Label: FLUARIX QUADRIVALENT 2016/2017- influenza virus vaccine suspension

  • NDC Code(s): 58160-905-41, 58160-905-52
  • Packager: GlaxoSmithKline Biologicals SA
  • Category: VACCINE LABEL

Drug Label Information

Updated November 18, 2016

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  • HIGHLIGHTS OF PRESCRIBING INFORMATION
    These highlights do not include all the information needed to use FLUARIX QUADRIVALENT safely and effectively. See full prescribing information for FLUARIX QUADRIVALENT.

    FLUARIX QUADRIVALENT (Influenza Vaccine)
    Suspension for Intramuscular Injection
    2016-2017 Formula
    Initial U.S. Approval: 2012

    INDICATIONS AND USAGE

    FLUARIX QUADRIVALENT is a vaccine indicated for active immunization for the prevention of disease caused by influenza A subtype viruses and type B viruses contained in the vaccine. FLUARIX QUADRIVALENT is approved for use in persons aged 3 years and older. (1)

    DOSAGE AND ADMINISTRATION

    For intramuscular injection only. (2)

    Age

    Vaccination Status

    Dose and Schedule

    3 through 8 years

    Not previously vaccinated with influenza vaccine

    Two doses (0.5‑mL each) at least 4 weeks apart (2.1)

    Vaccinated with influenza vaccine in a previous season

    One or 2 dosesa (0.5‑mL each) (2.1)

    9 years and older

    Not applicable

    One 0.5‑mL dose (2.1)

    a One dose or 2 doses (0.5‑mL each) depending on vaccination history as per the annual Advisory Committee on Immunization Practices (ACIP) recommendation on prevention and control of influenza with vaccines. If 2 doses, administer each 0.5‑mL dose at least 4 weeks apart. (2.1)

    DOSAGE FORMS AND STRENGTHS

    Suspension for injection supplied in 0.5‑mL single-dose prefilled syringes. (3)

    CONTRAINDICATIONS

    History of severe allergic reactions (e.g., anaphylaxis) to any component of the vaccine, including egg protein, or following a previous dose of any influenza vaccine. (4, 11)

    WARNINGS AND PRECAUTIONS

    If Guillain-Barré syndrome has occurred within 6 weeks of receipt of a prior influenza vaccine, the decision to give FLUARIX QUADRIVALENT should be based on careful consideration of potential benefits and risks. ( 5.1)
    Syncope (fainting) can occur in association with administration of injectable vaccines, including FLUARIX QUADRIVALENT. Procedures should be in place to avoid falling injury and to restore cerebral perfusion following syncope. ( 5.2)

    ADVERSE REACTIONS

    In adults, the most common (≥10%) injection site adverse reaction was pain (36%); the most common systemic adverse events were muscle aches (16%), headache (16%), and fatigue (16%). ( 6.1)
    In children aged 3 through 17 years, the injection site adverse reactions were pain (44%), redness (23%), and swelling (19%). ( 6.1)
    In children aged 3 through 5 years, the most common (≥10%) systemic adverse events were drowsiness (17%), irritability (17%), and loss of appetite (16%); in children aged 6 through 17 years, the most common systemic adverse events were fatigue (20%), muscle aches (18%), headache (16%), arthralgia (10%), and gastrointestinal symptoms (10%). ( 6.1)

    To report SUSPECTED ADVERSE REACTIONS, contact GlaxoSmithKline at 1-888-825-5249 or VAERS at 1-800-822-7967 or www.vaers.hhs.gov.

    USE IN SPECIFIC POPULATIONS

    Geriatric Use: Antibody responses were lower in geriatric subjects who received FLUARIX QUADRIVALENT than in younger subjects. ( 8.5)

    See 17 for PATIENT COUNSELING INFORMATION.

    Revised: 11/2016

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  • FULL PRESCRIBING INFORMATION: CONTENTS*
  • 1 INDICATIONS AND USAGE

    FLUARIX® QUADRIVALENT is indicated for active immunization for the prevention of disease caused by influenza A subtype viruses and type B viruses contained in the vaccine [see Description (11)]. FLUARIX QUADRIVALENT is approved for use in persons aged 3 years and older.

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  • 2 DOSAGE AND ADMINISTRATION

    For intramuscular injection only.

    2.1 Dosage and Schedule

    The dose and schedule for FLUARIX QUADRIVALENT are presented in Table 1.

    Table 1. FLUARIX QUADRIVALENT: Dosing

    Age

    Vaccination Status

    Dose and Schedule

    3 through 8 years

    Not previously vaccinated with influenza vaccine

    Two doses (0.5‑mL each) at least 4 weeks apart

    Vaccinated with influenza vaccine in a previous season

    One or 2 dosesa (0.5‑mL each)

    9 years and older

    Not applicable

    One 0.5‑mL dose

    a One dose or 2 doses (0.5‑mL each) depending on vaccination history as per the annual Advisory Committee on Immunization Practices (ACIP) recommendation on prevention and control of influenza with vaccines. If 2 doses, administer each 0.5‑mL dose at least 4 weeks apart.

    2.2 Administration Instructions

    Shake well before administration. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If either of these conditions exists, the vaccine should not be administered.

    Attach a sterile needle to the prefilled syringe and administer intramuscularly.

    The preferred site for intramuscular injection is the deltoid muscle of the upper arm. Do not inject in the gluteal area or areas where there may be a major nerve trunk.

    Do not administer this product intravenously, intradermally, or subcutaneously.

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  • 3 DOSAGE FORMS AND STRENGTHS

    FLUARIX QUADRIVALENT is a suspension for injection. Each 0.5‑mL dose is supplied in single-dose prefilled TIP‑LOK® syringes.

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  • 4 CONTRAINDICATIONS

    Do not administer FLUARIX QUADRIVALENT to anyone with a history of severe allergic reactions (e.g., anaphylaxis) to any component of the vaccine, including egg protein, or following a previous administration of any influenza vaccine [see Description (11)].

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  • 5 WARNINGS AND PRECAUTIONS

    5.1 Guillain-Barré Syndrome

    If Guillain‑Barré syndrome (GBS) has occurred within 6 weeks of receipt of a prior influenza vaccine, the decision to give FLUARIX QUADRIVALENT should be based on careful consideration of the potential benefits and risks.

    The 1976 swine influenza vaccine was associated with an increased frequency of GBS. Evidence for a causal relation of GBS with subsequent vaccines prepared from other influenza viruses is inconclusive. If influenza vaccine does pose a risk, it is probably slightly more than one additional case/one million persons vaccinated.

