PITAVASTATIN ALTER 2 mg FILM-COATED TABLETS

2. What you need to know before you take Pitavastatin Alter

Do not take Pitavastatin Alter

• if you are allergic to pitavastatin, to any other statin or to any of the other ingredients of this medicine (listed in section 6).
• if you are pregnant or breast-feeding.
• if you are a woman and can become pregnant, and you are not using a reliable contraceptive method (see “Pregnancy and breast-feeding”).
• if you currently have liver problems.
• if you are taking ciclosporin, a medicine used after organ transplants.
• if you have repeated or unexplained muscle pain.

If you are in doubt, consult your doctor or pharmacist before taking this medicine.

Warnings and precautions

Consult your doctor or pharmacist before taking this medicine:

• if you have severe respiratory problems (severe breathing problems).
• if you have ever had kidney problems.
• if you have ever had liver problems. Statins can affect the liver in some people. Your doctor will usually do blood tests (to see how your liver is working) before and during treatment with this medicine.
• if you have ever had thyroid problems.
• if you or a family member have a history of muscle problems.
• if you have previously had muscle problems when taking other medicines to lower cholesterol (e.g. statins or fibrates).
• if you drink a lot of alcohol.
• if you are taking or have taken in the last 7 days a medicine containing fusidic acid (used to treat bacterial infections) by mouth or by injection. The combination of fusidic acid and Pitavastatin Alter can cause serious muscle problems (rhabdomyolysis).
• if you have or have had myasthenia (a disease that causes generalised muscle weakness that, in some cases, affects the muscles used for breathing) or ocular myasthenia (a disease that causes weakness of the eye muscles), as statins can sometimes worsen the disease or cause myasthenia to appear (see section 4).

If any of the above applies to you (or you are in doubt), consult your doctor or pharmacist before taking this medicine. Also, inform your doctor or pharmacist if you experience constant muscle weakness. Further tests and medicines may be needed to diagnose and treat this problem.

While you are taking this medicine, your doctor will check if you have diabetes or are at risk of developing diabetes. This risk of diabetes increases if you have high levels of sugars and fats in the blood, are overweight, and have high blood pressure.

Children and adolescents

Pitavastatin should not be given to children under 6 years of age.

Before taking pitavastatin, adolescent girls should receive guidance and advice on contraceptives.

Other medicines and Pitavastatin Alter

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Some medicines can interfere with how others work.

In particular, tell your doctor or pharmacist if you are taking any of the following medicines:

• other medicines called “fibrates”, such as gemfibrozil and fenofibrate.
• erythromycin or rifampicin, antibiotics used for infections.
• warfarin or any other medicine used to thin the blood.
• HIV medicines called ‘protease inhibitors’ (e.g. ritonavir, lopinavir, darunavir, atazanavir) and ‘non-nucleoside reverse transcriptase inhibitors’ (e.g. efavirenz).
• niacin (vitamin B3).
• If you need to take fusidic acid by mouth to treat a bacterial infection, you will need to stop using this medicine. Your doctor will tell you when you can restart treatment with pitavastatin. The use of pitavastatin with fusidic acid can cause muscle weakness, sensitivity, or pain (rhabdomyolysis). For more information on rhabdomyolysis, see section 4.
• If you are taking medicines containing glecaprevir or pibrentasvir, medicines used to treat hepatitis C. Your doctor may need to change your dose of pitavastatin.

If any of the above applies to you (or you are in doubt), consult your doctor or pharmacist before taking this medicine.

Taking Pitavastatin Alter with food and drink

You can take pitavastatin with or without food.

Pregnancy, breast-feeding, and fertility

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.

Do not take pitavastatin if you are pregnant or breast-feeding. If you want to become pregnant, inform your doctor before starting to take pitavastatin.

If you are a woman who can become pregnant, you must use a reliable contraceptive method while taking pitavastatin. If you become pregnant while taking pitavastatin, stop taking pitavastatin and contact your doctor immediately.

Driving and using machines

This medicine is unlikely to affect your ability to drive or use machines. However, if you feel dizzy or drowsy while taking pitavastatin, do not drive or use machines or tools.

Pitavastatin Alter contains lactose

This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, contact them before taking this medicine.

3. How to take Pitavastatin Alter

Always take this medicine exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist.

Taking this medicine

Swallow the tablet whole with water, with or without food. You can take it at any time of day. However, try to take the tablet at the same time every day.

How much to take

• The usual starting dose is 1 mg once a day. After a few weeks, your doctor may decide to increase your dose. The maximum dose in adults and children over 10 years is 4 mg a day.
• If you have liver problems, you should not take more than 2 mg a day.

Use in children

• The maximum dose in children under 10 years is 2 mg a day.
• If necessary, the tablets can be dispersed in a glass of water just before taking; then rinse the glass with more water and drink immediately. Do not use fruit juices or milk to disperse the tablets.
• Pitavastatin is not recommended for use in children under 6 years of age.

