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Quinoric 200mg Film Coated Tablets

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Document: leaflet MAH BRAND_PL 17907-0017 change

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PACKAGE LEAFLET: INFORMATION FOR THE USER

Quinoric® 200mg Film-coated Tablets

Hydroxychloroquine sulfate

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 Quinoric® Tablets are and what they are used for

2.    What you need to know before you take Quinoric® Tablets

3.    How to take Quinoric® Tablets

4.    Possible side effects

5.    How to store Quinoric® Tablets

6 Contents of the pack and other information

1. What Quinoric® Tablets are and what they are used for

Quinoric® Tablets contain a medicine called hydroxychloroquine sulfate. Quinoric® Tablets work by reducing inflammation in people with autoimmune diseases (this is where the body's immune system attacks itself by mistake).

It can be used for:

   Rheumatoid arthritis (inflammation of the joints)

   Juvenile idiopathic arthritis (in children)

   Discoid and systemic lupus erythematosus (a disease of the skin or the internal organs)

   Skin problems which are sensitive to sunlight

2. What you need to know before you take Quinoric® Tablets

Do not take Quinoric® Tablets and tell your doctor if:

   You are allergic (hypersensitive) to:

-    hydroxychloroquine

-    other similar medicines such as quinolones and quinine


-    any of the other ingredients of this medicine (listed in section 6) Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue

   You have an eye problem which affects the retina, the inside of the eye

   You are pregnant, might become pregnant or think you may be pregnant or breast-feeding (see 'Pregnancy and Breast-feeding' below)

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

Warnings and Precautions

Talk to your doctor or pharmacist before taking this medicine if:

   You have liver, kidney or heart problems

   You have serious stomach or gut problems

   You have any problems with your blood. You may have blood tests to check this

   You have any problems with your nervous system or brain

   You have psoriasis (red scaly patches on the skin usually affecting the knees, elbows and scalp)

   You have had a bad reaction to quinine in the past

   You have a genetic condition known as 'glucose-6-dehydrogenase deficiency'

   You have a rare illness called 'porphyria' which affects your metabolism Potentially life-threatening skin rashes (Stevens-Johnson syndrome, toxic epidermal necrolysis) have been reported with the use of hydroxychloroquine, appearing initially as reddish target-like spots or circular patches often with central blisters on the trunk.

-    Additional signs to look for include ulcers in the mouth, throat, nose, genitals and conjunctivitis (red and swollen eyes).

-    These potentially life-threatening skin rashes are often accompanied by flu-like symptoms. The rash may progress to widespread blistering or peeling of the skin

-    The highest risk for occurrence of serious skin reactions is within the first weeks of treatment.

If you have developed Stevens-Johnson syndrome or toxic epidermal necrolysis with the use of hydroxychloroquine, you must not be re-started on this medicine at any time.


If you develop a rash or these skin symptoms, seek immediate advice from a doctor and tell him that you are taking this medicine.

Before treatment with Quinoric® Tablets:

   Before you take this medicine you should have your eyes examined

   This testing should be repeated at least every 12 months whilst taking Quinoric® Tablets

   If you are over 65, need to take a high dose (2 tablets a day) or have kidney problems then this examination should be performed more often

   Quinoric® Tablets can cause lowering of the blood glucose level. Please ask your doctor to inform you of signs and symptoms of low blood glucose levels. A check of the blood glucose level may be necessary

Other medicines and Quinoric® Tablets

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

The following medicines may increase the chance of you getting side effects when taken with Quinoric® Tablets:

   Some antibiotics used for infections (such as gentamicin, neomycin or tobramycin)

   Cimetidine - used for stomach ulcers

   Neostigmine and pyridostigmine - used for muscle weakness

   Medicines that may affect the kidney or liver

   Medicines that affect skin or the eyes.

   Halofantrine, mefloquine - used for malaria

   Amiodarone - used for heart problems

   Moxifloxacin - used to treat infections

   Medicines used for epilepsy

The following medicines can change the way Quinoric® Tablets work or Quinoric® Tablets may affect the way some of these medicines work

   Digoxin - used for heart problems

   Medicines for diabetes (such as insulin or metformin)

   Antacids - used for heartburn or indigestion. You should leave a gap of at least 4 hours between taking these medicines and Quinoric® Tablets

   Rabies vaccine

   Ciclosporin - used after an organ transplantation to help prevent rejection


   Praziquantel - used to treat worm infections

   Agalsidase - used to treat a rare condition called Fabry's disease Pregnancy and breast-feeding

Do not take Quinoric® Tablets if you are:

   pregnant, might become pregnant or think you may be pregnant.

   breast-feeding or planning to breast-feed. This is because small amounts may pass into mother's milk.

Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding.

Driving or using machines

You may get eye problems while taking this medicine. If this happens, do not drive or use any tools or machines, and tell your doctor straight away.

3. How to take Quinoric® Tablets

Always take Quinoric® Tablets exactly as your doctor has told you. Please check with your doctor or pharmacist if you are not sure.

The recommended dose is Adults, including the elderly

   One or two tablets each day

Use in children and adolescents

   One tablet each day

   This medicine is only suitable for children who weigh more than 31kg (around 5 stones). It may take several weeks before you notice the benefit of taking Quinoric® Tablets.

Route and method of administration

   Take this medicine by mouth.

   Swallow the tablets whole with a meal or a glass of milk. Do not crush or chew your tablets.

Duration of treatment

   If you are taking this medicine for skin problems that are sensitive to sunlight, only take Quinoric® Tablets during periods of high exposure to light.