    5.2 Syncope

    Syncope (fainting) can occur in association with administration of injectable vaccines, including FLUARIX QUADRIVALENT. Syncope can be accompanied by transient neurological signs such as visual disturbance, paresthesia, and tonic-clonic limb movements. Procedures should be in place to avoid falling injury and to restore cerebral perfusion following syncope.

    5.3 Preventing and Managing Allergic Vaccine Reactions

    Prior to administration, the healthcare provider should review the immunization history for possible vaccine sensitivity and previous vaccination‑related adverse reactions. Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of FLUARIX QUADRIVALENT.

    5.4 Altered Immunocompetence

    If FLUARIX QUADRIVALENT is administered to immunosuppressed persons, including individuals receiving immunosuppressive therapy, the immune response may be lower than in immunocompetent persons.

    5.5 Limitations of Vaccine Effectiveness

    Vaccination with FLUARIX QUADRIVALENT may not protect all susceptible individuals.

    5.6 Persons at Risk of Bleeding

    As with other intramuscular injections, FLUARIX QUADRIVALENT should be given with caution in individuals with bleeding disorders, such as hemophilia or on anticoagulant therapy, to avoid the risk of hematoma following the injection.

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  • 6 ADVERSE REACTIONS

    The safety experience with FLUARIX (trivalent influenza vaccine) is relevant to FLUARIX QUADRIVALENT because both vaccines are manufactured using the same process and have overlapping compositions [see Description (11)].

    6.1 Clinical Trials Experience

    Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared with rates in the clinical trials of another vaccine, and may not reflect the rates observed in practice. There is the possibility that broad use of FLUARIX QUADRIVALENT could reveal adverse reactions not observed in clinical trials.

    In adults who received FLUARIX QUADRIVALENT, the most common (≥10%) injection site adverse reaction was pain (36%). The most common (≥10%) systemic adverse events were muscle aches (16%), headache (16%), and fatigue (16%).

    In children aged 3 through 17 years who received FLUARIX QUADRIVALENT, injection site adverse reactions were pain (44%), redness (23%), and swelling (19%). In children aged 3 through 5 years, the most common (≥10%) systemic adverse events were drowsiness (17%), irritability (17%), and loss of appetite (16%); in children aged 6 through 17 years, the most common systemic adverse events were fatigue (20%), muscle aches (18%), headache (16%), arthralgia (10%), and gastrointestinal symptoms (10%).

    FLUARIX QUADRIVALENT in Adults

    Trial 1 (NCT01204671) was a randomized, double-blind (2 arms) and open-label (one arm), active-controlled, safety, and immunogenicity trial. In this trial, subjects received FLUARIX QUADRIVALENT (n = 3,036) or one of 2 formulations of comparator trivalent influenza vaccine (FLUARIX, TIV-1, n = 1,010 or TIV-2, n = 610), each containing an influenza type B virus that corresponded to one of the 2 type B viruses in FLUARIX QUADRIVALENT (a type B virus of the Victoria lineage or a type B virus of the Yamagata lineage). The population was aged 18 years and older (mean age: 58 years) and 57% were female; 69% were white, 27% were Asian, and 4% were of other racial/ethnic groups. Solicited events were collected for 7 days (day of vaccination and the next 6 days). The frequencies of solicited adverse events are shown in Table 2.

    Table 2. FLUARIX QUADRIVALENT: Incidence of Solicited Local Adverse Reactions and Systemic Adverse Events within 7 Daysa of Vaccination in Adultsb (Total Vaccinated Cohort)

    Trivalent Influenza Vaccine (TIV)

    FLUARIX QUADRIVALENTc

    n = 3,011-3,015

    %

    TIV-1

    (B Victoria)d

    n = 1,003

    %

    TIV-2

    (B Yamagata)e

    n = 607

    %

    Any

    Grade 3f

    Any

    Grade 3f

    Any

    Grade 3f

    Local

    Pain

    36.4

    0.8

    36.8

    1.2

    31.3

    0.5

    Redness

    1.9

    0.0

    1.7

    0.0

    2.0

    0.0

    Swelling

    2.1

    0.0

    2.1

    0.0

    1.3

    0.0

    Systemic

    Muscle aches

    16.4

    0.5

    19.4

    0.8

    16.1

    0.5

    Headache

    15.9

    0.9

    16.4

    0.8

    13.2

    0.7

    Fatigue

    15.8

    0.7

    18.4

    0.6

    14.8

    0.5

    Arthralgia

    8.4

    0.5

    10.4

    0.7

    9.4

    0.3

    Gastrointestinal symptomsg

    6.5

    0.4

    6.5

    0.2

    5.9

    0.3

    Shivering

    4.2

    0.4

    5.0

    0.3

    4.3

    0.2

    Feverh

    1.6

    0.0

    1.2

    0.0

    1.5

    0.0

    Total vaccinated cohort for safety included all vaccinated subjects for whom safety data were available. n = number of subjects with diary card completed.

    a Seven days included day of vaccination and the subsequent 6 days.

    b Trial 1: NCT01204671.

    c Contained the same composition as FLUARIX (trivalent formulation) manufactured for the 2010-2011 season and an additional influenza type B virus of Yamagata lineage.

    d Contained the same composition as FLUARIX manufactured for the 2010-2011 season (2 influenza A subtype viruses and an influenza type B virus of Victoria lineage).

    e Contained the same 2 influenza A subtype viruses as FLUARIX manufactured for the 2010-2011 season and an influenza type B virus of Yamagata lineage.

    f Grade 3 pain: Defined as significant pain at rest; prevented normal everyday activities.
    Grade 3 redness, swelling: Defined as >100 mm.
    Grade 3 muscle aches, headache, fatigue, arthralgia, gastrointestinal symptoms, shivering: Defined as prevented normal activity.
    Grade 3 fever: Defined as >102.2°F (39.0°C).

    g Gastrointestinal symptoms included nausea, vomiting, diarrhea, and/or abdominal pain.

    h Fever: Defined as ≥99.5°F (37.5°C).

    Unsolicited events occurring within 21 days of vaccination (Day 0 to 20) were reported in 13%, 14%, and 15% of subjects who received FLUARIX QUADRIVALENT, TIV-1, or TIV-2, respectively. The unsolicited adverse reactions that occurred most frequently (≥0.1% for FLUARIX QUADRIVALENT) included dizziness, injection site hematoma, injection site pruritus, and rash. Serious adverse events occurring within 21 days of vaccination were reported in 0.5%, 0.6%, and 0.2% of subjects who received FLUARIX QUADRIVALENT, TIV-1, or TIV-2, respectively.

