DACORTIN 30 mg TABLETS

2. What you need to know before taking Dacortin 30 mg

Do not take Dacortin 30 mg tablets:

• if you are allergic to prednisone, other glucocorticoids, or any of the other components of this medicine (listed in section 6)
• if you have stomach ulcers, gastritis, esophagitis (digestive system diseases)
• if you have viral infections (such as simple ocular herpes, chickenpox), before or after being vaccinated

Your doctor may have recommended taking Dacortin despite suffering from some of the following diseases, and therefore, regular monitoring may be necessary:

• if you have osteomalacia and osteoporosis (bone diseases)
• if you have severe diabetes
• if you have uncontrolled psychosis (mental disorder)
• if you have untreated tuberculosis
• if you have bacterial, fungal, or amoebic infections, or systemic mycosis (infection caused by fungi and disseminated throughout the body)
• if you have lymphomas (a type of tumor of the lymphatic system) that have appeared after vaccination against tuberculosis
• if you have any psychiatric illness. Consult your doctor about the convenience of using this medicine
• if you have severe high blood pressure

• if you have asystole (heart disease) with pulmonary edema and uremia (syndrome characterized by excess nitrogenous substances in the blood)
• if you have severe myasthenia (muscle disease)

• if you have renal insufficiency.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Dacortin 30 mg.

Treatment with Dacortin 30 mg may increase the risk of infections, as it can decrease the body's defenses, leading to new infections or reactivating existing ones (e.g., tuberculosis or hepatitis B). In severe infections or in the case of tuberculosis, Dacortin should only be used in combination with treatment for the infection.

Inform your doctor if you suffer from any type of infection and if you have been vaccinated or plan to be vaccinated. If symptoms of acute diseases, such as infectious, digestive, or mental disorders, appear during treatment, consult your doctor.

You should avoid contact with people who have chickenpox or measles. If you are exposed to these infections during treatment with Dacortin, you should contact a doctor immediately, even if you do not have any symptoms.

This medicine will be administered with caution in people who suffer from stomach ulcers, ulcerative colitis (intestinal disease), diverticulitis (intestinal disease), or enteric anastomosis (after surgery) or mental disorders.

If you suffer from osteoporosis, your doctor may recommend taking extra calcium and vitamin D.

Inform your doctor if you have heart disease and need high doses of prednisone.

If you are diabetic, have heart failure, or have very high blood pressure or glaucoma, your doctor will monitor you regularly.

If this medicine is administered with fluoroquinolones (e.g., ciprofloxacin), the risk of tendon ruptures and tendinitis increases.

Your doctor may increase the dose if you suffer from a stressful situation (infections, surgery, trauma, etc.).

In long-term treatments, your doctor will regularly perform checks to avoid complications in the eyes, blood tests, growth control (in children and adolescents), and monitoring of the hypothalamic-pituitary-adrenal axis function.

Contact your doctor if you experience blurred vision or other visual disturbances.

In prolonged treatments with Dacortin, your doctor may prescribe potassium supplements and reduce sodium (salt) intake.

Consult your doctor before starting to take Dacortin if you have scleroderma (also known as systemic sclerosis, an autoimmune disorder), as daily doses equal to or greater than 15 mg may increase the risk of a serious complication called scleroderma renal crisis. The signs of a scleroderma renal crisis are increased blood pressure and decreased urine production. Your doctor may advise you to have your blood pressure and urine checked periodically.

The administration of Dacortin to children should be carefully evaluated, and if administered, it should be an intermittent or alternating treatment.

When administering to elderly patients, your doctor will monitor you regularly. Elderly patients should avoid prolonged treatment with this medicine.

Taking Dacortin may give false results in skin tests for allergy tests (tuberculin test, allergy patches, etc.).

Use in athletes

This medicine contains prednisone, which may produce a positive result in doping tests.

Treatment should not be interrupted abruptly, but rather gradually. Do not stop using this medicine without consulting your doctor (see section 3 "How to take Dacortin").

Taking Dacortin 30 mg with other medicines

Inform your doctor if you are taking or have recently taken other medicines, including those purchased without a prescription.

