B. Braun

Germany - Melsungen

Biotechnology1 H-1B visas (FY2023)

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Focus: Infusion therapy and pain management

B. Braun is a life sciences company focused on Infusion therapy and pain management.

CardiovascularInfectious DiseasesMetabolic DiseasesNephrologyNeurology

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Products & Portfolio (27)

23 discontinued products not shown

ACETAMINOPHEN

acetaminophen

Peak

INTRAVENOUS · SOLUTION

12.1 Mechanism of Action The precise mechanism of the analgesic and antipyretic properties of acetaminophen is not established but is thought to primarily involve central actions. 12.2 Pharmacodynamics Acetaminophen has been shown to have analgesic and antipyretic activities in animal and human studies. Single doses of acetaminophen up to 3,000 mg and repeated doses of 1,000 mg every 6 hours for 48 hours have not been shown to cause a significant effect on platelet aggregation. Acetaminophen does not have any immediate or delayed effects on small-vessel hemostasis. Clinical studies of both healthy subjects and patients with hemophilia showed no significant changes in bleeding time after receiving multiple doses of oral acetaminophen. 12.3 Pharmacokinetics Distribution The pharmacokinetics of Acetaminophen Injection have been studied in patients and healthy subjects up to 60 years old. The pharmacokinetic profile of Acetaminophen Injection has been demonstrated to be dose proportional in adults following administration of single doses of 500, 650, and 1,000 mg. The maximum concentration (C max ) occurs at the end of the 15-minute intravenous infusion of Acetaminophen Injection. Compared to the same dose of oral acetaminophen, the C max following administration of Acetaminophen Injection is up to 70% higher, while overall exposure (area under the concentration time curve [AUC]) is very similar. Pharmacokinetic parameters of Acetaminophen Injection (AUC, C max , terminal elimination half-life [T ½ ], systemic clearance [CL], and volume of distribution at steady state [Vss]) following administration of a single intravenous dose of 15 mg/kg in children and adolescents and 1,000 mg in adults are summarized in Table 5. Table 5. Acetaminophen Injection Pharmacokinetic Parameters Subpopulations Mean (SD) AUC 0-6h (mcg × h/mL) C max (mcg/mL) T ½ (h) CL (L/h/kg) Vss (L/kg) Children 38 (8) 29 (7) 3.0 (1.5) 0.34 (0.10) 1.2 (0.3) Adolescents 41 (7) 31 (9) 2.9 (0.7) 0.29 (0.08) 1.1 (0.3) Adults 43 (11) 28 (21) 2.4 (0.6) 0.27 (0.08) 0.8 (0.2) The concentrations of acetaminophen observed in neonates greater than 32 weeks gestational age at birth treated with 12.5 mg/kg dose are similar to infants, children and adolescents treated with a 15 mg/kg dose, and similar to adults treated with a 1,000 mg dose. At therapeutic levels, binding of acetaminophen to plasma proteins is low (ranging from 10% to 25%). Acetaminophen appears to be widely distributed throughout most body tissues except fat. Elimination Metabolism Acetaminophen is primarily metabolized in the liver by first-order kinetics and involves three principal separate pathways: Conjugation with glucuronide, conjugation with sulfate, and oxidation via the cytochrome P450 enzyme pathway, primarily CYP2E1, to form a reactive intermediate metabolite (N-acetyl-p-benzoquinone imine or NAPQI). With therapeutic doses, NAPQI undergoes rapid conjugation with glutathione and is then further metabolized to form cysteine

mild to moderate pain in adultolder () Management of moderate to severe pain with adjunctive opioid analgesics in adultolder () Reduction of fever in adult

2021

ACETIC ACID 0.25% IN PLASTIC CONTAINER

acetic acid

LOE Approaching

IRRIGATION, URETHRAL · SOLUTION

CLINICAL PHARMACOLOGY Irrigation of the urinary bladder with acetic acid solution in a concentration of 0.25% has been shown to exert an antimicrobial action against a variety of microorganisms (especially ammonia-forming bacteria) that frequently gain access to the urinary bladder in patients who require prolonged indwelling urethral catheterization. Its antimicrobial action is dependent on administration via the indwelling catheter at a sufficient rate (continuous or intermittent) to maintain an effluent pH of 5.0 or lower. Maintenance of low pH of bladder urine also helps reduce formation of calcium encrustations in the indwelling catheter.

