CANDIFIX 150 mg HARD CAPSULES

Introduction

Package Leaflet: Information for the User

Candifix 150 mg Hard Capsules EFG

Fluconazole

Read the package leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this package 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, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the Package Leaflet

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

1. What is Candifix and what is it used for

Candifix is one of a group of medicines called “antifungals”. The active substance is fluconazole.

Candifix is used to treat infections caused by fungi, and it can also be used to prevent fungal infections from occurring. The most common cause of fungal infections is a yeast called Candida.

Adults

Your doctor may prescribe this medicine to treat the following types of fungal infections:

• Cryptococcal meningitis – a fungal infection in the brain.
• Coccidioidomycosis – a disease of the bronchopulmonary system.
• Infections caused by Candidathat are localized in the bloodstream, in body organs (e.g., heart, lungs), or in the urinary tract.
• Mucosal candidiasis – an infection that affects the lining of the mouth, throat, or is associated with dental prostheses.
• Genital candidiasis – an infection of the vagina or penis.
• Skin infections – e.g., athlete's foot, ringworm, jock itch, nail infections.

They may also prescribe this medicine for:

• Preventing the recurrence of cryptococcal meningitis.
• Preventing the recurrence of mucosal Candidainfections.
• Reducing the repeated occurrence of vaginal Candidainfections.
• Preventing the spread of Candidainfections (if your immune system is weak and not functioning properly).

Children and Adolescents (0 to 17 years)

Your doctor may prescribe this medicine to treat the following types of fungal infections:

• Mucosal candidiasis – an infection that affects the lining of the mouth or throat.
• Infections caused by Candidathat are localized in the bloodstream, in body organs (e.g., heart, lungs), or in the urinary tract.
• Cryptococcal meningitis – a fungal infection in the brain.

They may also prescribe this medicine for:

• Preventing the spread of Candidainfections (if your immune system is weak and not functioning properly).
• Preventing the recurrence of cryptococcal meningitis.

2. What you need to know before you take Candifix

Do not take Candifix:

• If you are allergic (hypersensitive) to fluconazole, to other medicines you have taken to treat fungal infections, or to any of the other ingredients of this medicine (listed in section 6). The symptoms can include itching, skin redness, or difficulty breathing.
• If you are taking astemizole, terfenadine (antihistamine medicines for treating allergies).
• If you are taking cisapride (used to treat stomach upset).
• If you are taking pimozide (used to treat mental illnesses).
• If you are taking quinidine (used to treat heart arrhythmias).
• If you are taking erythromycin (an antibiotic for treating infections).

Warnings and Precautions

Consult your doctor or pharmacist before starting to take Candifix:

• If you have liver or kidney problems.
• If you have a heart condition, including heart rhythm problems.
• If you have abnormal levels of potassium, calcium, or magnesium in your blood.
• If severe skin reactions occur (itching, skin redness, or difficulty breathing).
• If signs of "adrenal insufficiency" appear, in which the adrenal glands do not produce enough of certain hormones, such as cortisol (chronic or prolonged fatigue, muscle weakness, loss of appetite, weight loss, abdominal pain).
• If you have ever had a severe skin rash or skin peeling, blisters, and/or sores in the mouth after taking Candifix.

Severe skin reactions, including drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in relation to fluconazole treatment. Stop taking fluconazole and seek immediate medical attention if you notice any of the symptoms related to these severe skin reactions described in section 4.

Talk to your doctor or pharmacist if the fungal infection does not improve; it may be necessary to use an alternative antifungal treatment.

Other Medicines and Candifix

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

Inform your doctor immediately if you are taking astemizole, terfenadine (an antihistamine for treating allergies), cisapride (used for stomach upset), pimozide (used for treating mental illnesses), quinidine (used for treating heart arrhythmias), or erythromycin (an antibiotic for treating infections), as these medicines should not be taken with Candifix (see section: “Do not take Candifix if”).

There are some medicines that can interact with Candifix.

Make sure your doctor knows if you are taking any of the following medicines, as it may be necessary to adjust the dose or monitor to check that the medicines are still having the desired effect:

:

• Rifampicin or rifabutin (antibiotics for infections).
• Abrocitinib (used to treat atopic dermatitis, also known as eczema).
• Alfentanil, fentanyl (used as anesthetics).
• Amitriptyline, nortriptyline (used as antidepressants).
• Amphotericin B, voriconazole (antifungals).
• Medicines that make the blood less viscous, to prevent the formation of clots (warfarin or similar medicines).
• Benzodiazepines (midazolam, triazolam, or similar medicines) used to help sleep or for anxiety.
• Carbamazepine, phenytoin (used to treat seizures).
• Nifedipine, isradipine, amlodipine, verapamil, felodipine, and losartan (for hypertension - high blood pressure).
• Olaparib (used to treat ovarian cancer).
• Cyclosporine, everolimus, sirolimus, or tacrolimus (to prevent transplant rejection).
• Cyclophosphamide, vinca alkaloids (vincristine, vinblastine, or similar medicines) used to treat cancer.
• Halofantrine (used to treat malaria).
• Statins (atorvastatin, simvastatin, and fluvastatin or similar medicines) used to reduce high cholesterol levels.
• Methadone (used for pain).
• Celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Non-Steroidal Anti-Inflammatory Drugs - NSAIDs).
• Oral contraceptives.
• Prednisone (steroid).
• Zidovudine, also known as AZT; saquinavir (used in patients infected with HIV).
• Medicines for diabetes, such as chlorpropamide, glibenclamide, glipizida, or tolbutamide.
• Theophylline (used to control asthma).
• Tofacitinib (used to treat rheumatoid arthritis).
• Tolvaptan (used to treat hyponatremia [low sodium levels in the blood] or to slow down kidney function deterioration).
• Vitamin A (nutritional supplement).
• Ivacaftor (alone or in combination with medicines used to treat cystic fibrosis).
• Amiodarone (used to treat irregular heartbeats [arrhythmias]).
• Hydrochlorothiazide (diuretic).
• Ibrutinib (used to treat blood cancer).
• Lurasidone (used to treat schizophrenia).

Taking Candifix with Food and Drinks

You can take the medicine with or without food.

Pregnancy, Breast-feeding, and Fertility

If you are pregnant or breast-feeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

If you are planning to become pregnant, it is recommended that you wait one week after a single dose of fluconazole before becoming pregnant.

For longer treatment cycles with fluconazole, consult your doctor about the need to use adequate contraceptive methods during treatment, which should be continued for one week after the last dose.

Do not take fluconazole if you are pregnant, think you may be pregnant, or are planning to become pregnant, unless your doctor has told you to. If you become pregnant while taking this medicine or within one week of the last dose, consult your doctor.

Fluconazole taken during the first or second trimester of pregnancy may increase the risk of miscarriage. Fluconazole during the first trimester may increase the risk of a baby being born with congenital anomalies affecting the heart, bones, and/or muscles.

There have been reports of babies born with congenital anomalies affecting the skull, ears, and bones of the thigh and elbow in women treated for three months or more with high doses (400-800 mg daily) of fluconazole for coccidioidomycosis. The relationship between fluconazole and these cases is unclear.

You can continue breast-feeding after taking a single dose of 150 mg of fluconazole. You should not continue breast-feeding if you are taking repeated doses of fluconazole.

Driving and Using Machines

When driving or using machines, keep in mind that dizziness or seizures may occasionally occur.

Candifix Contains Lactose

This medicine contains lactose (milk sugar). If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

Candifix Contains Sodium

This medicine contains less than 1 mmol of sodium (23 mg) per capsule; it is essentially “sodium-free”.

3. How to Take Candifix

Follow the instructions for taking Candifix exactly as indicated by your doctor or pharmacist. If you are in doubt, consult your doctor or pharmacist again.

The capsules should be swallowed whole with the help of a glass of water. It is best to take your medicines at the same time every day.

The following is the recommended dose of this medicine for the different types of infections:

Adults

Use in Adolescents 12 to 17 Years of Age

Follow the dose indicated by your doctor (either the adult dose or the child dose).

Use in Children Up to 11 Years

The maximum daily dose for children is 400 mg per day.

The dose will be based on the child's weight in kilograms.

Use in Children 0 to 4 Weeks of Age

Use in children 3 to 4 weeks of age:

• The same dose as described in the table, but administered once every 2 days. The maximum dose is 12 mg per kilogram of body weight every 48 hours.

Use in children under 2 weeks of age:

• The same dose as described in the table, but administered once every 3 days. The maximum dose is 12 mg per kilogram of body weight every 72 hours.

Sometimes, doctors may prescribe different doses than those described. Follow the instructions for administration exactly as indicated by your doctor. Consult your doctor or pharmacist if you have doubts.

Elderly Patients

The usual adult dose, unless you have kidney problems.

Patients with Kidney Problems

Your doctor may change the dose, depending on how well your kidneys are functioning.

If You Take More Candifix Than You Should

In case of overdose or accidental ingestion, consult your doctor, pharmacist, or go to the nearest hospital immediately. You can also call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount taken. The symptoms of a possible overdose may include hearing, seeing, feeling, and thinking things that are not real (hallucinations and paranoid behavior). It may be appropriate to initiate symptomatic treatment (with supportive measures and stomach lavage if necessary).

If You Forget to Take Candifix

Do not take a double dose to make up for forgotten doses. If you have forgotten to take a dose, take it as soon as you remember. If it is almost time for the next dose, do not take the forgotten dose.

If you have any doubts about the use of this medicine, 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.

Stop taking fluconazole and seek medical attention immediately if you notice any of the following symptoms:

• Widespread rash, high body temperature, and enlarged lymph nodes (DRESS syndrome or drug hypersensitivity syndrome).

Some people develop allergic reactions, although severe allergic reactions are rare.If any adverse effect appears, talk to your doctor or pharmacist. This includes any possible adverse effect not mentioned in this prospectus. If you experience any of the following symptoms, inform your doctor immediately.

• Sudden wheezing, difficulty breathing, or chest tightness.
• Swelling of the eyelids, face, or lips.
• Itching all over the body, skin redness, or red spots with itching.
• Skin rash.
• Severe skin reactions, such as blistering rash (this can affect the mouth and tongue).

Fluconazole may affect your liver. Signs that indicate liver problems include:

• Fatigue.
• Loss of appetite.
• Vomiting.
• Yellowing of the skin or the whites of the eyes (jaundice).

If you experience any of these symptoms, stop taking the medicine and inform your doctor immediately.

Other Adverse Effects

Additionally, if you consider that any of the adverse effects you are suffering from is serious or if you notice any adverse effect not mentioned in this prospectus, inform your doctor or pharmacist.

Common adverse effects (may affect up to 1 in 10 patients) are:

• Headache.
• Stomach upset, diarrhea, discomfort, vomiting.
• Elevated blood test results indicating liver function.
• Rash.

Uncommon adverse effects (may affect up to 1 in 100 patients) are:

• Reduction of red blood cells, which can make your skin pale and cause weakness or difficulty breathing.
• Decreased appetite.
• Insomnia, feeling of numbness.
• Seizures, dizziness, feeling of spinning, tingling, pinching, or numbness, changes in taste sensation.
• Constipation, heavy digestion, gas, dry mouth.
• Muscle pain.
• Liver damage and yellowing of the skin and eyes (jaundice).
• Hives, blisters (hives), itching, increased sweating.
• Fatigue, general feeling of discomfort, fever.

Rare adverse effects (may affect up to 1 in 1000 patients) are:

• White blood cells in the blood that help defend against infections and blood cells that help stop bleeding, lower than normal.
• Red or purple discoloration of the skin, which may be due to a low number of platelets, other changes in blood cells.
• Changes in blood tests (high cholesterol, fat levels).
• Low potassium levels in the blood.
• Tremors.
• Abnormal electrocardiogram (ECG), changes in heart rate or rhythm.
• Liver function failure.
• Allergic reactions (sometimes severe), including widespread rash with blisters and skin peeling, severe allergic reactions, swelling of the lips or face.
• Hair loss.

Adverse effects of unknown frequency, but which may occur (cannot be estimated from the available data):

• Hypersensitivity reaction with skin rash, fever, inflamed glands, increased eosinophils (a type of white blood cell), and inflammation of internal organs (liver, lungs, heart, kidneys, and large intestine) (drug reaction or rash with eosinophilia and systemic symptoms [DRESS]).

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 does not appear in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es.

By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Candifix

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

Do not use this medicine after the expiration date stated on the packaging after CAD. The expiration date is the last day of the month indicated.

No special storage conditions are required.

Medicines should not be disposed of via wastewater or household waste. Deposit the packaging and medicines you no longer need at the SIGRE point in the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medicines you no longer need. This way, you will help protect the environment.

6. Package Contents and Additional Information

Composition of Candifix

The active ingredient is fluconazole. Each hard capsule contains 150 mg of fluconazole.

The other ingredients (excipients) are:

• Capsule content: lactose monohydrate (lactose), pregelatinized corn starch, magnesium stearate, anhydrous colloidal silica, and sodium lauryl sulfate.
• Capsule composition: gelatin and titanium dioxide (E171).

Appearance of the Product and Package Contents

The capsules have a white body and cap.

They are available in blisters of 1 and 4 hard capsules and in a clinical package of 100 hard capsules.

Only some package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing authorization holder:

ARAFARMA GROUP S.A.

C/ Fray Gabriel de San Antonio 6-10

Pol. Ind. del Henares

19180 Marchamalo. Guadalajara. Spain

Manufacturer:

ARAFARMA GROUP S.A.

C/ Fray Gabriel de San Antonio 6-10

Pol. Ind. del Henares

19180 Marchamalo. Guadalajara. Spain

Date of the Last Revision of this Prospectus:September 2024

Other Sources of Information

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