    FLUARIX QUADRIVALENT in Children

    Trial 2 (NCT01196988) was a randomized, double-blind, active-controlled, safety, and immunogenicity trial. In this trial, subjects received FLUARIX QUADRIVALENT (n = 915) or one of 2 formulations of comparator trivalent influenza vaccine (FLUARIX, TIV-1, n = 912 or TIV-2, n = 911), each containing an influenza type B virus that corresponded to one of the 2 type B viruses in FLUARIX QUADRIVALENT (a type B virus of the Victoria lineage or a type B virus of the Yamagata lineage). Subjects were aged 3 through 17 years and 52% were male; 56% were white, 29% were Asian, 12% were black, and 3% were of other racial/ethnic groups. Children aged 3 through 8 years with no history of influenza vaccination received 2 doses approximately 28 days apart. Children aged 3 through 8 years with a history of influenza vaccination and children aged 9 years and older received one dose. Solicited local adverse reactions and systemic adverse events were collected using diary cards for 7 days (day of vaccination and the next 6 days). The frequencies of solicited adverse events are shown in Table 3.

    Table 3. FLUARIX QUADRIVALENT: Incidence of Solicited Local Adverse Reactions and Systemic Adverse Events within 7 Daysa after First Vaccination in Children Aged 3 through 17 Yearsb (Total Vaccinated Cohort)

    Trivalent Influenza Vaccine (TIV)

    FLUARIX QUADRIVALENTc

    %

    TIV-1

    (B Victoria)d

    %

    TIV-2

    (B Yamagata)e

    %

    Any

    Grade 3f

    Any

    Grade 3f

    Any

    Grade 3f

    Aged 3 through 17 Years

    Local

    n = 903

    n = 901

    n = 905

    Paing

    43.7

    1.6

    42.4

    1.8

    40.3

    0.8

    Redness

    23.0

    1.0

    21.3

    0.2

    20.9

    0.7

    Swelling

    18.5

    0.8

    17.2

    1.1

    14.9

    0.2

    Aged 3 through 5 Years

    Systemic

    n = 291

    n = 314

    n = 279

    Drowsiness

    17.2

    1.0

    12.4

    0.3

    13.6

    0.7

    Irritability

    16.8

    0.7

    13.4

    0.3

    14.3

    0.7

    Loss of appetite

    15.5

    0.3

    8.0

    0.0

    10.4

    0.7

    Feverh

    8.9

    0.3

    8.9

    0.3

    8.2

    1.1

    Aged 6 through 17 Years

    Systemic

    n = 613

    n = 588

    n = 626

    Fatigue

    19.7

    1.5

    18.5

    1.4

    15.5

    0.5

    Muscle aches

    17.5

    0.7

    16.0

    1.4

    15.8

    0.5

    Headache

    16.3

    1.3

    19.2

    0.7

    15.2

    0.6

    Arthralgia

    9.8

    0.3

    9.4

    0.7

    7.3

    0.2

    Gastrointestinal symptomsi

    9.8

    1.0

    9.5

    0.7

    7.2

    0.3

    Shivering

    6.4

    0.5

    4.4

    0.5

    5.0

    0.0

    Feverh

    6.0

    1.1

    8.5

    0.5

    6.1

    0.3

    Total vaccinated cohort for safety included all vaccinated subjects for whom safety data were available. n = number of subjects with diary card completed.

    a Seven days included day of vaccination and the subsequent 6 days.

    b Trial 2: NCT01196988.

    c Contained the same composition as FLUARIX (trivalent formulation) manufactured for the 2010-2011 season and an additional influenza type B virus of Yamagata lineage.

    d Contained the same composition as FLUARIX manufactured for the 2010-2011 season (2 influenza A subtype viruses and an influenza type B virus of Victoria lineage).

    e Contained the same 2 influenza A subtype viruses as FLUARIX manufactured for the 2010-2011 season and an influenza type B virus of Yamagata lineage.

    f Grade 3 pain: Defined as cried when limb was moved/spontaneously painful (children ˂6 years), or significant pain at rest, prevented normal everyday activities (children ≥6 years).
    Grade 3 redness, swelling: Defined as >50 mm.
    Grade 3 drowsiness: Defined as prevented normal activity.
    Grade 3 irritability: Defined as crying that could not be comforted/prevented normal activity.
    Grade 3 loss of appetite: Defined as not eating at all.
    Grade 3 fever: Defined as >102.2°F (39.0°C).
    Grade 3 fatigue, muscle aches, headache, arthralgia, gastrointestinal symptoms, shivering: Defined as prevented normal activity.

    g Percentage of subjects with any pain by age subgroup: 39%, 38%, and 37% for FLUARIX QUADRIVALENT, TIV-1, and   TIV-2, respectively, in children aged 3 through 8 years and 52%, 50%, and 46% for FLUARIX QUADRIVALENT,   TIV-1, and TIV-2, respectively, in children aged 9 through 17 years.

    h Fever: Defined as ≥99.5°F (37.5°C).

    i Gastrointestinal symptoms included nausea, vomiting, diarrhea, and/or abdominal pain.

    In children who received a second dose of FLUARIX QUADRIVALENT, TIV-1, or TIV-2, the incidences of adverse events following the second dose were generally lower than those observed after the first dose.

    Unsolicited adverse events occurring within 28 days of any vaccination were reported in 31%, 33%, and 34% of subjects who received FLUARIX QUADRIVALENT, TIV-1, or TIV-2, respectively. The unsolicited adverse reactions that occurred most frequently (≥0.1% for FLUARIX QUADRIVALENT) included injection site pruritus and rash. Serious adverse events occurring within 28 days of any vaccination were reported in 0.1%, 0.1%, and 0.1% of subjects who received FLUARIX QUADRIVALENT, TIV-1, or TIV-2, respectively.

    FLUARIX (Trivalent Formulation)

    FLUARIX has been administered to 10,317 adults aged 18 through 64 years, 606 subjects aged 65 years and older, and 2,115 children aged 6 months through 17 years in clinical trials. The incidence of solicited adverse events in each age-group is shown in Tables 4 and 5.

