Variation Applications - PRAC Safety Signals
Instructions for marketing authorisation holders regarding variation applications following PRAC recommendations on safety signals
European Medicines Agency (EMA) publishes Pharmacovigilance Risk Assessment Committee (PRAC) recommendations on safety signals on monthly basis. The list of abovementioned recommendations is available at EMA website and HALMED website (please see the table below).
Starting from the January 2015 PRAC meeting, EMA publishes recommendations for updates of product information translated to all official European Union (EU) languages. The recommended texts need to be included in product information for medicinal products authorised via national and centralized procedures.
Starting from May 2015, EMA started publishing PRAC recommendations in English at the same time as publishing the translations to all official European Union (EU) languages. EMA publishes the recommendations and the translations approximately 3 weeks following the PRAC meeting.
The Croatian translation of PRAC recommendations, starting from May 2015 PRAC meeting, will be published at HALMED website at the same time as the PRAC recommendations in English, on which occasion a Newsletter will be sent. The obligation to submit the variation to HALMED relates to medicinal products, authorised in Croatia via national procedure, which contain active substances and/or excipients for which the PRAC recommendation is adopted. When submitting the variation, marketing authorisation holders are requested to use the adopted Croatian translation whenever available, and to classify the variation as IAIN C.I.z.
Only when Croatian translations are not available at EMA website (signals prior to January 2015 PRAC meeting), marketing authorisation holders are requested to translate the texts from English.
Pursuant to the recommendations from the Co-ordination Group for Mutual Recognition and Decentralised Procedure (CMDh) Recommendation for classification of unforeseen variations according to Article 5 of Commission Regulation (EC) No 1234/2008, the variation should be classified as:
- IAIN C.I.z - when the variation implements the agreed Croatian translation of the PRAC recommendation,
- IB C.I.z - when the implementation of the PRAC recommendation requires a simpler assessment, for example due to a minor modification of the text or in the event that a Croatian translation has not been published for a specific PRAC signal (signals prior to January 2015 PRAC meeting)
- II C.I.z - when additional data that requires a complete assessment is submitted within the variation, besides the implementation of the agreed wording.
The deadline for submission of variation application is defined in the PRAC recommendation. Marketing authorisation holder is required to quote the relevant EPITT reference number (listed in the table below for the relevant active substance) as the procedure code in the variation application.
Additional information for the marketing authorisation holders
EMA publishes the PRAC recommendation approximately 3 weeks after the end of the PRAC meeting. At that time, HALMED publishes the link to the PRAC recommendation and the Croatian translation of the recommendation and sends the Newsletter containing the summary of the most important information.
In line with article 50 of the Medicinal Products Act, Official Gazette No. 76/13, 90/14, 100/18) and article 16 of Regulation (EC) No 726/2004 marketing authorisation holders have a legal obligation to ensure that their product information is kept up to date with the current scientific knowledge. When the PRAC recommendation relates to regulatory procedure, such as the variation for updates of Summary of Product Characteristics (SmPC) and Package Leaflet (PL), the marketing authorisation holder is requested to submit the variation application. The obligation to submit the variation to HALMED relates to medicinal products that are authorised in Croatia via national procedure and which contain the active substance for which the endorsed PRAC recommendation includes the change in the product information.
HALMED is reminding the marketing authorisation holders about the importance of keeping track of PRAC recommendations regularly in order to ensure that they are informed of PRAC recommendations relating to their respective medicinal products in a timely manner and that they act in accordance to these recommendations.
In order to update the product information based on PRAC recommendations on safety signals endorsed after July 1st 2013 it is required to submit the variation application for all medicines which are authorised in Croatia via national procedure and are containing the active substance that is subject to PRAC recommendation, regardless of other regulatory procedures that are pending or foreseen (such as renewal or variation).
The list of all signals discussed at PRAC meetings since September 2012 is available here (updated 25/11/2024).
More information about the assessment procedure, scientific conclusions and the summary of PRAC recommendations for each safety signal is available at EMA website, in PRAC Minutes and PRAC recommendations on safety signals.
More information about signal management is available here.
PRAC recommendations, translations and active substances that are subject to recommendations
| PRAC meeting dates | Recommendation in English language (first published / last updated) |
Recommendation in Croatian language (first published / last updated) |
