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Indocid 100mg Suppositories

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Inacid® 100mg Suppositories

(indometacin)

Ref: 1176/260413/1/F

Patient Information Leaflet

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

Your medicine is called Inacid 100mg Suppositories but will be referred to as Inacid throughout this leaflet.

In this leaflet:

^ What Inacid Suppositories are and what they are used for ^2 Before you use Inacid Suppositories How to use Inacid Suppositories ^4 Possible Side Effects ^2 How to store Inacid Suppositories ^2 Further information


^ What Inacid Suppositories are and what they are used for

Inacid Suppositories contain the active ingredient indomethacin.

This belongs to a group of medicines known as ‘non-steroidal anti-inflammatory agents' or NSAlDs. These work by reducing the body's ability to produce Inflammation, which may cause pain and discomfort. Your doctor has prescribed Inacid for you because you are suffering from one of the following:

*    Rheumatoid arthritis (disease mainly of the joints)

*    Osteoarthritis (disease of the joints)

*    Ankylosing spondylitis (a form of arthritis which mainly affects the back)

*    Pain, inflammation, and swelling following orthopaedic surgery.

*    Musculoskeletal disorders (muscles and bone disorders).

*    Period pain.

*    Low back pain.

*    Disease of the hip joint.

*    Acute gouty arthritis (a form of arthritis in which crystals build up in the joints).


Risk of heart attack or stroke

Medicines such as Inacid may be associated with a small increased risk of heart attack (‘Myocardial Infarction') or stroke. Any risk is likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment. You might be at risk of these conditions (for example If you have high blood pressure, diabetes or high cholesterol or are a smoker) you should discuss your treatment with your doctor or pharmacist.

Taking other medicines

Tell your doctor or pharmacist if you are taking any of the following:

*    Aspirin or similar medicines.

*    Other non-steroidal anti-inflammatory medicines including diflunisal.

*    Anticoagulants, which thin the blood.

*    A medicine for gout called probenecid.

*    Methotrexate, a drug used in the treatment of cancer, severe skin disease and rheumatoid arthritis.

*    Cyclosporin, a drug used to prevent the body from rejecting a recent organ or bone-marrow transplant, and to treat severe skin disease and rheumatoid arthritis.

*    Lithium for treatment of mental disorders.

*    Diuretics (water tablets).

*    Cardiac glycosides, such as digoxin, medicines used in the treatment of congestive heart failure and certain alterations of heart rhythm.

*    Antihypertensive medicines for the treatment of high blood pressure.

*    A nasal decongestant called phenylpropanolamine usually found in over-the-counter cold relief preparations.

*    Corticosteroid drugs, including anti-Inflammatory and replacement therapies.

*    Mifepristone, a treatment used in emergency for termination of pregnancy.

*    Antibiotics from the quinolone group of antibiotics.

Pregnancy and Breast-feeding

Ask your doctor or pharmacist for advice before taking this medicine. If you are pregnant or planning to become pregnant or if you are breastfeeding, Inacid may make it more difficult to become pregnant. You should inform your doctor if you are planning to become pregnant or if you have problems becoming pregnant.

Driving and using machines

Inacid can cause headaches, dizziness, drowsiness and visual disturbances in some people. If this happens to you, avoid activities which require you to be alert; for example, driving a car and operating machinery.


[2 Before you use Inacid Suppositories

Do not use Inacid Suppositories

*    If you are hypersensitive (allergic) to indomethacin or any of the other ingredients in Inacid Suppositories (for example, if you have experienced breathing difficulties, skin rashes which look like nettle rash, or a runny nose) or If you are hypersensitive to aspirin or another non-steroidal anti-inflammatory medicine. A full list of the ingredients is in section 6 -Further information.

*    If you have a peptic ulcer (ulcer in your stomach or duodenum) or bleeding in your stomach, or have had two episodes of peptic ulcers, stomach bleeding or perforation.

*    If you are suffering from inflammation of the rectum causing soreness, bleeding and sometimes a discharge of mucus and/or pus from your anus.

*    If you have polyps (soft fleshy swellings that grow inside the nose) in your nose, associated with itching, nettle rash, wheezing, or swelling of the face, lips, tongue and/or throat or difficulties in swallowing or breathing.

Take special care with Inacid Suppositories

*    If you are epileptic

*    If you have Parkinson's disease

*    If you have a psychiatric problem

*    If you have heart disease, high blood pressure or have a tendency for fluid retention

*    If you are being treated for infection or you have a fever

*    If you know you suffer from asthma, digestive tract, liver or kidney disease, diabetes or heart failure

*    If you have a problem with your blood clotting.

