THERVAN 10 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the Patient

Thervan 10 mg film-coated tablets EFG

Thervan 20 mg film-coated tablets EFG

Thervan 30 mg film-coated tablets

Thervan 40 mg film-coated tablets EFG

Thervan 60 mg film-coated tablets

Thervan 80 mg film-coated tablets EFG

Atorvastatin calcium

Read the entire package leaflet carefully before starting to take this medication because 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 side effects not listed in this package leaflet. See section 4.

Contents of the Package Leaflet

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

1. What is Thervan and what is it used for

Atorvastatin belongs to a group of medications known as statins, which are medications that regulate lipids (fats).

Atorvastatin is used to reduce lipids such as cholesterol and triglycerides in the blood when a low-fat diet and lifestyle changes have not been successful on their own. If you are at high risk of heart disease, atorvastatin may also be used to reduce this risk even if your cholesterol levels are normal. During treatment, you should follow a standard low-cholesterol diet.

2. What you need to know before taking Thervan

Do not take Thervan

• if you are allergic to atorvastatin or any of the other components of this medication (listed in section 6).
• if you have or have had a disease that affects the liver.
• if you have or have had unexplained abnormal results in blood tests for liver function.
• if you are a woman of childbearing age and do not use adequate contraceptive measures.
• if you are pregnant or trying to become pregnant.
• if you are breastfeeding.
• if you use the combination of glecaprevir/pibrentasvir for the treatment of hepatitis C.

Warnings and precautions

Consult your doctor or pharmacist before starting to take this medication:

• if you have severe respiratory failure.
• if you are taking or have taken in the last 7 days a medication that contains fusidic acid (a medication used to treat bacterial infections) orally or by injection. The combination of fusidic acid and atorvastatin can cause serious muscle problems (rhabdomyolysis).
• if you have had a previous stroke with bleeding in the brain, or have small fluid-filled sacs in the brain due to previous strokes.
• if you have kidney problems.
• if you have an underactive thyroid gland (hypothyroidism).
• if you have or have had repeated or unexplained muscle pain, personal or family history of muscle problems.
• if you have had muscle problems during treatment with other medications to lower lipid levels (e.g., with another statin or fibrates).
• if you regularly drink large amounts of alcohol.
• if you have a history of liver problems.
• if you are over 70 years old.
• if you have or have had myasthenia (a disease that causes generalized muscle weakness that, in some cases, affects the muscles used for breathing) or ocular myasthenia (a disease that causes weakness of the eye muscles), as statins can sometimes worsen the disease or cause myasthenia (see section 4).

In any of these cases, your doctor may indicate that you should have blood tests before and, possibly, during treatment with atorvastatin to predict the risk of muscle-related side effects. It is known that the risk of muscle-related side effects (e.g., rhabdomyolysis) increases when certain medications are taken at the same time (see section 2 "Other medications and Thervan").

Also, inform your doctor or pharmacist if you experience constant muscle weakness. Additional tests and medications may be necessary to diagnose and treat this problem.

While taking this medication, your doctor will monitor you for diabetes or the risk of developing diabetes. This risk of diabetes increases if you have high levels of sugar and fat in the blood, are overweight, and have high blood pressure.

Other medications and Thervan

Inform your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication. There are some medications that can affect the proper functioning of atorvastatin or the effects of these medications may be modified by atorvastatin. This type of interaction can decrease the effect of one or both medications. Alternatively, it could increase the risk or severity of side effects, including a serious condition that causes muscle deterioration known as rhabdomyolysis, described in section 4:

• Medications used to modify the functioning of your immune system, e.g., cyclosporine.
• Certain antibiotics or antifungal medications, e.g., erythromycin, clarithromycin, telithromycin, ketoconazole, itraconazole, voriconazole, fluconazole, posaconazole, rifampicin, fusidic acid.
• Other medications to regulate lipid levels, e.g., gemfibrozil, other fibrates, colestipol.
• Certain calcium channel blockers used to treat angina or high blood pressure, e.g., amlodipine, diltiazem; medications to regulate your heart rate, e.g., digoxin, verapamil, amiodarone.
• Letermovir, a medication that helps prevent diseases caused by cytomegalovirus.
• Medications used to treat AIDS, e.g., ritonavir, lopinavir, atazanavir, indinavir, darunavir, tipranavir combined with ritonavir, etc.
• Certain medications used to treat hepatitis C, such as telaprevir, boceprevir, and the combination of elbasvir/grazoprevir
• Other medications that are known to interact with atorvastatin include: ezetimibe (which reduces cholesterol), warfarin (which reduces blood clotting), oral contraceptives, stiripentol (an anticonvulsant to treat epilepsy), cimetidine (used for heartburn and peptic ulcer), phenazone (a pain reliever), colchicine (used to treat gout), and antacids (products for indigestion that contain aluminum or magnesium).
• Medications obtained without a prescription: St. John's Wort.
• If you need to take oral fusidic acid to treat a bacterial infection, you will need to stop using this medication temporarily. Your doctor will indicate when it is safe to restart treatment with atorvastatin. Taking atorvastatin in combination with fusidic acid can rarely cause muscle weakness, pain, or discomfort (rhabdomyolysis). For more information on rhabdomyolysis, see section 4.
• Daptomycin (a medication used to treat skin and skin structure infections with complications and bacteria present in the blood).

