SmPC: information for the user

febuxostat cinfa 120 mg film-coated tablets

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

• Keep this leaflet, as you may need to read it again.
• If you have any questions, ask 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.

5Storage of febuxostat cinfa

6.Contents of the pack and additional information

Febuxostat cinfa tablets contain the active ingredient febuxostat and are used to treat gout, which is associated with an excess of a chemical compound called uric acid (urate) in the body. In some people, uric acid accumulates in the blood to the point where it cannot be dissolved. When this occurs, urate crystals form both inside and around the joints and kidneys. These crystals can cause sudden and intense pain, redness, heat, and swelling in the joints (this is called gout attacks). If left untreated, large deposits called tophi can form around the joints and inside them. Tophi can damage the joints and bones.

Febuxostat cinfa acts by reducing the concentration of uric acid. Keeping uric acid levels low by taking febuxostat once a day slows the formation of crystals and, over time, reduces symptoms. If uric acid levels are kept low for a sufficient period, the size of the tophi also decreases.

Febuxostat cinfa 120 mg tablets are also used in the treatment and prevention of high levels of uric acid in the blood, which can occur when chemotherapy is started to treat blood cancer.

When chemotherapy is administered, cancer cells are destroyed, and as a result, uric acid levels in the blood increase, unless its formation is prevented.

Febuxostat cinfa is for adults.

Do not take febuxostat cinfa

• if you are allergic to febuxostat 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 febuxostat cinfa:

• if you have or have had heart failure, heart problems, or stroke
• if you have or have had kidney disease and/or severe allergic reactions to allopurinol (a medicine used to treat gout)
• if you have or have had liver disease or liver function abnormalities
• if you are being treated for high uric acid levels due to Lesch-Nyhan syndrome (a rare genetic disorder in which there is too much uric acid in the blood)
• if you have thyroid problems.

If you experience allergic reactions to febuxostat, stop taking this medicine (see also section 4).Possible symptoms of allergic reactions may be:

• skin rash including severe forms (e.g. blisters, nodules, exfoliative rashes that cause itching), itching
• swelling of the limbs or face
• difficulty breathing
• fever with enlarged lymph nodes
• also severe allergic reactions that can put your life at risk, associated with cardio-circulatory arrest.

Your doctor may decide to permanently discontinue treatment with febuxostat.

Rare cases of life-threatening skin eruptions (Stevens-Johnson syndrome) have been reported with the use of febuxostat, initially appearing on the trunk as red spots in the shape of a target or circular spots often with a blister in the center. It may also include ulcers in the mouth, throat, nose, genitals, and conjunctivitis (red and swollen eyes). The rash may evolve into generalized blisters or skin peeling.

If you have developed Stevens-Johnson syndrome with the use of febuxostat, do not restart treatment at any time. If you develop a rash or these symptoms on your skin, go immediately to your doctor and tell them that you are taking this medicine.

If you experience a gout attack (a sudden onset of intense pain accompanied by sensitivity, redness, heat, and swelling of a joint), wait for the attack to subside before starting treatment with febuxostat.

Some people may experience a gout attack when starting certain medicines that control uric acid levels. Not everyone experiences these attacks, but they can occur even while taking febuxostat, especially during the first weeks or months of treatment. It is essential to continue taking febuxostat daily, as this medicine continues to act to reduce uric acid levels. If you continue to take febuxostat, gout attacks will become less frequent and less painful.

If necessary, your doctor will prescribe other medicines to prevent or treat gout attack symptoms (such as joint pain and swelling).

In patients with very high uric acid levels (e.g. those undergoing chemotherapy for cancer), treatment with medicines to reduce uric acid levels may lead to the accumulation of xanthine in the urinary tract, with possible stone formation, although this has not been observed in patients treated with febuxostat for tumor lysis syndrome.

Your doctor may perform blood tests to check that your liver is functioning normally.

Children and adolescents

Do not administer this medicine to children under 18 years of age, as the safety and efficacy have not been established.

Taking febuxostat cinfa with other medicines

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine.

