Filing under Rule 425 under the Securities Act |
of 1933 and deemed filed under Rule 14a-12 of |
the Securities Exchange Act of 1934 |
Filing by: Jazz Pharmaceuticals, Inc. |
Subject Company: Jazz Pharmaceuticals, Inc. |
SEC File No. of Jazz Pharmaceuticals, Inc.: |
001-33500 |
Registration No. 333-177528 |
The following includes a slide presentation relating to the proposed transactions described therein that was first used on November 15, 2011 at the 8th Annual Lazard Capital Markets Healthcare Conference.
Bruce
Cozadd Chairman and CEO
November 15, 2011
8
th
Annual Lazard Capital Markets
Healthcare Conference |
Forward-Looking
Statements 2
"Safe Harbor" Statement under the Private Securities Litigation Reform Act of 1995
dependence
on
sales
of
Xyrem
®
and
Luvox
CR
®
products
and
its
ability
to
increase
sales
of
its
Xyrem;
This presentation contains forward-looking statements, including, but not limited
to, statements related to Jazz Pharmaceuticals growth potential and future
financial performance, including 2011 financial guidance, and statements related
to the anticipated consummation of the business combination transaction between Jazz
Pharmaceuticals and Azur Pharma Public Limited Company (formerly Azur Pharma Limited),
including the timing and benefits thereof. These forward-looking statements
are based on Jazz Pharmaceuticals current expectations and inherently
involve significant risks and uncertainties. Jazz Pharmaceuticals actual results and
the timing of events could differ materially from those anticipated in such forward
looking statements as a result of these risks and uncertainties, which include,
without limitation, risks related to: Jazz Pharmaceuticals
competition, including potential generic competition; Jazz Pharmaceuticals
dependence on single source suppliers and manufacturers; the ability of Jazz
Pharmaceuticals to protect its intellectual property and defend its patents;
regulatory obligations and oversight; Jazz Pharmaceuticals cash flow; and Jazz Pharmaceuticals ability
to complete the transaction with Azur Pharma on the proposed terms and schedule and
achieve the anticipated benefits of the transaction. These and those other
applicable risks are described in more detail under the caption Risk
Factors and elsewhere in Jazz Pharmaceuticals Securities and Exchange Commission (SEC)
filings and reports, including in its Quarterly Report on Form 10-Q for the quarter
ended September 30, 2011 and definitive proxy statement related to the Azur
Pharma transaction. Jazz Pharmaceuticals undertakes no duty or obligation to
update any forward-looking statements contained in this presentation as a result of new information,
future events or changes in its expectations. |
3
Additional Information
Additional Information and Where to Find It
In connection with the
proposed transaction between Jazz Pharmaceuticals and Azur Pharma, the companies have filed documents with
the SEC, including the filing by Jazz Pharmaceuticals of a definitive proxy statement
relating to the proposed transaction and related matters, and the filing by Azur
Pharma of a registration statement on Form S-4 that includes the definitive proxy statement/prospectus relating to the
proposed transaction and related matters. The definitive proxy statement/prospectus has
been mailed to Jazz Pharmaceuticals stockholders in connection with the
proposed transaction. INVESTORS AND SECURITY HOLDERS ARE URGED TO READ THE REGISTRATION
STATEMENT ON FORM S-4 AND THE RELATED DEFINITIVE PROXY STATEMENT/PROSPECTUS BECAUSE
THEY CONTAIN IMPORTANT INFORMATION ABOUT JAZZ PHARMACEUTICALS, AZUR PHARMA, THE
PROPOSED TRANSACTION AND RELATED MATTERS. Investors and security holders may
obtain free copies of these documents and other related documents filed with the SEC at the SECs web site at
www.sec.gov, or by directing a request to Jazz Pharmaceuticals Investor Relations
department at Jazz Pharmaceuticals, Inc., Attention: Investor Relations, 3180
Porter Drive, Palo Alto, California 94304, to Jazz Pharmaceuticals Investor Relations department at 650-496-2800 or by email to
investorinfo@jazzpharma.com. Investors and security holders may obtain free copies
of the documents filed with the SEC on Jazz Pharmaceuticals website at
www.jazzpharmaceuticals.com under the heading Investors and then under the heading SEC Filings.
