Reboxetine 4mg Tablets
S109 LEAFLET Edronax 20150515
PACKAGE LEAFLET: INFORMATION FOR THE USER EDRONAX® 4mg TABLETS REBOXETINE 4mg TABLETS (reboxetine methanesulphonate)
Your medicine is known as the above names but will be referred to as Edronax throughout the following 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 gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Edronax is and what it is used for
2. Before you take Edronax
3. How to take Edronax
4. Possible side effects
5. How to store Edronax
6. Further information
1. WHAT EDRONAX IS AND WHAT IT IS USED FOR
The active substance in Edronax is reboxetine which is part of a group of medicines called antidepressants. Edronax is used in acute treatment of depressive illness / major depression as well as for maintaining the improvement of your symptoms when you have initially responded to treatment with reboxetine.
2. BEFORE YOU TAKE EDRONAX
Do not take Edronax
• if you are allergic (hypersensitive) to reboxetine or any of the other ingredients of Edronax. For a full list of excipients, see section 6.
Use in children and adolescents:
Edronax should not usually be used in children and adolescents less than 18 years old. Patients under 18 have an increased risk of undesirable effects, such as suicide attempt, suicidal thoughts and hostility (mainly aggressiveness, oppositional behaviour and anger) when they are treated with this class of medicines. Nevertheless, it is possible that your doctor decides to prescribe Edronax to a patient under 18 if it is in the patient's interest. If your doctor has prescribed Edronax to a patient less than 18 years old and you want to discuss this, please contact him/her.
Furthermore, if any of the symptoms listed above appear or worsen when a patient under 18 is taking Edronax, you should inform your doctor.
Also, the long-term safety of Edronax in regard to growth, maturation and cognitive and behavioural development in this age group has not yet been demonstrated.
Taking other medicines
Given that Edronax may interact with other medicines, tell your doctor if you are taking the following medicines:
• Certain antifungals, e.g. ketoconazole
• Certain antibiotics, e.g. erythromycin, rifampicin.
• Medicines called ergot derivatives used to treat migraine or Parkinson's disease
• Certain antidepressants called MAO inhibitors, tricyclics, nefazodone, SSRIs (such as fluvoxamine) or lithium
• Other MAO inhibitors such as linezolid (an antibiotic) and methylene blue (used to treat high levels of methaemoglobin in the blood)
• Any potassium-losing diuretics (medicines for eliminating water), e.g thiazides
• Medicines used to treat epilepsy e.g. phenobarbital, carbamazepine and phenytoin
• Herbal medicines containing St. John's Wort (Hypericum perforatum)
Your doctor will tell you whether you can take Edronax with 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, herbal medicines, as well as vitamins and minerals.
Taking Edronax with food and drink
Edronax can be taken with or without food.
Take special care with Edronax
Tell your doctor if you:
• suffer from convulsions or epilepsy. Treatment with reboxetine should be stopped if seizures occur.
• have any signs of urinary problems, enlarged prostate or a history of heart problems.
• are taking medicines to lower your blood pressure.
• have liver or kidney problems. Your doctor may need to adjust your dosage.
• are taking any other medicine for depression such as MAO inhibitors, tricyclics, nefazodone, SSRIs (such as fluvoxamine) or lithium.
• are taking other MAO inhibitors such as linezolid (an antibiotic) or methylene blue (see section “Taking other medicines”).
• ever had episodes of mania (overactive behaviour or thoughts).
• have eye problems, such as certain kinds of glaucoma (increased pressure in the eye).
Thoughts of suicide and worsening of your depression:
If you are depressed 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 or harming 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 straight away.
You may find it helpful to tell a relative or close friend that you are depressed, and ask them to read this leaflet. You might ask them to tell you if they think your depression is getting worse, or if they are worried about changes in your behaviour.
Pregnancy and Breast-feeding
Ask your doctor or pharmacist for advice before taking any medicine.
Pregnancy
There are no adequate experiences from the use of Edronax in pregnant women. Do not take Edronax if you are pregnant, unless your doctor considers it absolutely necessary, following a careful clinical risk/benefit consideration. Tell your doctor immediately if you are pregnant or are planning to become pregnant.
Breast-feeding
Edronax passes into the breast milk in small amounts. There is a risk of a potential effect on the baby. Therefore, you should discuss the matter with your doctor and he/she will decide whether you should stop breast-feeding or stop the therapy with Edronax.
Driving and using machines
Caution is recommended when driving or using machines.
You should not drive or operate machinery until you know you are not affected (i.e. feel drowsy) by Edronax, and that it is safe to do so.
3. HOW TO TAKE EDRONAX
• For adults the usual dose is 8 mg a day (one 4 mg tablet twice a day). Based on how you respond to the medicine, after 3 to 4 weeks your doctor may tell you to take up to 10 mg per day if necessary. The maximum daily dose should not exceed 12 mg.
• In patients with poor kidney or liver function, the starting dose is 4 mg per day. This may be increased depending on the individual response.
• The use of Edronax 4 mg tablets cannot be recommended for elderly patients.
• Edronax should not be used in children and adolescents under 18 years.
The tablets should be taken in two divided doses, one dose in the morning and one in the evening. You should swallow your tablet whole with a glass of water. Do not chew the tablet.
To help you remember to take Edronax, you may find it easier to take your tablets at the same time every day.
Always take Edronax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Like other drugs Edronax will not relieve your symptoms immediately. You should start to feel better within a few weeks.
It is important that you continue to take your tablets, even though you feel better, until your doctor advises you to stop. Please be patient, if you stop taking your tablets too early, your symptoms might come back.
If you take more Edronax than you should
You should never take more tablets than your doctor recommends. If you take too many tablets, contact your doctor or local hospital immediately. If you take more
Edronax than you should, you may experience symptoms of overdose including low blood pressure, anxiety and hypertension.
If you forget to take Edronax
If you forget to take Edronax, take your next dose at the normal time. Do not take a double dose to make up for a forgotten tablet.
If you intend to stop Edronax
You should not stop your medicine without talking to your doctor, as your symptoms may come back.
There have been a few reports of withdrawal symptoms including headache, dizziness, nervousness and nausea, (feeling sick), when patients stopped treatment with Edronax.
After marketing reboxetine, the following side effects have been reported:
• Hyponatremia (very low levels of sodium in the blood)
• Aggressive behaviour, hallucination
• Suicidal ideation, suicidal behaviour
Cases of suicidal ideation and suicidal behaviours have been reported during reboxetine therapy or early after treatment discontinuation (see section 2 “Take special care with Edronax”)
• Cold extremities, Raynaud's phenomenon (poor blood circulation to the extremities usually in the toes and fingers but could also affect nose and ears, the skin turns pale and becomes cold and numb)
• Allergic skin inflammation
• Testicular pain
• Irritability
• Increased pressure in the eye
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 (see details below). By reporting side effects you can help provide more information on the safety of this medicine.
United Kingdom
Yellow Card Scheme website: www.mhra.gov.uk/yellowcard
5. HOW TO STORE EDRONAX
4. POSSIBLE SIDE EFFECTS
Like all medicines, Edronax can cause side effects, although not everybody gets them. With Edronax most side effects are mild and usually go away after the first few weeks of treatment.
If any of the side effects below gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
Very common side effects (more than one in 10 patients)
• Difficulties to sleep (insomnia)
• Dizziness
• Dry mouth
• Constipation
• Nausea (feeling sick)
• Sweating
Common side effects (less than one in 10 patients)
• Headache
• Lack or loss of appetite
• Agitation, anxiety
• Paraesthesia (pins and needles), inability to sit or stand still, altered taste sensation
• Lack of visual focus
• Increased heart rate, palpitation (heart pounding)
• Widened blood vessels, fall in blood pressure when standing up, increased blood pressure
• Vomiting
• Rash
• Sensation of incomplete emptying or slowed emptying of the bladder, urinary infection, painful urination, inability to completely empty the bladder
• Erectile dysfunction (impotence), ejaculatory pain, or ejaculatory delay
• Chills
Uncommon side effects (between 1 and 10 out of 1000 patients)
• Dilated pupils
• Spinning sensation
Rare side effects (between 1 and 10 out of 10000 patients)
• Glaucoma (a condition resulting in increased pressure in the eye)
• Do not store above 25°C.
• KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
• Do not use after the expiry date printed on the carton label or blister strip.
• If your doctor tells you to stop taking the tablets, take any which you have left back to your pharmacist for safe disposal. Only keep them if the doctor tells you to.
• If the medicine becomes discoloured or shows any other signs of deterioration, you should seek the advice of 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 that are no longer required. These measures will help to protect the environment.
6. FURTHER INFORMATION
What Edronax contains
• Each tablet contains 5.224mg of the active ingredient reboxetine methanesulphonate, equivalent to 4mg rebotexine.
• Edronax Tablets also contain the following inactive ingredients: microcrystalline cellulose, calcium hydrogen phosphate dihydrate, crospovidone, silicon dioxide and magnesium stearate.
What Edronax looks like and contents of the pack
• Edronax Tablets are round white tablet marked P and U on either side of a scoreline on one side and 7671 on the other.
• Edronax Tablets are available as blister packs of 60 tablets.
Product Licence holder
Procured from within the EU and repackaged by the Product
Licence holder: S&M Medical Limited, Chemilines House,
Alperton Lane, Wembley, HA0 1DX.
Manufacturer
This product is manufactured by either of the below manufacturers-
• Pharmacia & Upjohn SpA, Marina Del Tronto, Ascoli Piceno, Italy.
• Pfizer Italia S.r.l.; Via del Commercio 25/27 - 63046 Marino Del Tronto, Ascoli Piceno, Italy.
POM PL: 19488/0109
Leaflet revision date: 15 May 2015
Edronax is a registered trademark of Pharmacia Italia SpA, Italy.
S109 LEAFLET Edronax 20150515