Active substance subject to signal (EPITT number) |
|---|---|---|---|
| 28 - 31 October 2024 | PRAC recommendation (25/11/2024) | PRAC recommendation (25/11/2024) |
Angiotensin II receptor blockers (ARBs): azilsartan; candesartan; eprosartan; irbesartan; losartan; olmesartan; telmisartan; valsartan (single ingredient and fixed dose combinations) - (signal: intestinal angioedema; EPITT no 20104); Paracetamol (single ingredient and fixed dose combinations) - (signal: High anion gap metabolic acidosis (HAGMA) due to pyroglutamate acidosis; EPITT no 20105) |
| 2 - 5 September 2024 | PRAC recommendation (30/09/2024) | PRAC recommendation (30/09/2024) |
Medroxyprogesterone acetate (MPA) (signal: Meningioma; EPITT no. 20030) |
| 8 - 11 July 2024 | PRAC recommendation 12/08/2024) | PRAC recommendation 12/08/2024) |
Acetazolamide (signal: Pulmonary oedemas; EPITT no. 20050); Bumetanide (signal: Toxic epidermal necrolysis and Stevens-Johnson syndrome; EPITT no. 20033); Glofitamab (signal: Immune effector cell-associated neurotoxicity syndrome; EPITT no. 20058); Glucagon-like peptide-1 (GLP-1) receptor agonists: dulaglutide; exenatide; insulin degludec, liraglutide; liraglutide; insulin glargine, lixisenatide; lixisenatide; semaglutide; tirzepatide (signal: Aspiration and pneumonia aspiration; EPITT no. 19974); human papillomavirus 9-valent vaccine (recombinant, adsorbed); human papillomavirus vaccine [types 6, 11, 16, 18] (recombinant, adsorbed) (signal: Granuloma; EPITT no. 20046) |
| 10 - 13 June 2024 | PRAC recommendation 08/07/2024) | PRAC recommendation 08/07/2024) |
Axicabtagene ciloleucel; brexucabtagene autoleucel; ciltacabtagene autoleucel; idecabtagene vicleucel; lisocabtagene maraleucel; tisagenlecleuce (signal: secondary malignancy of T-cell origin; EPITT no 20040) |
| 13 - 16 May 2024 | PRAC recommendation 10/06/2024) | PRAC recommendation 10/06/2024) |
Baricitinib (signal: hypoglycaemia in diabetic patients; EPITT no 20038); dabrafenib; trametinib (signal: acute febrile neutrophilic dermatosis; EPITT no 20022); manidipine (signal: ascites; EPITT no 20026); propofol (signal: hepatic failure; EPITT no 20020) |
| 8 - 11 April 2024 | PRAC recommendation 06/05/2024) | PRAC recommendation 06/05/2024) |
Adagrasib (signal: Serious cutaneous adverse reactions (SCARs); EPITT no 20051); Atezolizumab; avelumab; cemiplimab; dostarlimab; durvalumab; ipilimumab; nivolumab; nivolumab, relatlimab; pembrolizumab; tislelizumab; tremelimumab (signal: Coeliac disease; EPITT no 19958); Atezolizumab; avelumab; cemiplimab; dostarlimab; durvalumab; ipilimumab; nivolumab; nivolumab, relatlimab; pembrolizumab; tislelizumab; tremelimumab (signal: Pancreatic failure; EPITT no 19955); Chlorhexidine for cutaneous use, indicated for skin disinfection, and relevant fixed-dose combinations (signal: Persistent corneal injury and significant visual impairment; EPITT no 19970); Ethambutol (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT no 20018) |
| 4 - 7 March 2024 | PRAC recommendation 02/04/2024) | PRAC recommendation 02/04/2024) |
Aemaciclib; palbociclib; ribociclib (signal: Erythema multiforme; EPITT no 19973) |
| 8 - 11 January 2024 | PRAC recommendation 05/02/2024) | PRAC recommendation 05/02/2024) |
Amphotericin B, lipid formulations (signal: Hyperkalaemia; EPITT no 19966); avatrombopag (signal: Antiphospholipid syndrome; EPITT no 19954); cefotaxime (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT no: 19960); cobimetinib; vemurafenib (signal: Aphthous ulcer, mouth ulceration, stomatitis; EPITT br. 19961). |
| 27 - 30 November 2023 | PRAC recommendation 05/01/2024) | PRAC recommendation 05/01/2024) |
Axicabtagene ciloleucel (signal: Progressive multifocal leukoencephalopathy (PML); EPITT no 19940); Dabrafenib; trametinib (signal: Peripheral neuropathy; EPITT no 19947); Pirfenidone (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT no: 19920) |
| 23 - 26 October 2023 | PRAC recommendation (20/11/2023) | PRAC recommendation (20/11/2023) |
Dapagliflozin; dapagliflozin, metformin; dapagliflozin, saxagliptin (signal: Acquired phimosis and phimosis; EPITT no. 19935) |
| 25 - 28 September 2023 | PRAC recommendation (23/10/2023) | PRAC recommendation (23/10/2023) |
Azacitidine (injectable formulations) (signal: Cutaneous vasculitis; EPITT no. 19929) |
| 28 - 31 August 2023 | PRAC recommendation (25/09/2023) | PRAC recommendation (25/09/2023) |
Acetazolamide (signal: Choroidal effusion and choroidal detachment; EPITT no. 19924) |
| 3 - 6 July 2023 | PRAC recommendation (31/07/2023) | PRAC recommendation (31/07/2023) |
Olaparib (signal: Hepatocellular damage and hepatitis; EPITT no. 19846) |
| 5 - 8 June 2023 | PRAC recommendation (03/07/2023) | PRAC recommendation (03/07/2023) |
Nivolumab (signal: Cytokine release syndrome; EPITT no. 19880); tofacitinib (signal: Acnes; EPITT no. 19885) |
| 10 - 12 May 2023 | PRAC recommendation (05/06/2023) | PRAC recommendation (05/06/2023) |
Lenvatinib (signal: Adrenal insufficiency; EPITT br. 19870) |
| 13 - 16 March 2023 | PRAC recommendation (11/04/2023) | PRAC recommendation (11/04/2023) |
Propofol (signal: Medication errors that could potentially lead to life-threatening/fatal cases; EPITT no. 19851); voriconazole; flucloxacillin (signal: Drug interaction with flucloxacillin leading to subtherapeutic voriconazole levels; EPITT no. 19849) |
| 6 - 9 February 2023 | PRAC recommendation (06/03/2023) | PRAC recommendation (06/03/2023) |
Bosutinib (signal: interstitial lung disease; EPITT no. 19843); Colistimethate sodium for intravenous use (signal: pseudo-Bartter syndrome; EPITT no. 19845) |
