ETORICOXIB VISO FARMACEUTICA 90 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the Patient

Etoricoxib Viso Farmacéutica 30 mg film-coated tablets EFG

Etoricoxib Viso Farmacéutica 60 mg film-coated tablets EFG

Etoricoxib Viso Farmacéutica 90 mg film-coated tablets EFG

Etoricoxib Viso Farmacéutica 120 mg 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 Etoricoxib Viso Farmacéutica film-coated tablets are and what they are used for
2. What you need to know before you take Etoricoxib Viso Farmacéutica film-coated tablets
3. How to take Etoricoxib Viso Farmacéutica film-coated tablets
4. Possible side effects
5. Storage of Etoricoxib Viso Farmacéutica film-coated tablets
6. Contents of the pack and other information

1. What Etoricoxib Viso Farmacéutica film-coated tablets are and what they are used for

What is Etoricoxib?

• Etoricoxib contains the active substance etoricoxib. Etoricoxib belongs to a group of medicines called selective COX-2 inhibitors. These belong to a family of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).

What is Etoricoxib used for?

• Etoricoxib helps to reduce pain and swelling (inflammation) in the joints and muscles in people 16 years of age and older with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout.
• Etoricoxib is also used for short-term treatment of moderate pain after dental surgery in people 16 years of age and older.

What is osteoarthritis?

Osteoarthritis is a disease of the joints. It leads to the gradual breakdown of the cartilage that cushions the ends of the bones. This causes swelling (inflammation), pain, tenderness, stiffness, and disability.

What is rheumatoid arthritis?

Rheumatoid arthritis is a long-term inflammatory disease of the joints. It causes pain, stiffness, swelling, and progressive loss of movement in the affected joints. It also causes inflammation in other areas of the body.

What is gout?

Gout is a disease of sudden, recurring attacks of very painful and red inflammation of the joints. It is caused by deposits of mineral crystals in the joint.

What is ankylosing spondylitis?

Ankylosing spondylitis is a long-term inflammatory disease of the spine and large joints.

2. What you need to know before you take Etoricoxib Viso Farmacéutica film-coated tablets

Do not take Etoricoxib Viso Farmacéutica:

• if you are allergic (hypersensitive) to etoricoxib or any of the other ingredients of this medicine (listed in section 6)
• if you are allergic to non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and COX-2 inhibitors (see Possible side effects, section 4)
• if you currently have an ulcer or bleeding in your stomach or duodenum
• if you have severe liver disease
• if you have severe kidney disease
• if you are or may be pregnant, or are breast-feeding (see "Pregnancy, breast-feeding, and fertility")
• if you are under 16 years of age
• if you have inflammatory bowel disease, such as Crohn's disease, ulcerative colitis, or colitis
• if you have uncontrolled high blood pressure (consult your doctor or nurse if you are not sure if your blood pressure is under control)
• if your doctor has diagnosed you with heart problems, including heart failure (of moderate or severe type), angina (chest pain)
• if you have had a heart attack, surgical revascularization, peripheral arterial disease (poor circulation in the legs or feet due to narrow or blocked arteries)
• if you have had any type of stroke (including transient ischaemic attack or transient cerebral ischaemia).

Etoricoxib may slightly increase your risk of heart attack and stroke, and this is why it should not be used in those patients who have already had heart problems or a stroke.

If you think you are at risk of these conditions, do not take the tablets until you have spoken to your doctor.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Etoricoxib if:

• You have a history of stomach ulcers or bleeding.
• You are dehydrated, for example, due to a prolonged illness with vomiting or diarrhea.
• You have swelling due to fluid retention.
• You have a history of heart failure or any other form of heart disease.
• You have a history of high blood pressure. Etoricoxib may increase blood pressure in some people, especially at high doses, and your doctor will want to check your blood pressure from time to time.
• You have a history of liver or kidney disease.
• You are being treated for an infection. Etoricoxib may mask or hide fever, which is a sign of infection.
• You have diabetes, high cholesterol, or are a smoker, as these may increase your risk of heart disease.
• You are a woman trying to become pregnant.
• You are over 65 years of age.

If you are not sure if any of the above applies to you, talk to your doctor before taking this medicineto check if etoricoxib is suitable for you.

Etoricoxib works just as well in adult and elderly patients. If you are over 65 years of age, your doctor will want to keep a close check on you.

No dose adjustment is necessary for patients over 65 years of age.

Children and adolescents

Do not give this medicine to children and adolescents under 16 years of age.

Taking Etoricoxib Viso Farmacéutica with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including those obtained without a prescription.

In particular, if you are taking any of the following medicines, your doctor may want to check that your medicines are working properly once you start taking Etoricoxib:

• medicines that thin your blood (anticoagulants), such as warfarin
• rifampicin (an antibiotic)
• methotrexate (a medicine used to suppress the immune system and often used in rheumatoid arthritis)
• cyclosporin or tacrolimus (medicines used to suppress the immune system)
• lithium (a medicine used to treat some types of depression)
• medicines used to help control high blood pressure and heart failure, called ACE inhibitors and angiotensin receptor antagonists, for example, enalapril and ramipril, and losartan and valsartan
• diuretics (water tablets)
• digoxin (a medicine for heart failure and irregular heartbeat)
• minoxidil (a medicine used to treat high blood pressure)
• tablets or oral solution of salbutamol (a medicine for asthma)
• oral contraceptives (the combination may increase your risk of side effects)
• hormone replacement therapy (the combination may increase your risk of side effects)
• acetylsalicylic acid (aspirin), the risk of stomach ulcers is greater if you take Etoricoxib with acetylsalicylic acid.