    Table 4. FLUARIX (Trivalent Formulation): Incidence of Solicited Local Adverse Reactions and Systemic Adverse Events within 4 Daysa of Vaccination in Adults (Total Vaccinated Cohort)

    Trial 3b

    Trial 4c

    Aged 18 through 64 Years

    Aged 65 Years and Older

    FLUARIX

    n = 760

    %

    Placebo

    n = 192

    %

    FLUARIX

    n = 601-602

    %

    Comparator

    n = 596

    %

    Any

    Gr 3d

    Any

    Gr 3d

    Any

    Gr 3d

    Any

    Gr 3d

    Local

    Pain

    54.7

    0.1

    12.0

    0.0

    19.1

    0.0

    17.6

    0.0

    Redness

    17.5

    0.0

    10.4

    0.0

    10.6

    0.2

    13.1

    0.7

    Swelling

    9.3

    0.1

    5.7

    0.0

    6.0

    0.0

    8.9

    0.7

    Systemic

    Muscle aches

    23.0

    0.4

    12.0

    0.5

    7.0

    0.3

    6.5

    0.0

    Fatigue

    19.7

    0.4

    17.7

    1.0

    9.0

    0.3

    9.6

    0.7

    Headache

    19.3

    0.1

    21.4

    1.0

    7.5

    0.3

    7.9

    0.3

    Arthralgia

    6.4

    0.1

    6.3

    0.5

    5.5

    0.5

    5.0

    0.2

    Shivering

    3.3

    0.1

    2.6

    0.0

    1.7

    0.2

    2.2

    0.0

    Fevere

    1.7

    0.0

    1.6

    0.0

    1.7

    0.0

    0.5

    0.0

    Total vaccinated cohort for safety included all vaccinated subjects for whom safety data were available. n = number of subjects with diary card completed. Gr 3 = Grade 3.

    a Four days included day of vaccination and the subsequent 3 days.

    b Trial 3 was a randomized, double-blind, placebo-controlled, safety, and immunogenicity trial (NCT00100399).

    c Trial 4 was a randomized, single-blind, active-controlled, safety, and immunogenicity trial (NCT00197288). The active   control was FLUZONE®, a U.S.-licensed trivalent, inactivated influenza vaccine (Sanofi Pasteur Inc.).

    d Grade 3 pain, muscle aches, fatigue, headache, arthralgia, shivering: Defined as prevented normal activity.
    Grade 3 redness, swelling: Defined as >50 mm.
    Grade 3 fever: Defined as >102.2°F (39.0°C).

    e Fever: Defined as ≥100.4°F (38.0°C) in Trial 3, and ≥99.5°F (37.5°C) in Trial 4.

    Table 5. FLUARIX (Trivalent Formulation): Incidence of Solicited Local Adverse Reactions and Systemic Adverse Events within 4 Daysa of First Vaccination in Children Aged 3 through 17 Yearsb (Total Vaccinated Cohort)

    Aged 3 through 4 Years

    Aged 5 through 17 Years

    FLUARIX

    n = 350

    %

    Comparator

    n = 341

    %

    FLUARIX

    n = 1,348

    %

    Comparator

    n = 451

    %

    Any

    Gr 3c

    Any

    Gr 3c

    Any

    Gr 3c

    Any

    Gr 3c

    Local

    Pain

    34.9

    1.7

    38.4

    1.2

    56.2

    0.8

    56.1

    0.7

    Redness

    22.6

    0.3

    19.9

    0.0

    17.7

    1.0

    16.4

    0.7

    Swelling

    13.7

    0.0

    13.2

    0.0

    13.9

    1.5

    13.3

    0.7

    Systemic

    Irritability

    20.9

    0.9

    22.0

    0.0

    Loss of appetite

    13.4

    0.9

    15.0

    0.9

    Drowsiness

    13.1

    0.6

    19.6

    0.9

    Feverd

    6.6

    1.4

    7.6

    1.5

    4.2

    0.3

    3.3

    0.2

    Muscle aches

    28.8

    0.4

    28.8

    0.4

    Fatigue

    19.9

    1.0

    18.8

    1.1

    Headache

    15.1

    0.5

    16.4

    0.9

    Arthralgia

    5.6

    0.1

    6.2

    0.2

    Shivering

    3.1

    0.1

    3.5

    0.2

    Total vaccinated cohort for safety included all vaccinated subjects for whom safety data were available. n = number of subjects with diary card completed. Gr 3 = Grade 3.

    a Four days included day of vaccination and the subsequent 3 days.

    b Trial 6 was a single-blind, active-controlled, safety, and immunogenicity U.S. trial (NCT00383123). The active control was FLUZONE, a U.S.-licensed trivalent, inactivated influenza vaccine (Sanofi Pasteur Inc.).

    c Grade 3 pain, irritability, loss of appetite, drowsiness, muscle aches, fatigue, headache, arthralgia, shivering: Defined as prevented normal activity.
    Grade 3 swelling, redness: Defined as >50 mm.
    Grade 3 fever: Defined as >102.2°F (39.0°C).

    d Fever: Defined as ≥99.5°F (37.5°C).

    In children who received a second dose of FLUARIX or the comparator vaccine, the incidences of adverse events following the second dose were similar to those observed after the first dose.

    Serious Adverse Events: In the 4 clinical trials in adults (N = 10,923), there was a single case of anaphylaxis within one day following administration of FLUARIX (<0.01%).

    6.2 Postmarketing Experience

    Beyond those events reported above in the clinical trials for FLUARIX QUADRIVALENT or FLUARIX, the following adverse events have been spontaneously reported during postapproval use of FLUARIX (trivalent influenza vaccine). This list includes serious events or events which have causal connection to FLUARIX. Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to the vaccine.

    Blood and Lymphatic System Disorders

    Lymphadenopathy.

    Cardiac Disorders

    Tachycardia.

    Ear and Labyrinth Disorders

    Vertigo.

    Eye Disorders

    Conjunctivitis, eye irritation, eye pain, eye redness, eye swelling, eyelid swelling.

    Gastrointestinal Disorders

    Abdominal pain or discomfort, swelling of the mouth, throat, and/or tongue.

    General Disorders and Administration Site Conditions

    Asthenia, chest pain, feeling hot, injection site mass, injection site reaction, injection site warmth, body aches.

    Immune System Disorders

    Anaphylactic reaction including shock, anaphylactoid reaction, hypersensitivity, serum sickness.

    Infections and Infestations

    Injection site abscess, injection site cellulitis, pharyngitis, rhinitis, tonsillitis.

    Nervous System Disorders

    Convulsion, encephalomyelitis, facial palsy, facial paresis, Guillain-Barré syndrome, hypoesthesia, myelitis, neuritis, neuropathy, paresthesia, syncope.

    Respiratory, Thoracic, and Mediastinal Disorders

    Asthma, bronchospasm, dyspnea, respiratory distress, stridor.

    Skin and Subcutaneous Tissue Disorders

    Angioedema, erythema, erythema multiforme, facial swelling, pruritus, Stevens-Johnson syndrome, sweating, urticaria.

    Vascular Disorders

    Henoch-Schönlein purpura, vasculitis.

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  • 7 DRUG INTERACTIONS

    7.1 Concomitant Vaccine Administration

    FLUARIX QUADRIVALENT should not be mixed with any other vaccine in the same syringe or vial.

