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Suvaxyn Aujeszky 783 + O/W


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Summary for the public


What is Suvaxyn Aujeszky 783 + O/W?

Suvaxyn Aujeszky 783 + O/W is a vaccine that contains a live attenuated (weakened) form of Aujeszky’s disease virus strain NIA3-783. Suvaxyn Aujeszky 783 + O/W is a powder and solvent that are made up into an emulsion (a mixture of oil- and water-based liquids) for injection.


What is Suvaxyn Aujeszky 783 + O/W used for?

Suvaxyn Aujeszky 783 + O/W is used to vaccinate pigs from the age of 10 weeks against Aujeszky’s disease, an illness similar to rabies that is caused by a herpesvirus. It prevents death and symptoms of the disease and reduces the shedding of the virus. Vaccination of gilts (female pigs that have not yet had piglets) and sows (female pigs that have had piglets before) with Suvaxyn Aujeszky 783 + O/W can also result in immunity in the pig’s offspring.

Suvaxyn Aujeszky 783 + O/W is given as two 2-ml injections into the muscle of the neck behind the ear, three to four weeks apart. Immunity starts after three weeks and lasts for three months. Female breeding pigs should be revaccinated before their first mating or during each pregnancy, three to six weeks before giving birth. Breeding boars (male pigs) should be revaccinated every six months. To vaccinate a whole herd, one dose should be given to every male and female breeding pig every four months.


How does Suvaxyn Aujeszky 783 + O/W work?

Suvaxyn Aujeszky 783 + O/W is a vaccine. Vaccines work by ‘teaching’ the immune system (the body’s natural defences) how to defend itself against a diseases. Suvaxyn Aujeszky 783 + O/W contains small amounts of a weakened form of the virus that causes Aujeszky’s disease. The virus has been genetically modified: it has had one of its gene deleted (the gene that makes it able to produce an enzyme called thymidine kinase) and this is what makes it weaker. The vaccine also contains ‘adjuvants’ (a compound containing aluminium as well as mineral oil, an emulsifier and a detergent) to stimulate a better response.

When a pig is given the vaccine, the immune system recognises the weakened viruses as ‘foreign’ and makes antibodies against them. In the future, the immune system will be able to produce antibodies more quickly when it is again exposed to the viruses. This protects the pigs against the disease. The antibodies are also passed on from mother to piglet through the colostrums (first milk) and milk. This enables the piglets of vaccinated pigs to be protected against the disease.


How has Suvaxyn Aujeszky 783 + O/W been studied?

The effectiveness of Suvaxyn Aujeszky 783 + O/W has been studied in a large number of pigs in several farms in studies lasting around two years. The herds of pigs were monitored for signs of infection with the type of Aujeszky’s disease virus that is can be caught in the field.

The studies compared the levels of infection in vaccinated and unvaccinated pigs.


What benefit has Suvaxyn Aujeszky 783 + O/W shown during the studies?

Suvaxyn Aujeszky 783 + O/W was effective at preventing infection with the virus.

After vaccination, the number of pig herds with signs of infection fell significantly, as did the number of infected pigs within the herds. There was no change in the infection rates in the pigs that were not vaccinated.


What is the risk associated with Suvaxyn Aujeszky 783 + O/W?

In up to a half of pigs being vaccinated, a slight temporary reaction can occur at the site of injection. This can be up to 2 cm in diameter after first injection and up to 5 cm after the second, but they usually disappear within three weeks. An increase in body temperature up to about 40.5°C can occur in a small number of pigs, lasting for up to two days.


What are the precautions for the person who gives the medicine or comes into contact with the animal?

Wash and disinfect hands and equipment after use. Accidental injection can cause severe pain and swelling, particularly if the vaccine is injected into a joint or finger. In case of accidental injection, seek prompt medical advice and show the Package Leaflet to the doctor. If pain persists for more than 12 hours after examination, seek medical advice again.


What is the time to allow before the animal can be slaughtered and the meat used for human consumption (withdrawal period)?

The withdrawal period is zero days.


Why has Suvaxyn Aujeszky 783 + O/W been approved?

