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Rivastigmine 4.5mg Capsules Hard

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PACKAGE LEAFLET: INFORMATION FOR THE USER

Rivastigmine 1.5 mg Capsules, hard Rivastigmine 3 mg Capsules, hard Rivastigmine 4.5 mg Capsules, hard Rivastigmine 6 mg Capsules, hard

Rivastigmine

Read all of this leaflet carefully before you start taking this medicine.

-    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. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.

-    If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

In this leaflet:

1.    What Rivastigmine is and what it is used for

2.    Before you take Rivastigmine

3.    How to take Rivastigmine

4.    Possible side effects

5.    How to store Rivastigmine

6.    Further information

1. WHAT RIVASTIGMINE IS AND WHAT IT IS USED FOR

This medicinal product contains Rivastigmine which belongs to a group of medicines called cholinesterase inhibitors.

Rivastigmine is used to treat the symptoms of mild to moderately severe Alzheimer’s dementia.

Rivastigmine is used to treat the symptoms of mild to moderately severe dementia in patients with Parkinson’s disease.

2. BEFORE YOU TAKE RIVASTIGMINE

Before taking Rivastigmine it is important that you read the following section and discuss any questions you might have with your doctor.

Do not take Rivastigmine if you:

-    are allergic (hypersensitive) to Rivastigmine, or any of the other ingredients of Rivastigmine.

-    have severe liver problems

Take special care with Rivastigmine if you

-    have, or have ever had

-    impaired kidney

-    impaired liver function

-    irregular heartbeat

-    an active stomach ulcer

-    asthma or severe respiratory disease

-    difficulties in passing urine

-    seizures (fits or convulsions)

-    have not taken Rivastigmine for several days, do not take the next dose until you have talked to your doctor.

-    have experience gastro-intestinal reactions such as nausea (feeling sick) and vomiting (being sick).

-    have a low body weight.

-    suffer from trembling.

If any of these apply to you, your doctor may need to monitor you more closely while you are on this medicine.

Children and adolescents

The use of Rivastigmine in children and adolescents (age below 18 years) is not recommended.

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

If you have to undergo surgery whilst taking Rivastigmine, you should inform the doctor before you are given any anaesthetics, because Rivastigmine may exaggerate the effects of some muscle relaxants during anaesthesia.

Rivastigmine should not be given at the same time as other medicines with similar effects to Rivastigmine. Rivastigmine might interfere with anticholinergic medicines (medicines used to relieve stomach cramps or spasms, to treat Parkinson’s disease or to prevent travel sickness).

Taking Rivastigmine with food and drink

Rivastigmine should be taken with meals. Capsules should be swallowed whole with water.

Pregnancy and breast-feeding

It is preferable to avoid the use of Rivastigmine during pregnancy, unless clearly necessary. Tell your doctor if you become pregnant during treatment.

Women on Rivastigmine should not breast-feed.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

Your illness may impair your ability to drive or operate machinery and you must not carry out these activities unless your doctor tells you that it is safe to do so. Rivastigmine may cause dizziness and somnolence, mainly at the start of treatment or when increasing the dose. If you experience such effects, you should not drive or operate machinery.

Important information about some of the ingredients of Rivastigmine

Rivastigmine 1.5 mg capsule contains colouring agents including Tartrazine (E102), which may cause allergic reactions.

Rivastigmine 3 mg capsule contains colouring agents including Tartrazine (E102) and Sunset yellow FCF (E110), which may cause allergic reactions.

Rivastigmine 6 mg capsule contains colouring agents including Tartrazine (E102) and Sunset yellow FCF (E110), which may cause allergic reactions.

3. HOW TO TAKE RIVASTIGMINE

Always take Rivastigmine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

Swallow the capsules whole with a drink, without opening or crushing them.

You should take Rivastigmine twice a day with food (in the morning and evening).

Your doctor will tell you what dosage of Rivastigmine to take, starting with a low dose and gradually increasing, depending on how you respond to the treatment. The highest dose that should be taken is 6.0 mg twice a day. If you have not taken Rivastigmine for several days, do not take the next dose until you have talked to your doctor.

