Sortis 40

Leaflet accompanying the packaging: information for the user

Warning! Keep the leaflet! Information on the immediate packaging in a foreign language.

Sortis 40, 40 mg, film-coated tablets

Atorvastatin

You should carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

• You should keep this leaflet, so that you can read it again if you need to.
• If you have any further questions, you should ask your doctor, pharmacist, or nurse.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If you experience any side effects, including any not listed in this leaflet, you should tell your doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet

• 1. What is Sortis 40 and what is it used for
• 2. Important information before taking Sortis 40
• 3. How to take Sortis 40
• 4. Possible side effects
• 5. How to store Sortis 40
• 6. Contents of the packaging and other information

1. What is Sortis 40 and what is it used for

Sortis 40 belongs to a group of medicines called statins, which regulate lipid metabolism in the body.
Sortis 40 is used to reduce the levels of lipids such as cholesterol and triglycerides in the blood when a low-fat diet and changes in lifestyle are not effective on their own. Sortis 40 can also be used to reduce the risk of heart disease, even if your cholesterol levels are normal. During treatment, you should continue to follow a standard low-cholesterol diet.

2. Important information before taking Sortis 40

When not to take Sortis 40:

• if you are allergic to atorvastatin or any of the other ingredients of this medicine (listed in section 6),
• if you have or have had liver disease,
• if you have had unexplained, abnormal liver function tests,
• in women of childbearing age who are not using effective methods of contraception,
• in pregnant or breast-feeding women,
• if you are taking glecaprevir with pibrentasvir for the treatment of hepatitis C virus infection.

Warnings and precautions

Before starting treatment with Sortis 40, you should discuss this with your doctor, pharmacist, or nurse:

• if you have severe respiratory failure,
• if you are taking or have taken fusidic acid (an antibiotic) orally or by injection in the last 7 days. Taking fusidic acid with Sortis 40 may cause serious muscle problems (rhabdomyolysis),
• if you have had a stroke with bleeding in the brain, or if there is a small amount of fluid in the brain from a previous stroke,
• if you have kidney problems,
• if you have hypothyroidism (underactive thyroid),
• if you have had repeated or unexplained muscle pain, or muscle problems in the past, or similar problems in relatives,
• if you have had muscle problems while taking other lipid-lowering medicines (e.g. other statins or fibrates) in the past,
• if you regularly drink large amounts of alcohol,
• if you have had liver disease in the past,
• if you are over 70 years old,
• if you have or have had myasthenia (a disease that causes general muscle weakness, including in some cases muscles involved in breathing) or myasthenic syndrome (a disease that causes muscle weakness in the eyes), as statins can sometimes worsen the symptoms of the disease or cause myasthenia (see section 4).

Your doctor will order a blood test before starting treatment with Sortis 40 and, if possible, during treatment to monitor the risk of muscle-related side effects. It is known that the risk of muscle-related side effects, such as rhabdomyolysis, is higher when certain medicines are taken at the same time (see section 2 "Sortis 40 and other medicines").
Your doctor or pharmacist should also be informed if muscle weakness persists. To diagnose and treat this condition, additional tests and medications may be necessary.
During treatment with Sortis 40, your doctor will closely monitor you for the development of diabetes or the risk of developing diabetes. Patients with high blood sugar and lipid levels, patients who are overweight, and patients with high blood pressure may be at risk of developing diabetes.

Sortis 40 and other medicines

You should tell your doctor or pharmacist about all medicines you are taking or have recently taken, as well as any medicines you plan to take. Some medicines may change the effect of Sortis 40 or the effect of these medicines may be changed by Sortis 40.
This type of interaction can cause reduced efficacy of one or both medicines. At the same time, it can increase the risk of serious side effects, including severe muscle damage known as rhabdomyolysis, described in section 4:

• immunosuppressants, such as cyclosporine,
• certain antibiotics or antifungal medicines, such as erythromycin, clarithromycin, telithromycin, ketoconazole, itraconazole, voriconazole, fluconazole, posaconazole, rifampicin, fusidic acid,
• other lipid-lowering medicines, such as gemfibrozil, other fibrates, colestyramine,
• certain calcium channel blockers used for angina or high blood pressure, such as amlodipine, diltiazem; as well as medicines that regulate heart rhythm, such as digoxin, verapamil, amiodarone,
• letermovir, a medicine used to prevent cytomegalovirus disease,
• medicines used to treat HIV infection, such as ritonavir, lopinavir, atazanavir, indinavir, darunavir, tipranavir in combination with ritonavir, etc.,
• certain medicines used to treat hepatitis C virus infection, such as telaprevir, boceprevir, and a combination product containing elbasvir with grazoprevir, ledipasvir with sofosbuvir
• other medicines that are known to interact with Sortis 40, such as ezetimibe (which lowers cholesterol), warfarin (which reduces blood clotting), oral contraceptives, stiripentol (an antiepileptic medicine), cimetidine (used to treat heartburn and stomach ulcers), phenazon (a pain reliever), colchicine (a medicine used to treat gout), and antacids (medicines used for indigestion, containing aluminum or magnesium),
• over-the-counter medicines: St. John's Wort,
• if you need to take fusidic acid orally to treat a bacterial infection, you should temporarily stop taking this medicine. Your doctor will tell you when you can safely restart treatment with Sortis 40. Taking Sortis 40 with fusidic acid can rarely cause muscle weakness, tenderness, or pain (rhabdomyolysis). More information about rhabdomyolysis can be found in section 4.

