Eltrombopag Olpha

Leaflet accompanying the packaging: patient information

Eltrombopag Olpha, 12.5 mg, film-coated tablets

Eltrombopag Olpha, 25 mg, film-coated tablets

Eltrombopag Olpha, 50 mg, film-coated tablets

Eltrombopag Olpha, 75 mg, film-coated tablets

eltrombopag

Read the leaflet carefully before taking the medicine, as it contains important information for the patient.

• The leaflet should be kept in case it needs to be read again.
• In case of any doubts, the doctor or pharmacist should be consulted.
• This medicine has been prescribed specifically for one person. It should not be given to others. The medicine may harm another person, even if the symptoms of their illness are the same.
• If the patient experiences any side effects, including any not listed in this leaflet, they should tell their doctor or pharmacist. See section 4.

Table of contents of the leaflet

• 1. What is Eltrombopag Olpha and what is it used for
• 2. Important information before taking Eltrombopag Olpha
• 3. How to take Eltrombopag Olpha
• 4. Possible side effects
• 5. How to store Eltrombopag Olpha
• 6. Contents of the pack and other information

1. What is Eltrombopag Olpha and what is it used for

Eltrombopag Olpha contains eltrombopag, which belongs to a group of medicines called thrombopoietin receptor agonists. The medicine is used to increase the number of platelets in the patient's blood. Platelets are blood cells that help reduce the risk of bleeding or prevent it. Eltrombopag Olpha is used to treat a blood clotting disorder called primary immune thrombocytopenia (ITP) in patients over 1 year of age who have already been treated with other medicines (corticosteroids or immunoglobulins) and have not responded to them. Primary immune thrombocytopenia is caused by a low platelet count (thrombocytopenia). People with primary immune thrombocytopenia are more prone to bleeding. Symptoms that patients with primary immune thrombocytopenia may notice include petechiae (small, flat, red spots under the skin), purpura, nosebleeds, gum bleeding, and difficulty stopping bleeding in case of injury or trauma. Eltrombopag Olpha may also be used to treat low platelet count (thrombocytopenia) in adults with hepatitis C virus (HCV) infection who have had difficulty due to side effects during treatment with interferon. Many people with hepatitis C have a low platelet count, not only due to the disease but also as a result of the action of certain antiviral drugs used to treat it. Taking Eltrombopag Olpha may help patients complete full treatment with antiviral drugs (peginterferon and ribavirin).

2. Important information before taking Eltrombopag Olpha

When not to take Eltrombopag Olpha

• if the patient is allergic to eltrombopag or any of the other ingredients of the medicine (listed in section 6 under "What Eltrombopag Olpha contains"). The doctor should be consulted if the patient thinks they have any of the above conditions.

Warnings and precautions

Before starting treatment with Eltrombopag Olpha, the doctor should be consulted:

• if the patient has liver disease. People with a low platelet count, as well as advanced (long-term) liver disease, are at higher risk of side effects, including life-threatening liver damage and blood clots. If the doctor considers that the benefits of taking this medicine outweigh the risks, the patient will be closely monitored during treatment.
• if the patient is at risk of blood clots in the veins or arteries, or if there have been cases of blood clots in the family. The risk of blood clots may be increased:
• if the patient is elderly,
• if the patient has been immobile for a long time,
• if the patient has cancer,
• if the patient is taking oral contraceptives or hormone replacement therapy,
• if the patient has recently undergone surgery or had an injury,
• if the patient is overweight,
• if the patient smokes,
• if the patient has advanced chronic liver disease. The doctor should be informed before starting treatment if any of the above conditions apply to the patient. Eltrombopag Olpha should not be taken unless the doctor considers that the expected benefits outweigh the risk of blood clots.
• if the patient has cataracts (clouding of the lens of the eye),
• if the patient has other blood diseases, such as myelodysplastic syndrome (MDS). Before starting treatment with Eltrombopag Olpha, the doctor will perform tests to rule out this disease. If the patient has MDS and takes this medicine, MDS may worsen.

The doctor should be informed if any of the above situations apply to the patient.

Eye examination

The doctor will recommend an eye examination to detect cataracts. If the patient does not undergo regular eye examinations, the doctor should recommend regular examinations. The occurrence of any bleeding in the retina (the layer of light-sensitive cells at the back of the eye) or near it may also be examined.

