Introduction
Package Leaflet: Information for the User
Asey 500 mg Film-Coated Tablets EFG
Levofloxacin
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet, you may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Contents of the pack
- What is Asey and what is it used for
- What you need to know before you take Asey
- How to take Asey
- Possible side effects
- Storage of Asey
- Contents of the pack and other information
1. What is Asey and what is it used for
The name of this medicine is Asey 500 mg film-coated tablets EFG.
Asey contains the active substance levofloxacin, which belongs to a group of medicines called antibiotics. Levofloxacin is a type of antibiotic known as a quinolone, and it works by killing the bacteria that cause infections in your body.
Antibiotics are used to treat bacterial infections and will not work for viral infections such as the common cold or flu.
It is important that you follow the instructions regarding dose, administration interval, and treatment duration as indicated by your doctor.
Do not store or reuse this medicine. If you have any leftover antibiotic after completing treatment, return it to the pharmacy for proper disposal. Do not throw away medicines via wastewater or household waste.
Aseycan be used to treat infections in:
- The paranasal sinuses.
- The lungs, in people with long-term respiratory problems or pneumonia.
- The urinary tract, including the kidneys or bladder.
- The prostate, when the infection is persistent.
- The skin and under the skin, including muscles. This is sometimes referred to as "soft tissue".
In some special situations, Asey can be used to reduce the risk of acquiring a lung infection called anthrax or worsening of such disease after being exposed to the anthrax-causing bacteria.
2. What you need to know before you take Asey
Do not take Asey and consult your doctor if:
- You are allergic to levofloxacin, other quinolone antibiotics such as moxifloxacin, ciprofloxacin, or ofloxacin, or any of the other ingredients of this medicine (listed in section 6).
- Signs of an allergic reaction include: skin rash, difficulty swallowing or breathing, swelling of lips, face, throat, or tongue.
- You have or have had epilepsy.
- You have ever had tendon problems, such as tendonitis, related to the use of quinolone medicines. The tendon is the tissue that connects your muscle to your skeleton.
- You are a child or adolescent in the growth phase.
- You are pregnant, might become pregnant, or think you may be pregnant.
- You are breastfeeding or plan to breastfeed.
Do not take this medicine if any of the above applies to you. If in doubt, consult your doctor or pharmacist before taking Asey.
Warnings and precautions
Before you start taking this medicine
You should not take antibacterial medicines containing fluoroquinolones or quinolones, including Asey, if you have experienced any severe side effects in the past when taking a quinolone or fluoroquinolone. If this applies to you, inform your doctor as soon as possible.
Consult your doctor or pharmacist before starting to take this medicine if:
- You are 60 years of age or older.
- You are using corticosteroids, sometimes called steroids (see section Taking Asey with other medicines).
- You have had a seizure (convulsions) in the past.
- You have had brain damage due to a stroke or other brain injury.
- You have kidney problems.
- You have what is known as "glucose-6-phosphate dehydrogenase deficiency", as you may be prone to having serious blood problems when taking this medicine.
- You have had mental problems in the past.
- You have been diagnosed with an aneurysm of a large blood vessel (aortic aneurysm or large peripheral vessel aneurysm) or a "bulge" of a large blood vessel.
- You have had a previous episode of aortic dissection (tear in the aortic wall).
- You have been diagnosed with heart valve insufficiency (regurgitation of the heart valves).
- You have a family history of aortic dissection or aneurysm, congenital heart valve disease, or other risk factors or predisposing conditions (e.g., connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, Turner syndrome, or Sjögren's syndrome (an autoimmune inflammatory disease), or vascular disorders such as Takayasu arteritis, giant cell arteritis, Behçet's disease, hypertension, atherosclerosis, rheumatoid arthritis (a joint disease), or endocarditis (a heart infection)).
- You have ever had heart problems: caution should be exercised when using this type of medicine if you were born with, or have a family history of, prolonged QT interval (seen on an electrocardiogram (ECG), a graphical representation of the heart's electrical activity), have an imbalance in blood salt levels (especially low potassium or magnesium levels in the blood), have a slow heart rate (called "bradycardia"), have a weak heart (heart failure), have a history of heart attack (myocardial infarction), if you are a woman or an elderly person, or are taking other medicines that may cause abnormal changes in the ECG (see section Taking Asey with other medicines).
- You are diabetic.
- You have ever had liver problems.
- You have developed a severe skin rash or peeling of the skin, blisters, and/or sores in the mouth after taking levofloxacin.
- You have myasthenia gravis.