The Committee for Medicinal Products for Veterinary Use (CVMP) concluded that the benefits of Suvaxyn Aujeszky 783 + O/W exceed the risks for the active and passive immunisation of pigs to prevent or reduce the mortality and clinical signs of Aujeszky’s disease and to reduce the excretion of Aujeszky’s disease field virus, and recommended that Suvaxyn Aujeszky 783 O/W be given a marketing authorisation. The benefit-risk balance may be found in module 6 of this EPAR.


Other information about Suvaxyn Aujeszky 783 + O/W

The European Commission granted a marketing authorisation valid throughout the European Union for Suvaxyn Aujeszky 783 + O/W to Fort Dodge Animal Health Holland on 7 August 1998. The marketing authorisation was renewed on 7 August 2003. Information on the prescription status of this product may be found on the label/outer package.

Authorisation details
Name: Suvaxyn Aujeszky 783 + O/W
EMEA Product number: EMEA/V/C/000038
Active substance: Live attenuated Aujeszky's Disease Virus, strain NIA3-783
INN or common name: Adjuvanted live attenuated vaccine against aujeszky's disease in pigs
Species: Pigs
ATCvet Code: QI09AA01
Marketing Authorisation Holder: Fort Dodge Animal Health Holland
Revision: 8
Date of issue of Market Authorisation valid throughout the European Union: 07/08/1998
Contact address:
Fort Dodge Animal Health Holland
CJ van Houtenlaan 36
1381 CP Weesp
The Netherlands




