NDC 65162-890 Olopatadine Hydrochloride

Olopatadine Hydrochloride

NDC Product Code 65162-890

NDC 65162-890-23

Package Description: 1 BOTTLE, SPRAY in 1 CARTON > 665 SPRAY, METERED in 1 BOTTLE, SPRAY

NDC Product Information

Olopatadine Hydrochloride with NDC 65162-890 is a a human prescription drug product labeled by Amneal Pharmaceuticals Llc. The generic name of Olopatadine Hydrochloride is olopatadine hydrochloride. The product's dosage form is spray, metered and is administered via nasal form.

Labeler Name: Amneal Pharmaceuticals Llc

Dosage Form: Spray, Metered - A non-pressurized dosage form consisting of valves which allow the dispensing of a specified quantity of spray upon each activation.

Product Type: Human Prescription Drug What kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.

Olopatadine Hydrochloride Active Ingredient(s)

What is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

  • OLOPATADINE HYDROCHLORIDE 665 ug/1

Inactive Ingredient(s)

About the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.

  • BENZALKONIUM CHLORIDE (UNII: F5UM2KM3W7)
  • SODIUM PHOSPHATE, DIBASIC, ANHYDROUS (UNII: 22ADO53M6F)
  • EDETATE DISODIUM (UNII: 7FLD91C86K)
  • SODIUM CHLORIDE (UNII: 451W47IQ8X)
  • HYDROCHLORIC ACID (UNII: QTT17582CB)
  • SODIUM HYDROXIDE (UNII: 55X04QC32I)
  • WATER (UNII: 059QF0KO0R)

Administration Route(s)

What are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Nasal - Administration to the nose; administered by way of the nose.
  • Nasal - Administration to the nose; administered by way of the nose.

Pharmacological Class(es)

What is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Decreased Histamine Release - [PE] (Physiologic Effect)
  • Histamine H1 Receptor Antagonists - [MoA] (Mechanism of Action)
  • Histamine-1 Receptor Inhibitor - [EPC] (Established Pharmacologic Class)

Product Labeler Information

What is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Amneal Pharmaceuticals Llc
Labeler Code: 65162
FDA Application Number: ANDA210901 What is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: ANDA - A product marketed under an approved Abbreviated New Drug Application. What is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 02-03-2020 What is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2021 What is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N What is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA’s requests for correction to deficient or non-compliant submissions. Values = ‘Y’ or ‘N’.

* Please review the disclaimer below.

Olopatadine Hydrochloride Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index

1 Indications And Usage

Olopatadine hydrochloride (HCl) nasal spray is an H1 receptor antagonist indicated for the relief of the symptoms of seasonal allergic rhinitis in adults and children 6 years of age and older.

2 Dosage And Administration

Administer olopatadine HCl nasal spray by the intranasal route only.

2.1 Adults And Adolescents 12 Years Of Age And Older:

The recommended dosage is two sprays per nostril twice daily.

2.2 Children 6 To 11 Years Of Age:

The recommended dosage is one spray per nostril twice daily.

2.3 Administration Information

Priming: Before initial use, prime olopatadine HCl nasal spray by releasing 5 sprays or until a fine mist appears. When olopatadine HCl nasal spray has not been used for more than 7 days, re-prime by releasing 2 sprays. Avoid spraying olopatadine HCl nasal spray into the eyes.

3 Dosage Forms And Strengths

Olopatadine HCl nasal spray, 665 mcg is a clear, colorless solution packaged in a white plastic bottle fitted with a metered-dose spray pump, a white colored dust cover and white safety clip. Each spray (100 microliters) delivers 665 mcg of olopatadine hydrochloride, USP.

4 Contraindications

None.

5.1 Local Nasal Effects

Epistaxis and Nasal Ulceration:In placebo (vehicle nasal spray)-controlled clinical trials of 2 weeks to 12 months duration, epistaxis and nasal ulcerations were reported [see Adverse Reactions (6)]. Nasal Septal Perforation:Three placebo (vehicle nasal spray)-controlled long term (12 months) safety trials were conducted. In the first safety trial, patients were treated with an investigational formulation of olopatadine HCl nasal spray containing povidone (not the commercially marketed formulation) or a vehicle nasal spray containing povidone. Nasal septal perforations were reported in one patient treated with the investigational formulation of olopatadine HCl nasal spray and 2 patients treated with the vehicle nasal spray. In the second safety trial with olopatadine HCl nasal spray, which does not contain povidone, there were no reports of nasal septal perforation. In the third safety trial, one patient exposed to the 3.7 pH vehicle nasal spray (containing no povidone) reported a nasal septal perforation [see Adverse Reactions (6)]. Before starting olopatadine HCl nasal spray, conduct a nasal examination to ensure that patients are free of nasal disease other than allergic rhinitis. Perform nasal examinations periodically for signs of adverse effects on the nasal mucosa and consider stopping olopatadine HCl nasal spray if patients develop nasal ulcerations.

5.2 Activities Requiring Mental Alertness

In clinical trials, the occurrence of somnolence has been reported in some patients taking olopatadine HCl nasal spray [see Adverse Reactions (6)]. Patients should be cautioned against engaging in hazardous occupations requiring complete mental alertness and motor coordination such as driving or operating machinery after administration of olopatadine HCl nasal spray. Concurrent use of olopatadine HCl nasal spray with alcohol or other central nervous system depressants should be avoided because additional reductions in alertness and additional impairment of central nervous system performance may occur.

