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Omeprazole 20 Mg Gastro-Resistant Hard Capsules

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Document: leaflet MAH GENERIC_PL 00289-1655 change

Package leaflet: Information for the patient Omeprazole 10 mg gastro-resistant capsules, hard Omeprazole 20 mg gastro-resistant capsules, hard Omeprazole 40 mg gastro-resistant capsules, hard

Omeprazole

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 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 Omeprazole Capsule is and what it is used for

2.    What you need to know before you take Omeprazole Capsules

3.    How to take Omeprazole Capsules

4.    Possible side effects

5.    How to store Omeprazole Capsules

6.    Contents of the pack and other information

1. What Omeprazole Capsule is and what it is used for

Omeprazole Capsules contains the active substance omeprazole. It belongs to a group of

medicines called ‘proton pump inhibitors’. They work by reducing the amount of acid that

your stomach produces.

Omeprazole Capsules are used to treat the following conditions:

In adults:

•    ‘Gastro-oesophageal reflux disease’ (GORD). This is where acid from the stomach escapes into the gullet (the tube which connects your throat to your stomach) causing pain, inflammation and heartburn.

•    Ulcers in the upper part of the intestine (duodenal ulcer) or stomach (gastric ulcer).

•    Ulcers which are infected with bacteria called ‘Helicobacter pylori’. If you have this condition, your doctor may also prescribe antibiotics to treat the infection and allow the ulcer to heal.

•    Ulcers caused by medicines called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). Omeprazole Capsules can also be used to stop ulcers from forming if you are taking NSAIDs.

•    Too much acid in the stomach caused by a growth in the pancreas (Zollinger-Ellison syndrome).

In children:

Children over 1 year of age and > 10 kg

   ‘Gastro-oesophageal reflux disease’ (GORD). This is where acid from the stomach escapes into the gullet (the tube which connects your throat to your stomach) causing pain, inflammation and heartburn. In children, the symptoms of the condition can include the return of stomach contents into the mouth (regurgitation), being sick (vomiting) and poor weight gain.

Children and adolescents over 4 years of age

Ulcers which are infected with bacteria called ‘Helicobacter pylori’. If your child has this condition, your doctor may also prescribe antibiotics to treat the infection and allow the ulcer to heal.

2. What you need to know before you take Omeprazole Capsules Do not take Omeprazole Capsules

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

•    if you are allergic to medicines containing other proton pump inhibitors (e.g. pantoprazole, lansoprazole, rabeprazole, esomeprazole).

•    if you are taking a medicine containing nelfinavir (used for HIV infection).

Do not take Omeprazole Capsules if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Omeprazole Capsules

Warnings and precautions

Talk to your doctor or pharmacist before taking Omeprazole Capsules

•    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 Omeprazole 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 Omeprazole Capsules. Remember to also mention any other ill-effects like pain in your joints.

Omeprazole Capsules may hide the symptoms of other diseases. Therefore, if any of the following happen to you before you start taking Omeprazole Capsules or while you are taking it, talk to your doctor straight away:

•    You lose a lot of weight for no reason and have problems swallowing.

•    You get stomach pain or indigestion.

•    You begin to vomit food or blood.

•    You pass black stools (blood-stained faeces).

•    You experience severe or persistent diarrhoea, as omeprazole has been associated with a small increase in infectious diarrhoea.

•    You have severe liver problems.

•    You have reduced body stores or risk factors for reduced vitamin B12 and receive omeprazole long-term treatment. As with all acid reducing agents, omeprazole may lead to a reduced absorption of vitamin B12.

If you take Omeprazole Capsules on a long-term basis (longer than 1 year) your doctor will probably keep you under regular surveillance. You should report any new and exceptional symptoms and circumstances whenever you see your doctor.

Taking a proton pump inhibitor like omeprazole 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).

Other medicines and Omeprazole Capsules

Tell your doctor or pharmacist if you have recently taken or might take any other medicines. This includes medicines that you buy without a prescription. This is because Omeprazole Capsules can affect the way some medicines work and some medicines can have an effect on Omeprazole Capsules.

Do not take Omeprazole Capsules if you are taking a medicine containing nelfinavir (used to treat HIV infection).