Sortis 40 with food, drink, and alcohol

Information on the use of Sortis 40 can be found in section 3. However, you should pay attention to the following information:
Grapefruit juice
You should not drink more than one or two small glasses of grapefruit juice per day, as larger amounts of grapefruit juice can change the effect of Sortis 40.
Alcohol
While taking this medicine, you should avoid drinking excessive amounts of alcohol.
More detailed information on this can be found in section 2 "Warnings and precautions".

Pregnancy and breast-feeding

Taking Sortis 40 during pregnancy or when planning to become pregnant is contraindicated.
Taking Sortis 40 in women of childbearing age is contraindicated if they do not use effective methods of contraception.
Taking Sortis 40 during breast-feeding is contraindicated.
The safety of using Sortis 40 during pregnancy and breast-feeding has not been established.
Before taking any medicine, you should consult your doctor or pharmacist.

Driving and using machines

Normally, the medicine does not affect the ability to drive or use machines. However, you should not drive if the medicine affects your ability to do so. You should not use any tools or machines if taking the medicine affects your ability to use them.

Sortis 40 contains lactose monohydrate

Patients who have been informed by their doctor about intolerance to some sugars should contact their doctor before taking this medicine.

Sortis 40 contains sodium

This medicine contains less than 1 mmol (23 mg) of sodium per tablet, which means it is considered "sodium-free".

Sortis 40 contains benzoic acid (E 210)

This medicine contains 0.00016 mg of benzoic acid per tablet.

3. How to take Sortis 40

Before starting treatment, your doctor will recommend a low-cholesterol diet; this diet should be continued during treatment with Sortis 40.
Sortis 10 (10 mg), Sortis 20 (20 mg), Sortis 40 (40 mg), and Sortis 80 (80 mg) are available.
The usual starting dose of Sortis for adults and children over 10 years old is 10 mg once daily. This dose may be increased by your doctor if necessary, up to a dose suitable for you. Your doctor will adjust the dose of Sortis at intervals of at least 4 weeks. The maximum dose of Sortis is 80 mg once daily.
Sortis 40 tablets should be swallowed whole, with water; they can be taken at any time of day, with or without food. However, you should try to take the tablet at the same time every day.
This medicine should always be taken as directed by your doctor or pharmacist. If you are unsure, you should ask your doctor or pharmacist.

The duration of treatment with Sortis 40 is determined by your doctor.

If you feel that the effect of Sortis 40 is too strong or too weak, you should consult your doctor.

Taking a higher dose of Sortis 40 than recommended

If you accidentally take too many Sortis 40 tablets (more than the usual daily dose), you should contact your doctor or the nearest hospital for advice.

Missing a dose of Sortis 40

If you forget to take a dose, you should simply take the next dose at the scheduled time. You should not take a double dose to make up for a missed dose.

Stopping treatment with Sortis 40

If you have any further questions about taking this medicine, you should ask your doctor or pharmacist.

4. Possible side effects

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

If you experience any of the following serious side effects or symptoms, you should stop taking the medicine and contact your doctor or go to the emergency department of the nearest hospital immediately.

Rare: may occur in up to 1 in 1,000 people

• Severe allergic reaction causing swelling of the face, tongue, and throat, which can cause severe breathing difficulties.
• Severe skin disease characterized by peeling and swelling of the skin, blisters on the skin, mouth, eyes, genitals, and fever. Skin rash with pink-red spots, especially on the hands or feet, with possible blisters.
• Muscle weakness, tenderness, or pain, or muscle rupture, or reddish-brown urine. If you also feel unwell or have a high fever, this may be caused by muscle breakdown (rhabdomyolysis). Muscle breakdown does not always go away, even if you stop taking atorvastatin, and it can be life-threatening and cause kidney problems.

Very rare: may occur in up to 1 in 10,000 people

• If you experience unexpected or unusual bleeding or bruising, this may indicate liver problems. You should consult your doctor as soon as possible.
• Systemic lupus erythematosus (including rash, joint disorders, and effects on blood cells).

Other possible side effects of Sortis 40:

Common: may occur in up to 1 in 10 people

• nasal congestion, sore throat, nosebleeds,
• allergic reactions,
• increased blood glucose levels (in diabetic patients, blood glucose levels should continue to be closely monitored), increased blood creatine kinase levels,
• headaches,
• nausea, constipation, bloating, indigestion, diarrhea,
• joint pain, muscle pain, and back pain,
• blood test results indicating abnormal liver function.

Uncommon: may occur in up to 1 in 100 people

• loss of appetite, weight gain, decreased blood glucose levels (in diabetic patients, blood glucose levels should continue to be closely monitored),
• nightmares, insomnia,
• dizziness, numbness or tingling in the fingers of the hands and feet, decreased sensitivity to pain and touch, changes in taste, memory loss,
• blurred vision,
• ringing in the ears and (or) in the head,
• vomiting, belching, upper and lower abdominal pain, pancreatitis (causing abdominal pain),
• hepatitis,
• skin rash, skin rash, and itching, hives, hair loss,
• neck pain, muscle fatigue,
• fatigue, malaise, weakness, chest pain, swelling, especially of the ankles, elevated temperature,
• presence of white blood cells in the urine.

Rare: may occur in up to 1 in 1,000 people

• vision disorders,
• unexpected bleeding or bruising (bruises),
• cholestasis (yellowing of the skin and whites of the eyes),
• tendon rupture.

Very rare: may occur in up to 1 in 10,000 people

• allergic reactions - symptoms may include sudden wheezing and chest pain or tightness, swelling of the eyelids, face, lips, mouth, tongue, or throat, difficulty breathing, collapse,
• hearing loss,
• gynecomastia (excessive breast tissue growth in men).

Frequency not known: cannot be estimated from the available data

• persistent muscle weakness,
• Myasthenia (a disease that causes general muscle weakness, including in some cases muscles involved in breathing). Myasthenic syndrome (a disease that causes muscle weakness in the eyes). You should talk to your doctor if you experience muscle weakness in your arms or legs, worsening after periods of activity, double vision, or drooping eyelids, difficulty swallowing, or shortness of breath.

Other possible side effects reported during treatment with some statins (medicines of the same type):

• sexual disorders,
• depression,
• breathing problems, including persistent cough and (or) shortness of breath or fever,
• diabetes; the likelihood of developing this disease is higher in patients with high blood sugar and lipid levels, patients who are overweight, and patients with high blood pressure. During treatment with this medicine, your doctor will perform the necessary tests.

Reporting side effects

If you experience any side effects, including any not listed in this leaflet, you should tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Drug Safety, Urząd Rejestracji Produktów Leczniczych, Wyrobów Medycznych i Produktów Biobójczych (Office for Registration of Medicinal Products, Medical Devices, and Biocides)
Al. Jerozolimskie 181C
02-222 Warsaw
tel.: +48 22 49 21 301
fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Sortis 40

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the month.
There are no special precautions for storage.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What Sortis 40 contains

• The active substance of the medicine is atorvastatin. Each film-coated tablet contains 40 mg of atorvastatin (as atorvastatin calcium trihydrate).
• The other ingredients are: calcium carbonate, microcrystalline cellulose, lactose monohydrate, sodium croscarmellose, polysorbate 80, hydroxypropylcellulose, and magnesium stearate.

The coating of Sortis 40 contains: hypromellose, macrogol 8000, titanium dioxide (E 171), talc, simethicone emulsion containing simethicone, emulsifying agents (polysorbate 65, macrogol 400 stearate, glycerol monostearate 40-55), thickening agents (methylcellulose, xanthan gum), benzoic acid (E 210), sorbic acid, and sulfuric acid.

What Sortis 40 looks like and what the packaging contains

White, round, film-coated tablets with a diameter of 9.5 mm, with the inscription "40" on one side and "ATV" on the other side.
Sortis 40 is available in blisters of polyamide/Al/PVC-Al/vinyl in a cardboard box.
The packaging contains 30 film-coated tablets.
For more detailed information, you should contact the marketing authorization holder or the parallel importer.

Marketing authorization holder in Latvia, the country of export:

Upjohn EESV
Rivium Westlaan 142
2909 LD Capelle aan den IJssel
Netherlands

Manufacturer:

Pfizer Manufacturing Deutschland GmbH
Betriebsstätte Freiburg
Mooswaldallee 1
79090 Freiburg
Germany
Mylan Hungary Kft.
Mylan utca 1
Komárom, 2900
Hungary

Parallel importer:

InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw

Repackaged by:

InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing authorization number in Latvia, the country of export:98-0600

Parallel import authorization number: 208/23

Date of leaflet approval: 11.06.2024

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