Product Characteristics

ANNEX I

SUMMARY OF PRODUCT CHARACTERISTICS


1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
QUALITATIVE AND QUANTITATIVE COMPOSITION
Powder:
Active substance(s)
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion
*
CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent:
One dose of 2 ml contains
Adjuvants :
Aluminium hydroxide
2.1 mg
Mineral oil (Marcol 52)
425
µ
l
Mannide mono oleate (Arlacel A)
46
µ
l
Polysorbate 80 (Tween 80)
17
µ
l
Excipient
Thiomersal
0.15 mg
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
CLINICAL PARTICULARS
4.1 Target species
Pigs
4.2
Indications for use, specifying the target species
Active immunisation of pigs from the age of 10 weeks to prevent the mortality and clinical signs of
Aujeszky’s Disease and to reduce the excretion of Aujeszky’s Disease field virus. Passive
immunisation of the progeny of vaccinated gilts and sows to reduce mortality and clinical signs of
Aujeszky’s Disease and to reduce the excretion of Aujeszky’s Disease field virus.
- Active immunity: The onset of immunity is from 3 weeks after basic vaccination. The immunity lasts
for 3 months after basic vaccination.
4.3 Contraindications
None
4.4
Special warnings for each target species
None
2
4.5
Special precautions for use
Special precautions for use in animals
Do not administer in conjunction with other medicinal products. Vaccinate only healthy animals. Each
piglet of vaccinated gilts or sows should ingest a sufficient quantity of colostrum and milk.
Special precautions to be taken by the person administering the veterinary medicinal product to
animals
Wash and disinfect hands and equipment after use.
To the user:
This product contains mineral oil. Accidental injection/self injection may result in severe pain and
swelling, particularly if injected into a joint or finger, and in rare cases could result in the loss of the
affected finger if prompt medical attention is not given. If you are accidentally injected with this
product, seek prompt medical advice even if only a very small amount is injected and take the package
insert with you.
If pain persists for more than 12 hours after medical examination, seek medical advice again.
To the physician:
This product contains mineral oil. Even if small amounts have been injected, accidental injection with
this product can cause intense swelling, which may, for example, result in ischaemic necrosis and even
the loss of a digit. Expert, PROMPT, surgical attention is required and may necessitate early incision
and irrigation of the injected area, especially where there is involvement of finger pulp or tendon.
4.6 Adverse reactions (frequency and seriousness)
Slight, transient and local reactions up to 2 cm in diameter after first vaccination and up to 5 cm after
second vaccination may occur up to 50% of the pigs. In general these reactions disappear within 3
weeks post primary vaccination. A transient increase in body temperature, up to about 40.5 o C and
lasting for up to 2 days, may occur in a small number of pigs after vaccination.
In very rare cases (<1/100000), hypersensitivity can be observed.
4.7 Use during pregnancy, lactation or lay
Can be used during pregnancy and lactation.
4.8 Interaction with other medicinal products and other forms of interaction
No information is available on the compatibility of this vaccine with any other. Therefore the safety
and efficacy of this product when used with any other (either used on the same day or at different
times) has not been demonstrated.
4.9
Amounts to be administered and administration route
For intramuscular use
To reconstitute the vaccine, inject 3 ml of solvent into the small vial with the powder. Shake gently to
disolve the vaccine and transfer the disolved vaccine into the vial with the solvent.
To avoid foaming, shake gently the vial after reconstitution of the freeze-dried component in the liquid
component. Use sterile syringes and needles. Administer by intramuscular injection of 1 dose (2 ml)
per pig in the neck in the area behind the ear.
3
Basic vaccination of fattening pigs and breeding pigs (gilts, sows and boars):
Inject one dose per fattening pig from the age of 10 weeks. A second dose may be injected 3 – 4
weeks after the first injection. The presence of maternal antibodies against Aujeszky’s Disease
Virus may have a negative influence on the result of vaccination.
Inject one dose per breeding pigs (gilts, sows and boars) from the age of 10 weeks followed by a
second injection 3 – 4 weeks after the first injection.
Re-vaccination of breeding pigs (gilts, sows and boars):
Inject one dose per gilt before the first mating, or
Inject one dose per gilt or sow during each gestation at 3 - 6 weeks before the expected date of
farrowing.
Inject one dose per boar at least every 6 months.
For whole herd vaccination, an injection of one dose may be administered per gilt, sow and boar every
4 months.
4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary
Apart from an increase in the extent of the tissue reaction at the site of injection, no other undesirable
effects have been observed.
4.11 Withdrawal period
Zero days
5.
IMMUNOLOGICAL PROPERTIES
ATC vet code: QI 09 AD 01
