Fipalan

Leaflet accompanying the packaging: patient information

Fypalan, 2 mg, coated tablets

Fypalan, 4 mg, coated tablets

Fypalan, 6 mg, coated tablets

Fypalan, 8 mg, coated tablets

Fypalan, 10 mg, coated tablets

Fypalan, 12 mg, coated tablets

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

• Keep this leaflet, you may need to read it again.
• In case of any doubts, consult a doctor or pharmacist.
• This medicine has been prescribed to you by a doctor for a specific person. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If the patient experiences any undesirable effects, including any undesirable effects not mentioned in this leaflet, they should inform their doctor or pharmacist. See section 4.

Table of contents of the leaflet

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

1. What is Fypalan and what is it used for

Fypalan contains the active substance perampanel. It belongs to a group of medicines called antiepileptic drugs. These medicines are used to treat epilepsy, in which the patient has recurring seizures (epileptic seizures). It has been prescribed to the patient by a doctor to reduce the number of seizures.

Fypalan is used in combination with other antiepileptic medicines to treat certain types of epilepsy:

• In adults, adolescents (from 12 years of age), and children (from 4 to 11 years of age)
• Fypalan is used to treat seizures that affect only a part of the brain (called partial seizures).
• After such partial seizures, the patient may or may not experience seizures that affect the entire brain (called secondary generalized seizures).
• In adults and adolescents (from 12 years of age), and children (from 7 to 11 years of age)
• The medicine is also used to treat seizures that affect the entire brain from the start (called primary generalized seizures), which can cause convulsions or loss of consciousness.

2. Important information before taking Fypalan

When not to take Fypalan:

Warnings and precautions

If the patient has liver or kidney problems, they should discuss this with their doctor or pharmacist before starting Fypalan. The patient should not take Fypalan if they have severe liver or kidney problems. Before taking the medicine, the patient should inform their doctor about any history of alcoholism or drug addiction.

• Fypalan may cause dizziness or drowsiness in the patient, especially at the start of treatment.
• Fypalan may increase the risk of falls, especially in elderly patients; this may be due to the patient's condition.
• Fypalan may cause aggression, anger, or violence. It may also cause unusual or extreme changes in behavior and mood, thinking disorders, and (or) loss of contact with reality. If the patient, their family, or friends notice any of these effects, they should contact their doctor or pharmacist.

In a small number of patients treated with antiepileptic medicines, thoughts of self-harm or suicidal thoughts have occurred. If such thoughts occur at any time, the patient should immediately consult their doctor.

• DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) has been reported in patients taking perampanel, a severe skin reaction that can be life-threatening.
• Stevens-Johnson syndrome (SJS) is a severe skin reaction that can be life-threatening.

If the patient experiences any of these symptoms after taking Fypalan (or is unsure), they should consult their doctor or pharmacist.

Children

Fypalan is not recommended for use in children under 4 years of age. The safety and efficacy of Fypalan in children under 4 years of age with partial seizures or under 7 years of age with primary generalized seizures have not been established.

Fypalan and other medicines

The patient should tell their doctor or pharmacist about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take. This includes over-the-counter medicines and herbal medicines. Taking Fypalan with certain other medicines may cause undesirable effects or affect their efficacy. The patient should not start or stop taking other medicines without consulting their doctor or pharmacist.

• Other antiepileptic medicines, such as carbamazepine, oxcarbazepine, and phenytoin, used to treat seizures, may affect the efficacy of Fypalan. The patient should tell their doctor if they are taking or have recently taken these medicines, as dose adjustment may be necessary.
• Felbamate (a medicine used to treat epilepsy) may also affect the efficacy of Fypalan. The patient should tell their doctor if they are taking or have recently taken this medicine, as dose adjustment may be necessary. Fypalan may affect the efficacy of midazolam (a medicine used to treat prolonged, acute seizures, as a sedative, and for sleep disorders). The patient should tell their doctor if they are taking midazolam, as dose adjustment may be necessary.
• Certain other medicines, such as rifampicin (a medicine used to treat bacterial infections), St. John's Wort (a medicine used to treat mild anxiety disorders), and ketoconazole (a medicine used to treat fungal infections), may affect the efficacy of Fypalan. The patient should tell their doctor if they are taking or have recently taken these medicines, as dose adjustment may be necessary.
• Hormonal contraceptives (including oral contraceptives, implants, injections, and patches). The patient should tell their doctor about any hormonal contraceptives they are taking. Fypalan may reduce the efficacy of certain hormonal contraceptives, such as levonorgestrel. During Fypalan treatment, the patient should use other methods of safe and effective contraception (such as condoms or an intrauterine device). The patient should continue to use these methods for one month after stopping Fypalan treatment. The patient should discuss with their doctor which contraceptive method is best for them.