*    If you are having blood tests, make sure that the doctor doing them knows that you are taking Inacid.

*    If you have rheumatoid arthritis your doctor may want to examine your eyes at intervals during your treatment with Inacid. You should see your doctor if you notice any change in your vision


How to use Inacid Suppositories

Always use Inacid Suppositories exactly as your doctor has told you.

You should check with your doctor or pharmacist if you are not sure. Suppositories must not be taken by the mouth.

They are to be placed in the rectum (back passage). Empty your bowels (if necessary) before use. Remove the suppository from the foil and, lying on your back or your side with your knees bent up, push the suppository-pointed end first - up into your back passage. Lie still for a minute or so, and then wash your hands. The suppository should remain in place and dissolve completely.

The amount you use will depend upon your condition.

Dosage:

The usual adult dosage is one suppository to be inserted into the rectum once or twice a day. One should be used at bedtime and if another is necessary it should be used in the morning.

Not recommended for use in children.

If you use more Inacid Suppositories than you should

If you use too many suppositories by mistake or someone else accidentally uses your suppositories, contact your doctor immediately or go to the nearest casualty department.

If you forget to use Inacid Suppositories

If you forget to take the suppository, take it as soon as you remember. If it is nearly time for your next dose, just carry on with the next dose as normal.

Do not use an extra suppository to make up for forgotten doses.

If you stop using Inacid Suppositories

You should use Inacid Suppositories for as long as your doctor tells you to. It may be dangerous to stop using them without your doctor's advice.


Patient Information Leaflet (continued)

Possible side effects

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

If you experience an allergic reaction, STOP TAKING the medicine and seek immediate medical help:

Symptoms of allergic reactions are:

*    Itching;

*    Rashes;

*    Sensitivity to sunlight;

*    Loss of hair; swollen face, lips, tongue and throat;

*    Difficulty in breathing and swallowing; inflammation of blood or lymph glands (lymph glands are all over the body but are noticeable in the neck and armpit when swollen as bean shaped);

*Severe light headedness or dizziness due to a rapid fall in blood pressure.

*    The allergic reaction may include problems with the liver, kidneys or blood cells (see below for liver, kidney and blood problems).

If you suffer from any of the following at any time during your treatment STOP TAKING the medicine and seek immediate medical help:

*    Pass blood in your faeces (stools/motions)

*    Pass black tarry stools

*    Vomit any blood or dark particles that look like coffee grounds

STOP TAKING the medicine and tell your doctor if you experience:

*    Indigestion or heartburn

*    Abdominal pain (pains in your stomach) or other abnormal stomach symptoms.

Medicines such as Indocid may be associated with a small increased risk of heart attack (‘Myocardial Infarction') or stroke.

Other side effects include:

Problems with the central nervous system:

*    Headache, dizziness, light-headedness, depression, vertigo (sensation that things around you are moving) and tiredness (including feeling unwell and listlessness).

*    Reactions reported infrequently include anxiety, confusion, fainting, drowsiness, fits, coma, peripheral neuropathy which may be experienced as loss of sensation, numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness, involuntary muscle movements, sleeplessness, hallucinations (seeing or hearing things that are not there), mental disorders including a loss of personal identitiy. Rarely, pins and needles, speech problems, worsening of epilepsy and parkinsonism symptoms (symptoms that mimic those of Parkinson's disease such as tremor or abnormal movements). If these side effects are severe you may need to stop treatment with this medicine. You should talk to your doctor.

Problems with the digestive system:

*    The most frequent reactions are nausea, loss of appetite, vomiting, trapped wind, constipation, and diarrhoea.

*    Reactions reported infrequently include inflammation of the mouth and stomach, wind, narrowing and/or obstruction of the intestines which may be seen as a swollen abdomen, and vomiting.

Liver disorders:

*    Rarely, inflammation of the liver and jaundice, symptoms of which may be yellowing of the eyes and skin.

Heart and kidney disorders:

*    High or low blood pressure, abnormal heartbeat, chest pain, palpitations, heart failure, kidney problems which can lead to water retention, reduction in the amount of urine passed, protein and blood in the urine, increased levels of urea in the blood.

*    These changes in urine and blood composition would normally be picked up in urine or blood tests.

Blood disorders:

*    Infrequently, blood disorders which are usually detected in blood tests, but may be seen as pale skin, tiredness, fever, sore throat and mouth, small red spots on the skin, bruising or prolonged bleeding after Injury. Blood disorders such as leucopenia and anaemia may be seen with symptoms of severe chills, mouth ulcers, headache, shortness of breath and dizziness.

Eye disorders:

*    Infrequently, blurred vision, double vision, pain in the eye and other visual disturbances.


Problems with the ear:

*    Ringing in the ears and other hearing disturbances, including deafness rarely.

Other side effects:

*    Bleeding from the vagina in women;

*    Increased levels of sugar in the blood, sugar in the urine, high levels of potassium in the blood, which are generally diagnosed by laboratory tests;

*    Flushing and sweating;

*    Bleeding from the nose;

*    Breast changes including enlargement and tenderness in men and women;

*    Ulcers in the lining of the mouth.

Side effects associated with the use of Indocid suppositories

*    Bleeding, inflammation, burning pain, discomfort, itching or the feeling of a full back passage.

Laboratory tests

Misleading results have been seen with patients having a Dexamethasone suppression test (DST) while using this medicine.

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.


How to store Inacid Suppositories

*    KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.

*    Do not store above 25°C.

*    Store in the original package

Do not use this medicine after the expiry date shown on the carton or suppository label.

If your doctor tells you to stop taking this medicine, return any unused medicine to your pharmacist for safe disposal. Only keep this medicine, if your doctor tells you to.

If your medicine becomes discoloured or shows any other signs of deterioration, consult your pharmacist who will tell you what to do.

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.


3 Further information

What Inocid Suppositories contain

Each suppository contains 100mg of indometacin as the active ingredient. Also contains butylhydroxyanisole (320), butylhydroxytoluene (321), edetic acids, glycerol, macrogols and purified water.

What Inacid Suppositories looks like and the contents of the pack

Inacid are white to yellowish, torpedo-shaped suppositories.

Inacid comes in packs of 12 or 10 suppositories.

Manufacturer and Licence Holder

Inacid is manufactured by Iroko Products Ltd, One Silk Street, London,

EC2Y 8HQ, United Kingdom. and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.

IMPORTANT

Remember this medicine is for you. Only a doctor can prescribe it. Never give your medicine to other people. It may harm them, even if their symptoms are the same as yours.

If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.


POM PL 15184/1176 Inacid 100mg Suppositories


Inacid is a registered trademark of Merck & Co., Inc.

Revision date: 26/04/13

Blind or partially sighted?

Is this leaflet hard to see or read?

Phone Lexon (UK) Limited, Tel: 01527 505414 for help.


Patient Information Leaflet

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

Your medicine is called Indocid 100mg Suppositories but will be referred to as Indocid throughout this leaflet.

In this leaflet:

^ What Indocid Suppositories are and what they are used for ^2 Before you use Indocid Suppositories How to use Indocid Suppositories ^4 Possible Side Effects ^2 How to store Indocid Suppositories ^2 Further information


^ What Indocid Suppositories are and what they are used for

Indocid Suppositories contain the active ingredient indomethacin.

This belongs to a group of medicines known as ‘non-steroidal anti-inflammatory agents' or NSAlDs. These work by reducing the body's ability to produce Inflammation, which may cause pain and discomfort. Your doctor has prescribed Indocid for you because you are suffering from one of the following:

*    Rheumatoid arthritis (disease mainly of the joints)

*    Osteoarthritis (disease of the joints)

*    Ankylosing spondylitis (a form of arthritis which mainly affects the back)

*    Pain, inflammation, and swelling following orthopaedic surgery.

*    Musculoskeletal disorders (muscles and bone disorders).

*    Period pain.

*    Low back pain.

*    Disease of the hip joint.

*    Acute gouty arthritis (a form of arthritis in which crystals build up in the joints).


Risk of heart attack or stroke

Medicines such as Indocid may be associated with a small increased risk of heart attack (‘Myocardial Infarction') or stroke. Any risk is likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment. You might be at risk of these conditions (for example If you have high blood pressure, diabetes or high cholesterol or are a smoker) you should discuss your treatment with your doctor or pharmacist.

Taking other medicines

Tell your doctor or pharmacist if you are taking any of the following:

*    Aspirin or similar medicines.

*    Other non-steroidal anti-inflammatory medicines including diflunisal.

*    Anticoagulants, which thin the blood.

*    A medicine for gout called probenecid.

*    Methotrexate, a drug used in the treatment of cancer, severe skin disease and rheumatoid arthritis.

*    Cyclosporin, a drug used to prevent the body from rejecting a recent organ or bone-marrow transplant, and to treat severe skin disease and rheumatoid arthritis.

*    Lithium for treatment of mental disorders.

*    Diuretics (water tablets).

*    Cardiac glycosides, such as digoxin, medicines used in the treatment of congestive heart failure and certain alterations of heart rhythm.

*    Antihypertensive medicines for the treatment of high blood pressure.

*    A nasal decongestant called phenylpropanolamine usually found in over-the-counter cold relief preparations.

*    Corticosteroid drugs, including anti-Inflammatory and replacement therapies.

*    Mifepristone, a treatment used in emergency for termination of pregnancy.

*    Antibiotics from the quinolone group of antibiotics.

Pregnancy and Breast-feeding

Ask your doctor or pharmacist for advice before taking this medicine. If you are pregnant or planning to become pregnant or if you are breastfeeding, Inacid may make it more difficult to become pregnant. You should inform your doctor if you are planning to become pregnant or if you have problems becoming pregnant.

Driving and using machines

Indocid can cause headaches, dizziness, drowsiness and visual disturbances in some people. If this happens to you, avoid activities which require you to be alert; for example, driving a car and operating machinery.


[2 Before you use Indocid Suppositories

Do not use Indocid Suppositories

*    If you are hypersensitive (allergic) to indomethacin or any of the other ingredients in Indocid Suppositories (for example, if you have experienced breathing difficulties, skin rashes which look like nettle rash, or a runny nose) or If you are hypersensitive to aspirin or another non-steroidal anti-inflammatory medicine. A full list of the ingredients is in section 6 -Further information.

*    If you have a peptic ulcer (ulcer in your stomach or duodenum) or bleeding in your stomach, or have had two episodes of peptic ulcers, stomach bleeding or perforation.

*    If you are suffering from inflammation of the rectum causing soreness, bleeding and sometimes a discharge of mucus and/or pus from your anus.

*    If you have polyps (soft fleshy swellings that grow inside the nose) in your nose, associated with itching, nettle rash, wheezing, or swelling of the face, lips, tongue and/or throat or difficulties in swallowing or breathing.

Take special care with Indocid Suppositories

*    If you are epileptic

*    If you have Parkinson's disease

*    If you have a psychiatric problem

*    If you have heart disease, high blood pressure or have a tendency for fluid retention

*    If you are being treated for infection or you have a fever

*    If you know you suffer from asthma, digestive tract, liver or kidney disease, diabetes or heart failure

*    If you have a problem with your blood clotting.

*    If you are having blood tests, make sure that the doctor doing them knows that you are taking Indocid.

*    If you have rheumatoid arthritis your doctor may want to examine your eyes at intervals during your treatment with Indocid. You should see your doctor if you notice any change in your vision


How to use Inocid Suppositories

Always use Indocid Suppositories exactly as your doctor has told you.

You should check with your doctor or pharmacist if you are not sure. Suppositories must not be taken by the mouth.

They are to be placed in the rectum (back passage). Empty your bowels (if necessary) before use. Remove the suppository from the foil and, lying on your back or your side with your knees bent up, push the suppository-pointed end first - up into your back passage. Lie still for a minute or so, and then wash your hands. The suppository should remain in place and dissolve completely.

The amount you use will depend upon your condition.

Dosage:

The usual adult dosage is one suppository to be inserted into the rectum once or twice a day. One should be used at bedtime and if another is necessary it should be used in the morning.

Not recommended for use in children.

If you use more Indocid Suppositories than you should

If you use too many suppositories by mistake or someone else accidentally uses your suppositories, contact your doctor immediately or go to the nearest casualty department.

If you forget to use Indocid Suppositories

If you forget to take the suppository, take it as soon as you remember. If it is nearly time for your next dose, just carry on with the next dose as normal.

Do not use an extra suppository to make up for forgotten doses.

If you stop using Indocid Suppositories

You should use Indocid Suppositories for as long as your doctor tells you to. It may be dangerous to stop using them without your doctor's advice.


Indocid ® 100mg Suppositories

(indometacin)

Patient Information Leaflet (continued)

Possible side effects

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

If you experience an allergic reaction, STOP TAKING the medicine and seek immediate medical help:

Symptoms of allergic reactions are:

*    Itching;

*    Rashes;

*    Sensitivity to sunlight;

*    Loss of hair; swollen face, lips, tongue and throat;

*    Difficulty in breathing and swallowing; inflammation of blood or lymph glands (lymph glands are all over the body but are noticeable in the neck and armpit when swollen as bean shaped);

*Severe light headedness or dizziness due to a rapid fall in blood pressure.

*    The allergic reaction may include problems with the liver, kidneys or blood cells (see below for liver, kidney and blood problems).