Some medicines may increase the effects of Dacortin, so your doctor will monitor you closely if you are taking these medicines (including some for HIV: ritonavir, cobicistat).

Dacortin may interfere with the following medicines:

• Non-steroidal anti-inflammatory drugs (e.g., indomethacin, salicylates)
• Antidiabetics
• Enzyme inducers:
• • Carbamazepine, phenytoin, phenobarbital, or primidone (medicines used to treat epilepsy)
  • Rifampicin, rifabutin (antibiotics)
• Enzyme inhibitors, such as ketoconazole (used for fungal infections)
• Ephedrine
• Oral anticoagulants (such as Sintrom)
• Estrogens (medicines used for hormonal disorders), oral contraceptives
• Atropine
• Cardiac glycosides (medicines used to treat heart diseases)
• Potassium-eliminating diuretics (medicines used to eliminate water) and laxatives
• Praziquantel (antiparasitic medicine)
• Some medicines used to treat high blood pressure
• Some medicines for malaria
• Immunosuppressive substances (medicines used to prevent rejection)
• Non-depolarizing neuromuscular blockers (medicines used mainly in the ICU or operating room)
• Growth hormone
• Protirelin (medicine that stimulates the thyroid)
• Fluoroquinolones: may increase the risk of tendon disorders.
• Antacids
• Salicylates (medicines of the aspirin type)

Interference with laboratory tests: allergy tests may be suppressed.

Pregnancy and lactation

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.

Dacortin, like most medicines, should not be administered during pregnancy or breastfeeding, unless your doctor considers it essential. Therefore, you should inform your doctor as soon as possible if you become pregnant during treatment.

Dacortin passes into breast milk, so breastfeeding should be avoided during treatment, especially in long-term treatments and when high doses are used.

Driving and using machines

It should be taken into account that in long-term treatments, visual acuity may decrease. This could negatively affect the ability to drive and use machinery.

Dacortin 30 mg contains lactose

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

3. How to take Dacortin 30 mg tablets

Follow your doctor's instructions for taking this medicine exactly. If you are unsure, consult your doctor or pharmacist again.

As a general rule, the daily dose will be divided into several doses after meals and at bedtime. In some cases, it may be taken as a single dose in the morning, every day or every other day, with a sufficient amount of liquid.

As soon as a satisfactory response is obtained, you should take the maintenance dose. Both doses will be determined by your doctor.

The dose depends on the type and severity of the disease and the individual patient's response, and in long-term treatments, the maintenance dose should be as low as possible.

The initial dose will be 20 to 90 mg per day in adults and 0.5 to 2 mg per day per kilogram of body weight in children.

The general maintenance dose will be 5 to 10 mg per day in adults and 0.25 to 0.5 mg per day per kilogram of body weight in children. When used in children as an anti-inflammatory and immunosuppressive agent, doses of 0.05 to 2 mg per day per kilogram of body weight are recommended.

To stop treatment, your doctor will indicate how to do it. For long-term treatments, a gradual reduction will be made: in general, the dose should be reduced by 10% every 8-15 days. For short-term treatments (less than 10 days), it is not necessary to gradually reduce the dose.

In elderly patients, the same dosage as in adults will be applied, taking into account the recommendations mentioned in section 2 "Warnings and precautions".

If you take more Dacortin 30 mg 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 0420, indicating the medicine and the amount ingested.

If you forget to take Dacortin 30 mg

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

If you interrupt treatment with Dacortin 30 mg

Do not stop using this medicine without consulting your doctor.

If you have any other questions about 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 everyone gets them.

The side effects observed are, according to their frequency of presentation: very common (may affect more than 1 in 10 patients); common (may affect up to 1 in 10 patients); uncommon (may affect up to 1 in 100 patients); rare (may affect up to 1 in 1,000 patients); very rare (may affect up to 1 in 10,000 patients); frequency not known (cannot be estimated from the available data).

In most cases, adverse reactions occur especially when used at high doses and in long-term treatments and are detailed below:

Blood and lymphatic system disorders:leukocytosis (increase in white blood cells), lymphopenia (decrease in lymphocytes), eosinopenia (decrease in eosinophils), polycythemia (increase in red blood cells).