Regular tests will be necessary

Before starting treatment with Eltrombopag Olpha, the doctor will perform blood tests to assess blood cells, including platelets. During treatment with the medicine, these tests will be repeated at regular intervals.

Blood tests to assess liver function

Taking eltrombopag may cause changes in blood test results indicating liver damage - increased activity of certain liver enzymes, in particular alanine aminotransferase and aspartate aminotransferase, and increased bilirubin. If the patient is taking interferon-based treatment with Eltrombopag Olpha for low platelet count associated with hepatitis C, some liver diseases may worsen. Blood tests to assess liver function will be performed in the patient before starting treatment with Eltrombopag Olpha and at regular intervals during treatment. It may be necessary to stop taking Eltrombopag Olpha if the levels of these substances increase too much or if other symptoms of liver damage occur. See "Liver disorders" in section 4 of this leaflet.

Platelet count tests

If the patient stops taking Eltrombopag Olpha, there is a likelihood of a decrease in platelet count within a few days. The platelet count will be monitored, and the doctor will discuss appropriate precautions with the patient. A very high platelet count may increase the risk of blood clots. However, blood clots can also occur when the platelet count is normal or too low. The doctor will adjust the dose of Eltrombopag Olpha for the patient to prevent excessive increase in platelet count. Immediate medical attention should be sought if the patient experiences any of the following symptoms of a blood clot:

• swelling, pain, or tenderness in one leg,
• sudden shortness of breath, especially with sudden chest pain or rapid heartbeat,
• abdominal pain, abdominal enlargement, blood in the stool.

Bone marrow tests

In patients with bone marrow disorders, medicines like Eltrombopag Olpha may worsen these disorders. Changes in the bone marrow may be indicated by abnormal blood test results. The doctor may order direct bone marrow tests during treatment with Eltrombopag Olpha.

Tests to detect gastrointestinal bleeding

If the patient is taking interferon-based treatment with Eltrombopag Olpha, they will be monitored for symptoms of gastrointestinal bleeding after completion of treatment with this medicine.

Heart tests

The doctor may consider it necessary to examine the patient's heart during treatment with Eltrombopag Olpha and perform an electrocardiogram (ECG).

Elderly patients (65 years and older)

There is limited data on the use of eltrombopag in patients aged 65 and older. Caution should be exercised when taking Eltrombopag Olpha in patients aged 65 and older.

Children and adolescents

Eltrombopag is not recommended in children under 1 year of age with primary immune thrombocytopenia. The medicine is also not recommended in patients under 18 years of age with low platelet count associated with hepatitis C virus infection.

Other medicines and Eltrombopag Olpha

The doctor or pharmacist should be told about all medicines the patient is taking, has recently taken, or plans to take, including those obtained without a prescription and vitamins. Some commonly used medicines interact with eltrombopag - including prescription and non-prescription medicines and mineral supplements. These include:

• antacids used to treat heartburn, acid reflux, and stomach ulcers (see also "When to take Eltrombopag Olpha" in section 3),
• statins, which lower cholesterol levels,
• certain medicines used to treat HIV infection, such as lopinavir and ritonavir,
• cyclosporin used in transplants or immune system diseases,
• minerals such as iron, calcium, magnesium, aluminum, selenium, and zinc, which may be components of vitamin and mineral supplements (see also "When to take Eltrombopag Olpha" in section 3),
• medicines such as methotrexate and topotecan, used to treat cancer.

The doctor should be consulted if the patient is taking any of the above medicines. Some of them should not be taken while taking Eltrombopag Olpha, while others may require dose adjustment or appropriate timing of administration. The doctor will review the patient's medicines and recommend changes if necessary. If the patient is taking medicines to prevent blood clots, there is an increased risk of bleeding. The doctor will discuss this with the patient. If the patient is taking corticosteroids, danazol, and/or azathioprine, the doses of these medicines may be reduced or their use stopped during concurrent use of Eltrombopag Olpha.

Taking Eltrombopag Olpha with food and drink

Eltrombopag Olpha should not be taken with dairy products or drinks, as the calcium in dairy products affects the absorption of the medicine. See "When to take Eltrombopag Olpha" in section 3 for more information.

