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Lansoprazole 30 Mg Gastro-Resistant Capsules

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Document: leaflet MAH GENERIC_PL 00289-0676 change

PACKAGE LEAFLET: INFORMATION FOR THE USER

Lansoprazole 15 mg Gastro-resistant Capsules Lansoprazole 30 mg Gastro-resistant Capsules Lansoprazole

Read all of this leaflet carefully before you start using 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 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. See section 4

What is in this leaflet:

1.    What Lansoprazole Gastro-resistant Capsules are and what they are used for

2.    What you need to know before you take Lansoprazole Gastro-resistant Capsules

3.    How to take Lansoprazole Gastro-resistant Capsules

4.    Possible side effects

5.    How to store Lansoprazole Gastro-resistant Capsules

6.    Contents of the pack and other information

1.    What Lansoprazole Gastro-resistant capsules are and what they are used for

Lansoprazole Gastro-resistant Capsules is a medicine which reduces the amount of acid made by the stomach (selective proton pump inhibitor).

Lansoprazole Gastro-resistant Capsules is given

•    To treat ulcers in the duodenum and stomach (diagnosed through gastroscopy or X-ray)

•    To treat inflammation of the gullet caused by reflux of stomach acid into the gullet (reflux oesophagitis)

•    As long-term treatment to prevent a recurrence of inflammation of the gullet due to reflux of stomach acid

•    To remove the bacterium Helicobacter pylori together with suitable antibiotics in the treatment of ulcers in the stomach or duodenum (eradication therapy) and to prevent the recurrence of ulcers in patients with Helicobacter pylori-related ulcers in the stomach and intestines

•    In the treatment of Zollinger-Ellison syndrome (ulcer formation in the stomach and duodenum, due to increased production of a hormone which secretes stomach acid, caused by a certain type of tumour).

•    To treat and prevent ulcers in the duodenum and stomach caused by the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin.

2.    What you need to know before you take Lansoprazole Gastro-resistant Capsules Do not take Lansoprazole Gastro-resistant Capsules

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

•    If you are taking a medicine called atazanavir, which is used in the treatment of HIV infection.

Warnings and precautions

Talk to your doctor or pharmacist or nurse before taking Lansoprazole Gastro-resistant

Capsules

•    If you have impaired liver function (see section 3. How to take Lansoprazole Gastro-resistant Capsules).

•    If you use Lansoprazole Gastro-resistant Capsules in combination with antibiotics to eradicate Helicobacter pylori, you should carefully read the package leaflet of these antibiotics too.

•    If you take Lansoprazole Gastro-resistant Capsules for longer than 1 year, therapy should be regularly monitored and the doctor should carefully consider the benefit versus risk ratio.

•    If you experience any problems with your eyesight following long-term use (longer than 1 year), treatment with Lansoprazole Gastro-resistant Capsules should be promptly discontinued and you should consult an ophthalmologist.

•    If you are due to have a specific blood test (Chromogranin A).

•    If you have ever had a skin reaction after treatment with a medicine similar to Lansoprazole Gastro-resistant Capsules that reduces stomach acid.

If you get a rash on your skin, especially in areas exposed to the sun tell your doctor as soon as you can, as you may need to stop your treatment with Lansoprazole Gastro-resistant Capsules. Remember to also mention any other ill-effects like pain in your joints.

If diarrhoea occurs during the treatment with your medicine contact your doctor immediately, as your medicine has been associated with a small increase in infectious diarrhoea.

Before treatment with Lansoprazole Gastro-resistant Capsules,

•    the diagnosis of ulcers in the duodenum or stomach and inflammation of the gullet due to reflux of stomach acid should be confirmed by gastroscopy or other appropriate diagnostic measures (e.g. X-ray with contrast media)

•    for a stomach ulcer, the possiblity of a malignant stomach tumour should be excluded. Intake of Lansoprazole Gastro-resistant Capsules may mask the symptoms of a tumour and delay diagnosis of this condition.

Lansoprazole reduces the acid content of the stomach. This can lead to an increase in the number of natural bacteria present in the gastrointestinal tract. Treatment with Lansoprazole Gastro-resistant Capsules therefore leads to a slightly increased risk of infections in the gastrointestinal tract, such as with Salmonella or Campylobacter.

