PANTOPRAZOL TARBIS 40 mg GASTRO-RESISTANT TABLETS

Introduction

Package Leaflet: Information for the Patient

Pantoprazole Tarbis 40 mg Gastro-Resistant Tablets EFG

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

1. What is Pantoprazole Tarbis and what is it used for
2. What you need to know before you take Pantoprazole Tarbis
3. How to take Pantoprazole Tarbis
4. Possible side effects
5. Storage of Pantoprazole Tarbis
6. Contents of the pack and other information

1. What is Pantoprazole Tarbis and what is it used for

Pantoprazole Tarbis is a selective inhibitor of the "proton pump", a medicine that reduces the amount of acid produced in your stomach. It is used for the treatment of diseases related to stomach and intestine acid.

Pantoprazole Tarbisis used for:

Adults and adolescents from 12 years:

• Reflux esophagitis. It is an inflammation of your esophagus (the tube that connects your throat to your stomach) accompanied by acid reflux from the stomach.

Adults:

• Infection with a bacterium called Helicobacter pylori in patients with stomach and/or duodenal ulcer in combination with two antibiotics (eradication treatment). The goal is to get rid of the bacteria and thus reduce the likelihood of ulcer recurrence and
• Stomach and duodenal ulcers, and
• Zollinger-Ellison syndrome and other conditions in which too much acid is produced in the stomach.

2. What you need to know before you take Pantoprazole Tarbis

Do not takePantoprazole Tarbis

• If you are allergic (hypersensitive) to pantoprazole or any of the other ingredients of Pantoprazole Tarbis (see section 6).

• If you are allergic to medicines that contain other proton pump inhibitors (e.g., omeprazole, lansoprazole, rabeprazole, esomeprazole)

Warnings and precautions

Consult your doctor before starting to take Pantoprazole Tarbis:

If you suffer a skin rash, especially in areas of the skin exposed to the sun, consult your doctor as soon as possible as it may be necessary to interrupt treatment with Pantoprazole Tarbis. Remember to mention any other symptoms you may notice, such as joint pain.

Tell your doctor immediatelyif you notice any of the following symptoms:

• unintentional weight loss
• repeated vomiting
• difficulty swallowing
• blood in vomit
• pale appearance and feeling of weakness (anemia)
• blood in your stools
• severe or persistent diarrhea, as pantoprazole has been associated with a small increase in infectious diarrhea.

Your doctor will decide if you need any additional tests to rule out a malignant disease because pantoprazole can alleviate cancer symptoms and may delay its diagnosis. If, despite treatment, your symptoms persist, complementary tests will be performed.

If you take pantoprazole for a prolonged period (more than a year), your doctor may perform regular follow-up. You should tell your doctor about any new or unexpected symptoms and/or events each time you visit your doctor.

Consult your doctor or pharmacist before starting to take Pantoprazole Tarbis.

UsingPantoprazole Tarbiswith other medicines

Pantoprazole Tarbis may affect the effectiveness of other medicines, so tell your doctor if you are taking

• Medicines such as ketoconazole, itraconazole, and posaconazole (used to treat fungal infections) or erlotinib (used to treat certain types of cancer), as Pantoprazole Tarbis may cause these and other medicines to not work properly.
• Warfarin or phenprocoumon, which affect blood coagulation. You may need additional controls.

• Atazanavir (used to treat HIV infection).

Tell your doctor or pharmacist what you are using, have recently used, or may need to use any other medicine.

Pregnancy and breastfeeding

There is not enough data on the use of pantoprazole in pregnant women. It has been reported that in humans, pantoprazole is excreted in breast milk.

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

Driving and using machines

Pantoprazole Tarbis is unlikely to affect your ability to drive or use tools or machines. Side effects such as dizziness and visual disturbances (see section 4) may occur. If they do, you should not drive or use machines.

3. How to take Pantoprazole Tarbis

Follow exactly the administration instructions of this medicine indicated by your doctor. In case of doubt, consult your doctor again.

