TEVA UK Ref: 231-30-88267-J LEA GABAPENTIN TEVA A/S CAP TUK (RAT)	Version: 2	01 February 2016

PAGE 1: FRONT FACE (INSIDE OF REEL)

What is in this leaflet:

1.    What Gabapentin Teva capsules are and what they are used for

2.    What you need to know before you take Gabapentin Teva capsules

3.    How to take Gabapentin Teva capsules

4.    Possible side effects

5.    How to store Gabapentin Teva capsules

6.    Contents of the pack and other information

1.    What Gabapentin Teva capsules are and what they are used for

Gabapentin belongs to a group of medicines used to treat epilepsy and neuropathic pain (long lasting pain caused by damage to the nerves). The active substance in Gabapentin Teva capsules is gabapentin.

Gabapentin Teva capsules are used to treat:

Various forms of epilepsy: (seizures that are initially limited to certain parts of the brain, whether the seizure spreads to other parts of the brain or not). Your doctor will prescribe Gabapentin Teva capsules for you to help treat your epilepsy when your current treatment is not fully controlling your condition. You should take Gabapentin Teva capsules in addition to your current treatment unless told otherwise. Gabapentin Teva capsules can also be used on its own to treat adults and children over 12 years of age.

^m Peripheral neuropathic pain: (long lasting pain caused by damage to the nerves). A variety of different diseases can cause peripheral neuropathic pain (primarily occurring in the legs and/or arms), such as diabetes or shingles. Pain sensations may be described as hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, pins and needles etc. Another symptom may be numbness.

2.    What you need to know before you take Gabapentin Teva capsules

Do not take Gabapentin Teva capsules:

•    if you are allergic to gabapentin or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor or pharmacist before taking Gabapentin Teva capsules,

•    if you suffer from kidney problems your doctor may prescribe a different dosing schedule

•    if you are on haemodialysis (to remove waste products because of kidney failure), tell your doctor if you develop muscle pain and/or weakness

•    if you develop signs such as persistent stomach pain, feeling sick and being sick contact your doctor immediately as these may be symptoms of acute pancreatitis (an inflamed pancreas).

Cases of abuse and dependence have been reported for gabapentin from post-marketing experience. Talk to your doctor if you have a history of abuse or dependence.

A small number of people being treated with anti-epileptics such as Gabapentin Teva capsules have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor.

Important information about potentially serious reactions

A small number of people taking gabapentin get an allergic reaction or potentially serious skin reaction, which may develop into more serious problems if they are not treated. You need to know the symptoms to look out for while you are taking Gabapentin Teva capsules.

Read the description of these symptoms in section 4. of this leaflet under 'Contact your doctor immediately if you experience any of the following symptoms after taking this medicine as they can be serious'.

Muscle weakness, tenderness or pain and particularly, if at the same time, you feel unwell or have a high temperature, may be caused by an abnormal muscle breakdown which can be life-threatening and lead to kidney problems. You may also experience discoloration of your urine, and a change in blood test results (notably blood creatine phosphokinase increased). If you experience any of these signs or symptoms, please contact your doctor immediately.

Other medicines and Gabapentin Teva capsules

Tell your doctor or pharmacist if you are taking/using, have recently taken/used or might take/use any other medicines, including medicines obtained with or without a prescription.

Medicines containing opioids such as morphine

If you are taking any medicines containing opioids (such as morphine), please tell your doctor or pharmacist as opioids may increase the effect of Gabapentin Teva capsules. In addition, combination of Gabapentin Teva capsules with opioids may cause symptoms like sleepiness and/or decrease in breathing.

Antacids for indigestion

If Gabapentin Teva capsules and antacids containing aluminium and magnesium are taken at the same time, absorption of Gabapentin Teva capsules from the stomach may be reduced. It is therefore recommended that Gabapentin Teva capsules are taken at the earliest two hours after taking an antacid.

Gabapentin Teva capsules

•    are not expected to interact with other antiepileptic drugs or the oral contraceptive pill.

•    may interfere with some laboratory tests, if you require a urine test tell your doctor or hospital that you are taking Gabapentin Teva capsules.

Gabapentin Teva capsules with food

Gabapentin Teva capsules can be taken with or without food. Pregnancy, breast-feeding and fertility

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.

Pregnancy

Gabapentin Teva capsules should not be taken during pregnancy, unless you are told otherwise by your doctor. Effective contraception must be used by women of child-bearing potential.

There have been no studies specifically looking at the use of gabapentin in pregnant women, but other medications used to treat seizures have reported an increased risk of harm to the developing baby, particularly when more than one seizure medication is taken at the same time. Therefore, whenever possible, you should try to take only one seizure medication during pregnancy and only under the advice of your doctor.

Contact your doctor immediately if you become pregnant, think you might be pregnant or are planning to become pregnant while taking Gabapentin Teva capsules. Do not suddenly discontinue taking this medicine as this may lead to breakthrough seizure, which could have serious consequences for you and your baby.

Breast-feeding

Gabapentin, the active substance of Gabapentin Teva capsules, is passed on through human milk. Because the effect on the baby is unknown, it is not recommended to breast-feed while using Gabapentin Teva capsules.

Fertility

There is no effect on fertility in animal studies.

Driving and using machines

Gabapentin Teva capsules may cause dizziness, problems with coordination, drowsiness and tiredness. You should not drive, operate complex machinery or take part in other potentially hazardous activities until you know whether this medication affects your ability to perform these activities.

Gabapentin Teva capsules contains lactose

The capsules contain lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3. How to take Gabapentin Teva capsules

Gabapentin Teva capsules are not recommended for use in children below 6 years of age.

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Your doctor will determine what dose is appropriate for you. For higher dosages, which cannot be applied with these strengths, other strengths and dosages forms are available.

Epilepsy, the recommended dose is

Adults and adolescents:

Take the number of capsules as instructed. Your doctor will usually build up your dose gradually. The starting dose will generally be between 300 mg and 900 mg each day. Thereafter, the dose may be increased as instructed by your doctor, up to a maximum of 3600 mg each day and your doctor will tell you to take this in 3 divided doses, i.e. once in the morning, once in the afternoon and once in the evening.

Children aged 6 years and above:

The dose to be given to your child will be decided by your doctor as it is calculated against your child's weight. The treatment is started with a low initial dose which is gradually increased over a period of approximately 3 days. The usual dose to control epilepsy is 25-35 mg/kg/day. It is usually given in 3 divided doses, by taking the capsule(s) each day, usually once in the morning, once in the afternoon and once in the evening.

Gabapentin Teva capsules are not recommended for use in children below 6 years of age.

Peripheral Neuropathic Pain, the recommended dose is

Adults:

Take the number of capsules as instructed by your doctor. Your doctor will usually build up your dose gradually. The starting dose will generally be between 300 mg and 900 mg each day. Thereafter, the dose may be increased as instructed by your doctor up to a maximum of 3600 mg each day and your doctor will tell you to take this in 3 divided doses, i.e. once in the morning, once in the afternoon and once in the evening.

If you have kidney problems or are receiving haemodialysis

Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys or are undergoing haemodialysis.

TEVA UK Ref: 231-30-88267-J LEA GABAPENTIN TEVA A/S CAP TUK (RAT)	Version: 2	01 February 2016

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If you are an elderly patient (over 65 years of age), you should take the normal dose of Gabapentin Teva capsules unless you have problems with your kidneys. Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys.

If you have the impression that the effect of Gabapentin Teva capsules is too strong or too weak, talk to your doctor or pharmacist as soon as possible.

Method of administration

Gabapentin Teva capsules are for oral use. Always swallow the capsules whole with plenty of water.

Continue taking Gabapentin Teva capsules until your doctor tells you to stop.

If you take more Gabapentin Teva capsules than you should

If you or someone else accidentally takes too many capsules, or if you think a child has swallowed any, contact your doctor or go to your nearest hospital casualty department immediately. As Gabapentin Teva capsules may make you drowsy, it is recommended that you ask someone else to drive you to the doctor or hospital, or that you call an ambulance. Symptoms of an overdose are dizziness, double vision, slurred speech, loss of consciousness, drowsiness and mild diarrhoea. Take along any capsules that you have not taken, together with the container and the label so that the hospital can easily tell what medicine you have taken.

If you forget to take Gabapentin Teva capsules

If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. Do not take a double dose to make up for a forgotten dose.

If you stop taking Gabapentin Teva capsules

Do not stop taking Gabapentin Teva capsules unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week. If you stop taking Gabapentin Teva capsules suddenly or before your doctor tells you, there is an increased risk of seizures.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Contact your doctor immediately if you experience any of the following symptoms after taking this medicine as they can be serious:

•    Severe skin reactions that require immediate attention, swelling of the lips and face, skin rash and redness, and/or hair loss (these may be symptoms of a serious allergic reaction)

•    Persistent stomach pain, feeling sick and being sick as these may be symptoms of acute pancreatitis (an inflamed pancreas)

•    Gabapentin Teva capsules may cause a serious or life-threatening allergic reaction that may affect your skin or other parts of your body such as your liver or blood cells. You may or may not have rash when you get this type of reaction. It may cause you to be hospitalised or to stop Gabapentin Teva capsules.

Call your doctor right away if you have any of the following symptoms:

•    skin rash

•    hives

•    fever

•    swollen glands that do not go away

•    swelling of your lips and tongue

•    yellowing of your skin or of the whites of the eyes

•    unusual bruising or bleeding

•    severe fatigue or weakness

•    unexpected muscle pain

•    frequent infections

These symptoms may be the first signs of a serious reaction. A doctor should examine you to decide if you should continue taking Gabapentin Teva capsules.

•    If you are on haemodialysis, tell your doctor if you develop muscle pain and/or weakness.

Other side effects include:

Very common (may affect more than 1 in 10 people)

•    Viral infection

•    Feeling drowsy, dizziness, lack of co-ordination

•    Feeling tired, fever

Common (may affect up to 1 in 10 people)

•    Pneumonia, respiratory infections, urinary tract infection, inflammation of the ear or other infections

•    Low white blood cell counts

•    Anorexia, increased appetite

•    Anger towards others, confusion, mood changes, depression, anxiety, nervousness, difficulty with thinking

•    Convulsions, jerky movements, difficulty with speaking, loss of memory, tremors, difficulty sleeping, headache, sensitive skin, decreased sensation (numbness), difficulty with coordination, unusual eye movement, increased, decreased or absent reflexes

•    Blurred vision, double vision

•    Vertigo

•    High blood pressure, flushing or dilation of blood vessels

•    Difficulty breathing, bronchitis, sore throat, cough, dry nose

•    Vomiting (being sick), nausea (feeling sick), problems with teeth, inflamed gums, diarrhoea, stomach pain, indigestion, constipation, dry mouth or throat, flatulence

•    Facial swelling, bruises, rash, itching, acne

•    Joint pain, muscle pain, back pain, twitching

•    Difficulties with erection

•    Swelling in the legs and arms, difficulty with walking, weakness, pain, feeling unwell, flu-like symptoms

•    Decrease in white blood cells, increase in weight

•    Accidental injury, fracture, abrasion

Additionally in clinical studies in children, aggressive behaviour and jerky movements were reported commonly.

Uncommon (may affect up to 1 in 100 people)

•    Allergic reaction such as hives

•    Decreased movement

•    Racing heartbeat

•    Swelling that may involve the face, trunk and limbs

•    Abnormal blood test results suggesting problems with the liver

•    Mental impairment

•    Falls

•    High blood sugar (most often observed in patients with diabetes)

Rare (may affect up to 1 in 1,000 people):

•    Loss of consciousness

•    Low blood sugar (most often observed in patients with diabetes)

After marketing the following side effects have been reported:

•    Decreased platelets (blood clotting cells)

•    Hallucinations

•    Problems with abnormal movements such as writhing, jerking movements and stiffness

•    Ringing in the ears

•    A group of side effects that could include swollen lymph nodes (isolated small raised lumps under the skin), fever, rash, and inflammation of liver occurring together

•    Yellowing of the skin and eyes (jaundice), inflammation of the liver

•    Acute kidney failure, incontinence

•    Increased breast tissue, breast enlargement

•    Adverse events following the abrupt discontinuation of gabapentin (anxiety, difficulty sleeping, feeling sick, pain, sweating), chest pain

•    Breakdown of muscle fibres (rhabdomyolysis)

•    Change in blood test results (creatine phosphokinase increased)

•    Problems with sexual functioning including inability to achieve a sexual climax, delayed ejaculation

•    Low blood sodium level 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 of this medicine.

5.    How to store Gabapentin Teva capsules

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the blister and the carton after EXP. The expiry date refers to the last day of that month.

Do not store above 25°C.

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 Gabapentin Teva capsules contain

-    The active substance is gabapentin.

-    Each capsule contains 100 mg, 300 mg or 400 mg gabapentin.

-    The other ingredients are

Capsule content: Lactose anhydrous, Maize starch, Talc.

Capsule shell: gelatin and the following colours:

100 mg capsules: titanium dioxide (E 171).

300 mg capsules: titanium dioxide (E 171), yellow iron oxide (E 172). 400 mg capsules: titanium dioxide (E 171), red and yellow iron oxides (E 172).

Printing Ink: Shellac, Propylene Glycol, Ammonia solution, Potassium Hydroxide, Black iron oxide.

What Gabapentin Teva capsules look like and contents of the pack

The 100 mg capsules are white with the imprinting "100" on one side and "G" on the other.

The 300 mg capsules are yellow with the imprinting "300" on one side and "G" on the other.

The 400 mg capsules are orange with the imprinting "400" on one side and "G" on the other.

Pack sizes:

Blisters: 10, 20, 50, 90, 100, 200 (2x100), 250 capsules.

Hospital pack: 500 (5x100), 1000 (10x100) capsules.

Unit dose: 20x1, 60x1, 100x1 capsule.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

MA holder: ratiopharm GmbH, Graf-Arco-Str.3, D-89079 Ulm, Germany.

Manufacturer:

Teva UK Limited, Eastbourne, BN22 9AG.

This leaflet was last revised in February 2016.

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