Other medicines and Lansoprazole Gastro-resistant Capsules:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

In particular, tell your doctor if you are taking any of the following medicines:

•    atazanavir (medicine for the treatment of HIV/AIDS)

•    ketoconazole and itraconazole (medicines for treatment of fungal infections)

•    digoxin (used to treat heart problems)

•    tacrolimus (medicine used to prevent rejection of a transplant)

•    theophylline, (medicine used to treat asthma)

•    phenytoin or carbamazepine, (medicines used to treat epilepsy)

•    warfarin (medicine used to prevent blood clotting)

•    fluvoxamine (medicine for the treatment of depression)

•    St Johns wort (Hypericum perforatum), used to treat mild depression

•    antacids (used to treat heartburn or acid regurgitation)

sucralfate (used for healing ulcers)

The effects of simultaneous administration of lansoprazole and various antibiotics (particularly clarithromycin) has not been systematically investigated. Increased interactions with other medicines are likely. Monitoring of the plasma levels of other medicines administered during simultaneous treatment with lansoprazole and antibiotics is therefore recommended.

Interactions have been observed when lansoprazole was combined with certain antibiotics such as clarithromycin and amoxicillin and in a combination of all three medicines. These affect the absorption, availability to the body, the breakdown and the elimination of these medicines. The effect of clarithromycin on lansoprazole is increased if the patient is a so-called slow metaboliser.

Caution should be exercised when combining lansoprazole with drugs which have a narrow therapeutic index, as the effect of lansoprazole on the metabolism of other drugs has not been extensively investigated.

Lansoprazole Gastro-resistant Capsules with food, drink and alcohol

Lansoprazole Gastro-resistant Capsules should be taken on an empty stomach. For the best results you should take Lansoprazole at least 30 minutes before 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.

Use of Lansoprazole Gastro-resistant Capsules is not recommended during pregnancy. Limited experience to date with the use of lansoprazole in pregnant women has produced no evidence of any side effects on the unborn child or on the pregnancy itself.

You should avoid breast-feeding while taking Lansoprazole Gastro-resistant Capsules, as there has been insufficient experience with its use during lactation. Based on the results of animal studies, it is thought that lansoprazole crosses into the breast milk.

When making a decision as to whether breast-feeding or therapy with Lansoprazole Gastro-resistant Capsules should be continued or discontinued, the benefits of breast-feeding for the child and the benefits of therapy with Lansoprazole Gastro-resistant Capsules for the mother should be considered.

Driving and using machines

Side effects such as dizziness, vertigo, tiredness, fatigue and visual disturbances sometimes occur in patients taking Lansoprazole. If you experience side effects like these you should take caution as your ability to react may be decreased.

You alone are responsible to decide if you are in a fit condition to drive a motor vehicle or perform other tasks that demand increased concentration. Because of their effects or undesirable effects, one of the factors that can reduce your ability to do these things safely is your use of medicines. Descriptions of these effects can be found in other sections.

Read all the information in this leaflet for guidance.

Discuss with your doctor, nurse or pharmacist if you are unsure about anything. Lansoprazole Gastro-resistant Capsules contains

This medicinal product contains sucrose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

How to take Lansoprazole Gastro-resistant Capsules

3.


Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Lansoprazole Gastro-resistant Capsules are swallowed whole with sufficient liquid (e.g. a glass of water). If you find the capsules difficult to swallow your doctor may advise on alternative ways to take your medicine. The capsules may be opened but the granules inside may not be chewed or crushed because this will stop them from working properly. Lansoprazole Gastro-resistant Capsules should be taken on an empty stomach (at least 30 minutes before meals).

If you are taking your medicine once a day, try to take it at the same time each day. You may get best results if you take it first thing in the morning. If you are taking your medicine twice a day, you should have the first dose in the morning and the second dose in the evening.

The dose of your medicine depends on your condition. The usual doses of Lansoprazole Gastro-resistant Capsules are given below. Your doctor will sometimes prescribe you a different dose and will tell you how long your treatment will last.

The recommended dose is

Treatment of heartburn and acid regurgitation

One 15 mg and 30 mg capsule for 4 weeks. If symptoms persist you should report to your doctor. If your symptoms are not relieved within 4 weeks, please contact your doctor.

Prevention of a recurrence of inflammation of the gullet due to reflux of stomach acid

The recommended dose is 15 mg lansoprazole once daily. If required, the dose can be increased to 30 mg lansoprazole once daily.

Treatment of inflammation of the gullet due to reflux of stomach acid

The recommended dose is 15 mg or 30 mg lansoprazole once daily for 4 weeks. Relief of symptoms is obtained rapidly. If the symptoms are not relieved within 4 weeks with a daily dose of 30 mg, further examinations are recommended.

Treatment of duodenal ulcer

One 30 mg capsule every day for 2 weeks.

