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PACKAGE LEAFLET: INFORMATION FOR THE USER

Dosulepin

Tablets and Capsules

Dosulepin hydrochloride

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 becomes serious, or if you notice any side effects not listed in this leaflet, please tell yourdoctor or pharmacist.

In this leaflet:

1.    What dosulepin is and what it is used for

2.    Before you take dosulepin

3.    How to take dosulepin

4.    Possible side effects

5.    How to store dosulepin

6.    Furtherinformation

1. WHAT DOSULEPIN IS AND WHAT IT IS USED FOR

Dosulepin hydrochloride belongs to a group of medicines called antidepressants. Dosulepin Capsules and Tablets are used to treat depression and can also help reduce feelings of anxiety. Your doctor has prescribed Dosulepin as other medicines are unsuitable for you. Please ask you doctor or pharmacist if you need more information.

2. BEFORE YOU TAKE DOSULEPIN CAPSULES ANDTABLETS

Do not take Dosulepin Capsules and Tablets if:

•    you know that you are allergic (hypersensitive) to dosulepin or any of the other ingredients (listed in section 6 of this leaflet)

•    you have an irregular heart beat or any other heart problems

•    you have liver problems

•    you have an eye condition known as glaucoma

•    you are a man that has prostate problems (difficulty in passing waterorenlarged prostate)

•    you have been diagnosed as having mania (feeling over-excited with unusual behaviour)

•    you have fits (epilepsy)

Notfor use in children

Thoughts of suicide and worsening of your depression or anxiety disorder

If you are depressed and/or have anxiety disorders you can sometimes have thoughts of harming or killing yourself. These may be increased when first starting antidepressants, since these medicines all take time to work, usually about two weeks but sometimes longer.

You may be more likely to think like this:

•    If you have previously had thoughts about killing orharming yourself.

•    If you are a young adult.

Information from clinical trials has shown an increased risk of suicidal behaviour in adults aged less than 25 years with psychiatric conditions who were treated with an antidepressant.

If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straightaway.

You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet. You might ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in yourbehaviour.

Take special care with Dosulepin Capsules and Tablets if:

•    you are going to the dentist or going to have surgery, tell your surgeon you are taking Dosulepin Capsules and Tablets. It may affect the anaesthetic used

•    you are diabetic, as your blood sugar levels may change whilst taking dosulepin

•    you are receiving electro-shock therapy (ECT) (used in severe depression)

•    you have a thyroid (a gland in your neck) problem, difficulty in passing urine, or a tumour of the adrenal gland (a gland above the kidney)


•    you suffer from porphyria (a disease causing damage to nerves and skin sensitivity)

Taking other medicines:

You should tell your doctor if you are taking or have taken any of the following medicines as they may affect how your Dosulepin Capsules and Tablets work:

•    A medicine used to treat depression called a mono-amine oxidase inhibitor (MAOI). You should not take Dosulepin Capsules and Tablets at the same time as MAOIs or within 14 days of stopping them, e.g. selegiline, rasagiline.

•    Other medicines used to treat depression called SSRIs (selective serotonin re-uptake inhibitors)

•    Any medicines given to you for treating high blood pressure (hypertension) e.g. betanidine, debrisoquine, guanethidine, clonidine.

•    Medicines used in heart conduction disorders, e.g. quinidine, amiodarone, felcainide, procainamide, propafenone ordisopyramide.

•    Any hayfever/allergy medicines which contains terfenadineorastemizole

•    Sotalol, quinidine, Cisapride, pentamidine isetionate, clonidine (medicines for heart or blood pressure problems);

•    Halofantrine (a medicine for malaria)

•    Rifampicin (an antibacterial)

•    Any medicines called barbiturates (eg amylobarbital for sleeplessness) or methylphenidate (used to treat behavioural problems)

•    Any medicine that contains an opioid/narcotic analgesics (these include codeine, morphine, co-proxamol and co-dydramol)

•    Tramadol, a strong pain-killer

•    Medicines called sympathomimetic agents -these include ephedrine, pseudoephedrine, adrenaline and noradrenaline (these may be found in medicines used to treat heart problems and asthma as well as some decongestants and cough/cold remedies)

•    Medicines called antimuscarinics (medicines for Parkinson's Disease, stomach and bladder problems)

•    Pimozide and sertindole (medicines for serious mental problems)

•    Cimetidine (used to treat stomach ulcers)

•    Diuretic medicines ("water tablets”)

•    Calcium channel blockers (medicine for heart problems eg amlodipine, diltiazem, nifedipine, verapamil)

•    Medicines for epilepsy or fits e.g. phenytoin, primidone, carbamazepine

•    oestrogen-containing contraceptives (these may decrease the antidepressant effect of dosulepin)Local anaesthetics

•    Quinolone antibiotics e.g. moxifloxacin.

•    Atomoxetine used to treat Attention-Deficit/ Hyperactivity Disorder (ADHD)

•    Wafarin, coumarin or other anticoagulants, as there could be changes in bleeding times.

•    Ritonavir used in the treatment of HIV

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

Taking with food and drink

Dosulepin can make you feel drowsy. If you drink alcohol with these capsules or tablets this can make you feel more drowsy.

The capsules and tablets should be swallowed whole with a drinkof water. Do not chew them.

Pregnancy and breast-feeding

If you are or think you might be pregnant or you plan to become pregnant, or if you are breastfeeding you must tell your doctor before you take this medicine. Your doctor will decide if you can take these capsules ortablets.

Driving and using machines

Dosulepin can make you feel drowsy. Do not drive, operate machinery or do anything that requires you to be alert until you know how the capsules or tablets will affect you. Feeling drowsy in the day may lessen as treatment continues, but if drowsiness becomes a problem, you should tell yourdoctor.


Important information about some of the ingredients of Dosulepin Capsules and Tablets

These capsules and tablets contain a sugar called lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. They also contain the colours sunset yellow (E110) in the tablets and ponceau 4R (E124) in the capsules, which can cause allergic reactions.

3.    HOW TO TAKE DOSULEPIN

Your doctor will tell you how many capsules or tablets to take and when you should take them. This will also be on the carton label. Ask your pharmacist or doctor for help if you are not sure howto take your capsules ortablets or if you want more information.

The capsules and tablets should be swallowed whole with a drink of water. Do not chew them.

The usual dose is:

Adults: One 25mg capsule three times a day or one 75mg tablet at night. In some cases the doctor may increase your dose, if he considers this necessary. Normally not more than 9 capsules or 3 tablets should be taken each day

Elderly: The usual starting dose is between 1 and 3 capsules ortablets a day.

It may take two to four weeks of treatment before you begin to see an improvement in your mood although you might feel there is an improvement in your anxiety symptoms before then. It is important that you keep taking these capsules or tablets until your doctortells you to stop.

If you stop taking Dosulepin capsules or tablets

Do not stop taking dosulepin just because you feel better. If you stop taking dosulepin too soon, your condition may get worse and you may suffer irritability, increased sweating or difficultly sleeping. If your doctor wants you to stop taking dosulepin, your doctor will ask you to stop gradually.

If you forget to take Dosulepin capsules ortablets

Do not worry. Simply leave out that dose completely and then take your next dose at the right time. Do not take a double dose to make up for a forgotten dose. If you are unsure, check again with yourdoctoror pharmacist.

If you take more Dosulepin capsules or tablets than you should

You should only ever take the number of caspules or tablets that your doctor has told you to take. Do not change the dose yourself. If you think your caspules or tablets are not working well enough, speak to your doctor to see if the dose can be increased.

Dosulepin may seriously harm you and may be life threatening if you take too many capsules or tablets. You should SEEK IMMEDIATE HELP if a child takes any capsules or tablets or if you or anybody else accidentally takes too many capsules or tablets. Remember to take the pack with you, even if it is empty.

4.    POSSIBLE SIDE EFFECTS

Like all medicines, Dosulepin Capsules and Tablets can cause side effects, although not everybody gets them.

If you get any of the following rare side effects (that affect less than 1 person in 1000) after taking these capsules or tablets, you should contact your doctor immediately:

•    yellowing of the skin or whites of the eyes (jaundice)

•    hepatitis (damage to the liver causing dark urine, jaundice, nausea and fever)

•    a fever (high temperature, sweating, shivering)

. discomfort around the right lower rib cage

changes in the blood including bone marrow (these will be found if you have blood tests)

•    severe mood changes such as extreme excitability

   fits

The most common side effects (that affect less than 1 person in 10)are:

•    dry mouth

, blurred vision

, changes in the heart beat or heart conduction


•    constipation and difficulty in passing water • increased appetite

. weight gain

These side effects usually lessen as treatment continues.

Other side effects you may also experience are:

•    drowsiness

• increased sweating

skin rashes, including itchy rashes and hives • tremor(shaking)

•    changes in sexual function

low blood pressure, which may cause dizziness orfainting

   an allergic reaction (eg skin sensitivity to light,

   itching, redness)

   confusion

changes in levels of sugar and sodium in the

   blood (seen in blood tests)

•    enlargementofthe testicles

•    swelling of the breasts in men

milk production in the breasts not related to

   pregnancyorbreastfeeding

•    impairment of movement

•    abnormal body movements

•    delusions (abnormal thoughts)

An increased risk of bone fractures has been observed in patients taking this type of medicine.

You may experience withdrawal reaction when stopping Dosulepin; the symptoms may include insomnia, irritability and excessive sweating.

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

5.    HOW TO STORE DOSULEPIN

Do not store above 25°C. Keep the capsules and tablets in the original container, and in a safe place (preferably a locked cupboard) where children cannot see or reach them. Your medicine could seriously harm them.

Do not take this product after the expiry date shown on the carton.

If your doctor decides to stop the treatment, you must return any left over capsules or tablets to your pharmacist. Only keep the capsules or tablets if yourdoctortells you to.

6. FURTHER INFORMATION

What Dosulepin contains

The active substance is dosulepin hydrochloride. Each capulse contains 25mg of dosuelpin hydrochloride and each tablet conains 75mg ofdosulepin hydrochloride

The other ingredients in the capsules are lactose, maize starch and magnesium stearate. The capsule shell contains gelatin and the colours ponceau 4R (E124), titanium dioxide (E171) and yellow iron oxide (E172). The ink on the capsule contains titanium dioxide (E171), shellac and dimethicone.

The other ingredients in the tablets are tricalcium phosphate, maize starch, povidone, magnesium stearate, purifed water, hypromellose, macrogol 400, and colours sunset yellow (E110), ponceau 4R (E124), indigo carmine (E132) and titanium dioxide (E171).

What Dosulepin looks like and contents of the pack

Dosulepin Capsules are red and have “TH” and "25” printed on them in white ink.

Dosulepin Tablets are round with a red shiny coating and are marked with “PTN 75” on one side.

Dosulepin Capsules and Tablets are provided in packs of 14 or 28 capsules and tablets

Marketing Authorisation Holder and Manufacturer

Co-pharma Ltd,

Unit4 Metro Centre,

Tolpis Lane, Watford,

Herts, WD189SS,

United Kingdom

This leaflet was last revised 08/2010


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