• Acetylsalicylic acid for the prevention of heart attacks or strokes:

Etoricoxib can be taken with low dosesof aspirin. If you are currently taking low doses of aspirin to prevent heart attacks or strokes, do not stop taking aspirin until you talk to your doctor

• Acetylsalicylic acid and other non-steroidal anti-inflammatory drugs (NSAIDs):

do not take high dosesof aspirin or other anti-inflammatory medicines while taking this medicine.

Taking Etoricoxib Viso Farmacéutica with food and drink

The onset of effect of Etoricoxib may be faster if taken without food.

Pregnancy, breast-feeding, and fertility

Pregnancy

Etoricoxib tablets should not be taken during pregnancy. Do not take the tablets if you are pregnant, think you may be pregnant, or plan to become pregnant. If you become pregnant, stop taking the tablets and consult your doctor. Consult your doctor if you have any doubts or need more information.

Breast-feeding

It is not known if Etoricoxib is excreted in human milk. If you are breast-feeding or plan to breast-feed, consult your doctor before taking Etoricoxib. If you are using this medicine, do not breast-feed.

Fertility

Etoricoxib is not recommended for use in women who are trying to become pregnant.

Driving and using machines

In some patients taking Etoricoxib, dizziness and somnolence have been reported.

Do not drive if you experience dizziness or somnolence.

Do not use tools or machines if you experience dizziness or somnolence.

3. How to take Etoricoxib Viso Farmacéutica film-coated tablets

Always take this medicine exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist.

Do not take more than the recommended dose for your condition. Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take Etoricoxib for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

There are different doses available for this medicine, and depending on your disease, your doctor will prescribe the tablet with the dose that is suitable for you.

The recommended dose is:

Osteoarthritis

The recommended dose is 30 mg once daily, increased to a maximum of 60 mg once daily if needed.

Rheumatoid arthritis

The recommended dose is 60 mg once daily, increased to a maximum of 90 mg once daily if needed.

Ankylosing spondylitis

The recommended dose is 60 mg once daily, increased to a maximum of 90 mg once daily if needed.

Acute pain conditions

Etoricoxib should only be used for the period of acute pain.

Gout

The recommended dose is 120 mg once daily, which should only be used during the acute attack, limited to a maximum of 8 days of treatment.

Post-operative dental pain

The recommended dose is 90 mg once daily, limited to a maximum of 3 days of treatment.

Patients with liver problems

• If you have mild liver disease, do not take more than 60 mg daily.
• If you have moderateliver disease, do not take more than 30mg daily.

Use in children and adolescents

Children or adolescents under 16 years of age should not take Etoricoxib tablets.

Patients over 65 years of age

No dose adjustment is necessary for patients over 65 years of age. As with other medicines, caution should be exercised in elderly patients.

Method of administration

This medicine is administered orally. Take the tablets once daily. Etoricoxib can be taken with or without food.

If you take more Etoricoxib than you should

Never take more tablets than your doctor recommends. If you take too many Etoricoxib tablets, seek medical attention immediately.

In case of overdose or accidental ingestion, you can also contact the Toxicology Information Service, Tel. 91 562 04 20, indicating the medicine and the amount taken. It is recommended to bring the packaging and the leaflet of the medicine to the healthcare professional.

If you forget to take Etoricoxib

It is important that you take this medicine as your doctor has told you. If you forget a dose, just resume your normal schedule the next day. Do not take a double dose to make up for forgotten doses.

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

4. Possible side effects

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

If you develop any of these signs, stop taking this medicine and talk to your doctor immediately (see section 2. What you need to know before you take Etoricoxib Viso Farmacéutica film-coated tablets):

• difficulty breathing, chest pain, or swelling of the ankle, or if these get worse
• yellowing of the skin and eyes (jaundice) - these are signs of liver problems
• severe stomach pain or persistent stomach pain or your stools turn black
• an allergic reaction - which can include skin problems such as ulcers or blistering, or swelling of the face, lips, tongue, or throat that can cause difficulty in breathing

The frequency of possible side effects is defined as follows:

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

Common (may affect up to 1 in 10 people)

Uncommon (may affect up to 1 in 100 people)

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

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

The following side effects may occur during treatment with Etoricoxib:

Very common:

• stomach pain

Common:

• alveolar osteitis (inflammation and pain after tooth extraction)
• swelling of the legs and/or feet due to fluid retention (edema)
• dizziness, headache
• palpitations (rapid or irregular heartbeat), irregular heartbeat (arrhythmia)
• high blood pressure
• wheezing or difficulty breathing (bronchospasm)
• constipation, gas (excess gas), gastritis (inflammation of the stomach lining), heartburn, diarrhea, indigestion (dyspepsia)/stomach discomfort, nausea, vomiting, esophagitis (inflammation of the esophagus), mouth ulcers
• changes in blood tests related to your liver
• bruising
• weakness and fatigue, flu-like illness

Uncommon:

• gastroenteritis (inflammation of the gastrointestinal tract that affects both the stomach and the small intestine/common cold), cold, urinary tract infection
• changes in laboratory results (decreased red blood cell count, decreased white blood cell count, decreased platelet count)
• hypersensitivity (allergic reaction, including hives, which can be severe enough to require immediate medical attention)
• increased or decreased appetite, weight gain
• anxiety, depression, decreased mental sharpness; seeing, hearing, or feeling things that are not there (hallucinations)
• altered taste, inability to sleep, numbness or tingling, somnolence
• blurred vision, eye irritation and redness
• ringing in the ears, vertigo (feeling of spinning while standing)
• abnormal heartbeat (atrial fibrillation), rapid heartbeat, heart failure, feeling of tension, pressure, or heaviness in the chest (angina pectoris), heart attack
• flushing, stroke, transient ischemic attack (mini-stroke), severe increase in blood pressure, inflammation of blood vessels
• cough, shortness of breath, nosebleed
• stomach swelling, changes in bowel movements, dry mouth, stomach ulcer, inflammation of the stomach lining that can be severe and can cause bleeding, irritable bowel syndrome, pancreatitis (inflammation of the pancreas)
• swelling of the face, skin rash or itching
• muscle cramp/spasm, muscle pain/stiffness
• high levels of potassium in the blood, changes in blood or urine tests related to kidney function, severe kidney problems
• chest pain

Rare:

• angioedema (allergic reaction with swelling of the face, lips, tongue, and/or throat that can cause difficulty breathing or swallowing, which can be severe enough to require immediate medical attention)/anaphylactic/anaphylactoid reactions, including shock (severe allergic reaction that requires immediate medical attention)

• confusion, nervousness
• liver problems (hepatitis)
• low sodium levels in the blood
• liver changes, yellowing of the skin and/or eyes (jaundice)
• severe skin reactions

Reporting of side effects:If you experience 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 to the Spanish Medicines Agency's Pharmacovigilance System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Etoricoxib Viso Farmacéutica

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 packaging. The expiry date refers to the last day of that month.

Store below 30°C.

Medicines should not be disposed of via wastewater or household waste. Place the packaging and any unused medicines in the SIGRE collection point at your pharmacy. If you are unsure, ask your pharmacist how to dispose of the packaging and any unused medicines. This will help protect the environment.

6. Package Contents and Additional Information

Composition ofEtoricoxib Viso Farmacéutica

• The active ingredient is etoricoxib. Each film-coated tablet contains 30 mg, 60 mg, 90 mg, or 120 mg of etoricoxib.

• The other ingredients are:

Tablet core: Anhydrous dicalcium phosphate (Calipharm A), microcrystalline cellulose (Avicel PH 101), sodium croscarmellose (Ac-di-sol), magnesium stearate, microcrystalline cellulose (Avicel PH 200 LM)

Tablet coating:

For 30 mg, 60 mg, and 120 mg

Hypromellose, titanium dioxide (E171), macrogol, aluminum lake of indigo carmine (E132), iron oxide yellow (E172), isopropyl alcohol, methylene chloride (dichloromethane)

For 90 mg

Hypromellose, titanium dioxide (E171), macrogol, isopropyl alcohol, methylene chloride (dichloromethane)

Appearance of the Productand Package Contents

Etoricoxib Viso Farmacéutica tablets are available in four concentrations:

30 mg tablets: film-coated, biconvex, round, blue-green tablets marked with "11" on one side and "G" on the other, approximately 6 mm in diameter.

60 mg tablets: film-coated, biconvex, round, dark green tablets marked with "76" on one side and "G" on the other, approximately 8 mm in diameter.

90 mg tablets: film-coated, biconvex, round, white tablets marked with "757" on one side and "G" on the other, approximately 9 mm in diameter.

120 mg tablets: film-coated, biconvex, round, light green tablets marked with "758" on one side and "G" on the other, approximately 10.5 mm in diameter.

30 mg tablets: package sizes of 5, 28, 30, 90, 98 tablets in blisters. 60 mg and 90 mg tablets: package sizes of 7, 14, 20, 28, 30, 50, 90, 100 tablets in blisters.

120 mg tablets: package sizes of 2, 5, 7, 14, 20, 28, 30, 90 tablets in blisters.

Not all package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Glenmark Arzneimittel GmbH

Industriestr. 31

82194 Gröbenzell

Germany

Manufacturer:

Glenmark Pharmaceuticals s.r.o.

Fibichova, 143

56617 Vysoke Myto

Czech Republic

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:

Glenmark Farmacéutica, S.L.U.

C/ Retama 7, 7ª planta

28045 Madrid

Spain

This medicine is authorized in the EEA member states with the following names:

Date of the last revision of the leaflet:November 2016

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