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Ondansetron 8 Mg Film-Coated Tablets

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Document: leaflet MAH GENERIC_PL 04416-0876 change

Sandoz Ltd    PL 04416/0875-0876

Ondansetron 4 mg/8 mg film-coated tablets

Page 1 01/03/2016

Package leaflet: information for the user

Ondansetron 4 mg Film-coated Tablets Ondansetron 8 mg Film-coated Tablets

Ondansetron (as hydrochloride dihydrate)

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 Ondansetron Tablets are and what are they used for

2.    What you need to know before you take Ondansetron Tablets

3.    How to take Ondansetron Tablets

4.    Possible side effects

5.    How to store Ondansetron Tablets

6.    Contents of the pack and other information

1. What Ondansetron Tablets is and what it is used for

Ondansetron belongs to a group of medicines called anti-emetics, drugs against feeling sick (nausea) or being sick (vomiting).

This medicine is used for

-    preventing nausea (feeling sick) and vomiting (being sick) caused by chemotherapy (in adults and children) or radiotherapy for cancer (adults only),

-    preventing nausea and vomiting after surgery (adults only).

2. What you need to know before you take Ondansetron Tablets

Do not take Ondansetron Tablets:

-    if you are taking apomorphine, a medicine used to treat Parkinson's disease,

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

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Warnings and precautions PIL.0875-6.007.0d

Talk to your doctos or pharmacist before taking Ondansetron Tablets:

-    if you have ever had heart problems (e.g. congestive heart failure which causes shortness of breath and swollen ankles),

-    if you have an uneven heart beat (arrhythmias),

-    if you are allergic to medicines similar to ondansetron, such as granisetron or palonosetron,

-    if you have liver problems,

-    if you suffer from any blockage in your gut or if you have severe constipation,

-    if your blood levels of potassium or magnesium are reduced,

-    if you are having your tonsils out.

Other medicines and Ondansetron Tablets

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

medicines. This includes medicines that you buy without a prescription and herbal medicines.

This is because Ondansetron 4mg / 8mg Film-coated Tablets can affect the way some

medicines work. Also some other medicines can affect the way Ondansetron 4mg / 8mg Film-

coated Tablets works.

In particular, tell your doctor or pharmacist:

-    if you are taking phenytoin, carbamazepin (used to treat epilepsy or other illnesses), or rifampicin (used to treat certain infections): the ondansetron blood concentrations are decreased,

-    if you are taking tramadol (used to treat pain): the effect of tramadol may be reduced,

-    if you are taking medicines used to treat heart problems such as anti-arrhythmic medicines (e.g. amiodarone) and beta-blockers (e.g. timolol or atenolol),

-    if you are taking any cancer medicines which are known to have toxic effects on the heart (especially anthracyclines e.g. daunorubicin, doxorubicin or trastuzumab). These medicines may not be used together with ondansetron as they may increase the risk of irregular heartbeat,

-    if you are taking serotonergic drugs (including SSRIs and SNRIs), used to treat major depression and other mental disorders,

-    if you are taking apomorphine (a medicine used to treat Parkinson's disease), because severe drop in blood pressure and loss of consciousness were reported when Ondansetron 4mg / 8mg Film-coated Tablets was used with apomorphine.

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.

Because of insufficient experience the use of ondansetron during pregnancy is not recommended.

Do not breast-feed if you are taking this medicine. This is because small amounts pass into the mother’s milk.

Driving and using machines

Ondansetron has no or negligible effect on the ability to drive or use machines.

Ondansetron 4mg / 8mg Film-coated Tablets contains lactose.

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Ondansetron Tablets

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

• Swallow each tablet whole with a little water.

Your doctor will decide on the correct dose of ondansetron therapy for you. The dose varies depending on why you are being given ondansetron and on your liver function

Patients receiving chemotherapy and/or radiotherapy that causes nausea and vomiting:

•    Adults (including the elderly):

The recommended dose is 8 mg 1 to 2 hours before chemotherapy, followed by 8 mg 12 hours later.

After the first 24 hours following chemotherapy, ondansetron tablets can be given to prevent nausea and vomiting. The usual dose is 8 mg twice a day, which can be taken up to 5 days.

•    Children aged over 6 months and adolescents (less than 18 years of age):

The doctor will decided the dose depending on the child’s size (body surface area) or weight. Look at the label for more information. The usual dose for a child is up to 4 mg twice a day. This can be given for up to 5 days.