6 Adverse Reactions

  • The most clinically significant adverse reactions described in other sections of labeling include; Epistaxis, Nasal Ulceration, and Nasal Septal Perforation [see Warnings and Precautions (5.1)]Somnolence [see Warnings and Precautions (5.2)]

6.1 Clinical Trials Experience

The safety data described below reflect exposure to olopatadine HCl nasal spray in 2,770 patients with seasonal or perennial allergic rhinitis in 10 controlled clinical trials of 2 weeks to 12 months duration. The safety data from adults and adolescents are based upon 6 placebo (3.7 pH vehicle nasal spray or 7.0 pH vehicle nasal spray)-controlled clinical trials in which 1,834 patients with seasonal or perennial allergic rhinitis (652 males and 1,182 females) 12 years of age and older were treated with olopatadine HCl nasal spray two sprays per nostril twice daily. There were 1,180 patients (olopatadine HCl nasal spray, 587; vehicle nasal spray, 593) that participated in 3 efficacy and safety trials of 2 weeks duration. There were 2,840 patients (olopatadine HCl nasal spray, 1,247; 3.7 pH vehicle nasal spray, 1,251; 7.0 pH vehicle nasal spray, 342) that participated in 3 long-term clinical trials of 1 year duration. The racial distribution of adult and adolescent patients receiving olopatadine HCl nasal spray was 77% white, 9% black, and 14% other. The incidence of discontinuation due to adverse reactions in these controlled clinical trials was comparable for olopatadine HCl nasal spray and vehicle nasal spray. Overall, 4.7% of the 1,834 adult and adolescent patients across all 6 studies treated with olopatadine HCl nasal spray, 3.5% of the 1,844 patients treated with 3.7 pH vehicle nasal spray discontinued due to adverse reactions, and 2.9% of the 342 patients treated with 7.0 pH vehicle nasal spray discontinued due to adverse reactions. The safety data from pediatric patients 6 to 11 years of age are based upon 3 clinical trials in which 870 children with seasonal allergic rhinitis (376 females and 494 males) were treated with olopatadine HCl nasal spray 1 or 2 sprays per nostril twice daily for 2 weeks. The racial distribution of pediatric patients receiving olopatadine HCl nasal spray was 68.6% white, 16.6% black, and 14.8% other. The incidence of discontinuation due to adverse reactions in these controlled clinical trials was comparable for olopatadine HCl nasal spray and vehicle nasal spray. Overall, 1.4% of the 870 pediatric patients across all 3 studies treated with olopatadine HCl nasal spray and 1.3% of the 872 pediatric patients treated with vehicle nasal spray discontinued due to adverse reactions. Safety information for pediatric patients 2 to 5 years of age is obtained from one vehicle-controlled study of 2 weeks duration [see Pediatric Use (8.4)].Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Adults and Adolescents 12 Years of Age and Older in Short-Term (2-week) Trials:There were 1,180 patients 12 years of age and older (olopatadine HCl nasal spray, 587; vehicle nasal spray, 593) that participated in 3 efficacy and safety trials of 2 weeks duration. Table 1 presents the most common adverse reactions (0.9% or greater in patients treated with olopatadine HCl nasal spray) that occurred more frequently in patients treated with olopatadine HCl nasal spray compared with vehicle nasal spray in the 3 clinical trials of 2 weeks duration.  Table 1: Adverse Reactions Occurring at an Incidence of 0.9% or Greater in Controlled Clinical Trials of 2 Weeks Duration with Olopatadine HCl Nasal Spray in Adolescent and Adult Patients 12 Years of Age and Older with Seasonal Allergic RhinitisAdverse ReactionAdult and Adolescent Patients 12 Years and OlderOlopatadine HCl Nasal Spray N = 587Vehicle Nasal Spray N = 593Bitter taste 75 (12.8%)5 (0.8%)Headache 26 (4.4%)24 (4%)Epistaxis 19 (3.2%)10 (1.7%)Pharyngolaryngeal Pain 13 (2.2%)8 (1.3%)Post-nasal drip 9 (1.5%)5 (0.8%)Cough 8 (1.4%)3 (0.5%)Urinary tract infection 7 (1.2%)3 (0.5%)CPK elevation 5 (0.9%)2 (0.3%)Dry mouth 5 (0.9%)1 (0.2%)Fatigue 5 (0.9%)4 (0.7%)Influenza 5 (0.9%)1 (0.2%)Nasopharyngitis 5 (0.9%)4 (0.7%)Somnolence 5 (0.9%)2 (0.3%)Throat irritation 5 (0.9%)0 (0%)There were no differences in the incidence of adverse reactions based on gender or race. Clinical trials did not include sufficient numbers of patients 65 years of age and older to determine whether they respond differently from younger subjects. Pediatric Patients 6 to 11 Years of Age: There were 1,742 pediatric patients 6 to 11 years of age (Olopatadine nasal spray, 870; vehicle nasal spray, 872) with seasonal allergic rhinitis that participated in 3 clinical trials of 2 weeks duration. Two of the studies used the investigational formulation of olopatadine nasal spray, and one of the studies used olopatadine HCl nasal spray. One study evaluated the safety of olopatadine HCl nasal spray at doses of 1 and 2 sprays per nostril twice daily in 1188 patients, in which 298 were exposed to olopatadine HCl 1 spray, 296 were exposed to olopatadine HCl 2 sprays, 297 were exposed to vehicle 1 spray, and 297 were exposed to vehicle 2 sprays twice daily for 2 weeks. Table 2 presents the most common adverse reactions (greater than 1% in pediatric patients 6 to 11 years of age treated with olopatadine HCl nasal spray 1 spray/nostril) that occurred more frequently with olopatadine HCl nasal spray compared with vehicle nasal spray.Table 2. Adverse Reactions Occurring at an Incidence of Greater than 1% in a Controlled Clinical Trial of 2 Weeks Duration with Olopatadine HCl Nasal Spray in Pediatric Patients 6 to 11 Years of Age With Seasonal Allergic RhinitisAdverse ReactionPediatric Patients 6 to 11 Years of AgeOlopatadine HCl Nasal Spray 1 spray per nostril N = 298Vehicle Nasal Spray 1 spray per nostril N = 297Epistaxis 17 (5.7%)11 (3.7%)Headache 13 (4.4%)11 (3.7%)Upper respiratory tract infection 8 (2.6%)0Bitter taste 3 (1%)0Pyrexia 4 (1.3%)3 (1%)Rash4 (1.3%)0There were no differences in the incidence of adverse reactions based on gender, race, or ethnicity. Pediatric Patients 2 to 5 Years of Age: The safety of olopatadine HCl nasal spray at a dose of 1 spray per nostril twice daily was evaluated in one 2-week vehicle-controlled study in 132 patients (olopatadine HCl nasal spray, 66; vehicle nasal spray. 