Amiodarone Hydrochloride 200mg Tablets
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Package leaflet: Information for the user
Amiodarone hydrochloride 100mg tablets Amiodarone hydrochloride 200mg tablets Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Amiodarone tablets are and what they are used for
2. What you need to know before you take Amiodarone tablets
3. How to take Amiodarone tablets
4. Possible side effects
5. How to store Amiodarone tablets
6. Contents of the pack and other information
1. What Amiodarone tablets are and what they are used for Amiodarone hydrochloride 100mg or 200mg tablets (called Amiodarone tablets in this leaflet) contain a medicine called Amiodarone hydrochloride. This belongs to a group of medicines called anti-arrhythmics.
It works by controlling the uneven beating of your heart (called ‘arrhythmias’). Taking the tablets helps your heartbeat to return to normal.
Amiodarone tablets can be used to:
• Treat uneven heartbeats where other medicines either have not worked or cannot be used
• Treat an illness called Wolff-Parkinson-White Syndrome. This is where your heart beats unusually fast
• Treat other types offast or uneven heartbeats known as ‘atrial flutter’ or ‘atrial fibrillation. Amiodarone tablets are used only when other medicines cannot be used
• Treat fast heartbeats which may happen suddenly and may be uneven. Amiodarone Tablets are used only when other medicines cannot be used
| 2. What you need to know before you take Amiodarone tablets |
Do not take Amiodarone tablets
• You are allergic to iodine, amiodarone or any of the other ingredients of Amiodarone tablets (listed in Section 6 below)
Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue
• You have a slower than usual heartbeat (called ‘sinus bradycardia’) or an illness called ‘sino-atrial’ heart block
• You have any other problems with your heartbeat and do not have a pacemaker fitted
• You have ever had thyroid problems. Your doctor should test your thyroid before giving you this medicine
• You are taking certain other medicines which could affect your heartbeat (see ‘Other medicines and Amiodarone tablets’ below)
• You are pregnant or breast-feeding (see ‘Pregnancy, breast feeding and fertility’ below) Do not take this medicine if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Amiodarone tablets.
Warnings and precautions
Talk to your doctor or pharmacist before taking Amiodarone tablets:
• You have heart failure
• You have liver problems
• You have any problems with your lungs or have asthma
• You have any problems with your eyesight. This includes an illness called ‘optic neuritis’
• You are about to have an operation
• You are elderly (over 65 years of age). The doctor will need to monitor you more carefully
• You have a pacemaker or implantable cardioverter defibrillator (ICD). Your doctor will check that your device is working properly shortly after you start taking the tablets or if your dose is changed.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Amiodarone tablets.
Other medicines and Amiodarone tablets
Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines.
In particular, do not take this medicine and tell your doctor, if you are taking:
• Other medicines for an uneven heartbeat (such as sotalol, quinidine, procainamide, disopyramide or bretylium).
• Medicines for infections (such as intra-venous erythromycin, co-trimoxazole, moxifloxacin or pentamidine)
• Medicines for schizophrenia (such as chlorpromazine, thioridazine, fluphenazine, pimozide, haloperidol, amisulpiride or sertindole)
• Medicines for other mental illnesses (such as lithium, doxepin, maprotiline or amitriptyline)
• Medicines for malaria (such as quinine, mefloquine, chloroquine or halofantrine)
• Medicines used for hay fever, rashes or other allergies called antihistamines (such as terfenadine, astemizole or mizolastine)
Tell your doctor if you are taking any of the following medicines:
• Medicines for infection (such as ciprofloxacin, ofloxacin or levofloxacin)
• Medicines for heart problems called beta-blockers (such as propranolol)
• Medicines called calcium channel blockers - for chest pain (angina) or high blood pressure (such as diltiazem or verapamil)
• Medicines for constipation (laxatives) such as bisacodyl or senna
• Medicines for high cholesterol (statins) such as simvastatin or atorvastatin
The following medicines can increase the chance of you getting side effects, when taken with Amiodarone tablets:
• Amphotericin (when given directly into a vein) - used for fungal infections
• Medicines for inflammation (corticosteroids) such as hydrocortisone, betamethasone or prednisolone
• Water tablets (diuretics)
• General anaesthetics or high dose oxygen - used during surgery
• Tetracosactide - used to test some hormone problems Amiodarone tablets may increase the effect of the following medicines:
• Ciclosporin and tacrolimus - used to help prevent rejection of transplants
• Medicines for impotence such as sildenafil, tadalafil or vardenafil
• Fentanyl - used for pain relief
• Ergotamine - used for migraines
• Midazolam - used to relieve anxiety or to help you relax before surgery
• Flecainide - another medicine used for uneven heartbeats. Your doctor should monitor your treatment and may half your dose of Flecainide
• Lidocaine - used as an anaesthetic
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Amiodarone tablets.
