Sialanar

glycopyrronium

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This is a summary of the European public assessment report (EPAR) for Sialanar. It explains how the Agency assessed the medicine to recommend its authorisation in the EU and its conditions of use. It is not intended to provide practical advice on how to use Sialanar.

For practical information about using Sialanar, patients should read the package leaflet or contact their doctor or pharmacist.

What is Sialanar and what is it used for?

Sialanar is a medicine for treating severe drooling of saliva in children and adolescents (aged 3 years and above) with conditions affecting the nervous system, such as cerebral palsy, epilepsy and neurodegenerative diseases. It contains the active substance glycopyrronium bromide.

How is Sialanar used?

Sialanar is available as a solution to be taken by mouth three times a day, one hour before or two hours after meals. The starting dose depends on the patient’s body weight. The dose is then adjusted according to how the patient responds to the medicine and its side effects.

Sialanar should be prescribed by a doctor with experience in treating children with nervous system conditions and it can only be obtained with a prescription.

How does Sialanar work?

The active substance in Sialanar, glycopyrronium bromide, blocks receptors in the salivary glands known as muscarinic receptors. These receptors trigger the production of saliva when activated by nerves from the brain. By blocking the receptors, the medicine is expected to help reduce the amount of saliva produced by the glands and so reduce drooling.

What benefits of Sialanar have been shown in studies?

Two published studies showed that glycopyrronium bromide was effective at reducing drooling in children and adolescents with nervous system conditions, using a standard rating scale known as mTDS (where a score of 1 means no drooling and a score of 9 means profuse drooling).

In one of the studies in 38 children and adolescents with severe drooling, around 74% of those taking glycopyrronium bromide after 8 weeks had their scores reduced by 3 points or more compared with 18% of those taking placebo (a dummy treatment).

The second study involved 27 children and adolescents with severe drooling who took either glycopyrronium bromide or placebo for 8 weeks and then had their treatment switched for another 8 weeks. This study focused on the average final drooling scores after 8 weeks of treatment, which were 1.9 in patients on glycopyrronium bromide and 6.3 in patients on placebo.

What are the risks associated with Sialanar?

The most common side effects with Sialanar (which may affect more than 1 in 10 people) are irritability, flushing, blocked nose, reduced secretions in the airways, dry mouth, constipation, diarrhoea, vomiting and inability to completely empty the bladder (urinary retention). For the full list of all side effects reported with Sialanar, see the package leaflet.

Sialanar must not be used in patients with glaucoma (an eye condition), urinary retention, severe kidney impairment or a history of certain intestinal conditions or myasthenia gravis (a condition affecting muscles). It must also not be used in patients who are pregnant or are taking potassium chloride tablets or capsules or medicines which have anticholinergic effect. For the full list of restrictions with Sialanar, see the package leaflet.

Why is Sialanar approved?

Glycopyrronium bromide is well established in the EU as a treatment for drooling, and published studies show that it is effective in treating severe drooling in children and adolescents with nervous system conditions which can affect their quality of life. With regard to its risks, the side effects that occur with glycopyrronium bromide can be managed by adequately monitoring patients and adjusting the dose.

The Agency’s Committee for Medicinal Products for Human Use (CHMP) therefore concluded that benefits of Sialanar outweigh its risks and recommended that it be granted marketing authorisation in the EU.

What measures are being taken to ensure the safe and effective use of Sialanar?

To help prescribers and carers use the medicine as safely as possible, the company that markets Sialanar will provide them with educational material containing information on how to use the medicine properly and manage its side effects.

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Sialanar have also been included in the summary of product characteristics and the package leaflet.

Other information about Sialanar

The European Commission granted a marketing authorisation valid throughout the European Union for Sialanar on 15 September 2016.

For more information about treatment with Sialanar, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Name Language First published Last updated
Sialanar : EPAR - Summary for the public BG = bălgarski 2016-09-29  
Sialanar : EPAR - Summary for the public ES = español 2016-09-29  
Sialanar : EPAR - Summary for the public CS = čeština 2016-09-29  
Sialanar : EPAR - Summary for the public DA = dansk 2016-09-29  
Sialanar : EPAR - Summary for the public DE = Deutsch 2016-09-29  
Sialanar : EPAR - Summary for the public ET = eesti keel 2016-09-29  
Sialanar : EPAR - Summary for the public EL = elliniká 2016-09-29  
Sialanar : EPAR - Summary for the public EN = English 2016-09-29  
Sialanar : EPAR - Summary for the public FR = français 2016-09-29  
Sialanar : EPAR - Summary for the public IT = italiano 2016-09-29  
Sialanar : EPAR - Summary for the public LV = latviešu valoda 2016-09-29  
Sialanar : EPAR - Summary for the public LT = lietuvių kalba 2016-09-29  
Sialanar : EPAR - Summary for the public HU = magyar 2016-09-29  
Sialanar : EPAR - Summary for the public MT = Malti 2016-09-29  
Sialanar : EPAR - Summary for the public NL = Nederlands 2016-09-29  
Sialanar : EPAR - Summary for the public PL = polski 2016-09-29  
Sialanar : EPAR - Summary for the public PT = português 2016-09-29  
Sialanar : EPAR - Summary for the public RO = română 2016-09-29  
Sialanar : EPAR - Summary for the public SK = slovenčina 2016-09-29  
Sialanar : EPAR - Summary for the public SL = slovenščina 2016-09-29  
Sialanar : EPAR - Summary for the public FI = suomi 2016-09-29  
Sialanar : EPAR - Summary for the public SV = svenska 2016-09-29  
Sialanar : EPAR - Summary for the public HR = Hrvatski 2016-09-29  

This EPAR was last updated on 04/04/2018 .

Authorisation details

Product details

Product details for Sialanar
NameSialanar
Agency product numberEMEA/H/C/003883
Active substance

glycopyrronium bromide

International non-proprietary name (INN) or common name

glycopyrronium

Therapeutic area Sialorrhea
Anatomical therapeutic chemical (ATC) code A03AB02

Publication details

Publication details for Sialanar
Marketing-authorisation holder

Proveca Limited

Revision2
Date of issue of marketing authorisation valid throughout the European Union15/09/2016

Contact address:

Proveca Limited
Neo
Charlotte Street
Manchester
M1 4ET
United Kingdom

Product information

Product information

11/05/2017  Sialanar -EMEA/H/C/003883 -IAIN/0003

Name Language First published Last updated
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04
Sialanar : EPAR - Product Information HR = Hrvatski 2016-09-29 2018-04-04

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
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  
Sialanar : EPAR - All Authorised presentations HR = Hrvatski 2016-09-29  

Pharmacotherapeutic group

Drugs for functional gastrointestinal disorders

Therapeutic indication

Symptomatic treatment of severe sialorrhoea (chronic pathological drooling) in children and adolescents aged 3 years and older with chronic neurological disorders.

Assessment History

Changes since initial authorisation of medicine

Name Language First published Last updated
Sialanar : EPAR - Procedural steps taken and scientific information after authorisation HR = Hrvatski 2017-05-11 2018-04-04

Initial marketing-authorisation documents

Name Language First published Last updated
Sialanar : EPAR - Public assessment report HR = Hrvatski 2016-09-29  
CHMP summary of opinion for Sialanar HR = Hrvatski 2016-07-22