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Value Health One-A-Day Allergy Relief 10 Mg Tablets

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1. TRADE NAME OF THE MEDICINAL PRODUCT

Galpharm one-a-day allergy and hayfever relief 10mg tablets

Morrison’s one-a-day allergy and hayfever relief 10mg tablets Sainsbury’s one-a-day allergy and hayfever relief 10mg tablets Wilkinson’s one-a-day allergy and hayfever relief 10mg tablets Superdrug one-a-day hayfever and allergy 10mg tablets Asda one-a-day hayfever and allergy 10mg tablets Tesco one-a-day hayfever and allergy relief 10mg tablets Boots one-a-day allergy relief 10 mg tablets Value Health one-a-day allergy relief 10 mg tablets Numark one-a-day allergy 10mg tablets

Sainsbury’s Healthcare one-a-day allergy and hayfever relief 10mg tablets Health Essentials one-a-day hayfever and allergy relief 10mg tablets

2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 10 mg of loratadine.

For excipients, see 6.1.

3 PHARMACEUTICAL FORM Tablet

White, oval tablets, scored on one side and plain on the other side, debossed “L” and “10” on each side of the scoreline.

4 CLINICAL PARTICULARS

4.1    Therapeutic indications

Galpharm one-a-day allergy and hayfever relief 10mg tablets are indicated for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria.

4.2    Posology and method of administration

Adults and children 12 years of age and over: 10mg daily (one tablet once daily).

The tablets may be taken without regard to mealtime.

Children aged 2 to under 12 years with:

Body weight more than 30 kg: 10mg daily (one tablet once daily).

Body weight 30 kg or less: The 10mg strength tablet is not appropriate in children with a body weight less than 30 kg.

Efficacy and safety of Galpharm one-a-day allergy and hayfever relief 10mg tablets in children under 2 years of age have not been established.

Patients with severe liver impairment should be administered a lower initial dose because they may have reduced clearance of loratadine. An initial dose of one tablet every other day is recommended for adults and children weighing more than 30 kg.

No dosage adjustments are required in the elderly or in patients with renal insufficiency.

4.3 Contraindications

Galpharm one-a-day allergy and hayfever relief 10mg tablets are contraindicated in patients who are hypersensitive to loratadine or to any of the excipients in the formulation.

4.4    Special warnings and precautions for use

Loratadine should be used with caution in the treatment of patients with severe liver impairment (see Section 4.2).

Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product.

The administration of Galpharm one-a-day allergy and hayfever relief 10mg tablets should be discontinued at least 48 hours before skin tests, as antihistamines may prevent or reduce otherwise positive reactions to dermal reactivity index.

4.5    Interaction with other medicinal products and other forms of interaction

When administered concomitantly with alcohol, Loratadine 10 mg tablets have no potentiating effects as measured by psychomotor performance studies.

Due to the wide therapeutic index of loratadine no clinically relevant interactions are expected and none were observed in the conducted clinical trials (see Section 5.2).

Potential interaction may occur with all known inhibitors of CYP3A4 or CYP2D6 resulting in elevated levels of loratadine (see Section 5.2), which may cause an increase in adverse events.

4.6 Pregnancy and lactation

Loratadine was not teratogenic in animal studies. The safe use of loratadine during pregnancy has not been established. The use of Galpharm one-a-day allergy and hayfever relief 10mg tablets during pregnancy is therefore not recommended.

Loratadine is excreted in breast milk, therefore the use of loratadine is not recommended in breastfeeding women.

4.7 Effects on ability to drive and use machines

In clinical trials that assessed driving ability, no impairment occurred in patients receiving loratadine. However, patients should be informed that very rarely some people experience drowsiness, which may affect their ability to drive or use machines.

4.8 Undesirable effects

In clinical trials in a paediatric population children aged 2 through 12 years, common adverse reactions reported in excess of placebo were headache (2.7%), nervousness (2.3%), and fatigue

(1%).

In clinical trials involving adults and adolescents in a range of indications including AR and CIU, at the recommended dose of 10 mg daily, adverse reactions with loratadine were reported in 2 % of patients in excess of those treated with placebo. The most frequent adverse reactions reported in excess of placebo were somnolence (1.2%), headache (0.6%), increased appetite (0.5%) and insomnia (0.1%). Other adverse reactions reported very rarely during the post-marketing period are listed in the following table.

Immune disorders

Anaphylaxis

Nervous system disorders

Dizziness

Cardiac disorders

T achycardia, palpitation

Gastrointestinal disorders

Nausea, dry mouth, gastritis

Hepato-biliary disorders

Abnormal hepatic function

Skin and subcutaneous tissue disorders

Rash, alopecia

General disorders and administration site conditions

Fatigue

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

4.9 Overdose

Overdosage with loratadine increased the occurrence of anticholinergic symptoms. Somnolence, tachycardia, and headache have been reported with overdoses.