Taking Thervan with food, drinks, and alcohol

See section 3 for instructions on how to take this medication. Please note the following:

Grapefruit juice

Do not take more than one or two small glasses of grapefruit juice per day, as large quantities of grapefruit juice can alter the effects of atorvastatin.

Alcohol

Avoid drinking large amounts of alcohol while taking this medication. See the details in section 2 "Warnings and precautions".

Pregnancy, breastfeeding, and fertility

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.

Do not take atorvastatin if you are pregnant, think you may be pregnant, or are trying to become pregnant.

Do not take atorvastatin if you are breastfeeding your child.

Do not take atorvastatin if you are of childbearing age unless you use adequate contraceptive measures.

The safety of atorvastatin during pregnancy and breastfeeding has not been established.

Driving and using machines

Normally, this medication does not affect your ability to drive or operate machinery. However, do not drive if this medication affects your ability to drive. Do not operate tools or machinery if this medication affects your ability to operate them.

Thervan contains lactose and sodium

This medication contains lactose. If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.

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

3. How to take Thervan

Follow your doctor's instructions for taking this medication exactly. If you are in doubt, consult your doctor or pharmacist again.

Before starting treatment, your doctor will put you on a low-cholesterol diet, which you should also follow during treatment with atorvastatin.

The usual initial dose of atorvastatin is 10 mg once a day in adults and children from 10 years old. Your doctor may increase it if necessary until you reach the dose you need. Your doctor will adjust the dose at intervals of 4 weeks or more. The maximum dose of atorvastatin is 80 mg once a day.

The atorvastatin tablets should be swallowed whole with a glass of water and can be taken at any time of day with or without food. However, try to take your tablet at the same time every day.

Your doctor will decide the duration of treatment with Thervan

Ask your doctor if you think the effect of atorvastatin is too strong or too weak.

If you take more Thervan than you should

If you accidentally take too many atorvastatin tablets (more than your usual daily dose), consult your doctor or the nearest hospital or call the Toxicology Information Service, phone 91 562 04 20, indicating the medication and the amount taken. Bring the remaining tablets, the box, and the complete packaging so that hospital staff can easily identify the medication you have taken.

If you forget to take Thervan

If you forget to take a dose, take the next scheduled dose at the correct time.

Do not take a double dose to make up for missed doses.

If you interrupt treatment with Thervan

Consult your doctor or pharmacist again.

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

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone will experience them.

If you notice any of the following serious side effects or symptoms, stop taking these tablets and inform your doctor immediately or go to the emergency department of the nearest hospital.

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

• Severe allergic reaction that causes swelling of the face, tongue, and throat, which can cause great difficulty breathing.
• Severe disease with severe scaling and inflammation of the skin; blisters on the skin, mouth, genitals, and eyes, and fever. Rash with pink-red spots, especially on the palms of the hands or soles of the feet, which can form blisters.
• Muscle weakness, pain, or discomfort, muscle rupture, or brownish-red urine, and especially if you also have discomfort or have a high fever, may be due to abnormal muscle breakdown (rhabdomyolysis). Abnormal muscle breakdown does not always disappear, even after stopping atorvastatin, and can be fatal and cause kidney problems.

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

• If you experience unexpected or unusual bleeding or bruising, this may suggest a liver problem. You should consult your doctor as soon as possible.
• Lupus-like syndrome (including rash, joint disorders, and effects on blood cells).

Other possible side effects with atorvastatin:

Frequent: may affect up to 1 in 10 people

• inflammation of the nasal passages, sore throat, nosebleeds
• allergic reactions
• increases in blood sugar levels (if you are diabetic, monitor your blood sugar levels), increased creatine kinase in the blood
• headache
• nausea, constipation, gas, indigestion, diarrhea
• joint pain, muscle pain, and back pain
• blood test results that may show abnormal liver function.

