CADUET 5 mg/10 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the User

Caduet 5mg/10mg film-coated tablets

amlodipine besylate/atorvastatin calcium trihydrate

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, pharmacist, or nurse.
• 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

1. What Caduet is and what it is used for
2. What you need to know before you take Caduet
3. How to take Caduet
4. Possible side effects
5. Storing Caduet
6. Contents of the pack and other information

1. What Caduet is and what it is used for

Caduet is used to prevent cardiovascular events (such as angina, heart attack) in patients with high blood pressure and who also have other risk factors for cardiovascular disease, such as smoking, being overweight, high cholesterol levels, family history of heart disease, or diabetes. The presence of these risk factors, in addition to high blood pressure, makes patients more likely to suffer from cardiovascular events.

Caduet is a product that contains two active substances, amlodipine (a calcium antagonist) and atorvastatin (a statin), and is used when your doctor considers it appropriate to take both medicines. Amlodipine is used to treat high blood pressure (hypertension), and atorvastatin reduces cholesterol levels.

High blood pressure (hypertension) is a disease in which blood pressure is permanently elevated in an abnormal way and is one of the risk factors for suffering from cardiovascular events (angina, heart attack, stroke).

Cholesterol is a substance that is naturally found in the body and is necessary for normal growth. However, if there is too much cholesterol in the blood, it can deposit on the walls of blood vessels, increasing the risk of blood clots forming and suffering from cardiovascular events. This is one of the most common causes of heart disease.

2. What you need to know before you take Caduet

Do not take Caduet

• if you are allergic (hypersensitive) to amlodipine or atorvastatin or to any other calcium channel blocker or to any of the other ingredients of this medicine (listed in section 6)
• if you currently have a disease that affects the liver (if in the past you had a disease that affected the liver, see below in the "Warnings and precautions" section)
• if you have had unexplained abnormal results in blood tests for liver function
• if you are pregnant, trying to become pregnant, or breastfeeding
• if you are taking any of the following medicines: ketoconazole, itraconazole (medicines used to treat fungal infections), telithromycin (an antibiotic)
• if you have low blood pressure (hypotension)
• if you have narrowing of the heart valve (aortic stenosis) or cardiogenic shock (a situation where the heart is unable to provide enough blood to the body)
• if you have heart failure after a heart attack
• if you use the combination of glecaprevir/pibrentasvir for the treatment of hepatitis C.

Warnings and precautions

Tell your doctor, pharmacist, or nurse before you start taking Caduet

• if you have severe respiratory failure
• if you are taking or have taken in the last 7 days a medicine that contains fusidic acid (used to treat bacterial infections) orally or by injection. The combination of fusidic acid and Caduet can cause serious muscle problems (rhabdomyolysis)
• if you have kidney problems
• if you have an underactive thyroid gland (hypothyroidism)
• if you have repeated or unexplained muscle pain, personal or family history of muscle problems
• if you have had muscle problems in the past while taking other cholesterol-lowering medicines (e.g., statins or fibrates)
• if you regularly drink large amounts of alcohol
• if you have had liver disease in the past
• if you are over 70 years old

• if you have had a previous stroke with bleeding in the brain or have small fluid-filled sacs in the brain due to previous strokes
• if you have or have had myasthenia (a disease that causes generalized muscle weakness that can affect the muscles used for breathing) or ocular myasthenia (a disease that causes weakness of the eye muscles), as statins can sometimes worsen the disease or cause myasthenia to appear (see section 4).

In any of these cases, your doctor will indicate whether you should have blood tests before and possibly during treatment with Caduet to calculate the risk of muscle side effects. It is known that the risk of muscle side effects, such as rhabdomyolysis, increases when taken with certain medicines (see "Using Caduet with other medicines" section).

Also, inform your doctor or pharmacist if you experience constant muscle weakness. Additional tests and medicines may be necessary to diagnose and treat this problem.

While taking this medicine, your doctor will check if you have diabetes or are at risk of developing diabetes. This risk of diabetes increases if you have high sugar and fat levels in your blood, are overweight, and have high blood pressure.

Other medicines and Caduet

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

There are some medicines that can interact with Caduet. This interaction can mean that one or both medicines are less effective. It can also increase the risk or severity of side effects, including the important muscle damage known as rhabdomyolysis and myopathy (described in Section 4):

• Some antibiotics, such as rifampicin, fusidic acid, or "macrolide antibiotics", such as erythromycin, clarithromycin, telithromycin, or medicines for treating fungal infections, such as ketoconazole, itraconazole
• Medicines for controlling your lipid levels: fibrates, such as gemfibrozil or colestipol
• Medicines for controlling your heart rate, such as amiodarone, diltiazem, and verapamil
• Anticonvulsants, such as carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone
• Medicines used to modify the functioning of your immune system, such as cyclosporine, tacrolimus, sirolimus, temsirolimus, and everolimus
• Medicines used in the treatment of HIV infection, such as ritonavir, lopinavir, atazanavir, indinavir, darunavir, tipranavir combined with ritonavir, etc., nelfinavir
• Some medicines used in the treatment of hepatitis C, such as telaprevir, boceprevir, and the combination of elbasvir/grazoprevir, ledipasvir/sofosbuvir
• Letermovir, a medicine that helps prevent diseases caused by cytomegalovirus
• Medicines used in the treatment of depression, such as nefazodone and imipramine
• Medicines used in the treatment of mental disorders, such as neuroleptics
• Medicines for treating heart failure, such as beta-blockers
• Medicines for treating high blood pressure, such as angiotensin II receptor antagonists, ACE inhibitors, verapamil, and diuretics
• Alpha-blockers used in the treatment of high blood pressure and prostate problems
• Other medicines that are known to interact with Caduet include ezetimibe (which reduces cholesterol), warfarin (which reduces blood clotting), oral contraceptives, stiripentol (anticonvulsants for treating epilepsy), cimetidine (used for heartburn and peptic ulcers), phenazone (a pain reliever), colchicine (used for treating gout), and antacids (indigestion products containing aluminum or magnesium)
• Amifostine (used for cancer treatment)
• Sildenafil (for erectile dysfunction)
• Dantrolene and baclofen (muscle relaxants)
• Corticosteroids
• Medicines without a prescription that contain St. John's Wort (Hypericum perforatum)
• If you need to take fusidic acid orally to treat a bacterial infection, you will need to stop using this medicine. Your doctor will tell you when you can restart treatment with Caduet. The use of Caduet with fusidic acid can cause muscle weakness, sensitization, or pain (rhabdomyolysis). For more information on rhabdomyolysis, see section 4.

Caduet can lower your blood pressure even more if you are already taking other medicines to treat high blood pressure.

Tell your doctor or pharmacist if you are using or have recently used other medicines, including those obtained without a prescription.

Taking Caduet with food, drinks, and alcohol

Caduet can be taken at any time of the day, with or without food.

Grapefruit juice

Do not drink more than one or two glasses of grapefruit juice per day, as large quantities of grapefruit juice can alter the effects of Caduet.

Alcohol

Avoid drinking too much alcohol while taking Caduet. See the details in the "Warnings and precautions" section.

Pregnancy, breastfeeding, and fertility

Do not take Caduet if you are pregnant, breastfeeding, or trying to become pregnant. When taking Caduet or any other medicine, women of childbearing age should take adequate contraceptive measures. Consult your doctor or pharmacist before using any medicine.

Amlodipine has been shown to pass into breast milk in small amounts.

Driving and using machines

Do not drive or operate machinery if you feel dizzy after taking this medicine.

Caduet contains sodium

This medicine contains less than 23 mg of sodium (1mmol) per tablet, which is essentially "sodium-free".

3. How to take Caduet

Follow exactly the administration instructions of this medicine given by your doctor or pharmacist. If you are unsure, consult your doctor or pharmacist again.

Adults

The usual initial dose of Caduet for adults is one 5 mg/10 mg tablet per day. If necessary, your doctor may increase the dose to one 10 mg/10 mg tablet per day.

Caduet should be swallowed whole, with a little water. The tablets can be taken orally at any time of the day, with or without food. However, try to take your tablet at the same time every day.

Follow your doctor's dietary recommendations, especially regarding fat restriction in your diet, quitting smoking, and regular exercise.

If you think the effect of the Caduet tablets is too strong or too weak, tell your doctor or pharmacist.

Use in children and adolescents

This medicine is not recommended for children and adolescents.

If you take more Caduet than you should

If you accidentally take too many Caduet tablets (more than your usual daily dose), consult your doctor or the nearest hospital or call the Toxicology Information Service, phone 91 562 04 20 (indicating the medicine and the amount taken). Bring the remaining tablets, the package, and the complete box so that hospital staff can easily identify the medicine you have taken.

Excess fluid can accumulate in the lungs (pulmonary edema) causing difficulty breathing, which can develop up to 24-48 hours after ingestion.

If you forget to take Caduet

If you forget to take a dose, take the next scheduled dose at the correct time.

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

If you stop taking Caduet

Do not stop taking Caduet unless your doctor tells you to. If you have any further questions on the use of this medicine or wish to stop treatment, 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.

If any of the following occur, stop taking Caduet and inform your doctor immediately

• Swelling of the face, tongue, and airways that can cause great difficulty in breathing.
• If you have unexplained muscle weakness, muscle pain on palpation, pain or rupture in the muscles, or brownish-red urine color, and at the same time, you feel unwell or have a fever. (Very rarely, this combination of effects can become a potentially life-threatening disease called rhabdomyolysis).
• Lupus-like syndrome (including rash, joint disorders, and effects on blood cells).

Very common: may affect more than 1 in 10 people

• Swelling of arms, hands, legs, joints, or feet

Common: may affect up to 1 in 10 people

• Allergic reaction
• Headache (especially at the beginning of treatment), dizziness, feeling of fatigue, somnolence
• Irregular heartbeats, flushing
• Palpitations (abnormal sensation of heartbeat), difficulty breathing
• Nasal passage inflammation, sore throat, nosebleeds
• Feeling of discomfort, abdominal pain, indigestion, changes in bowel habits (including diarrhea, constipation, and flatulence)
• Pain in muscles and joints, muscle cramps and spasms, back pain, pain in the limbs, muscle fatigue
• Increased blood sugar levels (if you have diabetes, you should continue to carefully monitor your blood sugar levels), increased creatine kinase in the blood, blood test results showing that your liver function may become abnormal
• Vision problems (including double vision), blurred vision

Uncommon: may affect up to 1 in 100 people

• Hepatitis (inflammation of the liver)
• Rhinorrhea, loss of appetite, decreased blood sugar levels (if you have diabetes, you should continue to carefully monitor your blood sugar levels), weight gain or loss
• Difficulty sleeping, with nightmares, mood changes (including anxiety), depression, tremors, nervous system sensitivity (decreased sensitivity) of the arms and legs, memory loss
• Ringing or buzzing in the ears, weakness, increased sweating, low blood pressure
• Dry mouth, taste disturbances, vomiting, belching
• Hair loss, bruising or small spots on the skin, skin discoloration, decreased skin sensitivity to touch or pain, numbness or tingling in the fingers and toes, skin rash, urticaria, or itching
• Urinary disorders (including excessive urination at night and increased frequency of urination), impotence, abnormal breast development in men
• Feeling of discomfort, pancreatitis (inflammation of the pancreas that causes stomach pain), pain, neck pain, chest pain
• Positive urine tests for white blood cells
• Abnormal heart rhythm
• Cough

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

• Unexpected bleeding or bruising
• Severe muscle inflammation, very intense muscle pain or cramps, muscle rupture that can rarely lead to rhabdomyolysis (destruction of muscle cells) and abnormal muscle rupture. Abnormal muscle rupture may not always disappear, even after stopping Caduet, and can be life-threatening and cause kidney problems
• Decreased platelet count in the blood
• Liver disorders (yellowing of the skin and whites of the eyes)
• Severe allergic skin reactions, skin redness, blistering rash, skin peeling that can spread rapidly to the rest of the body and may start with symptoms such as those of the flu, accompanied by high fever (toxic epidermal necrolysis)
• Inflammation of the deep layers of the skin - including inflammation of the lips, eyelids, and tongue
• Inflammation or swelling of the skeletal muscle, blistering rash, sudden and severe skin inflammation in an area
• Tendon inflammation, tendon injury
• Confusion

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

• Allergic reaction - symptoms may include sudden wheezing and chest pain or tightness, swelling of the eyelids, face, lips, mouth, tongue, or throat, difficulty breathing, collapse
• Decreased white blood cell count
• Increased muscle tension or stiffness
• Heart attack, inflammation of small blood vessels, stomach pain (gastritis)
• Gum growth, gum bleeding
• Hearing loss, liver failure
• Photosensitivity (skin sensitivity to light)

Frequency not known: cannot be estimated from available data

• Constant muscle weakness

• Sexual dysfunction
• Respiratory problems including persistent cough and/or difficulty breathing or fever
• Disorders combining stiffness, tremors, and/or movement disorders
• Diabetes. It is more likely if you have high sugar and fat levels in the blood, are overweight, and have high blood pressure. Your doctor will monitor you while you are taking this medicine
• Severe myasthenia (a disease that causes generalized muscle weakness that, in some cases, affects the muscles used for breathing)

Eye myasthenia (a disease that causes weakness of the eye muscles).

Consult your doctor if you experience weakness in the arms or legs that worsens after periods of activity, double vision, or drooping eyelids, difficulty swallowing, or difficulty breathing.

Reporting of Adverse Effects

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

5. Storage of Caduet

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

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

Do not store above 30°C.

Medicines should not be disposed of through wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE collection point in the pharmacy. 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 Caduet

The active ingredients are amlodipine and atorvastatin. The Caduet 5 mg/10 mg tablets contain 5 mg of amlodipine as amlodipine besylate and 10 mg of atorvastatin as atorvastatin calcium trihydrate.

The other ingredients are: calcium carbonate, sodium croscarmellose, microcrystalline cellulose, pregelatinized maize starch, polysorbate 80, hypromellose, colloidal silicon dioxide (anhydrous), and magnesium stearate.

The coating of the Caduet 5 mg/10 mg tablets contains: Opadry II White 85F28751 (polyvinyl alcohol, titanium dioxide (E171), and macrogol 3000, talc).

Appearance of the Product and Package Contents

The Caduet 5 mg/10 mg tablets are white, oval-shaped, marked with "CDT 051" on one side, and smooth on the other.

The Caduet tablets are available in packs with blister packs containing 7, 10, 14, 20, 28, 30, 50, 56, 60, 90, 100, or 200 tablets, or bottles with child-resistant closures containing 30 or 90 tablets.

Only some pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Viatris Healthcare Limited

Damastown Industrial Park

Mulhuddart, Dublin 15

Dublin

Ireland

Manufacturer

Pfizer Manufacturing Deutschland GmbH

Mooswaldallee 1

79108 Freiburg Im Breisgau

Germany

or

Mylan Hungary Kft.

Mylan utca 1

Komárom, 2900

Hungary

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

Viatris Pharmaceuticals, S.L.U.

Calle General Aranaz, 86

28027 Madrid

Spain

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

Austria Caduet

Czech Republic Caduet

France Caduet

Hungary Caduet

Latvia Caduet

Malta Caduet

Portugal Caduet

Spain Caduet

Date of the last revision of this prospectus: 03/2023

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/)