| 9 - 12 January 2023 | PRAC recommendation (06/02/2023) | PRAC recommendation (06/02/2023) |
3-hydroxy 3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins): atorvastatin; fluvastatin; lovastatin; pitavastatin; pravastatin; rosuvastatin; simvastatin and other relevant fixed dose combinations; pravastatin, fenofibrate; simvastatin, fenofibrate (signal: Myasthenia gravis; EPITT no. 19822); Dabrafenib; trametinib (signal: Haemophagocytic lymphohistiocytosis, EPITT br. 19824); Regorafenib (signal: Thrombotic microangiopathy, EPITT br. 19832) |
| 24 - 27 October 2022 | PRAC Recommendation (21/11/2022) | PRAC Recommendation (21/11/2022) |
Durvalumab (signal: myelitis transverse; EPITT no. 19815); elasomeran (COVID-19 mRNA vaccine - Spikevax) (signal: heavy menstrual bleeding, EPITT br. 19780); tozinameran (COVID-19 mRNA vaccine - Comirnaty) (signal: heavy menstrual bleeding, EPITT br. 19783) |
| 26 - 29 September 2022 | PRAC Recommendation (24/10/2022) | PRAC Recommendation (24/10/2022) |
Codeine, ibuprofen (signal: Renal tubular acidosis and hypokalaemia; EPITT no. 19820) |
| 29 August - 1 September 2022 | PRAC Recommendation (26/09/2022) | PRAC Recommendation (26/09/2022) |
Pneumococcal polysaccharide vaccine (23 serotypes) (signal: Extensive swelling of vaccinated limb; EPITT no. 19768) |
| 7 - 10 March 2022 | PRAC Recommendation (04/04/2022, updated 18/07/2022) | PRAC Recommendation (04/04/2022, updated 18/07/2022) |
Alemtuzumab (signal: vitiligo; EPITT br. 19737); Calcineurin inhibitors for systemic use (ciclosporin; tacrolimus) and mammalian target of rapamycin (mTOR) inhibitors for systemic use (everolimus; sirolimus; temsirolimus) (signal: Drug interaction with cannabidiol leading to calcineurin inhibitors and mTOR inhibitors serum levels increased and toxicity; EPITT no. 19614); Elasomeran (COVID-19 mRNA vaccine - Spikevax) (signal: Capillary leak syndrome; EPITT no. 19743) |
| 7 - 10 February 2022 | PRAC Recommendation (07/03/2022) | PRAC Recommendation (07/03/2022) |
Enzalutamide (signal: Erythema multiforme; EPITT no. 19734); Obinutuzumab (signal: Non-overt disseminated intravascular coagulation; EPITT no. 19711); Sorafenib (signal: Tumour lysis syndrome; EPITT no. 19733) |
| 10 - 13 January 2022 | PRAC Recommendation (07/02/2022) | PRAC Recommendation (07/02/2022) |
Durvalumab (signal: Arthralgia; EPITT no. 19709); Pregabalin (signal: Toxic epidermal necrolysis; EPITT no. 19723) |
| 29 November - 2 December 2022 | PRAC recommendation (06/01/2022) | PRAC recommendation (06/01/2022) |
Olmesartan; olmesartan, amlodipine; olmesartan, hydrochlorothiazide; olmesartan medoxomil, amlodipine besilate, hydrochlorothiazide (signal: Autoimmune hepatitis; EPITT no 19258). |
| 25 - 28 October 2021 | PRAC recommendation (22/11/2021) | PRAC recommendation (22/11/2021) |
Ertapenem (signal: Toxic encephalopathy in patients with renal impairment; EPITT no. 19498); Labetalol (signal: Nipple pain and suppressed lactation; EPITT no. 19639); Lenvatinib (signal: Colitis; EPITT no. 19691) |
| 27 - 30 September 2021 | PRAC recommendation (26/10/2021) | PRAC recommendation (26/10/2021) |
COVID-19 mRNA vaccine (nucleoside-modified) - Comirnaty (signal: Erythema multiforme; EPITT no. 19721); COVID-19 mRNA vaccine (nucleoside-modified) - Spikevax (signal: Erythema multiforme; EPITT no. 19720); Piperacillin; piperacillin, tazobactam (signal: Haemophagocytic lymphohistiocytosis; EPITT no. 19676); Warfarin (signal: Anticoagulant-related nephropathy; EPITT no. 19652) |
| 27 - 30 September 2021 | PRAC recommendation (08/10/2021) | PRAC recommendation (08/10/2021) |
COVID-19 vaccine (ChAdOx1-S [recombinant]) - Vaxzevria (signal: Immune thrombocytopenia; EPITT no 19678) |
|
30 August - 2 September 2021 |
PRAC recommendation (27/09/2021) | PRAC recommendation (27/09/2021) |
Methotrexate (signal: Progressive multifocal leukoencephalopathy; EPITT br. 18473); Ponatinib (signal: Panniculitis; EPITT br. 19681) |
|
5 - 8 July 2021 |
PRAC recommendation (02/08/2021) | PRAC recommendation (02/08/2021) |
Donepezil (signal: Cardiac conduction disorders including QT prolongation and Torsade de Pointes; EPITT no. 19667); immune checkpoint inhibitors: atezolizumab; avelumab; cemiplimab; durvalumab; ipilimumab; pembrolizumab; nivolumab (signal: Immune-mediated cystitis; EPITT no. 19610); octreotide (signal: Pancreatic exocrine insufficiency; EPITT no. 19661). |
|
7 - 10 June 2021 |
PRAC recommendation (05/07/2021) | PRAC recommendation (05/07/2021) |
Ceftriaxone (signal: Hepatitis; EPITT no. 19603); Tofacitinib (signal: Major adverse cardiovascular events (MACE) and malignancies excluding non-melanoma skin cancer (NMSC) from a clinical trial; EPITT no. 19382) |
|
7 - 10 June 2021 |
PRAC recommendation (22/06/2021) | PRAC recommendation (22/06/2021) |
COVID-19 vaccine (ChAdOx1-S [recombinant]) - Vaxzevria (signal: Capillary leak syndrome; EPITT no 19672) |
|
3 - 6 May 2021 |
PRAC recommendation (31/05/2021) | PRAC recommendation (31/05/2021) |
Alemtuzumab (signal: Sarcoidosis; EPITT no. 19638); Clindamycin for systemic use (signal: Acute renal failure; EPITT no. 19647); COVID-19 mRNA vaccine (nucleoside-modified) (Comirnaty) (signal: Localised swelling in persons with history of dermal filler injections; EPITT no. 19674); Secukinumab (signal: Henoch-Schonlein purpura; EPITT no. 19640); Sulfamethoxazole, trimethoprim (co-trimoxazole) (signal: Acute respiratory distress syndrome (ARDS); EPITT no. 19625); Sulfamethoxazole, trimethoprim (co-trimoxazole) (signal: Haemophagocytic lymphohistiocytosis; EPITT no. 19655); Tramadol; tramadol, dexketoprofen; tramadol, paracetamol (signal: Serotonin syndrome; EPITT no. 19635) |