Tell your doctor or pharmacist before taking Asey if you are unsure whether any of the above applies to you.
During treatment with this medicine:
- If you experience sudden and severe pain in the abdomen, chest, or back, which can be symptoms of aortic dissection or aneurysm, go to the emergency room immediately. The risk may increase if you are receiving systemic corticosteroid treatment.
- If you start experiencing sudden onset of shortness of breath, especially when lying down, or if you notice swelling in the ankles, feet, or abdomen, or the appearance of heart palpitations (feeling of rapid or irregular heartbeat), inform your doctor immediately.
- If you start experiencing sudden, involuntary jerks, muscle spasms, or muscle contractions - consult a doctor immediately, as these could be signs of myoclonus. Your doctor may need to interrupt treatment with levofloxacin and initiate appropriate treatment.
- If you experience fatigue, pale skin, bruising, uncontrolled bleeding, fever, sore throat, and a severe deterioration of your general condition, or a feeling that your resistance to infections may be decreased - consult a doctor immediately, as these could be signs of blood disorders. Your doctor should monitor your blood with blood counts. In the event of abnormal blood counts, your doctor may need to interrupt treatment.
Rarely, pain and swelling in the joints and inflammation or rupture of the tendons can occur. The risk is greater if you are an elderly person (over 60 years old), have received an organ transplant, have kidney problems, or are being treated with corticosteroids. Tendon inflammation and rupture can occur within the first 48 hours of treatment and even several months after stopping treatment with Asey. At the first sign of pain or inflammation of a tendon (e.g., in the ankle, wrist, elbow, shoulder, or knee), stop taking Asey, contact your doctor, and rest the affected area. Avoid any unnecessary exercise, as this may increase the risk of tendon rupture.
Rarely, you may experience symptoms of nerve damage (neuropathy) such as pain, burning, tingling, numbness, and/or weakness, especially in the feet and legs or hands and arms. If this happens, stop taking Asey and inform your doctor immediately to prevent the development of a potentially irreversible disorder.
Severe, long-lasting, and potentially irreversible side effects
Antibacterial medicines containing fluoroquinolones or quinolones, including Asey, have been associated with very rare but serious side effects, some of which were long-lasting (persistent for months or years), disabling, or potentially irreversible. This includes pain in the tendons, muscles, and joints of the upper and lower limbs, difficulty walking, abnormal sensations such as pins and needles, tingling, prickling, numbness, or burning (paresthesia), sensory disorders such as decreased vision, taste, smell, or hearing, depression, decreased memory, intense fatigue, and severe sleep disorders.
If you experience any of these side effects after taking Asey, contact your doctor immediately before continuing treatment. You and your doctor will decide whether to continue or not, also considering the use of an antibiotic of another class.
Severe skin reactions
Severe skin reactions have been reported, including Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) with the use of levofloxacin.
- SJS/TEN may initially appear on the trunk as reddish targets or circular patches often with blisters in the center. They can also appear as ulcers in the mouth, throat, nose, genitals, and eyes (red and swollen eyes). These severe skin rashes are often preceded by fever and/or flu-like symptoms. The rashes can progress to widespread skin peeling and life-threatening or fatal complications.
- DRESS is initially manifested with flu-like symptoms and a rash on the face, then a more widespread rash with elevated body temperature, elevated liver enzymes observed in blood tests, and an increase in a type of white blood cell (eosinophilia) and enlarged lymph nodes.
If you develop a severe rash or any of these skin symptoms, stop taking levofloxacin and contact your doctor or seek immediate medical attention.
Taking Asey with other medicines
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. This is because Asey can affect the way other medicines work. Also, some medicines can affect the way Asey works.
In particular, inform your doctor if you are taking any of the following medicines, as this may increase the risk of side effects when taking them with Asey:
- Corticosteroids, sometimes called steroids, used for inflammation. You may have a higher risk of tendon inflammation and/or rupture.
- Warfarin, used to make the blood more fluid. You may have a higher risk of bleeding. Your doctor may need to perform periodic blood tests to check if your blood is clotting correctly.
- Theophylline, used for respiratory problems. You may have a higher risk of having a seizure (convulsions) if taken with Asey.
- Non-steroidal anti-inflammatory drugs (NSAIDs), used for pain and inflammation, such as acetylsalicylic acid, ibuprofen, fenbufen, ketoprofen, indomethacin. You may have a higher risk of having a seizure (convulsions) when taken with Asey.
