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How to use FLUCONAZOLE ARISTO 200 mg HARD CAPSULES

Introduction

Package Leaflet: Information for the User

Fluconazole ARISTO 200 mg hard capsules EFG

Fluconazole

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

What is Fluconazole ARISTO and what is it used for
What you need to know before you take Fluconazole ARISTO
How to take Fluconazole ARISTO
Possible side effects
Storage of Fluconazole ARISTO
Contents of the pack and other information

1. What is Fluconazole ARISTO and what is it used for

Fluconazole ARISTO is one of a group of medicines called “antifungals”. The active substance is fluconazole.

Fluconazole ARISTO is used to treat infections caused by fungi, and it can also be used to prevent fungal infections from occurring. The most common cause of fungal infections is a yeast called Candida.

Adults

Your doctor may prescribe this medicine for you to treat the following types of fungal infections:

Cryptococcal meningitis – a fungal infection in the brain.
Coccidioidomycosis – a disease of the bronchopulmonary system.
Candidainfections located in the bloodstream, in organs of the body (e.g. heart, lungs) or in the urinary tract.
Mucosal candidiasis – an infection that affects the lining of the mouth, throat or associated with dental prostheses.
Genital candidiasis – an infection of the vagina or penis.
Skin infections – e.g. athlete's foot, ringworm, jock itch, nail infection.

They may also prescribe Fluconazole ARISTO for you to:

Prevent the recurrence of cryptococcal meningitis.
Prevent the recurrence of mucosal infections.
Reduce the repeated occurrence of vaginal Candidainfections.
Prevent the spread of Candidainfections (if your immune system is weak and not working properly).

Children and adolescents (0 to 17 years)

Your doctor may prescribe this medicine for you to treat the following types of fungal infections:

Mucosal candidiasis – an infection that affects the lining of the mouth or throat.
Candidainfections located in the bloodstream, in organs of the body (e.g. heart, lungs) or in the urinary tract.
Cryptococcal meningitis – a fungal infection in the brain.

They may also prescribe Fluconazole ARISTO for you to:

Prevent the spread of Candidainfections (if your immune system is weak and not working properly).
Prevent the recurrence of cryptococcal meningitis.

2. What you need to know before you take Fluconazole ARISTO

Do not take Fluconazole ARISTO if

You are allergic (hypersensitive) to fluconazole, to other medicines used to treat fungal infections, or to any of the other ingredients of Fluconazole ARISTO. Symptoms may include itching, skin rash or difficulty breathing.
You are taking astemizole, terfenadine (antihistamine medicines for treating allergies).
You are taking cisapride (used for stomach upset).
You are taking pimozide (used for treating mental health conditions).
You are taking quinidine (used for treating heart rhythm disorders).
You are taking erythromycin (an antibiotic for treating infections).

Be cautious with Fluconazole ARISTO

Tell your doctor if

You have liver or kidney problems.
You have a heart condition, including heart rhythm disorders.
You have abnormal levels of potassium, calcium or magnesium in your blood.
You experience severe skin reactions (itching, skin rash or difficulty breathing).
You have ever had a severe skin rash or peeling of the skin, blisters and/or sores in the mouth after taking Fluconazole ARISTO.

Severe skin reactions, including drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in relation to Fluconazole ARISTO treatment. Stop taking Fluconazole ARISTO and seek immediate medical attention if you notice any of the symptoms related to these severe skin reactions described in section 4.

If the fungal infection does not improve, alternative antifungal treatment may be necessary.

Using other medicines

Tell your doctor immediatelyif you are taking astemizole, terfenadine (an antihistamine for treating allergies), cisapride (used for stomach upset), pimozide (used for treating mental health conditions), quinidine (used for treating heart rhythm disorders) or erythromycin (an antibiotic for treating infections), as these medicines should not be taken with Fluconazole ARISTO (see section: “Do not take Fluconazole ARISTO if”).

There are some medicines that may interact with Fluconazole ARISTO.

Make sure your doctor knows if you are taking any of the following medicines:

Rifampicin or rifabutin (antibiotics for infections).
Alfentanil, fentanyl (used as anesthetics).
Amitriptyline, nortriptyline (used as antidepressants).
Amphotericin B, voriconazole (antifungals).
Medicines that make the blood less viscous, to prevent blood clots (warfarin or similar medicines).
Benzodiazepines (midazolam, triazolam or similar medicines) used to help you sleep or for anxiety.
Carbamazepine, phenytoin (used for treating seizures).
Nifedipine, isradipine, amlodipine, felodipine and losartan (for high blood pressure).
Ciclosporin, everolimus, sirolimus or tacrolimus (to prevent transplant rejection).
Cyclophosphamide, vinca alkaloids (vincristine, vinblastine or similar medicines) used for treating cancer.
Halofantrine (used for treating malaria).
Statins (atorvastatin, simvastatin and fluvastatin or similar medicines) used for reducing high cholesterol levels.
Methadone (used for pain relief).
Celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Non-Steroidal Anti-Inflammatory Drugs – NSAIDs).
Oral contraceptives.
Prednisone (steroid).
Zidovudine, also known as AZT; saquinavir (used in HIV-infected patients).
Medicines for diabetes, such as chlorpropamide, glibenclamide, glipizide or tolbutamide.
Theophylline (used for controlling asthma).
Vitamin A (nutritional supplement).

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

Taking Fluconazole ARISTO with food and drinks

You can take the medicine with or without food.

Pregnancy, breastfeeding and fertility

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

If you are planning to become pregnant, it is recommended that you wait one week after a single dose of fluconazole before becoming pregnant.

For longer treatment cycles with fluconazole, consult your doctor about the need to use adequate contraceptive methods during treatment, which should be continued for one week after the last dose.

Do not take Fluconazole ARISTO if you are pregnant, think you may be pregnant or are planning to become pregnant or breastfeed, unless your doctor has told you to. If you become pregnant while taking this medicine or within one week of the last dose, consult your doctor.

Fluconazole taken during the first or second trimester of pregnancy may increase the risk of miscarriage. Fluconazole during the first trimester may increase the risk of a baby being born with congenital anomalies affecting the heart, bones and/or muscles.

There have been reports of babies born with congenital anomalies affecting the skull, ears and bones of the thigh and elbow in women treated for three months or more with high doses (400-800 mg daily) of fluconazole for coccidioidomycosis. The relationship between fluconazole and these cases is unclear.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

When driving or operating machinery, you should be aware that dizziness or seizures may occasionally occur.

Important information about some of the ingredients of Fluconazole ARISTO

This medicine contains a small amount of lactose (milk sugar). If your doctor has told you that you have an intolerance to some sugars, consult them before taking this medicine.

3. How to take Fluconazole ARISTO

Follow the instructions for administration of Fluconazole ARISTO exactly as indicated by your doctor. Ask your doctor or pharmacist if you have any doubts.

The capsules should be swallowed whole with the help of a glass of water. It is best to take your medicines at the same time every day.

The following is the usual dose of this medicine for the different types of infections:

Adults

Condition	Dose
For treating cryptococcal meningitis	400 mg on the first day and then 200 mg to 400 mg once a day for 6 to 8 weeks or longer if necessary. In some cases, the dose may be increased to 800 mg
For preventing the recurrence of cryptococcal meningitis	200 mg once a day until your doctor tells you to stop
For treating coccidioidomycosis	200 mg to 400 mg once a day from 11 months to 24 months or longer if necessary. In some cases, the dose may be increased to 800 mg
For treating internal fungal infections caused by Candida	800 mg on the first day and then 400 mg once a day until your doctor tells you to stop
For treating mucosal infections that affect the lining of the mouth, throat or associated with dental prostheses	200 mg to 400 mg on the first day and then 100 mg to 200 mg until your doctor tells you to stop
For treating mucosal candidiasis – the dose depends on the location of the infection	50 mg to 400 mg once a day for 7 to 30 days until your doctor tells you to stop
For preventing mucosal infections that affect the lining of the mouth and throat	100 mg to 200 mg once a day, or 200 mg 3 times a week, while the risk of developing an infection continues
For treating genital candidiasis	150 mg in a single dose
For reducing the repeated occurrence of vaginal candidiasis	150 mg every 3 days for a total of 3 doses (days 1, 4 and 7) and then once a week while the risk of developing an infection continues
For treating fungal skin or nail infections	Depending on the location of the infection, 50 mg once a day, 150 mg once a week, 300 to 400 mg once a week for 1 to 4 weeks (for athlete's foot, up to 6 weeks may be necessary; for nail infections, treatment should continue until a healthy nail grows)
For preventing the spread of Candidainfections (if your immune system is weak and not working properly)	200 mg to 400 mg once a day while the risk of developing an infection continues

Adolescents 12 to 17 years of age

Follow the dose indicated by your doctor (either the adult dose or the child dose).

Children up to 11 years

The maximum daily dose for children is 400 mg per day.

The dose will be based on the child's weight in kilograms.

Condition	Daily dose
Mucosal candidiasis and throat infections caused by Candida– the dose and duration of treatment depend on the severity of the infection and its location	3 mg per kg of body weight (on the first day, 6 mg per kg of body weight may be given)
Cryptococcal meningitis or internal fungal infections caused by Candida	6 mg to 12 mg per kg of body weight
For preventing the spread of Candidainfections in children (if their immune system is weak and not working properly)	3 mg to 12 mg per kg of body weight

Use in children from 0 to 4 weeks of age

Use in children from 3 to 4 weeks of age:

The same dose as described in the table, but administered every 2 days. The maximum dose is 12 mg per kg of body weight every 48 hours.

Use in children under 2 weeks of age:

The same dose as described in the table, but administered every 3 days. The maximum dose is 12 mg per kg of body weight every 72 hours.

Sometimes, doctors may prescribe different doses than those described. Follow the instructions for administration indicated by your doctor exactly. Ask your doctor or pharmacist if you have any doubts.

