FINGOLIMOD KOANAA 0.5 mg HARD CAPSULES

Introduction

Package Leaflet: Information for the User

Fingolimod Koanaa 0.5 mg Hard Capsules EFG

Read the entire package leaflet carefully before starting to take this medication, as it contains important information for you.

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

Contents of the Package Leaflet

1. What is Fingolimod Koanaa and what is it used for
2. What you need to know before taking Fingolimod Koanaa
3. How to take Fingolimod Koanaa
4. Possible side effects
5. Storage of Fingolimod Koanaa
6. Package Contents and Additional Information

1. What is Fingolimod Koanaa and what is it used for

The active ingredient of Fingolimod Koanaa is fingolimod.

What Fingolimod Koanaa is used for

Fingolimod Koanaa is used in adults and in children and adolescents (10 years of age and older) to treat relapsing-remitting multiple sclerosis (MS) (with relapses), particularly in:

• Patients who do not respond to treatment despite MS treatment.

or

• Patient who rapidly develop severe MS.

Fingolimod does not cure MS, but it helps reduce the number of relapses and slow the progression of physical disabilities due to MS.

What is Multiple Sclerosis

MS is a chronic disease that affects the central nervous system (CNS), which consists of the brain and spinal cord. In MS, inflammation destroys the protective sheath (called myelin) that covers the nerves in the CNS, preventing the nerves from functioning properly. This process is called demyelination.

Relapsing-remitting MS is characterized by repeated attacks (relapses) of neurological symptoms that reflect the inflammation occurring in the CNS. Symptoms vary from patient to patient but usually include difficulty walking, loss of sensation in some part of the body (numbness), vision problems, or balance disorders. The symptoms of a relapse may disappear completely when the relapse ends, but some problems may persist.

How Fingolimod Koanaa Works

Fingolimod helps combat the immune system's attacks on the CNS by reducing the ability of some white blood cells (lymphocytes) to move freely within the body and preventing them from reaching the brain and spinal cord. This limits the nerve damage attributed to multiple sclerosis. Fingolimod also reduces some of the immune responses of your body.

2. What you need to know before starting to take Fingolimod Koanaa

Do not take Fingolimod Koanaa

• to fingolimod or to any of the other components of this medicine (included in section 6).
• you have a weakened immune response(due to an immunodeficiency syndrome, a disease, or medications that suppress the immune system).
• if you have a severe active or chronic infectionsuch as hepatitis or tuberculosis.
• if you have active cancer.
• if you have severe liver problems.
• if you have any type of irregular or abnormal heartbeat(arrhythmia), including patients in whom the electrocardiogram (ECG) shows a prolonged QT interval before starting treatment with Fingolimod.
• such as quinidine, disopyramide, amiodarone, or sotalol.
• if you are pregnantor if you are a woman of childbearing age and are not using an effective contraceptive method.

If any of the above cases apply to you, tell your doctor without taking Fingolimod Koanaa.

Warnings and precautions

Consult your doctor or pharmacistbefore starting to take Fingolimod

• (such as beta-blockers, verapamil, diltiazem, or ivabradine, digoxin, anticholinesterase agents, or pilocarpine).
• or other signs of inflammation in the central vision area (macula) of the eye (a condition known as macular edema, see below) or eye inflammation or infection (uveitis) or if you havediabetes(which can cause eye problems).
• if you have high blood pressure that cannot be controlled with medication.
• if you have severe lung problemsor "smoker's cough."

If any of the above cases apply to you, inform your doctor before taking this medication.

Slow heart rate (bradycardia) and irregular heartbeats

At the start of treatment or after taking the first dose of 0.5 mg, in the case that you have changed the previous dose of 0.25 mg once a day, Fingolimod Koanaa produces a decrease in heart rate. As a result, you may feel dizzy or tired, be aware of your heartbeat, or your blood pressure may drop. If these effects are pronounced, inform your doctor as you may need immediate treatment. Fingolimod may also cause your heartbeats to become irregular, especially after the first dose. Irregular heartbeats usually normalize in less than a day. The slow heart rate usually normalizes within a month.

Your doctor will ask you to stay in the office or hospital for at least 6 hours, with pulse and blood pressure checks every hour, after taking the first dose of Fingolimod Koanaa or after taking the first dose of 0.5 mg, in the case that you have changed the previous dose of 0.25 mg once a day, so that appropriate measures can be taken in case of adverse effects that appear at the start of treatment. You should have an electrocardiogram before the first dose of Fingolimod and after the 6-hour monitoring period. Your doctor may continuously monitor your electrocardiogram during this time. If after the 6-hour period you have a very slow or decreasing heart rate, or if your electrocardiogram shows abnormalities, you will need to be monitored for a longer period (at least 2 hours more and possibly overnight, until this is resolved). The same may apply if you are resuming Fingolimod after a pause in treatment, depending on both the duration of the pause and how long you were taking Fingolimod before the pause.

If you have or are at risk of having irregular or abnormal heartbeats, if your electrocardiogram is abnormal, or if you have heart disease or heart failure, Fingolimod may not be suitable for you.

If you have suffered from sudden fainting in the past or a decrease in heart rate, Fingolimod may not be suitable for you. You will be evaluated by a cardiologist (heart specialist) who will advise you on how to start treatment with Fingolimod, including nighttime monitoring.

If you are taking other medications that can slow your heart rate, Fingolimod may not be suitable for you. It is necessary for a cardiologist to evaluate you and determine if you can switch to alternative medications that do not decrease heart rate to allow treatment with Fingolimod Koanaa. If the aforementioned change is impossible, the cardiologist will advise you on how to start treatment with Fingolimod, including nighttime monitoring.

If you have never had chickenpox

If you have not had chickenpox, your doctor will check your immunity to the virus that causes it (varicella-zoster virus). If you are not protected against the virus, you will likely need to be vaccinated before starting treatment with Fingolimod. If so, your doctor will delay the start of treatment with Fingolimod for one month after completing the vaccination cycle.

Infections

Fingolimod reduces the number of white blood cells in your blood (especially the number of lymphocytes). White blood cells fight infections. During treatment with Fingolimod (and up to two months after interrupting treatment), you may be more likely to get infections. You may even worsen an infection you already have. Infections can be serious and potentially life-threatening. If you think you have an infection, have a fever, have flu-like symptoms, or have a headache accompanied by stiffness in the neck, sensitivity to light, nausea, and/or confusion (which can be symptoms of a fungal infection and may be symptoms of meningitis), contact your doctor immediately because it can be serious and potentially life-threatening. If you think your MS is getting worse (e.g., weakness or vision changes) or if you notice any new symptoms, inform your doctor immediately, as they may be symptoms of a rare brain disorder caused by an infection called progressive multifocal leukoencephalopathy (PML). PML is a serious disease that can cause severe disability or death. Your doctor will assess the need for an MRI to evaluate your condition and decide if you need to stop taking this medication.

It has been reported that patients treated with Fingolimod Koanaa have developed human papillomavirus (HPV) infection, including papilloma, dysplasia, warts, and HPV-associated cancer. Your doctor will assess whether you need to be vaccinated against HPV before starting treatment. If you are a woman, your doctor will also recommend that you have regular HPV check-ups.

Macular edema

Before starting treatment with this medication, your doctor may request an eye examination if you have or have had visual disorders or other signs of inflammation in the central vision area (macula) of the eye, eye inflammation or infection (uveitis), or diabetes.

After starting treatment with Fingolimod, your doctor may request an eye examination after 3 or 4 months of treatment.

The macula is a small area of the retina located at the back of the eye that allows you to see shapes, colors, and details clearly and sharply. Fingolimod can cause inflammation of the macula, and this condition is known as macular edema. Inflammation usually occurs within the first four months of treatment with Fingolimod.

If you have diabetes or have had eye inflammation known as uveitis, you are more likely to develop macular edema. In these cases, your doctor will want you to have regular eye checks to detect macular edema.

If you have had macular edema, consult your doctor before continuing treatment with Fingolimod.

Macular edema can cause the same visual symptoms as those produced by an MS attack (optic neuritis). At first, you may not have symptoms. It is necessary that you inform your doctor of any changes you notice in your vision. Your doctor may want to perform an eye examination, especially if:

• The center of your field of vision becomes blurry or has shadows;
• A blind spot appears in the center of your field of vision;
• You have trouble seeing colors or small details.

