Package leaflet: Information for the user

Pregabalin Caduceus 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg and 300mg Capsules, hard

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, pharmacist or nurse.

•    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, pharmacist or nurse. This includes any possible side effects not listed in this leaflet.

See section 4.

•    The full name of this medicine is Pregabalin Caduceus 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg and 300mg Capsules, hard but within the leaflet it will be referred to as Pregabalin Capsules.

What is in this leaflet

1.    What Pregabalin Capsules are and what they are used for

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

3.    How to take Pregabalin Capsules

4.    Possible side effects

5.    How to store Pregabalin Capsules

6.    Contents of the pack and other information

1.    What Pregabalin Capsules are and what they are used for

Pregabalin Capsules belongs to a group of medicines used to treat Central neuropathic pain, Epilepsy and Generalised Anxiety Disorder (GAD) in adults.

Central neuropathic pain: Pregabalin Capsules are used to treat long lasting pain caused by damage to the nerves. Pain sensations may be described as hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, numbness, pins and needles. Central neuropathic pain may also be associated with mood changes, sleep disturbance, fatigue (tiredness), and can have an impact on physical and social functioning and overall quality of life.

Epilepsy: Pregabalin Capsules are used to treat a certain form of epilepsy (partial seizures with or without secondary generalisation) in adults. Your doctor will prescribe Pregabalin Capsules for you to help treat your epilepsy when your current treatment is not controlling your condition. You should take Pregabalin Capsules in addition to your current treatment. Pregabalin Capsules are not intended to be used alone, but should always be used in combination with other antiepileptic treatment.

Generalised Anxiety Disorder: Pregabalin Capsules are used to treat Generalised Anxiety Disorder (GAD). The symptoms of GAD are prolonged excessive anxiety and worry that are difficult to control. GAD can also cause restlessness or feeling keyed up or on edge, being easily fatigued (tired), having difficulty concentrating or mind going blank, feeling irritable, having muscle tension or sleep disturbance. This is different to the stresses and strains of everyday life.

Pregabalin Capsules may also be prescribed to treat conditions not listed in this leaflet. If you have any questions, ask your doctor or pharmacist.

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

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

Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Pregabalin Capsules.

•    Some patients taking Pregabalin Capsules have reported symptoms suggesting an allergic reaction. These symptoms include swelling of the face, lips, tongue and throat as well as diffuse skin rash. Should you experience any of these reactions, you should contact your doctor immediately.

•    Pregabalin Capsules has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall) in elderly patients. Therefore, you should be careful until you are used to any effect the medicine might have.

•    Pregabalin Capsules may cause blurring or loss of vision or other changes in eyesight, many of which are temporary. You should immediately tell your doctor if you experience any changes in your vision.

•    Some patients with diabetes who gain weight while taking pregabalin may need an alteration in their diabetic medicines.

•    Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to pregabalin and the severity of these effects may be increased when taken together.

•    There have been reports of heart failure in some patients when taking Pregabalin Capsules; these patients were mostly elderly with cardiovascular conditions. Before taking this medicine you should tell your doctor if you have a history of heart disease.

•    There have been reports of kidney failure in some patients when taking Pregabalin Capsules. If while taking Pregabalin Capsules you notice decreased urination, you should tell your doctor as stopping the medicine may improve this.

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

•    When Pregabalin Capsules are taken with other medicines that may cause constipation (such as some types of pain medicines) it is possible that gastrointestinal problems may occur (e.g. constipation, blocked or paralysed bowel). Tell your doctor if you experience constipation, especially if you are prone to this problem.

•    Before taking this medicine you should tell your doctor if you have a history of alcoholism or any drug abuse or dependence. Do not take more medicine than prescribed.

•    There have been reports of convulsions when taking Pregabalin Capsules or shortly after stopping Pregabalin Capsules. If you experience a convulsion, contact your doctor immediately.

•    There have been reports of reduction in brain function (encephalopathy) in some patients taking Pregabalin Capsules when they have other conditions. Tell your doctor if you have a history of any serious medical conditions, including liver or kidney disease.