- Cyclosporine, used after organ transplants. You may have a higher risk of experiencing the side effects of cyclosporine.
- Medicines with known effects on heart rhythm. This includes medicines used for abnormal heart rhythm (antiarrhythmics such as quinidine, hydroquinidine, disopyramide, sotalol, dofetilide, ibutilide, and amiodarone), for depression (tricyclic antidepressants such as amitriptyline and imipramine), for psychiatric disorders (antipsychotics), and for bacterial infections (macrolide antibiotics such as erythromycin, azithromycin, and clarithromycin).
- Probenecid, used for gout, and cimetidine, used for ulcers and heartburn. Special care should be taken when taking these medicines with Asey.
- If you have kidney problems, your doctor may want to give you a lower dose.
Do not take Asey at the same time as the following medicines, as it may affect how Asey works:
- Iron tablets (for anemia), zinc supplements, antacids containing aluminum or magnesium (for acidity or heartburn), didanosine, or sucralfate (for stomach ulcers). See section 3 If you are already taking iron, zinc supplements, antacids, didanosine, or sucralfatebelow.
Determination of opiates in urine
Urine tests may show "false positive" results for the presence of strong painkillers called "opiates" in patients taking Asey. Inform your doctor that you are taking Asey if you have been asked to undergo a urine test.
Tuberculosis test
This medicine may cause a "false negative" result in some laboratory tests used to detect the bacteria that cause tuberculosis.
Pregnancy and breastfeeding
Do not take this medicine if:
- You are pregnant, might become pregnant, or think you may be pregnant.
- You are breastfeeding or plan to breastfeed.
Driving and using machines
Some side effects such as dizziness, drowsiness, altered balance (vertigo), or visual disturbances may occur. Some of these side effects can affect your ability to concentrate or slow your reaction time. If this happens, do not drive or operate any machinery that requires a high level of attention.
3. How to Take Asey
Follow your doctor's instructions for taking this medication exactly. If you are unsure, consult your doctor or pharmacist again.
How to Take This Medication
- Take this medication by mouth.
- Swallow the tablets whole with a little water.
- The tablets can be taken during or between meals.
Protect Your Skin from the Sun
Do not expose your skin directly to the sun (even on cloudy days) while taking this medication and for two days after stopping it, as your skin will become much more sensitive to the sun and may burn, sting, or even blister if you do not take the following precautions:
- Make sure to use high-protection sun creams.
- Always wear a hat and clothing that covers your arms and legs.
- Avoid UVA sunlamps.
If You Are Already Taking Iron Tablets, Zinc Supplements, Antacids, Didanosine, or Sucralfate
Do not take these medications at the same time as Asey. You should take these medications at least two hours before or two hours after taking Asey.
What Dose Should You Take
- Your doctor will decide what amount of Asey you should take.
- The dose will depend on the type of infection you have and where the infection is located in your body.
- The duration of treatment will depend on the severity of your infection.
- If you think the effect of the medication is too weak or too strong, do not change the dose yourself, ask your doctor.
Adults and Elderly Patients
- Infection in the Paranasal Sinuses
one Asey 500 mg tablet, once a day
- Infection in the Lungs, in People with Long-Term Respiratory Problems
one Asey 500 mg tablet, once a day
one Asey 500 mg tablet, once or twice a day
- Urinary Tract Infection, Including Kidneys or Bladder
half or one Asey 500 mg tablet, per day
one Asey 500 mg tablet, once a day
- Infection in the Skin and Under the Skin, Including Muscles
one Asey 500 mg tablet, once or twice a day
Adults and Elderly Patients with Kidney Problems
Your doctor may give you a lower dose.
Use in Children and Adolescents
This medication should not be given to children or adolescents.
If You Take More Asey Than You Should
If you accidentally take more tablets than you should, inform your doctor or get immediate medical help. Take the medication with you so the doctor knows what you have taken. You can also call the Toxicology Information Service on phone 91 562 04 20, indicating the medication and the amount ingested. The effects that may appear are: epileptic seizures (convulsions), confusion, dizziness, decreased consciousness, tremors, heart disorders that can cause irregular heartbeats as well as discomfort (nausea) or stomach burning.
If You Forget to Take Asey
If you forget to take a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for forgotten doses.
If You Stop Treatment with Asey
Do not stop your treatment with Asey even if you feel better. It is important that you finish the treatment that your doctor has prescribed. If you stop taking it too soon, the infection may come back, your condition may worsen, or the bacteria may become resistant to the medication.
If you have any other questions about using this medication, ask your doctor or pharmacist.
