RIVAROXABAN 10 mg Film-Coated Tablets

Contents of the leaflet

1. Introduction
2. What is Rivaroxaban Cipla and what is it used for
3. What you need to know before taking Rivaroxaban Cipla
4. How to take Rivaroxaban Cipla
5. Possible side effects
6. Storage of Rivaroxaban Cipla
7. Package contents and additional information

Introduction

Package Leaflet: Information for the Patient

Rivaroxaban Cipla 10 mg film-coated tablets EFG

Read the entire package leaflet carefully before starting to take this medication, as it contains important information for you.

• Keep this package leaflet, as you may need to read it again.
• If you have any questions, consult your doctor or pharmacist.
• This medication has been prescribed to you only, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
• If you experience side effects, consult your doctor or pharmacist, even if they are side effects not listed in this package leaflet. See section 4.

Contents of the Package Leaflet

1. What is Rivaroxaban Cipla and what is it used for
2. What you need to know before taking Rivaroxaban Cipla
3. How to take Rivaroxaban Cipla
4. Possible side effects
5. Storage of Rivaroxaban Cipla
6. Contents of the pack and further information

1. What is Rivaroxaban Cipla and what is it used for

This medication contains the active substance rivaroxaban and is used in adults to:

• prevent the formation of blood clots in the veins after hip or knee replacement surgery. Your doctor has prescribed this medication because after surgery you have a higher risk of developing blood clots.
• treat blood clots in the veins of the legs (deep vein thrombosis) and in the blood vessels of the lungs (pulmonary embolism), and to prevent these blood clots from occurring again in the blood vessels of the legs and/or lungs.

This medication belongs to a group of medications called antithrombotic agents. It works by blocking a clotting factor (factor Xa) and thus reducing the tendency of blood to form clots.

2. What you need to know before taking Rivaroxaban Cipla

Do not take Rivaroxaban Cipla

• if you are allergic to rivaroxaban or any of the other ingredients of this medication (listed in section 6).
• if you have excessive bleeding.
• if you have a disease or problem in an organ of the body that increases the risk of severe bleeding (e.g., stomach ulcer, injury or bleeding in the brain, or recent brain or eye surgery).
• if you are taking medications to prevent blood clotting (e.g., warfarin, dabigatran, apixaban, or heparin), except when switching from one anticoagulant treatment to another or while receiving heparin through a venous or arterial catheter to prevent it from becoming blocked.
• if you have a liver disease that increases the risk of bleeding.
• if you are pregnant or breastfeeding.

Do not take rivaroxaban and inform your doctorif any of these circumstances apply to you.

Warnings and precautions

Consult your doctor or pharmacist before starting to take this medication.

Be careful with rivaroxaban

• if you have an increased risk of bleeding, as may occur in the following situations:
• • moderate or severe kidney failure, as kidney function may affect the amount of medication that works in your body.
  • if you are taking other medications to prevent blood clotting (e.g., warfarin, dabigatran, apixaban, or heparin) when switching to another anticoagulant treatment or while receiving heparin through a venous or arterial catheter to prevent it from becoming blocked (see section "Other medications and Rivaroxaban Cipla").
  • bleeding disorder.
  • very high blood pressure, not controlled by medical treatment.
  • stomach or intestinal diseases that may cause bleeding, such as inflammation of the stomach or intestine, inflammation of the esophagus (throat), e.g., due to gastroesophageal reflux disease (a disease in which stomach acid rises up into the esophagus), or tumors located in the stomach, intestines, genital tract, or urinary tract.
  • a problem in the blood vessels of the back of the eyes (retinopathy).
  • a lung disease in which the bronchi are dilated and filled with pus (bronchiectasis) or previous lung bleeding.
• if you have a heart valve prosthesis.
• if you know you have a disease called antiphospholipid syndrome (an immune system disorder that increases the risk of blood clots), inform your doctor so that they can decide whether it may be necessary to modify the treatment.
• if your doctor determines that your blood pressure is unstable or you are scheduled to receive another treatment or undergo surgery to remove a blood clot from your lungs.

