Deferasirox Vivanta 90 mg Film-Coated Tablets

Introduction

Package Leaflet: Information for the User

Deferasirox Vivanta 90mg film-coated tablets EFG

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

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

1. What is Deferasirox Vivanta and what is it used for

What isDeferasirox Vivanta

Deferasirox Vivanta contains the active substance deferasirox. It is an iron chelator, a medicine used to remove excess iron from the body (also called iron overload). It captures and removes excess iron, which is then mainly excreted in the feces.

WhatDeferasirox Vivantais used for

Repeated blood transfusions may be necessary in patients with various types of anemia (e.g., thalassemia, sickle cell anemia, or myelodysplastic syndromes (MDS)). However, repeated blood transfusions can cause an accumulation of excess iron. This is because blood contains iron, and the body has no natural way to remove excess iron obtained from blood transfusions. In patients with non-transfusion-dependent thalassemic syndromes, iron overload may also appear over time, mainly due to increased absorption of iron from the diet in response to low blood cell counts. Over time, excess iron can damage important organs such as the liver and heart. Medicines called iron chelators are used to remove excess iron and reduce the risk of organ damage.

Deferasirox is used to treat chronic iron overload caused by frequent blood transfusions in patients with beta-thalassemia major, aged 6 years and older.

Deferasirox is also used to treat chronic iron overload when treatment with deferoxamine is contraindicated or not suitable in patients with beta-thalassemia major with iron overload caused by infrequent blood transfusions, in patients with other types of anemia, and in children aged 2 to 5 years.

Deferasirox is also used to treat patients aged 10 years and older who have iron overload associated with thalassemic syndromes but are not transfusion-dependent, when treatment with deferoxamine is contraindicated or not suitable.

2. What you need to know before you take Deferasirox Vivanta

Do not take Deferasirox Vivanta

• if you are allergic to deferasirox or any of the other ingredients of this medicine (listed in section 6). If this applies to you, tell your doctor before taking Deferasirox. If you think you may be allergic, consult your doctor.
• if you have moderate or severe kidney disease.
• if you are currently taking any other iron chelator medicine.

Deferasirox Vivanta is not recommended

• if you are in an advanced stage of myelodysplastic syndrome (MDS, decreased production of blood cells by the bone marrow) or have advanced cancer.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Deferasirox.

• if you have a kidney or liver problem.
• if you have a heart problem due to iron overload.
• if you notice a pronounced decrease in the amount of urine you pass (sign of a kidney problem).
• if you develop a severe rash, or difficulty breathing and dizziness or swelling mainly of the face and throat (signs of a severe allergic reaction, see also section 4 «Possible side effects»).
• if you experience a combination of any of the following symptoms: a rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, high fever, flu-like symptoms, swollen lymph nodes (signs of a severe skin reaction, see also section 4 «Possible side effects»).
• if you notice a combination of drowsiness, pain in the upper right abdomen, yellowing of the skin or eyes, and dark urine (signs of liver problems).
• if you notice difficulty thinking, remembering information, or solving problems, or are less conscious or awake, or feel drowsy and weak (signs of high ammonia levels in the blood, which may be associated with liver or kidney problems, see also section 4 «Possible side effects»).
• if you suffer from vomiting blood and/or black stools.
• if you suffer from frequent abdominal pain, particularly after eating or taking deferasirox.
• if you suffer from frequent heartburn.
• if you have a low platelet or white blood cell count in your blood test.
• if you have blurred vision.
• if you have diarrhea or vomiting.

If you are in any of these situations, inform your doctor immediately.

Monitoring of your treatment with Deferasirox Vivanta

During treatment, you will have regular blood and urine tests. These tests will monitor the amount of iron in your body (ferritin level in the blood) to see how well the treatment with deferasirox is working. The tests will also monitor kidney function (creatinine level in the blood, protein in the urine) and liver function (transaminase level in the blood). Your doctor may ask you to have a kidney biopsy if they suspect significant kidney damage. They may also perform MRI (magnetic resonance imaging) tests to determine the amount of iron in your liver. Your doctor will take these tests into account to decide on the most suitable dose of Deferasirox Vivanta for you and will also use these tests to decide when you should stop your treatment with Deferasirox.

Every year, your vision and hearing will be checked during treatment as a precaution.