|
6 - 9 April 2021 |
PRAC recommendation (03/05/2021) | PRAC recommendation (03/05/2021) |
Azathioprine (signal: Erythema nodosum; EPITT no. 19623) |
|
8 - 11 March 2021 |
PRAC recommendation (06/04/2021) | PRAC recommendation (06/04/2021) |
Anakinra; canakinumab (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT no. 19566); COVID-19 vaccine (ChAdOx1-S [recombinant]) (COVID-19 Vaccine AstraZeneca) (signal: Anaphylactic reaction; EPITT no. 19668); Trastuzumab emtansine (signal: Extravasation and epidermal necrosis; EPITT no. 19611) |
|
8 - 11 February 2021 |
PRAC recommendation (08/03/2021) | PRAC recommendation (08/03/2021) |
Prednisolone; prednisone (signal: Bradycardia; EPITT no. 19613) |
|
11 - 14 January 2021 |
PRAC recommendation (08/02/2021) | PRAC recommendation (08/02/2021) |
adalimumab (signal: Abnormal weight gain; EPITT br. 19520); anastrozole (signal: Depressed mood disorders; EPITT br. 19592); hydrocortisone (brand name: Alkindi) (signal: Adrenal crisis; EPITT br. 19656) |
|
23 - 26 November 2020 |
PRAC recommendation (06/01/2021) | PRAC recommendation (06/01/2021) |
kapecitabin (signal: anafilaktička reakcija; EPITT br. 19561); klorokin; hidroksiklorokin (signal: psihijatrijski poremećaji; EPITT br. 19572); pembrolizumab (signal: vaskulitis E; EPITT br. 19578); capecitabine (signal: Anaphylactic reaction; EPITT br. 19561); chloroquine; hydroxychloroquine (signal: Psychiatric disorders; EPITT br. 19572); pembrolizumab (signal: Vasculitis E; EPITT br. 19578) |
|
26 - 29 October 2020 |
PRAC recommendation (23/11/2020) | PRAC recommendation (23/11/2020) |
cftriaxone (signal: Encephalopathy; EPITT no: 19492); dabrafenib; trametinib (signal: Sarcoidosis; EPITT no: 19574); ibrutinib (signal: Hepatitis E; EPITT no: 19569); lamotrigine (signal: Photosensitivity; EPITT no: 19548) |
|
28 September - 01 October 2020 |
PRAC recommendation (26/10/2020) | PRAC recommendation (26/10/2020) |
citalopram; desvenlafaxine; escitalopram; fluoxetine; fluvoxamine; milnacipran; paroxetine; sertraline; venlafaxine; vortioxetine (signal: Postpartum haemorrhage; EPITT br. 19552); pembrolizumab (signal: Sjogren’s syndrome; EPITT br. 19564) |
|
31 August - 3 September 2020 |
PRAC recommendation (28/09/2020) | PRAC recommendation (28/09/2020) |
abiraterone (signal: Anaphylactic reaction; EPITT number: 19535); fluoroquinolones for systemic and inhalation formulations (signal: Heart valve regurgitation, cervical artery dissection, and aortic aneurysm and dissection; EPITT number: 19522); interferon alfa-2a; peginterferon alfa-2a (signal: Neuromyelitis optica spectrum disorder; EPITT number: 19532); pomalidomide (signal: Progressive multifocal leukoencephalopathy (PML); EPITT number: 19546) |
|
6 - 9 July 2020 |
PRAC recommendation (03/08/2020) | PRAC recommendation (03/08/2020) |
lisdexamfetamine (signal: QT prolongation and cardiac arrhythmia; EPITT number: 19533); tumour necrosis factor alpha inhibitors: adalimumab; certolizumab pegol; etanercept; golimumab; infliximab (signal: Kaposi’s sarcoma; EPITT number: 19480) |
|
8 - 11 June 2020 |
PRAC recommendation (06/07/2020) | PRAC recommendation (06/07/2020) |
desogestrel (signal: Supressed lactation; EPITT br. 19504); hormone replacement therapy (HRT): tibolone (signal: New information on the known risk of breast cancer; EPITT br. 19482); macrogol-containing products (all molecular weights and combinations) for bowel preparation (signal: Colitis ischaemic; EPITT br. 19517) |
|
11 - 14 May 2020 |
PRAC recommendation (23/06/2020) | PRAC recommendation (23/06/2020) |
baricitinib (signal: Diverticulitis; EPITT br. 19496); buprenorphine; buprenorphine, naloxone (signal: Drug-drug interaction with serotonergic drugs leading to serotonin syndrome; EPITT br. 19475); hormone replacement therapy (HRT) (signal: New information on the known risk of breast cancer; EPITT br. 19482); mirtazapine (signal: Amnesia; EPITT br. 19506); mirtazapine (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT br. 19565); sertraline (signal: Microscopic colitis; EPITT br. 19513) |
|
14 - 17 April 2020 |
PRAC recommendation (11/05/2020) | PRAC recommendation (11/05/2020) |
andeksanet alfa (signal: Erroneous assay results for levels of anti-factor Xa activity; EPITT number: 19493); ibuprofen; ketoprofen; and fixed-dose combinations (signal: Serious exacerbation of infections; EPITT number: 19415); idelalisib (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT number: 19500); insulin (signal: Cutaneous amyloidosis; EPITT number: 19499) |
|
9 - 12 March 2020 |
PRAC recommendation (06/04/2020) | PRAC recommendation (06/04/2020) |
immune check point inhibitors: atezolizumab; cemiplimab; durvalumab (signal: tuberculosis; EPITT number: 19464); nivolumab (signal: haemophagocytic lymphohistiocytosis; EPITT number: 19467); paroxetine (signal: microscopic colitis; EPITT number: 19474); thiazide, thiazide-like diuretics and combinations (signal: choroidal effusion; EPITT number: 19468) |
|
10 - 13 February 2020 |
PRAC recommendation (10/3/2020) | PRAC recommendation (06/04/2020) |
nivolumab (signal: Haemophagocytic lymphohistiocytosis; EPITT no 19467) |
|
13 - 16 January 2020 |
PRAC recommendation (10/02/2020) | PRAC recommendation (10/02/2020) |
abiraterone (signal: Interaction with sulphonylureas leading to hypoglycaemia; EPITT No.:19445), golimumab (signal: Inflammatory myopathy; EPITT No.: 19460) |
