Enyglid 2 mg tablets

Introduction

Package Leaflet: Information for the Patient

Enyglid 0.5 mg EFG Tablets

Enyglid 1 mg EFG Tablets

Enyglid 2 mg EFG Tablets

repaglinide

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

1. What is Enyglid and what is it used for

Enyglid is an oral antidiabetic medicine that contains repaglinide, which helps your pancreas produce more insulin and lowers your blood sugar (glucose) level.

Type 2 diabetes is a disease in which your pancreas does not produce enough insulin to control your blood sugar level or in which your body is unable to respond properly to the insulin it produces.

Enyglid is used to control type 2 diabetes in adults, as an addition to diet and exercise: treatment should be started if diet, exercise and weight loss alone have not been able to control (or lower) your blood sugar level.

Enyglid can also be taken with metformin.

It has been shown that Enyglid lowers your blood sugar level, which helps to prevent complications of diabetes.

2. What you need to know before you take Enyglid

Do not take Enyglid

• If you are allergic to repaglinide or any of the other ingredients of this medicine (listed in section 6).
• If you have type 1 diabetes.
• If your blood acid level is increased (diabetic ketoacidosis).
• If you have severe liver disease.
• If you are taking gemfibrozil (a medicine used to lower fat levels in the blood).

Warnings and precautions

Consult your doctor before taking Enyglid:

• If you have liver problems. Enyglid is not recommended for patients with moderate liver disease. Enyglid should not be taken if you have severe liver disease (see Do not take Enyglid).
• If you have kidney problems. Enyglid should be taken with caution.
• If you are going to have major surgeryor have recently had a serious illness or infection. In these circumstances, you may not achieve diabetic control.
• If you are under 18or over 75 years, Enyglid is not recommended. It has not been studied in these age groups.

Consult your doctorif any of the above applies to you. Enyglid may not be suitable for you. Your doctor will advise you.

Children and adolescents

Do not take this medicine if you are under 18 years old.

If you have low blood sugar (hypoglycaemia)

You may have hypoglycaemia if your blood sugar level is too low. This can happen:

• If you take too much Enyglid.
• If you do more exercise than usual.
• If you take other medicines or have kidney or liver problems (see other sections of section 2, What you need to know before you take Enyglid).

Warning signs of hypoglycaemiaappear suddenly and can be: cold sweat, cool pale skin, headache, fast heartbeat, nausea, excessive hunger, temporary visual disturbances, fatigue, weakness and unusual tiredness, nervousness or tremor, anxiety, confusion and difficulty concentrating.

If your blood sugar level is low or if you feel that you are going to have a hypoglycaemia:take glucose tablets or a sugary drink and rest.

When the symptoms of hypoglycaemia disappear or when your blood sugar levels stabilise, continue with your treatment with Enyglid.

Inform others that you have diabetes and that if you lose consciousnessdue to hypoglycaemia, they should lay you on your side and seek immediate medical assistance. They should not give you anything to eat or drink, as you may choke.

• If severe hypoglycaemiais not treated, it can cause brain damage (temporary or permanent) or even death.
• If you have a hypoglycaemiathat makes you lose consciousness or if you have repeated hypoglycaemias, inform your doctor. You may need to adjust the dose or administration schedule of Enyglid, your diet or exercise.

If your blood sugar level is too high

Your blood sugar level may become too high (hyperglycaemia). This can happen:

• If you take too little Enyglid.
• If you have an infection or fever.
• If you eat more than usual.
• If you do less exercise than usual.

Warning signs of high blood sugarappear gradually. These include: excessive urination, thirst, dry skin and a feeling of dryness in the mouth. Inform your doctor. You may need to adjust the dose of Enyglid, your diet or exercise.

Using Enyglid with other medicines

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

If your doctor prescribes it, you can take Enyglid with metformin, another medicine for diabetes.

If you are taking gemfibrozil (used to lower fat levels in the blood), you should not take Enyglid.

Your body's response to Enyglid may change if you take other medicines, especially:

• Monoamine oxidase inhibitors (MAOIs) (for the treatment of depression).
• Beta-blockers (for the treatment of high blood pressure or heart disease).
• ACE inhibitors (for the treatment of heart disease).
• Salicylates (e.g. aspirin).
• Octreotide (for the treatment of cancer).
• Non-steroidal anti-inflammatory drugs (NSAIDs) (a type of pain reliever).
• Steroids (anabolic steroids and corticosteroids, for anaemia or to treat inflammation).
• Oral contraceptives (to prevent pregnancy).
• Thiazides (diuretics).
• Danazol (for the treatment of breast cysts and endometriosis).
• Thyroid products (for the treatment of low thyroid hormone levels).
• Sympathomimetics (for the treatment of asthma).
• Clarithromycin, trimethoprim, rifampicin (antibiotic medicines).
• Itraconazole, ketoconazole (medicine for fungal infections).
• Gemfibrozil (to treat high fat levels in the blood).
• Ciclosporin (to suppress the immune system).
• Deferasirox (to reduce chronic iron overload)
• Clopidogrel (to prevent blood clots)
• Phenytoin, carbamazepine, phenobarbital (to treat epilepsy).
• St John's Wort (a herbal medicinal plant).