Amiodarone tablets with food and, drink and alcohol
Do not drink grapefruit juice while taking this medicine. This is because drinking grapefruit juice while taking Amiodarone tablets can increase your chance of getting side effects. Limit the amount of alcohol you drink while taking this medicine. This is because drinking alcohol while taking this medicine will increase the chance of you having problems with your liver. Talk to your doctor or pharmacist about the amount of alcohol you can drink.
Protect your skin from sunlight
Keep out of direct sunlight while taking this medicine and for a few months after you have finished taking it. This is because your skin will become much more sensitive to the sun and may burn, tingle or severely blister if you do not take the following precautions:
• Make sure you use high factor sun cream
• Always wear a hat and clothes which cover your arms and legs
Pregnancy, breast feeding and fertility
• Amiodarone tablets are not normally given during pregnancy
• Do not take if you are breast-feeding or plan to breast-feed. This is because small amounts of this medicine may pass into the mothers’ milk.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
You may have blurred eyesight after taking this medicine. If this happens, do not drive or use any tools or machines.
Amiodarone tablets contain
• Lactose: If you have been told by your doctor that you have intolerance to some sugars, you should contact your doctor before taking this medicine.
• Iodine: Amiodarone tablets contain 37.5mg of iodine in a 100 mg tablet and 75 mg of iodine in a 200mg tablet. Iodine is present in Amiodarone hydrochloride, the medicine your tablets contain. Iodine can cause problems to your thyroid (see ‘Tests under section 3’ below)
| 3. How to take Amiodarone tablets |
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure
The recommended dose is:
Adults
• The usual starting dose is 200mg (one 200mg or two 100mg Amiodarone tablets) three times a day for the first week, followed by 200mg twice a day for the next week and then 200mg once a day, until you told otherwise
• In some cases, your doctor may then decide to either increase or lower the amount you take each day. This will depend on how you react to this medicine.
Children and adolescents
• There are only limited data on the efficacy and safety in children. Your doctor will decide on an appropriate dose.
Older people
• The doctor may give you a lower dose of Amiodarone tablets. Also, the doctor should check your blood pressure and thyroid function regularly
Taking this medicine:
• Take this medicine by mouth
• Swallow the tablets whole with a glass of water. Do not crush or chew your tablets
• If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor
• The score line is not intended for breaking the tablets. g
| Amiodarone Insert I Same size artwork 430 mm x 140 mm Front
If you take more Amiodarone tablets than you should
If you take more Amiodarone tablets than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you have taken. The following effects may happen: feeling dizzy, faint or tired, confusion, slow heartbeat, damage to the liver or being sick.
If you forget to take Amiodarone tablets
If you forget a dose, take it as soon as you remember it. However, if it is nearly time for the next dose, skip the missed dose.
Do not take a double dose to make up for a forgotten tablet.
If you stop taking Amiodarone tablets
Keep taking Amiodarone tablets until your doctor tells you to stop. Do not stop taking Amiodarone tablets just because you feel better. If you stop taking this medicine the uneven heartbeats may come back. This could be dangerous.
Tests
Your doctor will take regular tests to check how your liver is working. Amiodarone tablets can affect how your liver works. Ifthis happens, your doctor will decide whether you should keep taking these tablets.
Your doctor may do regular thyroid tests while you are taking this medicine. This is because Amiodarone tablets contain iodine which can cause problems to your thyroid. Your doctor may also do other regular tests such as blood tests, chest X-rays, ECG (electrical test of your heartbeat) and eye tests both before and while you are taking Amiodarone tablets.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
| 4. Possible side effects |
Like all medicines, Amiodarone tablets can cause side effects, although not everybody gets them.
Amiodarone tablets may stay in your blood for up to a month after stopping treatment. You may still get side effects in this time.
Stop taking Amiodarone tablets and see a doctor or go to a hospital straight away if:
• You have an allergic reaction. The signs may include: a rash, swallowing or breathing problems, swollen eyelids,face, lips, throat or tongue
Common (affects less than 1 in 10 people)
• You get yellowing of the skin or eyes (jaundice) feel tired or sick, loss of appetite, stomach pain or high temperature. These can be signs of liver problems or damage which can be very dangerous
• Difficulty breathing or tightness in the chest, coughing which will not go away, wheezing, weight loss and fever. This could be due to inflammation of your lungs which can be very dangerous
Uncommon (affects less than 1 in 100 people)
• Your heartbeat becomes even more uneven or erratic. This can lead to a heart attack, so you should go to hospital straight away
Very rare (affects less than 1 in 10,000 people)
• You get loss of eyesight in one eye or your eyesight becomes dim and colourless. Your eyes may feel sore or tender and feel painful to move. This could be an illness called ‘optic neuropathy or neuritis’
• Your heartbeat becomes very slow or stops beating. If this happens, go to hospital straight away
Stop taking Amiodarone tablets and see a doctor straight away if you notice any of the following serious side effects - you may need urgent medical treatment: Uncommon (affects less than 1 in 100 people)
• Feeling numb or weak, tingling or burning feelings in any part of your body Very rare (affects less than 1 in 10,000 people)
• Skin rash caused by narrow or blocked blood vessels (called ‘vasculitis’)
• Headache (which is usually worse in the morning or happens after coughing or straining), feeling sick (nausea) fits, fainting, eyesight problems or confusion can occur. These could be signs of problems with your brain
• Moving unsteadily or staggering, slurred or slow speech
• Feeling faint, dizzy, unusually tired and short of breath.
