Prospecto: Information for the User
Actiq 200 micrograms Lozenges with Integrated Oral Applicator
Actiq 400 micrograms Lozenges with Integrated Oral Applicator
Actiq 600 micrograms Lozenges with Integrated Oral Applicator
Actiq 800 micrograms Lozenges with Integrated Oral Applicator
Actiq 1.200 micrograms Lozenges with Integrated Oral Applicator
Actiq 1.600 micrograms Lozenges with Integrated Oral Applicator
fentanyl
Read this prospectus carefully before starting to use this medication, as it contains important information for you.
1.What is Actiq and what is it used for
2.What you need to know before starting to use Actiq
3.How to use Actiq
4.Possible adverse effects
5.Storage of Actiq
6.Contents of the package and additional information
Actiq contains fentanil as its active substance, a potent analgesic that belongs to the group of opiates. Actiq is presented in lozenges with a built-in buccal applicator.
Do not use Actiq:
Do not use Actiq if you are in any of the above situations. If you are unsure, consult your doctor or pharmacistBEFOREusing Actiq.
Warnings and precautions
During treatment with Actiq, continue to use the opioid analgesic medication you take for your persistent pain (present all the time) associated with cancer.
Keep this medication in a safe and protected place, where others cannot access it (see section5Storage of Actiqfor more information).
Consult your doctor or pharmacistBEFOREstarting to use Actiq if:
Consult your doctorDURINGuse of Actiq if:
Long-term use and tolerance
This medication contains fentanyl, an opioid. Repeated use of opioid analgesics may make the medication less effective (your body becomes accustomed to it, known as pharmacological tolerance). You may also become more sensitive to pain when using Actiq. This is known as hyperalgesia. Increasing the dose of Actiq may continue to reduce pain for a while, but it may also be harmful. If you notice that the medication loses its effectiveness, consult your doctor. Your doctor will decide whether it is better to increase the dose or gradually reduce the use of Actiq.
Dependence and addiction
Repeated use of Actiq may also cause dependence, abuse, and addiction, which could lead to a potentially fatal overdose. The risk of these adverse effects may be higher with a higher dose and longer use. Dependence or addiction may cause you to feel a lack of control over the amount of medication you should use or the frequency with which you should use it. You may feel the need to continue using the medication even if it does not help alleviate pain.
The risk of dependence or addiction varies from person to person. The risk of becoming dependent or addicted to Actiq may be higher if:
If you notice any of the following symptoms while using Actiq, it could be a sign of dependence or addiction.
If you notice any of these signs, consult your doctor to determine the best course of treatment for you, when it is appropriate to stop the medication, and how to do it safely.
Seek medical adviceURGENTLYif:
Children and adolescents
Actiq is not recommended for children and adolescents under 16 years of age.
Use in athletes
This medication contains fentanyl, which may produce a positive result in doping control tests.
Other medications and Actiq
Do not use this medication and inform your doctor or pharmacist:
Inform your doctor or pharmacist before using Actiq if you are taking or have taken recently or may need to take any other medication. This includes over-the-counter medications and herbal remedies. In particular, inform your doctor or pharmacist if you are using any of the following medications:
However, if your doctor prescribes Actiq with sedative medications, the dose and duration of concomitant treatment should be limited by your doctor.
If you are to undergo surgery that requires general anesthesia, consult your doctor or nurse.
Use of Actiq with food, drinks, and alcohol
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, or think you may be pregnant, consult your doctor or pharmacist before using this medication.
Pregnancy
Actiq should not be used during pregnancy unless you have consulted your doctor.
If Actiq is used for long periods during pregnancy, there is a risk that the newborn may experience withdrawal symptoms that can be fatal if not recognized and treated by a doctor (see section 4 “Other adverse effects, frequency not known”).
Do not use Actiq during delivery as it may cause respiratory problems in the newborn.
Breastfeeding
Fentanyl may pass into breast milk and cause adverse effects in the infant. Do not use Actiq if you are breastfeeding your baby. Do not start breastfeeding before at least 5 days have passed since the last dose of Actiq.
Driving and operating machinery
This medication may affect your ability to drive or operate certain tools or machinery. Consult your doctor about the safety of driving or operating certain tools or machinery after using Actiq.
