Leaflet: information for the user

Apaloz30 mg EFG tablets

Aripiprazol

Read this leaflet carefully before you start taking this medicine, as it contains important information for you.

•Keep this leaflet, as you may need to read it again.

•If you have any questions, consult your doctor or pharmacist.

•This medicine has been prescribed for you only, and you must not give it to others even if they have the same symptoms as you, as it may harm them.

•If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

1. What Apaloz is and what it is used for

2. What you need to know before taking Apaloz

3. How to take Apaloz

4. Possible side effects

5. Storage of Apaloz

6. Contents of the pack and additional information

This medication contains the active ingredient aripiprazol and belongs to a group of medications known as antipsychotics. It is used to treat adults and adolescents aged 15 years or more who suffer from a condition characterized by symptoms such as hearing, seeing, and feeling things that do not exist, distrust, false beliefs, incoherent speech, and monotony of emotional and behavioral state. People in this state may also feel depressed, guilty, anxious, or tense.

Aripiprazol is used to treat adults and adolescents aged 13 years or more who suffer from a disorder characterized by symptoms such as feeling euphoric, having excessive energy, needing less sleep than usual, speaking rapidly with flight of ideas, and sometimes, severe irritability. In addition, it also prevents this situation in patients who have responded to treatment with aripiprazol.

Do not take Apaloz

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

Warnings and precautions

Consult your doctor before starting to take this medicine.

Cases of patients experiencing suicidal thoughts and behaviors during treatment with aripiprazole have been reported. Inform your doctor immediately if you have thoughts or feelings of harming yourself.

Before starting treatment with this medicine, tell your doctor if you have:

• high blood sugar levels (characterized by excessive thirst, increased urine production, increased appetite, and feeling weak) or a family history of diabetes;
• • seizures, as your doctor may want to monitor you more closely;
  • irregular and involuntary muscle movements, especially in the face;
  • cardiovascular diseases (heart and circulation diseases), family history of cardiovascular disease, stroke or mini-stroke, abnormal blood pressure;
  • blood clots or family history of blood clots, as antipsychotics have been associated with the formation of blood clots;
  • history of addiction to gambling.

If you notice that you are gaining weight, developing unusual movements, experiencing drowsiness that interferes with your daily activities, having difficulty swallowing, or experiencing allergic symptoms, please inform your doctor.

If you have dementia (loss of memory and other mental abilities), you or the person caring for you or a family member should inform your doctor if you have ever had a stroke or "mini" stroke.

Talk to your doctor immediately if you have thoughts or feelings of harming yourself. Cases of patients experiencing suicidal thoughts and behaviors during treatment with aripiprazole have been reported.

Talk to your doctor immediately if you notice numbness or stiffness of the muscles with high fever, sweating, altered mental state, or a very fast or irregular heartbeat.

Inform your doctor if you, your family, or caregiver notice that you are developing impulses or urges to behave in an unusual way in you and cannot resist the impulse, instinct, or temptation to carry out certain activities that may harm you or others. This is known as impulse control disorder and may include behaviors such as addiction to gambling, excessive eating or spending, abnormally high sex drive, or excessive concern about an increase in sexual thoughts and feelings.

Your doctor may consider adjusting or interrupting the dose.

Aripiprazole may cause drowsiness, a drop in blood pressure when standing up, dizziness, and changes in the ability to move and maintain balance, which could cause falls. Caution should be exercised, especially if you are an elderly patient or have weakness.

Children and adolescents

Do not use this medicine in children and adolescents under 13 years old. The safety and effectiveness of this medicine in these patients are unknown.

Other medicines and Apaloz

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine, including over-the-counter medicines.

Medicines that lower blood pressure: aripiprazole may increase the effect of medicines used to lower blood pressure. Make sure to inform your doctor if you are using any medicine to control blood pressure.

If you are taking aripiprazole with another medicine, it may mean that your doctor needs to change your dose of aripiprazole or the dose of the other medicines. It is especially important to mention to your doctor if you are taking:

These medicines may increase the risk of adverse effects or reduce the effect of aripiprazole; if you observe any unusual symptoms when taking any of these medicines with aripiprazole, inform your doctor.