The active substance stimulates active immunity against Aujeszky’s Disease in pigs. By reconstitution
of the immunogen in the oil emulsion, the stimulation of immunity after injection is prolonged.
Progeny of vaccinated gilts and sows derive a passive immunity via the colostrum and milk.
The gE- (glycoprotein E negative) characteristic of the vaccine virus makes it possible to distinguish
between antibodies induced by vaccination with this product and those induced by field infection with
Aujeszky’s Disease Virus, if the vaccine is used in association with an appropriate diagnostic test.
Therefore, the product is suitable to be used in eradication programmes against Aujeszky’s Disease
field virus in pigs based on the presence or absence of antibodies against the gE-antigen of that virus.
6.
PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Aluminium hydroxide
Mineral oil (Marcol 52)l
Mannide mono oleate (Arlacel A)
Polysorbate 80 (Tween 80)
Thiomersal
Disodiumhydrogenphosphate
Sodiumhydrogenphosphate
Mannitol
Water for injections
4
6.2
Incompatibilities
Do not mix with any other vaccine or immunological product.
6.3
Shelf life
Shelf-life of the veterinary medicinal product as packaged for sale (powder) : 2 years.
Shelf-life of the veterinary medicinal product as packaged for sale (solvent) : 2 years.
Shelf-life after reconstitution according to directions : 1 hour
6.4
Special precautions for storage
Store and transport refrigerated (2°C – 8
°
C). Do not freeze.
6.5
Nature and composition of immediate packaging
Cardboard box with 1 vial of powder and 1 bottle of solvent or 10 vials of powder and 10 bottles of
solvent for injection
Powder for emulsion for injection :
7-ml vials of Type I hydrolytic glass containing 10, 50 or 100 doses of freeze-dried powder. The vials
are closed with a butyl rubber stopper and sealed with an aluminium cap.
Solvent for emulsion for injection :
20 ml, 100 ml or 200 ml bottles of Type I hydrolytic glass containing solvent for the 10-doses, 50-
doses or 100-doses presentation. The bottles are closed with a butyl rubber stopper and sealed with an
aluminium cap.
Not all pack sizes may be marketed.
6.6 Special precautions for the disposal of unused medicinal product or waste materials, if
any.
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant approved
for use by the competent authorities.
7. MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
8.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/001-006
9.
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
07/08/1998
22/08/2008
5
10
DATE OF REVISION OF THE TEXT
22.08.2008
Detailed information on this veterinary medicinal product is available on the website of the European
Medicines Agency (EMEA) http://www.emea.europa.eu /.
Prohibition of sale, supply and/or use
The import, sale, supply and/or use of Suvaxyn Aujeszky 783 + OW is or may be prohibited in certain
Member States on the whole or part of their territory pursuant to National animal health policy. Any
person intending to import, sell, supply and/or use Suvaxyn Aujeszky 783 + OW must consult the
relevant Member State’s competent authority on the current vaccination policies prior to the import,
sale, supply and/or use.
6
ANNEX II
A.
MANUFACTURER(S) OF THE BIOLOGICAL ACTIVE SUBSTANCE(S) AND
MANUFACTURING AUTHORISATION HOLDER(S) RESPONSIBLE FOR
BATCH RELEASE
B.
CONDITIONS OR RESTRICTIONS OF THE MARKETING
AUTHORISATION REGARDING SUPPLY OR USE
C.
CONDITIONS OR RESTRICTIONS OF THE MARKETING
AUTHORISATION WITH REGARD TO SAFE AND EFFECTIVE USE
D.
STATEMENT OF THE MRLs
7
A. MANUFACTURER(S) OF THE BIOLOGICAL ACTIVE SUBSTANCE(S) AND
MANUFACTURING AUTHORISATION HOLDER(S) RESPONSIBLE FOR BATCH
RELEASE
Name and address of the manufacturers of the biological active substances
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
Name and address of the manufacturer(s) responsible for batch release
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
B. CONDITIONS OR RESTRICTIONS OF THE MARKETING AUTHORISATION
REGARDING SUPPLY OR USE
To be supplied only on veterinary prescription.
According to Article 71 of Directive 2001/82/EC of the European Parliament and of the Council as
amended, Member States prohibit or may prohibit the import, sale, supply and/or use of the veterinary
medicinal product on the whole or part of their territory if it is established that:
a) the administration of the veterinary medicinal product to animals will interfere with the
implementation of national programmes for the diagnosis, control and eradication of animal
in foodstuffs or other products obtained from treated animals.
b) the disease to which the veterinary medicinal product is intended to confer immunity is largely
absent from the territory.
C. CONDITIONS OR RESTRICTIONS OF THE MARKETING AUTHORISATION WITH
REGARD TO THE SAFE AND EFFECTIVE USE OF THE PRODUCT
Not applicable.
D.
STATEMENT OF THE MRLs
Annex II of Council Regulation (EEC) No 2377/90
Pharmacologically active substance
Animal Species
Other provisions
Aluminium hydroxide
All food-producing
species
Disodiumhydrogenphosphate
Mannitol
Mineral oil
Polysorbate 80
Sodiumhydrogenphosphate
Thiomersal
8
diseases, or will cause difficulties in certifying the absence of contamination in live animals or
 
