Advise the patient and family members or caregivers to read the FDA-approved patient labeling (Patient Information and Instructions for Use
).
Instruct patients and their family members or caregivers to:
- Become familiar with the following information contained in the carton as soon as they receive EVZIO:
- EVZIO Instructions for Use
- Trainer for EVZIO Instructions for Use
- Trainer for EVZIO
- Become familiar with the device labeling color scheme of EVZIO and the Trainer for EVZIO
- The 2 mg dosage form of EVZIO is blue and purple.
- The Trainer for EVZIO is black and white.
- Practice using the Trainer before EVZIO is needed.
- Each EVZIO can only be used one time; however, Trainer for EVZIO can be re-used for training purposes and its red safety guard can be removed and replaced.
- Both EVZIO and Trainer for EVZIO incorporate the electronic voice instruction system.
- It is recommended that patients and caregivers become familiar with the Trainer for EVZIO provided and read the Instructions for Use; however, untrained caregivers or family members should still attempt to use EVZIO during a suspected opioid overdose while awaiting definitive emergency medical care.
Recognition of Opioid Overdose
Instruct the patients and their family members or caregivers how to recognize the signs and symptoms of an opioid overdose requiring the use of EVZIO such as the following:
- Extreme sleepiness - inability to awaken a patient verbally or upon a firm sternal rub.
- Breathing problems - this can range from slow or shallow breathing to no breathing in a patient who cannot be awakened.
- Other signs and symptoms that may accompany sleepiness and breathing problems include the following:
- Extremely small pupils (the black circle in the center of the colored part of the eye) sometimes called “pinpoint pupils.”
- Slow heartbeat and/or low blood pressure.
Risk of Recurrent Respiratory and Central Nervous System Depression
Instruct patients and their family members or caregivers that since the duration of action of most opioids may exceed that of EVZIO, they must seek immediate emergency medical assistance after the first dose of EVZIO and keep the patient under continued surveillance [see Dosage and Administration (2.2), Warnings and Precautions (5.3)].
Limited Efficacy for/with Partial Agonists or Mixed Agonist/Antagonists
Instruct patients and their family members or caregivers that the reversal of respiratory depression caused by partial agonists or mixed agonist/antagonists such as buprenorphine and pentazocine, may be incomplete and may require higher doses of naloxone hydrochloride or repeated administration of EVZIO [see Dosage and Administration (2.2), Warnings and Precautions (5.3)].
Precipitation of Severe Opioid Withdrawal
Instruct patients and their family members or caregivers that the use of EVZIO in patients who are opioid dependent may precipitate an acute abstinence syndrome characterized by the following signs and symptoms: body aches, diarrhea, tachycardia, fever, runny nose, sneezing, piloerection, sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, abdominal cramps, weakness, and increased blood pressure. In neonates, opioid withdrawal may be life threatening if not recognized and properly treated, and may include the following signs and symptoms: convulsions, excessive crying, and hyperactive reflexes [see Warnings and Precautions (5.3, Adverse Reactions (6
)].
Administration Instructions
Instruct patients and their family members or caregivers about the following important information:
- Make sure EVZIO is present whenever persons may be intentionally or accidentally exposed to an opioid to treat serious opioid overdose (i.e., opioid emergencies).
- Administer EVZIO as quickly as possible if a patient is unresponsive and an opioid overdose is suspected, even when in doubt, because prolonged respiratory depression may result in damage to the central nervous system or death. EVZIO is not a substitute for emergency medical care [see Dosage and Administration (2.1
)].
- EVZIO is user actuated and may be administered through clothing [e.g., pants, jeans, etc.] if necessary.
- Inject EVZIO while pressing into the anterolateral aspect of the thigh. In pediatric patients less than 1 year of age, pinch the thigh muscle while administering EVZIO.
- Upon actuation, EVZIO automatically inserts the needle intramuscularly or subcutaneously, delivers the naloxone, and retracts the needle fully into its housing. The needle is not visible before, during, or after injection.
- Each EVZIO can only be used one time.
- If the electronic voice instruction system on EVZIO does not work properly, EVZIO will still deliver the intended dose of naloxone hydrochloride when used according to the printed instructions on its label.
- The electronic voice instructions are independent of activating EVZIO and it is not necessary to wait for the voice instructions to be completed prior to moving to the next step in the injection process.
- Post-injection, the black base locks in place, a red indicator appears in the viewing window and electronic visual and audible instructions signal that EVZIO has delivered the intended dose of naloxone hydrochloride.
- EVZIO’s red safety guard should not be replaced under any circumstances. However, the Trainer is designed for re-use and its red safety guard can be removed and replaced.
- Periodically visually inspect the naloxone solution through the viewing window. If the solution is discolored, cloudy, or contains solid particles, replace it with a new EVZIO.
- Replace EVZIO before its expiration date.
---------------------------------------------------------------------------------------------------------------
Manufactured for:
kaleo, Inc.
Richmond, VA 23219
*For California Only: This product uses batteries containing Perchlorate Material – special handling may apply. See
www.dtsc.ca.gov/hazardouswaste/perchlorate
This product may be covered by one or more U.S. patents or pending patent applications. See
www.kaleopharma.com/pat for details.