LURASIDONE CINFA 18.5 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the Patient

Lurasidona Cinfa 18.5 mg film-coated tablets EFG

Lurasidona Cinfa 37 mg film-coated tablets EFG

Lurasidona Cinfa 74 mg film-coated tablets 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, consult 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 not listed in this package leaflet. See section 4.

Contents of the Package Leaflet

1. What is Lurasidona Cinfa and what is it used for?
2. What you need to know before taking Lurasidona Cinfa
3. How to take Lurasidona Cinfa
4. Possible side effects
5. Storage of Lurasidona Cinfa
6. Package contents and additional information

1. What is Lurasidona Cinfa and what is it used for

Lurasidona Cinfa contains the active substance lurasidone and belongs to a group of medications called antipsychotics. It is used to treat the symptoms of schizophrenia in adults (18 years of age and older) and adolescents from 13 to 17 years. Lurasidone acts by blocking brain receptors that dopamine and serotonin act on. Dopamine and serotonin are neurotransmitters (substances that allow nerve cells to communicate with each other) involved in the symptoms of schizophrenia. By blocking these receptors, lurasidone helps to normalize brain activity, reducing the symptoms of schizophrenia.

Schizophrenia is a disorder with symptoms such as hearing, seeing, or feeling things that do not exist, having false beliefs, exaggerated suspicion, withdrawal, incoherent speech and behavior, and lack of emotions. People suffering from this disorder may feel depressed, anxious, guilty, or tense. This medication is used to improve their schizophrenia symptoms.

2. What you need to know before taking Lurasidona Cinfa

Do not take Lurasidona Cinfa

• if you are allergic to lurasidone or any of the other components of this medication (listed in section 6)
• if you are taking medications that may affect the concentration of lurasidone in your blood, such as:
• • medications for fungal infections such as itraconazole, ketoconazole (except in shampoo), posaconazole, or voriconazole
  • medications for infections, such as the antibiotic clarithromycin or telithromycin
  • medications for HIV infection such as cobicistat, indinavir, nelfinavir, ritonavir, and saquinavir
  • medications for chronic hepatitis such as boceprevir and telaprevir
  • nefazodone, a medication for depression
  • rifampicin, a medication for tuberculosis
  • medications for seizures such as carbamazepine, phenobarbital, and phenytoin
  • St. John's Wort (Hypericum perforatum), a medicinal plant for treating depression.

Warnings and precautions

The full effect of this medication may take several days or even weeks to appear. Consult your doctor if you have any questions about this medication.

Consult your doctor or pharmacist before taking lurasidone or during treatment, especially if:

• you have suicidal thoughts or behaviors
• you suffer from Parkinson's disease or dementia
• you have been diagnosed with a disease whose symptoms are high fever and muscle stiffness (also called malignant neuroleptic syndrome) or have ever suffered from stiffness, tremors, or mobility problems (extrapyramidal symptoms) or abnormal movements of the tongue or face (tardive dyskinesia). You should be aware that these conditions can be caused by this medication
• you suffer from heart disease or are being treated for a heart condition that makes you prone to low blood pressure or have a family history of irregular heartbeats (including QT prolongation)
• you have a history of seizures or epilepsy
• you have a history of blood clots, or any other family member has a history of blood clots, as medications for schizophrenia have been associated with blood clot formation
• you experience breast enlargement in men (gynecomastia), milky secretion from the nipples (galactorrhea), absence of menstruation (amenorrhea), or erectile dysfunction
• you suffer from diabetes or are prone to it
• you have reduced kidney function
• you have reduced liver function
• you gain weight
• your blood pressure drops when standing up, which can cause you to faint.
• you are dependent on opioids (treated with buprenorphine) or severe pain (treated with opioids) or depression or other diseases treated with antidepressants. The use of these medications in combination with lurasidone may cause serotonin syndrome, a potentially fatal disease (see "Other medications and Lurasidona Cinfa").