These could be signs of a very slow heartbeat (especially in people over 65 years old) or other problems with your heart’s natural beat Some cases of bleeding in the lungs have been reported in patients taking Amiodarone tablets. You should tell your doctor straight away if you cough up any blood.
Tell your doctor as soon as possible if you have any of the following side effects: Very common (affects more than 1 in 10 people)
• Blurred eyesight or seeing a coloured halo in dazzling light Common (affects less than 1 in 10 people)
• Feeling extremely restless or agitated, weight loss, increased sweating and being unable to stand the heat. These could be signs of an illness called ‘hyper-thyroidism’
• Feeling extremely tired, weak or ‘run-down’, weight gain, being unable to stand the cold, constipation and aching muscles. These could be signs of an illness called ‘hypothyroidism’
• Trembling when you move your arms or legs
• Blue or grey marks on parts of your skin exposed to sunlight, especially the face Uncommon (affects less than 1 in 100 people)
• Muscle cramps, stiffness or spasm
Very rare (affects less than 1 in 10,000 people)
• Swelling of the testicles
• Red, scaly patches of skin, loss ofhair or loosening of nails (called ‘exfoliative dermatitis’)
• Feeling tired, faint, dizzy or having pale skin. These could be signs of anaemia
• You may bleed or bruise more easily than usual. This could be because of a blood disorder (called ‘thrombocytopenia’)
• Feeling unwell, confused or weak, feeling sick (nausea), loss of appetite, feeling irritable. This could be an illness called ‘syndrome of inappropriate anti-diuretic hormone secretion’ (SIADH)
Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a few days:
Very common (affects more than 1 in 10 people).
• Feeling sick (nausea) or being sick (vomiting)
• Change in the way things taste
• Changes in the amount of liver enzymes at the beginning of treatment. This can be seen in blood tests
• Burning more easily in the sun (see ‘Protect your skin from sunlight’ in Section 2) Common (affects less than 1 in 10 people)
• Slightly slower heart beat
• Nightmares
• Problems sleeping
Very rare (affects less than 1 in 10,000 people)
• Headache
• Balance problems, feeling dizzy (vertigo)
• Difficulty in getting or maintaining an erection or in ejaculating
• Hair loss, balding
• Skin rash
• Skin redness during radio-therapy
Not known (frequency cannot be estimated from the available data)
• Hives (itchy, lumpy rash)
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety ofthis medicine.
| 5. How to store Amiodarone tablets |
• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after expiry date stated on the pack. The expiry date refers to last day of the month.
• Do not store above 250C. Store in the original package.
• Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
| 6. Contents of the pack and other information |
What Amiodarone tablets contain:
The active substance is Amiodarone hydrochloride.
Each 100mg tablet contains 100mg of Amiodarone hydrochloride.
Each 200mg tablet contains 200mg of Amiodarone hydrochloride.
The other ingredients are lactose monohydrate, maize starch, povidone, pregelatinised starch, magnesium stearate and colloidal anhydrous silica.
What Amiodarone tablets look like and the contents of the pack Amiodarone 100mg tablets are flat white tablets, marked “100”, with break line. Amiodarone 200mg tablets are flat white tablets, marked “200”, with break line.
The tablets are available in blister packs 28 and of 30 tablets. Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Name and address: Bristol Laboratories Ltd,
Unit 3, Canalside, Northbridge Road, Berkhamsted, Hertfordshire,
HP4 1EG United Kingdom Telephone: 0044 (0)1442 200922
Fax: 0044 (0)1442 873717
Email: info@bristol-labs.co.uk
Amiodarone hydrochloride 100mg tablets; PL 17907/0369 Amiodarone hydrochloride 200mg tablets; PL 17907/0394
This leaflet was last revised in May 2014
To request a copy of this leaflet in Braille, large print or audio format, please contact the licence holder at the address (or telephone, fax, email) above.
V4 30-05-2014 DO
Amiodarone Insert Same size artwork 430 mm x 140 mm Back
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