Jazz Pharmaceuticals and
its directors and executive officers and Azur Pharma and its directors and executive officers may be deemed
participants in the solicitation of proxies from the stockholders of Jazz
Pharmaceuticals in connection with the proposed transaction. Information
regarding the special interests of these directors and executive officers in the
proposed transaction is included in the proxy statement/prospectus described
above. Additional information regarding the directors and executive officers of Jazz Pharmaceuticals is also included in Jazz
Pharmaceuticals proxy statement for its 2011 Annual Meeting of Stockholders,
which was filed with the SEC on April 12, 2011. These documents are available
free of charge at the SECs web site and from Investor Relations at Jazz Pharmaceuticals as described above.
This communication does
not constitute an offer to sell, or the solicitation of an offer to sell, or the solicitation of an offer to subscribe for or
buy, any securities nor shall there be any sale, issuance or transfer of securities in
any jurisdiction in which such offer, solicitation or sale would be unlawful
prior to registration or qualification under the securities laws of any such jurisdiction.
For full prescribing information refer to product websites.
|
Building
Shareholder Value by Focusing on Patient Needs Jazz
Pharmaceuticals mission is to improve
patients
lives by identifying, developing and
commercializing valuable pharmaceutical
products in focused therapeutic areas
4 |
5
Strategy to Build Shareholder Value
Grow Xyrem sales in
current indications
Increased focus on
achieving full potential
1
Maintain entrepreneurial, ownership culture at the company
4
Make disciplined resource allocation decisions
2
3
Acquire additional
marketed or close to
approval products
Leverage our expertise
and infrastructure
Pursue lower risk
development of
specialty products
Invest percentage
of sales longer-term |
Current Business Overview |
$39
$54
$97
$230-235
1
2010
2009
2008
2007
2011G
$143
$0
$25
$50
$75
$100
$175
$200
$125
$150
$225
$250
Xyrem -
Strong Sales Growth
8%
7
1.
Based on guidance provided on November 1, 2011. The company is not updating the
prior guidance and actual results may differ. |
Xyrem is
a Standard of Care in Narcolepsy
Only FDA-approved product for both cataplexy and
excessive daytime sleepiness in patients with
narcolepsy
Marketed in U.S. since 2002
Marketed in major European countries by
UCB and in Canada by Valeant
Currently marketed in U.S. by 110-person specialty sales force
Over 9,000 patients on therapy, usually in conjunction with stimulant therapy
Distributed
under
proprietary
Xyrem
Success
Program
®
8 |
The
Burden of Narcolepsy
Affects
1
in
2000
in
US
1
multiple
sclerosis
and
Parkinson's
disease
2
>
cystic
fibrosis
3
Although narcolepsy is thought to affect between
125,000 and 200,000 Americans, only about
50,000
are
diagnosed
4
Key symptoms can be debilitating
Cataplexy occurs in 60%-100% of patients
100% experience excessive daytime sleepiness
1.
National Institute of Neurological Disorders and Stroke.
http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm. Accessed March 17, 2011.
2.
Narcolepsy Sleep Foundation.
www.sleepfoundation.org/article/sleep-related-problems/narcolepsy-and-sleep. Accessed March 17, 2011.
3.
Zemanick et al. J Cyst Fibros. 2010;9:1-16.
4.
American Sleep Association.
http;//www.sleepassociation.org/index.php?p=aboutnarcolepsy. Accessed March 17, 2011.
9 |
2
-40
-30
-20
-10
0
Xyrem has Demonstrated Effect
on Two Key Symptoms of Narcolepsy
XYREM
6 g/night
(n=58)
XYREM
9 g/night
(n=47)
Placebo
(n=59)
16%
*
37%
*
3%
Improvement in Epworth
Sleepiness Scale
Week 2
Week 4
Baseline
Reduction in Weekly
Cataplexy Attacks
-28%
-49%*
-69%+
10
-80
-60
-40
-20
0
Placebo (n=33)
XYREM 6 g/night (n=31)
XYREM 9 g/night (n=33)
*p<0.001 vs placebo
*p<0.05 vs placebo
+p<0.005 vs placebo
1 |
Most
Common Adverse Events in Controlled Studies of Xyrem
Adverse Event
1
% of Patients (N=655)
Placebo
Xyrem
Nausea
4
19
Dizziness
4
18
Headache
15
18
Vomiting
1
8
Somnolence
4
6
Urinary incontinence
4
<1
6
Nasopharyngitis
5
6
Label includes boxed warning that sodium oxybate is a central nervous system
depressant with abuse potential and should not be used with alcohol or other
CNS depressants. See complete boxed warning at end of presentation.
