CLIPPER 5 mg PROLONGED-RELEASE GASTRO-RESISTANT TABLETS

2. What you need to know before you take Clipper

Do not take Clipper Tablets:

• if you are allergic to beclometasone dipropionate or any of the other ingredients of this medicine (listed in section 6)
• if you have tuberculosis (TB)
• if you have any infection in the colon or rectum caused by a fungus or virus
• if you have severe liver disease.

Warnings and precautions

Consult your doctor, pharmacist, or nurse before starting treatment with Clipper tablets.

Be particularly careful with Clipper Tablets and always contact your doctor if you have:

• liver problems
• kidney problems
• diabetes
• stomach or intestinal ulcers
• high blood pressure
• osteoporosis, a disorder in which bone tissue loss causes brittle bones
• Addison's disease or hypoadrenalism, a disorder caused by low secretion of corticosteroid hormone from the adrenal glands
• increased eye pressure, called glaucoma
• cataracts, a disorder in which the eye lenses become opaque, causing poor vision or blindness
• an infection of the large intestine
• severe depression or manic-depression (bipolar disorder), or if a close relative has had these diseases, i.e., has had depression while taking steroid medications like beclometasone dipropionate.

If this happens to you, talk to your doctor before taking beclometasone dipropionate.

Contact your doctor if you experience blurred vision or other visual disturbances.

If you have never had chickenpox, herpes, or measles, do not come into close contact with people who may have these diseases. If you become ill or are exposed to someone with chickenpox, herpes, measles, or an infectious disease, contact your doctor immediately.

Mental problems while taking beclometasone dipropionate

Mental health problems can occur while taking steroids like beclometasone dipropionate (see also section 4 – Possible side effects):

• these diseases can be serious
• they usually start a few days or weeks after treatment begins
• they occur more frequently at high doses
• many of these problems disappear if the dose is reduced or treatment is stopped. However, if problems appear, they need treatment.

Talk to your doctor if you (or someone taking the medicine) show any signs of mental problems. It is particularly important if you are depressed or have suicidal thoughts. In some cases, mental problems appear when the dose is reduced or treatment is stopped.

Taking Clipper with other medicines

Before starting treatment, please inform your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medicine, including those obtained without a prescription. Especially if you are already using or taking other steroid medications.

Some medicines may increase the effects of Clipper, so your doctor will monitor you closely if you are taking these medicines (including some for HIV: ritonavir, cobicistat).

Pregnancy and breastfeeding

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

Driving and using machines

Clipper Tablets should not affect your ability to drive or use machines. However, some patients may feel drowsy after taking this medicine. If you are affected by this, do not drive or use machines, or perform any task that requires concentration and alertness.

Clipper Tablets contain lactose monohydrate.If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medicine.

3. How to take Clipper Tablets

Follow the instructions for administration of this medicine exactly as prescribed by your doctor. If you are unsure, consult your doctor or pharmacist again. It is essential that you take your tablets regularly.

Clipper Tablets are specially formulated so that you only need to take one tablet a day, preferably in the morning. It is best to take the tablets on an empty stomach or after a light breakfast.

Take the tablets with a glass of liquid, for example, water. Do not break or chew your tablets.

Dose:

The usual dose in adults, including the elderly, is one5 mg tablet once a day.

Your treatment will usually last up to 4 weeks. Do not stoptaking your medicine until your doctor tells you to.

Use in children

Children should nottake this medicine.

If you take more Clipper Tablets than you should

If you have taken more Clipper Tablets than you should, consult your doctor or pharmacist immediately.

If you forget to take Clipper Tablets

If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, do nottake the missed dose, just take the next dose when it is due. Do not take a double doseto make up for the missed dose.

If you stop taking Clipper Tablets:

Do not stoptaking your tablets, even if you feel better, unless your doctor tells you to.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

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

Serious side effects: consult a doctor immediately

Steroids, including beclometasone dipropionate, can cause serious mental health problems. These are common in both adults and children. They can affect 5 in every 100 people taking medicines like beclometasone dipropionate:

• feeling depressed, including having suicidal thoughts
• feeling overexcited (mania) or having mood swings
• feeling anxious, having problems sleeping, difficulty thinking, or feeling confused and having memory loss
• feeling, seeing, or hearing things that do not exist. Having strange or frightening thoughts, changing your behavior, or feeling alone.

If you notice any of these problems, talk to your doctor immediately.

The following side effects have also been reported. Talk to your doctor as soon as possible if you experience any of these side effects, but do not stoptreatment unless your doctor tells you to. If you are unsure what these side effects are, ask your doctor to explain them to you.

Uncommon side effects:may affect up to 1 in 100 people

• feeling sick (nausea)
• constipation
• stomach pain
• flu-like illness
• fever
• heavy menstrual periods
• headache
• anxiety
• drowsiness
• muscle cramps

Taking high dosesof beclometasone dipropionate for a long time can cause systemic effects. These rare side effects, which can affect up to 1 in 1,000 people, include:

• problems with the functioning of the adrenal gland (adrenal suppression)
• round, puffy face (called "moon face")
• fat deposits at the back of the neck (called "buffalo hump")
• excess fat deposits in the body (obesity)
• fungal infection in the mouth
• decrease in the number of white blood cells called leukocytes and monocytes, which help the body fight infections by destroying harmful microorganisms in the blood
• increase in the number of white blood cells called granulocytes
• significant redness and inflammation of the skin on the face
• headache
• increased cranial pressure
• reduction in bone mineral density (thinning of the bones)
• increased eye pressure (glaucoma)
• cataracts

Side effects of unknown frequency(cannot be estimated from the available data) have been identified as class effects of corticosteroids:

• blurred vision
• hypo

If you think any of the side effects you are experiencing are serious, or if they last for a long time, please tell your doctor or pharmacist. While taking these tablets, if you notice any unusual or unmentioned side effects, inform your doctor or pharmacist immediately.

Reporting side effects

If you experience any side effects, talk to your doctor or pharmacist, even if they are not listed in this leaflet. You can also report them directly through the national reporting system included in the Spanish Pharmacovigilance System for Human Use Medicines https://www.notificaram.es.

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Clipper Tablets

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton and label. The expiry date is the last day of the month stated.
• This medicine does not require any special storage conditions.
• Medicines should not be disposed of via wastewater or household waste. Place the empty packaging and any unused medicine in the pharmacy's SIGRE collection point. Ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Pack contents and further information

Composition of Clipper Tablets

• The active substance is beclometasone dipropionate.
• The other ingredients are lactose monohydrate, hypromellose (E464), microcrystalline cellulose, corn starch, magnesium stearate, macrogol 4000, methacrylic acid copolymer, titanium dioxide (E171), and talc.

Appearance and pack contents

Clipper 5 mg Gastro-resistant prolonged-release tablets are white-ivory in color and have a round, convex shape.

They are available in blister packs of 10 and 30 tablets.

Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

The marketing authorization holder is:

CHIESI ESPAÑA, S.A.U.

Plaça d’Europa, 41-43, Planta 10

08908 L’Hospitalet de Llobregat

Barcelona (Spain)

The manufacturer is:

Doppel Farmaceutici, S.r.l.

Via Martiri delle Foibe 1, Cortemaggiore

Piacenza (Italy)

This medicine is authorized in the Member States of the European Economic Area under the following names:

Date of last revision of this leaflet: 06/2019.

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