66) 2 to 5 years of age with allergic rhinitis [see Pediatric Use (8.4)]. Long-Term (12-month) Safety Trials: In a 12-month, placebo (vehicle nasal spray)-controlled, safety trial, 890 patients 12 years of age and older with perennial allergic rhinitis were randomized to treatment with olopatadine HCl nasal spray 2 sprays per nostril twice daily (445 patients) or vehicle nasal spray (445 patients). In the olopatadine HCl and vehicle nasal spray groups, 72% and 74% of patients, respectively, completed the trial. Overall, 7% and 5%, respectively, discontinued study participation due to an adverse event. The most frequently reported adverse reaction was epistaxis, which occurred in 25% of patients treated with olopatadine HCl nasal spray and 28% in patients treated with vehicle nasal spray. Epistaxis resulted in discontinuation of 0.9% of patients treated with olopatadine HCl nasal spray and 0.2% of patients treated with vehicle nasal spray. Nasal ulcerations occurred in 10% of patients treated with olopatadine HCl nasal spray and 9% of patients treated with vehicle nasal spray. Nasal ulcerations resulted in discontinuation of 0.4% of patients treated with olopatadine HCl nasal spray and 0.2% patients treated with vehicle nasal spray. There were no patients with nasal septal perforation in either treatment group. Somnolence was reported in 1 patient treated with olopatadine HCl nasal spray and 1 patient treated with vehicle nasal spray. Weight increase was reported in 6 patients treated with olopatadine HCl nasal spray and 1 patient treated with vehicle nasal spray. Depression or worsening of depression occurred in 9 patients treated with olopatadine HCl nasal spray and in 5 patients treated with vehicle nasal spray. Three patients, two of whom had pre-existing histories of depression, who received olopatadine HCl nasal spray were hospitalized for depression compared to none who received vehicle nasal spray. In a second 12-month, placebo (vehicle nasal spray)-controlled, safety trial, 459 patients 12 years of age and older with perennial allergic rhinitis were treated with 2 sprays per nostril of an investigational formulation of olopatadine HCl nasal spray containing povidone (not the commercially marketed formulation) and 465 patients were treated with 2 sprays of a vehicle nasal spray containing povidone. Nasal septal perforations were reported in one patient treated with the investigational formulation of olopatadine HCl nasal spray and 2 patients treated with the vehicle nasal spray. Epistaxis was reported in 19% of patients treated with the investigational formulation of olopatadine HCl nasal spray and 12% of patients treated with vehicle nasal spray. Somnolence was reported in 3 patients treated with the investigational formulation of olopatadine HCl nasal spray compared to 1 patient treated with vehicle nasal spray. Fatigue was reported in 5 patients treated with the investigational formulation of olopatadine HCl nasal spray compared to 1 patient treated with vehicle nasal spray. In a third 3-arm 12-month, placebo (vehicle nasal spray)-controlled, safety trial conducted post approval, 1,026 patients 12 years of age and older with perennial allergic rhinitis were randomized to treatment with olopatadine HCl nasal spray (343 patients), a 3.7 pH vehicle nasal spray (341 patients), or a 7.0 pH vehicle nasal spray (342 patients). All treatments were administered as 2 sprays per nostril, twice daily. Overall, 5% of olopatadine HCl nasal spray patients, 2% of 3.7 pH vehicle patients and 3% of 7.0 pH vehicle patients discontinued due to adverse events. The most frequently reported adverse event was epistaxis, which occurred in 24% of patients treated with olopatadine HCl nasal spray, 20% of patients treated with 3.7 pH vehicle nasal spray, and 23% of patients treated with 7.0 pH vehicle nasal spray. Epistaxis resulted in the discontinuation of 2 patients treated with olopatadine HCl nasal spray and 1 patient treated with 7.0 pH vehicle nasal spray. Nasal septal perforation was reported for one patient treated with the 3.7 pH vehicle nasal spray. Nasal ulcerations occurred in 9% of patients treated with olopatadine HCl nasal spray, 8% of patients treated with 3.7 pH vehicle nasal spray, and 9% of patients treated with 7.0 pH vehicle nasal spray. Nasal ulceration resulted in the discontinuation of 1 patient treated with olopatadine HCl nasal spray. Hyposmia and anosmia were each reported by one patient treated with olopatadine HCl nasal spray. Neither somnolence nor weight loss was reported. Depression occurred in 3 patients treated with olopatadine HCl nasal spray, 2 patients treated with 3.7 pH vehicle nasal spray, and 3 patients treated with 7.0 pH vehicle nasal spray. There were no long-term clinical trials in children below 12 years of age.