Inform your doctor if you have any of these situationsbefore taking this medication. Your doctor will decide whether you should be treated with this medication and whether you should be kept under closer observation.

If you need surgery

• It is very important to take this medication before and after surgery, exactly at the times indicated by your doctor.
• If your operation requires the placement of a catheter or injection into the spinal column (e.g., for epidural or spinal anesthesia, or pain relief):
• • It is very important to take this medication exactly at the times indicated by your doctor.
  • Inform your doctor immediately if you experience numbness or weakness in your legs or problems with your intestines or bladder after anesthesia, as urgent attention is necessary.

Children and adolescents

This medication is not recommended for children under 18 years of age.There is not enough information about its use in children and adolescents.

Other medications and Rivaroxaban Cipla

Inform your doctor or pharmacist if you are using, have recently used, or may need to use any other medication, including those obtained without a prescription.

• If you are taking
• • any medication for a fungal infection (e.g., fluconazole, itraconazole, voriconazole, posaconazole), unless it is only applied to the skin.
  • ketoconazole tablets (used to treat Cushing's syndrome, in which the body produces excess cortisol).
  • any medication for bacterial infections (e.g., clarithromycin, erythromycin).
  • any antiviral medication for HIV/AIDS (e.g., ritonavir).
  • other medications to reduce blood clotting (e.g., enoxaparin, clopidogrel, or vitamin K antagonists, such as warfarin or acenocoumarol).
  • anti-inflammatory medications or pain relievers (e.g., naproxen or acetylsalicylic acid).
  • dronedarone, a medication for the treatment of irregular heartbeat
  • certain medications for the treatment of depression (selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs)).

If any of the above circumstances apply to you, inform your doctorbefore taking this medication, as the effect of rivaroxaban may be increased. Your doctor will decide whether you should be treated with this medication and whether you should be kept under closer observation.

If your doctor considers that you have a higher risk of developing stomach or intestinal ulcers, they will recommend that you also use an ulcer prevention treatment.

• If you are taking
• • any medication for the treatment of epilepsy (phenytoin, carbamazepine, phenobarbital).
  • St. John's Wort (Hypericum perforatum), a herbal remedy for the treatment of depression.

• rifampicin, an antibiotic.

If any of the above circumstances apply to you, inform your doctorbefore taking this medication, as the effect of rivaroxaban may be decreased. Your doctor will decide whether you should be treated with this medication and whether you should be kept under closer observation.

Pregnancy and breastfeeding

Do not take this medication if you are pregnant or breastfeeding. If there is any possibility that you may become pregnant, use a reliable contraceptive while taking this medication. If you become pregnant while taking this medication, inform your doctor immediately, who will decide how you should be treated.

Driving and using machines

Rivaroxaban may cause dizziness (a frequent side effect) or fainting (a rare side effect) (see section 4, "Possible side effects"). You should not drive, ride a bicycle, or use tools or machines if you are affected by these symptoms.

Rivaroxaban Cipla contains lactose and sodium

If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.

This medication contains less than 1 mmol of sodium (23 mg) per tablet; this is essentially "sodium-free".

3. How to take Rivaroxaban Cipla

Follow the administration instructions of this medication exactly as indicated by your doctor. If you are in doubt, consult your doctor or pharmacist again.

What dose to take

• To prevent the formation of blood clots in the veins after hip or knee replacement surgery.
• The recommended dose is one 10 mg rivaroxaban tablet once a day.
• To treat blood clots in the veins of the legs and in the blood vessels of the lungs, and to prevent blood clots from occurring again.

After at least 6 months of treatment for blood clots, the recommended dose is one 10 mg tablet once a day or one 20 mg tablet once a day. Your doctor has prescribed rivaroxaban 10 mg once a day.

Swallow the tablet, preferably with water.

This medication can be taken with or without food.