It is especially important to inform your doctor or pharmacist if you are using medicines that contain any of the following substances, as they may interact with febuxostat, and your doctor may need to take special measures:

• Mercaptopurine (used to treat cancer)
• Azathioprine (used to reduce immune response)
• Theophylline (used to treat asthma)

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, or think you may be pregnant, consult your doctor or pharmacist before using this medicine.

It is not known if febuxostat can harm the fetus. Febuxostat should not be used during pregnancy. It is not known if febuxostat passes into breast milk. Do not use febuxostat if you are breastfeeding or planning to breastfeed.

Driving and operating machinery

Be aware that you may experience dizziness, drowsiness, blurred vision, numbness, or tingling during treatment, so if this happens, do not drive or operate machinery.

This medicine contains sodium.

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

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

• The recommended dose is one tablet per day.
• The tablets are taken orally, with or without food.

Gout

Febuxostat is available in tablets of 80 mg and 120 mg. Your doctor will prescribe the most suitable dose.

Continue taking febuxostat every day, even if you no longer have gout attacks.

Prevention and treatment of high uric acid levels in patients undergoing chemotherapy for cancer

Febuxostat is available in tablets of 120 mg.

Start taking febuxostat two days before chemotherapy and continue as directed by your doctor. The treatment is generally of short duration.

If you take more febuxostat cinfa than you should

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount ingested.

If you forget to take febuxostat cinfa

If you forget a dose of febuxostat, take it as soon as you remember, unless it is almost time to take the next one; in that case, skip the missed dose and take the next one at the usual time. Do not take a double dose to make up for the missed ones.

If you interrupt treatment with febuxostat cinfa

Although you may be feeling better, do not stop taking febuxostat unless your doctor tells you to. If you stop taking febuxostat, your uric acid levels may increase again, and symptoms may worsen due to the formation of new urate crystals in the joints and kidneys.

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

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

Stop taking this medicine and contact your doctor immediately or go to the nearest hospital if you experience any of the following rare side effects (may affect up to 1 in 1000 people), as you may experience a severe allergic reaction:

• Anaphylactic reactions, hypersensitivity to the medicine (see also section 2 “Warnings and precautions”)
• Skin eruptions that can be life-threatening, characterized by the formation of blisters and peeling of the skin and mucous membranes (e.g. mouth and genitals), painful ulcers in the mouth and/or genital areas, accompanied by fever, sore throat, and fatigue (Stevens-Johnson syndrome/toxic epidermal necrolysis), or by swollen lymph nodes, enlarged liver, hepatitis (including liver failure), increased white blood cell count (hypersensitivity to medications with eosinophilia and systemic symptoms - DRESS syndrome) (see section 2)
• Generalized skin eruptions

Thecommon side effects(may affect up to 1 in 10 people) are as follows:

• Abnormal liver test results
• Diarrhea
• Headache
• Rash (including various types of rash, see below the sections “uncommon” and “rare”)
• Nausea
• Increased symptoms of gout
• Localized swelling due to fluid retention in tissues (edema)

Other side effects not mentioned above are included below.

Theuncommon side effects(may affect up to 1 in 100 people) are as follows:

• Decreased appetite, change in blood sugar level (diabetes) whose symptom may be excessive thirst, increased blood fats, weight gain
• Loss of sexual appetite
• Difficulty sleeping, somnolence
• Dizziness, numbness, tingling sensation, decreased or altered sensitivity (hypoaesthesia, hemiparesis, or paresthesia), altered sense of taste, decreased sense of smell (hyposmia)
• ECG (electrocardiogram) abnormalities, irregular or rapid heartbeat, perception of heartbeats (palpitations)
• Flushes or redness (facial or neck flushing), increased blood pressure, bleeding (haemorrhage, observed only in patients receiving chemotherapy for blood diseases)
• Cough, respiratory difficulties, chest discomfort, inflammation of the nasal passages and/or throat (upper respiratory tract infection), bronchitis
• Dry mouth, abdominal pain or discomfort, gas, heartburn, indigestion, constipation, frequent bowel movements, vomiting, abdominal discomfort
• Itching, urticaria, skin inflammation or discoloration, small red spots or purpura on the skin, small rashes on the skin, rashes on the skin covered with small interconnected bumps, rash, rashes, and spots on the skin, other skin alterations
• Muscle cramps, muscle weakness, muscle pain, and joint pain, bursitis or arthritis (inflammation of the joints, usually accompanied by pain, swelling, or stiffness), limb pain, back pain, muscle spasms
• Blood in urine, frequent urination, abnormal urine tests (increased protein concentration in urine), reduced kidney function
• Fatigue, chest pain, chest discomfort
• Stones in the gallbladder or bile ducts (cholelithiasis)
• Increased levels of thyroid-stimulating hormone (TSH) in the blood
• Blood biochemistry changes or changes in the number of blood cells or platelets (abnormal blood test results)
• Stones in the kidney
• Erectile dysfunction

