RISPERIDONE VIATRIS 1 mg FILM-COATED TABLETS

2. What you need to know before you take Risperidone Viatris

Do not take Risperidone Viatris

• If you are allergic to risperidone or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Consult your doctor or pharmacist before taking Risperidone Viatris:

• If you are taking furosemide (a ‘diuretic’ used to reduce swelling and fluid retention caused by various medical problems, including heart or liver disease).
• If you have any heart disease. For example, if you have a weakness in the heart muscle (heart failure), have had a heart attack, if you are prone to low blood pressure, or if you are taking medications for blood pressure. Risperidone may cause low blood pressure, and it may be necessary to adjust your dose.
• If you or a family member have a history of irregular heart rhythm, as this medicine has been associated with potentially serious changes in heart rhythm.
• If you have any factors that may increase the risk of a blood clot, such as high blood pressure, cardiovascular disorders, or problems with the blood vessels in the brain.
• If you have any factors that may increase the risk of a blood clot, such as smoking, or have smoked, or if you are likely to be immobile for a long period (for example, after surgery or illness).
• If you or a family member have a history of blood clots, as these medications have been associated with the formation of blood clots.
• If you have, or have had, low levels of white blood cells in the blood, especially if these have occurred when taking other medications.
• If you have ever experienced involuntary movements of the tongue, mouth, and face.
• If you have ever had a disease with the following symptoms: fever, muscle stiffness, sweating, or decreased level of consciousness (also known as Neuroleptic Malignant Syndrome).
• If you have Parkinson's disease (a brain disease that affects movement, such as tremors, rigidity, slow movements, and difficulty walking) or dementia (a general decline in all areas of mental ability, such as memory loss and other mental abilities), especially dementia with Lewy bodies (abnormal protein deposits that develop within nerve cells in Parkinson's disease).
• If you are diabetic or at risk of developing diabetes (you may have high blood sugar levels).
• If you have epilepsy.
• If you are a man and have ever had a prolonged or painful erection.
• If you have problems controlling your body temperature, are prone to excessive heat, or are, or may be, exposed to high temperatures or engage in extreme exercise.
• If you are, or become, dehydrated or have low blood volume (hypovolemia) during treatment.
• If you have low levels of potassium or magnesium in the blood.
• If you have kidney problems.
• If you have liver problems.
• If you have an abnormally high level of the hormone prolactin in the blood or if you have a tumor that may be dependent on prolactin.

If you are not sure if any of these apply to you, consult your doctor or pharmacist before taking risperidone.

During treatment

Risperidone may cause changes in the number of white blood cells, which help fight infections. Therefore, before and after treatment, your doctor may perform blood tests.

Risperidone may cause weight gain. Significant weight gain can negatively affect your health. Your doctor should regularly measure your body weight.

As diabetes or worsening of pre-existing diabetes has been seen in patients taking risperidone, your doctor should check if you have sugar in your blood. Patients with pre-existing diabetes should regularly check their blood sugar levels.

Risperidone often increases the levels of a hormone called prolactin. This can cause side effects such as menstrual disorders or fertility problems in women or breast swelling in men (see Possible side effects). If these side effects occur, it is recommended to evaluate the levels of prolactin in the blood.

If you are going to undergo eye surgery, inform your doctor or hospital staff that you are taking this medicine. During cataract surgery (a clouding of the lens in the eye), this medicine may affect the pupil or iris (the colored part of the eye), which could cause eye damage.

Elderly patients with dementia

In elderly patients with dementia, there is an increased risk of stroke or mini-stroke (also known as transient ischemic attack or TIA). You should not take risperidone if you have dementia caused by a stroke.

During treatment with risperidone, you should visit your doctor frequently.

You should seek immediate medical attention if you or your caregiver notice a sudden change in your mental state, sudden weakness, numbness in the face, arms, or legs, especially if it is on one side, vision problems, or difficulty speaking, even if it is only for a short period. These can be signs of a stroke.

Children and adolescents

Before starting treatment for conduct disorder, other possible causes for aggressive behavior should be ruled out.

Before starting treatment, your weight or your child's weight may be measured and may be monitored regularly during treatment.

If fatigue occurs during treatment, changing the time of administration may improve attention difficulties.

A small, inconclusive study has reported an increase in height in children who took risperidone, but it is not known if this is a drug effect or due to another reason.

Taking Risperidone Viatris with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including those obtained without a prescription and herbal medicines.

