Prospecto: information for the user

Fentanilo Matrix Normon 25 micrograms/h transdermal patch EFG

Fentanilo

Read this prospect carefully before starting to use this medication, as it contains important information for you.

• Keep this prospect, as you may need to read it again.
• If you have any doubts, consult your doctor, pharmacist, or nurse.
• This medication has been prescribed only to you (or your child), and you must not give it to other people even if they have the same symptoms as you, as it may harm them.
• If you experience any adverse effects, consult your doctor, pharmacist, or nurse, even if they are not listed in this prospect. See section4.

1.What is Fentanilo Matrix Normon and for what it is used

2.What you need to know before starting to use Fentanilo Matrix Normon

3.How to use Fentanilo Matrix Normon

4.Possible adverse effects

5.Storage of Fentanilo Matrix Normon

6.Contents of the package and additional information

This medicine is called Fentanilo Matrix Normon

The patches help to relieve very strong and lasting pain:

• in adults who need continuous pain treatment
• in children over 2 years of age who are already using opioid medication and need continuous pain treatment.

Fentanilo Matrix Normon contains a medicine called fentanilo. It belongs to a group of strong pain-relieving medicines called opioids.

Do not use Fentanilo Matrix Normon

Do not use this medication if you or your child is in any of the above circumstances. If you are unsure, consult your doctor or pharmacist before using Fentanilo Matrix Normon.

Warnings and precautions

If the patch sticks to another person

The patch should only be used on the skin of the person for whom the doctor prescribed it. There have been some cases where the patch has accidentally stuck to another family member by close physical contact or sharing the same bed with the person wearing the patch. If the patch accidentally sticks to another person (particularly a child), the medication from the patch may pass through the other person's skin and may cause severe adverse effects, such as difficulty breathing, slow or weak breathing that can be fatal. In the event that the patch sticks to someone else's skin, it should be removed immediately and the person should seek medical attention.

Be especially careful with Fentanilo Matrix Normon

Consult your doctor or pharmacist beforeusing this medication if you are in any of the following circumstances. Your doctor will have to monitor you more closely:

• If you have ever had respiratory or breathing problems
• If you have ever had heart, liver, or kidney problems, or low blood pressure
• If you have ever had a brain tumor
• If you have ever had persistent headaches or a head trauma
• If you are elderly, as you may be more sensitive to the effects of this medication.
• If you have a condition called "myasthenia gravis," in which your muscles weaken and tire easily.

If you meet any of the above conditions (or if you are unsure), consult your doctor or pharmacist before using Fentanilo Matrix Normon.

While using the patch, report to your doctor if you have breathing problems while sleeping.Fentanilo Matrix Normon can cause sleep-related breathing disorders such as sleep apnea (pauses in breathing while sleeping) and sleep-related hypoxemia (low oxygen levels in the blood). Talk to your doctor if you, your partner, or caregiver observe any of the following symptoms:

• pauses in breathing while sleeping
• waking up at night due to lack of air
• difficulty staying asleep
• excessive daytime sleepiness.

Your doctor may decide to modify the dose.

While using the patch, report to your doctor if you notice a change in the pain you feel. If you feel:

• that the patch no longer relieves the pain
• an increase in pain
• there is a change in the way you feel the pain (for example, you feel pain in another part of your body)
• pain when you come into contact with your body that should not cause pain.

Do not change the dose on your own. Your doctor may decide to modify the dose or change the treatment.

Adverse effects and Fentanilo Matrix Normon

• Fentanilo Matrix Normon can make you feel exceptionally sleepy and make your breathing slower or weaker. In rare cases, these breathing problemscan be life-threatening or even fatal, especially in people who have not used strong prescribed opioids before. If you, or your partner, or caregiver, observe that the person wearing the patch is unusually sleepy, with slow or weak breathing:

• Remove the patch
• Call a doctor or go to the nearest hospital immediately
• Have the person move and talk as much as possible

• If you have a feverwhile using Fentanilo Matrix Normon, talk to your doctor. This may increase the amount of medication that passes through your skin.
• Fentanilo Matrix Normon can cause constipation; talk to your doctor or pharmacist for advice on how to prevent or relieve constipation.