    There are insufficient data to assess the concurrent administration of FLUARIX QUADRIVALENT with other vaccines. When concomitant administration of other vaccines is required, the vaccines should be administered at different injection sites.

    7.2 Immunosuppressive Therapies

    Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs, and corticosteroids (used in greater-than-physiologic doses), may reduce the immune response to FLUARIX QUADRIVALENT.

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  • 8 USE IN SPECIFIC POPULATIONS

    8.1 Pregnancy

    Pregnancy Exposure Registry

    There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to FLUARIX QUADRIVALENT during pregnancy. Healthcare providers are encouraged to register women by calling 1-888-452-9622.

    Risk Summary

    All pregnancies have a risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

    There are insufficient data on FLUARIX QUADRIVALENT in pregnant women to inform vaccine-associated risks.

    A developmental toxicity study was performed in female rats administered FLUARIX QUADRIVALENT prior to mating and during gestation and lactation periods. The total dose was 0.2 mL at each occasion (a single human dose is 0.5 mL). This study revealed no adverse effects on fetal or pre-weaning development due to FLUARIX QUADRIVALENT [see Data].

    Clinical Considerations

    Disease-Associated Maternal and/or Embryo/Fetal Risk: Pregnant women infected with seasonal influenza are at increased risk of severe illness associated with influenza infection compared with non-pregnant women. Pregnant women with influenza may be at increased risk for adverse pregnancy outcomes, including preterm labor and delivery.

    Data

    Animal Data: In a developmental toxicity study, female rats were administered FLUARIX QUADRIVALENT by intramuscular injection 4 and 2 weeks prior to mating, on gestation Days 3, 8, 11, and 15, and on lactation Day 7. The total dose was 0.2 mL at each occasion (a single human dose is 0.5 mL). No adverse effects on pre-weaning development up to post-natal Day 25 were observed. There were no vaccine-related fetal malformations or variations.

    8.2 Lactation

    Risk Summary

    It is not known whether FLUARIX QUADRIVALENT is excreted in human milk. Data are not available to assess the effects of FLUARIX QUADRIVALENT on the breastfed infant or on milk production/excretion. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for FLUARIX QUADRIVALENT and any potential adverse effects on the breastfed child from FLUARIX QUADRIVALENT or from the underlying maternal condition. For preventive vaccines, the underlying maternal condition is susceptibility to disease prevented by the vaccine.

    8.4 Pediatric Use

    Safety and effectiveness of FLUARIX QUADRIVALENT in children younger than 3 years have not been established.

    Safety and immunogenicity of FLUARIX QUADRIVALENT in children aged 3 through 17 years have been evaluated [see Adverse Reactions (6.1), Clinical Studies (14.3)].

    8.5 Geriatric Use

    In a randomized, double-blind (2 arms) and open-label (one arm), active-controlled trial, immunogenicity and safety were evaluated in a cohort of subjects aged 65 years and older who received FLUARIX QUADRIVALENT (n = 1,517); 469 of these subjects were aged 75 years and older. In subjects aged 65 years and older, the geometric mean antibody titers (GMTs) post-vaccination and seroconversion rates were lower than in younger subjects (aged 18 through 64 years) and the frequencies of solicited and unsolicited adverse events were generally lower than in younger subjects.

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  • 11 DESCRIPTION

    FLUARIX QUADRIVALENT, Influenza Vaccine, for intramuscular injection, is a sterile, colorless, and slightly opalescent suspension. FLUARIX QUADRIVALENT is prepared from influenza viruses propagated in embryonated chicken eggs. Each of the influenza viruses is produced and purified separately. After harvesting the virus-containing fluids, each influenza virus is concentrated and purified by zonal centrifugation using a linear sucrose density gradient solution containing detergent to disrupt the viruses. Following dilution, the vaccine is further purified by diafiltration. Each influenza virus solution is inactivated by the consecutive effects of sodium deoxycholate and formaldehyde leading to the production of a “split virus.” Each split inactivated virus is then suspended in sodium phosphate-buffered isotonic sodium chloride solution. Each vaccine is formulated from the split inactivated virus solutions.

    FLUARIX QUADRIVALENT has been standardized according to US Public Health Service (USPHS) requirements for the 2016‑2017 influenza season and is formulated to contain 60 micrograms (mcg) hemagglutinin (HA) per 0.5‑mL dose, in the recommended ratio of 15 mcg HA of each of the following 4 influenza virus strains: A/Christchurch/16/2010 (H1N1) NIB‑74XP (an A/California/7/2009 (H1N1) pdm09-like virus), A/Hong Kong/4801/2014 (H3N2) NYMC X-263B, B/Phuket/3073/2013, and B/Brisbane/60/2008.

    FLUARIX QUADRIVALENT is formulated without preservatives. FLUARIX QUADRIVALENT does not contain thimerosal. Each 0.5‑mL dose also contains octoxynol-10 (TRITON® X-100) ≤0.115 mg, α-tocopheryl hydrogen succinate ≤0.135 mg, and polysorbate 80 (Tween 80) ≤0.550 mg. Each dose may also contain residual amounts of hydrocortisone ≤0.0016 mcg, gentamicin sulfate ≤0.15 mcg, ovalbumin ≤0.050 mcg, formaldehyde ≤5 mcg, and sodium deoxycholate ≤65 mcg from the manufacturing process.

    The tip caps and plungers of the prefilled syringes of FLUARIX QUADRIVALENT are not made with natural rubber latex.

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  • 12 CLINICAL PHARMACOLOGY

    12.1 Mechanism of Action

    Influenza illness and its complications follow infection with influenza viruses. Global surveillance of influenza identifies yearly antigenic variants. Since 1977, antigenic variants of influenza A (H1N1 and H3N2) viruses and influenza B viruses have been in global circulation.

    Public health authorities give annual influenza vaccine composition recommendations. Inactivated influenza vaccines are standardized to contain the hemagglutinins of influenza viruses representing the virus types or subtypes likely to circulate in the United States during the influenza season. Two influenza type B virus lineages (Victoria and Yamagata) are of public health importance because they have co-circulated since 2001. FLUARIX (trivalent influenza vaccine) contains 2 influenza A subtype viruses and one influenza type B virus.

    Specific levels of hemagglutination-inhibition (HI) antibody titer post-vaccination with inactivated influenza virus vaccines have not been correlated with protection from influenza illness but the HI antibody titers have been used as a measure of vaccine activity. In some human challenge studies, HI antibody titers of ≥1:40 have been associated with protection from influenza illness in up to 50% of subjects.1,2 Antibody against one influenza virus type or subtype confers little or no protection against another virus. Furthermore, antibody to one antigenic variant of influenza virus might not protect against a new antigenic variant of the same type or subtype. Frequent development of antigenic variants through antigenic drift is the virological basis for seasonal epidemics and the reason for the usual replacement of one or more influenza viruses in each year’s influenza vaccine.