Other medicines and Deferasirox Vivanta

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. This includes, in particular:

• other iron chelators, which must not be taken with deferasirox,
• antacids (medicines used to treat heartburn) that contain aluminum, which must not be taken at the same time of day as Deferasirox,
• cyclosporine (used to prevent organ rejection after a transplant or for other diseases such as rheumatoid arthritis or atopic dermatitis),
• simvastatin (used to lower cholesterol levels),
• certain painkillers or anti-inflammatory medicines (e.g., aspirin, ibuprofen, corticosteroids),
• oral bisphosphonates (used to treat osteoporosis),
• anticoagulant medicines (used to prevent or treat blood clots),
• hormonal contraceptives (medicines for birth control),
• bepridil, ergotamine (used for heart problems and for migraines),
• repaglinide (used to treat diabetes),
• rifampicin (used to treat tuberculosis),
• phenytoin, phenobarbital, carbamazepine (used to treat epilepsy),
• ritonavir (used to treat HIV infection),
• paclitaxel (used to treat cancer),
• theophylline (used to treat respiratory diseases such as asthma),
• clozapine (used to treat psychiatric disorders such as schizophrenia),
• tizanidine (used as a muscle relaxant),
• cholestyramine (used to lower cholesterol levels in the blood).
• busulfan (used as pre-transplant treatment to destroy the original bone marrow before the transplant),
• midazolam (used to relieve anxiety and/or sleep disturbances.)

Additional tests may be needed to monitor the levels of some of these medicines in the blood.

Older adults (65 years and older)

Deferasirox can be used by people over 65 years of age at the same dose as other adults. Older patients may experience more side effects (especially diarrhea) than younger patients. The doctor should closely monitor side effects that may require a dose adjustment.

Children and adolescents

Deferasirox can be used in children and adolescents aged 2 years and older who receive periodic blood transfusions and in children and adolescents aged 10 years and older who do not receive periodic blood transfusions. As the patient grows, the doctor will adjust the dose.

Deferasirox is not recommended in children under 2 years of age.

Pregnancy and breastfeeding

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

Deferasirox is not recommended during pregnancy unless clearly necessary.

If you are currently using a hormonal contraceptive to prevent pregnancy, you should use an additional or different contraceptive (e.g., condom), as Deferasirox may reduce the effectiveness of hormonal contraceptives.

Breastfeeding is not recommended during treatment with Deferasirox.

Driving and using machines

If you feel dizzy after taking deferasirox, do not drive or operate tools or machines until you feel normal again.

Deferasirox Vivanta contains lactose and sodium.

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

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

3. How to take Deferasirox Vivanta

Treatment with deferasirox will be supervised by a doctor with experience in the treatment of iron overload caused by blood transfusions.

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

How much deferasirox to take

The dose of deferasirox is related to body weight for all patients. Your doctor will calculate the dose you need and tell you how many tablets to take each day.

• The usual daily dose of deferasirox film-coated tablets at the start of treatment for patients who receive periodic blood transfusions is 14 mg per kilogram of body weight. Your doctor may recommend a higher or lower dose depending on your individual treatment needs.
• The usual daily dose of deferasirox film-coated tablets at the start of treatment for patients who do not receive periodic blood transfusions is 7 mg per kilogram of body weight.
• Depending on how you respond to treatment, your doctor may later adjust your treatment to a higher or lower dose.
• The maximum recommended daily dose of deferasirox film-coated tablets is:
• • 28 mg per kilogram of body weight for patients who receive periodic blood transfusions,
  • 14 mg per kilogram of body weight for adult patients who do not receive periodic blood transfusions,
  • 7 mg per kilogram of body weight for children and adolescents who do not receive periodic blood transfusions.

In some countries, deferasirox may also be available as dispersible tablets, manufactured by other manufacturers. If you are switching from these dispersible tablets to Deferasirox Vivanta film-coated tablets, the dose you should take will change. Your doctor will calculate the dose you need and inform you about how many film-coated tablets you should take each day.

When to take Deferasirox Vivanta

• Take deferasirox once a day, every day, at the same time with some water. Take deferasirox film-coated tablets on an empty stomach or with a light meal.
• Taking deferasirox at the same time every day will also help you remember when you should take your tablets.

Patients with difficulty swallowing tablets can crush deferasirox film-coated tablets and take the powder with a soft food, such as yogurt or apple sauce (apple puree). The entire dose should be consumed immediately, without saving any for later.

How long to take Deferasirox Vivanta

Continue taking deferasirox every day for as long as your doctor tells you.This is a long-term treatment, which may last for months or years. Your doctor will regularly check your condition to ensure that the treatment is having the desired effect (see also section 2: «Monitoring of your treatment with Deferasirox Vivanta»).

If you have doubts about how long you should take Deferasirox Vivanta, consult your doctor.

If you take more Deferasirox Vivanta than you should

If you have taken too much deferasirox, or if someone else has taken your tablets by accident, contact your doctor or go to a hospital immediately. Show the doctor the pack of tablets. You may need urgent medical treatment. You may notice effects such as abdominal pain, diarrhea, nausea, and vomiting, and kidney or liver problems, which can be serious.

In case of overdose or accidental ingestion, go to a medical center or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medicine and the amount used.

If you forget to take Deferasirox Vivanta

If you have forgotten to take a dose, take it as soon as you remember on the same day. Take the next dose according to the usual schedule. Do not take a double dose the next day to make up for the missed dose(s).

