CINFATOS EXPECTORANT 10 mg + 100 mg ORAL SOLUTION IN SACHETS

2. What you need to know before taking cinfatós expectorant

This medicine can cause dependence. Therefore, treatment should be short-term.

Do not take cinfatós expectorant

• If you are allergic to dextromethorphan hydrobromide, guaifenesin, or any of the other components of this medicine (listed in section 6).
• If you have asthma.
• If you have a cough with a large amount of mucus and phlegm.
• If you have a severe lung disease.
• If you are being treated or have been treated in the last 2 weeks with a monoamine oxidase inhibitor (MAOI) used to treat depression or Parkinson's disease or other diseases (see section on Taking cinfatós expectorant with other medicines).
• If you have fructose intolerance (see section on Important information about some of the components of cinfatós expectorant).

Warnings and Precautions

Consult your doctor or pharmacist before taking cinfatós expectorant if you are a patient:

• with liver disease
• with atopic dermatitis (inflammatory skin disease characterized by erythema, itching, exudation, crusts, and scaling, which begins in childhood in individuals with a hereditary allergic predisposition).
• if you are taking other medicines such as antidepressants or antipsychotics, cinfatós expectorant may interact with these medicines and you may experience changes in your mental state (e.g., agitation, hallucinations, coma) and other effects such as body temperature above 38°C, increased heart rate, hypertension, and exaggerated reflexes, muscle stiffness, lack of coordination, and/or gastrointestinal symptoms (e.g., nausea, vomiting, and diarrhea).

Patient with persistent or chronic cough, such as that due to smoking or who are sedated, debilitated, or bedridden should not take this medicine.

There have been cases of abuse with medicines containing dextromethorphan by adolescents. This can cause serious side effects (see section If you take more cinfatós expectorant than you should).

Interference with laboratory tests

If you are going to undergo any diagnostic test (including blood tests, urine tests, skin tests using allergens, etc.), inform your doctor that you are taking this medicine, as it may alter the results.

Other medicines and cinfatós expectorant

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicine.

Note that these instructions may also apply to medicines that have been used before or may be used after.

Do not take this medicine during treatment or in the 2 weeks after treatment with the following medicines, as it may cause excitement, high blood pressure, and fever above 40°C (hyperpyrexia):

• Medicines used to treat depression such as monoamine oxidase inhibitors (MAOIs) (moclobemide, tranylcypromine) and serotonin reuptake inhibitors (paroxetine, fluoxetine)
• Bupropion (used to quit smoking)
• Linezolid (used as an antibacterial)
• Procarbazine (used to treat cancer)
• Selegiline (used to treat Parkinson's disease)

If you are using any of the following medicines, it may be necessary to modify the dose of one of them or interrupt treatment:

• Amiodarone and quinidine (for treating heart arrhythmias)
• Anti-inflammatory drugs (celecoxib, parecoxib, or valdecoxib)
• Central nervous system depressants (some of which are used to treat mental illnesses, allergies, Parkinson's disease, etc.)
• Expectorants and mucolytics (used to eliminate mucus and phlegm).
• Haloperidol (antipsychotic).

Taking cinfatós expectorant with food, drinks, and alcohol

Do not consume alcoholic beverages during treatment with this medicine, as it may cause adverse reactions.

Do not take with grapefruit or bitter orange juice, as they may increase the adverse effects of this medicine.

Pregnancy and Breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

Driving and Using Machines

Rarely, during treatment, drowsiness and dizziness may occur, so if you experience these symptoms, do not drive vehicles or operate hazardous machinery.

cinfatós expectorant contains sorbitol (E-420), sodium benzoate (E-211), and sodium

This medicine contains 1999.9 mg of sorbitol (E-420) in each sachet.

Sorbitol is a source of fructose. If your doctor has told you that you (or your child) have an intolerance to certain sugars, or have been diagnosed with hereditary fructose intolerance (HFI), a rare genetic disease in which the patient cannot break down fructose, consult your doctor before taking this medicine.

Sorbitol may cause gastrointestinal upset and a mild laxative effect.

This medicine contains 17.50 mg of sodium benzoate (E-211) in each sachet.

This medicine contains less than 1 mmol of sodium (23 mg) per sachet; it is essentially "sodium-free".

3. How to take cinfatós expectorant

Follow the administration instructions of the medicine contained in this package leaflet or as indicated by your doctor or pharmacist. If in doubt, ask your doctor or pharmacist.