Medicines that increase serotonin levels are generally used to treat diseases that include depression, generalized anxiety disorder, obsessive-compulsive disorder (OCD), and social phobia, as well as migraine and pain:

These medicines may increase the risk of adverse effects; if you observe any unusual symptoms when taking any of these medicines with aripiprazole, inform your doctor.

Taking Apaloz with food, drinks, and alcohol

This medicine can be taken regardless of meals.

Alcohol consumption should be avoided.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, or think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

The following symptoms may occur in newborn babies of mothers who have been treated with aripiprazole in the last three months of pregnancy (last three months of pregnancy): tremors, stiffness, and/or muscle weakness, drowsiness, agitation, breathing problems, and difficulty feeding. If your baby develops any of these symptoms, contact your doctor.

If you are taking aripiprazole, your doctor will discuss with you whether you should breastfeed your baby, considering the benefit of your treatment and the benefit of breastfeeding for your baby. If you are being treated with aripiprazole, do not breastfeed. Talk to your doctor about the best way to feed your baby if you are taking this medicine.

Driving and operating machinery

During treatment with this medicine, dizziness and vision problems (see section 4) may occur. This should be taken into account when requiring maximum attention, for example, when driving or operating machinery.

Apaloz contains lactose

This medicine contains lactose. If your doctor has told you that you have an intolerance to certain sugars, consult with him before taking this medicine.

Follow exactly the administration instructions of this medication as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

The recommended dose for adults is 15 mg once a day.Your doctor may prescribe lower and higher doses up to a maximum of 30 mg once a day.

Use in children and adolescents

This medication should be started with the oral solution (liquid) at a low dose.

The dose may be gradually increased tothe recommended dose for adolescents of 10 mg once a day. However, your doctor may prescribe lower or higher doses up to a maximum of 30 mg once a day.

If you estimate that the action of this medication is too strong or too weak, inform your doctor or pharmacist.

Try to take this medication at the same time every day. It does not matter if you take it with or without food. Take the tablets with water and swallow them whole.

Even if you feel better, do not alter or interrupt the daily dose of aripiprazole without consulting your doctor first.

If you take more Apaloz than you should

If you realize that you have taken more aripiprazole than your doctor recommended (or if someone else has taken part of your aripiprazole), contact your doctor immediately. If you cannot communicate with your doctor, go to the nearest hospital and bring the packaging with you.

Patients who have taken too much aripiprazole have experienced the following symptoms:

Other symptoms may include:

Contact your doctor or nearest hospital immediately if you experience any of the above symptoms.

In case ofoverdose, consult your doctor or pharmacist or call the Toxicological Information Service, phone: 91 562 04 20, indicating the medication and the amount ingested.

If you forgot to take Apaloz

If you forget a dose, take the missed dose as soon as you remember, but do not take a double dose to compensate for the missed dose.

If you interrupt treatment with Apaloz

Do not stop treatment just because you feel better. It is essential that you continue taking this medication for the time your doctor has indicated.

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

Like all medicines, this medicine can cause side effects, although not everyone will experience them.

Frequent side effects (may affect up to 1 in 10 patients):

• diabetes mellitus;

• difficulty sleeping;

• anxiety;

• feeling of restlessness and inability to stay still, difficulty staying seated;

• involuntary twisting, contorting, or spasmodic movements, restless legs;

• tremor;

• headache;

• fatigue;

• drowsiness;

• dizziness;

• shakiness and blurred vision;

• difficulty urinating or decreased frequency of bowel movements (constipation);

• indigestion;

• nausea;

• increased saliva production;

• vomiting;

• feeling of fatigue.

Rare side effects (may affect up to 1 in 100 patients):

• increased levels of prolactin hormone in the blood;

• extremely high blood sugar levels;

• depression;

• altered or increased sex drive;

• involuntary movements of the mouth, tongue, and limbs (tardive dyskinesia);

• muscle disorder causing twisting movements (dystonia);

• double vision;

• eye sensitivity to light;

• rapid heartbeat;

• low blood pressure upon standing, causing dizziness, fainting, or syncope;

• hiccups.