1979

AMINO ACIDS

lysine acetate, leucine, phenylalanine, valine, isoleucine, methionine, threonine, tryptophan, alanine, arginine, glycine, histidine, proline, glutamic acid, serine, aspartic acid, and tyrosine

Post-LOE

INJECTION · INJECTABLE

CLINICAL PHARMACOLOGY Plenamine™ 15% Amino Acids Injection provides seventeen crystalline amino acids. This completely utilizable substrate promotes protein synthesis and wound healing and reduces the rate of protein catabolism. A. Total Parenteral Nutrition (Central Infusion) When enteral feeding is inadvisable, Plenamine™ 15% given by central venous infusion in combination with energy sources, vitamins, trace elements and electrolytes, will completely satisfy the requirements for weight maintenance or weight gain, depending upon the dose selected. The energy component in parenteral nutrition by central infusion may be derived solely from dextrose or may be provided by a combination of dextrose and intravenous fat emulsion. The addition of intravenous fat emulsion provides essential fatty acids and permits a dietary balance of fat and carbohydrate, at the same time offering the option of reducing the dextrose load and/or increasing the total caloric input. An adequate energy supply is essential for optimal utilization of amino acids. B. Total Parenteral Nutrition (Peripheral Infusion) Plenamine™ 15% can also be administered as part of a total parenteral nutrition program by peripheral vein when the enteral route is inadvisable and use of the central venous catheter is contraindicated. Reduction of protein loss can be achieved by use of diluted Plenamine™ 15% in combination with dextrose or with dextrose and intravenous fat emulsion by peripheral infusion. Complete peripheral intravenous nutrition can be achieved in patients with low caloric requirements by a Plenamine™ 15% dextrose-fat regimen.

2012

BALANCED SALT

sodium chloride, potassium chloride, calcium chloride, magnesium chloride, sodium acetate, and sodium citrate

Post-LOE

IRRIGATION · SOLUTION

CLINICAL PHARMACOLOGY Balanced Salt Solution Sterile Irrigating Solution is an isotonic solution for use in irrigating tissues of the eyes.

2010

BUPIVACAINE HYDROCHLORIDE

bupivacaine hydrochloride with dextrose

Post-LOE

SPINAL · INJECTABLE

impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: (1) pain, (2) temperature, (3) touch, (4) proprioception, and (5) skeletal muscle tone.

INTRAVENOUS · SOLUTION

level. Calcium gluconate dissociates into ionized calcium in plasma. Ionized calcium and gluconate are normal constituents of body fluids.

2023

CEFAZOLIN AND DEXTROSE

cefazolin sodium

LOE Approaching

INJECTION · INJECTABLE

12.1 Mechanism of Action Cefazolin is an antibacterial drug [see ]. 12.2 Pharmacodynamics The pharmacokinetic/pharmacodynamic relationship for cefazolin has not been evaluated in patients. 12.3 Pharmacokinetics Studies have shown that following intravenous administration of cefazolin to normal volunteers, mean serum concentrations peaked at approximately 185 mcg/mL and were approximately 4 mcg/mL at 8 hours for a 1 gram dose. The serum half-life for cefazolin is approximately 1.8 hours following IV administration. In a study of constant intravenous infusion with dosages of 3.5 mg/kg for 1 hour (approximately 250 mg) and 1.5 mg/kg the next 2 hours (approximately 100 mg) in healthy volunteers, cefazolin serum concentrations at the third hour were approximately 28 mcg/mL. Plasma pharmacokinetic parameters of cefazolin in healthy volunteers (N=12) following a single 15-minute IV infusion of 2 grams of Cefazolin for Injection and Dextrose Injection are summarized in Table 7. Table 7: Mean (Standard Deviation) Plasma Pharmacokinetic Parameters of Cefazolin in Healthy Volunteers Dosage of Cefazolin for Injection and Dextrose Injection N C max (mcg/mL) T max T max reported as median (range) (h) AUC 0-inf (mcg*h/mL) t 1/2 (h) CL (L/h) V z (L) Single 2 grams Dose as a 15-Minute IV Infusion 12 280.9 (45.9) 0.25 (0.25-0.33) 509.9 (89.3) 2.01 (0.28) 4.03 (0.68) 11.50 (1.53) N= number of subjects observed; C max = maximum plasma concentration; T max = time to maximum plasma concentration; AUC 0-inf = area under the plasma concentration-time curve extrapolated to infinity; t 1/2 = apparent plasma terminal elimination half-life; CL = total clearance; V z = volume of distribution Model derived plasma pharmacokinetic parameters of cefazolin in adult patients weighing 120 kg or greater (N=12) following a single 30-minute IV infusion of 3 grams of Cefazolin for Injection and Dextrose Injection are summarized in Table 8. Table 8: Mean (Standard Deviation) Model Derived Plasma Pharmacokinetic Parameters of Cefazolin in Adult Patients Weighing ≥ 120 kg Dosage of Cefazolin for Injection and Dextrose Injection N C max (mcg/mL) T max (h) AUC 0--inf (mcg*h/mL) t 1/2 (h) CL (L/h ) Vz (L) Single 3 grams Dose as a 30-Minute IV Infusion 12 197.7 (46.6) 0.5 598.6 (206.6) 2.36 (0.687) 5.52 (1.72) 17.51 (3.63) * T max reported based on infusion duration N= number of subjects observed; C max = maximum plasma concentration; T max = time to maximum plasma concentration; AUC 0-inf = area under the plasma concentration-time curve extrapolated to infinity; t 1/2 = apparent plasma terminal elimination half-life; CL = total clearance; V z = volume of distribution Studies in patients hospitalized with infections indicate that cefazolin mean peak serum concentrations were approximately equivalent to those seen in healthy volunteers. Bile concentrations in patients without obstructive biliary disease can reach or exceed serum concentrations by up to five times; however, in patients with obs

respiratory tract infections due to Streptococcus pneumoniaeStaphylococcus aureusStreptococcus pyogenes in adults+14 more

2000

CEFEPIME AND DEXTROSE IN DUPLEX CONTAINER

cefepime hydrochloride

LOE Approaching

INJECTION · INJECTABLE

12.1 Mechanism of Action Cefepime is a cephalosporin antibacterial drug [see ]. 12.2 Pharmacodynamics Similar to other beta-lactam antimicrobial agents, the time that the unbound plasma concentration of cefepime exceeds the MIC of the infecting organism has been shown to best correlate with efficacy in animal models of infection. However, the pharmacokinetic/pharmacodynamic relationship for cefepime has not been evaluated in patients. 12.3 Pharmacokinetics Pharmacokinetic parameters for cefepime in healthy adult male volunteers (n=9) following single 30-minute IV infusions of cefepime 500 mg, 1 g, and 2 g are summarized in Table 5. Elimination of cefepime is principally via renal excretion with an average (±SD) half-life of 2 (±0.3) hours and total body clearance of 120 (±8) mL/min in healthy volunteers. Cefepime pharmacokinetics are linear over the range 250 mg to 2 g. There is no evidence of accumulation in healthy adult male volunteers (n=7) receiving clinically relevant doses for a period of 9 days. Table 5: Mean Pharmacokinetic Parameters for Cefepime (±SD), Intravenous Administration Parameter 500 mg IV 1 g IV 2 g IV C max , mcg/mL 39.1 (3.5) 81.7 (5.1) 163.9 (25.3) AUC, h∙mcg/mL 70.8 (6.7) 148.5 (15.1) 284.8 (30.6) Number of subjects (male) 9 9 9 Distribution The average steady-state volume of distribution of cefepime is 18.0 (±2.0) L. The serum protein binding of cefepime is approximately 20% and is independent of its concentration in serum. Concentrations of cefepime achieved in specific tissues and body fluids are listed in Table 6 . Table 6: Mean Concentrations of Cefepime in Specific Body Fluids (mcg/mL) or Tissues (mcg/g) Tissue or Fluid Dose/Route # of Patients Average Time of Sample Post-Dose (h) Average Concentration Blister Fluid 2 g IV 6 1.5 81.4 mcg/mL Bronchial Mucosa 2 g IV 20 4.8 24.1 mcg/g Sputum 2 g IV 5 4 7.4 mcg/mL Urine 500 mg IV 8 0–4 292 mcg/mL 1 g IV 12 0–4 926 mcg/mL 2 g IV 12 0–4 3120 mcg/mL Bile 2 g IV 26 9.4 17.8 mcg/mL Peritoneal Fluid 2 g IV 19 4.4 18.3 mcg/mL Appendix 2 g IV 31 5.7 5.2 mcg/g Gallbladder 2 g IV 38 8.9 11.9 mcg/g Prostate 2 g IV 5 1 31.5 mcg/g Data suggest that cefepime does cross the inflamed blood-brain barrier. The clinical relevance of these data are uncertain at this time. Metabolism and Excretion Cefepime is metabolized to N-methylpyrrolidine (NMP), which is rapidly converted to the N-oxide (NMP-N-oxide). Urinary recovery of unchanged cefepime accounts for approximately 85% of the administered dose. Less than 1% of the administered dose is recovered from urine as NMP, 6.8% as NMP-N-oxide, and 2.5% as an epimer of cefepime. Because renal excretion is a significant pathway of elimination, patients with renal dysfunction and patients undergoing hemodialysis require dosage adjustment [see ]. Specific Populations Patients with Renal Impairment Cefepime pharmacokinetics have been investigated in patients with various degrees of renal impairment (n=30). The average half-life in patients requiring

pneumonia (moderate to severe) caused by Streptococcus pneumoniae (including cases associated with concurrent bacteremia)Pseudomonas aeruginosaKlebsiella pneumoniae+4 more

2010

CEFOXITIN AND DEXTROSE IN DUPLEX CONTAINER

cefoxitin sodium

LOE Approaching

INJECTION · INJECTABLE

12.1 Mechanism of Action Cefoxitin is an antibacterial drug [ ] . 12.2 Pharmacodynamics The pharmacodynamic properties of cefoxitin are unknown. 12.3 Pharmacokinetics Absorption Following an intravenous dose of 1 gram, serum concentrations were 110 mcg/mL at 5 minutes, declining to less than 1 mcg/mL at 4 hours. Distribution Cefoxitin passes into pleural and joint fluids and is detectable in antibacterial concentrations in bile. Elimination Metabolism The half-life after an intravenous dose is 41 to 59 minutes. Excretion Approximately 85 percent of cefoxitin is excreted unchanged by the kidneys over a 6-hour period, resulting in high urinary concentrations. Probenecid slows tubular excretion and produces higher serum levels and increases the duration of measurable serum concentrations. Specific Populations Geriatric Patients In a published study of geriatric patients ranging in age from 64 to 88 years with normal renal function for their age (creatinine clearance ranging from 31.5 to 174.0 mL/min), the half-life for cefoxitin ranged from 51 to 90 minutes, resulting in higher plasma concentrations than in younger adults. These changes were attributed to decreased renal function associated with the aging process. 12.4 Microbiology Mechanism of Action Cefoxitin is a bactericidal agent that acts by inhibition of bacterial cell wall synthesis. Cefoxitin has activity in the presence of some beta-lactamases, both penicillinases and cephalosporinases, of Gram-negative and Gram-positive bacteria. Resistance Resistance to Cefoxitin is primarily through hydrolysis by beta-lactamase, alteration of penicillin-binding proteins (PBPs), and decreased permeability. Antimicrobial Activity Cefoxitin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections [see ]. Gram-positive bacteria Staphylococcus aureus Staphylococcus epidermidis Streptococcus agalactiae Streptococcus pneumoniae Streptococcus pyogenes Gram-negative bacteria Escherichia coli Haemophilus influenzae Klebsiella spp. Morganella morganii Neisseria gonorrhoeae Proteus mirabilis Proteus vulgaris Providencia spp. Anaerobic bacteria Clostridium spp. Peptococcus niger Peptostreptococcus spp. Bacteroides distasonis Bacteroides fragilis Bacteroides ovatus Bacteroides thetaiotaomicron Bacteroides spp. The following in vitro data are available, but their clinical significance is unknown. At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for cefoxitin against isolates of similar genus or organism group. However, the efficacy of cefoxitin in treating clinical infections caused by these bacteria has not been established in adequate and well-controlled clinical trials. Gram-negative bacteria Eikenella corrodens [non- β-lactamase producers] Anaerobic bacteria Clostridium perfringens Prevotella bivia Susceptibility Testing For specific information

lower respiratory tract infectionsincluding pneumonialung abscess+33 more

2006

CEFTRIAXONE AND DEXTROSE IN DUPLEX CONTAINER

ceftriaxone

LOE Approaching

INJECTION · INJECTABLE

12.1 Mechanism of Action Ceftriaxone is an antibacterial drug [see ]. 12.3 Pharmacokinetics Average plasma concentrations of ceftriaxone following a single 30-minute intravenous (IV) infusion of a 0.5, 1 or 2 g dose in healthy subjects are presented in Table 2. Multiple IV doses ranging from 0.5 to 2 g at 12- to 24-hour intervals resulted in 15% to 36% accumulation of ceftriaxone above single-dose values. TABLE 2: Ceftriaxone Plasma Concentrations After Single-Dose Administration Dose/Route Average Plasma Concentrations (mcg/mL) 0.5 hr 1 hr 2 hr 4 hr 6 hr 8 hr 12 hr 16 hr 24 hr 0.5 g IV IV doses were infused at a constant rate over 30 minutes. 82 59 48 37 29 23 15 10 5 1 g IV 151 111 88 67 53 43 28 18 9 2 g IV 257 192 154 117 89 74 46 31 15 Over a 0.15 to 3 g dose range in healthy adult subjects, the mean elimination half-life ranged from 5.8 to 8.7 hours, plasma clearance ranged from 0.58 to 1.45 L/hour, and renal clearance ranged from 0.32 to 0.73 L/hour. Distribution Ceftriaxone is reversibly bound to human plasma proteins and the binding of ceftriaxone decreases with increasing concentration from a value of 95% at plasma concentrations less than 25 mcg/mL to 85% at plasma concentration of 300 mcg/mL. Over a 0.15 to 3 g dose range in healthy adult subjects, the apparent volume of distribution ranged from 5.8 to 13.5 L. Ceftriaxone crosses the blood placenta barrier. Ceftriaxone penetrates the inflamed meninges of infants and pediatric patients. The average values of maximum plasma concentration, cerebrospinal fluid (CSF) concentrations, elimination half-life, plasma clearance and volume of distribution after a 50 mg/kg IV dose and after a 75 mg/kg IV dose in pediatric patients suffering from bacterial meningitis are shown in Table 3. TABLE 3: Average Pharmacokinetic Parameters of Ceftriaxone in Pediatric Patients With Meningitis 50 mg/kg IV 75 mg/kg IV Maximum Plasma Concentrations (mcg/mL) 216 275 Elimination Half-life (hr) 4.6 4.3 Plasma Clearance (mL/hr/kg) 49 60 Volume of Distribution (mL/kg) 338 373 CSF Concentrationinflamed meninges (mcg/mL) 5.6 6.4 Range (mcg/mL) 1.3 – 18.5 1.3 – 44 Time after dose (hr) 3.7 (±1.6) 3.3 (±1.4) After a 1 g IV dose, average concentrations of ceftriaxone, determined from 1 to 3 hours after dosing, were 581 mcg/mL in the gallbladder bile, 788 mcg/mL in the common duct bile, 898 mcg/mL in the cystic duct bile, and 78.2 mcg/g in the gallbladder wall compared to a corresponding concentration of 62.1 mcg/mL in plasma. Excretion Ceftriaxone concentrations in urine are shown in Table 4. TABLE 4: Urinary Concentrations of Ceftriaxone After Single-Dose Administration Dose/Route Average Urinary Concentrations (mcg/mL) 0-2 hr 2-4 hr 4-8 hr 8-12 hr 12-24 hr 24-48 hr 0.5 g IV 526 366 142 87 70 15 1 g IV 995 855 293 147 132 32 2 g IV 2692 1976 757 274 198 40 Thirty-three percent to 67% of a ceftriaxone dose was excreted in the urine as unchanged drug and the remainder was secreted in the bile and ultimately found in the f

the following infections caused by susceptible isolates of the designated bacteria: Lower Respiratory Tract Infections ()

2005

DEXTROSE 10% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER

dextrose and sodium chloride

LOE Approaching

INJECTION · INJECTABLE

CLINICAL PHARMACOLOGY Dextrose and Sodium Chloride Injections USP provide electrolytes and calories and are a source of water for hydration. All are capable of inducing diuresis depending on the clinical condition of the patient. Sodium, the major cation of the extracellular fluid, functions primarily in the control of water distribution, fluid balance, and osmotic pressure of body fluids. Sodium is also associated with chloride and bicarbonate in the regulation of the acid-base equilibrium of body fluid. Chloride, the major extracellular anion, closely follows the metabolism of sodium, and changes in the acid-base balance of the body are reflected by changes in the chloride concentration. Dextrose provides a source of calories. Dextrose is readily metabolized, may decrease losses of body protein and nitrogen, promotes glycogen deposition and decreases or prevents ketosis if sufficient doses are provided.

1988

DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER

dextrose and sodium chloride

LOE Approaching

INJECTION · INJECTABLE

1988

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Interview Prep Quick Facts

Portfolio: 275 approved products

Top TAs: Infectious Diseases, Metabolic Diseases, Nephrology

H-1B (2023): 1 approval

Portfolio Health

Launch2 (1%)

Peak4 (1%)

LOE Approaching252 (92%)

Post-LOE17 (6%)

275 total products

Therapeutic Area Focus

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