11
2
3
1. Occurring
in
5%
of
XYREM
patients
and
more
frequently
than
with
placebo.
2.
Data
on
file,
Jazz
Pharmaceuticals,
Inc.
3.
XYREM
(sodium
oxybate)
PI.
4.
Generally
nocturnal
enuresis. |
Update
on FDA Form 483 and Related Warning Letter
Fully committed to accurate and timely adverse event (AE) reporting
After receipt of FDA Form 483 in May, immediate actions initiated to
improve AE reporting procedures:
Implemented additional procedures at central pharmacy
Strengthened AE collection and reporting systems, including revised SOPs
Improved training and auditing programs
Timely response to October FDA warning letter submitted
Ongoing oversight strengthened to ensure robust safety reporting
systems
12 |
Strong
Sodium Oxybate Patent Coverage * Listed in FDA Orange Book
13
Number
Issue Date
Expiration Date
Distribution system patent*
7,765,106
7/27/2010
6/16/2024
Distribution system patent*
7,765,107
7/27/2010
6/16/2024
Distribution system patent
7,797,171
9/14/2010
6/16/2024
Distribution system patent*
7,668,730
2/23/2010
6/16/2024
Distribution system patent*
7,895,059
2/23/2011
12/17/2022
Formulation patent*
6,780,889
8/24/1999
7/4/2020
Formulation patent*
7,262,219
8/28/2007
7/4/2020
Process patent
6,472,431
10/29/1999
12/22/2019
Method of use patent*
7,851,506
12/14/2010
12/22/2019 |
Overview of Manufacturing and Distribution
DEA drug quota needed to manufacture controlled Schedule I
API
Exclusive relationships with API supplier and finished goods
manufacturer:
Siegfried approved by FDA for API supply
Unique proprietary distribution system uses exclusive single pharmacy
Risk management program and unique product attributes require high
touch capabilities
14 |
Current
Xyrem Patient Coverage Distribution*
Approximately 90% of insured patients
have access
Relatively low rates of required prior
authorizations
Low monthly out-of-pocket (OOP)
expenses
Over 70% of patients have monthly
OOP of
$50
78%
8%
4%
1%
9%
* Company data and MediMedia Formulary Compass: Sep/Oct 2011.
Commercial
Medicaid
Medicare Part D
Patient
Assistance
Program
Cash
15 |
16
New narcolepsy physician targets
Xyrem Success Program education
Patient services
-
Nursing program
-
Xyrem Patient Connection
-
Patient assistance programs
Increased Marketing Investment
Xyrem Growth Initiatives
Improve Market Penetration Over Time
Current Patients >9,000
Approximately 18% of 50K Diagnosed Narcolepsy Patients
|
17
1. National Institute of Mental Health.
http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america.shtml. Accessed March 3, 2008. 2. Kessler RC, et al. Arch Gen Psychiatry. 2005;62:617-627. 3. Fireman
B, et al. Am J Psychiatry. 2001;158:1904-1910. 4. Grabill K et al..Assessment
of obsessive-compulsive disorder: a review.J Anxiety Disord. 2008;22(1):1-17. 5. Hales RE, et al (eds). Textbook of Psychiatry. 1999:600-610. 6. Koran LM,
et al. Am J Health Syst Pharm. 2000;57:1972-1978.
Luvox CR
®
-
Important Treatment Option for OCD
Indicated for obsessive compulsive
disorder (OCD)
OCD affects ~ 2.2 million Americans
1,2
Often underdiagnosed
3,4
Difficult to differentiate from comorbidities
5
Only 43% of adults newly diagnosed with OCD received adequate treatment in the
year after their first visit for OCD
6
Label includes boxed warning regarding suicidality and antidepressant drugs.
See complete boxed warning at end of presentation. |
Luvox
CR Continued Sales Growth
$30
$6
$31-33
1
2009
2008
2011G
18
$0
$5
$10
$15
$20
$25
2010
2
$18
$35
$40
$27
1.
Based on guidance provided on November 1, 2011. The company is not updating the
prior guidance and actual results may differ. 2.
Includes $2 million of revenue recorded as a result of a change in the timing of when
Luvox CR revenue is recognized. The company now records sales upon shipment to distributors net of estimated returns. |
19
2011 Guidance Reflects High Operating Leverage
1.