The recommended dose is:

Adults and adolescents from 12 years: 1-2 sachets, every 4-6 hours as needed. Maximum 12 sachets every 24 hours.

Use in Children

Children from 6 to 12 years: 1 sachet every 4-6 hours as needed. Maximum 6 sachets every 24 hours.

Children from 2 to 6 years: there are other presentations more suitable for this population. Administer only under medical supervision, due to the risk of paradoxical effects of central nervous system stimulation.

Severe side effects can occur in children in case of overdose, including neurological disorders. Caregivers should not exceed the recommended dose.

Children under 2 years: contraindicated

Patient with liver failure: the dose should be reduced to half of the recommended dose for each population, not exceeding 4 daily doses in any case.

This medicine is taken orally.

Open the sachet and pour the contents directly into the mouth. It is recommended to drink a glass of water after each dose and plenty of liquid throughout the day.

It can be taken with or without food.

Do not take with grapefruit or bitter orange juice or with alcoholic beverages (see section on Taking cinfatós expectorant with food, drinks, and alcohol).

You should consult a doctor if your symptoms worsen, or if you also have a high fever, skin rash, or persistent headache, or if you do not improve after 7 days of treatment.

If you take more cinfatós expectorant than you should:

If you have taken more cinfatós expectorant than you should, you may notice: confusion, excitability, restlessness, nervousness, irritability, nausea, and vomiting.

Taking very high doses of this medicine can cause children to become drowsy, nervous, nauseous, vomit, or have changes in their gait.

There have been cases of abuse with medicines containing dextromethorphan in adolescents, which can cause serious side effects, such as anxiety, panic, memory loss, tachycardia (rapid heart rate), lethargy, hypertension or hypotension (high or low blood pressure), mydriasis (pupil dilation), agitation, vertigo, gastrointestinal upset, slurred speech, nystagmus (involuntary eye movement), fever, tachypnea (rapid breathing), brain damage, ataxia (uncoordinated movements), convulsions, respiratory depression, loss of consciousness, arrhythmias (irregular heartbeat), and death.

If you take more cinfatós expectorant than indicated, you may experience the following symptoms: nausea and vomiting, involuntary muscle contractions, agitation, confusion, drowsiness, disorders of consciousness, rapid involuntary eye movements, cardiac disorders (rapid heart rate), coordination disorders, psychosis with visual hallucinations, and hyperexcitability.

Other symptoms in case of massive overdose may include: coma, severe respiratory problems, and convulsions.

Contact your doctor or hospital immediately if you experience any of the mentioned symptoms.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone 91 562 04 20, indicating the medicine and the amount ingested.

4. Possible Side Effects

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

During the use of dextromethorphan and guaifenesin, the following side effects have been observed, whose frequency could not be established with precision:

• In some cases, the following have occurred: drowsiness, dizziness, vertigo, constipation, gastrointestinal upset, nausea, vomiting, headache, and skin itching (urticaria).
• In rarer cases: mental confusion.

Reporting of Side Effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this package leaflet. You can also report them directly through the Spanish Medicines and Health Products Agency (AEMPS) https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of cinfatós expectorant

Keep this medicine out of the sight and reach of children.

This medicine does not require special storage conditions.

Do not use this medicine after the expiration date that appears on the sachet after CAD. The expiration date is the last day of the month indicated.

Medicines should not be disposed of through wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE collection point in your pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of cinfatós expectorant

The active ingredients are dextromethorphan hydrobromide and guaifenesin. Each sachet contains 10 mg of dextromethorphan hydrobromide and 100 mg of guaifenesin.

The other components (excipients) are sodium saccharin, non-crystallizable liquid sorbitol (E-420), povidone, sodium benzoate (E-211), citric acid monohydrate, orange flavor, and purified water.

Appearance of the Product and Package Contents

cinfatós expectorant is a clear, slightly colored oral solution with an orange flavor.

Each box of cinfatós expectorant contains 18 sachets.

Marketing Authorization Holder and Manufacturer

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Date of the Last Revision of this Package Leaflet:October 2019

Detailed information about this medicine is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

You can access detailed and updated information about this medicine by scanning the QR code included in the package leaflet and packaging with your smartphone. You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/78985/P_78985.html

QR code to: https://cima.aemps.es/cima/dochtml/p/78985/P_78985.html