In the event of overdose, general symptomatic and supportive measures are to be instituted and maintained for as long as necessary. Administration of activated charcoal as a slurry with water may be attempted. Gastric lavage may be considered. Loratadine is not removed by haemodialysis and it is not known if loratadine is removed by peritoneal dialysis. Medical monitoring of the patient is to be continued after emergency treatment.

5 PHARMACOLOGICAL PROPERTIES

5.1 Pharmacodynamic properties

Pharmacotherapeutic group: antihistamines - H1 antagonist, ATC code: R06A X13.

Loratadine, the active ingredient in Galpharm one-a-day allergy and hayfever relief 10mg tablets, is a tricyclic antihistamine with selective, peripheral Hl-receptor activity.

Loratadine has no clinically significant sedative or anticholinergic properties in the majority of the population and when used at the recommended dosage.

During long-term treatment there were no clinically significant changes in vital signs, laboratory test values, physical examinations or electrocardiograms.

Loratadine has no significant H2-receptor activity. It does not inhibit norepinephrine uptake and has practically no influence on cardiovascular function or on intrinsic cardiac pacemaker activity.

5.2 Pharmacokinetic properties

After oral administration, loratadine is rapidly and well absorbed, and undergoes extensive first pass metabolism, mainly by CYP3A4 and CYP2D6. The major metabolite - desloratadine (DL)- is pharmacologically active and responsible for a large part of the clinical effect. Loratadine and DL achieve maximum plasma concentrations (Tmax) between 1-1.5 hours and 1.5-3.7 hours after administration, respectively.

Increase in plasma concentrations of loratadine has been reported after concomitant use with ketoconazole, erythromycin, and cimetidine in controlled trials, but without clinically significant changes (including electrocardiographic).

Loratadine is highly bound to plasma proteins (97% to 99%), its active metabolite moderately bound (73% to 76%) to plasma proteins.

In healthy subjects, the plasma distribution half-lives of loratadine and its active metabolite are approx. 1 and 2 hours, respectively. The mean elimination half-lives in healthy adult subjects were 8.4 hours (range = 3 to 20 hours) for loratadine and 28 hours (range = 8.8 to 92 hours) for the major active metabolite.

Approximately 40% of the dose is excreted via urine and 42% in the faeces over a 10 day period and mainly in the form of conjugated metabolites. Approximately 27% of the dose is excreted in the urine during the first 24 hours. Less than 1% of the active substance is excreted unchanged in active form, as loratadine or DL.

The bioavailability parameters of loratadine and of the active metabolite are dose proportional.

The pharmacokinetic profile of loratadine and its metabolites is comparable in healthy adult volunteers and healthy geriatric volunteers.

Concomitant ingestion of food can delay slightly the absorption of loratadine but without influencing the clinical effect.

In patients with chronic renal impairment, both the AUC and peak plasma levels (Cmax) increased for loratadine and its metabolite as compared to the AUCs and peak plasma levels (Cmax) of patients with normal renal function. The mean elimination half-lives of loratadine and its metabolite were not significantly different from that observed in normal subjects. Haemodialysis does not have an effect on the pharmacokinetics of loratadine or its active metabolite in subjects with chronic renal impairment.

In patients with chronic alcoholic liver disease, the AUC and peak plasma levels (Cmax) of loratadine were double while the pharmacokinetic profile of the active metabolite was not significantly changed from that in patients with normal liver function. The elimination half-lives for loratadine and its metabolite were 24 and 37 hours, respectively, and increased with increasing severity of liver disease.

Loratadine and its active metabolite are excreted in the breast milk of lactating women.

5.3 Preclinical safety data

Preclinical data reveal no special hazard based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity and carcinogenic potential.

In reproductive toxicity studies, no teratogenic effects were observed. However, prolonged parturition and reduced viability of offspring were observed in rats at plasma levels (AUC) 10 times higher than those achieved with clinical doses.

6 PHARMACEUTICAL PARTICULARS

6.1    List of excipients

Lactose monohydrate

Maize starch

Pregelatinised starch 1500 Magnesium stearate

6.2    Incompatibilities

Not applicable

6.3 Shelf life

3 years

6.4 Special precautions for storage

No special storage conditions

6.5


Nature and contents of container

The tablets are packed in transparent PVC/PVdC (PVC: 250 pm thick, PVdC coating: 60 g/m2) aluminium blisters or white opaque PVC/PVdC (PVC: 250 pm thick, PVdC coating: 40 g/m2) aluminium blisters in outer cartons containing 7, 14 & 30 tablets.

6.6 Special precautions for disposal

Not applicable

7    MARKETING AUTHORISATION HOLDER

Galpharm Healthcare Ltd

Wrafton Braunton Devon EX33 2DL United Kingdom

8    MARKETING AUTHORISATION NUMBER(S)

PL 16028/0080

9 DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION 21/04/2008

10 DATE OF REVISION OF THE TEXT 28/10/2014