It is especially important to tell your doctor or pharmacist if you are taking any of the following medicines:

• Medicines that act on your brain to help you calm down (benzodiazepines) or some pain medications (opioids), allergy medications (some antihistamines), as risperidone may increase the sedative effect of all these.
• Medicines that can change the electrical activity of your heart, such as those used for malaria (quinine, mefloquine), heart rhythm problems (such as quinidine, disopyramide, procainamide, propafenone, amiodarone, sotalol), allergies (antihistamines), some antidepressants (such as paroxetine, fluoxetine, sertraline, fluvoxamine, tricyclic antidepressants (such as amitriptyline), tetracyclic antidepressants (such as maprotiline) or other medications for mental health conditions (such as paliperidone or phenothiazines, used to treat psychosis or to calm down).
• Medicines that can cause a decrease in heart rate, such as beta-blockers or verapamil (used to treat high blood pressure or angina).
• Medicines that can cause a decrease in potassium or magnesium levels in the blood (for example, certain diuretics).
• Medicines for high blood pressure. Risperidone may cause a decrease in blood pressure.
• Medicines for Parkinson's disease (such as levodopa).
• Medicines that increase the activity of the central nervous system (psychostimulants, such as methylphenidate).
• Tablets for fluid retention (diuretics) used to treat heart problems or swelling of some parts of your body due to fluid accumulation (such as furosemide or chlorothiazide). Risperidone taken alone or in combination with furosemide may increase the risk of stroke or death in elderly patients with dementia.

The following medicines reduce the effect of risperidone:

• Rifampicin (a medicine used to treat some infections).
• Carbamazepine, phenytoin (medicines for epilepsy).
• Phenobarbital.

If you start or stop taking these medicines, you may need a different dose of risperidone.

The following medicines increase the effect of risperidone:

• Cimetidine, ranitidine (stomach acid reducers).
• Itraconazole and ketoconazole (medicines used to treat fungal infections).
• Some medicines used to treat HIV/AIDS, such as ritonavir.

If you start or stop taking these medicines, you may need a different dose of risperidone.

If you are not sure if any of these apply to you, consult your doctor or pharmacist before taking risperidone.

Taking Risperidone Viatris with food, drinks, and alcohol

You should avoid drinking alcoholic beverages during treatment with risperidone.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Your doctor will decide whether you can take it.

The following symptoms may occur in newborns of mothers who have been taking risperidone in the last trimester (the last three months of pregnancy): tremors, muscle stiffness, agitation, breathing difficulties, and feeding difficulties. If your baby has any of these symptoms, you may need to contact your doctor.

Risperidone may increase the levels of a hormone called “prolactin”, which can affect fertility (see section 4, “Possible side effects”).

Driving and using machines

During treatment with risperidone, dizziness, fatigue, and vision problems may occur. Do not drive or use tools or machines without consulting your doctor first.

Risperidone Viatris contains lactose

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

This medicine contains less than 1 mmol sodium (23 mg) per tablet;it is essentially “sodium-free”.

Risperidone Viatris 2 mg and 6 mgcontainsorange yellow

This medicine may cause allergic reactions because it contains orange yellow (E110). It may cause asthma, especially in patients allergic to acetylsalicylic acid.

3. How to take Risperidone Viatris

Take this medicine exactly as your doctor has told you. If you are not sure, ask your doctor or pharmacist.

Your doctor will tell you how much to take and for how long. This depends on your condition and varies from person to person.

The recommended dose is as follows:

For the treatment of schizophrenia

Adults

• The initial recommended dose is 2 mg per day, which may be increased to 4 mg per day on the second day of treatment.
• Depending on how you respond to treatment, your doctor may adjust your dose.
• Most people feel better with daily doses of 4 to 6 mg.
• The total daily dose can be divided into one or two doses per day. Your doctor will inform you which dose is most convenient for you.

Elderly patients

• The initial recommended dose is usually 0.5 mg twice a day.
• The dose may be gradually increased by your doctor to 1 mg or 2 mg twice a day.
• Your doctor will inform you which dose is most convenient for you.

Use in children and adolescents

• Children and adolescents under 18 years of age should not be treated with risperidone for schizophrenia.

For the treatment of mania

Adults

• The initial recommended dose is usually 2 mg once a day.
• The dose may be gradually adjusted by your doctor depending on how you respond to treatment.
• Most people feel better with doses of 1 to 6 mg once a day.

Elderly patients

• The initial recommended dose is usually 0.5 mg twice a day.

• The dose may be gradually adjusted by your doctor to 1 mg or 2 mg twice a day depending on how you respond to treatment.

Use in children and adolescents

• Children and adolescents under 18 years of age should not be treated with risperidone for mania.