Tell your doctor or pharmacist if you are taking any of the following medicines:

•    Ketoconazole, itraconazole, posaconazole or voriconazole (used to treat infections caused by a fungus)

•    Digoxin (used to treat heart problems)

•    Diazepam (used to treat anxiety, relax muscles or in epilepsy)

•    Phenytoin (used in epilepsy). If you are taking phenytoin, your doctor will need to monitor you when you start or stop taking Omeprazole Capsules

•    Medicines that are used to thin your blood, such as warfarin or other vitamin K blockers. Your doctor may need to monitor you when you start or stop taking Omeprazole Capsules

•    Rifampicin (used to treat tuberculosis)

•    Atazanavir (used to treat HIV infection)

•    Tacrolimus (in cases of organ transplantation)

•    St John’s wort (Hypericum perforatum) (used to treat mild depression)

•    Cilostazol (used to treat intermittent claudication)

•    Saquinavir (used to treat HIV infection)

•    Clopidogrel (used to prevent blood clots (thrombi)

•    Erlotinib (used to treat cancer)

•    Methotrexate (a chemotherapy medicine used in high doses to treat cancer) - if you are taking a high dose of methotrexate, your doctor may temporarily stop your Omeprazole Capsules treatment.

If your doctor has prescribed the antibiotics amoxicillin and clarithromycin as well as Omeprazole Capsules to treat ulcers caused by Helicobacter pylori infection, it is very important that you tell your doctor about any other medicines you are taking.

Omeprazole Capsules with food and drink

You can take your capsules with food or on an empty stomach.

Pregnancy and breast-feeding

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.

Omeprazole is excreted in breast milk but is not likely to influence the child when therapeutic doses are used. Your doctor will decide whether you can take Omeprazole Capsules if you are breastfeeding.

Driving and using machines

Omeprazole Capsules are not likely to affect your ability to drive or use any tools or machines. Side effects such as dizziness and visual disturbances may occur (see section 4). If affected, you should not drive or operate machinery.

Omeprazole Capsules contains sucrose

Omeprazole Capsules contain 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

3. How to take Omeprazole Capsules

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 tell you how many capsules to take and how long to take them for. This will depend on your condition and how old you are. The recommended doses are given below.

To treat symptoms of GORD such as heartburn and acid regurgitation:

•    If your doctor has found that your food pipe (gullet) has been slightly damaged, the recommended dose is 20 mg once a day for 4-8 weeks. Your doctor may tell you to take a dose of 40 mg for a further 8 weeks if your gullet has not yet healed.

•    The recommended dose once the gullet has healed is 10 mg once a day.

•    If your gullet has not been damaged, the usual dose is 10 mg once a day.

To treat ulcers in the upper part of the intestine (duodenal ulcer):

•    The recommended dose is 20 mg once a day for 2 weeks. Your doctor may tell you to take the same dose for a further 2 weeks if your ulcer has not yet healed.

•    If the ulcers do not fully heal, the dose can be increased to 40 mg once a day for 4 weeks.

To treat ulcers in the stomach (gastric ulcer):

•    The recommended dose is 20 mg once a day for 4 weeks. Your doctor may tell you to take the same dose for a further 4 weeks if your ulcer has not yet healed.

•    If the ulcers do not fully heal, the dose can be increased to 40 mg once a day for 8 weeks.

To prevent the duodenal and stomach ulcers from coming back:

•    The recommended dose is 10 mg or 20 mg once a day. Your doctor may increase the dose to 40 mg once a day.

To treat duodenal and stomach ulcers caused by NSAIDs (Non-Steroidal Anti-Inflammatory

Drugs):

•    The recommended dose is 20 mg once a day for 4 - 8 weeks.

To prevent duodenal and stomach ulcers if you are taking NSAIDs:

•    The recommended dose is 20 mg once a day.

To treat ulcers caused by Helicobacter pylori infection and to stop them coming back:

•    The usual dose is 20 mg omeprazole twice a day for one week.

•    Your doctor will also tell you to take two antibiotics among amoxicillin, clarithromycin and metronidazole.

