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Nityr

Generic name: nitisinone

What is Nityr?

Nityr is a prescription medication used for the treatment of adults and pediatric patients with hereditary tyrosinemia type 1 (HT-1) in combination with dietary restriction of tyrosine and phenylalanine.

How should I take Nityr?

  • Take Nityr tablets as directed by your doctor.
  • Nityr can be taken with or without food.
  • Follow the diet restrictions for tyrosine and phenylalanine that your healthcare provider has given you during treatment with Nityr.
  • People who have a problem swallowing Nityr tablets whole, including children, can take Nityr tablets mixed with water in an oral (by mouth) syringe or crushed and mixed with applesauce. Nityr tablets should not be mixed in any other liquid or food.
  • Read the Instructions for use that come with Nityr for the correct way to take Nityr using an oral syringe or mixed in applesauce.
  • Talk to your healthcare provider or pharmacist if you have questions about Nityr tablets or how to use the oral syringe. You can also contact the Nityr Patient Support Program on the U.S. toll free number, 1-800-847-8714. For more information visit: WWW.Nityr.US

How should I store Nityr?

  • Nityr tablets do not need to be refrigerated.
  • Store Nityr tablets at room temperature between 68°F to 77°F (20°C to 25°C).
  • Store Nityr tablets in the container that it comes in and keep the container tightly closed.
  • Keep Nityr tablets and Nityr that has been prepared in an oral syringe with water or in applesauce out of direct sunlight.

Take Nityr within 24 hours of adding water to Nityr tablets in an oral syringe. Throw away any unused Nityr tablets and water stored in the oral syringe after 24 hours of being mixed together.

Take Nityr within 2 hours of adding crushed Nityr tablets to applesauce. Throw away any crushed NITRY tablets and applesauce mixture that has not been used within 2 hours.

Keep Nityr and all medicines out of the reach of children.

What are the ingredients in Nityr?

Active ingredient: nitisinone

Inactive ingredients: glyceryl dibehenate and lactose monohydrate

Instructions for use for Nityr

Read this Instructions for Use before you start taking Nityr tablets using an oral syringe or mixed in applesauce, and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

  • People who have a problem swallowing Nityr tablets whole, including children, can take Nityr tablets mixed with water in an oral (by mouth) syringe or crushed and mixed with applesauce. Nityr tablets should not be mixed in any other liquid or food.
  • Follow the diet restrictions for tyrosine and phenylalanine that your healthcare provider has given you during treatment with Nityr.
  • Nityr can be taken with or without food.

Important information for taking Nityr using an oral syringe

  • Prepare only 1 or 2 Nityr tablets in an oral syringe at one time.
  • Each tablet is white to beige in color and can have yellow to brown tiny specks.
  • Use a 5 mL oral syringe with a cap (see below) to prepare Nityr tablets in an oral syringe. Ask your pharmacist for your oral syringe. You may need more than one 5 mL oral syringe if you take more than 2 Nityr tablets for your prescribed dose.
  • Use only room temperature water to prepare Nityr tablets in an oral syringe.
  • Wash your hands well before preparing Nityr tablets using an oral syringe.
  • Talk to your healthcare provider or pharmacist if you have questions about Nityr tablets or how to use the oral syringe. You can also contact the Nityr Patient Support Program by calling the United States (U.S.) toll free phone number, 1-800-847-8714.

Nityr oral syringe.

How to prepare and take 1 Nityr tablet using a 5 mL oral syringe:

Step 1. Remove the cap from the 5 mL oral syringe.

Step 2. Remove the plunger from the oral syringe and place 1 whole Nityr tablet inside the oral syringe (See Figure A).

Remove the plunger from the oral syringe and place 1 whole Nityr tablet inside the oral syringe.

Step 3. Replace the plunger (See Figure B).

Replace the plunger in the Nityr syringe.

Step 4. Draw up 2.6 mL of room temperature water into the oral syringe. Each line on the barrel of the syringe is 0.2 mL. There may be some air in the oral syringe. Leave the air in the oral syringe (See Figure C).