Treatment of stomach ulcer

One 30 mg capsule every day for 4 weeks.

Treatment of duodenal or stomach ulcer in patients requiring continued NSAID treatment

One 30 mg capsule every day for 4 weeks.

Prevention of stomach and duodenal ulcers caused by NSAIDs in patients who must continue taking NSAIDs:

The usual dose is 15 mg lansoprazole once daily. If the treatment fails, your doctor may adjust your dose to 30 mg once daily.

Treatment of infect of Helicobacter pylori

The usual dose is one 30 mg capsule in combination with two different antibiotics in the morning and one 30 mg capsule in combination with two different antibiotics in the evening. Treatment will usually be every day for 7 days.

The recommended combinations of antibiotics are:

-    30 mg Lansoprazole together with 500 mg clarithromycin and 1000 mg amoxicillin

-    30 mg Lansoprazole together with 250 mg clarithromycin and 400-500 mg metronidazole

-    30 mg Lansoprazole together with 400-500 mg metronidazole and 1000 mg amoxicillin

If you are being treated for infection because you have an ulcer, it is unlikely that your ulcer will return if the infection is successfully treated. To give your medicine the best chance of working, take it at the right time and do not miss a dose.

Zollinger-Ellison syndrome

The usual dose is two 30 mg capsules every day to start with, and then depending on how you respond to Lansoprazole, the dose that your doctor decides is best for you.

Dosage in patients with impaired kidney or liver function

No dose adjustment is necessary in patients with impaired kidney function. A daily dose of 30 mg lansoprazole should not, however, be exceeded.

In patients with mildly impaired liver function, a daily dose of 30 mg lansoprazole should not be exceeded. In patients with moderately impaired liver function, a daily dose of 15 mg lansoprazole should not be exceeded. Patients with severely impaired liver function should not take Lansoprazole Gastro-resistant Capsules.

Use in children and adolescents

Lansoprazole capsules are not recommended for children, ask your doctor for advice.

Elderly patients

In elderly patients, a dose adjustment may be necessary due to the slower elimination of lansoprazole. A daily dose of 30 mg should not be exceeded.

If you have the impression that the effect of Lansoprazole Gastro-resistant Capsules is too strong or too weak, please talk to your doctor.

If you take more Lansoprazole Gastro-resistant Capsules than you should

You should always consult a doctor. There has been no experience with the effects of lansoprazole overdose in humans. Daily doses of 180 mg were tolerated without any marked side effects. The side effects listed in section 4 may occur in a more severe form.

If you forget to take Lansoprazole Gastro-resistant Capsules

If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose. If this happens skip the missed dose and take the remaining capsules as normal. Do not take a double dose to make up for a forgotten dose.

If you stop taking Lansoprazole Gastro-resistant Capsules

If you take too low a dose, if you take your medicine irregularly or if you stop your treatment prematurely, this may endanger the success of your treatment or may cause relapses which are more difficult to treat. Please follow your doctor’s recommendations.

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.

The following side effects are allergic reactions which need immediate medical attention:

-    serious allergic reaction which causes swelling of the face, tongue or throat

-    difficulty in breathing or wheezing

-    serious allergic reaction which causes difficulty in breathing or dizziness (anaphylactic shock)

-    generally feeling weak

If you suffer from any of the following at any time during your treatment STOP TAKING your tablets and contact your doctor immediately:

Common: may affect up to 1 in 10 people

-    dry or sore mouth or throat

Uncommon: may affect up to 1 in 100 people

-    reduction in blood platelets, which increases risk of bleeding and bruising (thrombocytopenia)

-    increase in the number of certain white blood corpuscles (eosinophilia)

-    reduction in the number of white blood cells, which makes infection more likely (leucopenia)

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

-    inflammation of the pancreas, which causes severe pain in the abdomen and back

-    inflammation of the liver, yellowing of the skin or whites of the eyes caused by liver or blood problems (jaundice)

-    fever

-    inflammation of the kidneys (interstitial nephritis)

Very rare: may affect up to 1 in 10,000 people

-    inflammation of the mouth (stomatitis)

-    serious illness with blistering of the skin, mouth, eyes and genitals (Stevens-Johnson syndrome)

-    serious illness with blistering of the skin (toxic epidermal necrolysis)

-    severe reduction in number of white blood cells which makes infections more likely (agranulocytosis)

-    severe reduction in blood cells which can cause weakness, bruising or make infections more likely (pancytopenia)

-    inflammation which causes abdominal pain or diarrhoea (colitis)

These are very serious side effects. You may need urgent medical attention or hospitalisation.