Taking Fypalan with alcohol

The patient should consult their doctor before consuming alcohol. The patient should be cautious when consuming alcohol with antiepileptic medicines, including Fypalan.

• Consuming alcohol while taking Fypalan may cause reduced alertness in the patient and negatively affect their ability to drive, use machines, or operate equipment.
• Consuming alcohol while taking Fypalan may exacerbate feelings of anger, confusion, or sadness.

Pregnancy and breastfeeding

If the patient is pregnant, breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor before taking this medicine. The patient should not stop treatment without first discussing it with their doctor.

• Fypalan is not recommended during pregnancy.
• During Fypalan treatment, the patient should use effective contraception to avoid becoming pregnant. The patient should continue to use contraception for one month after stopping Fypalan treatment. The patient should tell their doctor if they are using hormonal contraception. Fypalan may reduce the efficacy of certain hormonal contraceptives, such as levonorgestrel. During Fypalan treatment, the patient should use other methods of safe and effective contraception (such as condoms or an intrauterine device). The patient should continue to use these methods for one month after stopping Fypalan treatment. The patient should discuss with their doctor which contraceptive method is best for them. It is not known whether Fypalan passes into breast milk. The doctor will weigh the benefits and risks of taking Fypalan during breastfeeding.

Driving and using machines

The patient should not drive or operate machinery until they know how Fypalan affects them.

• Fypalan may cause dizziness or drowsiness in the patient, especially at the start of treatment. If these symptoms occur, the patient should not drive, use machines, or operate equipment.
• Consuming alcohol while taking Fypalan may exacerbate these symptoms.

Fypalan contains lactose

Fypalan contains lactose (a type of sugar). If the patient has been diagnosed with intolerance to some sugars, they should consult their doctor before taking the medicine.

3. How to take Fypalan

The patient should always take this medicine exactly as their doctor has told them. If they are unsure, they should consult their doctor or pharmacist.

What dose to take

Treatment of partial and primary generalized seizures in adults and adolescents (12 years of age and older):

• The usual starting dose of Fypalan is 2 mg once daily, taken at bedtime.
• The doctor may gradually increase the dose by 2 mg, up to a maintenance dose between 4 mg and 12 mg, depending on the patient's response to treatment.
• If the patient has mild or moderate liver problems, the dose should not exceed 8 mg per day and should not be increased more frequently than every 2 weeks.
• The patient should not take more Fypalan than their doctor has prescribed. Finding the right dose of Fypalan for the patient may take several weeks.

The following table shows the recommended doses for the treatment of partial seizures in children aged 4 to 11 years and primary generalized seizures in children aged 7 to 11 years.

How to take it

The tablet should be swallowed whole, with a glass of water. Fypalan can be taken with or without food. The tablets should not be chewed, crushed, or divided.

Taking more Fypalan than prescribed

If the patient has taken more Fypalan than prescribed, they should contact their doctor immediately. The patient may experience confusion, anxiety, aggressive behavior, and decreased level of consciousness.

Missing a dose of Fypalan

• If the patient misses a dose, they should wait until the next scheduled dose and continue treatment as prescribed.
• The patient should not take a double dose to make up for the missed dose.
• If the patient has stopped taking Fypalan for less than 7 days, they should continue to take the medicine as prescribed by their doctor.
• If the patient has stopped taking Fypalan for more than 7 days, they should contact their doctor immediately.

Stopping Fypalan treatment

Fypalan should be taken for as long as the doctor has prescribed. The patient should not stop treatment unless their doctor tells them to. The doctor may gradually reduce the dose to prevent seizures from returning or worsening.