Do not drive or operate certain tools or machinery if: you feel drowsy or dizzy; you have blurred vision or double vision; you have difficulty concentrating. It is essential to know how Actiq affects you before driving or operating certain tools or machinery.
Actiq contains glucose
This medication contains approximately 1.89 grams of glucose per dose. This should be considered in patients with diabetes mellitus. Patients with glucose absorption problems or galactosemia should not take this medication.
It may cause tooth decay.
Actiq contains sucrose
This medication contains sucrose. Patients with hereditary fructose intolerance (HFI), glucose absorption problems, or galactosemia, or saccharase-isomaltase deficiency should not take this medication.
It may cause tooth decay.
Actiq contains sodium
This medication contains less than 23 mg of sodium (1 mmol) per lozenge; it is essentially “sodium-free”.
Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.
Before starting treatment and regularly during it, your doctor will also explain what you can expect from the use of Actiq, when and for how long you should use it, when you should contact your doctor, and when you should discontinue use (see also section 2).
When you start using Actiq for the first time, your doctor will collaborate with you to find the Actiq dose that relieves your breakthrough pain. It is very important that you use Actiq exactly as your doctor has instructed you.
How the medication penetrates the body
When you put Actiq in your mouth:
The fact that you use the medication in this way allows it to be absorbed quickly, which means rapid relief of breakthrough pain.
Determination of the correct dose
You should start to feel relief quickly while using Actiq. However, until you and your doctor determine the dose that effectively controls breakthrough pain, it is possible that you will not feel sufficient relief from pain 30 minutes after starting to use a unit of Actiq (15 minutes after using the Actiq lozenge). If this occurs, your doctor may allow you to use a second Actiq lozenge of the same dose to treat the same episode of breakthrough pain.
Do not use a second unit unless your doctor tells you to. Never use more than two units to treat a single episode of breakthrough pain.
During the determination of the correct dose, you may need to have units of Actiq with different concentrations available at home. However, keep only the concentrations of Actiq that you need at home. This allows you to prevent possible confusion and overdoses. Consult with the pharmacist on how to dispose of the Actiq units that you do not need.
How many units should be used
Once you have determined the correct dose with your doctor, use 1 unit for an episode of breakthrough pain. Consult your doctor if your correct dose of Actiq does not relieve breakthrough pain over several consecutive episodes of breakthrough pain. Your doctor will decide if it is necessary to modify your dose.
You must inform your doctor immediately if you use Actiq more than four times a day, as it may be necessary to change your treatment regimen. Your doctor may change the treatment for persistent pain; when persistent pain is controlled, your doctor may need to change the dose of Actiq.If your doctor suspects increased sensitivity to pain related to Actiq (hyperalgesia), a reduction in your Actiq dose may be considered (see section 2 "Warnings and precautions").To get better results, inform your doctor about the pain you are experiencing and how Actiq is acting, so that the dose can be changed if necessary.
Use of the medication
Opening the packaging -Each unit of Actiq is sealed in its own blister pack.
Use of the Actiq unit
Frequency of Actiq administration
Once you have achieved a dose that effectively controls your breakthrough pain, do not use more than four units of Actiq per day. If you think you may need more than four units of Actiq per day, you must notify your doctor immediately.
How many units of Actiq should be used
Do not use more than two Actiq lozenges to treat a single episode of breakthrough pain.
If you use more Actiq than you should
The most common adverse effects if you use too much are drowsiness, dizziness, and nausea.
What to do if a child or adult accidentally uses Actiq
If you think someone has accidentally used Actiq, seek medical assistance immediately. Try to keep the person awake (calling their name or shaking them by the arm or shoulder) until medical assistance arrives.
If you forget to take Actiq
If the breakthrough pain persists, you should use Actiq as instructed by your doctor. If the breakthrough pain disappears, do not use more Actiq until another episode of breakthrough pain occurs.
