DUTASTERIDE/TAMSULOSIN ALTER GENERICOS 0.5 mg/0.4 mg HARD CAPSULES

2. What you need to know before you take Dutasteride/Tamsulosin Alter Generics

Do not take dutasteride/tamsulosin

• if you are allergic (hypersensitive) to dutasteride, other 5-alpha reductase inhibitors, tamsulosin, soy, peanuts, or any of the other ingredients of this medicine (listed in section 6).
• if you have fainting spells due to low blood pressure when changing position (standing up from sitting or lying down) (orthostatic hypotension).
• if you have severe liver disease.
• if you are a woman, child, or adolescent.

Consult your doctorif you think you are in any of these situations.

This medicine is only for men. It must not be taken by women, children, or adolescents.

Warnings and precautions

Consult your doctor before starting to take this medicine:

• in some clinical studies, the number of patients who experienced heart failure was higher in those taking dutasteride and another medicine called an alpha blocker, such as tamsulosin, than in patients who took only dutasteride or only an alpha blocker. Heart failure means that your heart does not pump blood as it should.

• if you have liver problems. If you have any disease that affects your liver, you may need additional checks during your treatment with this medicine.

• if you have kidney problems.

• if you are going to have cataract surgery, inform your ophthalmologist that you are taking or have previously taken this medicine. Your ophthalmologist will need to take the necessary precautions to avoid complications during the operation.

• women, children, and adolescents should avoid contact with broken dutasteride/tamsulosin capsules, as the active ingredient can be absorbed through the skin. If there is any contact with the skin, the affected area should be washed immediately with water and soap.

• use a condom in your sexual relations. Dutasteride has been found in the semen of men taking dutasteride/tamsulosin. If your partner is pregnant or thinks she may be pregnant, you should avoid exposing her to your semen, as dutasteride may affect the normal development of a male baby. Dutasteride causes a decrease in sperm count, motility, and semen volume. This may reduce male fertility.

• this medicine affects the PSA blood test (prostate-specific antigen) used to detect prostate cancer. Your doctor may still use this test to detect prostate cancer, although they should be aware of this effect. If you have a blood test to determine your PSA, inform your doctor that you are taking this medicine. Men being treated with this medicine should have regular PSA checks.

• in a clinical study in men at high risk of prostate cancer, men who took dutasteride had a higher incidence of a serious type of prostate cancer than those who did not take dutasteride. The effect of dutasteride on this serious type of prostate cancer is not clear.

• this medicine may cause breast enlargement and tenderness. If this causes you discomfort, or if you notice lumps in the breast or nipple discharge, consult your doctor, as these changes can be signs of a serious disease, such as male breast cancer.

Using dutasteride/tamsulosin with other medicines

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines. This includes any medicines bought without a prescription.

Do not take dutasteride/tamsulosin with these medicines:

• other alpha blockers(for enlarged prostate or high blood pressure).

It is not recommended to take dutasteride/tamsulosin with these medicines:

• ketoconazole(used to treat fungal infections).

Certain medicines may interact with dutasteride/tamsulosin, which may increase the risk of you experiencing side effects. Some of these medicines are:

• PDE5 inhibitors(used to achieve or maintain an erection) such as vardenafil, sildenafil citrate, and tadalafil
• verapamil or diltiazem(for high blood pressure)
• ritonavir or indinavir(for HIV)
• itraconazole or ketoconazole(for fungal infections)
• nefazodone(an antidepressant)
• cimetidine(for stomach ulcers)
• warfarin(for blood clotting)
• erythromycin(an antibiotic used to treat infections) in combination with paroxetine (an antidepressant) or in combination with terbinafine (used to treat fungal infections)
• terbinafine(for fungal infections)
• diclofenac(used to treat pain and inflammation).

Tell your doctorif you are taking any of these medicines.

Taking dutasteride/tamsulosin with food and drinks

You should take this medicine 30 minutes after the same meal each day.

Do not take dutasteride/tamsulosin with alcoholic beverages. Alcohol may worsen the side effects of this medicine.

Pregnancy, breastfeeding, and fertility

Pregnant women (or women who may be pregnant) should avoid contact with broken capsules. Dutasteride is absorbed through the skin and may affect the normal development of a male baby. This risk is especially important during the first 16 weeks of pregnancy.

Use a condom in your sexual relations. Dutasteride has been found in the semen of men taking dutasteride/tamsulosin. If your partner is pregnant or thinks she may be pregnant, you should avoid exposing her to your semen.

Dutasteride/tamsulosin has been shown to decrease sperm count, motility, and semen volume. This may reduce male fertility.

Consult your doctorif a pregnant woman has been in contact with dutasteride/tamsulosin.

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor for advice before taking this medicine.

Driving and using machines

Some people may experience dizziness during treatment with this medicine, which may affect their ability to drive or operate machinery safely.

Do not drive or operate machineryif you are affected in this way.

This medicine contains soy lecithin.

This medicine contains soy lecithin, which may contain soybean oil. It must not be used in case of peanut or soy allergy.

3. How to take Dutasteride/Tamsulosin Alter Generics

Follow exactly the instructions of administration of this medicine indicated by your doctor. If you are in doubt, consult your doctor or pharmacist again.

If you do not take this medicine regularly, the control of your PSA levels may be affected.

What dose should you take

The recommended dose is one capsule once a day, 30 minutes after the same meal each day.

How to take it

The capsules should be swallowed whole, with water. Do not chew or open the capsules. Contact with the contents of the capsules can irritate your mouth or throat.

If you take more dutasteride/tamsulosin than you should

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

If you forget to take this medicine

Do not take a double dose to make up for forgotten doses. Take the next dose at the usual time.

Do not stop treatment with this medicine

Do not stop treatment with this medicine without consulting your doctor first.

If you have any other 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.

Allergic reaction

The symptoms of an allergic reaction can include:

• skin rash(which can itch)
• hives(like nettle rash)
• swelling of the eyelids, face, lips, arms, or legs

Contact your doctor immediately if you experience any of these symptoms and stop taking this medicine.

Dizziness, fainting, and fainting spells

This medicine can cause dizziness, fainting, and, in rare cases, fainting spells. You should be careful when getting up quickly after sitting or lying down, especially if you have to get up during the night, until you know how this medicine affects you. If you feel dizzy or faint during treatment, sit or lie down until these symptoms have disappeared.

Severe skin reactions

The signs of severe skin reactions can include:

• widespread rash with blisters and peeling of the skin, particularly around the mouth, nose, eyes, and genitals(Stevens-Johnson syndrome)

Contact your doctor immediately if you have these symptoms and stop using this medicine.

Common side effects (may affect more than 1 in 10 people)

• impotence (inability to achieve or maintain an erection)*
• decreased libido*
• difficulty with ejaculation*
• breast enlargement and tenderness (gynecomastia)
• dizziness

*In a small number of people, some of these side effects may continue after stopping this medicine.

Uncommon side effects (may affect up to 1 in 100 people)

• heart failure (the heart becomes less efficient at pumping blood through the body. This could cause symptoms such as difficulty breathing, excessive tiredness, and swelling in the ankles and legs)
• reduced blood pressure when standing up
• fast heart rate
• constipation, diarrhea, vomiting, nausea
• weakness or loss of strength
• headache
• itching, stuffy, or runny nose (rhinitis)
• skin rash, hives, itching
• hair loss (usually from the body) or hair growth

Rare side effects (may affect up to 1 in 1,000 people)

• sudden swelling of the soft tissues of the body (e.g., the throat or tongue) difficulty breathing and/or itching and rash, often as an allergic reaction (angioedema)
• fainting

Very rare side effects (may affect up to 1 in 10,000 people)

• prolonged and painful erection of the penis (priapism)
• severe skin reactions (Stevens-Johnson syndrome)

Other side effects

Frequency cannot be estimated from the available data:

• abnormal or rapid heart rhythm (arrhythmia or tachycardia or atrial fibrillation)
• difficulty breathing (dyspnea)
• depression
• pain and swelling in the testicles

Reporting of side effects

If you experience 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 Spanish Medicines Surveillance System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Dutasteride/Tamsulosin Alter Generics

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 packaging and on the blister. The expiry date is the last day of the month stated.

Store below 25°C.

After first opening of the package: 90 days.

Medicines should not be disposed of via wastewater or household waste. Return the packages and any unused medicines to a pharmacy. If you are in doubt, ask your pharmacist how to dispose of packages and unused medicines. This will help protect the environment.

6. Contents of the pack and other information

Composition of Dutasteride/Tamsulosin Alter Generics

• The active substances are dutasteride and tamsulosin hydrochloride. Each capsule contains 0.5 mg of dutasteride and 0.4 mg of tamsulosin hydrochloride.

• The other ingredients are:
• • Hard capsule shell: black iron oxide (E172), red iron oxide (E172), titanium dioxide (E171), yellow iron oxide (E172), gelatin.
  • Soft capsule of dutasteride:

• Contents of the soft capsule: propylene glycol monocaprylate, butylhydroxytoluene (E321).
• Capsule shell: gelatin, glycerol (E422), and titanium dioxide (E171).
• Tamsulosin pellets: methacrylic acid - ethyl acrylate copolymer (1:1) dispersion 30 percent (also contains polysorbate 80 and sodium lauryl sulfate), microcrystalline cellulose (E460), dibutyl sebacate, polysorbate 80 (E433), colloidal anhydrous silica, and calcium stearate.
• • Black ink: shellac (E904), black iron oxide (E172), propylene glycol (E1520), concentrated ammonia solution (E527), potassium hydroxide (E525).

Appearance of the product and contents of the pack

This medicine is presented in hard capsules, oblong, size 0EL, with a brown body and a beige cap, printed with C001 in black ink.

It is available in a high-density polyethylene (HDPE) bottle of 30 capsules.

Marketing authorization holder

Laboratorios Alter, S.A.

C/ Mateo Inurria 30

28036 Madrid

Spain

Manufacturer

Laboratorios León Farma, S.A.

Polígono Industrial Navatejera

C/ La Vallina s/n

24193 Navatejera, León

Spain

Date of the last revision of this leaflet: December 2018

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