Elderly patients

The usual dose for adults, unless you have kidney problems.

Patients with kidney problems

Your doctor may change your dose, depending on how well your kidneys are working.

If you take more Fluconazole ARISTO than you should

Taking too many capsules at once can make you feel unwell. Contact your doctor or the nearest hospital immediately. You can also call the Toxicology Information Service, phone 91 562 04 20, indicating the medicine and the amount taken. The symptoms of a possible overdose may include hearing, seeing, feeling and thinking things that are not real (hallucinations and paranoid behavior). It may be appropriate to initiate symptomatic treatment (with supportive measures and stomach lavage if necessary).

If you forget to take Fluconazole ARISTO

Do not take a double dose to make up for forgotten doses. If you have forgotten to take a dose, take it as soon as you remember. If it is almost time for your next dose, do not take the missed dose.

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

4. Possible Adverse Effects

Like all medicines, Fluconazol ARISTO can cause adverse effects, although not all people suffer from them.

Some people develop allergic reactions, although severe allergic reactions are rare.If any of the following symptoms appear, inform your doctor immediately.

Sudden wheezing, difficulty breathing, or chest tightness.
Swelling of the eyelids, face, or lips.
Itching all over the body, skin redness, or red spots with itching.
Skin rash.
Severe skin reactions, such as a rash that causes blisters (this can affect the mouth and tongue).

Fluconazol ARISTO may affect your liver. Signs that indicate liver problems include:

Fatigue.
Loss of appetite.
Vomiting.
Yellowing of the skin or the whites of the eyes (jaundice).

If you experience any of these symptoms, stop taking Fluconazol ARISTO and inform your doctor immediately.

Stop taking Fluconazol ARISTO and seek immediate medical attention if you notice any of the following symptoms:

Widespread rash, high body temperature, and swollen lymph nodes (DRESS syndrome or drug hypersensitivity syndrome).

Other Adverse Effects:

Additionally, if you consider that any of the adverse effects you are experiencing is serious or if you notice any adverse effect not mentioned in this prospectus, inform your doctor or pharmacist.

The following are common adverse effects that affect 1 to 10 out of every 100 patients:

Headache.
Stomach upset, diarrhea, discomfort, vomiting.
Elevated blood test results indicating liver function.
Rash.

The following are uncommon adverse effects that affect 1 to 10 patients out of every 1,000:

Reduction of red blood cells, which can make your skin pale and cause weakness or difficulty breathing.
Decreased appetite.
Insomnia, feeling of numbness.
Seizures, dizziness, feeling of spinning, tingling, pinching, or numbness, changes in taste sensation.
Constipation, heavy digestion, gas, dry mouth.
Muscle pain.
Liver damage and yellowing of the skin and eyes (jaundice).
Hives, blisters (hives), itching, increased sweating.
Fatigue, general feeling of discomfort, fever.

The following are rare adverse effects that affect 1 to 10 patients out of every 10,000:

White blood cells that help defend against infections and blood cells that help stop bleeding, lower than normal.
Red or purple skin discoloration, which may be due to a low platelet count, other changes in blood cells.
Changes in blood tests (high cholesterol, fat levels).
Low potassium levels in the blood.
Tremors.
Abnormal electrocardiogram (ECG), changes in heart rate or rhythm.
Liver function failure.
Allergic reactions (sometimes severe), including widespread rash with blisters and skin peeling, severe allergic reactions, swelling of the lips or face.
Hair loss.

Reporting Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is an adverse effect not mentioned in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: www.notificaRAM.es.

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

5. Storage of Fluconazol ARISTO

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

Do not use Fluconazol ARISTO after the expiration date stated on the packaging after CAD. The expiration date is the last day of the month indicated.

No special storage conditions are required.

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

6. Package Contents and Additional Information

Composition of Fluconazol ARISTO

The active ingredient is fluconazole.

Each hard capsule contains 200 mg of fluconazole.

The other ingredients (excipients) are:

Capsule content:

Lactose monohydrate (lactose).

Pregelatinized corn starch (corn starch).

Colloidal silicon dioxide.

Magnesium stearate (E 572).

Sodium lauryl sulfate.

Capsule composition:

Quinoline yellow

Titanium dioxide (E 171)

Gelatin

Carmine

Appearance of Fluconazol ARISTO 200 mg Hard Capsules and Package Contents

200 mg hard gelatin capsule, with a white body and a green cap.

It is available in packages of 7 hard capsules and a clinical package with 100 hard capsules.

Not all package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing authorization holder:

Aristo Pharma Iberia, S.L.

C/ Solana, 26

28850, Torrejón de Ardoz

Madrid, Spain

Manufacturer:

TOLL MANUFACTURING SERVICES, S.L.

C/ Aragoneses, 2.

28108 Alcobendas (Madrid) SPAIN.

Laboratorios Medicamentos Internacionales S.A. (MEDINSA)

C/Solana, 26