Based on guidance provided on November 1, 2011. The company is not updating
the prior guidance and actual results may differ. 2.
Includes Azur transaction related expenses of $10-11 million.
3.
Adjusted
net
income
and
adjusted
EPS
are
non-GAAP
financial
measures
that
exclude
certain
items
from
GAAP
net
income
and
GAAP
EPS.
A
reconciliation
of
adjusted
net
income to
GAAP net income and the related per share amounts is in a table included with this
presentation. 2010-
A
2011-
G
1
Total Product Sales
$170M
$261
268M
Xyrem
$143M
$230 -
235M
Luvox CR
$27M
$31 -
33M
SG&A and R&D Combined
2
$95M
$114
118M
GAAP Net Income
$33M
$128
131M
Adjusted Net Income
3
$61M
$160
163M
GAAP EPS
$0.83
$2.76
$2.81
Adjusted EPS
3
$1.55
$3.45
$3.50 |
Strategic Transaction with
Azur Pharma |
21
Strategic Benefits
Diversified portfolio of CNS and
womens health products
Increased scale and platform
for growth
Resources to invest in future
pipeline and strong franchise
management opportunities
Stronger, enhanced
management team
Projected Financial Benefits
Accretive transaction
1
Revenues >$475M
and cash flow >$200M in
first 12 months
Strong balance sheet
with no debt
Lower combined tax rate
1
Accretion for Jazz Pharmaceuticals shareholders is on a fully-taxed adjusted EPS
basis. Adjusted EPS is a non-GAAP financial measure that excludes certain items from GAAP EPS.
Compelling Strategic and Financial Benefits
Jazz
Pharmaceuticals plc
Ireland |
Azur
Pharma Compelling Fit with Jazz Pharmaceuticals
22
CNS
Womens
Health
Net Sales (Millions)
Strong commercial focus and expertise
in CNS and womens health
Approximately 170 employees:
105 people in 3 US sales forces
across pain, psychiatry and
womens health
16 person medical affairs team
50 people in home office
(18 Dublin; 32 Philadelphia)
Pipeline of line extensions for clozapine
franchise
1.
Based on estimate provided on September 19, 2011. The estimate is not being
updated. Total Net
Sales
Estimate
$5
$24
$57
$67
$83
$95-100
1 |
Prialt
- for Chronic Pain
2010 net sales of $20M (marketed by Azur since May 2010)
Only
non-opioid
intrathecal
(IT)
analgesic
for
severe
chronic
pain
1
Compelling growth opportunity with similar characteristics to Xyrem:
Requires high touch sales capability with heavy clinical emphasis
Currently used in less than 3% of available pain market pumps (approximately
1500)
Limited competitive threats and multiple years of patent and other protection
European rights licensed to Eisai; Azur retains ROW rights
23
1. See full prescribing information on website |
FazaClo
for Treatment Resistant Schizophrenia
2010 net sales of $37M
Orally disintegrating clozapine tablets approved for management of treatment
resistant schizophrenia
1
Approximately 10% prescription share despite largely generic clozapine market
FazaClo High Dose (HD) launched September 2010
More than 27% switched from Low Dose (LD) as of 3Q11
Dosing flexibility and lower pill burden
Generics
filed
to
FazaClo
settlement
with
Teva
with
potential
launch
of
lower
dosage
product in 2Q12 and HD in 2015
Additional clozapine line extensions in development
24
1. See full prescribing information on website |
25
Diversified
and
balanced
set
of
six
products
1
with 2010 net sales of $27M
Significant
growth
opportunity
driven
by
Elestrin
1
, a topical gel ERT therapy
Patents through 2022
Revamped Elestrin promotion model in 2010 leveraging ~ 50 sales representatives
0%
20%
40%
60%
80%
100%
2009
2010
2011E
Womens Health Products -
Targeting a Growing Market
Elestrin
Other Womens Health
Net Sales Contribution
1. See full prescribing information on website |
26
2011 Estimated Net Sales
Stand Alone Jazz Pharmaceuticals, Inc.