Draw up 2.6 mL of room temperature water into the oral syringe. Each line on the barrel of the syringe is 0.2 mL. There may be some air in the oral syringe. Leave the air in the Nityr oral syringe

Step 5. Replace the cap on the oral syringe. Let the oral syringe sit for at least 60 minutes (See Figure D).

Replace the cap on the Nityr oral syringe. Let the oral syringe sit for at least 60 minutes

Step 6. Turn the oral syringe up and down for at least 30 seconds (See Figure E).

urn the oral syringe up and down for at least 30 seconds.

Step 7. Check the oral syringe to see if the Nityr tablet has broken apart into very small pieces and the pieces are evenly spread through the water (suspension) (See Figure F).
Do not take the suspension if there are any large pieces of the Nityr tablet in the suspension or if there are any pieces of the tablet that are not evenly spread through the water.

If there are any pieces of the tablet that are not evenly spread through the water, let the oral syringe sit for 10 minutes.

Before giving the suspension, turn the oral syringe up and down for 30 seconds to continue to spread the pieces of Nityr tablet in the suspension.

Small pieces of Nityr tablets in the oral syringe.

Step 8. Remove the cap from the oral syringe (See Figure G).

Remove the cap from the oral syringe.

Step 9. Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth (See Figure H).

Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth.

Step 10. While keeping the oral syringe in the mouth, slowly push down on the plunger until a small amount of air is left in the oral syringe, between the plunger and the tip of the oral syringe (See Figure I). Do not press the plunger all the way down to the end of the syringe.

While keeping the oral syringe in the mouth, slowly push down on the plunger until a small amount of air is left in the oral syringe, between the plunger and the tip of the oral syringe.

Step 11. Draw up an additional 2 mL of water into the oral syringe (See Figure J).

Draw up an additional 2 mL of water into the oral syringe.

Step 12. Replace the cap on the oral syringe. Shake the oral syringe well for 10 seconds to spread the remaining tablet pieces evenly through the water in the oral syringe (See Figure K).

Replace the cap on the oral syringe. Shake the oral syringe well for 10 seconds to spread the remaining tablet pieces evenly through the water in the oral syringe.

Step 13. Remove the cap from the oral syringe (See Figure L).

 Remove the cap from the oral syringe.

Step 14. Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth (See Figure M).

Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth.

Step 15. While keeping the oral syringe in the mouth, slowly push down on the plunger until the oral syringe is empty (See Figure N). In case any pieces of the tablet are still present in the oral syringe, repeat steps 11 through 15.

While keeping the oral syringe in the mouth, slowly push down on the plunger until the oral syringe is empty.

Step 16. After use, remove the plunger from the syringe barrel. Rinse the syringe and the plunger with water after each use and let it dry. Do not replace the plunger into the barrel of the oral syringe until ready to use again to allow it to dry. Do not throw away the oral syringe or plunger.

If you are not taking the water and Nityr tablet suspension as soon as it is prepared, complete steps 1 through 5. When you are ready to take the suspension, complete steps 6 through 16.

After adding water to the tablet in the oral syringe you can keep Nityr tablet suspension at room temperature for 24 hours. Store Nityr tablet suspension in the oral syringe with the cap on and out of direct sunlight until ready for use. The suspension does not need to be refrigerated. Throw away any suspension that is not used within 24 hours after adding water to the tablet in the oral syringe. Empty the syringe in the drain and throw away (dispose of) the syringe by placing it in a trash can.

How to prepare and take 2 Nityr tablets using a 5 mL oral syringe:

Step 1. Remove the cap from the 5 mL oral syringe.

Step 2. Remove the plunger from the oral syringe and place 2 whole Nityr tablets inside the oral syringe (See Figure A). IFU 16

Remove the plunger from the oral syringe and place 2 whole Nityr tablets inside the oral syringe

Step 3. Replace the plunger (See Figure B).

Replace plunger.

Step 4. Draw up 5 mL of room temperature water into the oral syringe. There may be some air in the oral syringe. Leave the air in the oral syringe (See Figure C).