|
28 - 31 October 2019 |
PRAC recommendation (25/11/2019) | PRAC recommendation (25/11/2019) |
iron sucrose; iron carboxymaltose; iron isomaltoside; iron dextran; sodium ferric gluconate (signal: Arteriospasm coronary; EPITT No.: 19408) |
|
30 September - 3 October 2019 |
PRAC recommendation (28/10/2019) | PRAC recommendation (28/10/2019) |
durvalumab (signal: Myasthenia gravis; EPITT no 19451); lithium (signal: Drug-induced lichenoid reaction; EPITT no 19389) |
|
2 - 5 September 2019 |
PRAC recommendation (30/09/2019) | PRAC recommendation (30/09/2019) |
ibrutinib (signal: Ischaemic stroke; EPITT no 19369; ibuprofen (signal: Acute generalised exanthematous pustulosis (AGEP); EPITT no 19409); sodium-glucose co-transporter 2 (SGLT2) inhibitors* (signal: New information on the known association between SGLT2inhibitors and diabetic ketoacidosis in surgical patients; EPITT no 19355); teriflunomide (signal: Psoriasis; EPITT no 19366) *Canagliflozin; canagliflozin, metformin; dapagliflozin; dapagliflozin, metformin; empagliflozin; empagliflozin, metformin; empagliflozin, linagliptin; ertugliflozin, metformin; ertugliflozin, sitagliptin; saxagliptin, dapagliflozin |
|
8 - 11 July 2019 |
PRAC recommendation (05/08/2019) | PRAC recommendation (05/08/2019) |
parenteral nutrition products for neonates and children below 2 years containing amino acids and/or lipids with or without admixture of vitamins and/or trace elements (signal: Adverse outcomes in neonates treated with solutions not protected from light; EPITT no 19423); mesalazine (signal: Nephrolithiasis; EPITT no 19405); ondansetron (signal: Signal of birth defects following in-utero exposure during the first trimester of pregnancy arising from recent publications; EPITT no 19353); vascular Endothelial Growth Factor (VEGF) inhibitors for systemic administration* (signal: Artery dissections and aneurysms; EPITT no 19330) *Aflibercept; axitinib; bevacizumab; cabozantinib; lenvatinib; nintedanib; pazopanib; ponatinib; ramucirumab; regorafenib; sorafenib; sunitinib; tivozanib; vandetanib |
|
11 - 14 June 2019 |
PRAC recommendation (08/07/2019) | PRAC recommendation (08/07/2019) |
loperamide (signal: Brugada syndrome in the context of abuse with loperamide; EPITT No. 19379); propylthiouracil (signal: Risk of congenital anomalies; EPITT No. 19358); rivaroxaban (signal: Premature ending of the GALILEO study in patients who have received an artificial heart valve through a transcatheter aortic valve replacement; EPITT No. 19294); secukinumab (signal: Dermatitis exfoliative generalised; EPITT No. 19354); sulfasalazine (signal: Interference with dihydronicotinamide-adenine dinucleotide / dihydronicotinamide-adenine dinucleotide phosphate (NADH/NADP) reaction assays; EPITT No. 19351); temozolomide (signal: Drug reaction with eosinophilia and systemic symptoms (DRESS); EPITT No. 19332); topiramate (signal: Uveitis; EPITT No. 19345) |
|
13 - 16 May 2019 |
PRAC recommendation (11/06/2019) | PRAC recommendation (11/06/2019) |
clopidogrel; clopidogrel, acetylsalicylic acid (signal: interaction with boosted antiviral human immunodeficiency virus (HIV) therapy leading to insufficient inhibition of platelet aggregation; EPITT no. 19325) *desvenlafaxine; duloxetine; milnacipran; venlafaxine |
|
8 - 11 April 2019 |
PRAC recommendation (08/04/2019) | PRAC recommendation (08/04/2019) |
direct-acting oral anticoagulants (DOACs): apixaban; dabigatran etexilate; edoxaban; rivaroxaban (signal: Recurrent thrombosis in patients with antiphospholipid syndrome; EPITT no. 19320); modafinil (signal: Evaluation of data on foetal outcomes including congenital anomalies from a single observational study in the US; EPITT no. 19367); selective serotonin reuptake inhibitors: citalopram; escitalopram (signal: Drug interaction with fluconazole; EPITT no. 19327) |
|
12 - 15 March 2019 |
PRAC recommendation (08/04/2019) | PRAC recommendation (08/04/2019) |
nivolumab (signal: hypoparathyroidism; EPITT no. 19310); paracetamol (signal: paracetamol use in pregnancy and child neurodevelopment and effects on the urogenital apparat; EPITT no. 17796) |
|
14 - 17 January 2019 |
PRAC recommendation (01/02/2019) | PRAC recommendation (01/02/2019) |
biotin (signal: interference with clinical laboratory tests; EPITT no 19156); gabapentin (signal: dysphagia; EPITT no 19296) |
|
26 - 29 November 2018 |
PRAC recommendation (04/01/2019) | PRAC recommendation (04/01/2019) |
canagliflozin; dapagliflozin; empagliflozin; ertugliflozin (signal: Fournier’s gangrene; EPITT no 19308); carbimazole; thiamazole (signal: New information on the known risk of birth defects and neonatal disorders in case of exposure during pregnancy; EPITT no 19238); carbimazole; thiamazole (signal: Pancreatitis; EPITT no 19274); certolizumab pegol; etanercept; golimumab; infliximab (signal: Lichenoid skin reactions; EPITT no 19128); dulaglutide; exenatide; liraglutide (signal: Diabetic ketoacidosis; EPITT no 19237); perindopril (signal: Raynaud's phenomenon; EPITT no 19248) |
|
29 - 31 October 2018 |
PRAC recommendation (26/11/2018) | PRAC recommendation (26/11/2018) |
tacrolimus systemic formulation (signal: Hepatitis E infection; EPITT no 19246); xylometazoline (signal: Serious ventricular arrhythmia in patients with long QT syndrome; EPITT no 19242) |
|
1 - 4 October 2018 |
PRAC recommendation (29/10/2018) | PRAC recommendation (29/10/2018) |