Children and adolescents

The safety and efficacy in children and adolescents (under 18 years of age) has not been established and therefore, pregabalin should not be used in this age group.

Other medicines and Pregabalin Capsules

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

Pregabalin Capsules and certain other medicines may influence each other (interaction). When taken with certain other medicines, Pregabalin Capsules may potentiate the side effects seen with these medicines, including respiratory failure and coma. The degree of dizziness, sleepiness and decreased concentration may be increased if Pregabalin Capsules are taken together with medicinal products containing:

Oxycodone - (used as a painkiller)

Lorazepam - (used for treating anxiety)

Alcohol

Pregabalin Capsules may be taken with oral contraceptives.

Pregabalin Capsules with food, drink and alcohol

Pregabalin Capsules capsules may be taken with or without food.

It is advised not to drink alcohol while taking Pregabalin Capsules. Pregnancy and breast-feeding

Pregabalin Capsules should not be taken during pregnancy or when breast-feeding, unless you are told otherwise by your doctor. Effective contraception must be used by women of child-bearing potential.

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.

Driving and using machines

Pregabalin Capsules may produce dizziness, sleepiness and decreased concentration. You should not drive, operate complex machinery or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.

3. How to take Pregabalin Capsules

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

Your doctor will determine what dose is appropriate for you.

Pregabalin Capsules are for oral use only.

Central Neuropathic pain, Epilepsy or Generalised Anxiety Disorder:

•    Take the number of capsules as instructed by your doctor.

•    The dose, which has been adjusted for you and your condition, will generally be between 150mg and 600mg each day.

•    Your doctor will tell you to take Pregabalin Capsules either twice or three times a day. For twice a day take Pregabalin Capsules once in the morning and once in the evening, at about the same time each day. For three times a day take Pregabalin Capsules once in the morning, once in the afternoon and once in the evening, at about the same time each day.

If you have the impression that the effect of Pregabalin Capsules is too strong or too weak, talk to your doctor or pharmacist.

If you are an elderly patient (over 65 years of age), you should take Pregabalin Capsules normally except if you have problems with your kidneys.

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

Swallow the capsule whole with water.

Continue taking Pregabalin Capsules until your doctor tells you to stop.

If you take more Pregabalin Capsules than you should

Call your doctor or go to the nearest hospital emergency unit immediately. Take your box of Pregabalin Capsules with you. You may feel sleepy, confused, agitated or restless as a result of taking more Pregabalin Capsules than you should.

If you forget to take Pregabalin Capsules

It is important to take your Pregabalin Capsules regularly at the same time each day. If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. In that case, just carry on with the next dose as normal. Do not take a double dose to make up for a forgotten dose.

If you stop taking Pregabalin Capsules

Do not stop taking Pregabalin Capsules unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week.

After stopping long and short-term Pregabalin Capsules treatment, you need to know that you may experience certain side effects.

These include, trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, pain, sweating and dizziness. These symptoms may occur more commonly or severely if you have been taking Pregabalin Capsules for a longer period of time.

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

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not

everybody gets them.

If you experience swollen face or tongue or if your skin turns red

and starts to blister or peel you should seek immediate medical

advice.

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

•    Dizziness, drowsiness, headache.

Common (may affect up to 1 in 10 people)

•    Increased appetite.

•    Feeling of elation, confusion, disorientation, decrease in sexual interest, irritability.

•    Disturbance in attention, clumsiness, memory impairment, loss of memory, tremor, difficulty with speaking, tingling feeling, numbness, sedation, lethargy, insomnia, fatigue, feeling abnormal.

•    Blurred vision, double vision.

•    Vertigo, problems with balance, fall.

•    Dry mouth, constipation, vomiting, flatulence, diarrhoea, nausea, swollen abdomen.

•    Difficulties with erection.

•    Swelling of the body including extremities.

•    Feeling drunk, abnormal style of walking.

•    Weight gain.

•    Muscle cramp, joint pain, back pain, pain in limb.

•    Sore throat.

Uncommon (may affect up to 1 in 100 people)

•    Loss of appetite, weight loss, low blood sugar, high blood sugar.