Liver function tests

If you have severe liver problems, you should not take this medication. Fingolimod can affect liver function. You may not notice any symptoms, but if you notice a yellowish tone in your skin or the white part of your eye, unusually dark urine, or nausea and vomiting without apparent cause, inform your doctor immediately.

If you have any of these symptoms after starting treatment with Fingolimod, inform your doctor immediately.

During the first 12 months of treatment, your doctor will request blood tests to check your liver function. You may need to interrupt treatment if the results of your tests indicate a problem with your liver.

High blood pressure

Since Fingolimod causes a slight increase in blood pressure, your doctor will want you to have your blood pressure checked regularly.

Lung problems

Fingolimod has a mild effect on lung function. Patients with severe lung problems or "smoker's cough" are more likely to develop adverse effects.

Blood count

The expected effect of treatment with Fingolimod is to reduce the number of white blood cells in your blood. This effect usually normalizes within 2 months after interrupting treatment. If you need to have blood tests, inform your doctor that you are taking Fingolimod, as your doctor may not understand the results of the tests otherwise. For certain blood tests, your doctor may need more blood than usual.

Before starting treatment with Fingolimod, your doctor will confirm that you have enough white blood cells in your blood and may want to repeat checks regularly. If you do not have enough white blood cells, you may need to interrupt treatment with this medication.

Posterior reversible encephalopathy syndrome (PRES)

A condition called posterior reversible encephalopathy syndrome (PRES) has been rarely described in MS patients treated with Fingolimod. Symptoms may include sudden onset of severe headache, confusion, seizures, and changes in vision. Inform your doctor immediately if you experience any of these symptoms during treatment with Fingolimod because it can be serious.

Cancer

In patients with MS who have been treated with Fingolimod, cases of skin cancer have been reported. Inform your doctor immediately if you notice any nodules on the skin (e.g., shiny nodules with a pearl-like appearance), spots, or open sores that do not heal within weeks. Symptoms of skin cancer may include abnormal growth or changes in skin tissue (e.g., unusual moles) that change color, shape, or size over time. Before starting treatment with Fingolimod Koanaa, a skin examination is required to check for any nodules on the skin. Your doctor will also perform regular skin checks during treatment with this medication. If any skin problems appear, your doctor may refer you to a dermatologist, who may decide if it is important to visit you regularly.

In patients with MS who have been treated with Fingolimod, a type of cancer of the lymphatic system (lymphoma) has been reported.

Sun exposure and sun protection

Fingolimod weakens your immune system, which increases the risk of developing cancer, especially skin cancer. You should limit your exposure to the sun and UV rays by:

• using suitable protective clothing.
• applying sunscreen with a high UV protection index regularly.

Unusual brain lesions associated with MS relapses

Rare cases of large and unusual brain lesions associated with MS relapses have been reported in patients treated with Fingolimod. In the case of severe relapses, your doctor will assess the need for an MRI to evaluate your condition and decide if you need to stop taking Fingolimod.

Switching from other treatments to Fingolimod Koanaa

Your doctor may switch you directly from interferon beta, glatiramer acetate, or dimethyl fumarate to Fingolimod if there are no signs of treatment-related abnormalities. Your doctor may need to perform a blood test to rule out such abnormalities. After stopping natalizumab, you may need to wait 2-3 months before starting treatment with Fingolimod. To switch from teriflunomide, your doctor may advise you to wait for a period of time or undergo an accelerated elimination procedure. If you have been treated with alemtuzumab, a thorough evaluation is necessary, and you should discuss it with your doctor to decide if Fingolimod is suitable for you.

Women of childbearing age

If Fingolimod Koanaa is used during pregnancy, it may be harmful to the fetus. Before starting treatment with Fingolimod, your doctor will explain the risks and ask you to take a pregnancy test to ensure you are not pregnant. Your doctor will give you a card that explains why you should not become pregnant while taking Fingolimod and what you should do to avoid becoming pregnant while taking Fingolimod. During treatment and for 2 months after interrupting treatment, you must use an effective contraceptive method (see section "Pregnancy and breastfeeding").

Worsening of MS after stopping treatment with Fingolimod Koanaa

Do not stop taking Fingolimod Koanaa or change the dose your doctor has prescribed without discussing it with your doctor first.

Inform your doctor immediately if you think your MS is getting worse after stopping treatment with Fingolimod, as it can be serious (see section 3 "If you stop treatment with Fingolimod Koanaa" and also section 4 "Possible side effects").

Elderly people

Experience with Fingolimod in elderly patients (over 65 years) is limited. If in doubt, consult your doctor.

Children and adolescents

Fingolimod Koanaa should not be administered to children under 10 years of age, as it has not been studied in patients with MS in this age group.

The warnings and precautions mentioned above also apply to children and adolescents. The following information is especially important for children and adolescents and their caregivers:

• Before starting treatment with Fingolimod, your doctor will check your vaccination status. If you have not received certain vaccinations, it may be necessary to administer them before you can start treatment with Fingolimod.
• The first time you take Fingolimod Koanaa, or when you switch from a daily dose of 0.25 mg to a daily dose of 0.5 mg, your doctor will monitor your heart rate and heartbeats (see the previous section "Slow heart rate (bradycardia) and irregular heartbeats").
• If you have seizures or attacks before taking or while taking Fingolimod, inform your doctor.
• If you suffer from depression or anxiety or if during treatment with Fingolimod you feel depressed or anxious, inform your doctor. You may need closer monitoring.

Other medications and Fingolimod Koanaa

Inform your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication. Inform your doctor if you are taking any of the following medications:

• Medications that suppress or modulate the immune system, including other medications used to treat MS, such as interferon beta, glatiramer acetate, natalizumab, mitoxantrone, teriflunomide, dimethyl fumarate, or alemtuzumab. You should not use Fingolimod Koanaa with these medications because it could intensify the effect on the immune system (see also "Do not use Fingolimod Koanaa").
• Corticosteroidsdue to an added effect on the immune system.
• Vaccines. If you need a vaccine, inform your doctor first. During treatment with Fingolimod and up to two months after stopping it, you should not receive certain types of vaccines (live attenuated virus vaccines) because they can cause the infections they are intended to prevent. It is possible that other vaccines may not have the desired effect if administered during this period.
• Medications that slow the heart rate(e.g., beta-blockers such as atenolol). The use of Fingolimod with these medications can intensify the effect on the heart rate during the first days after starting treatment with Fingolimod.
• Medications for treating irregular heartbeats, such as quinine, disopyramide, amiodarone, or sotalol. If you take any of these medications, you should not use Fingolimod, as it could intensify the effect on irregular heartbeats (see also the section "Do not take Fingolimod Koanaa").
• Other medications:

• protease inhibitors, anti-infectives such as ketoconazole, azole antifungals, clarithromycin, or telithromycin.
• carbamazepine, rifampicin, phenobarbital, phenytoin, efavirenz, or St. John's Wort (potential risk of reduced effectiveness of Fingolimod).

3. How to take Fingolimod Koanaa

Treatment with Fingolimod Koanaa will be supervised by a doctor with experience in the treatment of multiple sclerosis.

Follow the instructions for administering this medicine exactly as indicated by your doctor or pharmacist. If you are unsure, consult your doctor or pharmacist again.

The recommended dose is.

Adults:

The dose is one 0.5 mg capsule per day.

Children and adolescents (from 10 years of age and older):

The dose depends on body weight:

• Children and adolescents with a weightof 40 kg or less: one 0.25 mg capsule per day.

Fingolimod Koanaa 0.5 mg hard capsules are not suitable for pediatric patients with a body weight of ≤ 40 kg.

Other medicines containing fingolimod are available in lower doses (such as 0.25 mg capsules).

• Children and adolescents with a weightover 40 kg: one 0.5 mg capsule per day.

For children and adolescents who start with a 0.25 mg capsule per day and later reach a stable weight over 40 kg, the doctor will instruct them to switch to a 0.5 mg capsule per day. In this case, it is recommended to repeat the first-dose observation period.

Do not exceed the recommended dose.

Fingolimod Koanaa is taken orally.

Take Fingolimod once a day with a glass of water. Fingolimod capsules should always be swallowed whole, without opening them. You can take this medicine with or without food.

Taking Fingolimod at the same time every day will help you remember when to take the medicine.

If you have doubts about the duration of treatment with this medicine, consult your doctor or pharmacist.

If you take more Fingolimod Koanaa than you should

If you have taken more Fingolimod than you should, inform your doctor immediately.

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

If you forget to take Fingolimod Koanaa

If you have been taking Fingolimod for less than 1 month and forget to take 1 dose during a whole day, talk to your doctor before taking the next dose. Your doctor may decide to keep you under observation when you take the next dose.

If you have been taking Fingolimod Koanaa for at least 1 month and have forgotten to take your treatment for more than 2 weeks, talk to your doctor before taking the next dose. Your doctor may decide to keep you under observation when you take the next dose. However, if you have forgotten to take your treatment for a period of up to 2 weeks, you can take the next dose as planned.

Never take a double dose to make up for forgotten doses.

If you stop treatment with Fingolimod Koanaa

Do not stop taking this medicine or change the dose to be taken without first discussing it with your doctor.

Fingolimod will remain in your body for up to 2 months after stopping treatment. The number of white blood cells in the blood (lymphocyte count) may remain low during this period, and it is possible that the side effects described in this leaflet may still occur. After stopping treatment with Fingolimod, you may have to wait for 6-8 weeks before starting a new treatment for MS.

If you need to restart treatment with Fingolimod after a pause of more than 2 weeks, the effect on heart rate that may occur at the start of treatment may recur, and you will need to be monitored in the doctor's office to restart treatment. Do not restart treatment with Fingolimod after interrupting it for more than 2 weeks without consulting your doctor.

Your doctor will decide if it is necessary to monitor you after stopping treatment with Fingolimod Koanaa and how to do so. Inform your doctor immediately if you think your MS is getting worse after stopping treatment with Fingolimod, as it could be serious.

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.

Some side effects can be serious or potentially serious

Common(may affect up to 1 in 10 people):

• Cough with expectoration (phlegm), chest discomfort, fever (signs of pulmonary disorders)
• Herpes virus infection (shingles or herpes zoster) with symptoms such as blisters, itching, burning, or pain of the skin, especially on the upper body or face. Other symptoms you may have are fever and weakness in the early stage of the infection, followed by numbness, itching, or red spots with intense pain
• Slow heart rate (bradycardia), irregular heart rhythm
• A type of skin cancer known as basal cell carcinoma (BCC) that often appears as a pearl-like nodule, although it can also have other forms
• It is known that the population with multiple sclerosis has depression and anxiety more frequently, and these have also been reported in pediatric patients treated with Fingolimod.
• Weight loss.

Uncommon(may affect up to 1 in 100 people):

• Pneumonia, with symptoms such as fever, cough, difficulty breathing
• Macular edema (inflammation in the central vision area of the retina at the back of the eye) with symptoms such as shadows or a blind spot in the center of the visual field, blurred vision, problems seeing colors or details
• Decreased number of blood platelets, which increases the risk of bleeding or bruising
• Malignant melanoma (a type of skin cancer that usually develops from an unusual mole). Possible signs of melanoma include moles that change in size, shape, thickness, or color over time, or the formation of new moles. Moles can be itchy, bleed, or ulcerate
• Seizures, fits (more frequent in children and adolescents than in adults)

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

• A disease called posterior reversible encephalopathy syndrome (PRES). Symptoms can include sudden onset of severe headache, confusion, seizures, and/or visual disturbances
• Lymphoma (a type of cancer that affects the lymphatic system)
• Squamous cell carcinoma: a type of skin cancer that can appear as a firm red nodule, an ulcer with a crust, or a new ulcer on an existing scar

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

• Abnormality in the electrocardiogram (inversion of the T wave)
• Tumor related to human herpesvirus 8 infection (Kaposi's sarcoma)