Uncommon: may affect up to 1 in 100 people

• loss of appetite, weight gain, decreased blood sugar levels (if you are diabetic, you should continue to carefully monitor your blood sugar levels)
• nightmares, insomnia
• dizziness, numbness or tingling in the fingers of the hands and feet, reduced sensitivity to pain or touch, changes in taste, memory loss
• blurred vision
• ringing in the ears and/or head
• vomiting, belching, upper and lower abdominal pain, pancreatitis (inflammation of the pancreas that causes stomach pain)
• hepatitis (inflammation of the liver)
• rash, skin rash, and itching, hives, hair loss
• neck pain, muscle fatigue
• fatigue, feeling unwell, weakness, chest pain, inflammation, especially in the ankles (edema), increased temperature
• positive urine tests for white blood cells.

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

• vision changes
• unexpected or unusual bleeding or bruising
• jaundice (yellowing of the skin and whites of the eyes)
• tendon injury.
• skin rash or ulcers in the mouth (drug-induced lichenoid reaction)
• purple-colored skin lesions (signs of inflammation of the blood vessels, vasculitis).

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

• allergic reaction - symptoms may include sudden wheezing and pain or tightness in the chest, swelling of the eyelids, face, lips, mouth, tongue, or throat, difficulty breathing, collapse
• hearing loss
• gynecomastia (breast enlargement in men).

Frequency not known: cannot be estimated from available data:

• constant muscle weakness
• severe myasthenia (a disease that causes generalized muscle weakness that, in some cases, affects the muscles used for breathing
• ocular myasthenia (a disease that causes weakness of the eye muscles)
• consult your doctor if you experience weakness in your arms or legs that worsens after periods of activity, double vision, or drooping eyelids, difficulty swallowing, or difficulty breathing.

Possible side effects of some statins (medications of the same type):

• sexual difficulties
• depression
• respiratory problems such as persistent cough and/or difficulty breathing or fever
• diabetes. It is more likely if you have high levels of sugar and fat in the blood, are overweight, and have high blood pressure. Your doctor will monitor you while you are taking this medication.

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are side effects not listed in this package leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medications: https://www.notificaram.es. By reporting side effects, you can contribute to providing more information on the safety of this medication.

5. Storage of Thervan

Keep this medication out of sight and reach of children.

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

This medication does not require special storage conditions.

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

6. Packaging Contents and Additional Information

Thervan Composition

• The active ingredient is atorvastatin.

Thervan 10 mg: Each film-coated tablet contains 10 mg of atorvastatin (as atorvastatin calcium trihydrate).

Thervan 20 mg: Each film-coated tablet contains 20 mg of atorvastatin (as atorvastatin calcium trihydrate).

Thervan 30 mg: Each film-coated tablet contains 30 mg of atorvastatin (as atorvastatin calcium trihydrate).

Thervan 40 mg: Each film-coated tablet contains 40 mg of atorvastatin (as atorvastatin calcium trihydrate).

Thervan 60 mg: Each film-coated tablet contains 60 mg of atorvastatin (as atorvastatin calcium trihydrate).

Thervan 80 mg: Each film-coated tablet contains 80 mg of atorvastatin (as atorvastatin calcium trihydrate).

• The other components (excipients) are: calcium carbonate (E170i), lactose monohydrate, microcrystalline cellulose (E460i), hydroxypropylcellulose (E463), polysorbate 80, sodium croscarmellose (E468), and magnesium stearate (E470b).

The coating contains: partially hydrolyzed poly(vinyl alcohol), titanium dioxide (E171), macrogol 4000 (E1521), and talc (E553b).

Product Appearance and Packaging Contents

Thervan 10 mg: Film-coated tablets, white, round, biconvex, smooth.

Thervan 20 mg: Film-coated tablets, white, round, biconvex, scored on one side. The score line should not be used to divide the tablet.

Thervan 30 mg: Film-coated tablets, white, round, biconvex, marked with "30" on one side.

Thervan 40 mg: Film-coated tablets, white, round, biconvex, marked with a cross on one side.

Thervan 60 mg: Film-coated tablets, white, round, biconvex, scored on one side and marked with "60" on the other. The score line should not be used to divide the tablet.

Thervan 80 mg: Film-coated tablets, white, round, biconvex, scored on one side and marked with "80" on the other. The score line should not be used to divide the tablet.

Thervan is marketed in PA/Al/PVC-Aluminum or PVC/PVDC/PVC-Aluminum blister packs.

Blister packs containing 28 tablets.

Marketing Authorization Holder and Manufacturer

Laboratorios Alter, S.A.

C/ Mateo Inurria 30

28036 Madrid

Spain

Date of the Last Revision of this Leaflet: October 2024

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