Merck known as MSD outside the United States and Canada, announced that the Japanese Ministry of Health, Labour and Welfare (MHLW) approved three products – Gardasil [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant], Zolinza vorinostat) and Cubicin (daptomycin for injection) – for use in Japan.

“These three new approvals will enable Merck to bring these new medicines and vaccines to the people of Japan,” said Tony Alvarez, president, MSD Japan. “Doing so will help Merck continue to fulfill its mission and deliver growth.”

In Japan, Gardasil, a quadrivalent Human Papillomavirus vaccine, (HPV) was approved for the prevention of cervical cancer (squamous cell cancer and adenocarcinoma) and their precursor lesions (cervical intraepithelial neoplasm grade 1/2/3 and cervical adenocarcinoma in situ), vulvar intraepithelial neoplasia grade 1/2/3, vaginal intraepithelial neoplasia grade 1/2/3 and genital warts caused by HPV types 6, 11, 16 and 18 in females 9 years of age and older.

Zolinza is an oral anticancer drug and was approved in Japan for the treatment of cutaneous T-cell lymphomas. As the result of a distribution agreement signed in 2011, Taiho Pharmaceutical Co., Ltd. will promote and distribute Zolinza in Japan.

Cubicin is an antibacterial agent with activity against Methicillin-Resistant Staphylococcus Aureus (MRSA) and was approved in Japan for the treatment of MRSA infections. Under a licensing agreement signed in 2007 between Merck and Cubist, MSD obtained the rights for development and distribution of Cubicin in Japan. Cubicin is marketed in the United States by Cubist Pharmaceuticals.

Gardasil is approved in the United States for use in girls and young women 9 through 26 years of age for the prevention of cervical, vulvar, vaginal and anal cancers caused by HPV types 16 and 18; genital warts caused by HPV types 6 and 11; and precancerous or dysplastic lesions caused by HPV types 6, 11, 16 and 18. Gardasil is also approved in the United States for use in boys and men ages 9 through 26 years of age for the prevention of anal cancer caused by HPV types 16 and 18, for the prevention of anal dysplasias and precancerous lesions caused by HPV types 6, 11, 16 and 18, and the prevention of genital warts caused by HPV types 6 and 11.

Gardasil is not approved in the United States for use in women older than 26 years of age. It does not eliminate the necessity for women to continue to undergo recommended cervical cancer screening. Recipients of Gardasil should not discontinue anal cancer screening if it has been recommended by a health care provider.

Gardasil has not been demonstrated to provide protection against diseases from vaccine and non-vaccine HPV types to which a person has previously been exposed through sexual activity. It is not intended to be used for treatment of active external genital lesions; cervical, vulvar, vaginal and anal cancers; cervical intraepithelial neoplasia, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, or anal intraepithelial neoplasia.

Gardasil has not been demonstrated to protect against disease due to HPV types not contained in the vaccine. Not all vulvar, vaginal and anal cancers are caused by HPV, and Gardasil protects only against those vulvar, vaginal and anal cancers caused by HPV Types 16 and 18.

Gardasil is contraindicated in individuals with hypersensitivity, including severe allergic reactions to yeast, or after a previous dose of Gardasil. Because vaccinees may develop syncope, sometimes resulting in falling with injury, observation for 15 minutes after administration is recommended. Syncope, sometimes associated with tonic-clonic movements and other seizure-like activity, has been reported following vaccination with Gardasil. When syncope is associated with tonic-clonic movements, the activity is usually transient and typically responds to restoring cerebral perfusion.

The most common adverse reaction was headache. Common adverse reactions that were observed among recipients of Gardasil at a frequency of at least 1.0 percent and greater than placebo were: fever, nausea, dizziness; and injection-site pain, swelling, erythema, pruritus and bruising.

Gardasil is a ready-to-use, three-dose, intramuscular vaccine. It should be administered in three separate intramuscular injections in the deltoid region of the upper arm or in the higher anterolateral area of the thigh. The following dosage schedule is recommended: First dose at elected date, second dose two months after the first dose and the third dose six months after the first dose.

Zolinza is a histone deacetylase (HDAC) inhibitor indicated in the United States for the treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma who have progressive, persistent or recurrent disease on or following two systemic therapies.

As pulmonary embolism and deep vein thrombosis have been reported as adverse reactions, physicians should be alert to the signs and symptoms of these events, particularly in patients with a prior history of thromboembolic events. Treatment with Zolinza can cause dose-related thrombocytopenia and anaemia. If platelet counts and/or haemoglobin are reduced during treatment with Zolinza, the dose should be modified or discontinued.

Gastrointestinal disturbances, including nausea, vomiting and diarrhoea, have been reported and may require the use of antiemetic and anti-diarrhoeal medications. Fluid and electrolytes should be replaced to prevent hydration. Pre-existing nausea, vomiting and diarrhoea should be adequately controlled before beginning therapy with Zolinza.  Hyperglycaemia has been observed in patients receiving Zolinza.

Serum glucose should be monitored, especially in diabetic or potentially diabetic patients receiving Zolinza. Adjustment of diet and/or glucose therapy may be necessary. Electrolytes should be monitored at baseline and periodically during treatment. Hypokalemia or hypomagnesemia should be corrected prior to administration with Zolinza.

The most common adverse events observed in clinical trials with ZOLINZA, regardless of causality, were fatigue (52 percent), diarrhoea (52 percent), nausea (41 percent), dysgeusia (28 percent), thrombocytopenia (26 percent), anorexia (24 percent), decreased weight (21 percent), and muscle spasms (20 percent).

Cubicin is approved in the United States and many other non-US markets as therapy for Staphylococcus aureus bloodstream infections (bacteremia), including right-sided endocarditis, caused by MRSA and Methicillin-Susceptible S. Aureus (MSSA), and complicated skin infections caused by certain Gram-positive bacteria, including MRSA. It is not indicated for the treatment of pneumonia. Most adverse events reported in clinical trials were mild to moderate in intensity.

The most common were anaemia, constipation, diarrhoea, nausea, vomiting, injection site reactions, and headache. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Cubicin, it should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria susceptible to Cubicin.