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

• Allergic reactions, including symptoms of rash or hives with itching, swelling of lips, tongue, or face, which is more likely to occur on the day treatment with Fingolimod starts.
• Risk of a rare brain infection called progressive multifocal leukoencephalopathy (PML). The symptoms of PML can be similar to those of an MS relapse. You may also have symptoms that you may not notice yourself, such as mood or behavior changes, memory loss, speech and communication difficulties, which your doctor may need to investigate further to rule out PML. Therefore, if you think your MS is getting worse or if you or those close to you notice any new or unusual symptoms, it is very important to inform your doctor as soon as possible
• Cryptococcal infections (a type of fungal infection), including cryptococcal meningitis with symptoms such as headache accompanied by neck stiffness, sensitivity to light, nausea, and/or confusion
• Merkel cell carcinoma (a type of skin cancer). Possible signs of Merkel cell carcinoma include the formation of a painless nodule of flesh-colored or blue-red color, usually on the face, head, or neck. Merkel cell carcinoma can also appear as a firm, painless nodule or mass. Long-term sun exposure and a weakened immune system can affect the risk of developing Merkel cell carcinoma.
• After stopping treatment with Fingolimod, MS symptoms may recur and may be worse than they were before or during treatment.
• Autoimmune form of anemia (decrease in the number of red blood cells) in which red blood cells are destroyed (autoimmune hemolytic anemia).

If you experience any of these symptoms, inform your doctor immediately.

Other side effects

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

• Influenza virus infection with symptoms such as fatigue, chills, sore throat, joint or muscle pain, fever
• Sensation of pressure or pain in the cheeks and forehead (sinusitis)
• Headache
• Diarrhea
• Back pain
• Blood test with altered liver enzyme levels
• Cough

Common(may affect up to 1 in 10 people):

• Pityriasis versicolor (fungal skin infection)
• Dizziness
• Severe headache, usually accompanied by nausea, vomiting, and sensitivity to light (migraine)
• Low level of white blood cells (lymphocytes, leukocytes)
• Weakness
• Rash with itching, redness of the skin, and burning (eczema)
• Itching
• Increased levels of certain lipids (triglycerides) in the blood
• Hair loss
• Difficulty breathing
• Depression
• Blurred vision (see also the section on macular edema under the heading "Some side effects can be serious or potentially serious")
• Hypertension (Fingolimod may cause a slight increase in blood pressure)
• Muscle pain
• Joint pain

Uncommon(may affect up to 1 in 100 people):

• Low levels of certain white blood cells (neutrophils)
• Depressive mood
• Nausea

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

• Lymphatic system cancer (lymphoma)

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

• Peripheral inflammation

If you consider any of the side effects to be serious, inform your doctor.

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. You can also report them directly through the Spanish Medicines Monitoring System: www.notificaRAM.es

By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Fingolimod Koanaa

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

Do not use this medicine after the expiration date shown on the carton and blister packs after EXP. The expiration date is the last day of the month indicated.

Store below 30°C.

Medicines should not be disposed of via wastewater or household waste. Deposit the containers and medicines you no longer need at the SIGRE collection point in the pharmacy. If in doubt, ask your pharmacist how to dispose of the containers and medicines you no longer need. This will help protect the environment.

6. Package contents and additional information

Composition of Fingolimod Koanaa

• The active ingredient is fingolimod. Each capsule contains 0.5 mg of fingolimod (as hydrochloride).
• The other excipients are:

Contents of the capsule:Microcrystalline cellulose, colloidal anhydrous silica, magnesium stearate

Capsule shell:Gelatin, titanium dioxide (E171), yellow iron oxide (E172)

Printing ink:Shellac (E904), propylene glycol (E1520), concentrated ammonia solution (E527), potassium hydroxide (E525), black iron oxide (E172)

Appearance of the product and package contents

Hard gelatin capsule with a white opaque body and a bright yellow cap with a printed mark "SML" on the cap and "1" on the body with black ink.

Fingolimod Koanaa capsules are available in packs containing 7, 7x1, 28, or 98 capsules, or in multipacks containing 84 capsules (3 packs of 28 capsules).

Not all pack sizes may be marketed.

Marketing authorization holder and manufacturer

Marketing authorization holder

Koanaa Healthcare GmbH

Fehrgasse 7, A-2401,

Fischamend,

Austria

Manufacturer

Drehm Pharma GmbH

Hietzinger

Hauptstraße 37/2

Austria

This medicine is authorized in the Member States of the European Economic Area under the following names:

France FINGOLIMOD KOANAA

Germany Fingolimod Koanaa 0.5 mg Hartkapseln

Italy Fingolimod Koanaa

Spain Fingolimod Koanaa 0.5 mg hard capsules EFG

Date of last revision of thisleaflet: 12/2020.

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