Pregnancy, breastfeeding

Eltrombopag Olpha should not be taken during pregnancy unless the doctor recommends it. The effect of eltrombopag during pregnancy is unknown.

• The doctor should be informed if the patient is pregnant, thinks they may be pregnant, or plans to have a baby.
• While taking Eltrombopag Olpha, the patient should use appropriate contraception to prevent pregnancy.
• The doctor should be informed if the patient becomes pregnant while taking Eltrombopag Olpha. Breastfeeding should not be done while taking Eltrombopag Olpha. It is not known whether Eltrombopag Olpha passes into breast milk. The doctor should be informed if the patient is breastfeeding or plans to breastfeed.

Driving and using machines

Eltrombopag Olpha may cause dizziness and other side effects that reduce concentration. The patient should not drive or operate machinery unless they are sure that these symptoms do not occur.

Eltrombopag Olpha contains isomalt and sodium

If the patient has previously been diagnosed with intolerance to some sugars, they should contact their doctor before taking the medicine. This medicine contains less than 1 mmol (23 mg) of sodium per film-coated tablet, which means it is essentially "sodium-free".

3. How to take Eltrombopag Olpha

This medicine should always be taken as directed by the doctor. In case of doubts, the doctor or pharmacist should be consulted. The dose or dosing schedule of Eltrombopag Olpha should not be changed unless the doctor or pharmacist recommends it. While taking Eltrombopag Olpha, the patient will remain under the care of a doctor experienced in treating the patient's condition.

How much to take

In the case of primary immune thrombocytopenia

• Adults and children (aged 6 to 17 years) - the usual starting dose for primary immune thrombocytopenia is one 50 mg tablet of Eltrombopag Olpha per day.
• Patients of East Asian/Southeast Asian origin may require a lower starting dose of 25 mg.
• Children (aged 1 to 5 years) - the usual starting dose for primary immune thrombocytopenia is one 25 mg tablet of Eltrombopag Olpha per day.

In the case of hepatitis C

• Adults - the usual starting dose for hepatitis C is one 25 mg tablet of Eltrombopag Olpha per day.
• Patients of East Asian/Southeast Asian origin should start treatment with the same dose of 25 mg.

The onset of action of Eltrombopag Olpha may occur within 1 to 2 weeks. Depending on the patient's response to treatment with Eltrombopag Olpha, the doctor may recommend a change in the daily dose.

How to take the tablets

The tablets should be swallowed whole with water. When to take the medicine The patient should make sure that -

• for 4 hours before taking Eltrombopag Olpha
• and for 2 hours after taking Eltrombopag Olpha the patient does not consume the following foods:
• dairy products, such as cheese, butter, yogurt, ice cream,
• milk or drinks containing milk, yogurt, or cream,
• antacids used to treat heartburn and acid reflux,
• mineral supplements containing iron, calcium, magnesium, aluminum, selenium, or zinc. If these instructions are not followed, the medicine will not be properly absorbed by the body.

The doctor or pharmacist should be consulted for more information about the appropriate foods and drinks.

Taking a higher dose of Eltrombopag Olpha than recommended

The doctor or pharmacist should be contacted immediately. If possible, they should be shown the medicine packaging or this leaflet. The patient's condition will be monitored for any side effects and appropriate treatment will be given promptly.

Missing a dose of Eltrombopag Olpha

The next dose should be taken at the usual time. No more than one dose of Eltrombopag Olpha should be taken per day.

Stopping treatment with Eltrombopag Olpha

Treatment with Eltrombopag Olpha should not be stopped without consulting the doctor. If the doctor recommends stopping treatment, the patient's platelet count will be monitored weekly for four weeks. See also "Bleeding or bruising after stopping treatment" in section 4. If the patient has any further doubts about taking this medicine, they should consult their doctor or pharmacist.

4. Possible side effects

Like all medicines, Eltrombopag Olpha can cause side effects, although not everybody gets them. Symptoms to watch out for: the doctor should be consulted

In patients taking eltrombopag for primary immune thrombocytopenia or low platelet count associated with hepatitis C, symptoms of severe side effects may occur. It is essential to inform the doctor about these symptoms. Increased risk of blood clots

In some patients, the risk of blood clots may increase, and medicines like Eltrombopag Olpha may worsen this condition. Sudden blockage of a blood vessel by a blood clot is an uncommon side effect and may affect up to 1 in 100 patients. Immediate medical attention should be sought if the patient experiences any symptoms of a blood clot, such as:

• swelling, pain, or tenderness in one leg,
• sudden shortness of breath, especially with sudden chest pain or rapid heartbeat,
• abdominal pain, abdominal enlargement, blood in the stool.