For the treatment of persistent aggression in patients with Alzheimer's dementia

Adults (including elderly patients)

• The initial recommended dose is usually 0.25 mg twice a day.
• The dose may be gradually adjusted by your doctor depending on how you respond to treatment.
• Most people feel better with 0.5 mg twice a day. Some patients require a dose of 1 mg twice a day.
• Treatment in patients with Alzheimer's dementia should not be prolonged for more than 6 weeks.

For the treatment of conduct disorders in children and adolescents

The dose depends on the child's weight:

For children weighing less than 50 kg:

• The initial recommended dose is usually 0.25 mg once a day.
• The dose may be increased every other day to 0.25 mg per day.
• The usual maintenance dose is 0.25 mg to 0.75 mg once a day.

For children weighing 50 kg or more:

• The initial recommended dose is usually 0.5 mg once a day.
• The dose may be increased every other day to 0.5 mg per day.
• The usual maintenance dose is 0.5 mg to 1.5 mg once a day.

The duration of treatment in patients with conduct disorders should not be prolonged for more than 6 weeks.

Children under 5 years of age should not be treated with risperidone for conduct disorders.

Patients with kidney or liver problems

Regardless of why you are taking this medicine, all initial and subsequent doses should be reduced by half. Dose increases should be slower in these patients.

Risperidone should be used with caution in this group of patients.

How to take Risperidone

• Swallow the tablet with plenty of water.
• Risperidone can be taken with or without food.

The tablet can be divided into equal doses.

If you take more Risperidone Viatris than you should

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount taken.

In case of overdose, you may feel drowsy or tired, have abnormal body movements, problems standing or walking, feel dizzy due to low blood pressure, or experience a fast or abnormal heart rate or seizures.

If you forget to take Risperidone Viatris

• If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. If you forget two or more doses, contact your doctor.
• Do not take a double dose (two doses at the same time) to make up for missed doses.

If you stop taking Risperidone Viatris

Do not stop taking this medicine unless your doctor has told you to. It is possible that the symptoms will return. If your doctor decides to stop the treatment, they should gradually decrease the dose over a few days.

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

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

Consult your doctor or go to the emergency department of a hospitalimmediately if:

Frequent (may affect up to 1 in 10 people):

• Develops lung infections, including severe lung infections such as pneumonia - you may have a very high temperature, cough with phlegm that may be bloody or frothy and discomfort.

Uncommon (may affect up to 1 in 100 people):

• Experiences a sudden change in mental state, sudden fatigue or numbness in the face, arms or legs, especially on one side, vision problems, or difficulty speaking, even for a short period. These can be signs of a stroke, mini-stroke (TIA, transient ischemic attack) or decreased blood flow to the brain.
• Experiences an abnormal heart rhythm, such as heart flutter (fibrillation) or very slow or abnormal heartbeat (heart block). This can be caused by abnormal electrical conduction of the heart and can be seen as an abnormal tracing of the heart's electrical activity (ECG). In some cases, it can be potentially fatal.
• Does not respond to stimuli (change in internal or external environment), has a low level of consciousness or becomes unconscious, or suffers from seizures (convulsions).
• Presents rhythmic involuntary movements of the tongue, mouth, and face. Withdrawal of risperidone may be necessary.
• Develops diabetes - a condition where the body is unable to control blood sugar levels properly. You may feel very thirsty, but with high urine output, have an increased appetite despite feeling tired and lethargic. If left untreated, it can cause coma or potentially fatal complications from uncontrolled diabetes.
• Experiences a higher number of infections, such as sore throat, mouth ulcers, etc., which can be caused by a decrease in white blood cells, including those that help protect against bacterial infections.
• Develops a lung infection caused by inhaling food into the airways or has pulmonary congestion (e.g., due to mucus accumulation).
• Presents a skin infection (usually in the fat layers of the thigh and buttocks, cellulitis).
• Has difficulty urinating or incomplete emptying of the bladder.
• Has severe constipation, which can be due to intestinal obstruction or severe hardening or compaction of feces.

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

• Presents a severe rash, itching, or hives on the skin, swelling of the face, lips, tongue, or throat, shortness of breath, difficulty breathing, dizziness, and shock. These can be signs of a severe allergic reaction or angioedema.
• Presents blood clots in the veins, especially in the legs (symptoms include swelling, pain, and redness of the leg), which can travel through the blood vessels to the lungs, causing chest pain and difficulty breathing. If you experience any of these symptoms, seek medical attention immediately.
• Presents fever, muscle stiffness, sweating, or decreased level of consciousness (a disorder called "neuroleptic malignant syndrome"). Immediate medical treatment may be necessary.
• If you experience a prolonged or painful erection. This is called priapism. Immediate medical treatment may be necessary.
• Presents severe stomach pain that reaches the back. This can be a symptom of pancreatitis.
• Develops increased eye pressure (glaucoma), which can cause vision problems and, in the long term, serious vision problems.
• Has low sodium levels in the blood, which can cause weakness and confusion with muscle pain. This can be due to inappropriate secretion of the hormone (ADH) that causes water retention in the body and dilutes the blood, reducing the amount of sodium. This can be associated with excessively high water intake (more than 2 liters of water per day).
• Suffers from severe fatigue or muscle pain, which can be due to muscle tissue breakdown (rhabdomyolysis).