If you suffer from any of the following at any time during your treatment STOP TAKING the medicine and seek immediate medical help:

*    Pass blood in your faeces (stools/motions)

*    Pass black tarry stools

*    Vomit any blood or dark particles that look like coffee grounds

STOP TAKING the medicine and tell your doctor if you experience:

*    Indigestion or heartburn

*    Abdominal pain (pains in your stomach) or other abnormal stomach symptoms.

Medicines such as Indocid may be associated with a small increased risk of heart attack (‘Myocardial Infarction') or stroke.

Other side effects include:

Problems with the central nervous system:

*    Headache, dizziness, light-headedness, depression, vertigo (sensation that things around you are moving) and tiredness (including feeling unwell and listlessness).

*    Reactions reported infrequently include anxiety, confusion, fainting, drowsiness, fits, coma, peripheral neuropathy which may be experienced as loss of sensation, numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness, involuntary muscle movements, sleeplessness, hallucinations (seeing or hearing things that are not there), mental disorders including a loss of personal identitiy. Rarely, pins and needles, speech problems, worsening of epilepsy and parkinsonism symptoms (symptoms that mimic those of Parkinson's disease such as tremor or abnormal movements). If these side effects are severe you may need to stop treatment with this medicine. You should talk to your doctor.

Problems with the digestive system:

*    The most frequent reactions are nausea, loss of appetite, vomiting, trapped wind, constipation, and diarrhoea.

*    Reactions reported infrequently include inflammation of the mouth and stomach, wind, narrowing and/or obstruction of the intestines which may be seen as a swollen abdomen, and vomiting.

Liver disorders:

*    Rarely, inflammation of the liver and jaundice, symptoms of which may be yellowing of the eyes and skin.

Heart and kidney disorders:

*    High or low blood pressure, abnormal heartbeat, chest pain, palpitations, heart failure, kidney problems which can lead to water retention, reduction in the amount of urine passed, protein and blood in the urine, increased levels of urea in the blood.

*    These changes in urine and blood composition would normally be picked up in urine or blood tests.

Blood disorders:

*    Infrequently, blood disorders which are usually detected in blood tests, but may be seen as pale skin, tiredness, fever, sore throat and mouth, small red spots on the skin, bruising or prolonged bleeding after Injury. Blood disorders such as leucopenia and anaemia may be seen with symptoms of severe chills, mouth ulcers, headache, shortness of breath and dizziness.

Eye disorders:

*    Infrequently, blurred vision, double vision, pain in the eye and other visual disturbances.


Problems with the ear:

*    Ringing in the ears and other hearing disturbances, including deafness rarely.

Other side effects:

*    Bleeding from the vagina in women;

*    Increased levels of sugar in the blood, sugar in the urine, high levels of potassium in the blood, which are generally diagnosed by laboratory tests;

*    Flushing and sweating;

*    Bleeding from the nose;

*    Breast changes including enlargement and tenderness in men and women;

*    Ulcers in the lining of the mouth.

Side effects associated with the use of Indocid suppositories

*    Bleeding, inflammation, burning pain, discomfort, itching or the feeling of a full back passage.

Laboratory tests

Misleading results have been seen with patients having a Dexamethasone suppression test (DST) while using this medicine.

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.


How to store Indocid Suppositories

*    KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.

*    Do not store above 25°C.

*    Store in the original package

Do not use this medicine after the expiry date shown on the carton or suppository label.

If your doctor tells you to stop taking this medicine, return any unused medicine to your pharmacist for safe disposal. Only keep this medicine, if your doctor tells you to.

If your medicine becomes discoloured or shows any other signs of deterioration, consult your pharmacist who will tell you what to do.

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.


Further information

What Indocid Suppositories contain

Each suppository contains 100mg of indometacin as the active ingredient. Also contains butylhydroxyanisole (320), butylhydroxytoluene (321), edetic acids, glycerol, macrogols and purified water.

What Indocid Suppositories looks like and the contents of the pack

Indocid are white to yellowish, torpedo-shaped suppositories.

Indocid comes in packs of 12 or 10 suppositories.

Manufacturer and Licence Holder

Indocid is manufactured by Iroko Products Ltd, One Silk Street, London, EC2Y 8HQ, United Kingdom. and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.

IMPORTANT

Remember this medicine is for you. Only a doctor can prescribe it. Never give your medicine to other people. It may harm them, even if their symptoms are the same as yours.

If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.


[PomI PL 15184/1176 Indocid 100mg Suppositories Indocid is a registered trademark of Merck & Co., Inc.

Revision date: 26/04/13

Blind or partially sighted?

Is this leaflet hard to see or read?

Phone Lexon (UK) Limited, Tel: 01527 505414 for help.