Liver disorders

Eltrombopag Olpha may cause changes in blood test results indicating liver damage. Liver disorders (increased enzyme activity in blood test results) are common and may affect up to 1 in 10 patients. Other liver problems are uncommon and may affect up to 1 in 100 patients. If any of the following symptoms of liver disorders occur:

• yellowing of the skin or whites of the eyes (jaundice),
• dark urine,

the doctor should be consulted immediately.

Bleeding or bruising after stopping treatment

Usually, within two weeks of stopping Eltrombopag Olpha, the patient's platelet count decreases to pre-treatment levels. A low platelet count may increase the risk of bleeding or bruising. The doctor will monitor the patient's platelet count for at least 4 weeks after stopping Eltrombopag Olpha. The doctor should be informed if the patient experiences bruising or bleeding after stopping treatment. In some patients, gastrointestinal bleeding may occur after stopping peginterferon, ribavirin, and eltrombopag. Symptoms include:

• black, tarry stools (a change in stool color, which is an uncommon side effect that may affect up to 1 in 100 patients),
• blood in the stool,
• vomiting blood or coffee ground-like material. The doctor should be told immediately if any of these symptoms occur.

The following side effects have been reported in adults taking eltrombopag for primary immune thrombocytopenia:

If these side effects worsen, the doctor, pharmacist, or nurse should be told.
Very common side effects(may affect more than 1 in 10 patients):

• infection of the nose, sinuses, throat, and upper respiratory tract (upper respiratory tract infection),
• cough, common cold,
• nausea, diarrhea,
• back pain.

Very common side effectsthat may be seen in blood tests:

• increased activity of liver enzymes (alanine aminotransferase (ALT)).

Common side effects(may affect up to 1 in 10 patients):

• flu, herpes simplex, pneumonia, sinusitis, tonsillitis, bronchitis, pharyngitis, and discomfort when swallowing,
• loss of appetite,
• sleep disturbances, depression,
• numbness, tingling, or prickling sensations, drowsiness, migraine,
• eye disorders, including abnormal eye test results, dry eye, eye pain, and blurred vision,
• ear pain, dizziness,
• pain, swelling, or tenderness in one leg (usually the calf) with warmth of the skin in the affected area (symptoms of deep vein thrombosis), localized bruising due to bleeding from a damaged blood vessel (hematoma), flushing,
• runny nose,
• mouth disorders, including dry mouth, mouth pain, tongue sensitivity, gum bleeding, mouth ulcers, toothache,
• liver function disorders,
• skin changes, including excessive sweating, rash, redness, itching, and flushing,
• muscle pain, muscle spasms, muscle weakness, bone pain,
• foamy urine (presence of air bubbles in the urine),
• heavy menstrual bleeding,
• high fever, feeling hot, chest pain, and feeling unwell.

Common side effectsthat may be seen in blood tests:

• decreased red blood cell count (anemia), decreased platelet count (thrombocytopenia), decreased white blood cell count, decreased hemoglobin level, increased eosinophil count, increased white blood cell count (leukocytosis),
• increased uric acid level, decreased potassium level,
• increased activity of liver enzymes (aspartate aminotransferase (AST)), increased bilirubin level in the blood,
• increased levels of certain proteins, increased creatinine level,
• increased alkaline phosphatase activity.

