Inegy 10 Mg/40 Mg Tablets
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18.10.14[5]
Inegy® 10 mg/40 mg Tablets
(ezetimibe/ simvastatin)
PATIENT INFORMATION LEAFLET
Your medicine is available by using the above name but will be referred to
as Inegy throughout the leaflet
Inegy Tablets are also available in other strengths.
Read all of this leaflet carefully before you start taking this medicinebecause 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 only. Do not pass it on to others. It may harm them, even if their signs of illness 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.
What is in this leaflet:
1. What Inegy is and what it is used for
2. What you need to know before you take Inegy
3. How to take Inegy
4. Possible side effects
5. How to store Inegy
6. Contents of the pack and other information
1. WHAT INEGY IS AND WHAT IT IS USED FOR
Inegy is a medicine used to lower levels of total cholesterol, “bad” cholesterol (LDL cholesterol), and fatty substances called triglycerides in the blood. In addition, Inegy raises levels of “good” cholesterol (HDL cholesterol).
INEGY works to reduce your cholesterol in two ways. The active ingredient ezetimibe reduces the cholesterol absorbed in your digestive tract. The active ingredient simvastatin belonging to the class of “statins” inhibits the production of the cholesterol your body makes by itself.
Cholesterol is one of several fatty substances found in the bloodstream. Your total cholesterol is made up mainly of LDL and HDL cholesterol.
LDL cholesterol is often called “bad” cholesterol because it can build up in the walls of your arteries forming plaque. Eventually this plaque build-up can lead to a narrowing of the arteries. This narrowing can slow or block blood flow to vital organs such as the heart and brain. This blocking of blood flow can result in a heart attack or stroke.
HDL cholesterol is often called “good” cholesterol because it helps keep the bad cholesterol from building up in the arteries and protects against heart disease.
Triglycerides are another form of fat in your blood that may increase your risk for heart disease.
INEGY is used for patients who cannot control their cholesterol levels by diet alone. You should stay on a cholesterol-lowering diet while taking this medicine.
Inegy is used in addition to your cholesterol-lowering diet if you have:
- a raised cholesterol level in your blood (primary hypercholesterolaemia [heterozygous familial and non-familial]) or elevated fat levels in your blood (mixed hyperlipidaemia):
- that is not well controlled with a statin alone
- for which you have used a statin and ezetimibe as separate tablets
- a hereditary illness (homozygous familial hypercholesterolaemia) that increases the cholesterol level in your blood. You may also receive other treatments.
Inegy does not help you lose weight.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE INEGY Do not take Inegy if:
- you are allergic (hypersensitive) to ezetimibe, simvastatin or any of the other ingredients of this medicine (listed in Section 6: Contents of the pack and other information)
- you currently have liver problems
- you are pregnant or breast feeding
- you are taking medicine(s) with one or more than one of the following active ingredients:
- itraconazole, ketoconazole, posaconazole or voriconazole (used to treat fungal infections)
- erythromycin, clarithromycin, or telithromycin (used to treat infections)
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and saquinavir (HIV protease inhibitors are used to treat HIV infections)
- boceprevir or telaprevir (used to treat hepatitis C virus infections)
- nefazodone (used to treat depression).
- gemfibrozil (used to lower cholesterol)
- ciclosporin (often used in organ transplant patients)
- danazol (a man-made hormone used to treat endometriosis, a condition in which the lining of the uterus grows outside the uterus).
-you are taking or, in the last 7 days, have taken or been given a medicine called fusidic acid (used to treat bacterial infection).
Ask your doctor if you are not sure if your medicine is listed above.
Warnings and precautions
Tell your doctor:
- about all your medical conditions including allergies.
- if you drink large amounts of alcohol or have ever had liver disease. Inegy may not be right for you.
-if you are due to have an operation. You may need to stop taking Inegy tablets for a short time.
Your doctor should do a blood test before you start taking Inegy and if you have any symptoms of liver problems while you take Inegy. This is to check how well your liver is working.
Your doctor may also want you to have blood tests to check how well your liver is working after you start taking Inegy.
While you are on this medicine your doctor will monitor you closely if you have diabetes or are at risk of developing diabetes. You are likely to be at risk of developing diabetes if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure.
Tell your doctor if you have severe lung disease.
The combined use of Inegy and fibrates (certain medicines for lowering cholesterol) should be avoided since the combined use of Inegy and fibrates has not been studied.
Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness.
This is because on rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
The risk of muscle breakdown is greater at higher doses of Inegy, particularly the 10/80 mg-dose. The risk of muscle breakdown is also greater in certain patients. Talk with your doctor if any of the following applies:
- you have kidney problems
- you have thyroid problems
- you are 65 years or older
- you are female
- you have ever had muscle problems during treatment with cholesterol lowering medicines called “statins”
(like simvastatin, atorvastatin, and rosuvastatin) or fibrates (like gemfibrozil and bezafibrate)
- you or close family members have a hereditary muscle disorder
Other medicines and Inegy
It is particularly important to tell your doctor if you are taking medicine(s) with any of the following active ingredients. Taking Inegy with any of these medicines can increase the risk of muscle problems (some of these have already been listed in the above section “Do not take Inegy if’).
- ciclosporin (often used in organ transplant patients)
- danazol (a man-made hormone used to treat endometriosis, a condition in which the lining of the uterus grows outside the uterus)
- medicines with an active ingredient like itraconazole, ketoconazole, fluconazole posaconazole, or voriconazole (used to treat fungal infections)
- fibrates with active ingredients like gemfibrozil and bezafibrate (used to lower cholesterol)
- erythromycin, clarithromycin, telithromycin, or fusidic acid (used to treat bacterial infections). Do not take fusidic acid while using this medicine. Also see section 4 of this leaflet.
- HIV protease inhibitors such as indinavir, nelfinavir, ritonavir, and saquinavir (used to treat AIDS)
- boceprevir or telaprevir (used to treat hepatitis C virus infections)
- nefazodone (used to treat depression)
- amiodarone (used to treat an irregular heartbeat)
- verapamil, diltiazem, or amlodipine (used to treat high blood pressure, chest pain associated with heart disease, or other heart conditions)
- large amounts (1 gram or more each day) of niacin or nicotinic acid (also used to lower cholesterol)
- colchicine (used to treat gout).
Also tell your doctor if you are taking niacin (nicotinic acid) or a niacin-containing product and are Chinese.
As well as the medicines listed above, tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including those obtained without prescription. In particular, tell your doctor if you are taking any of the following:
- medicines with an active ingredient to prevent blood clots, such as warfarin, fluindione, phenprocoumon or acenocoumarol (anticoagulants)
- colestyramine (also used to lower cholesterol), because it affects the way Inegy works
- fenofibrate (also used to lower cholesterol)
- rifampicin (used to treat tuberculosis).
You should also tell any doctor who is prescribing a new medicine for you that you are taking Inegy.
Inegy with food and drink
Grapefruit juice contains one or more components that alter the metabolism of some medications, including Inegy. Consuming grapefruit juice should be avoided as it may increase your risk of muscle problems.
Pregnancy and breast-feeding
Do not take Inegy if you are pregnant, are trying to get pregnant or think you may be pregnant. If you get pregnant while taking Inegy, stop taking it immediately and tell your doctor. Do not take Inegy if you are breastfeeding, because it is not known if the medicine is passed into breast milk.
Ask your doctor or pharmacist for advice before taking any medicine.
Children
Inegy is not recommended for children under the age 10.
Driving and using machines
Inegy is not expected to interfere with your ability to drive or to use machinery. However, it should be taken into account that some people get dizzy after taking Inegy.
Inegy contains lactose
Inegy tablets contain a sugar called lactose. 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 INEGY
Your doctor will determine the appropriate tablet strength for you, depending on your current treatment and your personal risk status.
The tablets are not scored and should not be divided.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
- Before starting Inegy, you should be on a diet to lower your cholesterol.
- You should keep on this cholesterol-lowering diet while taking Inegy.
Adults: the dose is 1 tablet by mouth once a day.
Adolescents (10 to 17 years of age): The dose is 1 tablet by mouth once a day (a maximum dose of 10mg/40mg once daily must not be exceeded).
The Inegy 10 mg/80 mg dose is only recommended for adult patients with very high cholesterol levels and at high risk of heart disease problems who have not reached their cholesterol goal on lower doses.
Take Inegy in the evening. You can take it with or without food.
If your doctor has prescribed INEGY along with another medicine for lowering cholesterol containing the active ingredient colestyramine or any other bile acid sequestrant, you should take INEGY at least 2 hours before or 4 hours after taking the bile acid sequestrant.
