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Reminyl 8mg Tablets

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Document: label-and-leaflet MAH BRAND_PLPI 18799-0271 change

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UKPIL = June 2015_

Package leaflet: Information for the user

Reminyl® 8mg Tablets

(galantamine hydrobromide)

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.

The name of your medicine is Reminyl 8mg Tablets but will be referred to as Reminyl throughout this leaflet. Please note that this leaflet also contains information about other strengths such as Reminyl 4mg and 12mg Tablets.

What is in this leaflet:

1.    What Reminyl is and what it is used for

2.    What you need to know before you take Reminyl

3.    How to take Reminyl

4.    Possible side effects

5.    How to store Reminyl

6.    Contents of the pack and other information

1. What Reminyl is and what it is used for

Reminyl contains the active substance ‘galantamine hydrobromide', an antidementia medicine. It is used in adults to treat the symptoms of mild to moderately severe Alzheimer's disease, a type of dementia that alters brain function.

Alzheimer's disease causes increasing memory loss, confusion and behavioural changes which make it increasingly difficult to carry out normal daily activities.

These effects are thought to be caused by a lack of ‘acetylcholine', a substance responsible for sending messages between brain cells. Reminyl increases the amount of acetylcholine in the brain and treats the signs of the disease.

2. What you need to know before you take Reminyl

Do not take Reminyl

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

•    if you have severe liver or severe kidney disease.

Warnings and precautions Talk to your doctor or pharmacist before taking Reminyl. This medicine is only used in Alzheimer's disease, and is not recommended for other types of memory loss or confusion.

Serious side effects Reminyl can cause serious skin reactions, heart problems, fits (seizures). You must be aware of these side effects while you are taking Reminyl. See ‘look out for serious side effects' in section 4.

Before you take Reminyl, your doctor needs to know if you have, or have had, any of the following

•    liver or kidney problems

•    a heart condition (such as chest discomfort that is often brought on by physical activity, a heart attack, heart failure, slow or uneven heart beat)

•    changes in ‘electrolyte' levels (naturally occurring chemicals in the blood, such as potassium)

•    a peptic (stomach) ulcer

•    blockage of the stomach or intestines

•    a disorder of the nervous system (such as epilepsy or Parkinson’s disease)

•    a respiratory disease or infection that affects breathing (such as asthma, obstructive pulmonary disease or pneumonia)

•    problems passing urine

Your doctor will decide if Reminyl is suitable for you, or if the dose needs to be changed.

Also tell your doctor if you recently had an operation on the stomach, intestines or bladder. Your doctor may decide that Reminyl is not suitable for you Reminyl can cause weight loss. Your doctor will check your weight regularly while you are taking Reminyl.

Children and adolescents

Reminyl is not recommended for children

and adolescents.

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

Reminyl should not be used with medicines that work in a similar way, these include:

•    donepezil or rivastigmine (for Alzheimer’s disease)

•    ambenonium, neostigmine or pyridostigmine (for severe muscle weakness)

•    pilocarpine (when taken by mouth for dry mouth or dry eyes)

Some medicines can make side effects more likely in people taking Reminyl.

These include:

•    paroxetine or fluoxetine (antidepressants)

•    quinidine (for uneven heart beat)

•    ketoconazole (an antifungal)

•    erythromycin (an antibiotic)

•    ritonavir (for human immunodeficiency virus or ‘HIV’).

•    non-steroidal anti-inflammatory painkillers (such as ibuprofen), which can increase the risk of ulcers.

•    medicines taken for heart conditions or high blood pressure (such as digoxin, amiodarone, atropine, beta-blockers, or calcium channel blocking agents).

If you take medicines for an uneven heart beat, your doctor may check your heart using an electrocardiogram (ECG).

Your doctor may give you a lower dose of Reminyl if you are taking any of these medicines.

Reminyl may affect some anaesthetics. If you are going to have an operation under a general anaesthetic, tell the doctor that you are taking Reminyl, well in advance.

If you have any questions, talk to your doctor or pharmacist for advice.

Pregnancy and breast-feeding If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

You should not breast-feed while you are taking Reminyl.

Driving and using machines Reminyl may make you feel dizzy or sleepy, especially during the first few weeks of treatment. If Reminyl affects you, do not drive or use any tools or machinery. Reminyl tablets contain lactose If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

Reminyl 12mg (orange -brown) Tablets contain orange-yellow S aluminium lake

The colouring in these tablets may cause allergic reaction.

3. How to take Reminyl

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

How much to take

You will start treatment with Reminyl at a low dose. The usual starting dose is 4mg, taken twice a day (a total of 8mg a day). Your doctor may gradually increase your dose, every 4 weeks or more, until you reach a dose that is suitable for you. The maximum dose is 12mg, taken twice a day (a total of 24mg a day).