   The doctor will work out the dose depending on your body weight If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor.

   If you have been taking this medicine for rheumatoid arthritis for a long time (more than 6 months) and you do not feel that it is helping


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you, see your doctor. This is because the treatment may need to be stopped.

If you take more Quinoric® Tablets than you should

   If you take more Quinoric® than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you have taken. The following effects may happen: headache, problems with your eyesight, fall in blood pressure, convulsions (fits), heart problems, followed by sudden severe breathing problems and possibly heart attack.

   Young children and babies are particularly at risk if they accidentally take these tablets. Take the child to a hospital straight away.

If you forget to take Quinoric® Tablets

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

If you stop taking Quinoric® Tablets

   Keep taking Quinoric® Tablets until your doctor tells you to stop. Do not stop taking Quinoric® Tablets just because you feel better. If you stop, your illness may get worse 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, Quinoric® Tablets can cause side effects, although not everybody gets them.

Stop taking Quinoric® Tablets and see a doctor or go to hospital straight away if:

Not known (frequency cannot be estimated from the available data)

   You have an allergic reaction. The signs may include: a red or lumpy rash, swallowing or breathing problems, swelling of your eyelids, lips, face, throat or tongue

   filled spots together with a high temperature, reddening and being more sensitive to the sun

   Blistering or peeling of the skin around the lips, eyes, mouth, nose and genitals, flu-like symptoms and fever. This could be a condition called Stevens-Johnson syndrome

Stop taking Quinoric® Tablets and see a doctor straight away if you notice any of the following serious side effects - you may need urgent medical treatment:


Common (may affect up to 1 in 10 people)

   You have any eye problems. This includes changes in the colour of your eye and problems with your eyesight such as blurring, sensitivity to light or the way you see colour

Uncommon (may affect up to 1 in 100 people)

   You have any muscle weakness, cramps, stiffness or spasms or changes in sensation such as tingling. If you take this medicine for a long time, your doctor will occasionally check your muscles and tendons to make sure they are working properly

Not known (frequency cannot be estimated from the available data)

   You have frequent infections such as fever, severe chills, sore throat or mouth ulcers. These could be signs of a blood problem called 'leucopenia' or 'agranulocytosis'

   You may bruise more easily than usual. This could be due to a blood problem called 'thrombocytopenia'

   You feel tired, faint or dizzy and have pale skin. These could be symptoms of something called 'anaemia'

   You feel weak, short of breath, bruise more easily than usual and get infections more easily than usual. These could be symptoms of something called 'aplastic anaemia'

   Weakening of the heart muscle (cardiomyopathy) resulting in difficulty in breathing, coughing, high blood pressure, swelling, increased heart rate, low amount of urine

   low blood sugar levels (hypoglycaemia). You may feel a sense of nervousness, shaky or sweaty

   You notice yellowing or your skin or eyes and your urine becomes darker in colour. This could be a liver problem, such as jaundice or hepatitis

   Fits

Tell your doctor or pharmacist if any of the following side effects

get serious or lasts longer than a few days:

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

   Stomach pain

   Feeling sick

Common (may affect up to 1 in 10 people)

   Skin rashes, itching

   Being sick, diarrhoea

   Loss of appetite (anorexia)

   Headache


   Changes in mood with uncontrollable laughing or crying Uncommon (may affect up to 1 in 100 people)

   Changes in the colour of your skin or the inside of your nose or mouth

   Hair loss or loss of hair colour

   Feeling nervous

   Ringing in the ear (tinnitus)

   Balance problems (vertigo) or feeling dizzy

   Liver problems shown by blood tests

Not known (frequency cannot be estimated from the available data)

   Psoriasis (red scaly patches on the skin usually affecting the knees, elbows and scalp)

   Hearing loss

   Mental problems (such as delusions, hallucinations or changes in mood)

   Symptoms of a condition called 'porphyria' which may include stomach pain, being sick, fits, blisters, itching

Heart and blood tests

   Your doctor may look at your heart's electrical activity using an ECG (electrocardiogram) machine.

   A blood test may show changes in the way the liver is working and occasionally the liver may stop working

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 Quinoric® Tablets

   Keep out of the sight and reach of children.

   Do not use Quinoric® Tablets after the expiry date which is stated on the pack. The expiry date refers to the last day of that month.

   Blisters: Store in the original package.

   Containers: Store in the original container. Keep the container tightly closed.

   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 Quinoric® Tablets contain

Each tablet contains 200mg Hydroxychloroquine Sulfate as the active ingredient.

Quinoric® Tablets also contain maize starch, calcium hydrogen phosphate dihydrate, colloidal anhydrous silica, polysorbate 80, purified talc, magnesium stearate, hypromellose, titanium dioxide and macrogol 6000.

What Quinoric® Tablets look like and content of the pack

Quinoric® Tablets are white, circular, biconvex, film-coated tablets embossed with 'BL' on one side and '200' on the other.

Quinoric® Tablets are supplied in blister packs of 60 tablets or HDPE containers of 100, 500 or 1000 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Bristol Laboratories Ltd,

Unit 3, Canalside, Northbridge Road,

Berkhamsted,Hertfordshire,

HP4 1EG, United Kingdom.

Telephone:    0044 (0) 1442 200922

Fax:    0044 (0) 1442 873717

Email:    info@bristol-labs.co.uk

Quinoric® 200mg Film-coated Tablets; PL 17907/0017 This leaflet was last revised in November 2015

To request a copy of this leaflet in Braille, large print or audio format, please contact the licence holder at the address (or telephone, fax, email) above.


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