6.2 Post-Marketing Experience

During the post approval use of olopatadine HCl nasal spray, the following adverse reactions have been identified. Because these reactions 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 drug exposure. The most common adverse reactions reported include dizziness, dysgeusia, epistaxis, headache, nasal discomfort, oropharyngeal pain, and somnolence. Additionally, hyposmia and anosmia have been reported with the use of olopatadine HCl nasal spray.

7 Drug Interactions

Formal drug-drug interaction studies were not conducted for olopatadine HCl nasal spray. Drug interactions with inhibitors of liver enzymes are not anticipated because olopatadine is eliminated predominantly by renal excretion. Drug interactions involving P450 inhibition and plasma protein binding are also not expected [see Clinical Pharmacology (12.3)].

8.1 Pregnancy

Pregnancy Category C:No adequate and well-controlled studies in pregnant women have been conducted. Animal reproductive studies in rats and rabbits revealed treatment-related effects on fetuses or pups. Because animal studies are not always predictive of human responses, olopatadine HCl nasal spray should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the embryo or fetus. A decrease in the number of live fetuses was observed in rabbits and rats at the oral olopatadine doses approximately 88 times and 100 times the maximum recommended human dose (MRHD) and above, respectively, for adults on a mg/m2 basis. In rats, viability and body weights of pups were reduced on day 4 post-partum at the oral dose approximately 100 times the MRHD for adults on a mg/m2 basis, but no effect on viability was observed at the dose approximately 35 times the MRHD for adults on a mg/m2 basis.

8.3 Nursing Mothers

Olopatadine has been identified in the milk of nursing rats following oral administration. It is not known whether topical nasal administration could result in sufficient systemic absorption to produce detectable quantities in human breast milk. Olopatadine HCl nasal spray should be used by nursing mothers only if the potential benefit to the patient outweighs the potential risks to the infant.

8.4 Pediatric Use

The safety and effectiveness of olopatadine HCl nasal spray has not been established for patients under 6 years of age. The safety of olopatadine nasal spray was evaluated in 3 vehicle-controlled 2-week studies in 870 patients 6 to 11 years of age [see Adverse Reactions (6.1)]. Doses studied included 1 and 2 sprays per nostril twice daily. One of these studies evaluated the safety of olopatadine HCl nasal spray at doses of 1 and 2 sprays per nostril twice daily in 1188 patients, of which, 298 patients were exposed to olopatadine HCl 1 spray and 297 patients were exposed to vehicle 1 spray. In this study, the incidence of epistaxis with olopatadine HCl treatment was 5.7%, compared to 3.2% seen in adult and adolescent studies. This study also evaluated the effectiveness of olopatadine HCl nasal spray in patients 6 through 11 years of age with seasonal allergic rhinitis [see Clinical Studies (14)]. The safety of olopatadine HCl nasal spray at a dose of 1 spray per nostril twice daily was evaluated in one 2-week vehicle-controlled study in 132 children ages 2 to 5 years of age with allergic rhinitis. In this trial, 66 patients (28 females and 38 males) were exposed to olopatadine HCl nasal spray. The racial distribution of patients receiving olopatadine HCl nasal spray was 66.7% white, 27.3% black, and 6.4% other. Two patients exposed to vehicle nasal spray discontinued due to an adverse reaction (1 patient with pneumonia and 1 patient with rhinitis) compared to no patients exposed to olopatadine HCl nasal spray. The most common (greater than 1%) adverse events reported were diarrhea (9.1%), epistaxis (6.1%), rhinorrhea (4.5%), bitter taste (3%) and wheezing (3%). Diarrhea was reported less frequently (< 1%) in the 6 to 11 year old age group. The incidence of epistaxis was higher in the pediatric population (5.7% in 6 to 11 year old patients and 6.1% in 2 to 5 year old patients) compared to the adult and adolescent population (3.2%).

8.5 Geriatric Use

Clinical studies of olopatadine HCl nasal spray did not include sufficient numbers of patients aged 65 years and older to determine whether they respond differently from younger patients. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy.

10 Overdosage

There have been no reported overdosages with olopatadine HCl nasal spray. Acute overdosage with this dosage form is unlikely due to the configuration of the primary container closure system. However, symptoms of antihistamine overdose may include drowsiness in adults and, initially, agitation and restlessness, followed by drowsiness in children. There is no known specific antidote to olopatadine HCl nasal spray. Should overdose occur, symptomatic or supportive treatment is recommended, taking into account any concomitantly ingested medications. No mortality was observed in rats at an intranasal dose of 3.6 mg/kg (approximately 6 times the MRHD for adults and adolescents ≥12 years of age and 7 times the MRHD for children 6 to 11 years of age on a mg/m2 basis), or in dogs at an oral dose of 5 g/kg (approximately 28,000 times the MRHD for adults and adolescents ≥12 years of age and 33,000 the MRHD for children 6 to 11 years of age on a mg/m2 basis). The oral median lethal dose (MLD) in mice and rats were 1,490 mg/kg and 3,870 mg/kg respectively (approximately 1,200 times and 6,500 times the MRHD for adults and adolescents ≥12 years of age and 1,500 times and 7,700 times the MRHD for children 6 to 11 years of age, on a mg/m2 basis, respectively). For additional information about overdose treatment, call a poison control center (1-800-222-1222).

11 Description

Olopatadine HCl nasal spray, 665 micrograms (mcg) is a metered-spray solution with nasal applicator for intranasal administration. Olopatadine hydrochloride USP, the active component of olopatadine HCl nasal spray, 665 mcg, is a white, water-soluble crystalline powder. The chemical name for olopatadine hydrochloride, USP is (Z)-11-[3-(dimethylamino)propylidene]-6,11-dihydrodibenz [b,e]oxepin-2-acetic acid hydrochloride. It has a molecular weight of 373.88, and its molecular formula is C21H23NO3 • HCl with the following chemical structure: Olopatadine HCl nasal spray, 665 mcg contains 0.6% w/v olopatadine (base) in a nonsterile aqueous solution with pH of approximately 3.7. After initial priming (5 sprays), each metered spray from the nasal applicator delivers 100 microliters of the aqueous solution containing 665 mcg of olopatadine hydrochloride USP, which is equivalent to 600 mcg of olopatadine (base) [see Dosage Forms and Strengths (3)]. Olopatadine HCl nasal spray, 665 mcg also contains benzalkonium chloride (0.01%), dibasic sodium phosphate (anhydrous), edetate disodium, sodium chloride, hydrochloric acid and/or sodium hydroxide (to adjust pH), and purified water.

12.1 Mechanism Of Action

Olopatadine is a histamine H1-receptor antagonist. The antihistaminic activity of olopatadine has been documented in isolated tissues, animal models, and humans.