    Annual revaccination is recommended because immunity declines during the year after vaccination, and because circulating strains of influenza virus change from year to year.

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  • 13 NONCLINICAL TOXICOLOGY

    13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

    FLUARIX QUADRIVALENT has not been evaluated for carcinogenic or mutagenic potential or male infertility in animals. Vaccination of female rats with FLUARIX QUADRIVALENT had no effect on fertility [see Use in Specific Populations (8.1)].

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  • 14 CLINICAL STUDIES

    14.1 Efficacy against Culture-Confirmed Influenza

    The efficacy experience with FLUARIX is relevant to FLUARIX QUADRIVALENT because both vaccines are manufactured using the same process and have overlapping compositions [see Description (11)].

    The efficacy of FLUARIX was evaluated in a randomized, double-blind, placebo-controlled trial conducted in 2 European countries during the 2006-2007 influenza season. Efficacy of FLUARIX, containing A/New Caledonia/20/1999 (H1N1), A/Wisconsin/67/2005 (H3N2), and B/Malaysia/2506/2004 influenza virus strains, was defined as the prevention of culture-confirmed influenza A and/or B cases, for vaccine antigenically matched strains, compared with placebo. Healthy subjects aged 18 through 64 years (mean age: 40 years) were randomized (2:1) to receive FLUARIX (n = 5,103) or placebo (n = 2,549) and monitored for influenza-like illnesses (ILI) starting 2 weeks post-vaccination and lasting for approximately 7 months. In the overall population, 60% of subjects were female and 99.9% were white. Culture-confirmed influenza was assessed by active and passive surveillance of ILI. Influenza-like illness was defined as at least one general symptom (fever ≥100°F and/or myalgia) and at least one respiratory symptom (cough and/or sore throat). After an episode of ILI, nose and throat swab samples were collected for analysis; attack rates and vaccine efficacy were calculated (Table 6).

    Table 6. FLUARIX (Trivalent Formulation): Attack Rates and Vaccine Efficacy against Culture-Confirmed Influenza A and/or B in Adults (Total Vaccinated Cohort)

    Attack Rates (n/N)

    Vaccine Efficacy

    N

    n

    %

    %

    LL

    UL

    Antigenically Matched Strainsa

    FLUARIX

    5,103

    49

    1.0

    66.9b

    51.9

    77.4

    Placebo

    2,549

    74

    2.9

    All Culture-Confirmed Influenza (Matched, Unmatched, and Untyped)c

    FLUARIX

    5,103

    63

    1.2

    61.6b

    46.0

    72.8

    Placebo

    2,549

    82

    3.2

    a There were no vaccine matched culture-confirmed cases of A/New Caledonia/20/1999 (H1N1) or B/Malaysia/2506/2004 influenza virus strains with FLUARIX or placebo.

    b Vaccine efficacy for FLUARIX exceeded a pre-defined threshold of 35% for the lower limit of the 2-sided 95% CI.

    c Of the 22 additional cases, 18 were unmatched and 4 were untyped; 15 of the 22 cases were A (H3N2) (11 cases with FLUARIX and 4 cases with placebo).

    In a post-hoc, exploratory analysis by age, vaccine efficacy (against culture-confirmed influenza A and/or B cases, for vaccine antigenically matched strains) in subjects aged 18 through 49 years was 73.4% (95% CI: 59.3, 82.8) (number of influenza cases: FLUARIX [n = 35/3,602] and placebo [n = 66/1,810]). In subjects aged 50 through 64 years, vaccine efficacy was 13.8% (95% CI: ‑137.0, 66.3) (number of influenza cases: FLUARIX [n = 14/1,501] and placebo [n = 8/739]). As the trial lacked statistical power to evaluate efficacy within age subgroups, the clinical significance of these results is unknown.

    14.2 Immunological Evaluation of FLUARIX QUADRIVALENT in Adults

    Trial 1 was a randomized, double-blind (2 arms) and open-label (one arm), active-controlled, safety, immunogenicity, and non-inferiority trial. In this trial, subjects received FLUARIX QUADRIVALENT (n = 1,809) or one of 2 formulations of comparator trivalent influenza vaccine (FLUARIX, TIV-1, n = 608 or TIV-2, n = 534), each containing an influenza type B virus that corresponded to one of the 2 type B viruses in FLUARIX QUADRIVALENT (a type B virus of the Victoria lineage or a type B virus of the Yamagata lineage). Subjects aged 18 years and older (mean age: 58 years) were evaluated for immune responses to each of the vaccine antigens 21 days following vaccination. In the overall population, 57% of subjects were female; 69% were white, 27% were Asian, and 4% were of other racial/ethnic groups.

    The immunogenicity endpoints were GMTs of serum hemagglutination-inhibition (HI) antibodies adjusted for baseline, and the percentage of subjects who achieved seroconversion, defined as a pre-vaccination HI titer of <1:10 with a post-vaccination titer ≥1:40 or at least a 4‑fold increase in serum HI antibody titer over baseline to ≥1:40 following vaccination, performed on the According-to-Protocol (ATP) cohort for whom immunogenicity assay results were available after vaccination. FLUARIX QUADRIVALENT was non‑inferior to both TIVs based on adjusted GMTs (upper limit of the 2‑sided 95% CI for the GMT ratio [TIV/FLUARIX QUADRIVALENT] ≤1.5) and seroconversion rates (upper limit of the 2‑sided 95% CI on difference of the TIV minus FLUARIX QUADRIVALENT ≤10%). The antibody response to influenza B strains contained in FLUARIX QUADRIVALENT was higher than the antibody response after vaccination with a TIV containing an influenza B strain from a different lineage. There was no evidence that the addition of the second B strain resulted in immune interference to other strains included in the vaccine (Table 7).