If you meet any of these conditions, consult your doctor, as it is possible that they may want to adjust your dose, monitor you more closely, or interrupt treatment with lurasidone.

Children and adolescents

Do not administer to children under 13 years of age.

Other medications and Lurasidona Cinfa

Inform your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication. This is especially important if you are taking:

• any medication that also acts on the brain, as their effects may be negatively additive to those of lurasidone in your brain
• medications that lower blood pressure, as this medication can also reduce blood pressure
• medications for Parkinson's disease and restless legs syndrome (e.g., levodopa), as this medication can reduce their effects
• medications containing ergot alkaloid derivatives (used to treat migraines), and other medications such as terfenadine and astemizole (used to treat hay fever and other allergic conditions), cisapride (used to treat digestive problems), pimozide (used to treat psychiatric diseases), quinidine (used to treat heart conditions), bepridil (used to treat chest pain)
• medications containing buprenorphine (used to treat opioid dependence) or opioids (used to treat severe pain) or antidepressants such as moclobemide, tranylcypromine, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, amitriptyline, doxepin, or trimipramine. These medications can interact with lurasidone, and you may experience symptoms such as involuntary and rhythmic muscle contractions, including the muscles that control eye movement, agitation, hallucinations, coma, excessive sweating, tremors, exaggerated reflexes, increased muscle tension, body temperature above 38°C. If you experience these symptoms, consult your doctor.

Inform your doctor if you are taking any of these medications, as it is possible that they may need to change the dose of that medication during treatment with lurasidone.

The following medications can increase the concentration of lurasidone in your blood:

• diltiazem (for treating hypertension)
• erythromycin (for treating infections)
• fluconazole (for treating fungal infections)
• verapamil (for treating hypertension or chest pain).

The following medications can decrease the concentration of lurasidone in your blood:

• amprenavir, efavirenz, etravirine (for treating HIV infection)
• aprepitant (for treating nausea and vomiting)
• armodafinil, modafinil (for treating somnolence)
• bosentan (for treating high blood pressure or finger ulcers)
• nafcillin (for treating infections)
• prednisone (for treating inflammatory diseases)
• rufinamide (for treating seizures).

Inform your doctor if you are taking any of these medications, as it is possible that they may change your dose of lurasidone.

Taking Lurasidona Cinfa with food, drinks, and alcohol

Consumption of alcohol should be avoided when taking this medication, as it will have a negative additive effect.

Do not drink grapefruit juice while taking this medication. Grapefruit can affect the action of this medication.

Pregnancy and breastfeeding

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

You should not take this medication during pregnancy unless agreed with your doctor.

If your doctor decides that the potential benefit of treatment during pregnancy justifies the potential risk to the unborn child, your doctor will closely monitor your child after birth. The reason is that in newborns of mothers who have used lurasidone in the last trimester (last three months) of pregnancy, the following symptoms may appear:

• tremors, stiffness, or muscle weakness, somnolence, agitation, respiratory problems, and difficulty feeding.

If your child develops any of these symptoms, you should consult your doctor.

It is not known whether lurasidone passes into breast milk. Inform your doctor if you are breastfeeding or plan to breastfeed.

Driving and using machines

During treatment with this medication, you may experience somnolence, dizziness, and vision problems (see section 4, Possible side effects). Do not drive, do not ride a bicycle, or operate tools or machinery until you know that this medication does not affect you negatively.

Lurasidona Cinfa contains sodium

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

3. How to take Lurasidona Cinfa

Follow the instructions for administration of this medication exactly as indicated by your doctor or pharmacist. If you are in doubt, ask your doctor or pharmacist again.

Your dose will be decided by your doctor and may depend on:

• how you respond to a dose
• if you are taking other medications (see section 2, Other medications and Lurasidona Cinfa)
• if you have kidney or liver problems.

Adults (18 years or older)

The recommended initial dose is 37 mg once a day.

Your doctor may increase or decrease the dose within the range of 18.5 mg to 148 mg once a day. The maximum dose should not exceed 148 mg once a day.

Adolescents from 13 to 17 years

The recommended initial dose is 37 mg of lurasidone once a day.

The dose may be increased or decreased by your doctor within the dose range of 37 to 74 mg once a day. The maximum daily dose should not exceed 74 mg.

How to take Lurasidona Cinfa

Swallow the tablet whole with water to mask its bitter taste. You should take the dose regularly every day at the same time, so it is easier to remember. You should take this medication with food or immediately after eating, as this helps the body absorb the medication and allows it to work better.

If you take more Lurasidona Cinfa than you should

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

You may experience somnolence, fatigue, abnormal body movements, problems standing and walking, dizziness due to low blood pressure, and abnormal heartbeats.

If you forget to take Lurasidona Cinfa

Do not take a double dose to make up for forgotten doses. If you forget to take a dose, take the next dose on the day after the forgotten dose. If you forget two or more doses, consult your doctor.

If you stop taking Lurasidona Cinfa

If you stop taking this medication, you will lose its effects. You should not stop taking the medication unless your doctor tells you to, as the symptoms may reappear.

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

4. Possible Adverse Effects

Like all medicines, this medicine can cause adverse effects, although not all people suffer from them.

Seek immediate medical attentionif you notice any of the following symptoms:

• a severe allergic reaction consisting of fever, swelling of the mouth, face, lips, or tongue, difficulty breathing, itching, skin rash, and sometimes a drop in blood pressure

(hypersensitivity). These reactions are frequent (may affect 1 in 10 people)

• severe rash with blisters affecting the skin, mouth, eyes, and genitals (Stevens-Johnson syndrome). The frequency of this reaction is unknown

• fever, sweating, muscle stiffness, and decreased level of consciousness. These could be symptoms of a condition known as malignant neuroleptic syndrome. These reactions are rare (may affect 1 in 1000 people)

• blood clots in the veins, especially in the legs (symptoms are swelling, pain, and redness of the leg), which can move through the bloodstream to the lungs and cause chest pain and difficulty breathing. If you notice any of these symptoms, seek medical attention immediately.

The following adverse effects may also appear in adults:

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

• feeling of agitation and inability to remain still
• nausea (vomiting)
• insomnia.

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

• Parkinsonism: this medical term describes numerous symptoms, including increased saliva secretion or very moist mouth, drooling, spasms when flexing the limbs, slow, reduced, or difficult body movements, facial expressiveness, muscle tension, neck stiffness, muscle rigidity, short, shuffling, and hurried steps, and lack of normal arm movements when walking, persistent eye blinking when tapping the forehead (abnormal reflex)
• speech problems, unusual muscle movements; a series of symptoms called extrapyramidal symptoms (EPS) that will typically include unusual involuntary muscle movements
• rapid heart rate
• increased blood pressure
• dizziness
• muscle spasms and rigidity
• vomiting
• diarrhea
• back pain
• rash and itching
• indigestion
• dry mouth or excess saliva
• abdominal pain
• drowsiness, fatigue, agitation, and anxiety
• weight gain
• increased creatine phosphokinase (a muscle enzyme) levels in blood tests
• increased creatinine (a kidney function marker) levels seen in blood tests
• decreased appetite.

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

• slow and difficult speech
• nightmares
• difficulty swallowing
• irritation of the stomach mucosa
• sudden feeling of anxiety
• seizures
• chest pain
• muscle pain
• temporary loss of consciousness
• feeling that everything is spinning
• abnormal nervous impulses in the heart
• slow heart rate
• joint pain
• difficulty walking
• stiff posture
• increased prolactin and glucose levels in the blood (blood sugar) or some liver enzymes in blood tests
• drop in blood pressure when standing up, which can cause fainting
• common cold
• hot flashes
• blurred vision
• sweating
• pain when urinating
• involuntary movements of the mouth, tongue, and limbs (tardive dyskinesia)
• low sodium levels in the blood that can cause fatigue and confusion, muscle spasms, seizures, and coma (hyponatremia)
• lack of energy (lethargy)
• gas (flatulence)
• neck pain
• erection problems
• painful or absent menstrual period
• reduction in the number of red blood cells (which carry oxygen throughout the body).

Rare (may affect up to 1 in 1000 people):

• Rhabdomyolysis, which is the breakdown of muscle fibers, releasing the contents of muscle fibers (myoglobin) into the bloodstream, causing muscle pain, nausea, confusion, abnormal heart rate and rhythm, and possibly dark urine
• increased eosinophils (a type of white blood cell)
• swelling under the skin surface (angioedema)
• deliberate self-harm
• stroke
• kidney failure
• reduction in the number of white blood cells (which fight infection) • breast pain, breast milk secretion
• sudden death.

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

• reduction in the number of a subgroup of white blood cells (neutrophils)
• sleep disorder
• newborns may show the following: agitation, increased or decreased muscle tone, tremors, drowsiness, respiratory or feeding problems
• abnormal increase in breast size.

In elderly people with dementia, a small increase in the number of deaths has been reported in patients taking schizophrenia medications compared to those who did not take them.

The following adverse effects may appear in adolescents:

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

• feeling of agitation and inability to remain still
• headache
• drowsiness
• nausea.

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

• decreased or increased appetite
• abnormal dreams
• difficulty sleeping, tension, agitation, anxiety, and irritability
• physical weakness, fatigue
• depression
• psychotic disorder: this is a medical term that describes many mental illnesses that cause abnormal thoughts and perceptions; people with psychosis lose contact with reality
• schizophrenia symptoms
• difficulty paying attention
• feeling that everything is spinning
• abnormal involuntary movements (dyskinesia)
• abnormal muscle tone, including torticollis and involuntary upward deviation of the eyes
• Parkinsonism: this medical term describes numerous symptoms, including increased saliva secretion or very moist mouth, drooling, spasms when flexing the limbs, slow, reduced, or difficult body movements, facial expressiveness, muscle tension, neck stiffness, muscle rigidity, short, shuffling, and hurried steps, and lack of normal arm movements when walking, persistent eye blinking when tapping the forehead (abnormal reflex)
• rapid heartbeats
• difficulty emptying the intestines (constipation)
• dry mouth or excess saliva
• vomiting
• sweating
• muscle rigidity
• erection problems
• increased creatine phosphokinase (a muscle enzyme) levels in blood tests
• increased prolactin (a hormone) levels in the blood, seen in blood tests
• weight gain or loss.

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

• hypersensitivity
• common cold, throat and nose infection
• decreased thyroid activity, thyroid inflammation
• aggressive behavior, impulsive behavior
• apathy
• confusional state
• depressed mood
• separation from normal mental processes (dissociation)
• hallucination (auditory or visual)
• homicidal thoughts
• difficulty sleeping
• increased or decreased sexual desire
• lack of energy
• altered mental state
• obsessive thoughts
• feeling of acute and disabling anxiety (panic attack)
• performing involuntary movements that serve no purpose (psychomotor hyperactivity)
• muscle hyperactivity (hyperkinesia), inability to rest (restlessness)
• uncontrollable urge to move the legs (restless legs syndrome), involuntary movements of the mouth, tongue, and limbs (tardive dyskinesia)
• sleep disorders
• deliberate suicidal thoughts
• abnormal thoughts
• instability (feeling that everything is spinning)
• altered sense of taste
• memory impairment
• abnormal skin sensation (paresthesia)
• feeling of having a band tightened around the head (tension headache), migraine
• difficulty focusing the eyes, blurred vision
• increased auditory sensitivity
• palpitations, heart rhythm disturbances
• drop in blood pressure when standing up, which can cause fainting
• increased blood pressure
• abdominal pain or discomfort
• absence or deficiency of saliva secretion
• diarrhea
• indigestion
• dry lips
• toothache
• partial or complete loss of hair, abnormal hair growth
• rash, hives
• muscle spasms and rigidity, muscle pain
• joint pain, pain in arms and legs, jaw pain
• presence of bilirubin in the urine, presence of proteins in the urine, a marker of kidney function
• pain or difficulty urinating, frequent urination, kidney disorder
• sexual dysfunction
• difficulty ejaculating
• abnormal increase in breast size, breast pain, breast milk secretion
• absent or irregular menstrual period
• making uncontrolled noises and movements (Tourette's syndrome)
• chills
• difficulty walking
• discomfort
• chest pain
• fever
• intentional overdose
• effects on thyroid function, seen in blood tests, increased cholesterol in the blood, increased triglycerides in the blood, decreased high-density lipoproteins, decreased low-density lipoproteins, seen in blood tests
• increased glucose in the blood (blood sugar), increased insulin in the blood, increased liver enzymes (a marker of liver function), seen in blood tests
• increased or decreased testosterone in the blood, increased thyroid-stimulating hormone in the blood, seen in blood tests
• electrocardiogram alterations
• decreased hemoglobin, reduced number of white blood cells (which fight infection), seen in blood tests.