The following side effects have been reported during the post-marketing phase of aripiprazole oral, but the frequency of occurrence is unknown:

• low white blood cell count;

• low platelet count;

• allergic reaction (e.g., swelling in the mouth, tongue, face, and throat, itching, and redness);

• onset or worsening of diabetes, ketoacidosis (ketones in the blood and urine), or coma;

• high blood sugar;

• insufficient sodium levels in the blood;

• loss of appetite (anorexia);

• weight loss;

• weight gain;

• suicidal thoughts, attempted suicide, and suicide;

• aggression;

• agitation;

• nervousness;

• combination of fever, muscle rigidity, rapid breathing, sweating, decreased consciousness, sudden changes in blood pressure and heart rate, and fainting (neuroleptic malignant syndrome);

• seizures;

• serotonin syndrome (a reaction that can cause intense feelings of happiness, drowsiness, clumsiness, restlessness, feeling drunk, fever, sweating, or muscle rigidity);

• speech disorder;

• fixation of the eyeballs in a position;

• sudden and unexplained death;

• potentially fatal irregular heartbeat;

• heart attack;

• slow heart rate;

• blood clots in the veins, especially in the legs (symptoms include swelling, pain, and redness), which can travel through the blood vessels to the lungs, causing chest pain and difficulty breathing (if you notice any of these symptoms, seek immediate medical attention);

• high blood pressure;

• fainting;

• accidental inhalation of food, which can lead to pneumonia (lung infection);

• spasms of the muscles around the glottis (a part of the larynx);

• pancreatitis;

• difficulty swallowing;

• diarrhea;

• abdominal discomfort;

• stomach upset;

• liver failure;

• inflammation of the liver;

• yellowing of the skin and the white part of the eyes;

• abnormal liver function test results;

• hives;

• light sensitivity;

• hair loss;

• excessive sweating;

• abnormal muscle degradation that can cause kidney problems;

• muscle pain;

• stiffness;

• involuntary loss of urine (incontinence);

• difficulty urinating;

• symptoms of withdrawal in newborns due to exposure to medications during pregnancy;

• prolonged and/or painful erection;

• difficulty controlling central body temperature or overheating;

• chest pain;

• swollen hands, ankles, or feet;

• in blood tests: fluctuations in blood sugar levels, increased hemoglobin A1c;

• inability to resist the impulse, instinct, or temptation to perform an action that may be harmful to yourself or others, which may include:

– strong impulse to gamble excessively despite serious personal or family consequences;

– altered or increased sex drive and concerning behavior for yourself or others, such as increased sex drive;

– uncontrolled excessive buying;

– binge eating (ingesting large amounts of food in a short period) or compulsive eating (eating more food than normal and more than needed to satisfy hunger);

– tendency to wander.

Inform your doctor if you experience any of these behaviors; they will explain how to manage or reduce the symptoms.

In elderly patients with dementia, there have been reported a higher number of fatal cases while taking aripiprazole. Additionally, cases of stroke or "mini" stroke have been reported.

Other side effects in children and adolescents

Adolescents aged 13 years or older experienced side effects similar in frequency and type to those of adults, except for drowsiness, involuntary spasms or contractions, restlessness, and fatigue, which were very frequent (affects more than 1 in 10 patients), and upper abdominal pain, dry mouth, increased heart rate, weight gain, increased appetite, muscle fasciculations, involuntary movements of the limbs, and dizziness, especially when getting up from lying or sitting, which were frequent (affects up to 1 in 10 patients).

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 prospectus. You can also report them directly through the Spanish System for the Vigilance of Medicines for Human Use: https://www.notificaRAM.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.

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

Do not use this medication after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

No special storage conditions are required.

Medications should not be disposed of through drains or in the trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and medications you no longer need. By doing so, you will help protect the environment.

Composition of Apaloz

• The active ingredient is aripiprazol. Each tablet contains 30 mg of aripiprazol.
• The other components are lactose monohydrate, maize pregelatinised starch, microcrystalline cellulose, hypromellose, magnesium stearate.

Appearance of the product and content of the packaging

Apaloz 30 mg is presented in the form of white, oblong, biconvex, and non-scored tablets.

Each package contains 28 tablets conditioned in blisters of Polyamide/Al/PVC-Al.

Holder of the marketing authorization and responsible for manufacturing

Laboratorios Alter, S.A.

Mateo Inurria, 30

28036 Madrid

Spain

Last review date of this leaflet: June 2020

The detailed and updated information of this medicine is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS) http://www.aemps.gob.es/