See section 4 for the complete list of possible adverse effects.

When wearing the patch, do not expose it to direct heat, such as heating pads, electric blankets, hot water bottles, hot tubs, or heat lamps or tanning beds. Do not take the sun or long hot baths and do not use saunas or hot tubs. If you do, it may increase the amount of medication released from the patch.

Long-term use and tolerance

This medication contains fentanilo, an opioid. Repeated use of opioid analgesics can make the medication less effective (your body becomes accustomed to it, known as pharmacological tolerance). It is also possible that you may become more sensitive to pain when using Fentanilo Matrix Normon. This is known as hyperalgesia. Increasing the dose of the patches may continue to reduce pain for a while, but it may also be harmful. If you notice that the medication is losing its effectiveness, consult your doctor. Your doctor will decide whether it is better to increase the dose or to gradually reduce the use of Fentanilo Matrix Normon.

Dependence and addiction

The repeated use of Fentanilo Matrix Normon can also cause dependence, abuse, and addiction, which could lead to a potentially fatal overdose. The risk of these adverse effects may be higher with a higher dose and longer use. Dependence or addiction can cause a feeling of lack of control over the amount of medication you should use or over how often you should use it. You may feel the need to continue using the medication even if it no longer helps to relieve pain.

The risk of dependence or addiction varies from person to person. The risk of becoming dependent or addicted to Fentanilo Matrix Normon may be higher if:

• You or any member of your family have abused alcohol or experienced dependence on it, prescription medications, or illegal drugs ("addiction").
• You smoke.
• You have ever had mood problems (depression, anxiety, or a personality disorder) or have been treated by a psychiatrist for other mental health conditions.

If you notice any of the following symptoms while using Fentanilo Matrix Normon, it could be a sign of dependence or addiction.

• You need to use the medication for a longer period than indicated by your doctor.
• You need to use a higher dose than recommended.
• You are using the medication for reasons other than those prescribed, such as to stay calm or to help you sleep.
• You have made repeated and unsuccessful attempts to stop using the medication or control its use.
• You feel unwell when you stop using the medication, and you feel better once you take it again ("withdrawal symptoms").

If you notice any of these signs, consult your doctor to determine the best course of treatment for you, when it is appropriate to stop the medication, and how to do it safely.

The repeated use of Fentanilo Matrix Normon can also cause dependence, abuse, and addiction, which could lead to a potentially fatal overdose.

Withdrawal symptoms from stopping Fentanilo Matrix Normon

Do not stop using this medication abruptly. Withdrawal symptoms such as restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhea, loss of appetite, tremors, chills, or sweating may occur. If you want to stop using this medication, talk to your doctor first. Your doctor will advise you on how to do it, usually by gradually reducing the dose to minimize unpleasant withdrawal symptoms.

Other medications and Fentanilo Matrix Normon

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication. This includes over-the-counter medications and herbal remedies. You should also inform your pharmacist that you are using Fentanilo Matrix Normon if you buy any medication at the pharmacy.

Your doctor will know which medications can be taken safely with Fentanilo Matrix Normon. It may be necessary to monitor you closely if you are taking any of the types of medications listed below or if you stop taking any of the types of medications listed, as this may affect the dose of Fentanilo Matrix Normon you need.