Other things you need to know while taking pitavastatin

• If you go to hospital or receive treatment for another problem, tell the medical staff that you are taking pitavastatin.
• Your doctor may do tests to check your cholesterol levels regularly.
• Do not stop taking pitavastatin without talking to your doctor first. Your cholesterol levels might increase.

If you take more Pitavastatin Alter than you should

If you take more pitavastatin than you should, tell your doctor or go to hospital immediately. Take the medicine pack with you.

In case of overdose or accidental ingestion, contact the Toxicology Information Service. Phone: 91 562 04 20, consult your doctor or pharmacist.

If you forget to take Pitavastatin Alter

Do not worry, take the next dose at the right time. Do not take a double dose to make up for forgotten doses.

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

4. Possible side effects

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

Stop taking Pitavastatin Alter and contact your doctor immediately if you notice any of the following serious side effects, as you may need urgent medical treatment:

• Allergic reaction: some of the signs are difficulty breathing, swelling of the face, lips, tongue, or throat, problems swallowing, intense itching of the skin (with hives).
• Lupus-like syndrome (with rash, joint disorders, and effects on blood cells). Frequency not known.

• Unexplained muscle pain or weakness, especially if you feel unwell, have a fever, or if your urine is brownish-red. In rare cases (less than 1 in 1,000), Pitavastatin Alter can cause unpleasant muscle effects. If these effects are not investigated, they can cause serious problems such as abnormal muscle breakdown (rhabdomyolysis), which can cause kidney problems.

• Respiratory problems including persistent cough and/or difficulty breathing or fever.
• Liver problems that can cause yellowing of the skin and eyes (jaundice).
• Pancreatitis (severe abdominal and back pain).

Other side effects include:

Common (may affect up to 1 in 10 people)

• joint pain, muscle pain
• constipation, diarrhoea, indigestion, nausea
• headache

Uncommon (may affect up to 1 in 100 people)

• muscle spasms
• weakness, tiredness, or malaise
• swelling of the ankles, feet, or fingers
• stomach pain, dry mouth, vomiting, loss of appetite, taste disturbance
• pallor and weakness or shortness of breath (anaemia)
• itching or skin rash
• ringing in the ears
• dizziness or drowsiness, insomnia (or other sleep disorders, including nightmares)
• increased need to urinate (urinary frequency)
• numbness and reduced sensitivity in the fingers and toes, legs, and face

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

• redness of the skin, rash, and itching of the skin
• vision loss
• tongue pain
• unpleasant or uncomfortable feeling in the stomach
• breast enlargement in men (gynaecomastia)

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

• Constant muscle weakness.
• Severe myasthenia (a disease that causes generalised muscle weakness that, in some cases, affects the muscles used for breathing).
• Ocular myasthenia (a disease that causes weakness of the eye muscles).
• Consult your doctor if you experience weakness in the arms or legs that worsens after periods of activity, double vision, or drooping eyelids, difficulty swallowing, or difficulty breathing.

Other possible side effects

• Memory loss
• Sexual dysfunction
• Depression
• Diabetes. This is more likely if you have high levels of sugars and fats in the blood, are overweight, and have high blood pressure. Your doctor will monitor you while you are taking this medicine.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via 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. Storage of Pitavastatin Alter

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

This medicine does not require any special storage conditions.

Do not use this medicine after the expiry date which is stated on the blister and carton after “EXP”. The expiry date is the last day of the month shown.

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

6. Contents of the pack and other information

Composition of Pitavastatin Alter

The active substance is pitavastatin.

Pitavastatin Alter 1 mg: Each tablet contains 1 mg of pitavastatin (as pitavastatin calcium).

Pitavastatin Alter 2 mg: Each tablet contains 2 mg of pitavastatin (as pitavastatin calcium).

Pitavastatin Alter 4 mg: Each tablet contains 4 mg of pitavastatin (as pitavastatin calcium).

The other ingredients are: lactose monohydrate, povidone, hydroxypropylcellulose, calcium carbonate, magnesium stearate, hypromellose, titanium dioxide (E171), triacetin.

Appearance and packaging

Pitavastatin Alter 1 mg: Film-coated tablets, round, biconvex, white or almost white, scored on one side. The score line is not intended for breaking the tablet.

Pitavastatin Alter 2 mg: Film-coated tablets, round, biconvex, white or almost white.

Pitavastatin Alter 4 mg: Film-coated tablets, round, biconvex, white or almost white, scored on one side. The score line is not intended for breaking the tablet.

PA/Aluminium/PVC-Aluminium blisters. Packs of 28 tablets.

Marketing Authorisation Holder and Manufacturer

Laboratorios Alter, S.A.

C/ Mateo Inurria 30

28036 Madrid

Spain

Date of last revision of this leaflet: May 2023

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