GERBIN 100 MG FILM-COATED TABLETS

2. What you need to know before you take Gerbin

It is important that you use the smallest dose that relieves your pain and do not take Gerbin for longer than necessary to control your symptoms.

Do not take Gerbin

• If you are in the third trimester of pregnancy or if you are breastfeeding.
• If you are allergic to aceclofenac or any of the other ingredients of this medicine (listed in section 6).
• If acetylsalicylic acid or other non-steroidal anti-inflammatory drugs have caused you asthma, rhinitis, urticaria, or other allergic reactions.
• If you have had a stomach or duodenal ulcer or have suffered a perforation of the digestive tract.
• If you have bleeding or coagulation problems (you bleed easily).
• If you have severe kidney problems.
• If you have severe liver problems.
• If you have established heart disease and/or cerebrovascular disease, for example, if you have had a heart attack, stroke, mini-stroke (TIA), or blockages in the blood vessels of the heart or brain, or have had surgery to remove a blockage or perform a coronary bypass.
• If you have problems with blood circulation (peripheral arterial disease).

Warnings and Precautions

Consult your doctor, pharmacist, or nurse before starting to take Gerbin

• If you have had or developed an ulcer, bleeding, or perforation in the stomach or duodenum, which may be manifested by intense or persistent abdominal pain and/or black stools, or even without previous warning symptoms.

This risk is greater when using high doses and prolonged treatments, in patients with a history of peptic ulcers, and in elderly patients. In these cases, your doctor will consider the possibility of associating a stomach protective medication.

Elderly patients suffer from a higher incidence of adverse effects, specifically gastrointestinal bleeding and perforation (in some cases fatal).

• If you have any liver disease.
• If you have kidney problems.
• If you have heart problems or have had a stroke.
• If you smoke.
• If you have diabetes.
• If you have angina, blood clots, high blood pressure, high cholesterol, or high triglycerides.

Medicines like Gerbin can be associated with an increased risk of suffering heart attacks ("myocardial infarctions"). Adverse effects can be minimized by using the lowest effective dose for the shortest possible time. Do not exceed the recommended dose or duration of treatment.

Similarly, this type of medicine can cause fluid retention, especially in patients with heart failure and/or high blood pressure (hypertension).

• If you have blood disorders.
• If you take medications that alter blood coagulation, such as oral anticoagulants like warfarin, or antiplatelet agents like acetylsalicylic acid, tell your doctor. You should also discuss the use of other medications that may increase the risk of such bleeding, such as corticosteroids and selective serotonin reuptake inhibitor antidepressants.
• If you have Crohn's disease or ulcerative colitis, as medicines like Gerbin can worsen these conditions.
• If you are recovering from major surgery.
• If you have had or still have bronchial asthma.
• In case of chickenpox, the use of this medicine should be avoided because, in rare cases, severe skin infections related to its use can occur.
• Hypersensitivity reactions can occur, and very rarely, severe allergic reactions (see section 4. Possible side effects) may appear. The risk is higher during the first month of treatment. Stop treatment immediately if you experience the first symptoms of skin rash, mucosal lesions, or other signs of hypersensitivity.

Consult your doctor, even if any of the above circumstances have occurred to you at any time.

Other Medicines and Gerbin

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Certain medicines can interact with Gerbin. In these cases, it may be necessary to change the dose or interrupt treatment with one of the medicines.

This is especially important if you are taking lithium, digoxin, diuretics, antihypertensives, anticoagulants, antiplatelet agents, hypoglycemic agents, methotrexate, corticosteroids, acetylsalicylic acid, or other non-steroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors (SSRIs), cyclosporine, tacrolimus, or zidovudine.

Taking Gerbin with Food and Drinks

Gerbin can be taken with or without food.

Pregnancy, Breastfeeding, and Fertility

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Pregnancy and Women of Childbearing Age

Do not take Gerbin if you are in the last 3 months of pregnancy, as it may harm your unborn baby or cause problems during delivery. It can cause kidney and heart problems in your unborn baby. It can affect your tendency and that of your baby to bleed and make labor longer than expected. You should not take Gerbin during the first 6 months of pregnancy unless it is absolutely necessary and your doctor advises you to do so. If you need treatment during this period or while trying to become pregnant, the lowest dose should be used for the shortest possible time. If you take it for more than a few days from the 20th week of pregnancy, this medicine may cause kidney problems in your unborn baby, which can lead to low levels of amniotic fluid surrounding the baby (oligohydramnios) or narrowing of a blood vessel (ductus arteriosus) in the baby's heart. If you need treatment for more than a few days, your doctor may recommend additional monitoring.

For women of childbearing age, it should be noted that medicines like Gerbin have been associated with a decrease in fertility.

Breastfeeding

Gerbin should not be taken if you are breastfeeding.