Pro forma Jazz Pharmaceuticals plc
A Growing, Diversified Product Portfolio
Luvox CR
13%
Xyrem 87%
Xyrem 63%
Luvox CR
9%
Prialt 6%
Womens
Health 10%
Other CNS
1%
FazaClo LD
8%
FazaClo HD
3% |
27
Transaction Closing on Track
SEC filings and
stockholder meeting
Transaction expected
to close January 2012
Transaction subject
to customary closing
conditions and
regulatory approvals
Azur approval of other
necessary actions required
US antitrust clearance
pending
Transaction taxable to Jazz
Pharmaceuticals, Inc.
stockholders
Jazz Pharmaceuticals plc shares
to be traded on Nasdaq under
JAZZ
Azur Pharma S-4 declared
effective
Proxy statement/prospectus
mailed to Jazz Pharmaceuticals,
Inc. stockholders in November
Jazz Pharmaceuticals, Inc.
stockholder meeting on
December 12, 2011 |
28
Strategic Benefits
Diversified portfolio of CNS and
womens health products
Increased scale and platform
for growth
Resources to invest in future
pipeline and strong franchise
management opportunities
Stronger, enhanced
management team
Projected Financial Benefits
Accretive transaction
1
Revenues >$475M
and cash flow >$200M in
first 12 months
Strong balance sheet
with no debt
Lower combined tax rate
1
Accretion for Jazz Pharmaceuticals shareholders is on a fully-taxed adjusted EPS
basis. Adjusted EPS is a non-GAAP financial measure that excludes certain items from GAAP EPS.
Compelling Strategic and Financial Benefits
Jazz
Pharmaceuticals plc
Ireland |
|
30
2010
Reconciliation of GAAP Net Income and EPS to Adjusted
Net Income and EPS in Financial Results and Guidance
(In millions, except per share amounts)
GAAP net income
Add:
Intangible asset amortization
Stock-based compensation expense
Non-cash interest expense and extinguishment of debt
Azur Pharma transaction related costs
Deduct:
Contract revenues
GAAP net income per diluted share (EPS)
Adjusted net income per diluted share (EPS)
Shares used in computing GAAP and adjusted net
income per diluted share amounts
Adjusted net income
Luvox CR revenue recognition timing change
(1)
$128-131M
7
13
2
$160-163
$2.76-2.81
$3.45-3.50
46-47
10-11
(1)
$33
8
8
14
$61
$0.83
$1.55
39
(1)
1.
Based on guidance provided on November 1, 2011. The company is not updating
the prior guidance and actual results may differ. -
-
2010
2011G
1 |
31
Xyrem
(sodium oxybate)
Boxed Warning
Sodium oxybate is GHB, a known drug of abuse. Abuse has been associated with some
important central nervous system (CNS)
adverse
events
(including
death).
Even
at
recommended
doses,
use
has
been
associated
with
confusion,
depression
and
other
neuropsychiatric
events.
Reports
of
respiratory
depression
occurred
in
clinical
trials.
Almost
all
of
the
patients
who
received sodium oxybate during clinical trials were receiving CNS stimulants.
Important CNS adverse events associated with abuse of GHB include seizure, respiratory
depression and profound decreases in
level
of
consciousness,
with
instances
of
coma
and
death.
For
events
that
occurred
outside
of
clinical
trials,
in
people
taking
GHB
for
recreational
purposes,
the
circumstances
surrounding
the
events
are
often
unclear
(e.g.,
dose
of
GHB
taken,
the
nature and amount of alcohol or any concomitant drugs).
Xyrem
is
available
through
the
Xyrem
Success
Program,
using
a
centralized
pharmacy
1-866-XYREM88
®
(1-866-997-3688).
The
Success
Program
provides
educational
materials
to
the
prescriber
and
the
patient
explaining
the
risks
and
proper
use
of
sodium oxybate, and the required prescription form. Once it is documented that the
patient has read and/or understood the materials, the drug will be shipped to the
patient. The Xyrem Success Program also recommends patient follow-up every 3
months. Physicians are expected to report all serious adverse events to the manufacturer.
(See WARNINGS). XYREM (sodium oxybate) PI
!WARNING:
Central nervous system depressant with abuse potential.
Should not be used with alcohol or other CNS depressants.
|
Luvox
CR (fluvoxamine maleate)
Boxed Warning
LUVOX CR (fluvoxamine maleate ) PI
Suicidality and Antidepressant Drugs
Antidepressants increased the risk compared to placebo of suicidal thinking
and behavior (suicidality) in children, adolescents, and young adults in
short-term studies of major depressive disorder (MDD) and other
psychiatric disorders.