Especially, inform your doctor or pharmacist if you are taking:

• Other pain medications, such as other strong opioid analgesics (e.g., buprenorphine, nalbuphine, or pentazocine) and some analgesics for neuropathic pain (gabapentin and pregabalin).
• Medications to help you sleep (such as temazepam, zaleplon, or zolpidem).
• Medications to help you calm down (tranquilizers, such as alprazolam, clonazepam, diazepam, hydroxyzine, or lorazepam) and medications for mental health conditions (antipsychotics, such as aripiprazole, haloperidol, olanzapine, risperidone, or phenothiazines).
• Medications to relax muscles (such as cyclobenzaprine or diazepam).
• Some medications used to treat depression called SSRIs or SNRIs (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, or venlafaxine). – see below for more information
• Some medications used to treat depression or Parkinson's disease called MAOIs (such as isocarboxazid, phenelzine, selegiline, or tranylcypromine). Do not use Fentanilo Matrix Normon in the 14 days following the discontinuation of these medications. – see below for more information
• Some antihistamines, especially those that cause drowsiness (such as chlorpheniramine, clemastine, ciproheptadine, diphenhydramine, or hydroxyzine).
• Some antibiotics used to treat infections (such as erythromycin or clarithromycin).
• Medications used to treat fungal infections (such as itraconazole, ketoconazole, fluconazole, or voriconazole).
• Medications used to treat HIV infection (such as ritonavir).
• Medications used to treat irregular heartbeats (such as amiodarone, diltiazem, or verapamil).
• Medications to treat tuberculosis (such as rifampicin).
• Some medications used to treat epilepsy (such as carbamazepine, phenobarbital, or phenytoin).
• Some medications used to treat nausea or dizziness (such as phenothiazines).
• Some medications used to treat heartburn or ulcers (such as cimetidine).
• Some medications used to treat angina (chest pain) or high blood pressure (such as nicardipine).
• Some medications used to treat blood cancer (such as idelalisib).

Using Fentanilo Matrix Normon with antidepressants

The risk of adverse effects increases if you are taking certain antidepressants. Fentanilo Matrix Normon may interact with these medications, and you may experience changes in mental state such as agitation, seeing, feeling, hearing, or smelling things that are not present (hallucinations), and other effects such as changes in blood pressure, rapid heartbeat, high body temperature, hyperactive reflexes, lack of coordination, muscle stiffness, nausea, vomiting, and diarrhea (these may be signs of a serotonin syndrome). If used together, your doctor may want to monitor you closely to detect these adverse effects, especially when starting treatment or when changing the dose of the medication.

Using with central nervous system depressants, including alcohol and some narcotics

The concomitant use of Fentanilo Matrix Normon and sedatives such as benzodiazepines or related medications increases the risk of drowsiness, difficulty breathing (respiratory depression), coma, and can be life-threatening. For this reason, concomitant use should only be considered when other treatment options are not possible.

However, if your doctor prescribes Fentanilo Matrix Normon along with sedatives, your doctor should limit the dose and duration of concomitant treatment.

Inform your doctor of all sedatives you are taking, and follow your doctor's dose recommendations strictly. It may be helpful to inform friends or family members about the signs and symptoms mentioned above. Contact your doctor if you experience these symptoms.

Do not drink alcohol while using Fentanilo Matrix Normon, unless you have talked to your doctor first.

Use in athletes

Inform athletes that this medication contains a component that may result in a positive analytical result for doping control.

Surgeries

If you think you will be receiving anesthesia, inform your doctor or dentist that you are using Fentanilo Matrix Normon.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, or if you think you may be pregnant or plan to become pregnant, consult your doctor or pharmacist before using this medication

Fentanilo Matrix Normon should not be used during pregnancy, unless you have talked to your doctor.

Fentanilo Matrix Normon should not be used during childbirth, as the medication may affect the newborn's breathing.

Prolonged use of Fentanilo Matrix Normon during pregnancy may cause withdrawal symptoms (such as loud crying, feeling restless, convulsions, poor feeding, and diarrhea) in your newborn, which can be potentially fatal if not recognized and treated. Talk to your doctor immediately if you think your newborn may have withdrawal symptoms.

Do not use Fentanilo Matrix Normon if you are breastfeeding. Do not breastfeed for 3 days after removing the Fentanilo Matrix Normon patch. This is because the medication may pass into breast milk.

Driving and operating machinery

Fentanilo Matrix Normon may affect your ability to drive and operate machinery, as it may cause drowsiness or dizziness. If this is the case, do not drive or operate machinery. Do not drive while using this medication until you know how it affects you.