Driving and Using Machines

If you experience dizziness, fainting, vertigo, or other central nervous system disorders while taking Gerbin, do not drive or use any tools or machinery.

Gerbin contains Sodium

This medicine contains less than 23 mg of sodium per tablet; it is essentially "sodium-free".

3. How to Take Gerbin

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

The tablets should be swallowed whole with a little water.

The recommended dose is 200 mg per day, i.e., one tablet in the morning and one in the evening (1 tablet every 12 hours).

The duration of treatment will be determined by your doctor. Do not stop treatment before it is indicated, even if you feel well.

If you think the effect of Gerbin is too strong or too weak, tell your doctor or pharmacist.

Use in Children

Not recommended.

Use in Elderly Patients

Your doctor will indicate the dose to take and will perform periodic checks.

Use in Patients with Renal or Heart Failure

Your doctor will indicate the dose to take and will perform periodic checks.

Use in Patients with Liver Failure

The dose should be reduced to 1 tablet/day.

Long-term Treatment

If you take Gerbin for a long time, your doctor should perform quarterly checks, for example, of the kidneys, liver, and blood tests.

If you Take More Gerbin than You Should

Consult your doctor, pharmacist, or nurse immediately, go to the nearest hospital, or contact the Toxicology Information Service. Telephone 915 620 420. Bring this leaflet with you.

If you Forget to Take Gerbin

Do not worry. Do not take a double dose to make up for forgotten doses. Take the next dose according to your usual schedule.

4. Possible Side Effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

The side effects that can occur with Gerbin include:

Common (may affect up to 1 in 10 people)

• Gastrointestinal disorders, abdominal pain, nausea, and diarrhea.
• Dizziness.
• Increased liver enzymes.

Uncommon (may affect up to 1 in 100 people)

• Flatulence, stomach inflammation, constipation, vomiting, and mouth ulcers.
• Itching, skin rash, skin inflammation (dermatitis), and urticaria.
• Increased urea, increased creatinine.

Rare (may affect up to 1 in 1,000 people)

• Blood in stools, gastrointestinal bleeding, gastrointestinal ulcers.
• Facial inflammation.
• Heart failure, high blood pressure.
• Anemia.
• Severe allergic reaction, allergies.
• Vision disturbances.
• Breathing difficulties.

Very Rare (may affect up to 1 in 10,000 people)

• Inflammation of the mouth mucosa, pancreatitis, intestinal perforation, vomiting blood.

Worsening of ulcerative colitis and Crohn's disease has also been observed.

• Purple spots on the skin, severe skin reactions.

Medicines like Gerbin can be associated, in very rare cases, with severe mucocutaneous reactions such as Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

• Palpitations, flushing, warmth, inflammation of blood vessels (vasculitis).
• Liver damage (including hepatitis), increased alkaline phosphatase

Medicines like Gerbin can be associated with liver disorders that cause yellowing of the skin and eyes, sometimes with high fever or swelling and sensitivity of the upper abdomen. If any of the following reactions occur: yellowing of the skin or eyes, stop treatment and inform your doctor IMMEDIATELY.

• Decreased white blood cells, decreased platelets, bone marrow depression, hemolytic anemia.
• Increased potassium in the blood.
• Depression, sleep disturbances, difficulty falling asleep.
• Tingling, drowsiness, headache, taste disturbances, tremors.
• Vertigo, ringing in the ears (tinnitus).
• Noisy breathing, bronchospasm.
• Leg cramps.
• Kidney function disorder (nephrotic syndrome), kidney failure.
• Fatigue, fluid retention (edema).
• Weight gain.

Exceptionally, severe skin infections have been observed during chickenpox.

Reporting of Side Effects

If you experience any side effects, talk to your doctor, pharmacist, or nurse, even if it is possible side effects not listed in this leaflet. You can also report side effects 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 Gerbin

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

Store below 30°C.

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

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 Other Information

Composition of Gerbin

The active ingredient is aceclofenac. Each tablet contains 100 mg of aceclofenac.

The other ingredients (excipients) are: microcrystalline cellulose, sodium croscarmellose, glycerol palmitostearate, povidone, hypromellose, poloxamer 40 stearate, and titanium dioxide (E-171).

Appearance of the Product and Contents of the Pack

Gerbin 100 mg film-coated tablets are white, biconvex, circular tablets.

Gerbin 100 mg film-coated tablets are available in packs of 20 or 40 tablets.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Laboratorios Almirall, S.L.

General Mitre, 151

08022 – Barcelona (Spain)

Manufacturer

Industrias Farmacéuticas Almirall, S.A.

Ctra. de Martorell, 41-61

08740 Sant Andreu de la Barca – Barcelona (Spain)

Date of Last Revision of this Leaflet: February 2023

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