direct acting antivirals (DAAV) indicated for the treatment of hepatitis C (signal: dysglycaemia; EPITT no 19234); dolutegravir (signal: evaluation of preliminary data from an observational study on birth outcomes in human immunodeficiency virus (HIV)-infected women; EPITT no 19244); hormonal contraceptives (signal: suicidality with hormonal contraceptives following a recent publication; EPITT no 19144); teriflunomide (signal: dyslipidaemia; EPITT no 19227) |
|
3 - 6 September 2018 |
PRAC recommendation (01/10/2018) | PRAC recommendation (01/10/2018) |
alemtuzumab (signal: Cytomegalovirus infection; EPITT no 19193); dimethyl fumarate (Tecfidera) (signal: immune thrombocytopenic purpura and thrombocytopenia; EPITT no 19192); duloxetine (signal: interstitial lung disease; EPITT no 19175); fluoroquinolones for systemic and inhaled use** (signal: aortic aneurysm and dissection; EPITT no 18651); hydrochlorothiazide (signal: skin cancer; EPITT no 19138); ipilimumab (signal: Cytomegalovirus gastrointestinal infection; EPITT no 19207) ** Ciprofloxacin; flumequine; levofloxacin; lomefloxacin; moxifloxacin; norfloxacin; ofloxacin; pefloxacin; prulifloxacin; rufloxacin. |
|
9 -12 July 2018 |
PRAC recommendation (06/08/2018) | PRAC recommendation (06/08/2018) |
Antiretrovirals1 (signal: autoimmune hepatitis; EPITT no 18956); Human normal immunoglobulin for intravenous administration (IVIg) (signal: Lupus-like syndrome and related terms; EPITT no 19098) 1 List of antiretrovirals: abacavir; abacavir, dolutegravir, lamivudine; abacavir; abacavir, lamivudine, zidovudine; atazanavir; atazanavir, cobicistat; bictegravir, emtricitabine, tenofovir alafenamide; darunavir; darunavir, cobicistat; darunavir, cobicistat, emtricitabine, tenofovir alafenamide; didanosine; dolutegravir; dolutegravir, rilpivirine; efavirenz; efavirenz, emtricitabine, tenofovir disoproxil; elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide; elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil; emtricitabine; emtricitabine, rilpivirine, tenofovir alafenamide; emtricitabine, rilpivirine, tenofovir disoproxil; emtricitabine, tenofovir alafenamide; emtricitabine, tenofovir disoproxil; enfuvirtide; etravirine; fosamprenavir; indinavir; lamivudine; lamivudine, tenofovir; lamivudine, zidovudine; lopinavir, ritonavir; maraviroc; nevirapine; raltegravir; rilpivirine; ritonavir; saquinavir; stavudine; tenofovir disoproxil; tipranavir; zidovudine |
|
11 - 14 June 2018 |
PRAC recommendation (09/07/2018) | PRAC recommendation (09/07/2018) | nabumetone (signal: drug reaction with eosinophilia and systemic symptoms; EPITT no 19241); varenicline (signal: loss of consciousness; EPITT no 19146); |
|
14 - 17 May 2018 |
PRAC recommendation (11/06/2018) | PRAC recommendation (11/06/2018) | apixaban; edoxaban (signal: drug interaction between apixaban or edoxaban and selective serotonin reuptake inhibitors (SSRI) and/or serotonin and noradrenaline reuptake inhibitors (SNRI) leading to increased risk of bleeding; EPITT no 19139); lenalidomide (signal: progressive multifocal leukoencephalopathy (PML); EPITT no 19130); lenograstim; lipegfilgrastim; pegfilgrastim (signal: pulmonary haemorrhage; EPITT no 19181); pembrolizumab (signal: aseptic meningitis; EPITT no 19115) |
|
9 - 12 April 2018 |
PRAC recommendation (07/05/2018) | PRAC recommendation (07/05/2018) | amitriptyline (signal: dry eye; EPITT no 19173); dasatinib (signal: Cytomegalovirus (CMV) reactivation; EPITT no 19111); lapatinib (signal: pulmonary hypertension; EPITT no 19089); phenprocoumon (signal: risk of birth defects and foetal loss following first trimester exposure as a function of the time of withdrawal; EPITT no 18902); vortioxetine (signal: angioedema and urticaria; EPITT no 19099) |
|
5 - 8 March 2018 |
PRAC recommendation (03/04/2018) | PRAC recommendation (03/04/2018) | cefalexin (signal: acute generalised exanthematous pustulosis (AGEP); EPITT no. 18911); norepinephrine (signal: stress cardiomyopathy; EPITT no. 19172) |
| 5 - 8 February 2018 | PRAC recommendation (05/03/2018) | PRAC recommendation (05/03/2018) | filgrastim; lenograstim; lipegfilgrastim; pegfilgrastim (signal: aortitis; EPITT number 18940); Hydroxycarbamide (signal: Cutaneous lupus erythematosus; EPITT number 18939); Ritonavir; lopinavir, ritonavir; ombitasvir, paritaprevir, ritonavir; levothyroxine (signal: Interaction possibly leading to decreased levothyroxine efficacy and hypothyroidism; EPITT number 18896). |
| 8 - 11 January 2018 | PRAC recommendation (05/02/2018) | PRAC recommendation (05/02/2018) | dulaglutide (gastrointestinal stenosis and obstruction - 18931), methotrexate (pulmonary alveolar haemorrhage - 18850), pemetrexed (nephrogenic diabetes insipidus - 18930) |
| 29 August - 1 September 2017 | PRAC recommendation (25/09/2017) | PRAC recommendation (25/09/2017) | mesalazine (risk of photosensitivity reactions- 18869), pramipexole (dystonia - 18866) |
| 27 - 30 November 2017 | PRAC recommendation (04/01/2018) | PRAC recommendation (04/01/2018) | insulin (pre-filled pens and cartridges): insulin aspart, insulin bovine, insulin degludec, insulin degludec/insulin aspart, insulin degludec/liraglutide, insulin detemir, insulin glargine, insulin glulisine, insulin human (rDNA), insulin human/insulin isophane, insulin lispro, insulin porcine (potential increased risk of medication error associated with withdrawing insulin from pre-filled pens and cartridges, leading to dysglycaemia - 18893), tofacitinib (angioedema - 18904) |
| 23 - 26 October 2017 | PRAC recommendation (20/11/2017) | * | ** |
