NITROFIX 15 mg TRANSDERMAL PATCHES

2. What you need to know before taking NITROFIX 15 mg

Do not use NITROFIX15mg

• If you are allergic (hypersensitive) to organic nitrates or any other components of NITROFIX 15 mg.
• If you have severe anemia, cerebral hemorrhage, or cranioencephalic trauma with increased intracranial or intraocular pressure (glaucoma).
• In case of acute circulatory failure (shock, collapse states).
• If you are being treated with medications containing sildenafil. Patients being treated with this medication should never take medications containing sildenafil (a medication used for erectile dysfunction) at the same time. For more information, consult your doctor or pharmacist.

Be careful with NITROFIX15mg

NITROFIX 15 mg should be used under strict medical supervision in cases of myocardial infarction or congestive heart failure. Caution is recommended when using NITROFIX 15 mg in patients with hypoxemia or ventilation-perfusion imbalance.

NITROFIX 15 mg is not indicated for the treatment of acute angina attacks. In this case, your doctor will prescribe rapid-acting nitro derivatives for sublingual use.

If treatment is to be discontinued, the dose and frequency of application of the NITROFIX 15 mg patch should be gradually reduced over a period of 4-6 weeks to avoid withdrawal reactions from this class of vasodilator drugs.

This medication may cause postural hypotension, especially in anxious patients, so avoid sudden changes in posture.

It is recommended to remove the patch before cardioversion or defibrillation.

It is possible for tolerance to the preparation or other nitro derivatives to develop. For this reason, your doctor may recommend applying NITROFIX 15 mg daily with a patch-free interval of 8 to 12 hours to maintain low plasma levels.

Nitroglycerin may interfere with the measurement of certain clinical tests (catecholamines and vanilmandelic acid in urine, increasing their excretion).

Immediately inform your doctor if any of the following situations occur while using NITROFIX 15 mg. Your doctor will decide whether it is necessary to interrupt treatment with NITROFIX 15 mg.

Use of other medications

Inform your doctor or pharmacist if you are using or have recently used other medications, including those purchased without a prescription.

It is advisable for your doctor to know if you are being treated with other medications, as they may enhance the depressor effect of NITROFIX 15 mg on blood pressure (calcium antagonists, beta blockers, diuretics, antihypertensives, tricyclic antidepressants, major tranquilizers, and dihydroergotamine).

Administration with other vasodilators should be done with caution to avoid adding effects.

The possibility that the ingestion of acetylsalicylic acid and non-steroidal anti-inflammatory substances may decrease the therapeutic response to NITROFIX 15 mg cannot be excluded.

The action of this medication on the heart may be altered if used in conjunction with preparations containing sildenafil for penile erection (see contraindications).

The use of topical products, especially if prolonged, may cause sensitization phenomena. In this case, treatment should be discontinued, and appropriate therapeutic measures should be taken.

Use of NITROFIX15mg with food and beverages

Excessive alcohol consumption should be avoided.

Pregnancy and breastfeeding

Consult your doctor or pharmacist before using any medication.

NITROFIX 15 mg should be used with caution during pregnancy and breastfeeding. In these circumstances, the product is only suitable in case of need and under direct medical supervision. If you are pregnant, notify your doctor immediately if you are regularly using this medication.

Use in children:Safety and efficacy in children under 18 years of age have not been established. Therefore, its use is not recommended.

Use in elderly:Geriatric patients are often more sensitive to hypotensive effects.

Driving and using machines

Due to the potential side effects (dizziness, hypotension, etc.) that may decrease reaction capacity, maximum precautions should be taken when driving vehicles or operating machinery at the start of treatment.

3. How to use NITROFIX 15 mg

Follow the administration instructions for NITROFIX 15 mg exactly as indicated by your doctor. Consult your doctor or pharmacist if you have doubts.

The response to nitro derivatives varies from person to person, and the minimum effective dose should be prescribed in each case. Since the amount of nitroglycerin released by the NITROFIX 15 mg patch is constant, the administered dose depends solely on the patch's contact area.

The normal dose is to start treatment with a NITROFIX 5 mg patch per day. If necessary, and depending on the demonstrated tolerance, treatment can be increased to a NITROFIX 10 mg or even NITROFIX 15 mg patch per day.

Application can be for a continuous period of 24 hours or intermittently, incorporating a patch-free interval of 8 to 12 hours (usually at night).

INSTRUCTIONS FOR CORRECT ADMINISTRATION

Each NITROFIX 15 mg patch is contained in a small, sealed protective bag. The adhesive area is coated with a protective film that should be removed just before application to the skin.