•    Change in perception of self, restlessness, depression, agitation, mood swings, difficulty finding words, hallucinations, abnormal dreams, panic attack, apathy, aggression, elevated mood, mental impairment, difficulty with thinking, increase in sexual interest, problems with sexual functioning including inability to achieve a sexual climax, delayed ejaculation.

•    Changes in eyesight, unusual eye movement, changes in vision including tunnel vision, flashes of light, jerky movements, reduced reflexes, increased activity, dizziness on standing, sensitive skin, loss of taste, burning sensation, tremor on movement, decreased consciousness, loss of consciousness, fainting, increased sensitivity to noise, feeling unwell.

•    Dry eyes, eye swelling, eye pain, weak eyes, watery eyes, eye irritation.

•    Heart rhythm disturbances, increased heart rate, low blood pressure, high blood pressure, changes in heart beat, heart failure.

•    Flushing, hot flushes.

•    Difficulty breathing, dry nose, nasal congestion.

•    Increased saliva production, heartburn, numb around mouth.

•    Sweating, rash, chills, fever.

•    Muscle twitching, joint swelling, muscle stiffness, pain including muscle pain, neck pain.

•    Breast pain.

•    Difficulty with or painful urination, incontinence.

•    Weakness, thirst, chest tightness.

•    Changes in blood and liver test results (blood creatinine phosphokinase increased, alanine amino transferase increased, aspartate aminotransferase increased, platelet count decreased, neutropenia, increase in blood creatinine, decrease in blood potassium).

•    Hypersensitivity, swollen face, itchiness, hives, runny nose, nose bleed, cough, snoring.

•    Painful menstrual periods.

•    Coldness of hands and feet.

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

•    Abnormal sense of smell, swinging vision, altered perception of depth, visual brightness, vision loss.

•    Dilated pupils, cross eyes.

•    Cold sweat, tightness of the throat, swollen tongue.

•    Inflammation of the pancreas.

•    Difficulty in swallowing.

•    Slow or reduced movement of the body.

•    Difficulty with writing properly.

•    Increased fluid in the abdomen.

•    Fluid in the lungs.

•    Convulsions.

•    Changes in the recording of electrical changes (ECG) in the heart which correspond to heart rhythm disturbances.

•    Muscle damage.

•    Breast discharge, abnormal breast growth, breast growth in males.

•    Interrupted menstrual periods.

•    Kidney failure, reduced urine volume, urinary retention.

Continued top of next column

•    Decrease in white blood cell count.

•    Inappropriate behaviour.

•    Allergic reactions (which may include difficulty breathing, inflammation of the eyes (keratitis) and a serious skin reaction characterised by rash, blisters, peeling skin and pain).

Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to pregabalin and the severity of these effects may be increased when taken together.

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 Website: 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 Pregabalin 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 carton or blister after EXP. The expiry date refers to the last day of that month.

Do not store above 30°C.

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 Pregabalin Capsules contain

•    The active substance is pregabalin. Each hard capsule contains either 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg or 300mg pregabalin.

•    The other ingredients are: mannitol, co-processed corn starch (consisting of corn starch and pregelatinised corn starch), talc, gelatine, titanium dioxide (E171) and black ink, (which contains shellac, black iron oxide (E172), potassium hydroxide). The 75mg, 100mg, 200mg, 225mg and 300mg capsules also contain red iron oxide (E172).

What Pregabalin Capsules looks like and contents of the pack

Pregabalin Capsules 25mg are available in two pack sizes made of PVC with an aluminium foil backing: 56 capsules pack and 84 capsules pack.

Pregabalin Capsules 50mg, 100mg and 200mg are available in one pack size made of PVC with an aluminium foil backing: 84 capsules pack.

Pregabalin Capsules 75mg, 150mg, 225mg and 300mg are available in one pack size made of PVC with an aluminium foil backing: 56 capsules pack.

Marketing Authorisation Holder

Caduceus Pharma Ltd 6th Floor

94 Wigmore Street London W1U 3RF UK

Manufacturer

Balkanpharma-Dupnitsa AD 3 Samokovsko Shosse Str.

Dupnitsa 2600 Bulgaria

This leaflet was last revised in February 2016.

Caduceus