VIZARSIN 50 mg FILM-COATED TABLETS

Introduction

Package Leaflet: Information for the User

Vizarsin 50 mg film-coated tablets

sildenafil

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 and other information

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

1. What is Vizarsin and what is it used for

Vizarsin contains the active substance sildenafil, which belongs to a group of medicines called phosphodiesterase type 5 inhibitors (PDE5). It works by dilating the blood vessels in the penis, allowing blood flow when you are sexually stimulated. Vizarsin will only help you to get an erection if you are sexually stimulated.

Vizarsin is indicated for the treatment of erectile dysfunction in adult men, sometimes called impotence. This occurs when a man cannot get or maintain an erection that is sufficient for satisfactory sexual activity.

2. What you need to know before you take Vizarsin

Do not take Vizarsin

• If you are allergic to sildenafil or any of the other ingredients of this medicine (listed in section 6).

• If you are taking medicines called nitrates, as the combination can cause a dangerous decrease in your blood pressure. Consult your doctor if you are taking any of these medicines, which are often given to relieve angina pectoris (or "chest pain"). If you are unsure, consult your doctor or pharmacist.

• If you are using any of the medicines called nitric oxide donors, such as amyl nitrate ("poppers"), as the combination can cause a dangerous decrease in your blood pressure.

• If you are taking riociguat. This medicine is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs caused by blood clots). PDE5 inhibitors, such as Vizarsin, have shown that they increase the hypotensive effect of this medicine. If you are taking riociguat or are unsure, consult your doctor.
• If you have a serious heart or liver problem.

• If you have recently had a stroke or heart attack, or if you have low blood pressure.

• If you have a rare inherited eye disease (such as retinitis pigmentosa).

• If you have previously experienced a loss of vision due to non-arteritic anterior ischemic optic neuropathy (NAION).

Warnings and precautions

Consult your doctor or pharmacist before taking Vizarsin:

• If you have sickle cell anemia (a blood disorder), leukemia (cancer of the blood cells), or multiple myeloma (cancer of the bone marrow).

• If you have a penile deformity or Peyronie's disease.

• If you have heart problems. Your doctor should carefully check if your heart can withstand the extra strain of having sex.

• If you have current stomach ulcers or bleeding problems (such as hemophilia).

• If you experience a sudden decrease or loss of vision, stop taking Vizarsin and contact your doctor immediately.

It is not recommended to use Vizarsin at the same time as any other oral or local treatment for erectile dysfunction.

You must not take Vizarsin with treatments for pulmonary arterial hypertension (PAH) that contain sildenafil or any other PDE5 inhibitor.

You must not take Vizarsin if you do not have erectile dysfunction. The use of Vizarsin is not indicated in women.

Special considerations in patients with kidney or liver problems

You should inform your doctor if you have kidney or liver problems. Your doctor may decide to reduce your dose.

Children and adolescents

The use of Vizarsin is not indicated in persons under 18 years of age.

Using Vizarsin with other medicines

Tell your doctor or pharmacist if you are using, have recently used, or might use any other medicines.

Vizarsin tablets may interfere with some medicines, especially those used to treat angina pectoris. In case of a medical emergency, you should inform your doctor, pharmacist, or nurse that you are taking Vizarsin and when you took it. Do not take Vizarsin with other medicines unless your doctor advises you to.

You must not take Vizarsin if you are taking medicines called nitrates, as the combination of these medicines can cause a dangerous decrease in your blood pressure. Always inform your doctor, pharmacist, or nurse if you are taking any of these medicines, which are often used to relieve angina pectoris (or "chest pain").

You must not take Vizarsin if you are taking medicines called nitric oxide donors, such as amyl nitrate ("poppers"), as the combination of these medicines can also cause a dangerous decrease in your blood pressure.

Tell your doctor or pharmacist if you are taking riociguat.

If you are taking medicines known as protease inhibitors, such as those used to treat HIV, your doctor may recommend that you start treatment with the lowest dose (25 mg) of Vizarsin.

Some patients who are taking an alpha-blocker, a medicine used to treat high blood pressure or prostate enlargement, may experience dizziness or lightheadedness, which can be caused by a decrease in blood pressure when sitting or standing up quickly. Some patients have experienced these symptoms when taking Vizarsin with alpha-blockers. This is more likely to happen within 4 hours after taking Vizarsin. To minimize the likelihood of these symptoms, you should be taking your daily dose of the alpha-blocker regularly before starting Vizarsin. Your doctor may advise you to start treatment with the lower dose (25 mg) of Vizarsin.

Using Vizarsin with food, drinks, and alcohol

Vizarsin can be taken with or without food. However, you may notice that Vizarsin takes a little longer to work if you take it with a large meal.

Consuming alcohol may temporarily impair your ability to get an erection. Therefore, to get the maximum benefit from the medicine, it is advised not to drink large amounts of alcohol before taking Vizarsin.

Pregnancy, breastfeeding, and fertility

The use of Vizarsin is not indicated in women.

Driving and using machines

Vizarsin can cause dizziness and affect vision. You should know how you react to Vizarsin before driving or using machines.