If you have difficulty swallowing the tablet whole, consult your doctor about other ways to take rivaroxaban. The tablet can be crushed and mixed with water or apple puree, immediately before taking it.

If necessary, your doctor may also administer the crushed tablet through a gastric tube.

Remember to carry your patient information card with you at all times. Inform the doctor and dentist treating you that you are taking rivaroxaban.

When to take Rivaroxaban Cipla

Take one tablet every day, until your doctor tells you to stop.

Try to take one tablet at the same time every day, to help you remember. The doctor will decide how long you should continue treatment.

To prevent the formation of blood clots in the veins after hip or knee replacement surgery:

Take the first tablet 6 to 10 hours after surgery.

If you have undergone major hip surgery, you will usually take tablets for 5 weeks.

If you have undergone major knee surgery, you will usually take tablets for 2 weeks.

If you take more Rivaroxaban Cipla than you should

Contact your doctor immediately if you have taken too much rivaroxaban. Taking too much rivaroxaban increases the risk of bleeding.

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 medication and the amount ingested.

If you forget to take Rivaroxaban Cipla

If you forget to take a dose, take it as soon as you remember. Take the next tablet the next day and, after that, take one tablet every day, as usual.

Do not take a double dose to make up for forgotten doses.

If you stop taking Rivaroxaban Cipla

Do not stop treatment with rivaroxaban without first talking to your doctor, as rivaroxaban prevents the development of a serious condition.

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

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone gets them.

Like other similar medications to reduce blood clotting, rivaroxaban can cause bleeding that can put the patient's life at risk. Excessive bleeding can cause a sudden drop in blood pressure (shock). In some cases, the bleeding may not be apparent.

Tell your doctor immediately if you experience any of the following symptoms:

• Signs of bleeding
• • bleeding in the brain or inside the skull (symptoms may include headache, weakness on one side of the body, vomiting, seizures, decreased level of consciousness, and stiffness of the neck. This is a serious medical emergency. Go to the doctor immediately!)
  • prolonged or excessive bleeding.
  • exceptional weakness, fatigue, paleness, dizziness, headache, unexplained swelling, difficulty breathing, chest pain or angina.

Your doctor will decide whether to keep you under closer observation or change your treatment.

• Signs of severe skin reactions
• • severe skin rash that spreads, blisters, or lesions on the mucous membranes, e.g., in the mouth or eyes (Stevens-Johnson syndrome/toxic epidermal necrolysis).
  • drug reaction that causes rash, fever, inflammation of internal organs, blood abnormalities, and systemic disease (DRESS syndrome).

The frequency of these side effects is very rare (affects up to 1 in 10,000 people).

• Signs of severe allergic reactions
• • swelling of the face, lips, mouth, tongue, or throat; difficulty swallowing; hives and difficulty breathing; sudden drop in blood pressure.

The frequency of severe allergic reactions is very rare (anaphylactic reactions, including anaphylactic shock; may affect up to 1 in 10,000 people) and uncommon (angioedema and allergic edema; may affect up to 1 in 100 people).

General list of possible side effects

Frequent(may affect up to 1 in 10 people)

• decrease in red blood cells that can cause paleness and weakness or difficulty breathing.
• bleeding in the stomach or intestine, urogenital bleeding (including blood in the urine and heavy menstrual bleeding), nosebleeds, bleeding gums.
• bleeding in the eye (including bleeding in the white of the eye).
• bleeding into a tissue or cavity of the body (hematoma, bruising).
• coughing up blood.
• bleeding from the skin or under the skin.
• bleeding after surgery.
• oozing of blood or fluid from a surgical wound.
• swelling of the limbs.
• pain in the limbs.
• alteration of kidney function (may be seen in tests performed by the doctor).
• fever.
• stomach pain, indigestion, dizziness or feeling of dizziness, constipation, diarrhea
• low blood pressure (symptoms may include dizziness or fainting when standing up).
• general decrease in strength and energy (weakness, fatigue), headache, dizziness.
• rash, itching of the skin.
• blood tests may show an increase in some liver enzymes.