Your doctor will explain what dose to start with and when the dose should be increased. If you are not sure what to do, or find the effect of Reminyl is too strong or too weak, talk to your doctor or pharmacist.

Your doctor will need to see you regularly to check that this medicine is working and to discuss how you are feeling.

If you have a liver or kidney problems,

your doctor may give you a reduced dose of Reminyl, or may decide this medicine is not suitable for you.

How to take

Take your dose of Reminyl twice a day, in the morning and evening, with water or other liquids. Try to take Reminyl with food.

Drink plenty of liquids while you are taking Reminyl, to keep yourself hydrated.

If you take more Reminyl than you should

If you take too much Reminyl, contact a doctor or hospital straight away. Take any remaining tablets and the packaging with you. The signs of overdose may include,

• severe nausea and vomiting,

• weak muscles, slow heart beat, fits (seizures) and loss of consciousness.

If you forget to take Reminyl

If you forget to take one dose, miss out the forgotten dose completely and take the next dose at the normal time. Do not take a double dose to make up for a forgotten dose.

If you forget to take more than one dose, contact your doctor.

If you stop taking Reminyl

Check with your doctor before you stop taking Reminyl. It is important to continue taking this medicine to treat your condition.

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.

Look out for serious side effects

Stop taking Reminyl and see a doctor or go to your nearest emergency department immediately if you notice any of the following.

Skin reactions, including:

•    Severe rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome).

•    Red rash covered with small pus-filled bumps that can spread over the body, sometimes with a fever (acute generalized exanthematous pustulosis).

•    Rash that may blister, with spots that look like small targets.

These skin reactions are rare in people taking Reminyl (may affect up to 1 in 1,000 people).

Heart problems, including changes in heart beat (such as a slow beat, extra beats) or palpitations (heart beat feels fast or uneven). Heart problems may show as an abnormal tracing on an electrocardiogram (ECG), and can be common in people taking Reminyl (may affect up to 1 in 10 people).

Fits (seizures). These are uncommon in people taking Reminyl (may affect up to 1 in 100 people).

You must stop taking Reminyl and get help immediately if you notice any of the side effects above.

Other side effects:

Very Common side effects (may affect more than 1 in 10 people):

•    Nausea and vomiting. These side effects are more likely to happen in the first few weeks of treatment or when the dose is increased. They tend to disappear gradually as the body gets used to the medicines and generally only last for a few days. If you have these effects, your doctor may recommend that you drink more liquids and may prescribe a medicine to stop you being sick.

Common side effects (may affect more than 1 in 10 people):

•    Decreased appetite; weight loss

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

•    Depression

• Feeling dizzy or fainting

• Muscle tremors or spasms

•    Headache

•    Feeling very tired ,weak or generally unwell

•    Feeling very sleepy with low energy

•    High blood pressure

•    Stomach pain or discomfort

•    Diarrhoea

•    Indigestion

•    Falls

•    Wounds

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

•    Allergic reaction

•    Not enough water in the body (dehydration)

•    Tingling or numb feeling of the skin (pins and needles)

•    Change in sense of taste

•    Daytime sleepiness

•    Blurred vision

•    Ringing in the ears that does not go away (tinnitus)

•    low blood pressure

•    Flushing

•    Feeling the need to vomit (retch)

•    Excessive sweating

•    Weak muscles

•    Increased level of liver enzymes

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

•    Inflamed liver (hepatitis)

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 at: www.mhra.gov.uk/yellowcard By reporting side effects you help provide more information on the safety of this medicine.

5. How to store Reminyl

There are no special storage conditions for Reminyl.

Keep out of the sight and reach of children.

Do not take your tablets after the expiry date which is stated on the carton and blister label after ‘Exp'. The expiry date refers to the last day of that month.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

If your tablets become discoloured or show any signs of deterioration, you should seek the advice of your pharmacist

6. Contents of the pack and other information

What Reminyl contains:

• Reminyl contain 8mg galantamine (as hydrobromide) as the active ingredient.

The tablets also contain the inactive ingredients:

colloidal anhydrous silica, crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, hypromellose, propylene glycol, talc, titanium dioxide (E171) and red ferric oxide (E172).

What Reminyl looks like and contents of the pack

Reminyl film-coated tablets are available in three strengths, each of which can be recognized by its colour and lettering:

The tablets are pink in colour and biconvex with the inscription ‘JANSSEN' on one side and ‘G8' on the other side. The tablets come in blister packs of 56 tablets.

Manufactured by: Janssen-Cilag SpA, Via C Janssen, 04010 Borgo San Michelle, Latina, Italy.

Procured from within the EU and repackaged by the Product Licence holder: B&S Healthcare, Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK.

Reminyl® 8mg Tablets;    i____i

PL 18799/0271    Lp°mJ

Leaflet date: 29.02.2016 Reminyl is a registered trademark of Shire Pharmaceutical Development Ltd.