When and how should you take Pantoprazole Tarbis?

Take the tablets whole, without chewing or crushing, with a little water, 1 hour before a meal.

Unless your doctor has indicated otherwise, the normal dose is:

Adults and adolescents from 12 years:

For the treatment of reflux esophagitis:

The usual dose is one tablet per day. Your doctor may indicate an increase to 2 tablets per day. The treatment time for reflux esophagitis is usually between 4 and 8 weeks. Your doctor will indicate how long you should take this medicine.

Adults:

For the treatment of an infection with a bacterium calledHelicobacter pyloriin patients with stomach and/or duodenal ulcer in combination with two antibiotics (eradication treatment)

One tablet twice a day plus the two antibiotic tablets, either amoxicillin, clarithromycin, and metronidazole (or tinidazole), each to be taken twice a day with your pantoprazole tablet. Take the first pantoprazole tablet 1 hour before breakfast and the second 1 hour before dinner. Follow your doctor's instructions and make sure to read the package leaflets of the antibiotics.

The duration of treatment is usually one to two weeks.

For the treatment of stomach and duodenal ulcers:

The usual dose is one tablet per day. The dose may be doubled by your doctor. Your doctor will indicate how long you should take this medicine. The treatment duration for stomach ulcers is usually between 4 and 8 weeks. The treatment duration for duodenal ulcers is usually between 2 and 4 weeks.

For long-term treatment of Zollinger-Ellison syndrome and other conditions in which there is an increase in stomach acid secretion

The recommended initial dose is two tablets per day.

Take the two tablets 1 hour before a meal. Later, your doctor may adjust the dose, depending on the amount of acid secretion you produce. If you are prescribed more than two tablets per day, you should take the tablets divided into two doses per day. If you are prescribed more than four tablets per day, you will be told exactly when you should finish the treatment.

Special patient groups:

• If you have kidney problems or moderate to severe liver problems, you should not take pantoprazole for the eradication of Helicobacter pylori.

• If you have severe liver problems, you should not take more than one 20 mg pantoprazole tablet per day (20 mg pantoprazole tablets are available for this case).

• Children (under 12 years): the use of these tablets is not recommended in children under 12 years.

If you take morePantoprazole Tarbisthan you should

Tell your doctor or pharmacist or call the Toxicology Information Service, telephone 91 562 04 20, indicating the medicine and the amount taken. There are no known symptoms of overdose.

If you forget to takePantoprazole TarbisDo not take a double dose to make up for forgotten doses. Take your next dose as usual.

If you stop takingPantoprazole TarbisDo not stop taking these tablets without consulting your doctor or pharmacist first.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, Pantoprazole Tarbis can cause side effects, although not everybody gets them.

The frequency of the possible side effects described below is as follows:

very common (affects more than 1 in 10 people)

common (affects 1 to 10 people in 100)

uncommon (affects 1 to 10 people in 1,000)

rare (affects 1 to 10 people in 10,000)

very rare (affects less than 1 in 10,000 people)

frequency not known (cannot be estimated from the available data).

If you consider that any of the side effects you are suffering from is serious or if you notice any side effect not mentioned in this leaflet, tell your doctor or pharmacist or contact the emergency department of the nearest hospital.

• Severe allergic reactions (rare frequency): swelling of the tongue and/or throat, difficulty swallowing, hives (urticaria), difficulty breathing, swelling of the face of allergic origin (Quincke's edema/angioedema), intense dizziness with very rapid heartbeats and profuse sweating.

• Severe skin reactions (frequency not known): blisters on the skin and rapid deterioration of general conditions, erosion (including slight bleeding) of eyes, nose, mouth/lips, or genitals (Stevens-Johnson syndrome, Lyell syndrome, erythema multiforme), and sensitivity to light, skin rash, possibly with joint pain.

• Other serious conditions (frequency not known):yellowing of the skin and the whites of the eyes (severe liver cell damage, jaundice), or fever, rash, increased kidney size sometimes with painful urination, and lower back pain (severe kidney inflammation)

Other side effects are:

• Common(affects 1 to 10 people in 100)

benign polyps in the stomach.

• Uncommon(affects 1 to 10 people in 1,000)

headache; dizziness; diarrhea; feeling of dizziness, vomiting; swelling and bloating (gas); constipation; dry mouth; abdominal pain and discomfort; skin rash, exanthema, eruption; feeling of weakness, fatigue, or general malaise; sleep disturbances.

• Rare(affects 1 to 10 people in 10,000)

vision changes such as blurred vision; hives; joint pain; muscle pain; weight changes; increased body temperature; swelling in the limbs (peripheral edema); allergic reactions; depression; breast enlargement in men

• Very rare(affects less than 1 in 10,000 people)

disorientation

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

hallucination, confusion (especially in patients with a history of these symptoms), decreased sodium levels in the blood, feeling of tingling, pricking, paresthesia (tingling), burning, or numbness, inflammation of the large intestine that causes persistent watery diarrhea.

Side effects identified through blood tests:

• Uncommon(affects 1 to 10 people in 1,000)

increase in liver enzymes

• Rare(affects 1 to 10 people in 10,000)

increase in bilirubin; increase in blood fat levels

• Very rare(affects less than 1 in 10,000 people)

reduction in platelet count, which could cause bleeding or more bruising than usual; reduction in white blood cell count, which could lead to more frequent infections.

Unknown frequency

If you are taking Pantoprazole Tarbis for more than three months, it is possible that your blood magnesium levels may decrease. Low magnesium levels can cause fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, or increased heart rate. If you have any of these symptoms, go to the doctor immediately. Low magnesium levels can also cause a decrease in blood potassium and calcium levels. Your doctor may decide to perform periodic blood tests to control magnesium levels.

If you are taking proton pump inhibitors like Pantoprazole Tarbis, especially for a period of more than one year, you may have a slightly increased risk of hip, wrist, and spine fractures. Tell your doctor if you have osteoporosis or if you are taking corticosteroids (which can increase the risk of osteoporosis).

Reporting of side effects

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

5. Storage of Pantoprazole Tarbis

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

Do not use this medicine after the expiry date that appears on the packaging after EXP. The expiry date is the last day of the month indicated.

Pantoprazole Tarbis in a polyethylene bottle does not require special storage conditions.

Pantoprazole Tarbis in an aluminum/aluminum blister: store below 30°C.

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

6. Contents of the pack and other information

Composition ofPantoprazole Tarbis

The active substance is pantoprazole. Each gastro-resistant tablet contains 40 mg of pantoprazole (in the form of sodium sesquihydrate).

• The other ingredients (excipients) are:

Core: Anhydrous disodium phosphate (E-339), Mannitol (E-421), Microcrystalline cellulose (E-460), Sodium croscarmellose, Magnesium stearate (E-470)

Coating: Hypromellose, Triethyl citrate, Sodium carboxymethyl starch of potato, Methacrylic acid-ethyl acrylate copolymer (1:1), dispersion 30%

Printing ink: Yellow iron oxide (E-172)

Appearance of the product and packaging contents

Gastro-resistant tablet, yellow, oval, concave, and smooth.

Packaging:

Bottles (high-density polyethylene packaging with a screw cap made of polyethylene) and blisters (aluminum/aluminum blisters).

Packaging with 14, 28, or 56 gastro-resistant tablets

Marketing authorization holder and manufacturer

Marketing authorization holder

Tarbis Farma, S.L.

Gran Vía Carlos III, 94

08028 Barcelona (Spain)

Manufacturer

Teva Pharma S.L.U.

Polígono Malpica c/ C, 4.

50016 Zaragoza

Spain

Date of the last revision of this leaflet: August 2019

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/