Talk to your doctor or pharmacist if you have any doubts about whether it is safe for you to drive while using this medication.

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

Your doctor will decide on the most suitable concentration of Fentanilo Matrix Normon for you, taking into account the intensity of your pain, your general condition, and the type of pain treatment you have received so far.

Before starting treatment and regularly during it, your doctor will also explain to you what you can expect from the use of Fentanilo Matrix Normon, when and for how long you should use it, when you should contact your doctor, and when you should discontinue use (see also section 2, “Withdrawal syndrome when discontinuing Fentanilo Matrix Normon treatment”).

How to apply and change the patches

• Each patch contains a sufficient amount of medication for3 days (72hours).
• You should change the patch every three days, unless your doctor has told you otherwise.
• Always remove the used patchbeforeapplying a new one.
• Change the patch alwaysat the same timeof the day every 3 days (72hours).
• If you are using more than one patch, change them all at the same time.
• Record the day of the week, date, and time each time you apply a patch to remember when to change it.
• The following table shows when to change the patch:

Where to apply the patch

Adults

• Apply the patch to a flat area of the trunk or arm (never over a joint).

Children

• Apply the patch always to the upper back so that your child has difficulty reaching or removing it.
• Check occasionally that the patch still adheres to the skin.
• It is essential that the child does not remove the patch and put it in their mouth, as this could put their life in danger or be fatal.
• Keep your child under close observation for 48hours after:

• Applying the first patch
• Applying a patch with a higher dose

• The patch may take some time to reach its maximum effect. Therefore, your child may need other painkillers until the patch is effective. Your doctor will explain this to you.

Adults and children:

Do not apply the patch to

• The same site twice in a row.
• Areas that move a lot (joints), irritated skin, or wounds.
• Areas of skin with a lot of hair. If there is hair, do not shave it (the skin irritates with shaving). Instead, cut it as close to the skin as possible.

How to apply the patch

Preparing the skin

• Before applying the patch, check that the skin is completely dry, clean, and fresh.
• If you need to wash the skin, use only cold water.
• Do not use soap or other cleaners, creams, moisturizers, oils, or talc before applying the patch.
• Do not apply the patch immediately after a bath or hot shower.

Dispose of the patch

• As soon as you remove the patch, fold it in half, with the adhesive side sticking to itself.
• Put it back in the original packaging and dispose of it according to your pharmacist's instructions.
• Keep used patches out of sight and reach of children; although used, the patches contain medication that can harm children and even be fatal.

Washing

• Always wash your hands only with water after handling the patches.

More information about using Fentanilo Matrix Normon

Daily activities during patch use

• The patches are water-resistant.
• You can take a shower or bath with the patch on, but do not rub it.
• If your doctor agrees, you can exercise or engage in sports with the patch on.
• You can also swim with the patch on, but:

• Do not use hot tubs.
• Do not cover the patch with elastic or tight clothing.

• When wearing the patch, do not expose it to direct heat, such as heating pads, electric blankets, hot water bottles, hot tubs, or heat lamps or tanning beds.Do not take the sun or prolonged hot baths, and do not use saunas. If you do, you may increase the amount of medication released from the patch.

How long does it take for the patches to act?

• The first patch may take some time to reach its maximum effect.
• Your doctor may give you additional painkillers during the first few days.
• After that, the patch should help relieve pain continuously, allowing you to stop taking other painkillers. However, your doctor may prescribe additional painkillers occasionally.

How long will you have to use the patches?

• The patches of Fentanilo Matrix Normon are indicated for prolonged pain. Your doctor will tell you how long you can expect to use the patches.

If the pain worsens

• If your pain worsens suddenly after applying the last patch, check the patch. If it no longer adheres well or has fallen off, replace it(see also the section If the patch falls off)).
• If your pain worsens over time while using the patches, your doctor may try patches with a higher dose or prescribe additional painkillers (or both).
• If increasing the patch dose does not help, your doctor may decide to stop using the patches.

