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warnings and cautions
5 WARNINGS AND PRECAUTIONS • Serious Rash, including Stevens-Johnson Syndrome: discontinue armodafinil tablets at the first sign of rash, unless the rash is clearly not drug-related. ( 5.1 ) • DRESS/Multi-organ Hypersensitivity Reactions: if suspected, discontinue armodafinil tablets. (5.2) • Angioedema and Anaphylaxis Reactions: if suspected, discontinue armodafinil tablets. (5.3) • Persistent Sleepiness: assess patients frequently for degree of sleepiness and, if appropriate, advise patients to avoid driving or engaging in any other potentially dangerous activity. ( 5.4 ) • Psychiatric Symptoms: use particular caution in treating patients with a history of psychosis, depression, or mania. Consider discontinuing armodafinil tablets if psychiatric symptoms develop. ( 5.5 ) • Known Cardiovascular Disease: consider increased monitoring. ( 5.7 ) 5.1 Serious Dermatologic Reactions, Including Stevens-Johnson Syndrome and Toxic Epidermal Necrosis Serious rash requiring hospitalization and discontinuation of treatment has been reported in association with the use of armodafinil tablets or modafinil (the racemic mixture of S- and R-enantiomers). Armodafinil tablets have not been studied in pediatric patients in any setting and are not approved for use in pediatric patients for any indication. In clinical trials of modafinil, the incidence of rash resulting in discontinuation was approximately 0.8% (13 per 1,585) in pediatric patients (age < 17 years); these rashes included 1 case of possible Stevens-Johnson syndrome (SJS) and 1 case of apparent multi-organ hypersensitivity reaction/Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) [see Warnings and Precautions (5.2) ] . Several of the cases were associated with fever and other abnormalities (e.g., vomiting, leukopenia). The median time to rash that resulted in discontinuation was 13 days. No such cases were observed among 380 pediatric patients who received placebo. Skin and mouth sores, blistering, and ulceration have been reported with modafinil and armodafinil tablets in the postmarketing setting. Recurrence of signs and symptoms of serious dermatologic reactions following rechallenge has been reported in some cases. Rare cases of serious or life-threatening rash, including SJS and toxic epidermal necrolysis (TEN), have been reported in adults and children in worldwide postmarketing experience with mod...
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adverse reactions
6 ADVERSE REACTIONS The following serious adverse reactions are described below and elsewhere in the labeling: • Serious Dermatologic Reactions [see Warnings and Precautions (5.1) ] • Drug Reaction with Eosinophilia and System Symptoms (DRESS)/Multiorgan Hypersensitivity [see Warnings and Precautions (5.2) ] • Angioedema and Anaphylaxis Reactions [see Warnings and Precautions (5.3) ] • Persistent Sleepiness [see Warnings and Precautions (5.4) ] • Psychiatric Symptoms [see Warnings and Precautions (5.5) ] • Effects on Ability to Drive and Use Machinery [see Warnings and Precautions (5.6) ] • Cardiovascular Events [see Warnings and Precautions (5.7) ] Most common adverse reactions (≥ 5%): headache, nausea, dizziness, and insomnia. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Mylan at 1-877-446-3679 (1-877-4-INFO-RX) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Armodafinil tablets have been evaluated for safety in over 1,100 patients with excessive sleepiness associated with OSA, SWD, and narcolepsy. Most Common Adverse Reactions In the placebo-controlled clinical trials, the most common adverse reactions (≥ 5%) associated with the use of armodafinil tablets more frequently than in placebo-treated patients were headache, nausea, dizziness, and insomnia. The adverse reaction profile was similar across the studies. Table 1 presents the adverse reactions that occurred at a rate of 1% or more and were more frequent in armodafinil tablet-treated patients than in placebo-treated patients in the placebo-controlled clinical trials. Table 1: Adverse Reactions in Pooled Placebo-Controlled Clinical Trials Adverse reactions that occurred in ≥ 1% of armodafinil tablet-treated patients and greater incidence than that of placebo. in OSA, Narcolepsy, and SWD with Armodafinil Tablets (150 mg and 250 mg) Armodafinil Tablets (%) N = 645 Placebo (%) N = 445 Headache 17 9 Nausea 7 3 Dizziness 5 2 Insomnia 5 1 Anxiety 4 1 Diarrhea 4 2 Dry Mouth 4 1 Depression 2 0 Dyspepsia 2 0 Fatigue 2 1 Palpitations 2 1 Rash 2 0 Upper Abdominal Pain 2 1 Agitation 1 0 Anorexia 1 0 Constipati...
adverse reactions table
Table 1: Adverse Reactions in Pooled Placebo-Controlled Clinical TrialsAdverse reactions that occurred in ≥ 1% of armodafinil tablet-treated patients and greater incidence than that of placebo. in OSA, Narcolepsy, and SWD with Armodafinil Tablets (150 mg and 250 mg)Armodafinil Tablets(%)N = 645Placebo(%)N = 445Headache179Nausea73Dizziness52Insomnia51Anxiety41Diarrhea42Dry Mouth41Depression20Dyspepsia20Fatigue21Palpitations 21Rash20Upper Abdominal Pain21Agitation10Anorexia10Constipation10Contact Dermatitis10Decreased Appetite10Depressed Mood10Disturbance In Attention10Dyspnea10Hyperhydrosis10Increased Gamma-Glutamyltransferase10Increased Heart Rate10Influenza-Like Illness10Loose Stools10Migraine10Nervousness10Pain10Paresthesia10Polyuria10Pyrexia10Seasonal Allergy10Thirst10Tremor10Vomiting10