12.2 Pharmacodynamics

Cardiac effects: In a placebo-controlled cardiovascular safety study, 32 healthy volunteers received 20 mg oral solution of olopatadine twice daily for 14 days (8-fold greater daily dose than the recommended daily nasal dose). The mean QTcF (QT corrected by Fridericia’s correction method for heart rate) change from baseline was -2.7 msec and -3.8 msec for olopatadine, and placebo, respectively. In this study, 8 subjects treated with olopatadine had a QTcF change from baseline of 30 to 60 msec, 1 subject had a QTcF change from baseline greater than 60 msec, and no subjects had QTcF values greater than 500 msec. Eight subjects treated with placebo had a QTcF change from baseline of 30 to 60 msec, no subjects had a QTcF change from baseline greater than 60 msec, and no subjects had QTcF values greater than 500 msec. In a 12-month study in 429 perennial allergic rhinitis patients treated with olopatadine HCl nasal spray 2 sprays per nostril twice daily, no evidence of any effect of olopatadine hydrochloride on QT prolongation was observed.

12.3 Pharmacokinetics

The pharmacokinetic properties of olopatadine were studied after administration by the nasal, oral, intravenous, and topical ocular routes. Olopatadine exhibited linear pharmacokinetics across the routes studied over a large dose range. Absorption: Healthy Subjects: Olopatadine was absorbed with individual peak plasma concentrations observed between 30 minutes and 1 hour after twice daily intranasal administration of olopatadine HCl nasal spray. The mean (± SD) steady-state peak plasma concentration (Cmax) of olopatadine was 16 ± 8.99 ng/mL. Systemic exposure as indexed by area under the curve (AUC0-12) averaged 66 ± 26.8 ng·h/mL. The average absolute bioavailability of intranasal olopatadine is 57%. The mean accumulation ratio following multiple intranasal administration of olopatadine HCl nasal spray was about 1.3. Seasonal Allergic Rhinitis (SAR) Patients: Systemic exposure of olopatadine in SAR patients after twice daily intranasal administration of olopatadine HCl nasal spray was comparable to that observed in healthy subjects. Olopatadine was absorbed with peak plasma concentrations observed between 15 minutes and 2 hours. The mean steady-state Cmax was 23.3 ± 6.2 ng/mL and AUC0-12 averaged 78 ± 13.9 ng·h/mL. Distribution: The protein binding of olopatadine was moderate at approximately 55% in human serum, and independent of drug concentration over the range of 0.1 to 1000 ng/mL. Olopatadine was bound predominately to human serum albumin. Metabolism: Olopatadine is not extensively metabolized. Based on plasma metabolite profiles following oral administration of [14C] olopatadine, at least six minor metabolites circulate in human plasma. Olopatadine accounts for 77% of peak plasma total radioactivity and all metabolites amounted to <6% combined. Two of these have been identified as the olopatadine N-oxide and N-desmethyl olopatadine. In in vitro studies with cDNA-expressed human cytochrome P450 isoenzymes (CYP) and flavin-containing monooxygenases (FMO), N-desmethyl olopatadine (Ml) formation was catalyzed mainly by CYP3A4, while olopatadine N-oxide (M3) was primarily catalyzed by FMO1 and FMO3. Olopatadine at concentrations up to 33,900 ng/mL did not inhibit the in vitro metabolism of specific substrates for CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4. The potential for olopatadine and its metabolites to act as inducers of CYP enzymes has not been evaluated. Elimination: The plasma elimination half-life of olopatadine is 8 to 12 hours. Olopatadine is mainly eliminated through urinary excretion. Approximately 70% of a [14C] olopatadine hydrochloride oral dose was recovered in urine with 17% in the feces. Of the drug-related material recovered within the first 24 hours in the urine, 86% was unchanged olopatadine with the balance comprised of olopatadine N-oxide and N-desmethyl olopatadine. Special Population: Hepatic Impairment: No specific pharmacokinetic study examining the effect of hepatic impairment was conducted. Since metabolism of olopatadine is a minor route of elimination, no adjustment of the dosing regimen of olopatadine HCl nasal spray is warranted in patients with hepatic impairment. Renal Impairment: The mean Cmax values for olopatadine following single intranasal doses were not markedly different between healthy subjects (18.1 ng/mL) and patients with mild, moderate and severe renal impairment (range 15.5 to 21.6 ng/mL). Mean plasma AUC0-12 was two-fold higher in patients with severe impairment (creatinine clearance <30 mL/min/1.73 m2). In these patients, peak steady-state plasma concentrations of olopatadine are approximately 10-fold lower than those observed after higher 20 mg oral doses, twice daily, which were well-tolerated. These findings indicate that no adjustment of the dosing regimen of olopatadine HCl nasal spray is warranted in patients with renal impairment. Gender: The mean systemic exposure (Cmax and AUC0-12) in female SAR patients following multiple administration of olopatadine was 40% and 27% higher, respectively than those values observed in male SAR patients. Race: The effects of race on olopatadine pharmacokinetics have not been adequately investigated. Age:Pediatric Patients 6 to 11 Years of Age: The systemic pharmacokinetics of olopatadine, olopatadine N-oxide and N-desmethyl olopatadine in patients 6 through 11 years of age were characterized using data from 42 pediatric patients administered olopatadine HCl nasal spray, one spray per nostril twice daily for a minimum of 14 days. The mean Cmax (15.4 ± 7.3 ng/mL) of olopatadine was approximately 2-fold less than was comparable to that observed in adults (78 ± 13.9 ng·h/mL). The Cmax and AUC0-12 of olopatadine N-oxide were comparable to that observed in adults. The Cmax and AUC0-12 of N-desmethyl olopatadine are approximately 18% and 37% higher than that observed in adults, respectively. Pediatric Patients 2 to 5 Years of Age: The systemic pharmacokinetics of olopatadine, olopatadine N-oxide, and N-desmethyl olopatadine were characterized using population pharmacokinetic methods applied to sparse data (approximately 5 samples per patient) obtained from 66 pediatric patients (2 to less than 6 years of age) administered one-half the recommended adult dose (1 spray per nostril) of olopatadine HCl nasal spray twice daily for a minimum of 14 days. The mean Cmax and AUC0-12 of olopatadine were 13.4 ± 4.6 ng/mL and 75± 26.4 ng·hr/mL respectively. The mean Cmax and AUC0-12 of olopatadine N-oxide and N-desmethyl olopatadine were similar to that of patients 6 to 11 years of age. Drug Interaction Studies Drug interactions with inhibitors of liver enzymes are not anticipated because olopatadine is eliminated predominantly by renal excretion. Olopatadine did not inhibit the in vitro metabolism of specific substrates for CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4. Based on these data, drug interactions involving P450 inhibition are not expected. Due to the modest protein binding of olopatadine (55%), drug interactions through displacement from plasma proteins are also not expected.