ANNEX III
LABELLING AND PACKAGE INSERT
9
A. LABELLING
10
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 1 x 10 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent :
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
1 vial with powder for injection (10 doses) and 1 bottle of solvent for injection (20 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
11
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/001
12
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
13
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 1 x 50 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder ::
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent:
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
1 vial with powder for injection (50 doses) and 1 bottle of solvent for injection (100 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
14
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/002
15
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
16
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 1 x 100 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent :
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
1 vial with powder for injection (100 doses) and 1 bottle of solvent for injection (200 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
17
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/003
18
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
19
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 10 x 10 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent :
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
10 vials with powder for injection (each containing 10 doses) and 10 bottles of solvent for injection
(each containing 20 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
20
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/004
21
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
22
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 10 x 50 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent :
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
10 vials with powder for injection (each containing 50 doses) and 10 bottles of solvent for injection
(each containing 100 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
23
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY” AND CONDITIONS OR
RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN”
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/005
24
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
25
 
PARTICULARS TO APPEAR ON THE OUTER PACKAGE
(Carton label 10 x 100 doses)
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
2.
STATEMENT OF ACTIVE AND OTHER SUBSTANCES
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent :
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
3.
PHARMACEUTICAL FORM
Powder and solvent for emulsion for injection
4.
PACKAGE SIZE
10 vials with powder for injection (each containing 10 doses) and 10 bottles of solvent for injection
(each containing 200 ml)
5.
TARGET SPECIES
Pigs
6.
INDICATION(S)
Active and passive immunisation of pigs against Aujeszky’s Disease.
7.
METHOD AND ROUTE(S) OF ADMINISTRATION
For intramuscular use of 1 dose (2 ml) per pig
8.
WITHDRAWAL PERIOD
Zero days
26
 
9.
SPECIAL WARNING(S), IF NECESSARY
Accidental injection is dangerous - see package insert before use for further information and additional
warnings.
10.
EXPIRY DATE
EXP {month/year}
Shelf life after reconstitution: Use within one hour
11.
SPECIAL STORAGE CONDITIONS
Store (and transport) at 2ºC - 8ºC (in a refrigerator). Do not freeze.
12. SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR WASTE
MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
13.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
Veterinary medicinal product subject to prescription.
The import, sale, supply and/or use of this veterinary medicinal product is or may be prohibited in
certain Member States on the whole or part of their territory, see package leaflet for further
information.
14.
THE WORDS “KEEP OUT OF THE REACH AND SIGHT OF CHILDREN” AND
CONDITIONS OR RESTRICTIONS REGARDING SUPPLY AND USE, if applicable
Keep out of the reach and sight of children
15. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
16.
MARKETING AUTHORISATION NUMBER(S)
EU/2/98/009/006
27
 
17.
MANUFACTURER’S BATCH NUMBER
Batch: {number} for the powder:
Batch: {number} for the solvent:
28
 
PARTICULARS TO APPEAR ON THE IMMEDIATE PACKAGE
(10 doses)
A.
Vials for the powder:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder for injection.
2.
QUANTITY OF THE ACTIVE SUBSTANCE(S)
Live attenuated Aujeszky’s Disease Virus
3.
CONTENTS BY WEIGHT, BY VOLUME OR NUMBER OF DOSES
10 doses
4.
ROUTE(S) OF ADMINISTRATION
For intramuscular use
5.
BATCH NUMBER
Lot {number}
6.
EXPIRY DATE
EXP {month/year}
7.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
29
 
B.
Bottles for the solvent:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, solvent for injection.
2.
QUANTITY
20 ml (10 doses)
3.
ROUTE OF ADMINISTRATION
For intramuscular use
4.
BATCH NUMBER
Lot {number}
5.
EXPIRY DATE
EXP {month/year}
Use within one hour after reconstitution
6.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
7.
SPECIAL WARNING(S)
Accidental injection is dangerous – see package insert before use
30
 
PARTICULARS TO APPEAR ON THE IMMEDIATE PACKAGE
(50 doses)
A.
Vials for the powder:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder for injection
2.
QUANTITY OF THE ACTIVE SUBSTANCE(S)
Live attenuated Aujeszky’s Disease Virus
3.
CONTENTS BY WEIGHT, BY VOLUME OR NUMBER OF DOSES
50 doses
4.
ROUTE(S) OF ADMINISTRATION
For intramuscular use
5.
BATCH NUMBER
Lot {number}
6.
EXPIRY DATE
EXP {month/year}
7.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
31
 
B.
Bottles for the solvent:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, solvent for injection
2.
QUANTITY
100 ml (50 doses)
3.
ROUTE OF ADMINISTRATION
For intramuscular use
4.
BATCH NUMBER
Lot {number}
5.
EXPIRY DATE
EXP {month/year}
Use within one hour after reconstitution
6.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
7.
SPECIAL WARNING(S)
Accidental injection is dangerous – see package insert before use
32
 
PARTICULARS TO APPEAR ON THE IMMEDIATE PACKAGE
(100 doses)
A.
Vials for the powder:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder for injection
2.
QUANTITY OF THE ACTIVE SUBSTANCE(S)
Live attenuated Aujeszky’s Disease Virus
3.
CONTENTS BY WEIGHT, BY VOLUME OR NUMBER OF DOSES
100 doses
4.
ROUTE(S) OF ADMINISTRATION
For intramuscular use
5.
BATCH NUMBER
Lot {number}
6.
EXPIRY DATE
EXP {month/year}
7.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
33
 