To treat too much acid in the stomach caused by a growth in the pancreas (Zollinger-

Ellison syndrome):

•    The recommended dose is 60 mg daily.

•    Your doctor will adjust the dose depending on your needs and will also decide how long you need to take the medicine for.

Use in children:

To treat symptoms of GORD such as heartburn and acid regurgitation:

•    Children over 1 year of age and with a body weight of more than 10 kg may take Omeprazole Capsules. The dose for children is based on the child’s weight and the doctor will decide the correct dose.

To treat ulcers caused by Helicobacter pylori infection and to stop them coming back:

•    Children aged over 4 years may take Omeprazole Capsules. The dose for children is based on the child’s weight and the doctor will decide the correct dose.

•    Your doctor will also prescribe two antibiotics called amoxicillin and clarithromycin for your child.

Taking this medicine

•    It is recommended that you take your capsules in the morning.

•    You can take your capsules with food or on an empty stomach.

•    Swallow your capsules whole with half a glass of water. Do not chew or crush the capsules. This is because the capsules contain coated pellets which stop the medicine from being broken down by the acid in your stomach. It is important not to damage the pellets.

What to do if you or your child has trouble swallowing the capsules

•    If you or your child have trouble swallowing the capsules:

-    Open the capsules and swallow the contents directly with half a glass of water or put the contents into a glass of still (non-fizzy) water, any acidic fruit juice (e.g. apple, orange or pineapple) or apple sauce.

-    Always stir the mixture just before drinking it (the mixture will not be clear). Then drink the mixture straight away or within 30 minutes.

-    To make sure that you have drunk all of the medicine, rinse the glass very well with half a glass of water and drink it. The solid pieces contain the medicine - do not chew or crush them.

If you take more Omeprazole Capsules than you should

If you take more Omeprazole Capsules than prescribed by your doctor, talk to your doctor or pharmacist straight away.

If you forget to take Omeprazole Capsules

If you forget to take a dose, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.

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.

If you notice any of the following rare but serious side effects stop taking Omeprazole Capsules and contact a doctor immediately:

•    Sudden wheezing, swelling of your lips, tongue and throat or body, rash, fainting or difficulties in swallowing (severe allergic reaction). Reddening of the skin with blisters or peeling. There may also be severe blisters and bleeding in the lips, eyes, mouth, nose and genitals. This could be ‘Stevens-Johnson syndrome’ or ‘toxic epidermal necrolysis’.

•    Yellow skin, dark urine and tiredness which can be symptoms of liver problems.

Other side effects include:

Common: may affect up to 1 in 10 people

•    Headache

•    Effects on your stomach or gut: diarrhoea, stomach pain, constipation, wind (flatulence)

•    Feeling sick (nausea) or being sick (vomiting).

Uncommon: may affect up to 1 in 100 people

•    Swelling of the feet and ankles

•    Disturbed sleep (insomnia)

•    Dizziness, tingling feelings such as “pins and needles”, feeling sleepy

•    Spinning feeling (vertigo)

•    Changes in blood tests that check how the liver is working

•    Skin rash, lumpy rash (hives) and itchy skin

•    Generally feeling unwell and lacking energy

•    Fracture of the hip, wrist or spine (see section 2).

Rare: may affect up to 1 in 1000 people

•    Blood problems such as a reduced number of white cells or platelets. This can cause weakness, bruising or make infections more likely

•    Allergic reactions, sometimes very severe, including swelling of the lips, tongue and throat, fever, wheezing

•    Low levels of sodium in the blood. This may cause weakness, being sick (vomiting) and cramps

•    Feeling agitated, confused or depressed

•    Taste changes

•    Eyesight problems such as blurred vision

•    Suddenly feeling wheezy or short of breath (bronchospasm).

•    Dry mouth

•    An inflammation of the inside of the mouth

•    An infection called “thrush” which can affect the gut and is caused by a fungus

•    Liver problems, including jaundice which can cause yellow skin, dark urine, and tiredness

•    Hair loss (alopecia)

•    Skin rash on exposure to sunshine

•    Joint pains (arthralgia) or muscle pains (myalgia)

•    Severe kidney problems (interstitial nephritis)

•    Increased sweating.