Draw up 5 mL of room temperature water into the oral syringe. There may be some air in the oral syringe. Leave the air in the oral syringe.

Step 5. Replace the cap on the oral syringe. Let the oral syringe sit for at least 60 minutes (See Figure D).

Replace the cap on the oral syringe. Let the oral syringe sit for at least 60 minutes.

Step 6. Turn the oral syringe up and down for at least 30 seconds (See Figure E).

Turn the oral syringe up and down for at least 30 seconds.

Step 7. Check the oral syringe to see if the Nityr tablets have broken apart into very small pieces and the pieces are evenly spread through the water (suspension) (See Figure F). Do not take the suspension if there are any large pieces of the Nityr tablets in the suspension or if there are any pieces of the tablets that are not evenly spread through the water.

If there are any pieces of the tablets that are not evenly spread through the water, let the oral syringe sit for 10 minutes.

Before giving the suspension, turn the oral syringe up and down for 30 seconds to continue to spread the pieces of Nityr tablets in the suspension.

Check the oral syringe to see if the Nityr tablets have broken apart into very small pieces and the pieces are evenly spread through the water (suspension).

Step 8. Remove the cap from the oral syringe (See Figure G).

Remove the cap from the oral syringe.

Step 9. Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth (See Figure H).

Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth.

Step 10. While keeping the oral syringe in the mouth, slowly push down on the plunger until a small amount of air is left in the oral syringe, between the plunger and the tip of the oral syringe (See Figure I). Do not press all the way down on the plunger.

While keeping the oral syringe in the mouth, slowly push down on the plunger until a small amount of air is left in the oral syringe, between the plunger and the tip of the oral syringe.

Step 11. Draw up 2 mL of water into the oral syringe (See Figure J).

Draw up 2 mL of water into the oral syringe.

Step 12. Replace the cap on the oral syringe. Shake the oral syringe well for 10 seconds to spread the remaining tablet pieces evenly through the water in the oral syringe (See Figure K).

Replace the cap on the oral syringe. Shake the oral syringe well for 10 seconds to spread the remaining tablet pieces evenly through the water in the oral syringe.

Step 13. Remove the cap from the oral syringe (See Figure L).

Remove the cap from the oral syringe.

Step 14. Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth (See Figure M).

Place the tip of the oral syringe in the mouth right away. If giving to a child, place the tip of the oral syringe along the inner cheek of the child’s mouth.

Step 15. While keeping the oral syringe in the mouth, slowly push down on the plunger until the oral syringe is empty (See Figure N). In case any pieces of the tablets are still present in the oral syringe, repeat steps 11 through 15.

While keeping the oral syringe in the mouth, slowly push down on the plunger until the oral syringe is empty.

Step 16. After use, remove the plunger from the oral syringe barrel. Rinse the oral syringe with water after each use and let it dry. Do not replace the plunger into the barrel of the oral syringe until ready to use again to allow it to dry. Do not throw away the oral syringe.

If you are not taking the water and Nityr tablets suspension as soon as it is prepared, complete steps 1 through 5. When you are ready to take the suspension, complete steps 6 through 16.

After adding water to the tablet in the oral syringe you can keep Nityr tablet suspension at room temperature for 24 hours. Store the suspension in the oral syringe with the cap on and out of direct sunlight until use. The suspension does not need to be refrigerated. Throw away any suspension that is not used within 24 hours after adding water to the tablets in the oral syringe. Empty the syringe in the drain and throw away (dispose of) the syringe by placing it in a trash can.

How to prepare and take more than 2 Nityr tablets using an oral syringe:

If more than two Nityr tablets are needed for the prescribed dose follow the instructions for "How to prepare and take 1 Nityr tablet using an oral syringe" and "How to prepare and take 2 Nityr tablets using an oral syringe" until you get your prescribed dose. You should not add more than 2 tablets to one syringe at a time.

How to prepare and take Nityr tablets in applesauce:

Wash your hands well before preparing Nityr tablets in applesauce.