B.
Bottles for the solvent:
1.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, solvent for injection
2.
QUANTITY
200 ml (100 doses)
3.
ROUTE OF ADMINISTRATION
For intramuscular use
4.
BATCH NUMBER
Lot {number}
5.
EXPIRY DATE
EXP {month/year}
Use within one hour after reconstitution
6.
THE WORDS “FOR ANIMAL TREATMENT ONLY”
For animal treatment only
7.
SPECIAL WARNING(S)
Accidental injection is dangerous – see package insert before use
34
 
B. PACKAGE LEAFLET
35
1.
NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER AND OF
THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH
RELEASE, IF DIFFERENT
Marketing authorisation holder and manufacturer :
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
Manufacturer for the batch release :
Fort Dodge Animal Health Holland
C.J. van Houtenlaan 36
1381 CP Weesp
The Netherlands
2.
NAME OF VETERINARY THE MEDICINAL PRODUCT
Suvaxyn Aujeszky 783 + O/W, powder and solvent for emulsion for injection.
3.
STATEMENT OF THE ACTIVE AND OTHER SUBSTANCE(S)
Powder:
Live attenuated Aujeszky’s Disease Virus, strain NIA 3 -783:
10 5.2 CCID 50 * per 2 ml dose of
reconstituted emulsion.
* CCID 50 = the quantity of virus, which infects 50% of the cell cultures inoculated.
Solvent:
One dose of 2 ml contains:
Aluminium hydroxide, Mineral oil (Marcol 52), Mannide mono oleate (Arlacel A), Polysorbate 80
(Tween 80), Thiomersal
4.
INDICATION(S)
Active immunisation of pigs from the age of 10 weeks to prevent the mortality and clinical signs of
Aujeszky’s Disease and to reduce the excretion of Aujeszky’s Disease field virus.
Passive immunisation of piglets from vaccinated gilts and sows to reduce mortality and clinical signs
of Aujeszky’s Disease and to reduce the excretion of Aujeszky’s Disease field virus.
- Active immunity: The onset of immunity is from 3 weeks after basic vaccination. The immunity lasts
for 3 months after basic vaccination.
5.
CONTRAINDICATIONS
None
36
6.
ADVERSE REACTIONS
Slight, transient and local reactions up to 2 cm in diameter after first vaccination and up to 5 cm after
second vaccination may occur up to 50% of the pigs. In general these reactions disappear within 3
weeks after the first vaccination. A transient increase in body temperature, up to about 40,5 o C and
lasting for up to 2 days, may occur in a small number of pigs after vaccination.
In very rare cases (<1/100000), hypersensitivity can be observed.
If you notice any other side effects, please inform your veterinary surgeon.
7.
TARGET SPECIES
Pigs
8.
DOSAGE FOR EACH SPECIES, ROUTE(S) AND METHOD OF ADMINISTRATION
For intramuscular use
One dose (2 ml) of reconstituted emulsion containing
10 5.2 CCID 50 of live attenuated Aujeszky’s
Disease Virus strain NIA 3 -783 for each pig.
Vaccination programme:
Basic vaccination of fattening pigs and breeding pigs (gilts, sows and boars):
Inject one dose per fattening pig from the age of 10 weeks. A second dose may be injected 3 – 4
weeks after the first injection. The presence of maternal antibodies against Aujeszky’s Disease
Virus may have a negative influence on the result of vaccination.
Inject one dose per breeding pig (gilts, sows and boars) from the age of 10 weeks followed by a
second injection 3 – 4 weeks after the first injection.
Re-vaccination of breeding pigs (gilts, sows and boars):
Inject one dose per gilt before the first mating, or
Inject one dose per gilt or sow during each gestation at 3 - 6 weeks before the expected date of
farrowing.
Inject one dose per boar at least every 6 months.
For whole herd vaccination, an injection of one dose may be administered per gilt, sow and boar every
4 months.
9.
