New Mexico Health Connections Drug Safety Updates. Drug Safety Updates Q Route of Administration. Action. Brand Name Generic Name Indications

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Q4 2017 Advair Diskus salmeterol Asthma, COPD inhaler Advair HFA salmeterol Asthma inhaler Airduo Respiclick salmeterol Asthma inhaler Alecensa alectinib Non-Small Cell Lung Cancer Genentech announced the FDA approval of Alecensa (alectinib) for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) as detected by an FDAapproved test. Page 1 of 6

Q4 2017 Alimta pemetrexed Non-Squamous Non- Small Cell Lung Cancer, Mesothelioma IV Information regarding myelosuppression and increased risk of myelosuppression without vitamin supplementation, renal failure, bullous and exfoliative skin toxicity, interstitial pneumonitis, radiation recall, and increased risk of toxicity with ibuprofen in patients with renal impairment were added to the Warnings and Precautions section of the Alimta drug label. Aranesp darbepoetin alfa Anemia due to Chronic Kidney Disease, Anemia IV or SubQ due to Chemotherapy in Patients with Cancer of the Aranesp (darbepoetin alfa) drug label regarding severe cutaneous reactions. Breo Ellipta vilanterol Asthma, COPD inhaler Dulera mometasone/ formoterol Asthma inhaler Page 2 of 6

Q4 2017 Gazyva obinutuzumab Chronic Lymphocytic Leukemia, Follicular Lymphoma IV New Mexico Health Connections Genentech announced the FDA approval of Gazyva (obinutuzumab), in combination with chemotherapy followed by Gazyva monotherapy in patients achieving at least a partial remission, for the treatment of adult patients with previously untreated stage II bulky, III or IV follicular lymphoma (FL). Gilenya fingolimod Multiple Sclerosis of the Gilenya (fingolimod) drug label regarding cutaneous malignancies. Keytruda pembrolizumab Melanoma, Non-Small Cell Lung Cancer, Head and Neck Cancer, Classical Hodgkin Lymphoma, Urothelial IV Carcinoma, Microsatellite Instability- High Cancer, Gastric Cancer of the Keytruda (pembrolizumab) drug label regarding increased mortality in patients with multiple myeloma (MM) when Keytruda is added to a thalidomide analogue and dexamethasone. Lemtrada alemtuzumab Multiple Sclerosis IV of the Lemtrada (alemtuzumab) drug label regarding the risk of acute acalculous cholecystitis. Limbrel (medical food) flavocoxid/citrated zinc bisglycinate Osteoarthritis The FDA recommended that Primus Pharmaceuticals voluntary recall Limbrel (flavocoxid/citrated zinc bisglycinate) due to serious adverse events, including drug-induced liver injury and hypersensitivity pneumonitis. Page 3 of 6

Q4 2017 Lomotil atropine/ diphenoxylate Diarrhea The FDA approved updates to the Indications and Contraindications sections of the Lomotil (atropine/diphenoxylate) drug label, to limit use to patients 13 years of age, and to expand the contraindications for pediatric patients from 2 years old to < 6 years old secondary to the risk of respiratory and central nervous system (CNS) depression. Pomalyst pomalidomide Multiple Myeloma of the Pomalyst (pomalidomide), Revlimid (lenalidomide), and Thalomid (thalidomide) drug labels regarding increased mortality in patients with multiple myeloma (MM) when Keytruda (pembrolizumab) is added to a thalidomide analogue and dexamethasone. Prevacid, Prevacid SoluTab lansoprazole GERD, Gastric/Duodenal Ulcer, Erosive Esophagitis, Zollinger Ellison Syndrome The FDA approved updates to the Warning and Precautions section of the Prevacid (lansoprazole) and Prevacid SoluTab (lansoprazole) drug labels, regarding interactions with investigations for neuroendocrine tumors and risks in patients with phenylketonuria (PKU). Promacta eltrombopag Thrombocytopenia, Aplastic Anemia of the Promacta (eltrombopag) drug label regarding the increased risk of death and progression of myelodysplastic syndromes (MDS) to acute myeloid leukemia (AML). Remicade infliximab Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis, Ankylosing Spondylitis, Plaque Psoriasis IV of the Remicade (infliximab) drug label regarding cardiovascular and cerebrovascular reactions during and after infusion. Page 4 of 6

Q4 2017 Revlimid lenalidomide Multiple Myeloma, Myelodysplastic Syndromes, Mantle Cell Lymphoma of the Pomalyst (pomalidomide), Revlimid (lenalidomide), and Thalomid (thalidomide) drug labels regarding increased mortality in patients with multiple myeloma (MM) when Keytruda (pembrolizumab) is added to a thalidomide analogue and dexamethasone. Reyataz atazanavir HIV-1 of the Reyataz (atazanavir) drug label regarding chronic kidney disease. Symbicort budesonide/ formoterol Asthma, COPD inhaler Thalomid thalidomide Multiple Myeloma, Erythema Nodosum Leprosum of the Pomalyst (pomalidomide), Revlimid (lenalidomide), and Thalomid (thalidomide) drug labels regarding increased mortality in patients with multiple myeloma (MM) when Keytruda (pembrolizumab) is added to a thalidomide analogue and dexamethasone. Page 5 of 6

Q4 2017 Tivicay dolutegravir HIV-1 The FDA approved Tivicay for use in combination with rilpivirine as a complete regimen to replace the current antiretroviral (ART) regimen in those who are virologically suppressed (HIV-1 RNA < 50 copies/ml) on a stable ART regimen for at least 6 months with no history of treatment failure or known substitutions associated with resistance to either antiretroviral. This update was made for consistency with the new Juluca drug approval. Triumeq abacavir/ dolutegravir/ lamivudine HIV-1 The FDA announced the approval of ViiV Healthcare s Triumeq (abacavir/dolutegravir/lamivudine) tablets, for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in pediatric patients weighing 40 kg. Uloric febuxostat Gout The FDA announced that preliminary results from a post-marketing safety study showed an increased risk of heart-related death and death from all causes with Uloric (febuxostat) compared to allopurinol. Page 6 of 6