Very Rare (may affect up to 1 in 10,000 people):

• Suffers from loss of appetite, unexplained weight loss, nausea, vomiting, stomach pain, difficulty breathing, slow heart rate, unusual muscle pain, or feeling weak, tired, or uncomfortable. These can be signs of a rare, potentially fatal complication of uncontrolled diabetes called diabetic ketoacidosis.

Consult your doctor immediately if you experience any of the adverse effects described above.

The following adverse effects may also occur:

Very Common (may affect more than 1 in 10 people):

• Parkinsonism. A medical term that includes many symptoms. Each individual symptom may occur with less frequency than in 1 in 10 people. Parkinsonism includes: increased salivation or water in the mouth, musculoskeletal stiffness, drooling, jerking when bending joints, slow body movements, reduced or problematic movements, facial expressionlessness, muscle tightness, stiff neck, muscle stiffness, small, rapid steps, dragging feet, lack of habitual arm movement when walking, persistent blinking in response to slaps on the forehead (an abnormal reflex).
• Headaches, difficulty falling asleep or staying asleep.
• Somnolence, sleep.

Common (may affect up to 1 in 10 people):

• Fatigue, unusual weakness (asthenia), feeling of tiredness, somnolence, or lack of energy (lethargy), restlessness, inability to remain seated, anxiety, depression, agitation, dizziness, feeling of tiredness, sleep disorders.
• Vomiting, diarrhea, constipation, nausea, acidity or indigestion, stomach pain or discomfort, sore throat, dry mouth, toothache.
• Weight gain, increased body temperature (high fever), increased appetite, loss of appetite.
• Shortness of breath, flu, blurred vision, eye infection or allergic reaction that can produce a sticky discharge, sinus infection, nasal or sinus congestion, nosebleeds, cough.
• Urinary tract infection, bedwetting, inability to control urine (incontinence), inability to control when to urinate.
• Tremor, muscle spasms, involuntary movements of the face, arms, or legs, repetitive movements or abnormal postures associated with muscle contractions, joint and muscle pain, back pain.
• Fluid retention (e.g., swelling of arms and legs), pain in the limbs.
• Rashes, redness of the skin, ear infections.
• Rapid heart rate, chest pain, high blood pressure.
• Falls.
• Increased prolactin hormone levels in the blood.

Uncommon (may affect up to 1 in 100 people):

• Excessive water consumption, thirst, fecal incontinence, gas, hoarse voice, and voice disorders.
• High blood sugar.
• Bladder infection, viral infection, and other infections, tonsil infection, stomach infection, fungal infection of the nails.
• Drop in blood pressure when standing up, low blood pressure, dizziness when changing posture, awareness of heartbeat, decreased heart rate.
• Pain when urinating, increased frequency of urination.
• Confusion, attention disorder, excessive sleepiness, nightmares, nervousness, euphoria (mania).
• Increased liver enzymes, low hemoglobin or red blood cell count (anemia), increased eosinophils (a type of white blood cell), increased creatine phosphokinase in the blood, decreased platelet count (blood cells that stop bleeding), increased cholesterol in the blood.
• Muscle weakness, excessive agitation associated with muscle spasms and tremors, ear pain, neck pain, joint inflammation, abnormal postures, joint stiffness, chest discomfort.
• Skin lesions, skin disorders, dry skin, intense itching of the skin, acne, hair loss, eczema (skin inflammation) that can be caused by mites, skin discoloration, increased skin thickness, flushing, sensations like pins and needles, decreased skin sensitivity to touch or pain, inflammation of fatty skin.
• Amenorrhea, sexual dysfunction, erectile dysfunction, ejaculation disorders, breast secretion, breast enlargement in men, breast pain or discomfort, decreased libido, irregular or delayed menstruation, vaginal discharge.
• Fainting, gait disorders (way of walking), slowness, weight loss, decreased appetite leading to malnutrition and weight loss, feeling depressed, balance disorders, allergy, chills, abnormal coordination, altered taste.
• Painful sensitivity to light, increased ocular blood flow, dry eyes, increased tearing.
• Crepitus in the lungs, speech problems, difficulty swallowing, harsh or whistling sounds when breathing.
• Tinnitus, sensation of spinning and dizziness (vertigo), facial edema.

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

• Unable to reach orgasm, breast enlargement or inflammation, heat, sensitive breasts.
• Dandruff.
• Coldness in the limbs, swelling of the tongue, inflammation of the lips, hardening of some parts of the body, such as the skin.
• Absence of movement or response while awake (catatonia).
• Sleepwalking.
• Sleep-related eating disorder.
• Crusts on the eyelids, eye rolls, problems with eye movement, complications during cataract surgery.
• Absence of emotion.
• Withdrawal syndrome.
• Decrease in body temperature.
• Rapid and shallow breathing, problems breathing while asleep, sinus arrhythmia (a normal variation in heart rate caused by breathing).
• Head tremor.
• Yellowing of the skin and eyes (jaundice).
• Sugar (glucose) in the urine, decreased blood sugar, increased triglycerides in the blood (a type of fat).

There have also been reports of decreased blood pressure when standing up with medications like risperidone, which is associated with a very high increase in heart rate.

Other Adverse Effects in Children and Adolescents

In general, it is expected that adverse effects in children will be similar to those that occurred in adults.

The following adverse effects were reported more frequently in children and adolescents (5 to 17 years) than in adults: feeling drowsy or less attentive, fatigue (tiredness), headache, increased appetite, vomiting, common cold symptoms, nasal congestion, abdominal pain, dizziness, cough, fever, tremor (shaking), diarrhea, and urinary incontinence (loss of control).

Reporting of Adverse Effects:

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that does not appear in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Risperidone Viatris

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

Do not use this medicine after the expiration date that appears on the blister pack and on the container after CAD. The expiration date is the last day of the month indicated.

Blister pack and bottle: Store below 30°C.

Once the bottle is opened, consume within the next 180 days.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines you no longer need in the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

Composition of Risperidone Viatris

The active ingredient is risperidone. Each film-coated tablet contains 1 mg of risperidone.

The other ingredients are:

Tablet core:Lactose monohydrate, pregelatinized cornstarch, microcrystalline cellulose (E-460), magnesium stearate, anhydrous colloidal silica, sodium lauryl sulfate.

Coating:Hypromellose (E-464), propylene glycol (E-490), titanium dioxide (E-171), talc (E-553B).

Appearance and Package Contents

White, round, biconvex, film-coated tablet, marked with a "1" on one side and a score line on the other side.

Package Sizes

Blister packs containing 20, 28, 30, 50, 56, 60, or 100 film-coated tablets.

Perforated unit-dose blister packs containing (28 × 1), (30 × 1), (56 × 1), (60 × 1), or (100 × 1) film-coated tablets.

Bottles containing 60, 100, or 250 film-coated tablets.

Not all package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Viatris Limited

Damastown Industrial Park

Mulhuddart, Dublin 15

Dublin

Ireland

Manufacturer

McDermott Laboratories Limited t/a Gerard Laboratories

35/36 Baldoyle Industrial Estate,

Grange Road, Dublin 13.

Ireland

or

Mylan Hungary Kft.

Mylan utca 1

H-2900 Komárom

Hungary

or

Mylan Dublin

Newenham Court

Northern Cross

Malahide Road

Dublin 17

Ireland

or

Logiters, Logistica Portugal, S.A.

Estrada dos Arneiros, 4

Azambuja, 2050-306

Portugal

or

Mylan Germany GmbH

Zweigniederlassung Bad Homburg Benzstrasse 1,

61352 Bad Homburg v. d. Höhe,

Germany

You can request more information about this medicine by contacting the local representative of the marketing authorization holder:

Viatris Pharmaceuticals, S.L.U.

C/ General Aranaz, 86

28027 - Madrid

Spain

This medicine is authorized in the Member States of the European Economic Area under the following names:

Germany: Risperidon Mylan 1 mg filmtabletten

Denmark: Rispemyl 1 mg filmovertrukne tabletter

Spain: Risperidona Viatris 1 mg comprimidos recubiertos con película EFG

Finland: Rismyl 1 mg kalvopäällysteiset tabletit

France: Risperidone Mylan Pharma 1 mg comprimé pelliculé sécable

Italy: Risperidone Mylan Pharma

Netherlands: Risperidon Mylan 1 mg filmomhulde tabletten

Portugal: Risperidona Mylan 1 mg comprimido revestido por película

Sweden: Rispemyl 1 mg filmdragerade tabletter

Date of the last revision of this leaflet:July 2019

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