13.1 Carcinogenesis, Mutagenesis, Impairment Of Fertility

Olopatadine administered orally was not carcinogenic in mice and rats at doses of up to 500 mg/kg/day and 200 mg/kg/day, respectively (approximately 420 and 340 times the MRHD for adults and adolescents ≥12 years of age and 500 and 400 times the MRHD for children 6 to 11 years of age by intranasal administration on a mg/m2 basis, respectively). There was no evidence of genotoxicity when olopatadine was tested in an in vitro bacteria reverse mutation test (Ames), an in vitro mammalian chromosome aberration assay or an in vivo mouse micronucleus test. Olopatadine administered orally to male and female rats at dose of 400 mg/kg/day, (approximately 680 times the MRHD for adults on a mg/m2 basis) resulted in a decrease in the fertility index and reduced implantation rate. No effects on fertility were observed at dose of 50 mg/kg/day (approximately 85 times the MRHD for adults on a mg/m2 basis).

13.2 Animal Toxicology

Reproductive Toxicology Studies Olopatadine was not teratogenic in rabbits and rats at oral doses of up to 400 or 600 mg/kg/day, respectively (approximately 1,400 and 1,000 times the MRHD for adults on a mg/m2 basis, respectively). However, a decrease in the number of live fetuses was observed in rabbits at the oral olopatadine doses of 25 mg/kg (approximately 88 times the MRHD for adults on a mg/m2 basis) and above, and in rats at oral doses of 60 mg/kg (approximately 100 times the MRHD for adults on a mg/m2 basis) and above. In rats, viability and body weights of pups were reduced on day 4 post-partum at the oral doses of 60 mg/kg (approximately 100 times the MRHD for adults on a mg/m2 basis) and above, but no effect on viability was observed at the dose of 20 mg/kg (approximately 35 times the MRHD for adults on a mg/m2 basis).

14 Clinical Studies

Adult and Adolescent Patients 12 Years of Age and Older: The efficacy and safety of olopatadine HCl nasal spray were evaluated in three randomized, double blind, parallel group, multicenter, placebo (vehicle nasal spray)-controlled clinical trials of 2 weeks duration in adult and adolescent patients, 12 years of age and older with symptoms of seasonal allergic rhinitis. The three clinical trials were conducted in the United States and included 1,598 patients (556 males, and 1,042 females) 12 years of age and older. In these three trials 587 patients were treated with olopatadine HCl nasal spray 0.6%, 418 patients were treated with olopatadine HCl nasal spray 0.4%, and 593 patients were treated with vehicle nasal spray. Assessment of efficacy was based on patient recording of 4 individual nasal symptoms (nasal congestion, rhinorrhea, itchy nose, and sneezing) on a 0 to 3 categorical severity scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe) as reflective or instantaneous scores. Reflective scoring required patients to record symptom severity over the previous 12 hours; the instantaneous scoring required patients to record symptom severity at the time of recording. The primary efficacy endpoint was the difference from placebo in the percent change from baseline in the average of morning and evening reflective total nasal symptom score (rTNSS) averaged for the 2-week treatment period. In all 3 trials, patients treated with olopatadine HCl nasal spray, two sprays per nostril, twice-daily, exhibited statistically significantly greater decreases in rTNSS compared to vehicle nasal spray. Results for the rTNSS from two representative trials are shown in Table 3. Table 3: Mean Reflective Total Nasal Symptom Score (rTNSS) in Adult and Adolescent Patients with Seasonal Allergic RhinitisTreatmentNBaselineChange from BaselineDifference from PlaceboEstimate95% CIp-valueStudy 1 Olopatadine HCl Nasal Spray 0.6% 1838.71-3.63-0.96(-1.42, -0.51)<0.0001Olopatadine HCl Nasal Spray 0.4% 1888.90-3.38-0.71(-1.17, -0.26)0.0023Vehicle Nasal Spray 1918.75-2.67Study 2 Olopatadine HCl Nasal Spray 0.6% 2209.17-2.90-0.98(-1.37, -0.59)<0.0001Olopatadine HCl Nasal Spray 0.4% 2289.26-2.63-0.72(-1.11, -0.33)0.0003Vehicle Nasal Spray 2239.07-1.92Itchy eyes and watery eyes were evaluated as secondary endpoints but eye redness was not evaluated. In two of the studies, patients treated with olopatadine HCl nasal spray had significantly greater decreases in reflective symptom scores for itchy eyes and watery eyes, compared to vehicle nasal spray. In the 2-week seasonal allergy trials, onset of action was also evaluated by instantaneous TNSS assessments twice-daily after the first dose of study medication. In these trials, onset of action was seen after 1 day of dosing. Onset of action was evaluated in three environmental exposure unit studies with single doses of olopatadine HCl nasal spray. In these studies, patients with seasonal allergic rhinitis were exposed to high levels of pollen in the environmental exposure unit and then treated with either olopatadine HCl nasal spray or vehicle nasal spray, two sprays in each nostril, after which they self-reported their allergy symptoms hourly as instantaneous scores for the subsequent 12 hours. Olopatadine HCl nasal spray 0.6% was found to have an onset of action of 30 minutes after dosing in the environmental exposure unit. Pediatric Patients 6 to 11 Years of Age: There were 3 clinical trials of 2 weeks duration with olopatadine nasal spray in patients 6 to 11 years of age with seasonal allergic rhinitis. Efficacy of olopatadine HCl nasal spray was evaluated in 2 of the 3 trials. One of the 2 trials that showed efficacy was a randomized, double blind, parallel group, multicenter, placebo (vehicle nasal spray)-controlled clinical trial of 2 weeks duration including 1,188 children ages 6 to < 12 years with seasonal allergic rhinitis. Assessment of efficacy was based on patient/caregiver recording of 4 individual nasal symptoms (nasal congestion, rhinorrhea, itchy nose, and sneezing) on a 0 to 3 categorical severity scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe) as reflective or instantaneous scores. Reflective scoring captured symptom severity over the previous 12 hours; the instantaneous scoring captured symptom severity at the time of recording. The primary efficacy endpoint was the difference from placebo in the percent change from baseline in the average of patient/caregiver-reported morning and evening reflective total nasal symptom score (rTNSS) averaged for the 2-week treatment period. Patients treated with olopatadine HCl nasal spray, 1 or 2 sprays per nostril twice daily, had statistically significantly greater decreases in rTNSS compared to vehicle nasal spray. Results for rTNSS are shown in Table 4. Table 4: Mean Reflective Total Nasal Symptom Score (rTNSS) in Pediatric Patients 6 to 11 Years of Age with Seasonal Allergic RhinitisTreatmentNBaselineChange From BaselineDifference from PlaceboEstimate95% CIp-valueOlopatadine HCl Nasal Spray 0.6%, 1 spray per nostril twice daily 2948.99-2.24-0.55(-0.90,-0.19)0.0015Vehicle Nasal Spray, 1 spray per nostril twice daily 2949.09-1.70Itchy eyes and watery eyes were evaluated as secondary endpoints in the same study but eye redness was not evaluated. Patients treated with olopatadine HCl nasal spray had significantly greater decreases in reflective symptom scores for itchy eyes and watery eyes, compared to vehicle nasal spray.