The use of Rivastigmine in children and adolescents (age below 18 years) is not recommended.

To benefit from your medicine you should take it every day.

Tell your caregiver that you are taking Rivastigmine.

This medicine should only be prescribed by a specialist and your doctor should regularly review whether it is having the desired effect. Your doctor will monitor your weight whilst you are taking this medicine.

If you take more Rivastigmine than you should

Tell your doctor if you find you have accidentally taken more Rivastigmine than you are told to. You may require medical attention. Some people who have accidentally taken too much Rivastigmine have experienced nausea, vomiting, diarrhoea, high blood pressure and hallucinations. Slow heart beat and fainting may also occur.

If you forget to take Rivastigmine

If you find you have forgotten to take your dose of Rivastigmine, wait and take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose.

4. POSSIBLE SIDE EFFECTS

Like all medicines, Rivastigmine can cause side effects, although not everybody gets them.

You may tend to get side effects most frequently when you start taking your medicine or increase to a higher dose. Side effects will gradually disappear most probably as your body becomes used to the medicine.

The following side effects have also been reported:

Very common side effects (affects more than 1 user in 10 ) include

-    dizziness

-    vomiting (being sick)

-    nausea (feeling sick)

-    diarrhoea

-    loss of apetite

Common side effects (affects 1 to 10 users in 100 ) include:

-    heartburn

-    stomach pain

-    headache

-    agitation

-    confusion

-    weakness

-    fatigue

-    sweating

-    generally feeling of being unwell

-    weight loss

-    trembling

Uncommon side effects (affects 1 to 10 users in 1,000) include:

-    depression

-    difficulty in sleeping

-    changes in liver function

-    fainting or accidentally falling

Rare side effects (affects 1 to 10 users in 10,000) include:

-    chest pain

-    fits or convulsions

-    rashes

-    stomach and intestinal ulcers

Very rare side effects (affect less than 1 user in 10,000) include:

-    blood in stools or when vomiting

-    urinary tract infection

-    inflammation of the pancreas (severe upper stomach pain, often with nausea and vomiting)

-    problems with heart rhythm (both fast and slow)

-    high blood pressure

-    hallucinations

-    worsening of Parkinson’s disease or development of similar symptoms (muscle stiffness, difficulty in carrying out movements).

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

-    severe vomiting that can lead to a rupture of the oesophagus (the tube that connects the mouth with the stomach).

-    itching

Patients with dementia associated with Parkinson’s disease experience some side effects more frequently and also some additional side effects: trembling, (very common), difficulty in sleeping, anxiety, restlessness, worsening of Parkinson’s disease or development of similar symptoms (muscle stiffness, difficulty in carrying out movements), abnormally slow or uncontrollable movements, slow heart beat, too much saliva, dehydration, (common), irregular heart beat and poor control of movements (uncommon).

Additional side effects which have been reported with Rivastigmine transdermal patches: severe confusion, anxiety, fever (common).

Should such symptoms occur, contact your doctor as you may need medical assistance.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

5. HOW TO STORE RIVASTIGMINE

Keep out of the reach and sight of children.

Do not use Rivastigmine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month. This medicinal product does not require any special storage conditions.

Only bottle

Rivastigmine should be used within 125 days of opening the bottle

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.

6. FURTHER INFORMATION

What Rivastigmine contains:

The active substance is rivastigmine.

Each Rivastigmine 1.5 mg capsule contains Rivastigmine(R,R)-tartrate corresponding to 1.5 mg rivastigmine.

Each Rivastigmine 3 mg capsule contains Rivastigmine(R,R)-tartrate corresponding to 3 mg of rivastigmine.

Each Rivastigmine 4.5 mg capsule contains Rivastigmine(R,R)-tartrate corresponding to 4.5 mg of rivastigmine.

Each Rivastigmine 6 mg capsule contains Rivastigmine(R,R)-tartrate corresponding to 6 mg of rivastigmine.