Uncommon(may affect up to 1 in 100 people)

• bleeding in the brain or inside the skull (see above, signs of bleeding).
• bleeding in a joint, causing pain and swelling.
• thrombocytopenia (low platelet count, cells that help blood clotting).
• allergic reaction, including skin allergic reaction.
• alteration of liver function (may be seen in tests performed by the doctor).
• blood tests may show an increase in bilirubin, some pancreatic or liver enzymes, or platelet count.
• fainting.
• feeling of discomfort.
• increased heart rate.
• dry mouth.
• hives.

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

• bleeding in a muscle.
• cholestasis (decreased bile flow), hepatitis, including traumatic hepatocellular injury (inflammation or liver damage).
• yellowing of the skin and eyes (jaundice).
• localized swelling.
• blood accumulation (hematoma) in the groin as a complication after heart surgery in which a catheter is inserted into the leg artery (pseudoaneurysm).

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

• accumulation of eosinophils, a type of white blood cell granulocyte that causes inflammation in the lung (eosinophilic pneumonia).

Frequency not known(frequency cannot be estimated from available data)

• kidney failure after severe bleeding.
• bleeding in the kidney, sometimes with blood in the urine, which causes the kidneys to fail (anticoagulant-related nephropathy),
• increased pressure in the muscles of the legs or arms after bleeding, causing pain, swelling, altered sensation, numbness, or paralysis (compartment syndrome after bleeding).

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are side effects not listed in this package leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medications: www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Rivaroxaban Cipla

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

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

This medicine does not require any special storage conditions.

Crushed tablets

Crushed tablets are stable in water or apple sauce for up to 4 hours.

Medicines should not be disposed of via wastewater or household waste. Dispose of the packaging and any unused medicine in the SIGRE collection point at your pharmacy. Ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Package contents and additional information

Composition of Rivaroxaban Cipla

• The active substance is rivaroxaban. Each tablet contains 10 mg of rivaroxaban.
• The other ingredients (excipients) are:

Tablet core: sodium croscarmellose, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate. See section 2 “Rivaroxaban Cipla contains lactose and sodium”.

Coating material: hypromellose 2910 (E 464), red iron oxide (E 172), macrogol (E 1521), titanium dioxide (E 171).

Appearance and package contents of the product

Rivaroxaban Cipla 10 mg film-coated tablets are pink, round, biconvex, 6.0 ± 0.20 mm in diameter, engraved with “10” on one side and smooth on the other.

They are available in PVC/PVDC/Aluminum blister packs packaged in boxes of 10, 14, 30, 56, 98, and 168 film-coated tablets.

Not all pack sizes may be marketed.

Along with the package leaflet of this medicine, a patient information card is included. This patient information card includes information that will be useful for patients and will alert other doctors that the patient is taking rivaroxaban. The patient should be advised to always carry this card with them.

Marketing authorization holder and manufacturer

Marketing authorization holder

Cipla Europe NV

De Keyserlei 58-60, Box-19,

2018, Antwerp,

Belgium

Manufacturer

Cipla Europe NV

De Keyserlei 58-60, Box-19,

2018, Antwerp,

Belgium

Or

Alterno AD D.O.O.,

Brnciceva ulica 29,

Ljubljana-Crnuce, 1231,

Slovenia

Local representative

Cipla Europe NV, branch in Spain,

C/Guzmán el Bueno, 133 Edificio Britannia,

28003, Madrid

Spain

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

Germany: Rivaroxaban Cipla 10 mg Filmtabletten

Spain: Rivaroxabán Cipla 10 film-coated tablets EFG

Norway: Rivaroxaban Cipla

France: Rivaroxaban Cipla 10 mg Comprimé pelliculé

Italy: Rivaroxaban Cipla

Denmark: Rivaroxaban Cipla 10 mg filmovertrukne tabletter

Ireland: Rivaroxaban Azure 10 mg Film-Coated Tablets

Date of last revision of this package leaflet: November 2024

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