Apply the NITROFIX 15 mg patch to clean, dry, healthy skin (without cream residue) with little hair.

The correct application procedure is as follows:

1.- Open the bag by tearing it at the mark and remove the patch from the inside.

2.- Fold the patch slightly with the dotted marks facing you, pull the tab, and discard the protective film.

3.- Apply the adhesive surface to the upper arm or chest. Carefully separate the other dotted part of the protective film.

4.- Press on the patch, ensuring its good placement.

Remove the NITROFIX 15 mg patch after 24 hours, unless otherwise recommended by your doctor. NITROFIX 15 mg patches are disposable. They should be kept out of the reach of children.

Apply a new NITROFIX 15 mg patch following the method described. This new patch should be applied to a different area than the previous one, e.g., on the opposite side of the chest.

Do not apply the system to the same area for consecutive days. The NITROFIX 15 mg patch adheres easily to the skin and does not come off with bathing, showering, or physical exercise.

If you use more NITROFIX15mg than you should

High doses of nitroglycerin can, in some cases, induce a rapid decrease in blood pressure and cause shock, tachycardia, methemoglobinemia, cyanosis, coma, and convulsions. Due to the controlled release of nitroglycerin with NITROFIX 15 mg, the risk of overdose is very rare. Any reduction in blood pressure and symptoms of collapse can be treated by elevating the lower limbs. Severe methemoglobinemia can be treated with an injection of methylene blue or toluidine blue.

In case of overdose or accidental ingestion, consult the Toxicology Information Service. Telephone: (91) 562 04 20.

If you forget to use NITROFIX15mg

Do not take a double dose to make up for forgotten doses. Make sure to complete the treatment cycle.

If you interrupt treatment with NITROFIX15mg

If you have any other doubts about the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medications, NITROFIX 15 mg can cause side effects, although not everyone will experience them.

Tolerance to nitroglycerin is generally good. Headache is the most frequent side effect, especially when high doses are used. This effect is usually counteracted with common analgesics, although in particularly intense cases, it may be necessary to reduce the dose or interrupt treatment.

Other possible side effects that may appear, especially at the start of treatment, are: arterial hypotension (especially postural), weakness, tachycardia, fainting, palpitations, flushing, dizziness, nausea, vomiting, and dermatitis. Except for dermatitis, all of these are attributable to the pharmacological action of nitroglycerin. The doctor should be immediately informed of side effects, and this will give them the opportunity to suspend treatment with NITROFIX 15 mg, at least temporarily.

Local tolerance is also generally good. Occasionally, itching, burning, and mild redness reactions may occur, and these are always dependent on the level of application. However, these effects usually disappear a few hours after removing the patch without the need for other measures.

If you consider that any of the side effects you are experiencing is serious or if you notice any side effect not mentioned in this leaflet, inform your doctor or pharmacist.

5. Storage of NITROFIX 15 mg

No special storage conditions are required

Keep out of the reach and sight of children.

Do not use NITROFIX 15 mg after the expiration date stated on the packaging or carton, after "EXP". The expiration date is the last day of the month indicated.

Do not use NITROFIX 15 mg if you notice visible signs of deterioration.

Medications should not be disposed of through wastewater or household waste. Ask your pharmacist how to dispose of the packaging and any unused medication. This will help protect the environment.

6. Package contents and additional information

Composition of NITROFIX 15 mg

The active ingredient is Nitroglycerin 80 mg, releasing 15 mg/24 hours.

The other components are DURO-tak 872852, sorbitan monooleate, propylene glycol, low-density polyethylene oval film, and transparent polyester film.

Appearance of NITROFIX 15 mg and package contents

NITROFIX are transparent transdermal patches with a surface area of 20 cm2 and are presented in packages of 7 or 30 transdermal patches.

Marketing authorization holder and manufacturer

Marketing authorization holder:

ARAFARMA GROUP, S.A.

C/ Fray Gabriel de San Antonio, 6-10

Pol. Ind. del Henares

19180 Marchamalo (Guadalajara). Spain.

Manufacturer:

IBSA FARMACEUTICI ITALIA SRL

Strada Statale Nº 11, Padana Superiore, km 160

20051-Cassina de’ Pecchi (MI)

Italy

Or

ALTERGON ITALIA SRL

Zona Industriale ASI,

Morra de Sanctis - 83040 (Av)

Italy

This leaflet was approved in April 2019.