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Title: Marketing and Sales Suspension Notice for Zelnorm Tablets, 6 mg

"Marketing and Sales Suspension Notice for Zelnorm Tablets, 6 mg"

OTTAWA, CANADA -- April 2, 2007 -- At Health Canada's request, Novartis Pharmaceuticals Canada Inc. is suspending marketing and sales of Zelnorm* (tegaserod hydrogen maleate) tablets in Canada to permit further evaluation of important safety information. Zelnorm is a serotonin 5-HT4 receptor partial agonist indicated for the symptomatic treatment of irritable bowel syndrome with constipation (IBS-C) in female patients whose main symptoms are constipation and abdominal pain and/or discomfort and for the treatment of chronic idiopathic constipation (CIC) in patients under 65 years of age. A recent retrospective analysis of pooled clinical trial data showed that the incidence of cardiovascular ischemic events1 in patients taking Zelnorm was higher than in those taking placebo: · In clinical studies involving over 18,600 patients, there was a statistically significant increase in the incidence of cardiovascular ischemic events1 [13 out of 11,614 (0.11%) Zelnorm; 1 out of 7,031 (0.01%) placebo (P =.024)]. · While most of these patients had at least one CV risk factor, for some, cardiovascular disease or risk had not been diagnosed at the initiation of treatment. Consistent with the decision to suspend marketing and sales of Zelnorm, Novartis is asking Canadian pharmacists and distributors to return the product to the company. Patients taking Zelnorm should discontinue treatment and contact their physician for advice about alternative therapies. Novartis has also suspended the marketing and sales activities of Zelnorm in the United States at the request of the Food and Drug Administration. Advice to Health Care Professionals: Prescribers are advised: · Not to initiate treatment of new patients; · To review treatment options for patients currently taking Zelnorm; · To return Zelnorm samples to Med-Turn International. A separate communication on the return process is currently being distributed. Pharmacists are advised: · Not to dispense further prescriptions for Zelnorm; · To advise patients to discontinue Zelnorm and contact their physicians if they have any concerns; · To return Zelnorm tablets to Med-Turn International. A separate communication on the return process is currently being distributed. · Novartis Pharmaceuticals Canada Inc. reiterates its commitment to the delivery of quality pharmaceutical products and is committed to ensuring the timely dissemination of new information that is important to physicians and patients. A brief statement will be placed on the http://www.novartis.ca website. Managing marketed health product-related adverse reactions depends on health care professionals and consumers reporting them. Reporting rates determined on the basis of spontaneously reported post-marketing adverse reactions are generally presumed to underestimate the risks associated with health product treatments. Any case of serious cardiovascular ischemic events or other serious or unexpected adverse reactions in patients receiving Zelnorm should be reported to Novartis or Health Canada at the following addresses: Novartis Pharmaceuticals Canada Inc. 385 Bouchard Blvd. Dorval, (QC) H9S 1A9 e-mail address: drug.safety@novartis.com Zelnorm Hotline:1-877-519-5399 Any suspected adverse reaction can also be reported to: Canadian Adverse Drug Reaction Monitoring Program (CADRMP) Marketed Health Products Directorate HEALTH CANADA Address Locator: 0701C OTTAWA, Ontario, K1A 0K9 Tel: (613) 957-0337 or Fax: (613) 957-0335 To report an Adverse Reaction, consumers and health professionals may call toll free: Tel: 866 234-2345 Fax: 866 678-6789 cadrmp@hc-sc.gc.ca The AR Reporting Form and the AR Guidelines can be found on the Health Canada web site or in The Canadian Compendium of Pharmaceuticals and Specialties. For other inquiries related to this communication, please contact Health Canada at: Marketed Health Products Directorate (MHPD) E-mail: mhpd_dpsc@hc-sc.gc.ca Tel: (613) 954-6522 Fax: (613) 952-7738 Any questions or require additional information regarding the use of Zelnorm should be directed to the Zelnorm Hotline at 1-877-519-5399. 1. Cardiovascular ischemic events occurring in Zelnorm-treated patients included myocardial infarction, stroke, and unstable angina pectoris. *Zelnorm is a registered trademark SOURCE: Health Canada

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