16.1 How Supplied

Olopatadine HCl nasal spray, 665 mcg is supplied in a white plastic bottle with nasal applicator, fitted with a metered-dose spray pump, a white colored dust cover and white safety clip in a box of 1 (NDC 65162-890-23). Each trade size bottle contains 30.5 g of clear, colorless liquid and will provide 240 metered sprays. After priming [see Dosage and Administration (2)], each spray delivers a fine mist containing 665 mcg of olopatadine hydrochloride, USP in 100 microliters of formulation through the nozzle. Before initial use, prime olopatadine HCl nasal spray, 665 mcg by releasing 5 sprays or until a fine mist appears. After periods of non-use greater than 7 days, re-prime olopatadine HCl nasal spray, 665 mcg by releasing 2 sprays. The correct amount of medication cannot be assured before the initial priming and after 240 sprays have been used, even though the bottle is not completely empty. The nasal device should be discarded after 240 sprays (enough for 30 days of dosing) have been used. Net content 30.5 g, 240 sprays: NDC 65162-890-23 (trade size)

16.2 Storage

Store at 4° to 25° C (39° to 77° F). Rx Only.

17 Patient Counseling Information

See FDA-approved Patient Labeling accompanying the product.

17.1 Local Nasal Effects And Other Common Adverse Reactions

Inform patients that treatment with olopatadine HCl nasal spray may lead to adverse reactions, which include epistaxis and nasal ulcerations [see Warnings and Precautions (5.1)]. Other common adverse reactions reported with use of olopatadine HCl nasal spray include bitter taste, headache, and pharyngolaryngeal pain [see Adverse Reactions (6)].

17.2. Activities Requiring Mental Alertness

Somnolence has been reported in some patients taking olopatadine HCl nasal spray. Caution patients against engaging in hazardous occupations requiring complete mental alertness and motor coordination such as driving or operating machinery after administration of olopatadine HCl nasal spray [see Warnings and Precautions (5.2)].

17.3 Concurrent Use Of Alcohol And Other Central Nervous System Depressants

Advise patients that concurrent use of olopatadine HCl nasal spray with alcohol or other central nervous system depressants should be avoided because additional reductions in alertness and additional impairment of central nervous system performance may occur [see Warnings and Precautions (5.2)].

17.4 Keep Spray Out Of Eyes

Inform patients to avoid spraying olopatadine HCl nasal spray in their eyes. Distributed by:Amneal Pharmaceuticals LLCBridgewater, NJ 08807Rev. 07-2018-00