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

•    Changes in blood count including agranulocytosis (lack of white blood cells)

•    Aggression

•    Seeing, feeling or hearing things that are not there (hallucinations)

•    Severe liver problems leading to liver failure and inflammation of the brain

•    Sudden onset of a severe rash or blistering or peeling skin. This may be associated with a high fever and joint pains (Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis)

•    Muscle weakness

•    Enlarged breasts in men.

Not known : frequency cannot be estimated from the available data

•    Inflammation in the gut (leading to diarrhoea).

•    Rash, possibly with pain in the joints.

•    If you are on Omeprazole 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 or 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.

Omeprazole Capsules may in very rare cases affect the white blood cells leading to immune deficiency. If you have an infection with symptoms such as fever with a severely reduced general condition or fever with symptoms of a local infection such as pain in the neck, throat or mouth or difficulties in urinating, you must consult your doctor as soon as possible so that a lack of white blood cells (agranulocytosis) can be ruled out by a blood test. It is important for you to give information about your medicine at this time.

Reporting of side effects

If you get 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 Omeprazole 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 outer and inner pack after EXP. The expiry date refers to the last day of that month.

Blister:

Do not store above 30oC. Store in the original package in order to protect from moisture Container:

Do not store above 30oC. Keep the bottle tightly closed in order to protect from moisture.

10 & 40 mg strengths:

The in-use storage time after first opening is 50 days 20 mg strength:

The in-use storage time after first opening is 56 days

20 mg capsules in 250 ml container only

The in-use storage time after first opening is 6 months

Do not use this medicine if you notice visible signs of deterioration.

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 Omeprazole Capsules contains

-    The active substance is omeprazole. Each capsule contains gastro-resistant granules of 10 mg, 20 mg or 40 mg omeprazole.

-    The other ingredients are

Capsule core - Sugar spheres (sucrose and corn starch), Sodium starch glycolate, Sodium laurilsulfate, Povidone K-30, Trisodium phosphate dodecahydrate, Hypromellose, Methacrylic acid-ethyl acrylate copolymer, Triethyl citrate, Titanium dioxide (E171), Talc, Sodium hydroxide

Capsule coating - Red iron oxide (E172) (10mg only), Erytrosine (E127), Indigo carmine (E132) (20 & 40mg only), Titanium dioxide (E171), water, gelatin, Quinoleine yellow (E104)

Printing ink - Shellac, Propylene glycol, Sodium hydroxide, Polyvinylpyrollidone, Titanium dioxide (E171)

What Omeprazole Capsules looks like and contents of the pack

10 mg Capsules: have an orange body marked with ‘10’ and red cap marked with ‘O’ 20 mg Capsules: have an orange body marked with ‘20’ and blue cap marked with ‘O’ 40 mg Capsules: have an orange body marked with ‘40’ and blue cap marked with ‘O’

Pack sizes:

Blisters:

Packs of 5, 7, 14, 15, 20, 21, 25, 28, 30, 35, 42, 50, 50x1 hospital pack, 56, 60, 98, or 100 capsules

Not all pack sizes may be marketed.

Containers:

Packs of 5, 7, 14, 15, 20, 21, 28, 30, 42, 50, 56 (2x28), 60 (2x30), 84 (2x42), 90 (3x30), 98 (7x14), 100 (2x50), 250 (1x250), 250 (5x50) or 500 (10x50) capsules.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder Teva UK Limited, Eastbourne, BN22 9AG

Manufacturer

10, 20 & 40 mg strengths:

Teva Pharmaceutical Works Private Limited Company

Pallagi ut 13, 4042 Debrecen

Hungary

Teva UK Ltd

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

Pharmachemie B.V.

Swensweg 5, 2031 GA Haarlem The Netherlands

Teva Pharma S.L.U.

C/C, n. 4, Poligono Industrial Malpica, 50016 Spain

Merckle GmbH

Ludwig-Merckle-Strasse 3, 89143 Blaubeuren Germany 10 & 20mg strengths:

Teva Sante

Rue Bellocier, 89100 Sens France

This leaflet was last revised in 10/2016

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