To prevent nausea and vomiting after an operation

•    Adults (including the elderly):

The usual adult dose is 16 mg before the operation.

•    Children aged over 1 month and adolescents (less than 18 years of age):

It is recommended that ondansetron is given as an intravenous injection.

Patients with moderate or severe liver problems

The total daily dose should not be more than 8 mg.

If you notice that the effect of ondansetron is too strong or too weak, talk to your doctor or pharmacist.

If you take more Ondansetron 4mg / 8mg Film-coated Tablets than you should

If you or your child take more Ondansetron 4mg / 8mg Film-coated Tablets than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.

If you forget to take Ondansetron 4mg / 8mg Film-coated Tablets

If you forget a dose and feel sick or vomit, take a tablet as soon as possible and then carry on as before. Do not take a double dose to make up for a forgotten dose. If you miss a dose but not feel sick take the next dose as on the label.

If you stop taking Ondansetron 4mg / 8mg Film-coated Tablets

Do not stop taking your tablets, even if you are feeling well, unless your doctor tells you.

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. Allergic reactions

If you have an allergic reaction, stop taking it and see a doctor straight away. The signs may include:

-    sudden wheezing and chest pain or chest tightness,

-    swelling of your eyelids, face, lips, mouth or tongue,

-    skin rash - red spots or lumps under your skin (hives) anywhere on your body,

-    collapse.

Other side effects include:

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

-    headache

Common (may affect up to 1 in 10 people):

-    a feeling of warmth or flushing

-    constipation

-    changes to liver function test results (if you take ondansetron tablets with a medicine called cisplatin, otherwise this side effect is uncommon)

Uncommon (may affect up to 1 in 100 people):

-    hiccups

-    low blood pressure, which can make you feel faint or dizzy

-    uneven heart beat

-    chest pain

-    fits

-    unusual body movements or shaking

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

-    dizziness or light-headedness

-    blurred vision

-    disturbance in heart rhythm (sometimes causing a sudden loss of consciousness)

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

- poor vision or temporary loss of eyesight, which usually comes back within 20 minutes Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any side effect not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme-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 Ondansetron Tablets

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

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

This medicinal product does not require any special storage conditions

Do not throw away any medicnes 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. Content of the pack and other information What Ondansetron Tablets contains

Ondansetron 4 mg Tablets

The active substance is ondansetron hydrochloride dihydrate. Each film-coated tablet contains ondansetron hydrochloride dihydratre equivalent to 4 mg ondansetron.

Ondansetron 8 mg Tablets

The active substance is ondansetron hydrochloride dihydrate. Each film-coated tablet contains ondansetron hydrochloride dihydrate equivalent to 8 mg ondansetron.

- The other ingredients are:

core: lactose anhydrous, cellulose microcrystalline, starch (maize) pregelatinised, magnesium stearate.

coating: hypromellose, lactose monohydrate, titanium dioxide (E171), glycerol triacetate, iron oxide yellow (E172).

What Ondansetron Tablets looks like and contents of the pack

Ondansetron 4 mg Tablets are yellow, oval shaped, film-coated tablets, plain on both sides. Ondansetron 8 mg Tablets are yellow, oval shaped, film-coated tablets, plain on both sides.

Ondansetron Tablets are packed in PVC/PVDC//Aluminium blisters.

Pack sizes:

Blisters containing 6, 10, 15, 20, 30, 50 and 100 film-coated tablets

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder Sandoz Ltd

Frimley Business Park,

Frimley,

Camberley,

Surrey,

GU16 7SR.

United Kingdom

Manufacturer

Salutas Pharma GmbH DieselstraPe 5 70839 Gerlingen Germany

Lek Pharmaceuticals d.d.

Verovskova 57 1526 Ljubljana Slovenia

Salutas Pharma GmbH Otto-von-Guericke-Allee 1 39179 Barleben Germany

LEK S.A.

ul. Domaniewska 50C 02-672 Warsaw Poland

or

S.C. Sandaz S.R.L.

Str. Livezeni nr. 7A

RO-540472 Targu-Mures Romania

This leaflet was last revised in 03/2016

PIL.0875-6.007.0d IS

V015: SPC & PIL update in line

with PSUSA