Crush only 1 Nityr tablet at a time.

Step 1. Measure about 1 teaspoon of applesauce and put it into a clean container, such as a glass or bowl.

Step 2. Place 1 Nityr tablet onto a metal teaspoon (See Figure A)

Place 1 Nityr tablet onto a metal teaspoon.

Step 3. Place a second teaspoon on top of the teaspoon holding the tablet. Apply light pressure with the second teaspoon by pressing and rotating the two teaspoons against each other (See Figure B) until the tablet is crushed to a fine powder (See Figure C).

Place a second teaspoon on top of the teaspoon holding the tablet. Apply light pressure with the second teaspoon by pressing and rotating the two teaspoons against each other (See Figure B) until the tablet is crushed to a fine powder (See Figure C).

Step 4. Carefully place all of the Nityr tablet powder from the metal teaspoon into the clean container of applesauce. Be sure that no tablet powder remains on the teaspoon (See Figure D).

Carefully place all of the Nityr tablet powder from the metal teaspoon into the clean container of applesauce. Be sure that no tablet powder remains on the teaspoon.

Step 5. If the prescribed dose is more than 1 tablet, repeat Steps 2 and 3, placing all of the Nityr tablet powder together in the container with the applesauce. You do not need to add more applesauce at this time if you take more than 1 tablet.

Step 6. Stir the Nityr tablet powder and the applesauce until all of the tablet powder is mixed well in the applesauce (See Figure E).

 Stir the Nityr tablet powder and the applesauce until all of the tablet powder is mixed well in the applesauce.

Step 7. Remove the Nityr tablet powder and applesauce mixture from the container using a teaspoon and swallow the mixture right away (See Figure F). Repeat this step until no mixture is left in the container.

Remove the Nityr tablet powder and applesauce mixture from the container using a teaspoon and swallow the mixture right away

Step 8. Measure another 1 teaspoon of applesauce and place it in the container used to mix the Nityr tablet powder and applesauce (See Figure G).

Measure another 1 teaspoon of applesauce and place it in the container used to mix the Nityr tablet powder and applesauce.

Step 9. Stir the fresh applesauce with the remaining Nityr tablet powder and applesauce mixture until they are mixed well (See Figure H).

Stir the fresh applesauce with the remaining Nityr tablet powder and applesauce mixture until they are mixed well

Step 10. Remove the Nityr tablet and applesauce mixture from the container using a teaspoon and swallow the mixture right away (See Figure I). Repeat this step until no mixture or powder is left in the container.

Remove the Nityr tablet and applesauce mixture from the container using a teaspoon and swallow the mixture right away.

Take the Nityr tablet and applesauce mixture within 2 hours after adding the Nityr tablet powder to the applesauce. Store the Nityr tablet and applesauce mixture at room temperature and out of direct sunlight until use. The mixture does not need to be refrigerated. Throw away any mixture that is not used within 2 hours after mixing in a trash can.

How should I store Nityr?

  • Nityr tablets do not need to be refrigerated.
  • Store Nityr tablets at room temperature between 68°F to 77°F (20°C to 25°C).
  • Store Nityr tablets in the container that it comes in and keep the container tightly closed.
  • Keep Nityr tablets and Nityr that has been prepared in an oral syringe with water or in applesauce out of direct sunlight.

Take Nityr within 24 hours of adding water to Nityr tablets in an oral syringe. Throw away any unused Nityr tablets and water stored in the oral syringe after 24 hours of being mixed together.

Take Nityr within 2 hours of adding crushed Nityr tablets to applesauce. Throw away any crushed NITRY tablets and applesauce mixture that has not been used within 2 hours.

Talk to your healthcare provider or pharmacist if you have questions about Nityr tablets or how to use the oral syringe. You can also contact the Nityr Patient Support Program on the U.S. toll free number, 1-800-847-8714. For more information visit: WWW.Nityr.US

Keep Nityr and all medicines out of the reach of children.

Source: National Library of Medicine. Last updated February 28, 2021.