Package leaflet: Information for the patient CABREN® 2.5 mg, 5 mg and 10 mg prolonged-release tablets

Felodipine

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.

-    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. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1.    What Cabren is and what it is used for

2.    What you need to know before you take Cabren

3.    How to take Cabren

4.    Possible side effects

5.    How to store Cabren

6.    Contents of the pack and other information

1. What Cabren is and what it is used for

Cabren contains the active substance felodipine. This belongs to a group of medicinces called calcium antagonists. It lowers blood pressure by dilating small blood vessels. It does not negatively affect the heart function.

Cabren is used in the treatment of high blood pressure (hypertension) and heart and chest pain brought on by for example exercise or stress (angina pectoris).

2. What you need to know before you take Cabren Do not take Cabren

-    if you are pregnant. You should tell your doctor as soon as possible if you become pregnant while using this medicine.

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

-    if you suffer from decompensated heart failure.

-    if you have acute myocardial infarction (heart attack).

-    if you have chest pain of recent onset, or angina pectoris that is lasting for more than 15 minutes or longer or is more severe than usual.

-    if you have disease of a heart valve or heart muscle, until you have talked to your doctor. Warnings and precautions

Cabren, like other blood-pressure lowering medicinal products, may in rare cases lead to pronounced low blood pressure which in some patients may result in an inadequate supply of blood to the heart. Symptoms of excessive low blood pressure and inadequate blood supply to the heart itself, frequently include dizziness and chest pain. If you experience these symptoms, seek emergency care immediately.

Talk to your doctor before taking Cabren, especially if you have problems with your liver.

Taking Cabren may cause your gums to become swollen. Practice good oral hygiene to help avoid your gums from swelling (see section 4).

Children

The use of Cabren is not recommended in children.

Other medicines and Cabren

Tell your doctor if you are taking, have recently taken or might take any other medicines. Some medicines/herbal remedies can affect treatment with Cabren.

Examples are:

•    cimetidine (medicine to treat gastric ulcers)

•    erythromycin (medicine to treat infections)

•    itraconazole (medicine to treat fungi)

•    ketoconazole (medicine to treat fungi)

•    medicines to treat HIV protease inhibitors (such as ritonavir)

•    medicines to treat HIV infection (such as efavirenz, nevirapine)

•    phenytoin (medicine to treat epilepsy)

•    carbamazepine (medicine to treat epilepsy)

•    rifampicin (medicine to treat infections)

•    barbiturates (medicine to treat anxiety, sleeping problems and epilepsy)

•    tacrolimus (medicine used in organ transplantations)

Medicines containing St John’s wort (Hypericumperforatum) (herbal product used to treat depression) may reduce the effect of Cabren and should therefore be avoided.

Cabren with food and drink

Do not drink grapefruit juice if you are treated with Cabren, as this may increase the effect of Cabren and the risk of side effects.

Pregnancy and breast-feeding Pregnancy

Do not use Cabren if you are pregnant.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Cabren is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed.

Driving and using machines

Cabren can have minor or moderate influence on your ability to drive and use machines. If you experience headache, nausea, dizziness or fatigue your ability to react may be impaired. Caution is recommended especially at the start of treatment.

Cabren contains lactose

Cabren contains lactose that is a type of sugar. If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Cabren

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. Cabren extended release tablets should be taken in the morning and be swallowed with water. The tablet must not be divided, crushed or chewed. This medicine can be taken without food or following a light meal not high in fat or carbohydrates.

Hypertension

Treatment should be started with 5 mg once a day. If necessary, your doctor may increase the dose or add another blood-pressure lowering medicine. The usual dose when treating this disease for a long time is 5-10 mg once a day. In elderly patients, a starting dose of 2.5 mg daily may be considered.

Stable angina pectoris

Treatment should be started with 5 mg once a day and if needed, your doctor may increase the dose to 10 mg once a day.

If you have liver problems

The level of felodipine in your blood may be increased. Your doctor may lower the dose.

Elderly people

Your doctor may initiate treatment with the lowest available dose.

If you take more Cabren than you should

If you take more than the recommended number of doses of Cabren, you may suffer from very low blood pressure and sometimes palpitations, high or, rarely, slow heart rate. Therefore, it is very important that you take the number of doses prescribed by your doctor. If you experience symptoms such as feeling faint, light-headedness or dizziness, contact your doctor immediately.

If you forget to take Cabren

If you forget to take a tablet, leave out that dose completely. Take your next dose at the right time. Do not take a double dose to make up for a forgotten dose.

If you stop taking Cabren

If you stop taking this medicine your condition may return. Please consult your doctor and seek advice before you stop taking Cabren. Your doctor will advise you how long to take your medicine. If you have any further questions on the use of this medicine, ask your doctor.

4. Possible side effects

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

If any of the following happen to you, stop taking Cabren and tell a doctor straight away:

• Hypersensitivity and allergic reactions: The signs may include raised lumps on your skin (weals) or swelling of your face, lips, mouth, tongue or throat.

The following undesirable effects have been identified. Most of these reactions appear at start of treatment or after a dose increase. Should such reactions occur, they are usually brief and diminish in intensity with time. If you experience any of the following symptoms and they persist, please tell your doctor.

Mild enlargement of the gums has been reported in patients with an inflammation in the mouth (gingivitis/periodontitis). The enlargement can be avoided or reversed by careful oral hygiene.

Very common: may affect more than 1 in 10 people

•    Ankle swelling

Common: may affect up to 1 in 10 people

•    Headache

•    Flushing

Uncommon: may affect up to 1 in 100 people

•    Abnormally rapid heart rate

•    Palpitations

•    Too low blood pressure (hypotension)

•    Nausea

•    Abdominal pain

•    Burning/prickling/numbness

•    Rash or itching

•    Fatigue

•    Dizziness

Rare: may affect up to 1 in 1,000 people

•    Fainting

•    Vomiting

•    Nettle rash

•    Pain in joints

•    Muscular pain

•    Impotence/sexual dysfunction

Very rare: may affect up to 1 in 10,000 people

•    Gingivitis (swollen gums)

•    Increased liver enzymes

•    Skin reactions due to increased sensitivity to sunlight

•    Inflammation of small blood vessels of the skin

•    A need to pass water frequently

•    Hypersensitivity reactions such as fever or swelling of the lips and tongue

Other undesirable effects may occur. If you have any bothersome or unusual reaction while taking Cabren, check with your doctor right away.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. 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 can help provide more information on the safety of this medicine.

5. How to store Cabren

Keep out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton, blister and bottle after ‘EXP’. The expiry date refers to the last day of that month.

Do not use this medicine if you notice the packaging is torn or damaged.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Cabren tablets contain:

•    The active ingredient is felodipine 2.5 mg, 5 mg, 10 mg.

•    The other ingredients in Cabren prolonged release tablets are lactose monohydrate, microcrystalline cellulose, hypromellose, povidone, propyl gallate, silica colloidal anhydrous magnesium stearate, ferric oxide yellow (E172), titanium dioxide (E171), talc and propylene glycol. Cabren 5mg and Cabren 10mg prolonged release tablets also contain ferric oxide red (E172)

What Cabren tablets look like and contents of the pack:

•    Cabren 2.5mg prolonged release tablet: Yellow, round, biconvex, film-coated, prolonged-release tablets with imprint 2.5.

•    Cabren 5mg prolonged release tablet: Light pink, round, biconvex, film-coated, prolonged-release tablets with imprint 5.

•    Cabren 10mg prolonged release tablet: Reddish brown, round, biconvex, film-coated, prolonged-release tablets with imprint 10.

•    They come in packs of 28 and 84 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

TEVA UK Limited, Eastbourne, BN22 9AG.

This leaflet was last revised: August 2015

PL 00289/1573-1575.