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

In this leaflet:

1.    Wat Adizem-XL capsules are and what they are used for

2.    Before you take Adizem-XL capsules

3.    How to take Adizem-XL capsules

4.    Possible side effects

5.    Howto store Adizem-XL capsules

6.    Further information

1. What Adizem-XL capsules are and what they are used for

These capsules have been prescribed for you to treat angina (chest pain caused by a reduction of oxygen to the heart muscle) or high blood pressure (hypertension). They contain the active ingredient diltiazem. Diltiazem belongs to a group of medicines called calcium antagonists. Calcium antagonists help more blood to reach the heart and reduce blood pressure. The other ingredients of Adizem-XL capsules are listed in section 6 of this leaflet.

Adizem-XL capsules are designed to work properly over 24 hours. If the capsules are crushed or chewed, the entire 24-hour dose may be absorbed rapidly into your body. This can be dangerous, causing serious problems such as an overdose.

2. Before you take Adizem-XL capsules Do not take Adizem-XL capsules if you:

•    are allergic (hypersensitive) to diltiazem or any of the other ingredients of the capsules (see section 6 ‘Further Information’);

•    have a slow or irregular heart beat;

•    have heart failure (which can cause shortness of breath or ankle swelling).

Children should not take these capsules.

Take special care with . lrfcem-.YL capsules

Before treatment mth Adizem-XL capsules tell your doctor or pharmacist if you:

•    have liver or kidney problems as your doctor may monitor you more closely;

•    have porphyria (a rare disease of the blood pigments);

•    have bowel problems.

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 tske Adizem-XL capsules with some other medicines, the effect of Adizem-XL capsules or the other medicine may be changed.

Tell your doctor or pharmacist if you are taking:

•    any other medicines for high blood pressure, such as beta blockers (for example atenolol), diuretics (for example bendrofluazide) or ACE inhibitors (examples include captopril and enalapril);

•    medicines known as alpha blockers, which you may be taking to treat high blood pressure or prostate disorders (for example prazosin);

•    any medicines which may cause low blood pressure or slow heart beat (for example aldesleukin to treat cancer of the kidneys, or antipsychotics to treat mental and behavioural disorders);

•    ivabradine to treat angina;

•    anti-arrhythmic medicines to treat an irregular or rapid heart beat (for example digoxin, amiodarone or beta-blockers);

•    cilostazol to treat intermittent claudication (a condition that causes leg pain due to a restriction in blood supply to the muscles);

•    medicines known as statins to reduce cholesterol levels in your blood (examples include simvastatin, atorvastatin or lovastatin);

•    medicines known as H₂ antagonists to treat stomach ulcers, indigestion or heartburn, such as cimetidine or ranitidine;

•    carbamazepine or phenytoin to treat seizures, fits or convulsions;

medicines known as benzodiazepines to treat anxiety or help you sleep (examples include midazolam or triazolam); medicines known as barbiturates to either treat fits or to help you sleep (examples include phenobarbital or primidone); antidepressants known as tricyclic antidepressants (examples include amitriptyline or imipramine) or lithium; rifampicin to treat tuberculosis; ciclosporin, sirolimus or tacrolimus to prevent organ transplant rejection or treat other immune system disorders; a specific type of medicine known as a protease inhibitor to treat HIV (examples include atazanavir or ritonavir); dantrolene (a muscle relaxant); theophylline to treat breathing problems such as asthma;

medicines known as nitrate derivatives to treat angina or high blood pressure (examples include glyceryl trinitrate or isosorbide mononitrate);

medicines for inflammation or allergies, known as steroids (for example methylprednisolone).

Anaesthetics and \di:em-XL capsules

If you are having a general anaesthetic, tell your doctor that you are taking these capsules.

Taking Adizem-XL capsules with alcohol

Do not tske Adizem-XL capsules at the same time as an alcoholic drink.

Pregnancy and breastfeeding

Do not take Adizem-XL capsules if you are pregnant, likely to become pregnant or are breastfeeding.

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

Driving and using machines

The capsules may cause a number of side effects such as dizziness and a general feeling of being unwell. These could affect your ability to drive (see section 4 for a full list of side effects) and are usually most noticeable when you start taking the capsules, or when changing to higher dose. If you are affected you should not drive or operate machinery.

3. How to take lfem-.Y/, capsules

Always take Adizem-XL capsules exactly as your doctor has told you. The label on your medicine will tell you how many capsules to take and how often.

The usual starting dose for adults is one 240 mg capsule every 24 hours. However, if you are elderly or have kidney problems then your doctor will probably suggest a lower starting dose of one 120 mg capsule every 24 hours.

Your doctor will decide how many capsules you should take.

Children should not take these capsules.

Do not exceed the dose recommended by your doctor. You should check with your doctor or pharmacist if you are not sure.

Swallow your capsules whole with a glass of water. Do not chew or crush the capsules.