Anyone
considering
the
use
of
LUVOX
CR
®
(fluvoxamine
maleate)
Extended-Release Capsules or any other antidepressant in a child,
adolescent, or young adult must balance this risk with the clinical need.
Short-term studies did not show an increase in the risk of suicidality
with antidepressants compared to placebo in adults beyond age 24; there was a
reduction in risk with antidepressants
compared
to
placebo
in
adults
aged
65
and
older.
Depression
and certain other psychiatric disorders are themselves associated with
increases in the risk of suicide. Patients of all ages who are started on
antidepressant therapy should be monitored appropriately and observed closely
for clinical worsening, suicidality, or unusual changes in behavior. Families
and caregivers should be advised of the need for close observation and
communication with the prescriber. LUVOX CR Capsules are not approved for
use
in
pediatric
patients.
(See
WARNINGS:
Clinical
Worsening
and
Suicide
Risk,
PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.)
|
Prialt
(ziconotide intrathecal infusion)
Boxed Warning
Severe psychiatric symptoms and neurological impairment may occur during
treatment with PRIALT. Patients with a pre-existing history of psychosis
should not be treated with PRIALT. All patients should be monitored
frequently
for
evidence
of
cognitive
impairment,
hallucinations,
or
changes
in
mood or consciousness. PRIALT therapy can be interrupted or discontinued
abruptly without evidence of withdrawal effects in the event of serious
neurological or psychiatric signs or symptoms
Prialt (ziconotide intrathecal infusion) PI
WARNING: |
FazaClo
(clozapine)
Boxed Warning
1. AGRANULOCYTOSIS
BECAUSE OF A SIGNIFICANT RISK OF AGRANULOCYTOSIS, A POTENTIALLY LIFE-THREATENING
ADVERSE EVENT, CLOZAPINE SHOULD BE RESERVED FOR USE IN (1) THE TREATMENT OF
SEVERELY ILL PATIENTS WITH SCHIZOPHRENIA WHO FAIL TO SHOW AN ACCEPTABLE RESPONSE
TO ADEQUATE COURSES OF STANDARD ANTIPSYCHOTIC DRUG TREATMENT, OR (2) FOR REDUCING
THE RISK OF RECURRENT SUICIDAL BEHAVIOR IN PATIENTS WITH SCHIZOPHRENIA OR
SCHIZOAFFECTIVE DISORDER WHO ARE JUDGED TO BE AT RISK OF REEXPERIENCING SUICIDAL
BEHAVIOR. PATIENTS BEING TREATED WITH CLOZAPINE MUST HAVE A BASELINE WHITE
BLOOD
CELL
(WBC)
COUNT
AND
ABSOLUTE
NEUTROPHIL
COUNT
(ANC)
BEFORE
INITIATION
OF
TREATMENT
AS WELL AS REGULAR WBC COUNTS AND ANCs DURING TREATMENT AND FOR AT LEAST 4 WEEKS
AFTER DISCONTINUATION OF TREATMENT. (SEE WARNINGS.) CLOZAPINE IS AVAILABLE ONLY
THROUGH A DISTRIBUTION SYSTEM THAT ENSURES MONITORING OF WBC COUNTS AND ANCs
ACCORDING TO THE SCHEDULE
DESCRIBED
BELOW
PRIOR
TO
DELIVERY
OF
THE
NEXT
SUPPLY
OF
MEDICATION.
(SEE
WARNINGS.)
2. SEIZURES
SEIZURES HAVE BEEN ASSOCIATED WITH THE USE OF CLOZAPINE. DOSE APPEARS TO BE AN
IMPORTANT PREDICTOR OF SEIZURE, WITH A GREATER LIKELIHOOD AT HIGHER CLOZAPINE
DOSES. CAUTION SHOULD BE USED WHEN ADMINISTERING CLOZAPINE TO PATIENTS
HAVING A HISTORY OF SEIZURES OR OTHER PREDISPOSING FACTORS. PATIENTS SHOULD
BE ADVISED NOT TO ENGAGE IN ANY ACTIVITY WHERE SUDDEN LOSS OF CONSCIOUSNESS COULD
CAUSE SERIOUS RISK TO THEMSELVES OR OTHERS. (SEE WARNINGS.) 3.
