzio : EPAR - Summary for the public LV = latviešu valoda 2009-02-16  
Zarzio : EPAR - Summary for the public LT = lietuvių kalba 2009-02-16  
Zarzio : EPAR - Summary for the public HU = magyar 2009-02-16  
Zarzio : EPAR - Summary for the public MT = Malti 2009-02-16  
Zarzio : EPAR - Summary for the public NL = Nederlands 2009-02-16  
Zarzio : EPAR - Summary for the public PL = polski 2009-02-16  
Zarzio : EPAR - Summary for the public PT = português 2009-02-16  
Zarzio : EPAR - Summary for the public RO = română 2009-02-16  
Zarzio : EPAR - Summary for the public SK = slovenčina 2009-02-16  
Zarzio : EPAR - Summary for the public SL = slovenščina 2009-02-16  
Zarzio : EPAR - Summary for the public FI = suomi 2009-02-16  
Zarzio : EPAR - Summary for the public SV = svenska 2009-02-16  
Zarzio : EPAR - Summary for the public HR = Hrvatski 2009-02-16  

This EPAR was last updated on 19/04/2016 .

Authorisation details

Product details

Product details for Zarzio
NameZarzio
Agency product numberEMEA/H/C/000917
Active substance

filgrastim

International non-proprietary name (INN) or common name

filgrastim

Therapeutic area NeutropeniaHematopoietic Stem Cell TransplantationCancer
Anatomical therapeutic chemical (ATC) code L03AA02
Biosimilar

A biosimilar medicine is a medicine which is similar to a biological medicine that has already been authorised (the ‘biological reference medicine’). The active substance of a biosimilar medicine similar to the one of the biological reference medicine. Biosimilar and biological reference medicines are used in general at the same dose to treat the same disease.

Publication details

Publication details for Zarzio
Marketing-authorisation holder

Sandoz GmbH

Revision11
Date of issue of marketing authorisation valid throughout the European Union06/02/2009

Contact address:

Sandoz GmbH
Biochemiestrasse 10
AT-6250 Kundl
Austria

Product information

Product information

25/02/2016  Zarzio -EMEA/H/C/000917 -WS/0917

Name Language First published Last updated
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19
Zarzio : EPAR - Product Information HR = Hrvatski 2009-11-09 2016-04-19

Contents

  • Annex I - Summary of product characteristics
  • Annex IIA - Manufacturing-authorisation holder responsible for batch release
  • Annex IIB - Conditions of the marketing authorisation
  • Annex IIIA - Labelling
  • Annex IIIB - Package leaflet

Please note that the size of the above document can exceed 50 pages.

You are therefore advised to be selective about which sections or pages you wish to print.


Name Language First published Last updated
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28
Zarzio : EPAR - All Authorised presentations HR = Hrvatski 2009-02-16 2010-04-28

Pharmacotherapeutic group

Immunostimulants

Therapeutic indication

  • Reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy (with the exception of chronic myeloid leukaemia and myelodysplastic syndromes) and reduction in the duration of neutropenia in patients undergoing myeloablative therapy followed by bone-marrow transplantation considered to be at increased risk of prolonged severe neutropenia. The safety and efficacy of filgrastim are similar in adults and children receiving cytotoxic chemotherapy.
  • Mobilisation of peripheral blood progenitor cells (PBPC).
  • In children and adults with severe congenital, cyclic, or idiopathic neutropenia with an absolute neutrophil count (ANC) of ≤0.5 x 109/l, and a history of severe or recurrent infections, long term administration of filgrastim is indicated to increase neutrophil counts and to reduce the incidence and duration of infection-related events.
  • Treatment of persistent neutropenia (ANC ≤ 1.0 x 109/l) in patients with advanced HIV infection, in order to reduce the risk of bacterial infections when other therapeutic options are inappropriate.

Assessment History

Changes since initial authorisation of medicine

Name Language First published Last updated
Zarzio : EPAR - Procedural steps taken and scientific information after authorisation HR = Hrvatski 2009-11-09 2016-04-19

Initial marketing-authorisation documents

Name Language First published Last updated
Zarzio : EPAR - Public assessment report HR = Hrvatski 2009-02-16  
Committee for medicinal products for human use summary of positive opinion for Zarzio HR = Hrvatski 2008-11-20  

Authorised

This medicine is approved for use in the European Union

More information on Zarzio