4. Possible Side Effects
Like all medications, this medication can cause side effects, although not everyone will experience them. They are usually mild to moderate and tend to disappear soon.
Stop Treatment with Asey and Contact a Doctor or Go to the Hospital Immediately if You Notice the Following Side Effects:
Very Rare(may affect up to 1 in 10,000 people)
- If you have an allergic reaction. The signs may include: skin rash, difficulty swallowing or breathing, swelling of lips, face, throat, or tongue.
Stop Treatment with Asey and Contact a Doctor Immediately if You Notice the Following Serious Side Effects, as You May Need Urgent Medical Treatment:
Rare(may affect up to 1 in 1,000 people)
- Watery diarrhea that may contain blood, possibly with stomach cramps and fever. These could be signs of a serious intestinal problem.
- Pain and inflammation in the tendons or ligaments, which could lead to rupture. The Achilles tendon is the one most frequently affected.
- Epileptic seizures (convulsions).
- Syndrome associated with alterations in water elimination and low sodium levels (SIADH).
- Lack of appetite, yellowing of skin and eyes, dark urine, itching, or painful stomach (abdomen). These may be signs of liver problems that can include fulminant liver failure.
- Widespread rash, high body temperature, elevated liver enzymes, blood abnormalities (eosinophilia), swollen lymph nodes, and other organs involved (drug reaction with eosinophilia and systemic symptoms, also known as DRESS or drug hypersensitivity syndrome). See also section 2.
Very Rare(may affect up to 1 in 10,000 people)
- Burning, tingling, pain, or numbness. These may be signs of what is called "neuropathy".
Frequency Not Known(frequency cannot be estimated from available data):
- Severe skin rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis. These can appear on the trunk as reddish spots in a target shape or circular patches, often with blisters in the center, skin peeling, ulcers in the mouth, throat, nose, genitals, and eyes, and may be preceded by fever and flu-like symptoms. See also section 2.
Consult an eye specialist immediately if your vision deteriorates or you have any other eye problems while taking Asey.
Tell Your Doctor if Any of the Following Side Effects Worsen or Last More Than a Few Days:
Common(may affect up to 1 in 10 people)
- Sleep problems.
- Headache, dizziness.
- Discomfort (nausea, vomiting) and diarrhea.
- Increased levels of some liver enzymes in the blood.
Uncommon(may affect up to 1 in 100 people)
- Changes in the number of other bacteria or fungi, infection by a fungus called Candida, which may require treatment.
- Changes in the number of white blood cells in your blood test results (leucopenia, eosinophilia).
- Stress (anxiety), confusion, nervousness, drowsiness, tremors, feeling of dizziness (vertigo).
- Difficulty breathing (dyspnea).
- Changes in taste, loss of appetite, stomach upset or indigestion (dyspepsia), stomach pain, feeling of bloating (flatulence) or constipation.
- Itching and skin rash, intense itching or hives (urticaria), excessive sweating (hyperhidrosis).
- Pain in the joints or muscle pain.
- Abnormal blood test results due to liver (elevated bilirubin) or kidney (elevated creatinine) problems.
- General weakness.
Rare(may affect up to 1 in 1,000 people)
- Appearance of bruises and easy bleeding due to a decrease in the number of platelets in the blood (thrombocytopenia).
- Decrease in the number of white blood cells in the blood (neutropenia).
- Exaggerated immune response (hypersensitivity).
- Decrease in blood sugar levels (hypoglycemia). This is important for diabetic patients.
- Seeing or hearing things that are not real (hallucinations, paranoia), changes in opinion and thoughts (psychotic reactions) with a risk of having suicidal thoughts or actions.
- Depression, mental disorders, feeling of restlessness (agitation), abnormal dreams or nightmares.
- Feeling of tingling in hands and feet (paresthesia).
- Ear disorders (tinnitus) or vision problems (blurred vision).
- Abnormally fast heartbeat (tachycardia) or decreased blood pressure (hypotension).
- Clearly defined red patches with or without blisters that develop a few hours after administration of levofloxacin and heal with residual post-inflammatory hyperpigmentation; usually recurs in the same area of the skin or mucous membrane after subsequent exposure to levofloxacin.
- Muscle weakness. This is important in people with myasthenia gravis (a rare nervous system disease).
- Changes in kidney function and, occasionally, kidney failure, which can be a consequence of an allergic reaction in the kidney called interstitial nephritis.
- Fever.