| 25 - 29 September 2017 | PRAC recommendation (23/10/2017) | PRAC recommendation (23/10/2017) | acetazolamide (acute generalised exanthematous pustulosis (AGEP) - 18892), azithromycin, clarithromycin, erythromycin, roxithromycin (acute generalised exanthematous pustulosis (AGEP) - 18891), cladribine (progressive multifocal leukoencephalopathy (PML) - 18875), desloratadine, loratadine (weight increased in children - 18906), doxycycline (doxycycline induced Jarisch-Herxheimer reaction - 18937), flucloxacillin (high anion gap metabolic acidosis (HAGMA) - 18844) |
| 29 August - 1 September 2017 | PRAC recommendation (25/09/2017) | PRAC recommendation (25/09/2017) | mesalazine (risk of photosensitivity reactions- 18869), pramipexole (dystonia - 18866) |
| 3 - 6 July 2017 | PRAC recommendation (7/8/2017) | PRAC recommendation (7/8/2017) | amoxicillin, amoxicillin/clavulanic acid (drug reaction with eosinophilia and systemic symptoms (DRESS) - 18802), ciprofloxacin, meropenem (incompatibility leading to possible precipitation when co-administered intravenously - 18790), darbepoetin alfa, epoetin alfa, epoetin beta, epoetin theta, epoetin zeta, methoxy polyethylene glycol-epoetin beta (severe cutaneous adverse reactions (SCARs) including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) - 18846), fulvestrant (anaphylactic reaction - 18832), intravenous (IV) fluids containing electrolytes and/or carbohydrates (hyponatraemia - 18631), prednisolone, prednisone (induced scleroderma renal crisis - 18888) |
| 6 - 9 June 2017 | PRAC recommendation (3/7/2017) | PRAC recommendation (3/7/2017) | gabapentin (respiratory depression without concomitant opioid use - 18814) |
| 2 - 5 May 2017 | PRAC recommendation (29/05/2017) | Risk minimisation strategy for high-strength and fixed combination insulin products, EMA/686009/2014 (23/10/2015) | brentuximab vedotin (cytomegalovirus (CMV) reactivation - 18799), insulin (pre-filled pens and cartridges - 18893) |
| 3 - 6 April 2017 | PRAC recommendation (02/05/2017) | PRAC recommendation (02/05/2017) | albiglutide (acute kidney injury - 18778), leflunomide, teriflunomide (falsely decreased ionised calcium levels - 18787), temozolomide (meningoencephalitis herpetic - 18785) |
| 6 - 9 March 2017 | PRAC recommendation (4/4/2017) | PRAC recommendation (4/4/2017) | loperamide (serious cardiac events with high doses of loperamide from abuse and misuse - 18339), nivolumab, pembrolizumab (transplant rejection - 18781) |
| 6 - 9 February 2017 | PRAC recommendation (6/3/2017) | PRAC recommendation (6/3/2017) | fluconazole (spontaneous abortion and stillbirth - 18666), nivolumab (pemphigoid - 18759) |
| 9 - 12 January 2017 | PRAC recommendation (06/02/2017) | PRAC recommendation (06/02/2017) | azacitidine (pericarditis and pericardial effusion - 18733), propofol, valproate (pharmacokinetic drug interaction leading to an increased propofol exposure - 18696) |
| 28 November - 1 December 2016 | PRAC recommendation (03/01/2017) | PRAC recommendation (03/01/2017) | acenocoumarol, phenprocoumon, fluindione, phenindione (calciphylaxis - 18710), methylphenidate (priapism - 18719), proton pump inhibitors: dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole (gastric polyps - 18725), vildagliptin, vildagliptin/metformin (pemphigoid - 18692) |
| 24 - 27 October 2016 | PRAC recommendation (21/11/2016) | PRAC recommendation (21/11/2016) | cobicistat containing products: cobicistat, cobicistat/atazanavir sulfate, cobicistat/darunavir, cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide, cobicistat/elvitegravir/emtricitabine/tenofovir disoproxil fumarate (drug interaction with corticosteroids leading to adrenal suppression - 18647), flucloxacillin (acute generalized exanthematous pustulosis (AGEP) - 18773), olanzapine (restless legs syndrome - 18659) |
| 26 - 29 September 2016 | PRAC recommendation (25/10/2016) | PRAC recommendation (25/10/2016) | levetiracetam, oral solution (medication errors associated with accidental overdose - 10519), metronidazole (severe hepatic and neurologic toxicity in patients with Cockayne syndrome - 18663) |
| 30 August - 02 September 2016 | PRAC recommendation (26/09/2016) | PRAC recommendation (26/09/2016) | agomelatine (urinary retention - 18637), boceprevir, daclatasvir, dasabuvir, elbasvir/grazoprevir, ledipasvir/sofosbuvir, ombitasvir/paritaprevir/ritonavir, simeprevir, sofosbuvir, sofosbuvir/velpatasvir (drug interaction between direct-acting antivirals (DAAV) and vitamin K antagonists leading to a reduced international normalised ratio (INR) - 18654), cobicistat containing products: cobicistat, cobicistat/atazanavir sulfate, cobicistat/darunavir, cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide, cobicistat/elvitegravir/emtricitabine/tenofovir disoproxil fumarate (drug interaction with corticosteroids leading to adrenal suppression - 18647), iomeprol (haemolysis - 18625) |
| 4 - 8 July 2016 | PRAC recommendation (02/08/2016) | PRAC recommendation (02/08/2016) | ferrous sulfate (mouth ulceration - 18623), proton pump inhibitors: dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole (elevated circulating levels of Chromogranin A - 18614) |
| 06 - 09 June 2015 | PRAC recommendation (04/07/2016) | PRAC recommendation (04/07/2016) | riociguat (increased mortality and serious adverse events (SAEs) in patients with pulmonary hypertension (PH) associated with idiopathic interstitial pneumonias (IIP) in a single clinical trial - 18681) |
| 10 - 13 May 2016 | PRAC recommendation (06/06/2016) | PRAC recommendation (06/06/2016) | natalizumab (Necrotising retinitis - 18605), warfarin (calciphylaxis - 18545) |