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

• skin infection,
• rectal or colon cancer,
• allergic reaction,
• loss of appetite, painful joint swelling due to uric acid (gout),
• lack of interest, mood changes, crying that is hard to control or occurs unexpectedly,
• balance disorders, speech and nerve disorders, tremors, paralysis of one side of the body, migraine with aura, nerve damage, vasodilation causing headache,
• eye disorders, including increased tearing, cataracts, retinal hemorrhage, dry eyes,
• rapid or irregular heartbeat (palpitations),
• shortness of breath, coughing up mucus, runny nose, sore throat, and discomfort when swallowing,
• gastrointestinal disorders, including vomiting, abdominal pain, indigestion, constipation, bloating, taste disturbances, hemorrhoids, stomach pain or discomfort,
• liver problems, including liver tumor, yellowing of the skin or whites of the eyes (jaundice),
• liver damage caused by inflammation (see "Liver disorders" above in section 4), liver damage caused by the medicine,
• skin changes, including skin discoloration, peeling, redness, itching, and sweating,
• muscle weakness,
• kidney problems, including kidney inflammation, excessive urination at night, kidney failure, presence of white blood cells in the urine,
• feeling hot, feeling unwell, skin reaction, such as redness or swelling and pain at the injection site, chest pain and discomfort, fluid accumulation in the body or limbs causing swelling,
• depression, anxiety, sleep disturbances, nervousness,
• fever, headache.

Uncommon side effectsthat may be seen in laboratory tests:

• changes in red blood cell shape, decreased red blood cell count (anemia) due to excessive destruction of red blood cells (hemolytic anemia), increased myelocyte count, increased band neutrophil count, presence of immature white blood cells, which may indicate certain diseases, increased platelet count, increased hemoglobin level,
• decreased calcium level,
• increased urea level in the blood, increased protein level in the urine,
• increased albumin level in the blood, increased total protein level, decreased albumin level in the blood, increased urine pH.

The following side effects have been reported in children (aged 1 to 17 years) taking eltrombopag for ITP:

If these side effects worsen, the doctor, pharmacist, or nurse should be told.
Very common side effects(may affect more than 1 in 10 children):

• infection of the nose, sinuses, throat, and upper respiratory tract, common cold (upper respiratory tract infection),
• cough,
• nausea, diarrhea, abdominal pain,
• high fever.

Common side effects(may affect up to 1 in 10 children):

• sleep disturbances (insomnia),
• nasal congestion, runny nose, or stuffy nose, sore throat, cough, runny nose, and sneezing,
• toothache, mouth disorders, including dry mouth, mouth pain, tongue sensitivity, gum bleeding, mouth ulcers.

The following side effects have been reported in patients taking eltrombopag in combination with peginterferon and ribavirin for hepatitis C:

Very common side effects(may affect more than 1 in 10 patients):

• loss of appetite
• headache
• cough
• nausea, diarrhea
• itching, swelling of the hands or feet, unusual hair loss
• muscle pain, muscle weakness
• fever, feeling tired, flu-like illness, weakness, chills.

Very common side effectsthat may be seen in blood tests:

• decreased red blood cell count (anemia).

Common side effects(may affect up to 1 in 10 patients):

• urinary tract infections, infection of the nose, sinuses, throat, and upper respiratory tract, common cold (upper respiratory tract infection), bronchitis, sinusitis, pharyngitis, and flu-like illness, dry mouth, mouth pain or inflammation,
• weight loss,
• sleep disturbances, drowsiness, depression, anxiety,
• dizziness, concentration and memory disorders, mood changes, liver dysfunction, tingling or numbness of the hands or feet,
• vision disorders, including cataracts, dry eye, retinal hemorrhage,
• dizziness,
• rapid or irregular heartbeat (palpitations),
• shortness of breath, coughing up mucus, runny nose, sore throat, and discomfort when swallowing,
• gastrointestinal disorders, including vomiting, abdominal pain, indigestion, constipation, bloating, taste disturbances, hemorrhoids, stomach pain or discomfort,
• liver problems, including liver tumor, yellowing of the skin or whites of the eyes (jaundice),
• liver damage caused by the medicine (see "Liver disorders" above in section 4),
• skin changes, including rash, dry skin, eczema, redness, itching,
• excessive sweating, skin growths, hair loss,
• joint pain, back pain, bone pain, limb pain (arms, legs, hands, or feet), muscle spasms,
• irritability, general feeling of being unwell, skin reaction, such as redness or swelling and pain at the injection site, chest pain and discomfort, fluid accumulation in the body or limbs causing swelling,
• depression, anxiety, sleep disturbances, nervousness,
• fever, headache.

Common side effectsthat may be seen in blood tests:

• increased blood sugar (glucose) level, decreased white blood cell count, decreased neutrophil count, decreased albumin level in the blood, decreased hemoglobin level, increased bilirubin level in the blood, changes in blood clotting enzymes.