Vizarsin contains lactose and sodium

If your doctor has told you that you have an intolerance to some sugars, consult him before taking this medicine.

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

3. How to take Vizarsin

Always take this medicine exactly as your doctor or pharmacist has told you. If you are unsure, consult your doctor or pharmacist.

The recommended starting dose is 50 mg.

You must not take Vizarsin more than once a day.

You should take Vizarsin about one hour before you plan to have sex. Swallow the tablet whole with a glass of water.

If you notice that the effect of Vizarsin is too strong or too weak, tell your doctor or pharmacist.

Vizarsin will only help you to get an erection if you are sexually stimulated. The time Vizarsin takes to work varies from person to person, but it normally takes between 30 minutes and 1 hour. The effect of Vizarsin may be delayed if you take it with a large meal.

If Vizarsin does not help you to get an erection, or if the erection does not last long enough to complete sexual intercourse, consult your doctor.

If you take more Vizarsin than you should

You may experience an increase in side effects and their severity. Doses above 100 mg do not increase efficacy.

You must not take more tablets than your doctor recommends.

Contact your doctor if you have taken more tablets than recommended.

If you have any further questions on 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. The side effects reported in association with the use of Vizarsin are usually mild to moderate and of short duration.

If you experience any of the following serious side effects, stop taking Vizarsin and seek medical attention immediately:

• Allergic reaction - this occurs with rare frequency(may affect up to 1 in 100 people).

Symptoms include sudden wheezing, difficulty breathing, or dizziness, swelling of the eyelids, face, lips, or throat.

• Chest pain - this occurs with rare frequency.

If they occur during or after intercourse:

• Sit in a semi-upright position and try to relax.
• Do not use nitratesto treat chest pain.

• Prolonged and sometimes painful erections - this occurs very rarely(may affect up to 1 in 1,000 people).

If you have an erection that lasts more than 4 hours, you should contact your doctor immediately.

• Sudden decrease or loss of vision - this occurs very rarely.

• Severe skin reactions - this occurs very rarely.

Symptoms can include severe skin peeling and swelling, blistering of the mouth, genitals, and around the eyes, as well as fever.

• Seizures or fits - this occurs very rarely.

Other side effects:

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

Common(may affect up to 1 in 10 people): nausea, facial flushing, hot flush (including a sudden feeling of heat in the upper body), indigestion, abnormal color perception, blurred vision, visual disturbance, nasal congestion, and dizziness.

Uncommon(may affect up to 1 in 100 people): vomiting, skin rash, eye irritation, eye discharge/red eyes, eye pain, flashing lights, visual clarity, sensitivity to light, watery eyes, palpitations, rapid heartbeat, high blood pressure, low blood pressure, muscle pain, feeling of tiredness, reduced sense of touch, vertigo, ringing in the ears, dry mouth, blocked or stuffy nose, inflammation of the nasal mucosa (including symptoms such as runny nose, sneezing, and nasal congestion), pain in the upper abdomen, gastroesophageal reflux disease (including symptoms such as heartburn), blood in urine, pain in arms or legs, nosebleeds, feeling of warmth, and feeling of fatigue.

Rare(may affect up to 1 in 1,000 people): fainting, stroke, heart attack, irregular heartbeat, temporary decrease in blood flow to some parts of the brain, feeling of tightness in the throat, numbness in the mouth, bleeding in the back of the eye, double vision, decrease in sharpness of vision, abnormal sensation in the eye, eye swelling or eyelid swelling, small particles or spots in the vision, seeing halos around lights, dilation of the pupil of the eye, change in color of the white of the eye, bleeding from the penis, presence of blood in the semen, dry nose, swelling inside the nose, feeling of irritability, and sudden decrease or loss of hearing.

During post-marketing experience, unstable angina (heart disease) and sudden death have been reported rarely. It should be noted that most of the men who experienced these side effects, although not all of them, had pre-existing heart conditions before taking this medicine. It is not possible to determine whether these side effects were directly related to Vizarsin.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if it is possible that they are not listed in this leaflet. You can also report side effects directly through the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Vizarsin

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

Do not use this medicine after the expiry date which is stated on the blister and carton after EXP. The expiry date refers to the last day of that month.

This medicine does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and additional information

Vizarsin composition

• The active substance is sildenafil. Each film-coated tablet contains sildenafil citrate equivalent to 50 mg of sildenafil.

• The other ingredients are:

See section 2 “Vizarsin contains lactose and sodium”:

Appearance and pack contents

Vizarsin 50 mg film-coated tablets are white, oblong and engraved with “50” on one side.

Vizarsin 50 mg film-coated tablets are available in packs of 1 film-coated tablet in a blister pack and also in packs of 4 x 1, 8 x 1 or 12 x 1 film-coated tablet in unit dose blister packs.

Only some pack sizes may be marketed.

Marketing authorisation holder and manufacturer

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia

For further information about this medicinal product, please contact the local representative of the marketing authorisation holder:

Date of last revision of this prospectus:

Detailed information on this medicinal product is available on the European Medicines Agency website: http://www.ema.europa.eu.