The following side effects have been reported at the approximate frequencies shown:

Common: may affect up to 1 in 10 people

-    headache, dizziness

-    feeling or being sick, diarrhoea, stomach pains, constipation, wind and indigestion

-    changes in liver function test values

-    skin rash, itching, hives

-    tiredness

Uncommon: may affect up to 1 in 100 people

-    depression

-    muscle and joint pain

fluid retention or swelling

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

-    reduction in red blood cells which can make the skin pale and cause weakness or breathlessness (anaemia)

-    hallucinations, confusion and difficulty in sleeping (insomnia)

-    drowsiness, a feeling of dizziness or “spinning”, restlessness, tingling or numbness in the hands and feet

-    change in the way you see things

-    palpitation and chest pain

-    fluid retention or swelling mainly in the legs

-    fungal infection of the gullet

-    change in the way things taste

-    inflammation of the tongue (glossitis)

-    skin reactions such as burning or pricking feeling under the skin, bruising, reddening and excessive sweating

-    sensitivity to light

-    hair loss

-    coughing, wheezing, and shortness of breath

-    abnormal enlargement of breast in    men    (gynaecomastia)

-    impotence

-    abnormal excessive sweating (hyperhidrosis)

-    loss of appetite and inability to eat (anorexia)

Very rare: may affect up to 1 in 10,000 people

-    dark discolouration of the tongue    (black tongue)

Not known: frequency cannot be estimated from the available data

-    If you are on Lansoprazole Gastro-resistant Capsules for more than three months it is possible that the levels of magnesium in your blood may fall.

Low levels of magnesium can be seen as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, increased heart rate. If you get any of these symptoms, please tell your doctor promptly. Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood. Your doctor may decide to perform regular blood tests to monitor your levels of magnesium.

-    rash, possibly pains in the joints

Taking a proton pump inhibitor like Lansoprazole Gastro-resistant Capsules, especially over a period of more than one year, may slightly increase your risk of fracture in the hip, wrist or spine. Tell your doctor if you have osteoporosis or if you are taking corticosteroids (which can increase the risk of osteoporosis).

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. 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 Lansoprazole Gatro-resistant capsules

Keep this medicine out of the sight and reach of children. Do not store above 25° C. Store in the original package. Do not transfer to another container. Do not use Lansoprazole Gastro-resistant Capsules after the expiry date which is stated on the outer packaging and blister strip.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away of medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Lansoprazole Gastro-resistant Capsules contain

•    The active ingredient is lansoprazole. Lansoprazole 15 mg, 30 mg Gastro-resistant Capsules contains 15 mg, 30 mg lansoprazole.

•    The other ingredients are sugar spheres (sucrose, maize starch), hypromellose, talc, magnesium carbonate, methacrylic acid ethylacrylate copolymer (1:1) dispersion 30%, triethyl citrate, titanium dioxide (E171)

•    The capsule shells contain: gelatin, titanium dioxide (E171) and red iron oxide (E172). In addition the 15 mg capsules contain brilliant blue FCF (E133) and the 30 mg capsules contain black iron oxide (E172)

•    The printing ink contains shellac, black iron oxide (E172) and propylene glycol.

What Lansoprazole Gastro-resistant Capsules looks like and contents of the pack

•    Lansoprazole 15 mg Gastro-resistant Capsules are hard gelatin capsules with a light blue opaque cap and flesh opaque body, filled with granules, and imprinted:

93 on the body

7350    on the cap

•    Lansoprazole 30 mg Gastro-resistant Capsules are hard gelatin capsules with a light grey opaque cap and flesh opaque body, filled with granules and imprinted:

93 on the body

7351    on the cap

•    The product is available in pack sizes* of 7, 14, 15, 28, 30, 50, 56, 98, and 100 capsules.

•    Only marketed pack sizes will be included in the printed version of the PIL

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder TEVA UK Ltd

Brampton Road, Hampden Park, Eastbourne, East Sussex BN22 9AG, United Kingdom

Manufacturer

TEVA Pharmaceutical Works Private Limited Company

Pallagi ut 13, 4042 Debrecen

Hungary

*OR

TEVA UK Ltd

Brampton Road, Hampden Park, Eastbourne, East Sussex

BN22 9AG, United Kingdom

*OR

Pharmachemie B.V.

Swensweg 5, Postbus 552

2003 RN Haarlem The Netherlands

* Only the actual site of batch release will appear on the printed version of the leaflet This leaflet was last revised in October 2016