    Table 7. FLUARIX QUADRIVALENT: Immune Responses to Each Antigen 21 Days after Vaccination in Adults (ATP Cohort for Immunogenicity)

    FLUARIX QUADRIVALENTa

    Trivalent Influenza Vaccine (TIV)

    TIV-1

    (B Victoria)b

    TIV-2

    (B Yamagata)c

    GMTs

    n = 1,809

    (95% CI)

    n = 608

    (95% CI)

    n = 534

    (95% CI)

    A/California/7/2009 (H1N1)

    201.1

    (188.1, 215.1)

    218.4

    (194.2, 245.6)

    213.0

    (187.6, 241.9)

    A/Victoria/210/2009 (H3N2)

    314.7

    (296.8, 333.6)

    298.2

    (268.4, 331.3)

    340.4

    (304.3, 380.9)

    B/Brisbane/60/2008 (Victoria lineage)

    404.6

    (386.6, 423.4)

    393.8

    (362.7, 427.6)

    258.5

    (234.6, 284.8)

    B/Brisbane/3/2007 (Yamagata lineage)

    601.8

    (573.3, 631.6)

    386.6

    (351.5, 425.3)

    582.5

    (534.6, 634.7)

    Seroconversiond

    n = 1,801

    %

    (95% CI)

    n = 605

    %

    (95% CI)

    n = 530

    %

    (95% CI)

    A/California/7/2009 (H1N1)

    77.5

    (75.5, 79.4)

    77.2

    (73.6, 80.5)

    80.2

    (76.5, 83.5)

    A/Victoria/210/2009 (H3N2)

    71.5

    (69.3, 73.5)

    65.8

    (61.9, 69.6)

    70.0

    (65.9, 73.9)

    B/Brisbane/60/2008 (Victoria lineage)

    58.1

    (55.8, 60.4)

    55.4

    (51.3, 59.4)

    47.5

    (43.2, 51.9)

    B/Brisbane/3/2007 (Yamagata lineage)

    61.7

    (59.5, 64.0)

    45.6

    (41.6, 49.7)

    59.1

    (54.7, 63.3)

    ATP = According‑to‑protocol; GMT = Geometric mean antibody titer; CI = Confidence Interval.

    ATP cohort for immunogenicity included subjects for whom assay results were available after vaccination for at least one trial vaccine antigen.

    a Contained the same composition as FLUARIX (trivalent formulation) manufactured for the 2010-2011 season and an additional influenza type B virus of Yamagata lineage.

    b Contained the same composition as FLUARIX manufactured for the 2010-2011 season (2 influenza A subtype viruses and an influenza type B virus of Victoria lineage).

    c Contained the same 2 influenza A subtype viruses as FLUARIX manufactured for the 2010-2011 season and an influenza type B virus of Yamagata lineage.

    d Seroconversion defined as a pre-vaccination HI titer of <1:10 with a post-vaccination titer ≥1:40 or at least a 4-fold increase in serum titers of HI antibodies to ≥1:40.

    14.3 Immunological Evaluation of FLUARIX QUADRIVALENT in Children

    Trial 2 was a randomized, double-blind, active-controlled, safety, immunogenicity, and non-inferiority trial. In this trial, subjects received FLUARIX QUADRIVALENT (n = 791) or one of 2 formulations of comparator trivalent influenza vaccine (FLUARIX, TIV-1, n = 819 or TIV-2, n = 801), each containing an influenza type B virus that corresponded to one of the 2 type B viruses in FLUARIX QUADRIVALENT (a type B virus of the Victoria lineage or a type B virus of the Yamagata lineage). In children aged 3 through 17 years, immune responses to each of the vaccine antigens were evaluated in sera 28 days following 1 or 2 doses. In the overall population, 52% of subjects were male; 56% were white, 29% were Asian, 12% were black, and 3% were of other racial/ethnic groups.

    The immunogenicity endpoints were GMTs adjusted for baseline, and the percentage of subjects who achieved seroconversion, defined as a pre-vaccination HI titer of <1:10 with a post-vaccination titer ≥1:40 or at least a 4‑fold increase in serum HI titer over baseline to ≥1:40, following vaccination, performed on the ATP cohort for whom immunogenicity assay results were available after vaccination. FLUARIX QUADRIVALENT was non-inferior to both TIVs based on adjusted GMTs (upper limit of the 2‑sided 95% CI for the GMT ratio [TIV/FLUARIX QUADRIVALENT] ≤1.5) and seroconversion rates (upper limit of the 2‑sided 95% CI on difference of the TIV minus FLUARIX QUADRIVALENT ≤10%). The antibody response to influenza B strains contained in FLUARIX QUADRIVALENT was higher than the antibody response after vaccination with a TIV containing an influenza B strain from a different lineage. There was no evidence that the addition of the second B strain resulted in immune interference to other strains included in the vaccine (Table 8).

    Table 8. FLUARIX QUADRIVALENT: Immune Responses to Each Antigen 28 Days after Last Vaccination in Children Aged 3 through 17 Years (ATP Cohort for Immunogenicity)

    FLUARIX QUADRIVALENTa

    Trivalent Influenza Vaccine (TIV)

    TIV-1

    (B Victoria)b

    TIV-2

    (B Yamagata)c

    GMTs

    n = 791

    (95% CI)

    n = 818

    (95% CI)

    n = 801

    (95% CI)

    A/California/7/2009 (H1N1)

    386.2

    (357.3, 417.4)

    433.2

    (401.0, 468.0)

    422.3

    (390.5, 456.5)

    A/Victoria/210/2009 (H3N2)

    228.8

    (215.0, 243.4)

    227.3

    (213.3, 242.3)

    234.0

    (219.1, 249.9)

    B/Brisbane/60/2008 (Victoria lineage)

    244.2

    (227.5, 262.1)

    245.6

    (229.2, 263.2)

    88.4

    (81.5, 95.8)

    B/Brisbane/3/2007 (Yamagata lineage)

    569.6

    (533.6, 608.1)

    224.7

    (207.9, 242.9)

    643.3

    (603.2, 686.1)

    Seroconversiond

    n = 790

    %

    (95% CI)

    n = 818

    %

    (95% CI)

    n = 800

    %

    (95% CI)

    A/California/7/2009 (H1N1)

    91.4

    (89.2, 93.3)

    89.9

    (87.6, 91.8)

    91.6

    (89.5, 93.5)

    A/Victoria/210/2009 (H3N2)

    72.3

    (69.0, 75.4)

    70.7

    (67.4, 73.8)

    71.9

    (68.6, 75.0)

    B/Brisbane/60/2008 (Victoria lineage)

    70.0

    (66.7, 73.2)

    68.5

    (65.2, 71.6)

    29.6

    (26.5, 32.9)

    B/Brisbane/3/2007 (Yamagata lineage)

    72.5

    (69.3, 75.6)

    37.0

    (33.7, 40.5)

    70.8

    (67.5, 73.9)

    ATP = According‑to‑protocol; GMT = Geometric mean antibody titer; CI = Confidence Interval.