Patient Information

  • Olopatadine (oh” loe pat’ a deen hye” droe klor’ ide) Nasal SprayFor Use in the nose (Intranasal) only.Read the Patient Information that comes with Olopatadine HCl Nasal Spray carefully before you start using it and each time you get a refill. There may be new information. This leaflet does not take the place of talking to your health care provider about your medical condition or your treatment.What is Olopatadine HCl Nasal Spray?Olopatadine HCl Nasal Spray is a prescription medicine used to provide relief of seasonal allergy symptoms in adults and children 6 years and older.Olopatadine HCl Nasal Spray contains an antihistamine medicine that may help reduce nasal symptoms of seasonal allergic rhinitis.What should I tell my health care provider before taking Olopatadine HCl Nasal Spray?Tell your health care provider about all your medical conditions, including if you are:allergic to any of the ingredients in Olopatadine HCl Nasal Spray. See the end of this leaflet for a complete list of the ingredients in Olopatadine HCl Nasal Spray.pregnant or planning to become pregnant. It is not known if Olopatadine HCl Nasal Spray will harm your unborn baby.breast-feeding a baby. It is not known if Olopatadine HCl passes into your breast milk.Tell your health care provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Olopatadine HCl Nasal Spray and other medicines may affect each other, causing side effects.Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine.How should I use Olopatadine HCl Nasal Spray?Olopatadine HCl Nasal Spray is for use in the nose only. Do not spray it in your eyes or mouth.Use Olopatadine HCl Nasal Spray exactly as your health care provider tells you. Do not stop taking Olopatadine HCl Nasal Spray without talking to your health care provider.This nasal device should be discarded after the labeled number of sprays (240) or after the expiration date on the medicine label or box.Do not use Olopatadine HCl Nasal Spray after the expiration date on the medicine label and box.Follow the Patient Instructions for Use below.What are the possible side effects of Olopatadine HCl Nasal Spray?Side effects of Olopatadine HCl Nasal Spray include:bad or bitter tasteheadachenosebleedssores in your nosehole in the nasal septumTell your health care provider if you have any side effect that bothers you or does not go away.These are not all of the possible side effects of Olopatadine HCl Nasal Spray. For more information, ask your health care provider or pharmacist.Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.What should I avoid while using Olopatadine HCl Nasal Spray?Olopatadine HCl Nasal Spray can make you sleepy.Avoid the following while using Olopatadine HCl Nasal Spray:operating machinery, driving a motor vehicle, or doing other dangerous activitiesusing alcohol or other medicines that can also make you sleepy, such as sedatives and tranquilizersGeneral information about Olopatadine HCl Nasal SprayMedicines are sometimes prescribed for conditions that are not mentioned in the patient leaflet. Do not use Olopatadine HCl Nasal Spray for a condition for which it was not prescribed. Do not give Olopatadine HCl Nasal Spray to other people, even if they have the same symptoms you have. It may harm them.This patient information leaflet summarizes the most important information about Olopatadine HCl Nasal Spray. If you would like more information about Olopatadine HCl Nasal Spray talk with your health care provider. You can ask your health care provider or pharmacist for information about Olopatadine HCl Nasal Spray that is written for health professionals. For more information go to www.amneal.com or call 1-877-835-5472.What are the ingredients of Olopatadine HCl Nasal Spray?Active ingredient: olopatadine hydrochloride, USP 665 micrograms per 100 microliter spray.Inactive ingredients: benzalkonium chloride 0.01%, dibasic sodium phosphate (anhydrous), edetate disodium, sodium chloride, hydrochloric acid and/or sodium hydroxide (to adjust pH), and purified water.What should I know about seasonal allergic rhinitis?"Rhinitis" means inflammation of the lining of the nose. Seasonal allergic rhinitis is sometimes called "hay fever". Seasonal allergic rhinitis can be caused by allergies to pollen. If you have allergic rhinitis, your nose becomes stuffy, runny and itchy. You may also sneeze a lot. You may also have red, itchy, watery eyes and itchy throat, or blocked itchy ears.Distributed by: Amneal Pharmaceuticals LLC Bridgewater, NJ 08807Rev. 07-2018-00

Pharmacist Give To Patient

  • Patient Instructions for UseOlopatadine Hydrochloride Nasal SprayRx OnlyFor use in the nose (Intranasal) only DOSINGUse Olopatadine HCl Nasal Spray exactly how your doctor tells you to. The usual dose of Olopatadine HCl Nasal Spray for people ages 12 and older is two sprays in each nostril, two times each day and for children 6 to 11, one spray in each nostril two times a day. BEFORE DOSINGRemove the white plastic overcap and the white safety clip just under the “shoulders” of the pump (Figure 1).Hold the bottle and press down on the shoulders of the white nasal applicator with your forefinger and middle finger.Support the bottom (base) of the bottle with your thumb while you do this (Figure 2). Prime the bottle five (5) times or until you see a fine mist come out of the nasal spray applicator. After you start using a bottle of Olopatadine HCl Nasal Spray, if you do not use it for more than seven (7) days, you will need to prime the pump again two (2) times before use. USING THE SPRAYGently blow your nose to clear the nostrils. Close one nostril. With your head tipped down (chin toward chest), place the nasal applicator 1/4 to 1/2 inch into a nostril. Hold the medicine bottle upright with the nasal applicator tip aimed toward the cheek side of the nose, away from the center of the nose (Figure 3).Breathe in gently through your nose. While breathing in press firmly and quickly on the applicator to release the spray (Figure 3).Breathe out through your mouth. Do not tip your head back or blow your nose right after using Olopatadine HCl Nasal Spray. This may cause you to get a bitter taste in your mouth.Change between the nostrils (alternate). Spray two sprays in each nostril. Wipe the nasal applicator with a clean tissue and replace the white plastic overcap and safety clip. (Figure 4)This nasal device should be discarded after the labeled number of sprays (240) or after the expiration date on the medicine label or box.Do not take extra doses or stop taking Olopatadine HCl Nasal Spray without talking with your doctor. If the nasal applicator becomes clogged, do not attempt to clear it using a pointed object. (Figure 5)To clean the nasal applicator, remove the plastic cap and then gently pull upwards to free the nasal applicator. (Figure 6 & 7)With the nasal applicator pointing downwards, wash by running warm tap water into the nasal applicator for about one minute. (Figure 8)Shake the applicator to remove any water and put the applicator back on the bottle.Prime by spraying two (2) times or until you see a fine mist.Repeat the above steps if needed. STORINGStore Olopatadine HCl Nasal Spray between 39° to 77°F (4° to 25°C).Do not use your Olopatadine HCl Nasal Spray after the expiration date on the label or box.Keep Olopatadine HCl Nasal Spray and all medicines out of the reach of children.For more information about Olopatadine HCl Nasal Spray visit www.amneal.com or call 1-877-835-5472.Distributed by: Amneal Pharmaceuticals LLC Bridgewater, NJ 08807Rev. 07-2016-00

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