MYOCARDITIS ANALYSES OF POSTMARKETING SAFETY DATABASES SUGGEST THAT THATCLOZAPINE
IS ASSOCIATED WITH AN INCREASED RISK OF FATAL MYOCARDITIS, ESPECIALLY DURING, BUT
NOT LIMITED TO, THE FIRST MONTH
OF
THERAPY.
IN
PATIENTS
IN
WHOM
MYOCARDITIS
IS
SUSPECTED,
CLOZAPINE
TREATMENT
SHOULD
BE
PROMPTLY DISCONTINUED. (SEE WARNINGS.)
FazaClo (clozapine) PI
WARNING: |
FazaClo
(clozapine)
Boxed Warning -
continued
4. OTHER ADVERSE CARDIOVASCULAR AND RESPIRATORY EFFECTS
ORTHOSTATIC
HYPOTENSION,
WITH
OR
WITHOUT
SYNCOPE,
CAN
OCCUR
WITH
CLOZAPINE
TREATMENT.
RARELY,
COLLAPSE CAN BE PROFOUND AND BE ACCOMPANIED BY RESPIRATORY AND/OR CARDIAC ARREST.
ORTHOSTATIC HYPOTENSION IS MORE LIKELY TO OCCUR DURING INITIAL TITRATION IN
ASSOCIATION WITH RAPID DOSE
ESCALATION.
IN
PATIENTS
WHO
HAVE
HAD
EVEN
A
BRIEF
INTERVAL
OFF
CLOZAPINE
(ie,
2
OR
MORE
DAYS
SINCE THE LAST DOSE) TREATMENT SHOULD BE STARTED WITH 12.5 MG ONCE OR TWICE DAILY.
(SEE WARNINGS AND DOSAGE AND ADMINISTRATION.) SINCE COLLAPSE, RESPIRATORY ARREST,
AND CARDIAC ARREST DURING INITIAL TREATMENT HAS OCCURRED IN PATIENTS WHO WERE
BEING ADMINISTERED BENZODIAZEPINES OR OTHER PSYCHOTROPIC DRUGS, CAUTION IS ADVISED
WHEN CLOZAPINE IS INITIATED IN PATIENTS TAKING A BENZODIAZEPINE OR ANY OTHER
PSYCHOTROPIC DRUG. (SEE WARNINGS.) 5.
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIARELATED PSYCHOSIS
ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS TREATED WITH ANTIPSYCHOTIC DRUGS ARE
AT AN INCREASED RISK OF DEATH. ANALYSES OF SEVENTEEN PLACEBO-CONTROLLED
TRIALS (MODAL DURATION OF 10 WEEKS),
LARGELY
IN
PATIENTS
TAKING
ATYPICAL
ANTIPSYCHOTIC
DRUGS,
REVEALED
A
RISK
OF
DEATH
IN
DRUG-TREATED PATIENTS OF BETWEEN 1.6 TO 1.7 TIMES THE RISK OF DEATH IN
PLACEBO-TREATED PATIENTS. OVER THE COURSE OF A TYPICAL 10-WEEK
CONTROLLED TRIAL, THE RATE OF DEATH IN DRUG-TREATED PATIENTS
WAS
ABOUT
4.5%,
COMPARED
TO
A
RATE
OF
ABOUT
2.6%
IN
THE
PLACEBO
GROUP.
ALTHOUGH
THE
CAUSES OF DEATH WERE VARIED, MOST OF THE DEATHS APPEARED TO BE EITHER CARDIOVASCULAR (eg,
HEART FAILURE,
SUDDEN
DEATH)
OR
INFECTIOUS
(eg,
PNEUMONIA)
IN
NATURE.
OBSERVATIONAL
STUDIES
SUGGEST
THAT, SIMILAR TO ATYPICAL ANTIPSYCHOTIC DRUGS, TREATMENT WITH CONVENTIONAL ANTIPSYCHOTIC
DRUGS MAY INCREASE MORTALITY. THE EXTENT TO WHICH THE FINDINGS OF
INCREASED MORTALITY IN OBSERVATIONAL STUDIES MAY BE ATTRIBUTED TO THE
ANTIPSYCHOTIC DRUG AS OPPOSED TO SOME CHARACTERISTIC(S) OF THE PATIENTS IS NOT
CLEAR. FAZACLO® (clozapine, USP) IS NOT APPROVED FOR THE
TREATMENT OF PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS. (SEE WARNINGS.)
FazaClo (clozapine) PI |
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