Endocrine disorders:signs of adrenal hyperactivity (Cushing's syndrome, disease caused by increased production of a hormone called cortisol); in long-term treatments, adrenocortical insufficiency (disease characterized by weakness, feeling of tiredness all the time, loss of appetite, and weight loss).

Eye disorders:glaucoma and cataracts. Blurred vision.

Gastrointestinal disorders:stomach ulcers, intestinal bleeding, pancreatitis (inflammation of the pancreas).

General disorders and administration site conditions:delayed wound healing.

Immune system disorders:severe allergic reactions, including arrhythmias, bronchospasm, decreased or increased blood pressure, circulatory failure, heart attack.

Infections and infestations:existing infections may worsen, and new infections may appear, which may be difficult to diagnose.

Metabolism and nutrition disorders:fluid retention (edema), potassium loss (which may cause cardiac arrhythmias), weight gain, increased blood sugar, diabetes mellitus, increased cholesterol and triglyceride levels in the blood, increased appetite, delayed growth in children.

Cardiac disorders (frequency not known):decreased heart rate.

Musculoskeletal and connective tissue disorders:muscle diseases and muscle weakness, tendon disorders, tendinitis, tendon ruptures, bone calcium loss, osteoporosis, delayed growth in children.

Nervous system disorders:increased intracranial pressure (especially in children), increased spasms in epileptic patients or onset of epilepsy.

Psychiatric disorders:psychosis, mania, depression, hallucinations, emotional instability, irritability, increased activity, euphoria, anxiety, sleep disturbances, suicidal thoughts.

Reproductive system and breast disorders:irregular or absent menstruation, hirsutism (excessive hair growth).

Skin and subcutaneous tissue disorders:acne or other skin problems (allergy, bruising, stretch marks), edema, skin color changes, dermatitis around the mouth.

Vascular disorders:high blood pressure, increased risk of arteriosclerosis (narrowing and hardening of the arteries) and thrombosis (blood clot formation), vasculitis, capillary fragility.

Renal and urinary disorders:scleroderma renal crisis in patients who already have scleroderma (an autoimmune disorder). The signs of a scleroderma renal crisis are increased blood pressure and decreased urine production.

Rapidly decreasing the dose after long-term treatment may cause muscle and joint pain.

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

Reporting of side effects:

If you experience any type of side effect, consult your doctor or pharmacist, 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 contribute to providing more information on the safety of this medicine.

5. Storage of Dacortin 30 mg tablets

No special storage conditions are required.

Keep Dacortin 30 mg tablets out of sight and reach of children.

Do not use Dacortin 30 mg tablets after the expiration date shown on the packaging after CAD. The expiration date is the last day of the month indicated.

Medicines should not be disposed of through wastewater or household waste. Deposit the packaging and medicines 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 medicines you no longer need. This way, you will help protect the environment.

6. Packaging Content and Additional Information

Composition of Dacortín 30 mg

• The active ingredient is prednisone. Each tablet contains 30 mg of prednisone.
• The other components are hydrated lactose, cornstarch, povidone, sodium carboxymethyl starch, talc, magnesium stearate, and purified water.

Appearance of the Product and Packaging Content

Dacortín 30 mg is presented in the form of white, oblong tablets. The upper face has a transverse groove with the number "15" engraved on each side of the groove. The lower face has two grooves that divide the tablet into three parts; each of them has the number "10" engraved. The tablet can be divided into 2 or 3 equal parts.

Dacortín 30 mg is available in packages of 30 or 500 tablets in blisters.

Marketing Authorization Holder

Laboratorios ERN, S.A.

Perú, 228

08020 Barcelona, Spain

Manufacturer

Merck, S.L.

Merck Industrial Estate

08100 Mollet del Vallés (Barcelona), Spain

or

CYNDEA PHARMA, S.L.

Emiliano Revilla Sanz Industrial Estate

Ágreda Avenue, 31 - 42110 Ólvega (Soria)

or

LABORATORIOS ERN, S.A.

Gorgs Lladó, 188

08210 Barberá del Vallés, Barcelona, Spain

Date of the last revision of this prospectus: 09/2017

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/.