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Adverse reactions to
XENLETA were generally
mild to moderate regardless of
oral or IV administration¹

3.3% (21/641) of patients taking XENLETA discontinued treatment due to adverse reaction vs 3.3% (21/641) of patients taking moxifloxacin²

Adverse reactions occurring in ≥2% of patients receiving XENLETA²

Trial 1 IV ± Oral Dosing
Trial 2 Oral Dosing Only

Adverse Reactions	XENLETA N=273	moxifloxacin ± linezolid N=273
Administration site reactions^a	7%	3%
Nausea	3%	2%
Hepatic enzyme elevation^b	3%	3%
Hypokalemia	3%	2%
Insomnia	3%	2%
Headache	2%	2%

Adverse Reactions	XENLETA N=368	moxifloxacin N=368
Diarrhea	12%	1%
Nausea	5%	2%
Vomiting	3%	1%
Hepatic enzyme elevation^b	2%	2%

Adverse Reactions	Trial 1 IV ± Oral Dosing		Trial 2 Oral Dosing Only
Adverse Reactions	XENLETA N=273	moxifloxacin ± linezolid N=273	XENLETA N=368	moxifloxacin N=368
Diarrhea	N/A	N/A	12%	1%
Administration site reactions^a	7%	3%	N/A	N/A
Nausea	3%	2%	5%	2%
Hepatic enzyme elevation^b	3%	3%	2%	2%
Hypokalemia	3%	2%	N/A	N/A
Insomnia	3%	2%	N/A	N/A
Vomiting	N/A	N/A	3%	1%
Headache	2%	2%	N/A	N/A

aAdministration site reactions include infusion site pain, infusion site phlebitis, and injection site reaction.
bHepatic enzyme elevation includes alanine aminotransferase increased, aspartate aminotransferase increased, and liver function test increased.

Total time on XENLETA can be as short as 5 days.²

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Indication and
Important Safety Information

Indication

XENLETA is a pleuromutilin antibacterial indicated for the treatment of adults with community-acquired bacterial pneumonia (CABP) caused by the following susceptible microorganisms: Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible isolates), Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.

Usage

To reduce the development of drug-resistant bacteria and maintain the effectiveness of XENLETA and other antibacterial drugs, XENLETA should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

Important Safety Information

CONTRAINDICATIONS

XENLETA is contraindicated in patients with known hypersensitivity to XENLETA or pleuromutilins.

XENLETA tablets are contraindicated for use with CYP3A4 substrates that prolong the QT interval.

WARNINGS AND PRECAUTIONS

XENLETA has the potential to prolong the QT interval. Avoid XENLETA in patients with known QT prolongation, ventricular arrhythmias, and patients receiving drugs that may prolong the QT interval.

Based on animal studies, XENLETA may cause fetal harm. Advise females of reproductive potential of the potential risk to the fetus and to use effective contraception.

Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all systemic antibacterial agents, including XENLETA, with severity ranging from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.

ADVERSE REACTIONS

The most common adverse reactions (≥2%) for (a) XENLETA Injection are administration site reactions, hepatic enzyme elevation, nausea, hypokalemia, insomnia, and headache and (b) XENLETA Tablets are diarrhea, nausea, vomiting, and hepatic enzyme elevation.

USE IN SPECIFIC POPULATIONS

In patients with severe hepatic impairment, reduce the dosage of XENLETA Injection to 150 mg infused over 60 minutes every 24 hours. XENLETA Tablets are not recommended in patients with moderate or severe hepatic impairment due to insufficient information to provide dosing recommendations.

Avoid XENLETA Injection and Tablets with concomitant strong or moderate CYP3A or P-gp inducers. Monitor for reduced efficacy of XENLETA.

Avoid XENLETA Tablets with strong CYP3A or P-gp inhibitors.

Monitor for adverse reactions of sensitive CYP3A substrates administered with XENLETA Tablets.

XENLETA has not been studied in pregnant women. Verify pregnancy status in females prior to initiating XENLETA and advise females to use contraception during treatment and for 2 days after the final dose. Lactating women should pump and discard milk for the duration of treatment with XENLETA and for 2 days after the final dose.

To report SUSPECTED ADVERSE REACTIONS, or administration during pregnancy, contact Nabriva Therapeutics US, Inc. at 1-855-5NABRIVA or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please see Full Prescribing Information for XENLETA.

References

File TM Jr, Goldberg L, Das A, et al. Efficacy and safety of IV-to-oral lefamulin, a pleuromutilin antibiotic, for treatment of community-acquired bacterial pneumonia: the phase 3 LEAP 1 trial. Clin Infect Dis. 2019 (online ahead of print).
XENLETA™ (lefamulin) [package insert]. King of Prussia, PA: Nabriva Therapeutics; 2019.

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Distributed by Nabriva Therapeutics US, Inc.

© 2019 Nabriva Therapeutics US, Inc.

PM-US-LEF-0077 SEP 2019