ADVICE ON CORRECT ADMINISTRATION
To reconstitute the vaccine, inject 3 ml of solvent into the small vial with the powder. Shake gently to
disolve the vaccine and transfer the disolved vaccine into the vial with the solvent.
To avoid foaming, shake gently the vial after reconstitution of the freeze-dried component in the liquid
component. Use sterile syringes and needles. Administer by intramuscular injection of 1 dose (2 ml)
per pig in the neck in the area behind the ear.
Vaccinate only healthy animals. Each piglet of vaccinated gilts or sows should ingest a sufficient
quantity of colostrum and milk.
37
10.
WITHDRAWAL PERIOD
Zero days
11.
SPECIAL STORAGE PRECAUTIONS
C). Do not freeze.
Do not use after the expiry date stated on the label.
Shelf-life after reconstitution according to directions : 1 hour.
°
C – 8
°
12.
SPECIAL WARNINGS
The import, sale, supply and/or use of Suvaxyn Aujeszky 783 + OW is or may be prohibited in certain
Member States on the whole or part of their territory pursuant to National animal health policy. Any
person intending to import, sell, supply and/or use Suvaxyn Aujeszky 783 + OW has to consult the
relevant Member States competent Authorities on the current vaccination policies prior to the import,
sale, supply and/or use.
No information is available on the compatibility of this vaccine with any other. Therefore the safety
and efficacy of this product when used with any other (either used on the same day or at different
times) has not been demonstrated.
Wash and disinfect hands and equipment after use.
To the user :
This product contains mineral oil. Accidental injection/self injection may result in severe pain and
swelling, particularly if injected into a joint or finger, and in rare cases could result in the loss of the
affected finger if prompt medical attention is not given.
If you are accidentally injected with this product, seek prompt medical advice even if only a very
small amount is injected and take the package insert with you.
If pain persists for more than 12 hours after medical examination, seek medical advice again.
To the physician:
This product contains mineral oil. Even if small amounts have been injected, accidental injection with
this product can cause intense swelling, which may, for example, result in ischaemic necrosis and even
the loss of a digit. Expert, PROMPT, surgical attention is required and may necessitate early incision
and irrigation of the injected area, especially where there is involvement of finger pulp or tendon.
13.
SPECIAL PRECAUTIONS FOR THE DISPOSAL OF UNUSED PRODUCT OR
WASTE MATERIALS , IF ANY
Dispose of waste material by boiling, incineration or immersion in an appropriate disinfectant
approved for use by the competent authorities.
14.
DATE ON WHICH THE PACKAGE LEAFLET WAS LAST REVISED
22.08.2008
Detailed information on this product is available on the website of the European Medicines Agency
(EMEA) http://www.emea.europa.eu /.
38
Keep out of the reach and sight of children.
Store and transport refrigerated (2
15.
OTHER INFORMATION
For animal treatment only.
The active substance stimulates active immunity against Aujeszky’s Disease in pigs. By reconstitution
of the immunogen in the oil emulsion the stimulation of immunity after injection is prolonged.
Progeny of vaccinated gilts and sows derive a passive immunity via the colostrum and milk. The
presence of maternal antibodies against Aujeszky’s Disease Virus may have a negative influence on
the result of vaccination.
The gE- (glycoprotein E negative) characteristic of the vaccine virus makes it possible to distinguish