    ATP cohort for immunogenicity included subjects for whom assay results were available after vaccination for at least one trial vaccine antigen.

    a Contained the same composition as FLUARIX (trivalent formulation) manufactured for the 2010-2011 season and an additional influenza type B virus of Yamagata lineage.

    b Contained the same composition as FLUARIX manufactured for the 2010-2011 season (2 influenza A subtype viruses and an influenza type B virus of Victoria lineage).

    c Contained the same 2 influenza A subtype viruses as FLUARIX manufactured for the 2010-2011 season and an influenza B virus of Yamagata lineage.

    d Seroconversion defined as a pre-vaccination HI titer of <1:10 with a post-vaccination titer ≥1:40 or at least a 4-fold increase in serum titers of HI antibodies to ≥1:40.

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  • 15 REFERENCES

    1.
    Hannoun C, Megas F, Piercy J. Immunogenicity and protective efficacy of influenza vaccination. Virus Res. 2004;103:133-138.
    2.
    Hobson D, Curry RL, Beare AS, et al. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J Hyg Camb. 1972;70:767-777.
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  • 16 HOW SUPPLIED/STORAGE AND HANDLING

    NDC 58160-905-41 Syringe in Package of 10: NDC 58160-905-52

    Store refrigerated between 2º and 8ºC (36º and 46ºF). Do not freeze. Discard if the vaccine has been frozen. Store in the original package to protect from light.

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  • 17 PATIENT COUNSELING INFORMATION

    Provide the following information to the vaccine recipient or guardian:

    Inform of the potential benefits and risks of immunization with FLUARIX QUADRIVALENT.
    Educate regarding potential side effects, emphasizing that: (1) FLUARIX QUADRIVALENT contains non‑infectious killed viruses and cannot cause influenza and (2) FLUARIX QUADRIVALENT is intended to provide protection against illness due to influenza viruses only, and cannot provide protection against all respiratory illness.
    Encourage women exposed to FLUARIX QUADRIVALENT during pregnancy to enroll in the pregnancy registry [see Use in Specific Populations (8.1)].
    Give the Vaccine Information Statements, which are required by the National Childhood Vaccine Injury Act of 1986 prior to each immunization. These materials are available free of charge at the Centers for Disease Control and Prevention (CDC) website ( www.cdc.gov/vaccines).
    Instruct that annual revaccination is recommended.

    FLUARIX and TIP‑LOK are registered trademarks of the GSK group of companies. The other brands listed are trademarks of their respective owners and are not trademarks of the GSK group of companies. The makers of these brands are not affiliated with and do not endorse the GSK group of companies or its products.

    Manufactured by GlaxoSmithKline Biologicals, Dresden, Germany,

    a branch of SmithKline Beecham Pharma GmbH & Co. KG, Munich, Germany

    Licensed by GlaxoSmithKline Biologicals, Rixensart, Belgium, U.S. License 1617

    Distributed by GlaxoSmithKline, Research Triangle Park, NC 27709

    ©2016 the GSK group of companies. All rights reserved.

    FLQ:7PI

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  • PRINCIPAL DISPLAY PANEL

    PRINCIPAL DISPLAY PANEL

    NDC 58160-905-52

    FLUARIX® QUADRIVALENT

    Influenza Vaccine

    2016/2017 Formula

    Rx only

    10 Disposable Prefilled Tip-Lok® Syringes

    each containing one 0.5 mL dose

    Tip-Lok® Syringes are compatible

    with Luer-Lok® Needles

    For 3 Years of Age and Older

    NEEDLES NOT INCLUDED

    FOR INTRAMUSCULAR ADMINISTRATION ONLY

    GlaxoSmithKline

    ©2016 the GSK group of companies

    Rev. 3/16

    481037

    Fluarix Quadrivalent 2016-2017 10 count carton
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  • INGREDIENTS AND APPEARANCE
    FLUARIX QUADRIVALENT  2016/2017
    influenza virus vaccine suspension
    Product Information
    Product Type VACCINE Item Code (Source) NDC:58160-905
    Route of Administration INTRAMUSCULAR
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    INFLUENZA A VIRUS A/CHRISTCHURCH/16/2010 NIB-74XP (H1N1) ANTIGEN (FORMALDEHYDE INACTIVATED) (UNII: F6VKT8IL26) (INFLUENZA A VIRUS A/CHRISTCHURCH/16/2010 NIB-74XP (H1N1) HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) - UNII:9PM6202D07) INFLUENZA A VIRUS A/CHRISTCHURCH/16/2010 NIB-74XP (H1N1) HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) 15 ug  in 0.5 mL
    INFLUENZA A VIRUS A/HONG KONG/4801/2014 X-263B (H3N2) ANTIGEN (FORMALDEHYDE INACTIVATED) (UNII: WSU74R91RL) (INFLUENZA A VIRUS A/HONG KONG/4801/2014 X-263B (H3N2) HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) - UNII:BAA3UN7VWD) INFLUENZA A VIRUS A/HONG KONG/4801/2014 X-263B (H3N2) HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) 15 ug  in 0.5 mL
    INFLUENZA B VIRUS B/PHUKET/3073/2013 ANTIGEN (FORMALDEHYDE INACTIVATED) (UNII: B93BQX9789) (INFLUENZA B VIRUS B/PHUKET/3073/2013 HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) - UNII:9HB0XUS9TM) INFLUENZA B VIRUS B/PHUKET/3073/2013 HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) 15 ug  in 0.5 mL
    INFLUENZA B VIRUS B/BRISBANE/60/2008 ANTIGEN (FORMALDEHYDE INACTIVATED) (UNII: W45Z4CJE2J) (INFLUENZA B VIRUS B/BRISBANE/60/2008 HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) - UNII:166D8OWM7B) INFLUENZA B VIRUS B/BRISBANE/60/2008 HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED) 15 ug  in 0.5 mL
    Inactive Ingredients
    Ingredient Name Strength
    OCTOXYNOL-9 (UNII: 7JPC6Y25QS)  
    .ALPHA.-TOCOPHEROL SUCCINATE, D- (UNII: LU4B53JYVE)  
    POLYSORBATE 80 (UNII: 6OZP39ZG8H)  
    SODIUM CHLORIDE (UNII: 451W47IQ8X)  
    MAGNESIUM CHLORIDE (UNII: 02F3473H9O)  
    SODIUM PHOSPHATE, DIBASIC, DODECAHYDRATE (UNII: E1W4N241FO)  
    POTASSIUM PHOSPHATE, MONOBASIC (UNII: 4J9FJ0HL51)  
    WATER (UNII: 059QF0KO0R)  
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:58160-905-52 10 in 1 CARTON
    1 NDC:58160-905-41 0.5 mL in 1 SYRINGE; Type 2: Prefilled Drug Delivery Device/System (syringe, patch, etc.)
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    BLA BLA125127 07/01/2016
    Labeler - GlaxoSmithKline Biologicals SA (372748392)
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