Using Enyglid with alcohol

Alcohol may change the effect of Enyglid on your blood sugar level. Be aware of the signs of hypoglycaemia.

Pregnancy and breast-feeding

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

Do not take Enyglid if you are pregnant or planning to become pregnant.

Do not take Enyglid if you are breast-feeding.

Driving and using machines

Your ability to drive or operate machines may be affected if your blood sugar level is too low or too high. Be aware that you may put yourself or others at risk.

Consult your doctor about the possibility of driving a car if:

• You have frequent hypoglycaemias
• You have few or no symptoms of hypoglycaemia

Enyglid contains sodium

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

3. How to take Enyglid

Take this medicine exactly as your doctor has told you. If you are not sure, ask your doctor again.

Your doctor will calculate your dose.

• Normally, the initial dose is 0.5 mg taken immediately before each main meal. The tablets should be taken with a glass of water immediately before or within 30 minutes before each main meal.
• The dose may be adjusted by your doctor up to 4 mg, which should be taken immediately before or within 30 minutes before each main meal. The maximum recommended dose is 16 mg per day.

Do not take more Enyglid than your doctor has recommended.

If you take more Enyglid than you should

If you take too many tablets, your blood sugar level may become too low and you may have a hypoglycaemia. Please read what a hypoglycaemia is and how to treat it in the section If you have low blood sugar (hypoglycaemia).

If you forget to take Enyglid

If you miss a dose, take the next dose as you normally would.

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

If you stop taking Enyglid

Be aware that the desired effect will not be achieved if you stop taking Enyglid. Your diabetes may worsen. If any change in your treatment is necessary, consult your doctor first.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Hypoglycaemia

The most common side effect is hypoglycaemia, which can affect up to 1 in 10 people (see If you have low blood sugar (hypoglycaemia) in section 2). Hypoglycaemic reactions are usually mild or moderate but can occasionally lead to loss of consciousness or hypoglycaemic coma. If this happens, you need immediate medical assistance.

Allergic reactions

Cases of allergic reactions are very rare (may affect up to 1 in 10,000 people). Symptoms such as swelling, difficulty breathing, fast heartbeat, dizziness, sweating, may be signs of an anaphylactic reaction. Contact your doctor immediately.

Other side effects

Common(may affect up to 1 in 10 people)

• Stomach pain
• Diarrhoea

Uncommon(may affect up to 1 in 1,000 people)

• Acute coronary syndrome (but may not be due to the medicine)

Rare(may affect up to 1 in 10,000 people):

• Vomiting
• Constipation
• Visual disturbances
• Severe liver problems, abnormal liver function such as increased liver enzymes in the blood

Frequency not known(cannot be estimated from the available data)

• Hypersensitivity (such as rash, itching, redness and swelling)
• Feeling unwell (nausea)

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Enyglid

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

Do not use this medicine after the expiry date which is stated on the blister or carton after "EXP". The expiry date refers to the last day of that month.

Store in the original package to protect from light.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and other information

What Enyglid contains

• The active substance is repaglinide. Each tablet contains 0.5 mg, 1 mg or 2 mg of repaglinide.
• The other ingredients are microcrystalline cellulose (E460), calcium hydrogen phosphate, sodium croscarmellose, povidone K25, glycerol, magnesium stearate, meglumine, poloxamer, yellow iron oxide (E172) only in the 1 mg tablets and red iron oxide (E172) only in the 2 mg tablets. See section 2 "Enyglid contains sodium".

Appearance of Enyglid and contents of the pack

The 0.5 mg tablets are white, round and biconvex with bevelled edges.

The 1 mg tablets are pale yellowish-brown, round and biconvex with bevelled edges and possible dark spots.

The 2 mg tablets are pink, mottled, round and biconvex with bevelled edges and possible dark spots.

Available in packs of 30, 60, 90, 120, 180, 270 or 360 tablets in blisters.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

ManufacturerKRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

TAD Pharma GmbH, Heinz-Lohmann-Straße 5, 27472 Cuxhaven, Germany

KRKA - FARMA d.o.o., V. Holjevca 20/E, 10450 Jastrebarsko, Croatia

For further information about this medicine, contact the local representative of the Marketing Authorisation Holder:

Date of last revision of this leaflet:

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu/.