4. Possible side effects

Like all medicines, Fypalan can cause side effects, although not everybody gets them.

• Very common (affecting more than 1 in 10 people) side effects:
• dizziness
• drowsiness (sleepiness or lethargy)

Common (affecting up to 1 in 10 people) side effects:

• increased or decreased appetite, weight gain
• aggression, anger, irritability, anxiety, or disorientation
• walking problems or other balance problems (ataxia, gait disturbances, balance disorders)
• slow speech (dysarthria)
• blurred vision or double vision (diplopia)
• peripheral vertigo
• nausea
• back pain
• feeling very tired
• falls

Uncommon (affecting up to 1 in 100 people) side effects:

• thoughts of self-harm or suicide, attempted suicide
• hallucinations (seeing, hearing, or feeling things that are not there)
• abnormal thinking and (or) loss of contact with reality (psychotic disorders)

Frequency not known (cannot be estimated from the available data) side effects:

• Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), a severe skin reaction that can be life-threatening.
• Stevens-Johnson syndrome (SJS), a severe skin reaction that can be life-threatening.

If the patient experiences any of these symptoms, they should stop taking perampanel and consult their doctor or seek medical attention. See also section 2.

Reporting side effects

If the patient experiences any side effects, including any not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Drug Safety, Ministry of Health, see contact details below.

5. How to store Fypalan

The medicine should be kept out of the sight and reach of children.

Do not use this medicine after the expiry date stated on the blister and carton after "EXP". The expiry date refers to the last day of the month stated.

There are no special precautions for storage.

Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines they no longer use. This will help protect the environment.

6. Contents of the packaging and other information

What Fypalan contains

The active substance is perampanel.

Fypalan 2 mg coated tablets: Each coated tablet contains 2 mg of perampanel.

Fypalan 4 mg coated tablets: Each coated tablet contains 4 mg of perampanel.

Fypalan 6 mg coated tablets: Each coated tablet contains 6 mg of perampanel.

Fypalan 8 mg coated tablets: Each coated tablet contains 8 mg of perampanel.

Fypalan 10 mg coated tablets: Each coated tablet contains 10 mg of perampanel.

Fypalan 12 mg coated tablets: Each coated tablet contains 12 mg of perampanel.

Other ingredients are:

Tablet core: lactose monohydrate, hydroxypropylcellulose, povidone K30, microcrystalline cellulose, magnesium stearate

Coating: 2 mg, 6 mg, 8 mg, 10 mg, 12 mg tablets: polyvinyl alcohol, partially hydrolyzed, talc, macrogol 3350, titanium dioxide (E171)

4 mg tablets: polyvinyl alcohol, partially hydrolyzed, talc, macrogol 3350

Additionally:

2 mg tablet: iron oxide, yellow (E172); iron oxide, red (E172)

4 mg tablet: iron oxide, red (E172)

6 mg tablet: iron oxide, yellow (E172); iron oxide, red (E172)

8 mg tablet: iron oxide, black (E172); iron oxide, red (E172)

10 mg tablet: iron oxide, yellow (E172); iron oxide, black (E172)

12 mg tablet: iron oxide, black (E172); iron oxide, red (E172)

What Fypalan looks like and contents of the pack

Coated tablet

2 mg: yellow, round, biconvex coated tablets

4 mg: red, round, biconvex coated tablets

6 mg: orange, round, biconvex coated tablets

8 mg: pink, round, biconvex coated tablets

10 mg: green, round, biconvex coated tablets

12 mg: gray to purple, round, biconvex coated tablets

Fypalan is available in packs of 7, 10, 28, 30, 98, and 100 coated tablets.

Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

G.L. Pharma GmbH, Schlossplatz 1, 8502 Lannach, Austria

For more information about this medicine, please contact the marketing authorization holder:

G.L. PHARMA POLAND Sp. z o.o., Al. Jana Pawła II 61/313, 01-031 Warsaw, Poland, Tel: 022/ 636 52 23; 636 53 02, biuro@gl-pharma.pl

Date of last revision of the leaflet: