Leaflet: information for the user

Estomil 15 mg hard-gastrorresistant EFG capsules

Lansoprazol

Read this leaflet carefully before starting to take this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any doubts, consult your doctor or pharmacist.
• This medicine has been prescribed for you only, and you must not give it to others, even if they have the same symptoms as you, as it may harm them.
• If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

Contents of theleaflet

1. WhatEstomilis and for what it is used
2. What you need to know before starting to takeEstomil
3. How to takeEstomil
4. Possible side effects
5. Storage ofEstomil
6. Contents of the package and additional information

The active ingredient is lansoprazol, a proton pump inhibitor. Proton pump inhibitors reduce the amount of acid produced by the stomach.

Your doctor may prescribe Estomil for the following indications:

• Treatment of duodenal and gastric ulcers
• Treatment of esophagitis caused by acid reflux
• Prevention of esophagitis caused by acid reflux
• Treatment of stomach burning and acid regurgitation
• Treatment of infections caused by the bacteria Helicobacter pylori, in combination with antibiotics
• Treatment or prevention of duodenal or gastric ulcers in patients requiring continuous treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) (NSAIDs are used for pain or inflammation)
• Treatment of Zollinger-Ellison syndrome

Your doctor may have prescribed Estomil for another indication or at a different dose than indicated in this leaflet. Follow your doctor's instructions for taking the medication.

You should consult a doctor if you worsen or do not improve after 14 days.

Do not take Estomil

• if you are allergic to lansoprazole or any of the other ingredients of this medicine (listed in section 6)

Warnings and precautions

Consult your doctor or pharmacist before starting to take Estomil:

• if you have reduced vitamin B12 reserves or risk factors for it and receive long-term treatment with lansoprazole. As all medicines that reduce the amount of acid, Estomil may reduce the absorption of vitamin B12,
• if you are scheduled to have a specific blood test (Cromogranina A),
• if you have ever had a skin reaction after treatment with a similar medicine to Estomil to reduce stomach acid,
• if you suffer from a skin rash, especially in sun-exposed areas, consult your doctor as soon as possible, as it may be necessary to interrupt Estomil treatment.Remember to mention any other symptoms you may notice, such as joint pain.

When taking lansoprazole, it may cause inflammation in the kidneys. Signs and symptoms may include decreased urine volume or the presence of blood in the urine and/or hypersensitivity reactions such as fever, skin rash, and joint stiffness. You must inform your doctor of these signs.

Inform your doctor if you have a severe liver disease. Your doctor may need to adjust the dose.

Your doctor may perform or have performed a supplementary test called endoscopy to diagnose your condition and/or rule out malignant disease.

In case of diarrhea during treatment withEstomil, contact your doctor immediately, asEstomilhas been associated with a slight increase in infectious diarrhea.

If your doctor has prescribedEstomilin addition to other medications for the treatment ofHelicobacter pyloriinfection (antibiotics) or with anti-inflammatory medications to treat pain or rheumatism, read the prospectuses of these medications carefully.

The fact of taking a proton pump inhibitor like Estomil, especially for a period of more than one year, may slightly increase the risk of fractures of the hip, wrist, or vertebrae. Inform your doctor if you have osteoporosis or are taking corticosteroids (which may increase the risk of osteoporosis).

If you have been takingEstomilfor a long time (more than 1 year), your doctor will probably perform regular checks. During your visits to your doctor, you must inform him of any new or abnormal symptoms and circumstances.

Other medicines and Estomil

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine, including those purchased without a prescription.

Especially, inform your doctor if you are using medicines that contain any of the following active ingredients, as Estomil may affect their mode of action:

• protease inhibitors for HIV such as atazanavir and nelfinavir (used in HIV treatment)
• methotrexate (used to treat autoimmune diseases and cancer)

• ketoconazole, itraconazole, rifampicin (used to treat infections)
• digoxin (used to treat heart problems)
• warfarin (used to treat blood clots)
• theophylline (used to treat asthma)
• tacrolimus (used to prevent transplant rejection)
• fluvoxamine (used to treat depression and other psychiatric disorders)
• antacids (used to treat heartburn or acid regurgitation)
• sucralfate (used to heal ulcers)
• St. John's Wort (Hypericum perforatum) (used to treat mild depression)

Taking Estomil with food and drinks

To get the best results from your medicine, you must takeEstomilat least 30 minutes before meals.

Pregnancy and breastfeeding

If you are pregnant, orin the lactation period, believe you may be pregnant or intend to become pregnant, consult your doctor or pharmacistbefore using this medicine.

Driving and operating machines

Patients takingEstomilmay occasionally experience side effects such as dizziness, vertigo, fatigue, and visual disturbances. If you experience any of these side effects, you must act with caution as your reaction time may be reduced.

You are the only one responsible for deciding whether you are in a condition to drive vehicles or perform activities that require a high level of concentration. Due to its effects or adverse reactions, one of the factors that may reduce your ability to carry out these operations safely is the use of medications.

In the following sections, you will find the descriptions of these effects.

Read this prospectus carefully.

If you have any doubts, ask your doctor or pharmacist.

Estomil contains saccharose and sodium hydroxide.

This medicine contains saccharose. If your doctor has indicated that you have an intolerance to certain sugars, consult with him before taking this medicine.

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

Follow exactly the administration instructions of this medication indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Take the entire capsule with a glass of water. If you have difficulty swallowing the capsule, your doctor will inform you of alternative ways to take the medication. Do not crush or chew the capsules or the contents of an empty capsule, as this will make them not work properly.

If you takeEstomilonce a day, try to take it at the same time every day. You may get better results if you takeEstomilin the morning.

If you takeEstomiltwice a day, you should take the first dose in the morning and the second at night.

The dose ofEstomildepends on your general condition. The normal doses ofEstomilfor adults are indicated below. In some cases, your doctor may prescribe a different dose and indicate a different duration of treatment.

Treatment of heartburn and acid regurgitation:one capsule of 15 mg or 30 mg per day for 4 weeks. If symptoms persist, inform your doctor. If symptoms do not improve after 4 weeks, consult your doctor.

Treatment of duodenal ulcer:one capsule of 30 mg per day for 2 weeks.

Treatment of gastric ulcer:one capsule of 30 mg per day for 4 weeks.

Treatment of esophagitis due to reflux:one capsule of 30 mg per day for 4 weeks.

Long-term prevention of esophagitis due to reflux:one capsule of 15 mg per day; your doctor may adjust the dose to one capsule of 30 mg per day.

Treatment of Helicobacter pylori infection:The normal dose is one capsule of 30 mg together with two different antibiotics in the morning and one capsule of 30 mg together with two different antibiotics at night. The treatment, usually, will be daily for 7 days.

The recommended antibiotic combinations are as follows:

• 30 mg ofEstomilwith 250–500 mg of clarithromycin and 1,000 mg of amoxicillin
• 30 mg ofEstomilwith 250 mg of clarithromycin and 400–500 mg of metronidazole

If you receive anti-infective treatment due to an ulcer, it is unlikely that the ulcer will recur if the infection is treated satisfactorily. To get the best results from your medication, take it at the right time anddo not forget any dose.

Treatment of duodenal or gastric ulcer in patients requiring continuous treatment with NSAIDs:one capsule of 30 mg per day for 4 weeks.

Prevention of duodenal or gastric ulcer in patients requiring continuous treatment with NSAIDs:one capsule of 15 mg per day; your doctor may adjust the dose to one capsule of 30 mg per day.

Zollinger-Ellison syndrome:The initial normal dose is two capsules of 30 mg per day; subsequently, your doctor will decide on the best dose for you based on your response to treatment withEstomil.

Use in children:

Estomilshould not be administered to children.

If you take more Estomil than you should:

If you take moreEstomilthan indicated, consult your doctor immediately or contact the Toxicology Information Service: phone 915 620 420.

If you forget to take Estomil:

If you forget to take a dose, take it as soon as you remember, unless the time for the next dose is near. In this case, skip the missed dose and take the capsules as usual.

Do not take a double dose to make up for the missed dose.

If you interrupt treatment with Estomil:

Do not stop treatment before time because symptoms have improved. It is possible that your condition has not been fully cured and may recur if you do not complete the entire treatment.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

Like all medicines,this medicinecan cause side effects, although not everyone will experience them.

Frequent side effects.

They may affect up to 1 in 10 people.

• headache, dizziness
• diarrhea, constipation, stomach pain, nausea and vomiting, flatulence, dryness or pain in the mouth or throat
• skin rash, itching
• changes in liver function test values
• fatigue
• benign polyps in the stomach.

Infrequent side effects.

They may affect up to 1 in 100 people.

• depression
• joint or muscle pain
• fluid retention or swelling
• changes in blood cell count
• increased risk of hip, wrist, and spinal fractures

Rare side effects.

They may affect up to 1 in 1,000 people.

• fever
• restlessness, drowsiness, confusion, hallucinations, insomnia, visual disturbances, vertigo
• alteration of taste, loss of appetite, inflammation of the tongue (glossitis)
• skin reactions such as burning or itching sensation under the skin, hematomas, redness, and excessive sweating
• light sensitivity
• hair loss
• tingling sensation (paresthesia), tremors
• anemia (pallor)
• kidney problems
• pancreatitis
• inflammation of the liver (may manifest as yellowish skin or eyes)
• swelling of the chest in men, impotence
• candidiasis (fungal infection, may affect the skin or mucous membranes)
• angioedema; contact your doctor immediately if you experience symptoms of angioedema, such as facial swelling, tongue, or throat inflammation, difficulty swallowing, urticaria, and difficulty breathing

Very rare side effects.

They may affect up to 1 in 10,000 people.

• severe hypersensitivity reactions, including anaphylactic shock. Symptoms of hypersensitivity reactions may include fever, rash, swelling, and, in some cases, a drop in blood pressure
• inflammation of the mouth (stomatitis)
• colitis (inflammation of the intestine)
• changes in analytical values, such as sodium, cholesterol, and triglyceride levels
• very severe skin reactions with redness, vesicles, severe inflammation, and skin loss
• in very rare casesEstomilmay cause a reduction in the number of white blood cells, which may lead to a decrease in your resistance to infections. If you experience an infection with symptoms such as fever and severe deterioration of your general condition, or fever with symptoms of local infection such as throat, pharynx, or mouth pain or urinary problems, consult your doctor immediately. A blood test will be performed to check for possible reduction in white blood cells (agranulocytosis)

Unknown frequency.

• if you have been taking Estomil for more than three months, it is possible that magnesium levels in the blood may decrease. Low magnesium levels may cause fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, and increased heart rate. If you notice any of these symptoms, inform your doctor immediately. Low magnesium levels may also lead to a decrease in potassium or calcium levels in the blood. Your doctor may request regular blood tests to monitor magnesium levels
• skin rash, possibly with joint pain
• visual hallucinations

Reporting of side effects:

If you experience any type of side effect, 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 System for the Vigilance of Medicines for Human Use: https://www.notificaram.es.

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

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

Do not store at a temperature above30°C.

Do not usethis medicationafter the expiration date that appears on theblister andthebox after CAD.The expiration date is the last day of the month indicated.

Medicines should not be disposed of through drains or in the trash. Dispose of packaging and medicines you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and medicines you no longer need. By doing so, you will help protect the environment.

Composition of Estomil

The active ingredient is lansoprazol.

The other components (excipients) are: sugar spheres (sacarosa and cornstarch), magnesium carbonate,hypromellose,polysorbate 80, macrogol 6000, triethyl citrate, talc, titanium dioxide(E-171),copolymer of methacrylic acid and ethyl acrylate and sodium hydroxide. The gelatin capsule is composed of: titanium dioxide (E-171), erythrosine, iron oxide red, and gelatin.

Appearance of the product and contents of the packaging

Estomil 15 mg hard-gastrorresistant capsules are presented in the form of hard-gastrorresistant capsules, which contain spherical gastrorresistant granules of lansoprazol, in packs of 28 and 56 capsules.

Only some pack sizes may be marketed.

Marketing authorization holder andmanufacturer responsible

Marketing authorization holder

Merck, S.L.

María de Molina, 40

28006 Madrid

Manufacturer responsible

Laboratorios Salvat, S.A.

C/Gall 30-36

08950 Esplugues de Llobregat (Barcelona)

Last review date of thisleaflet: December 2022

The detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS) http://www.aemps.gob.es/