If you interrupt treatment with Actiq
You should discontinue Actiq when you no longer have any breakthrough pain. However, you should continue taking your usual opioid analgesic medication for persistent cancer pain as instructed by your doctor. When you discontinue treatment with Actiq, you may experience withdrawal symptoms similar to possible adverse effects of Actiq. If you experience withdrawal symptoms or are concerned about pain relief, consult your doctor. Your doctor will evaluate whether you need medications to reduce or eliminate withdrawal symptoms.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine may cause side effects, although not everyone will experience them.If you notice any side effects, contact your doctor.
Severe side effects
You or your caregiver must REMOVE the Actiq unit from the mouth, contact your doctor immediately, and request urgent help if you experience any of the following side effects – you may need urgent medical attention:
Instructions for caregivers:
If you observe that the patient using Actiq has slow and/or shallow breathing or if it is difficult to wake them, TAKE THE FOLLOWING MEASURES IMMEDIATELY:
If you feel excessively dizzy, drowsy, or experience any other discomfort while using Actiq, remove the Actiq unit from your mouth using the applicator and dispose of it according to the instructions explained in this leaflet (see section 5). Then, contact your doctor for further instructions on using Actiq.
Nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, and low blood pressure.
Together, these symptoms may be a sign of a potentially life-threatening disease called adrenal insufficiency, a disease in which the adrenal glands do not produce enough hormones.
Other side effects
Very common:may affect more than 1 in 10 people
Common:may affect up to 1 in 10 people
Rare:may affect up to 1 in 100 people
Frequency not known
The following side effects have also been reported with the use of Actiq, but the frequency with which they occur is unknown:
The prolonged treatment with fentanyl during pregnancy may cause withdrawal symptoms in the newborn, which may be life-threatening (see section2).
While using Actiq, you may experience irritation, pain, and ulcers at the application site and gum bleeding.
Reporting of side effects
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicinal Products for Human Use:https://www.notificaram.es.By reporting side effects, you can contribute to providing more information on the safety of this medicine.
The analgesic medication Actiq is very potent and could be potentially fatal to a child if used accidentally. Actiq must be kept out of the sight and reach of children.
How to dispose of Actiq once used
The partially used units of Actiq may still contain enough medication to be harmful or potentially fatal to a child.
Even if there is some medication left in the applicator, the applicator must be disposed of properly, as follows:
Medications should not be thrown away in the sewage or trash. Deposit the containers and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the containers and medications you no longer need. This will help protect the environment.
Composition of Actiq
Lozenge:
Hydrated dextrates (equivalent to approximately 1.89 grams of glucose), citric acid, disodium phosphate, artificial berry flavor (maltodextrin (contains glucose), propylene glycol (E1520), artificial flavors, and triethyl citrate), magnesium stearate.
Edible adhesive used to attach the lozenge to the applicator:
Modified cornstarch-based edible coating (E 1450), glazed sugar (as sucrose and cornstarch), water.
Printing ink:
Water, white shellac, synthetic coal tar blue dye (E 133), and ammonium hydroxide to adjust pH (E527).
Appearance of the product and contents of the package
Each Actiq lozenge is composed of a white to off-white solid medication attached to an oral mucosa applicator. During storage, the lozenge may acquire a slightly speckled appearance. This is due to slight changes in the flavoring of the product and does not affect the medication's action in any way.
Actiq is available in 6 different doses: 200, 400, 600, 800, 1.200, and 1.600 micrograms. The dose is marked on the white lozenge, on the applicator, on the blister pack, and on the carton to ensure that you use the correct one. Each dose is associated with a specific color.
Each blister pack contains a single unit of Actiq.
The blister packs are supplied in boxes of 3, 6, 15, or 30 individual units of Actiq.
Only some package sizes may be commercially available.
Marketing authorization holder and responsible manufacturer
Marketing authorization holder
Teva Pharma B.V.
Swensweg 5, 2031 GA Haarlem
Holland
Responsible manufacturer
Merckle GmbH
Ludwig-Merckle-Strasse 3
89143 Blaubeuren
Germany
Local representative
Teva Pharma, S.L.U.
C/ Anabel Segura 11 Edificio Albatros B 1ª planta,
Alcobendas 28108, Madrid (Spain)
Last review date of this leaflet:May2024
For detailed and up-to-date information on this medication, please visit the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/
Have questions about this medication or your symptoms? Connect with a licensed doctor for guidance and personalized care.