Other Side Effects Include:
- Decrease in red blood cells in the blood (anemia). This can cause the skin to become pale or yellowish due to damage to red blood cells.
- Decrease in the number of all types of blood cells (pancytopenia).
- The bone marrow stops producing new blood cells, which can cause fatigue, reduced ability to fight infections, and uncontrolled bleeding (bone marrow failure).
- Fever, sore throat, and persistent general malaise. This may be due to a decrease in the number of white blood cells (agranulocytosis).
- Circulatory collapse (anaphylactic shock).
- Increased blood sugar levels (hyperglycemia) or decreased blood sugar levels that can lead to coma (hypoglycemic coma). This is important for diabetic patients.
- Changes in smell, loss of smell or taste (parosmia, anosmia, ageusia).
- Feeling very excited, euphoric, agitated, or enthusiastic (mania).
- Movement and gait disorders (dyskinesia, extrapyramidal disorders).
- Temporary loss of consciousness or posture (syncope).
- Temporary loss of vision.
- Hearing or vision problems.
- Abnormally fast heartbeat, irregular heartbeat with life-threatening risk, including cardiac arrest, alteration of heart rhythm (called "prolongation of the QT interval", observed in the ECG, a graphical representation of the heart's electrical activity).
- Difficulty breathing or wheezing (bronchospasm).
- Pulmonary allergic reactions.
- Pancreatitis (inflammation of the pancreas).
- Hepatitis (inflammation of the liver).
- Increased sensitivity of the skin to the sun and ultraviolet light (photosensitivity), darker skin areas (hyperpigmentation).
- Inflammation of the blood vessels that carry blood throughout the body due to an allergic reaction (vasculitis).
- Inflammation of the tissue inside the mouth (stomatitis).
- Muscle rupture and destruction (rhabdomyolysis).
- Red and swollen joints (arthritis).
- Pain, including back, chest, and limb pain.
- Sudden, involuntary jerks, muscle spasms, or contractions (myoclonus).
- Porphyria crisis in patients with porphyria (a very rare metabolic disease).
- Persistent headache with or without blurred vision (benign intracranial hypertension).
The administration of antibiotics containing quinolones and fluoroquinolones has been associated with very rare cases of long-lasting (even months or years) or permanent adverse reactions, such as tendon inflammation, tendon rupture, joint pain, limb pain, difficulty walking, abnormal sensations such as pinching, tingling, burning, numbness, or pain (neuropathy), depression, fatigue, sleep disorders, memory loss, and decreased hearing, vision, taste, and smell, in some cases regardless of the presence of pre-existing risk factors.
There have been reports of increased size and weakening or tearing of the aortic wall (aneurysms and dissections), which could lead to rupture and be fatal, and heart valve problems in patients who have received fluoroquinolones. See also section 2.
Reporting Side Effects
If you experience any side effects, 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 Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es.
By reporting side effects, you can help provide more information on the safety of this medication.
5. Storage of Asey
Keep this medication out of sight and reach of children.
This medication does not require special storage conditions, but it is preferable to store Asey in its original packaging in a dry place.
Do not use this medication after the expiration date shown on the packaging and blister pack after EXP. The expiration date is the last day of the month indicated.
Medications should not be disposed of in wastewater or household waste. Deposit the packaging and medications 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 medications you no longer need. This will help protect the environment.
6. Package Contents and Additional Information
Asey Composition
- The active ingredient is levofloxacin. Each tablet contains 500 mg of levofloxacin.
- The other ingredients (excipients) are:
- Core: crospovidone, hypromellose, microcrystalline cellulose, magnesium stearate, colloidal silica, stearic acid, talc.
- Coating: titanium dioxide (E-171), macrogol 6000, hypromellose, red iron oxide (E-172), and yellow iron oxide (E-172).
Product Appearance and Package Contents
Asey is a film-coated tablet for oral use. The tablets are orange, elongated, biconvex, and scored.
It is available in packs of 1, 7, and 14 tablets.
Only some pack sizes may be marketed.
Marketing Authorization Holder and Manufacturer
Marketing Authorization Holder
Especialidades Farmacéuticas Centrum, S.A.
C/ Sagitario, 14
03006 Alicante
Spain
Manufacturer
Normon, S.A.
Ronda de Valdecarrizo, 6
28760 Tres Cantos - Madrid (Spain)
Tel: +34 91 806 52 40
This leaflet does not contain all the information about your medication. If you have any questions or are unsure about something, consult your doctor or pharmacist.
Date of Last Revision of This Leaflet:September 2024.
Detailed and updated information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/).