between antibodies induced by vaccination with this product and those induced by field infection with
Aujeszky’s Disease Virus, if the vaccine is used in association with an appropriate diagnostic test.
Therefore, the product is suitable to be used in eradication programmes against Aujeszky’s Disease
field virus in pigs based on the presence or absence of antibodies against the gE-antigen of that virus.
Not all pack sizes may be marketed.
For any information about this veterinary medicinal product, please contact the local representative of
the marketing authorisation holder.
België/Belgique/Belgien
Fort Dodge Animal Health Benelux B.V.
Adenauerstrasse 20
D-52146 Würselen
Duitsland/Allemagne/Deutschland
Tel/Tél: 0800 50327
Luxemburg/Luxembourg
Fort Dodge Animal Health Benelux B.V.
Adenauerstrasse 20
D-52146 Würselen
Allemagne/Deutschland
Tel: 0800 50327
Република България
”СаниКо БЪЛГАРИЯ” ООД
1408 – София, България
бул. “Витоша” – 200, вх. “В”, ап. 51
пощенски адрес: 1606 – София, България
П.К. 237
Teл: + 359 28514413
Magyarország
Cymedica Hungary Kft.
Hr. Sz. 220/13
H-2053 Herceghalom
Tel.: + 36 305 652 187
Česká republika
Cymedica spol s.r.o.
Pod Nádražím 853
CZ-268 01 Hořovice
Tel: + 420 311 545 011
Malta
Fort Dodge Animal Health
Huizerstraatweg 117
NL-1411 GM Naarden
The Netherlands
Tel: + 31 35 699 3365
Danmark
ScanVet Animal Health A/S
66 Kongevejen
DK 3480 - Fredensborg
Tlf: + 45 48 48 43 17
Nederland
Fort Dodge Animal Health Benelux B.V.
Adenauerstrasse 20
D-52146 Würselen
Duitsland
Tel: 0800 4555554
39
Deutschland
Fort Dodge Veterinär GmbH
Adenauerstrasse 20
D-52146 Würselen
Tel: + 49 (0)2405 454 100
Norge
ScanVet informasjonskontor
Kongsveien 91
N-1177 Oslo
Tlf: +47 22 76 72 50
Eesti
UAB Magnum Veterinarija
Smelynes str. 2c
LT-53143 Penevezys
Leedu
Tel: + 370 45 507 400
Österreich
Fort Dodge Veterinär GmbH
Adenauerstr. 20
D-52146 Würselen
Tel: + 49 2405 454 100
Ελλάδα
ΛΑΠΑΦΑΡΜ Α.Ε.
Μενάνδρου 73
GR-10437 Αθήνα
Τηλ: + 30 210 524.6011
Polska
ScanVet Poland Sp. z .o. o.
Skiereszewo, ul. Kiszkowska 9
62-200 Gniezno
Tel.: +48 61 426 49 20
España
Fort Dodge Veterinaria S.A.
Ctra. Camprodón s/n “La Riba”
E -17813 Vall de Bianya – Girona
Tel: + 34 91 598 1336
Portugal
Fort Dodge Veterinaria S.A.
Ctra. Camprodón s/n “La Riba”
E-17813 Vall de Bianya – Girona
Espanha
Tel: + 34 91 598 1336
France
Fort Dodge Santé Animale
24, avenue Marcel Dassault – BP 440
F-37204 Tours Cedex 3
Tel: + 33 (0)2 47 74 89 89
România
Torox srl
Otopeni, Str. Drumul Garii 30
Judetul Ilfov, Romania
Tel.: +40 21 300 17 80
Ireland
Fort Dodge Animal Health Limited
Flanders Road
Hedge End
Southampton S030 4QH-UK
Tel: + 44 1489 781 711
Slovenija
Vet4vet d.o.o.
Gerbiceva 50a
SI-1000 Ljubljana
Tel: +386 1 2800672
Ísland
Vistor hf.
Hörgatún 2
210 Garðabær
Sími: + 354 535 7000
Slovenská republika
Cymedica spol s.r.o.
Pod Nádražím 853
CZ-268 01 Hořovice
Česká republika
Tel: + 420 311 545 011
Italia
Fort Dodge Veterinaria S.p.A.
Via Nettunense, 90
I-04011 Aprilia (LT)
Tel.: + 39 051 421 53 11
Suomi/Finland
ScanVet Eläinlääkkeet Oy
Tyrvännöntie 769
FIN-14610 Lepaa
Puh/Tel: + 358 (0)3 630 3100
40
Κύπρος
Premier Shukuroglou Ltd.
Olympou str. 4
CY-2234 Latsia
Τηλ: + 357 22815353
Sverige
Ceva Vetpharma AB
Annedalsvägen 9
SE-227 64 Lund
Tel: + 46 (0)46 12 81 00
Latvija
UAB Magnum Veterinarija
Smelynes str. 2c
LT-53143 Penevezys
Lietuva
Tel: + 370 45 507 400
United Kingdom
Fort Dodge Animal Health Limited
Flanders Road
Hedge End
Southampton S030 4QH-UK
Tel: + 44 (0)1489 781 711
Lietuva
UAB Magnum Veterinarija
Smelynes str. 2c
LT-53143 Penevezys
Tel: + 370 45 507 400
41


Source: European Medicines Agency



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