Capsule contents

Cellulose Microcrystalline (E460)

Tartaric acid (E334)

Silica Colloidal Anhydrous (E551)

Magnesium Stearate (E470b)

Rivastigmine 1.5 mg:

Capsule Cap & Body:

Tartrazine (E102)

Titanium dioxide (E171)

Sodium lauryl sulphate.

Imprinting ink composition:

Shellac

Propylene Glycol Sodium Hydroxide Titanium Dioxide (E171)

Povidone

Allura Red Aluminum Lake (E129)

Rivastigmine 3 mg:

Capsule Cap & Body:

Allura red (E129)

Tartrazine (E102)

Sunset Yellow FCF (E110)

Titanium dioxide (E171)

Sodium lauryl sulphate.

Imprinting ink composition:

Shellac

Propylene Glycol Sodium Hydroxide Titanium Dioxide (E171)

Povidone

Allura Red Aluminum Lake (E129)

Rivastigmine 4.5 mg:

Capsule Cap & Body:

Brilliant blue FCF (E133)

Allura red (E129)

Titanium dioxide (E171)

Sodium lauryl sulphate Imprinting ink composition:

Shellac

Propylene Glycol Strong Ammonia Solution Potassium Hydroxide Titanium Dioxide (E171)

Rivastigmine 6 mg:

Cap: Allura red (E129),Tartrazine (E102), Sunset Yellow FCF (E110), Titanium dioxide (E171) and Sodium lauryl sulphate.

Body: Brilliant blue FCF (E133), Allura red (E129), Titanium dioxide (E171) and Sodium lauryl sulphate.

Imprinting ink composition:

Shellac

Propylene Glycol Strong Ammonia Solution Potassium Hydroxide Titanium Dioxide (E171)

capsules imprinted ‘RIV 3 mg’ on body with red ink, filled with white to off white granular powder.

Rivastigmine 4.5 mg Capsules, hard:

Opaque pink cap/ Opaque pink body, “size 3” hard gelatin capsules imprinted ‘RIV 4.5 mg’ on body with white ink, filled with white to off white granular powder.

Rivastigmine 6 mg Capsules, hard:

Opaque orange cap/ Opaque pink body, “size 3” hard gelatin capsules imprinted ‘RIV 6 mg’ on body with white ink, filled with white to off white granular powder.

Packed in blister of 14 capsules, 28 capsules & 56 capsules and in a plastic bottle of 250 capsules.

Marketing Authorisation Holder and Manufacturer

Orchid Europe Ltd.

Building 3, Chiswick Park,

566 Chiswick High Road,

Chiswick, London, W4 5YA United Kingdom

This medicinal product is authorised in the Member States of the

EEA under the following names:

France    - [Rivastigmine] 1.5mg, 3.0mg, 4.5mg & 6.0mg

Capsules, dur

Germany    - Rivastigmin Orchid Europe Ltd 1,5/3/4,5/6 mg

Hartkapseln

Greece    - [Rivastigmine] 1.5mg, 3.0mg, 4.5mg & 6.0mg

Ka^aKia, aKAqpa

Spain    - [Rivastigmine] 1.5mg, 3.0mg, 4.5mg & 6.0mg

Capsulas duras

Italy    - “Rivastigmina Orchid Europe” 1.5mg, 3.0mg,

4.5mg & 6.0mg Capsule, rigide

Lithuania    - Rivastigmine Corpus Medica 1,5mg (3,0/4,5/

6,0 mg) kietos kasules

Netherlands    - [Rivastigmine] 1.5mg, 3.0mg, 4.5mg & 6.0mg

Capsules, hard

United Kingdom - Rivastigmine 1.5mg, 3mg, 4.5mg & 6mg Capsules, hard

This leaflet was last approved in 05/2011.

What Rivastigmine looks like and contents of the pack

Capsule, hard

Rivastigmine 1.5 mg Capsules, hard:

Opaque yellow cap/ Opaque yellow body, “size 3” hard gelatin capsules imprinted ‘RIV 1.5 mg’ on body with red ink, filled with white to off white granular powder.

Rivastigmine 3 mg Capsules, hard:

Opaque orange cap/ Opaque orange body, “size 3” hard gelatin