If you stop taking Deferasirox Vivanta

Do not stop your treatment with deferasirox unless your doctor tells you to. If you stop taking it, the excess iron will not be removed from your body (see also previous section «How long to take Deferasirox Vivanta»).

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them. Most adverse effects are mild or moderate and usually disappear after a few days or weeks of treatment.

Some adverse effects can be serious and require immediate medical attention.

These adverse effects are uncommon (may affect up to 1 in 100people) or rare (may affect up to 1 in 1,000people)

• If you have a severe rash,or difficulty breathing and dizziness or swelling, especially on the face and throat (signs of a severe allergic reaction),
• If you experience a combination of any of the following symptoms: rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, high fever, flu-like symptoms, swollen lymph nodes (signs of a severe skin reaction).
• If you notice a pronounced decrease in urine volume (sign of a kidney problem),
• If you notice a combination of drowsiness, pain in the upper right abdomen, yellowing of the skin or eyes, and dark urine (signs of liver problems),
• If you notice difficulty thinking, remembering information, or solving problems, or are less conscious or awake, or feel drowsy and weak (signs of high ammonia levels in the blood, which can be associated with liver or kidney problems and cause a change in brain function),
• If you suffer from vomiting blood and/or black stools,
• If you suffer from frequent abdominal pain, particularly after eating or taking deferasirox,
• If you suffer from frequent heartburn,
• If you have partial loss of vision,
• If you have severe pain in the upper abdomen (pancreatitis),

Stop taking the medicine and inform your doctor immediately.

Some adverse effects can be serious.

These adverse effects are uncommon

• If you have blurred vision,
• If you lose hearing ability,

inform your doctor as soon as possible.

Other Adverse Effects

Very common (may affect more than 1 in 10people)

• Changes in kidney function tests.

Common (may affect up to 1 in 10people)

• Gastrointestinal disorders, such as nausea, vomiting, diarrhea, abdominal pain, bloating, constipation, indigestion.
• Rashes
• Headache
• Changes in liver function tests
• Itching
• Changes in urine tests (protein in the urine)

If you suffer from any of these effects severely, inform your doctor.

Uncommon (may affect up to 1 in 100people)

• Dizziness
• Fever
• Sore throat
• Swelling in arms and legs
• Changes in skin color
• Anxiety
• Sleep disturbance
• Fatigue

If you suffer from any of these effects severely, inform your doctor.

Frequency Not Known(cannot be calculated from available data).

• Decrease in the number of cells involved in blood clotting (thrombocytopenia), red blood cells (worsening of anemia), white blood cells (neutropenia), or all types of blood cells (pancytopenia)
• Hair loss
• Kidney stones
• Low urine production
• Rupture of the stomach or intestine wall, which can be painful and cause nausea
• Severe pain in the upper abdomen (pancreatitis)
• Abnormal acid levels in the blood

Reporting Adverse Effects

If you experience any adverse effects, consult your doctor or pharmacist, even if they are possible adverse effects not listed in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Storage of Deferasirox Vivanta

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

This medicine does not require special storage conditions.

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

Do not use any packaging that is damaged or shows signs of tampering.

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 your pharmacy. If in doubt, 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 Deferasirox Vivanta

The active ingredient is deferasirox.

• Each film-coated tablet contains 90 mg of deferasirox.

The other ingredients are:

Tablet core

Microcrystalline cellulose (E460); sodium croscarmellose; low-substituted hydroxypropylcellulose (E463), poloxamer 188, povidone K30, lactose monohydrate, colloidal anhydrous silica (E551), sodium stearyl fumarate, hydrogenated castor oil.

Tablet coating

Opadry yellow 03H520019 (HPMC 2910/Hypromellose (E464)), titanium dioxide (E171), propylene glycol (E1520), talc (E553b), yellow iron oxide (E172).

Appearance of Deferasirox Vivanta and Package Contents

Yellow, oval, film-coated tablets (approximately 11 mm x 4 mm), biconvex, with beveled edges and engraved with "D" on one side and "90" on the other).

Each blister pack contains 30 or 90 film-coated tablets.

Only certain pack sizes may be marketed.

Marketing Authorization Holder

Vivanta Generics s.r.o.

Trtinová 260/1, Cakovice

196 00 Prague 9

Czech Republic

Manufacturer

Pharmadox Healthcare Ltd

KW20A Kordin Industrial Park,

Paola, PLA3000,

Malta

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

Local Representative:

Mabo-Farma S.A.

Calle Vía de los Poblados 3, Edificio 6

28033 Madrid

Spain

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

The Netherlands Deferasirox Vivanta 90 mg

Germany Deferasirox Vivanta 90 mg Filmtabletten

Spain Deferasirox Vivanta 90 mg film-coated tablets EFG

Italy Deferasirox Vivanta

Date of the last revision of this leaflet: 11/2022

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/.