Therare side effects(may affect up to 1 in 1,000 people) are as follows:

• Muscle damage, which in rare cases can be severe. It may cause muscle problems and particularly, if you are unwell or have a high fever, it may be due to abnormal muscle destruction. Contact your doctor immediately if you experience muscle pain, sensitivity, or weakness
• Severe swelling of the deeper layers of the skin, especially around the lips, eyes, genitals, hands, feet, or tongue, which may cause sudden difficulty breathing
• High fever accompanied by a rash similar to measles, swollen lymph nodes, enlarged liver (including liver failure), increased white blood cell count (leucocytosis, with or without eosinophilia)
• Redness of the skin (erythema), different types of rash (e.g. itching, with white patches with blisters, with blisters containing pus, with peeling of the skin, rash similar to measles), generalized erythema, necrosis, blistering of the skin and mucous membranes, leading to exfoliation and possible sepsis (Stevens-Johnson syndrome/toxic epidermal necrolysis)
• Anxiety
• Thirst
• Tinnitus (ringing in the ears)
• Blurred vision, changes in vision
• Hair loss
• Mouth ulcers
• Pancreatitis: common symptoms include abdominal pain, nausea, and vomiting
• Increased sweating
• Weight loss, increased appetite, uncontrolled loss of appetite (anorexia)
• Muscle stiffness and/or joint stiffness
• Abnormal blood cell count (white blood cells, red blood cells, or platelets)
• Urgent need to urinate
• Changes or decreased urine volume due to kidney inflammation (tubulointerstitial nephritis)
• Liver inflammation (hepatitis)
• Yellowing of the skin (jaundice)
• Liver damage
• Increased levels of creatine phosphokinase in the blood (a marker of muscle damage)
• Sudden cardiac death

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 use this medication after the expiration date that appears on the box and on the blister pack after CAD. The expiration date is the last day of the month indicated.

This medication does not require special storage conditions.

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

Composition of febuxostat cinfa

• The active ingredient is febuxostat.Each tablet contains 120 mg of febuxostat.

• The other components are:

Tablet core:microcrystalline cellulose, mannitol (E-421), hydroxypropyl cellulose, sodium croscarmellose, magnesium stearate, sodium lauryl sulfate, anhydrous colloidal silica.

Tablet coating:partially hydrolyzed poly(vinyl alcohol) (E-1203), titanium dioxide (E-171), macrogol (MW 3350), talc (E-553b), yellow iron oxide (E-172), and red iron oxide (E-172).

Appearance of the product and contents of the packaging

Yellow to pale yellow film-coated tablets, capsule-shaped, smooth on both sides, and with the code “F120” engraved on one side.

Febuxostat cinfa 120 mg is presented in ALU/ALU or PVC/PE/PVDC blisters of 28 tablets.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder

Cinfa, S.A.

Carretera Olaz-Chipi, 10. Industrial Estate Areta

31620 Huarte (Navarra) - Spain

Responsible manufacturer

Cinfa, S.A.

Carretera Olaz-Chipi, 10. Industrial Estate Areta

31620 Huarte (Navarra) - Spain

or

G.L. Pharma GmbH

Schlossplatz 1

Lannach 8502

Austria

Last review date of this leaflet:September 2020

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