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

• stomach flu (gastroenteritis), sore throat,
• decreased red blood cell count (anemia) due to excessive destruction of red blood cells (hemolytic anemia),
• confusion, agitation,
• mouth ulcers or inflammation, stomach inflammation,
• blood clots in the vein that carries blood to the liver (possible liver damage and/or gastrointestinal disorders), liver failure,
• skin changes, including skin discoloration, peeling, redness, itching, and sweating, and night sweats,
• disorders of blood clotting in small blood vessels with kidney failure, pain when urinating,
• rash, bruising at the injection site, chest discomfort,
• heart rhythm disorders (prolonged QT interval).

Reporting side effects

If side effects occur, including any not listed in this leaflet, the doctor, pharmacist, or nurse should be told. Side effects can be reported directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products: Al. Jerozolimskie 181C, 02-222 Warsaw, Tel.: +48 22 49 21 301; fax: +48 22 49 21 309; website: https://smz.ezdrowie.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, more information can be collected on the safety of the medicine.

5. How to store Eltrombopag Olpha

The medicine should be stored out of sight and reach of children. This medicine should not be taken after the expiry date stated on the carton and blister after "EXP". The expiry date refers to the last day of the month. No special precautions. Medicines should not be disposed of via wastewater or household waste. The pharmacist should be asked how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the pack and other information

What Eltrombopag Olpha contains

The active substance is eltrombopag olamine.
Eltrombopag Olpha, 12.5 mg, film-coated tablets
Each film-coated tablet contains eltrombopag olamine equivalent to 12.5 mg of eltrombopag.
Eltrombopag Olpha, 25 mg, film-coated tablets
Each film-coated tablet contains eltrombopag olamine equivalent to 25 mg of eltrombopag.
Eltrombopag Olpha, 50 mg, film-coated tablets
Each film-coated tablet contains eltrombopag olamine equivalent to 50 mg of eltrombopag.
Eltrombopag Olpha, 75 mg, film-coated tablets
Each film-coated tablet contains eltrombopag olamine equivalent to 75 mg of eltrombopag.
The other ingredients are:
Tablet core: microcrystalline cellulose, mannitol, povidone, isomalt (E 953), calcium silicate, sodium carboxymethylcellulose, magnesium stearate.
Tablet coating:
Eltrombopag Olpha, 12.5 mg, film-coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin.
Eltrombopag Olpha, 25 mg, film-coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin.
Eltrombopag Olpha, 50 mg, film-coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), iron oxide yellow (E 172), triacetin.
Eltrombopag Olpha, 75 mg, film-coated tablets:hypromellose, titanium dioxide (E 171), iron oxide red (E 172), triacetin.

What Eltrombopag Olpha looks like and contents of the pack

Eltrombopag Olpha, 12.5 mg, film-coated tablets
Orange to brown, round, biconvex film-coated tablets with "I" engraved on one side and a diameter of about 5.5 mm.
Eltrombopag Olpha, 25 mg, film-coated tablets
Dark pink, round, biconvex film-coated tablets with "II" engraved on one side and a diameter of about 8 mm.
Eltrombopag Olpha, 50 mg, film-coated tablets
Pink, round, biconvex film-coated tablets with "III" engraved on one side and a diameter of about 10 mm.
Eltrombopag Olpha, 75 mg, film-coated tablets
Red to brown, round, biconvex film-coated tablets with "IV" engraved on one side and a diameter of about 12 mm.
Blisters of OPA/Aluminum/PVC/Aluminum foil packaged in a cardboard box containing 10, 14, 28, 30, or 84 film-coated tablets, and single-dose blisters packaged in a cardboard box containing 10x1, 14x1, 28x1, 30x1, or 84x1 film-coated tablets. Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder

Olpha AS,
Rupnicu iela 5,
Olaine, Olaines novads, LV-2114,
Latvia
Email: olpha.poland.pv@insuvia.com

Manufacturer

Synthon B.V.
Microweg 22
6545 CM Nijmegen
Netherlands
Synthon Hispania S.L.
c/ Castelló, 1
08830 Sant Boi de Llobregat
Barcelona
Spain

Date of last revision of the leaflet: