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GRANUPAS 4 g gastro-resistant granules

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About the medicine

How to use GRANUPAS 4 g gastro-resistant granules

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the Patient

GRANUPAS 4 g Gastro-Resistant Granules

Para-aminosalicylic acid

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • 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 only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the Package Leaflet

  1. What is GRANUPAS and what is it used for
  1. What you need to know before you take GRANUPAS
  2. How to take GRANUPAS
  1. Possible side effects
  2. Storage of GRANUPAS
  3. Contents of the pack and other information

1. What is GRANUPAS and what is it used for

GRANUPAS contains para-aminosalicylic acid which is used in adults and in children from 28 days of age or older to treat resistant tuberculosis, in combination with other medicines, in cases of resistance or intolerance to other treatments.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you take GRANUPAS

Do not take GRANUPAS

  • if you are allergic to para-aminosalicylic acid or any of the other ingredients of this medicine (listed in section 6).
  • if you have severe kidney disease.

If you are not sure, consult your doctor or pharmacist before taking GRANUPAS.

Warnings and precautions

Consult your doctor or pharmacist or nurse before starting treatment with GRANUPAS

  • if you have liver problems or mild or moderate kidney disease
  • if you have a stomach ulcer
  • if you are infected with HIV

Children

GRANUPAS is not recommended for use in newborn babies (less than 28 days old).

Other medicines and GRANUPAS

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

It is especially important that you tell your doctor if you are taking any of the following medicines:

  • Anti-tuberculosis medicines or ethionamide (other treatments for tuberculosis)
  • Vitamin B12
  • Digoxin (for heart disease)
  • Diphenhydramine (for allergic reactions)

Pregnancy and breast-feeding

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

GRANUPAS should not be taken during pregnancy and should only be used if your doctor considers it essential. Do not breast-feed while taking GRANUPAS, as small amounts of this medicine may pass into breast milk.

Driving and using machines

GRANUPAS is unlikely to affect your ability to drive or use machines. If this happens, tell your doctor or pharmacist.

3. How to take GRANUPAS

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

Follow exactly the administration instructions of this medicine given by your doctor.

In case of doubt, ask your doctor or pharmacist.

Adults

The recommended dose for adults is 1 sachet, 3 times a day, with a schedule of 1 sachet every 8 hours. Your doctor may need to start treatment with a lower dose to avoid possible side effects.

Do not take more than 3 sachets per day. The treatment is usually given for two years (24 months).

  • Empty the contents of the sachet into a glass of tomato or orange juice.
  • Drink it immediately.
  • If some granules remain in the glass, add a little more juice and drink it immediately.

Use in infants, children and adolescents

The doctor will calculate the dose for infants, children and adolescents based on the patient's body weight. The recommended total daily dose is 150 mg per kg of body weight. This daily amount is divided into two doses distributed throughout the day.

  • Use the measuring spoon provided with the medicine to measure the dose.
  • To measure the dose:
    1. The lines on the measuring spoon indicate the amount (in milligrams of para-aminosalicylic acid). Take the correct amount that your doctor has prescribed.
    1. Put the granules directly into the measuring spoon.
      1. Gently tap the measuring spoon on a table to level the granules horizontally and fill it more if necessary.
    • Sprinkle the granules over apple puree or yoghurt.
    • Have your child eat it immediately.

    Use of this medicine

    • Do not crush or chew the granules. Swallow the granules whole. It is important that you do not dissolve, crush or chew the granules, as they may not be absorbed correctly and may cause stomach pain or bleeding.
    • Do not use the sachet if it is swollen or the granules have lost their original light brown color.
    • You may see granules in the stool; this is normal.

    If you take more GRANUPAS than you should

    Consult your doctor or pharmacist.

    If you forget to take a dose of GRANUPAS

    Do not take a double dose to make up for forgotten doses. Wait until the next dose is due and take the usual dose.

    If you have any other questions on how to use 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.

    During the first 3 months of your treatment with GRANUPAS, you should pay attention to any signs of an allergic reaction (such as rash, red spots on the skin that itch, itching, hives, watery eyes, itchy eyes or nasal congestion) or hepatitis (such as fever, fatigue, dark urine, very light stools, abdominal pain, yellow skin and eyes). If you experience any of these symptoms, you should consult your doctor immediately.

    Common side effects (occurring in more than 1 patient in 100):

    • dizziness,
    • stomach pain (abdominal pain),
    • vomiting,
    • nausea,
    • hiccups,
    • diarrhea,
    • soft stools,
    • redness of the skin or rash,
    • alteration of gait or balance.

    Uncommon side effects (occurring in more than 1 patient in 1,000):

    • loss of appetite (anorexia)

    Rare side effects (occurring in more than 1 patient in 10,000):

    • thyroid problems*,
    • decreased ability to absorb nutrients from food,
    • ulcer, intestinal bleeding,
    • yellowing of the skin or eyes (jaundice),
    • metallic taste,
    • itchy rash.
    • In people also infected with HIV, thyroid problems, in particular insufficient thyroid activity or low levels of thyroid hormones, are a very common side effect that may affect more than 1 in 10 people. Periodic monitoring of thyroid function is recommended for all people with HIV.

    Very rare side effects (occurring in less than 1 patient in 10,000):

    • reduction in the number of blood platelets,
    • red spots on the skin,
    • reduction in the number of white blood cells,
    • reduction in the number of red blood cells,
    • reduction in the ability of red blood cells to release oxygen,
    • low blood sugar levels,
    • tendon pain, headache,
    • visual disturbances, nerve damage to hands and feet,
    • dizziness,
    • crystals in the urine.
    • prolonged bleeding time,
    • liver cell destruction,
    • high enzyme levels,
    • weight loss,

    Side effects of unknown frequency (cannot be estimated from the available data)

    • hepatitis

    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 via the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

    5. Storage of GRANUPAS

    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 sachet after EXP. The expiry date is the last day of the month stated.

    Do not store above 25°C. Once opened, the sachets can be stored below 25°C for up to 24 hours.

    Do not use this medicine if you notice that the sachets are swollen or the granules are dark brown or purple in color

    Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

    6. Contents of the pack and other information

    Composition of GRANUPAS

    The active substance is para-aminosalicylic acid.

    Each sachet of gastro-resistant granules contains 4 g of para-aminosalicylic acid.

    The other ingredients are colloidal silicon dioxide, dibutyl sebacate, methacrylic acid copolymer (1:1) dispersion 30%, hypromellose, microcrystalline cellulose, talc.

    Appearance and packaging of the product

    This medicine is presented as a light brown gastro-resistant granule in sachets.

    Each carton contains 30 sachets. A measuring spoon is provided.

    Marketing authorisation holder

    Eurocept International BV

    Trapgans 5

    1244 RL Ankeveen

    The Netherlands

    Manufacturer

    Lucane Pharma

    172 rue de Charonne

    75011 Paris

    France

    Eurocept International BV

    Trapgans 5

    1244 RL Ankeveen

    The Netherlands

    You can request more information about this medicine from the local representative of the marketing authorisation holder:

    Belgium/Belgique/Belgien

    Lithuania

    Lucane Pharma

    FrostPharma AB

    Tel: + 33 153 868 750

    Tel: +46 775 86 80 02

    [email protected]

    [email protected]

    Bulgaria

    Luxembourg/Luxemburg

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Czech Republic

    Hungary

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Denmark

    Malta

    FrostPharma AB

    Lucane Pharma

    Tel: +45 808 20 101

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Germany

    Netherlands

    Lucane Pharma

    Eurocept International BV

    Tel: + 33 153 868 750

    Tel: +31 35 528 39 57

    [email protected]

    [email protected]

    Estonia

    Norway

    FrostPharma AB

    FrostPharma AB

    Tel: +46 775 86 80 02

    Tel: +47 815 03 175

    [email protected]

    [email protected]

    Greece

    Austria

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Spain

    Poland

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    France

    Portugal

    Lucane Pharma

    Overpharma

    Tel: + 33 153 868 750

    Tel: +351 214 307 760

    [email protected]

    [email protected]

    Croatia

    Romania

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Ireland

    Slovenia

    Lucane Pharma

    Lucane Pharma

    Tel: + 33 153 868 750

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Iceland

    Slovakia

    FrostPharma AB

    Lucane Pharma

    Tel: +46 775 86 80 02

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Italy

    Finland

    Lucane Pharma

    FrostPharma AB

    Tel: + 33 153 868 750

    Tel: +35 875 32 51 209

    [email protected]

    [email protected]

    Cyprus

    Sweden

    Lucane Pharma

    FrostPharma AB

    Tel: + 33 153 868 750

    Tel: +46 775 86 80 02

    [email protected]

    [email protected]

    Latvia

    United Kingdom

    FrostPharma AB

    Lucane Pharma

    Tel: +46 775 86 80 02

    Tel: + 33 153 868 750

    [email protected]

    [email protected]

    Date of last revision of this leaflet:

    Other sources of information

    Detailed information on this medicine is available on the European Medicines Agency website: http://www.ema.europa.eu.

    There are also links to other websites on rare diseases and orphan medicines.

Online doctors for GRANUPAS 4 g gastro-resistant granules

Discuss questions about GRANUPAS 4 g gastro-resistant granules, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

5.0 (71)
Doctor

Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Doctor

Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance. His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation. Patients commonly consult Dr Daniel Cichi for: 

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • sexually transmitted infections, erectile dysfunction;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders, weight loss, hair loss;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.

Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.

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€55
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Doctor

Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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€59
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Doctor

Анастасія Шалко

Family medicine 13 years exp.

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate

Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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€50
5.0 (140)
Doctor

Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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€50
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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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€58

Frequently Asked Questions

Is a prescription required for GRANUPAS 4 g gastro-resistant granules?
GRANUPAS 4 g gastro-resistant granules requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in GRANUPAS 4 g gastro-resistant granules?
The active ingredient in GRANUPAS 4 g gastro-resistant granules is 4-aminosalicylic acid. This information helps identify medicines with the same composition but different brand names.
Who manufactures GRANUPAS 4 g gastro-resistant granules?
GRANUPAS 4 g gastro-resistant granules is manufactured by Eurocept International B.V.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of GRANUPAS 4 g gastro-resistant granules online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether GRANUPAS 4 g gastro-resistant granules is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to GRANUPAS 4 g gastro-resistant granules?
Other medicines with the same active substance (4-aminosalicylic acid) include ANSATIPIN 150 mg HARD CAPSULES, CEMIDON 60 mg/ml INJECTABLE SOLUTION, CEMIDON B6 150 MG/25 MG TABLETS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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