You should take your capsules every 24 hours. For instance, if you take a capsule at 8 o’clock in the morning, you should take your next capsule at 8 o’clock the next morning.

If you take more Adizem-XL capsules than you should or if someone accidentally swallows your capsules

Call your doctor or hospital straight away.

People who have taken an overdose may become very unwell, feel faint, have a slow heart beat and lose consciousness. They may need emergency treatment in hospital. When seeking medical attention make sure that you take this leaflet and any remaining capsules with you to show to the doctor.

If you forget to take Adizem-XL capsules

If you remember within 4 hours of the time your capsule was due, take your capsule straight away. Take your next capsule at your normal time. If you are more than 4 hours late, please call your doctor or pharmacist for advice. Do not take a double dose to make up for a forgotten capsule.

If you stop taking. lrfcati-.YL capsules

You should not stop taking these capsules unless your doctor tells you to. If you want to stop taking your capsules, discuss this with your doctor first.

If you have any further questions on the use of Adizem-XL capsules ask your doctor or pharmacist.

Like all medicines, Adizem-XL capsules can cause side effects, although not everybody gets them.

Look out for the following severe allergic reactions. They have occurred in a small number of people, although their exact frequency cannot be estimated:

•    swelling of the face or throat;

•    skin rash or itching especially those covering your whole body, severe flaking, blistering or peeling of the skin, with or without a fever.

Tell your doctor immediately if you get any of these.

Very common side effects (probably affecting more than 1 in 10 people taking these capsules)

•    Swelling of the hands, ankles or feet. Common side effects (probably affecting more than 1 in 100 people taking these capsules)

•    Feeling sick, abdominal pain, indigestion, constipation.

•    Dizziness, headache.

•    Flushing or redness of the sldn.

•    A fast, slow or irregular heartbeat.

•    Generally feeling unwell.

•    Tiredness.

Uncommon side effects (probably affecting fewer than l in 100 people taking these capsules)

•    Diarrhoea, being sick.

•    A feeling of faintness, especially on standing up.

•    Nervousness.

•    Difficulty in sleeping.

•    A worsening in liver function tests (seen in a blood test).

Rare side effects (probably affecting fewer than l in 1000 people taking these capsules)

•    Dry mouth.

•    Hives.

Other side effects

Other side effects have occurred in a small number of people, but their exact frequency cannot be estimated:

•    Heart failure which can cause shortness of breath or ankle swelling.

•    Inflammation of the liver.

•    Changes in muscle tone and/or abnormalities of movement.

•    Mood changes, including depression.

•    Sldn problems such as an increased sensitivity to sunlight.

•    A reduction in blood platelets which increases the risk of bleeding or bruising.

•    Breast enlargement in men.

•    Bleeding, tender or enlarged gums.

•    Inflammation of blood vessels (often with sldn rash).

•    Gastrointestinal disorders (e.g. upset stomach).

•    Sweating.

•    Low blood pressure.

You may see the remains of the capsules in your faeces. This should not affect how the capsules work.

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

5. How to store l di:em-XL capsules

Keep out of the reach and sight of children.

Do not use any capsules after the expiry date which is stated on the carton. EXP 08 2020 means that you should not take the capsules after the last day of that month i.e. August 2020.

Do not store your capsules above 25°C.

Do not take your capsules if they are broken or crushed as this can be dangerous and can cause serious problems such as overdose.

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.

What Adizem-XL capsules contain

The active ingredient is diltiazem hydrochloride. Each capsule contains 120 mg, 180 mg, 200 mg, 240 mg or 300 mg of diltiazem hydrochloride.

The other ingredients are:

•    Microcrystalline cellulose

•    Ethylcellulose

•    Colloidal anhydrous silica

•    Polysorbate 80

•    Dibutyl sebacate

•    Magnesium stearate

•    Sodium laurilsulfate

•    Gelatin

•    Shellac

•    Propylene glycol

•    Simeticone

•    Iron oxide (E172)

•    Titanium dioxide (E171)

The capsules also contain the following colourants:

120 mg, 180 mg and 240 mg - Eiythrosine (E127) and indigo carmine (El32)

300 mg - Erythrosine (E127), indigo carmine (E132) and patent blue V (E131)

What Adizem-XL capsules look like and the contents of the pack

Adizem-XL capsules are marked DCR followed by the strength (eg. 120,180 etc.) and are coloured as follows:

120 mg - pale pink/navy blue,

180 mg - dark pink/royal blue,

200 mg-brown,

240 mg - dark red/blue,

300 mg - dark maroon/pale blue.

The capsules are packed in blister packs and then placed in boxes. In each box there are 28 capsules.

This leaflet was last revised in July 2011

Adizem®-XL capsules are protected by UK Patent No. 2258613.

® Adizem and the NAPP device (logo) are Registered Trade Marks. © 2009-2011 Napp Pharmaceuticals Limited.

15/08/2011 12:16