If you use too many patches or a patch with the wrong dose

If you have applied too many patches or a patch with the wrong dose, remove them and contact your doctor immediately or call the Toxicology Information Service, tel.: (91) 562 04 20, indicating the medication and the amount applied, or go to the hospital.

The signs of overdose include breathing problems or weak breathing, fatigue, extreme drowsiness, inability to think clearly or walk or speak normally, and dizziness or confusion. An overdose can also cause a brain disorder known as toxic leukoencephalopathy.

If you forgot to change the patch

• If you forget to change the patch, change it as soon as you remember and note the day and time. Then, change the patch again after3 days (72hours), as usual.
• If you are delayed, you should talk to your doctor, as you may need additional painkillers, butdo notapply additional patches.

If the patch falls off

• If the patch falls off before it should be changed, apply a new one immediately and note the day and time. Choose a new skin area:
• On the trunk or arm
• On the upper back of your child
• Inform your doctor about this and leave the patch on for another3 days (72hours)or for the time your doctor tells you, before changing the patch in the usual way
• If the patches tend to fall off, consult your doctor, pharmacist, or nurse.

If you want to stop using the patches

• Do not stop using this medication abruptly. If you want to stop using this medication, talk to your doctor first. Your doctor will tell you how to do it, usually by gradually reducing the dose so that the unpleasant effects of withdrawal are minimal. See also section 2, “Withdrawal symptoms when stopping Fentanilo Matrix Normon use”.

• If you stop using the patches, do not use them again without consulting your doctor first. You may need a different dose when you resume treatment.

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

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

If you, or your partner or caregiver, observe any of the following signs in the person wearing the patch, remove the patch and call a doctor or go immediately to the nearest hospital. You may need urgent medical treatment.

• Unusual drowsiness, slower or weaker breathing than expected.

Follow the previous recommendations and have the person wearing the patch move and speak as much as possible. In very rare cases, these breathing difficulties can compromise life or even be fatal, especially in people who have not used strong opioid analgesics (such as Fentanilo Matrix Normon or morphine) before. (Rare, may affect up to 1 in 100 people).

• Sudden swelling of the face or throat, severe irritation, redness, or blisters on the skin.

They can all be signs of a severe allergic reaction. (Frequency cannot be estimated from available data).

• Seizures (convulsions). (Rare, may affect up to 1 in 100 people).

• Decreased level of consciousness or loss of consciousness. (Rare, may affect up to 1 in 100 people).

The following side effects have also been reported:

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

• Nausea, vomiting, constipation
• Feeling sleepy (Drowsiness)
• Feeling dizzy
• Headache

Common (may affect up to 1 in 10 people)

• Allergic reaction
• Loss of appetite
• Difficulty sleeping
• Depression
• Feeling anxious or confused
• Seeing, feeling, or hearing things that are not present (hallucinations)
• Tremors or muscle spasms
• Strange sensation in the skin, such as tingling or prickling (paresthesia)
• Sensation of everything spinning (dizziness)
• Irregular or rapid heartbeats (palpitations, tachycardia)
• Increased blood pressure
• Sensation of lack of air (dyspnea)
• Diarrhea
• Dry mouth
• Stomach pain or indigestion
• Excessive sweating
• Itching, rash, or redness of the skin
• Difficulty urinating or emptying the bladder completely
• Intense fatigue, weakness, or general discomfort
• Sensation of cold
• Swelling of the hands, ankles, or feet (peripheral edema)

Rare (may affect up to 1 in 100 people)

• Feeling agitated or disoriented
• Sensation of being extremely happy (euphoria)
• Decreased sensation or sensitivity, especially in the skin (hypoesthesia)
• Memory loss
• Blurred vision
• Slow heart rate (bradycardia) or low blood pressure
• Blue discoloration of the skin caused by decreased oxygen in the blood (cyanosis)
• Loss of intestinal contractions (ileus)
• Rash on the skin with itching (eczema), allergic reaction, or other skin disorders where the patch is applied
• Flu-like illness
• Sensation of change in body temperature
• Fever
• Muscle contraction
• Difficulty obtaining or maintaining an erection (impotence) or problems with sexual relations

Rare side effects (may affect up to 1 in 1000 people)

• Pupil constriction (miosis)
• Occasional interruption of breathing (apnea)

The following side effects have also been reported, but their exact frequency is unknown:

• Lack of male sex hormones (androgen deficiency)
• Delirium (symptoms may include a combination of agitation, restlessness, disorientation, confusion, fear, seeing or hearing things that are not present, sleep disturbances, nightmares)
• You may become dependent on Fentanilo Matrix Normon (see section 2).

You may notice rashes, redness, or a mild itching sensation on the skin where the patch is applied. It is usually mild and disappears after removing the patch. If not, or if the patch irritates your skin a lot, inform your doctor.

Repeated use of the patches may make the medicine less effective (you become accustomed to it or become more sensitive to pain) or may cause dependence.

If you change from another analgesic to Fentanilo Matrix Normon or if you stop using Fentanilo Matrix Normon abruptly, you may experience withdrawal symptoms, such as dizziness, feeling sick, diarrhea, anxiety, or tremors. Inform your doctor if you notice any of these effects.

There have also been reported cases of newborn babies experiencing withdrawal symptoms after their mothers used Fentanilo Matrix Normon for an extended period during pregnancy.

Reporting of side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse, 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 Pharmacovigilance 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.

Where to store the patches

Keep all patches (used and unused) out of sight and reach of children.

Store this medication in a protected and secure location, where other people cannot access it. It can be very harmful and cause death to people who may accidentally or intentionally use this medication when not prescribed.

How long can you store Fentanilo Matrix Normon

Do not use this medication after the expiration date that appears on the box and on the package. The expiration date is the last day of the month indicated. If the patches are expired, take them to the pharmacy.

Do not use this medication if you observe that the patches are damaged.

Store in the original packaging to protect it from moisture.

How to dispose of used patches or patches no longer in use

Accidental exposure of another person to used and unused patches, especially in children, may result in a fatal outcome.

Used patches should be folded firmly in half, so that the adhesive side of the patch adheres to itself. Then, they should be safely disposed of by placing them in the original package and storing them out of sight and reach of other people, especially children, until they are safely disposed of. Ask your pharmacist how to dispose of the packaging and medications that you no longer need.

Medications should not be thrown down the drain or in the trash. Deposit the packaging and medications that you no longer need in the SIGRE point of the pharmacy. In case of doubt, ask your pharmacist how to dispose of the packaging and medications that you no longer need. This way, you will help protect the environment.

Composition of Fentanilo Matrix Normon

• The active principle is fentanilo.

Each transdermal patch (15 cm2area of the release surface) contains 4.8 mg of fentanilo, which releases a dose of 25 micrograms/hour.

• The other components of the patch are:

Adhesive layer:Acrylic polymer, lauric alcohol

Support film:Polyester sheet, treated with silicone.

Removable coating:Polyester / ethylene-vinyl acetate sheet

Printing ink

Appearance of the product and contents of the packaging

Fentanilo Matrix Normon 25 micrograms/h is a thin, transparent transdermal patch with rounded edges and the following printing: "fentanyl 25 µg/h".

Fentanilo Matrix Normon is available in packaging of 5 transdermal patches.

Holder of the marketing authorization and responsible manufacturer

LABORATORIOS NORMON, S.A.

Ronda de Valdecarrizo, 6 – 28760 Tres Cantos – Madrid (SPAIN)

OTHER PRESENTATIONS

Fentanilo MatrixNormon50 micrograms/h transdermal patch EFG

Fentanilo MatrixNormon75 micrograms/h transdermal patch EFG

Fentanilo MatrixNormon100 micrograms/h transdermal patch EFG

Last review date of this leaflet: March 2025

Other sources of information

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