If you take more Inegy than you should:
- please contact your doctor or pharmacist
If you forget to take Inegy:
- do not take an extra dose, just take your normal amount of Inegy at the usual time the next day
If you stop taking INEGY:
- talk to your doctor or pharmacist because your cholesterol may rise again.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Inegy can cause side effects, although not everybody gets them. (see Section 2 What you need to know before you take Inegy)
The following common side effects were reported (may affect up to 1 in 10 patients)
- muscle aches
- elevations in laboratory blood tests of liver (transaminases) and/or muscle (CK) function
The following uncommon side effects were reported (may affect up to 1 in 100 patients):
- elevations in blood tests of liver function; elevations in blood uric acid; elevations in the time it takes for blood to clot; protein in urine; weight decreased
- dizziness; headache; tingling sensation
- abdominal pain; indigestion; flatulence; nausea; vomiting; abdominal bloating; diarrhoea; dry mouth; heartburn
- rash; itching; hives
- joint pain, muscle pain, tenderness, weakness or spasms; neck pain; pain in arms and legs; back pain
- unusual tiredness or weakness; feeling tired; chest pain; swelling, especially in the hands and feet
- sleep disorder; trouble sleeping
Additionally, the following side effects have been reported in people taking either Inegy or medicines containing the active ingredients ezetimibe or simvastatin:
- low red blood cell count (anaemia); reduction in blood cell counts, which may cause bruising/bleeding (thrombocytopenia)
- numbness or weakness of the arms and legs; poor memory, memory loss, confusion
- breathing problems including persistent cough and/or shortness of breath or fever
- constipation
- inflammation of the pancreas often with severe abdominal pain
- inflammation of the liver with the following symptoms: yellowing of the skin and eyes, itching, dark coloured urine or pale coloured stool, feeling tired or weak, loss of appetite; liver failure; gallstones or inflammation of the gallbladder (which may cause abdominal pain, nausea, vomiting)
- hair loss; raised red rash, sometimes with target-shaped lesions (erythema multiforme)
- a hypersensitivity reaction including some of the following: hypersensitivity (allergic reactions including swelling of the face, lips, tongue and/or throat which may cause difficulty in breathing or swallowing and requires treatment immediately, pain or inflammation of the joints, inflammation of blood vessels, unusual bruising, skin eruptions and swelling, hives, skin sensitivity to the sun, fever, flushing, shortness of breath and feeling unwell, lupus-like disease picture (including rash, joint disorders, and effects on white blood cells))
- muscle pain, tenderness, weakness or cramps; muscle breakdown; tendon problems, sometimes complicated by rupture of the tendon
- decreased appetite
- hot flush; high blood pressure
- pain
- erectile dysfunction
- depression
- alterations in some laboratory blood tests for liver function
Additional possible side effects reported with some statins:
- sleep disturbances, including nightmares
- sexual difficulties
- diabetes. This is more likely if you have high levels of sugars and fats in your blood, are overweight and have high blood pressure. Your doctor will monitor you while you are taking this medicine.
Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness. This is because on rare occasions, muscle problems can be serious, including muscle breakdown resulting in kidney damage; and very rare deaths have occurred.
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 INEGY
Keep your tablets out of the sight and reach of children.
Do not store above 30oC.
Store in the original package in order to protect from moisture and light.
Do not take the tablets if they are past the expiry date which is clearly marked on the blister package and carton.
If your tablets become discoloured or show any other signs of deterioration, consult your doctor or pharmacist who will tell you what to do.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required.
These measures will help to protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION What Inegy contains
The active substances are ezetimibe and simvastatin.
Each tablet contains 10 mg ezetimibe and 40 mg simvastatin.
The other non-active ingredients are: butylated hydroxyanisole, citric acid monohydrate, hypromellose, croscarmellose sodium, lactose monohydrate, magnesium stearate, microcrystalline cellulose and propyl gallate.
What Inegy looks like and contents of the pack
Inegy are white to off-white, capsule-shaped tablets marked with ‘313' on one side and plain on the other side.
Inegy is supplied in blister packs of 28 tablets.
MANUFACTURER AND PRODUCT LICENCE HOLDER:
Manufactured by Merck Sharp & Dohme BV, Waarderweg 39, 2031 BN, Haarlem, The Netherlands. Procured from within the EU by Product Licence holder Star Pharmaceuticals Ltd., 5 Sandridge Close, Harrow, Middlesex HA1 1XD. Repackaged by Servipharm Ltd.
POM
PL No: 20636/2444
Leaflet revision and issue date (Ref) 18.10.14[5] Inegy is a trademark of MSD International GmbH.