Reporting of Adverse Effects

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect that is not listed in this prospectus. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting adverse effects, you can contribute to providing more information on the safety of this medicine.

5. Conservation of Lurasidona cinfa

Keep this medicine out of sight and reach of children.

Do not use this medicine after the expiration date that appears on the packaging and the blister pack after "EXP". The expiration date is the last day of the month indicated.

This medicine does not require special storage conditions.

Medicines should not be thrown away through wastewater or household waste. Deposit the packaging and medicines that you no longer need in the SIGRE collection point at the pharmacy. Ask your pharmacist how to dispose of the packaging and medicines that you no longer need. This way, you will help protect the environment.

6. Package Contents and Additional Information

Composition of Lurasidona cinfa

• The active ingredient is lurasidone.

Each 18.5 mg tablet contains lurasidone hydrochloride equivalent to 18.6 mg of lurasidone.

Each 37 mg tablet contains lurasidone hydrochloride equivalent to 37.2 mg of lurasidone.

Each 74 mg tablet contains lurasidone hydrochloride equivalent to 74.5 mg of lurasidone.

• The other components are:
• • Core: microcrystalline cellulose, mannitol (E-421), hypromellose, sodium croscarmellose, and magnesium stearate.
  • Coating: hypromellose, titanium dioxide (E-171), macrogol, yellow iron oxide (E-172) (present in 74 mg tablets), and indigo carmine (E-132) (present in 74 mg tablets).

Product Appearance and Package Contents

Lurasidona cinfa 18.5 mg film-coated tablets EFG

Film-coated tablets, round, white or off-white, engraved with "LL" on one side and smooth on the other, with a diameter of 6.1 mm.

Lurasidona cinfa 37 mg film-coated tablets EFG

Film-coated tablets, round, white or off-white, engraved with "LI" on one side and smooth on the other, with a diameter of 8.1 mm.

Lurasidona cinfa 74 mg film-coated tablets EFG

Film-coated tablets, oval, pale green to green, engraved with "LH" on one side and smooth on the other, measuring 12.1 mm x 7.1 mm.

It is available in package sizes containing 28 tablets in single-dose precut OPA/Al/PVC//Al blisters.

Marketing Authorization Holder

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) – Spain

Manufacturer

ELPEN Pharmaceutical Co Inc

Marathonos Ave. 95, Pikermi Attiki,

19009, Greece

or

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) – Spain

Date of Last Revision of this Prospectus: September 2024

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

You can access detailed and updated information about this medicine by scanning the QR code included in the prospectus and packaging with your smartphone. You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/89812/P_89812.html

QR code to: https://cima.aemps.es/cima/dochtml/p/89812/P_89812.html