| 11 - 14 April 2016 | PRAC recommendation (10/05/2016) | olanzapine (drug reaction with eosinophilia and systemic symptoms (DRESS) - 18534) | |
| 14 - 17 March 2016 | PRAC recommendation (11/04/2016) | PRAC recommendation (11/04/2016) | axitinib (nephrotic syndrome - 18484), mercaptopurine; azathioprine (lymphoproliferative disorders - 18503), tigecycline (hypofibrinogenaemia - 18479) |
| 08 - 11 February 2016 | PRAC recommendation (07/03/2016) | PRAC recommendation (07/03/2016) | Bcr-abl tyrosine kinase inhibitors: imatinib, dasatinib, nilotinib, bosutinib, ponatinib (Hepatitis B virus (HBV) reactivation - 18405), levodopa/carbidopa (intestinal gel, intussusception - 18424), mitotane (sex hormone disturbances and development of ovarian macrocysts - 18301) |
|
11 - 14 January 2016
|
PRAC recommendation (08/02/2016) | PRAC recommendation (08/02/2016) | ** |
| 30 November - 03 December 2015 | PRAC recommendation (06/01/2016) | PRAC recommendation (06/01/2016) | Hormone replacement therapy (HRT) medicinal products, which are not pharmaceutical forms for vaginal use, containing oestrogens or combined oestrogens-progestagens (18258) |
| 03 - 06 November 2015 | PRAC recommendation (30/11/2015) | * | ** |
|
05 - 08 October 2015 |
PRAC recommendation (03/11/2015) | PRAC recommendation (03/11/2015) | ** |
| 07 - 10 September 2015 | PRAC recommendation (06/10/2015) | PRAC recommendation (06/10/2015) | alendronic acid (18256), colecalciferol (18256), clodronic acid (18256), etidronic acid (18256), ibandronic (18256), neridronic acid (18256), pamidronic acid (18256), risedronic acid (18256), tiludronic acid (18256), zoledronic acid (18256), leflunomide (18221), thioctic acid (18406), trabectedin (18115) |
| 06 - 09 July 2015 | PRAC recommendation (07/08/2015) | PRAC recommendation (07/08/2015) | dexlansoprazole (18119), esomeprazole (18119), lansoprazole (18119), omeprazole (18119), pantoprazole (18119), rabeprazole (18119), donepezil (18261) |
| 08 - 11 June 2015 | PRAC recommendation (30/06/2015) | * | ** |
| 04 - 07 May 2015 | PRAC recommendation (01/06/2015) | PRAC recommendation (01/06/2015) | fingolimod (18241), latanoprost - Xalatan (18068), leflunomide (18189), natalizumab (18137) |
| 07 - 10 April 2015 | PRAC recommendation (28/04/2015) | PRAC recommendation (13/05/2015) | daclatasvir (18177), sofosbuvir (18177), sofosbuvir, ledipasvir (18177), interferon alfa-2a (18059), interferon alfa-2b (18059), interferon beta-1a (18059), interferon beta-1b (18059), peginterferon alfa-2a (18059), peginterferon alfa-2b (18059), peginterferon beta-1a (18059), trabectedin (18115) |
| 09 - 12 March 2015 | PRAC recommendation (31/03/2015) |
PRAC recommendation (22/04/2015) | aripiprazole (18127) |
| 09 - 12 February 2015 | PRAC recommendation (03/03/2015) |
PRAC recommendation (23/03/2015) | amiodarone (18091), aripiprazole (18086) |
| 06 - 09 January 2015 |
PRAC recommendation (27/01/2015 / 05/02/2015) |
PRAC recommendation (18/02/2015) | atorvastatin (18140), fluvastatin (18140), simvastatin (18140), gadodiamide (408), gadopentetic acid (408), lithium (18090), paroxetine (18089), valproate and related substances (17956) |
| 01 - 04 December 2014 | PRAC recommendation (22/12/2014) | * | ** |
| 03 - 06 November 2014 | PRAC recommendation (25/11/2014) |
* | leuprorelin (17753) |
| 06 - 09 October 2014 | PRAC recommendation (28/10/2014) |
* | ** |
| 08 - 11 September 2014 | PRAC recommendation (30/09/2014) |
* | androgen deprivation therapy (13886), imatinib (17946), leuprorelin (17753) |
| 07 - 10 July 2014 |
PRAC recommendation (29/07/2014) |
* | bupropion (17727) |
| 10 - 13 June 2014 | PRAC recommendation (01/07/2014) |
* | fluoroquinolones for systemic use (15914), mycophenolate mofetil (17760), mycophenolic acid (17760) |
| 05 - 08 May 2014 | PRAC recommendation (27/05/2014) |
* | ** |
| 07 - 10 April 2014 | PRAC recommendation (29/04/2014) |
* | clindamycin (17700), fentanyl patches (17778), levonorgestrel-releasing intrauterine device (IUD) (2706), simvastatin (13849) |
| 03 - 06 March 2014 | PRAC recommendation (25/03/2014) |
* | goserelin (17698) |
| 03 - 06 February 2014 |
PRAC recommendation (25/02/2014) |
* | amiodarone (17699), interferon beta (17653), paracetamol (17744) |
| 06 - 09 January 2014 | PRAC recommendation (28/01/2014) |
* | triamcinolone acetonide, suspension for injection (17616) |
| 02 - 05 December 2013 | PRAC recommendation (17/12/2013) |
* | ** |
| 04 - 07 November 2013 | PRAC recommendation (28/11/2013) |
* | leflunomide (17693), lenograstim (17586), levetiracetam (17450) |
| 07 - 10 October 2013 |
PRAC recommendation (06/11/2013 / 18/11/2013) |
* | doxycycline (17674) |
| 02 - 05 September 2013 | PRAC recommendation (04/10/2013) |
* | ** |
| PRAC meetings held from 3-5 September 2012 until 8-11 July 2013 | PRAC recommendation (28/11/2013 / 21/01/2014) |
* | clopidogrel (acquired haemophilia A - 17447), clopidogrel (cross-reactivity between clopidogrel and ticlopidine - 13830), clopidogrel (eosinophilic pneumonia - 16235), docetaxel (15433), filgrastim (16899), pegfilgrastim (16899), mirtazapine (16715), tamsulozin (17622), temozolomide (16857), tiotropium bromide (17305), tramadol (17404) |
* Croatian translation is not available
** No recommendations were made at the meeting relating to the active substances authorized in Croatia via national procedure / No recommendations were made at the meeting regarding variation applications for updates of product information
