IFIRMASTA 75 mg FILM-COATED TABLETS

2. What you need to know before you take Ifirmasta

Do not take Ifirmasta

• if you are allergic to irbesartan or any of the other ingredients of this medicine (listed in section 6),
• - if you are pregnant more than 3 months.(In any case, it is better to avoid taking this medicine also at the start of your pregnancy – see section Pregnancy),
• if you have diabetes or kidney insufficiency and are being treated with a blood pressure-lowering medicine containing aliskiren.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Ifirmasta and if any of the following apply to you:

Warnings:

• if you have excessive vomiting or diarrhea
• if you have kidney problems
• if you have heart problems
• - if you are taking Ifirmasta for diabetic kidney disease. In this case, your doctor may regularly perform blood tests, especially to measure potassium levels in case of impaired kidney function
• if you are going to have surgery(surgical intervention) or if you are going to be given anesthetics
• if you are taking any of the following medicines used to treat high blood pressure:

• an angiotensin-converting enzyme inhibitor (ACE inhibitor) (e.g., enalapril, lisinopril, ramipril), particularly if you have kidney problems related to diabetes,
• aliskiren.

Your doctor may check your kidney function, blood pressure, and blood electrolyte levels (e.g., potassium) at regular intervals.

See also the information under the heading “Do not take Ifirmasta”.

If you are pregnant, think you may be pregnant, or are planning to have a baby, inform your doctor. The use of Ifirmasta is not recommended during the first three months of pregnancy and is contraindicated during the second and third trimesters of pregnancy, as it may cause serious harm to your baby (see section Pregnancy).

Children and adolescents

This medicine should not be used in children and adolescents (<18 years) as the safety and efficacy have not been fully established.< p>

Taking Ifirmasta with other medicines

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

Your doctor may need to change your dose and/or take other precautions:

• If you are taking an angiotensin-converting enzyme inhibitor (ACE inhibitor) or aliskiren (see also the information under the headings “Do not take Ifirmasta” and “Warnings and precautions”).

You may need to have blood tests if you are taking:

• potassium supplements
• potassium-containing salt substitutes
• potassium-sparing medicines (such as certain diuretics)
• medicines containing lithium.

If you are using a type of painkiller called non-steroidal anti-inflammatory medicines, the effect of irbesartan may be reduced.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant, or are planning to have a baby, consult your doctor or pharmacist before using this medicine.

Pregnancy

You should inform your doctor if you are pregnant, think you may be pregnant, or are planning to have a baby. Normally, your doctor will advise you to stop taking Ifirmasta before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine to treat your high blood pressure. The use of Ifirmasta is not recommended during the first three months of pregnancy and is contraindicated during the second and third trimesters of pregnancy, as it may cause serious harm to your baby when administered during this period.

Breastfeeding

Inform your doctor if you are breastfeeding or are about to start breastfeeding, as the use of Ifirmasta is not recommended in breastfeeding women. Your doctor may decide to prescribe a different treatment if you want to breastfeed, especially for newborns or premature babies.

Driving and using machines

Ifirmasta is unlikely to affect your ability to drive or use machines. However, during treatment of high blood pressure, dizziness or fatigue may occasionally occur. If you experience these symptoms, consult your doctor before driving or using machines.

3. How to take Ifirmasta

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

Method of administration

Ifirmasta is administered orally. The tablets should be swallowed with a sufficient amount of liquid (e.g., a glass of water). Ifirmasta can be taken with or without food. You should try to take your daily dose at the same time every day. It is important that you continue to take this medicine until your doctor tells you to stop.

• Patient with high blood pressure

The normal dose is 150 mg once daily (two tablets a day). Depending on the response to blood pressure, this dose may be increased to 300 mg once daily (four tablets a day).

• Patient with high blood pressure and type 2 diabetes with kidney damage

In patients with high blood pressure and type 2 diabetes, the recommended maintenance dose for the treatment of kidney disease is 300 mg once daily (four tablets a day).

Your doctor may advise a lower dose, especially when starting treatment, in certain patients, such as hemodialysispatients or patients over 75 years of age.

The maximum blood pressure-lowering effect should be achieved within 4-6 weeks after starting treatment.

Use in children and adolescents

Ifirmasta should not be given to children under 18 years of age. If a child swallows several tablets, contact your doctor immediately.

If you take more Ifirmasta than you should

If you accidentally take too many tablets, contact your doctor immediately.

If you forget to take Ifirmasta

If you accidentally miss a dose, simply take your normal dose when it is due. Do not take a double dose to make up for a forgotten dose.

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

4. Possible side effects

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

Some of these side effects can be serious and may require medical attention.

As with similar medicines, rare cases of skin allergic reactions (rash, urticaria) as well as localized swelling of the face, lips, and/or tongue have been reported in patients treated with irbesartan. If you think you have had an allergic reaction, stop taking Ifirmasta and go to a hospital immediately.

The following side effects have been reported:

Very common: May affect more than 1 in 10 people

Common: May affect up to 1 in 10 people

Uncommon: May affect up to 1 in 100 people

The side effects reported in clinical trials in patients treated with Ifirmasta were:

• Very common (may affect more than 1 in 10 people): if you have high blood pressure and type 2 diabetes with kidney damage, blood tests may show a high level of potassium.
• Common (may affect up to 1 in 10 people): dizziness, nausea/vomiting, and fatigue, and blood tests may show high levels of an enzyme that measures muscle and heart function (creatine kinase). In patients with high blood pressure and type 2 diabetes with kidney damage, dizziness (especially when standing up), low blood pressure (especially when standing up), muscle or joint pain, and decreased levels of a protein present in red blood cells (hemoglobin).
• Uncommon (may affect up to 1 in 100 people): fast heartbeat, flushing, cough, diarrhea, indigestion/heartburn, sexual dysfunction (sexual function disorders), and chest pain.

Since the marketing of Ifirmasta, the following side effects have been reported:

Frequency not known: cannot be estimated from the available data

The side effects reported since the marketing of Ifirmasta are: feeling of spinning, headache, altered taste, ringing in the ears, muscle cramps, muscle and joint pain, reduced number of platelets, abnormal liver function, increased potassium levels in the blood, kidney failure, and inflammation of small blood vessels, mainly in the skin area (a condition known as leucocytoclastic vasculitis), and severe allergic reactions (anaphylactic shock). Rare cases of jaundice (yellowing of the skin and/or whites of the eyes) have also been reported.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via 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. Storage of Ifirmasta

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 carton after EXP. and on the blister after EXP. The expiry date refers to the last day of the month shown.

Do not store above 30°C.

Store in the original package to protect from moisture.

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

What Ifirmasta contains

• The active substance is irbesartan. Each film-coated tablet contains 75 mg of irbesartan (as hydrochloride).

The other ingredients are mannitol, hydroxypropyl cellulose, hydroxypropyl cellulose of low substitution (LH-21), hydroxypropyl cellulose of low substitution (LH-11), talc, macrogol 6000, and hydrogenated castor oil in the tablet core and polyvinyl alcohol, titanium dioxide (E171), macrogol 3000, and talc in the film coating.

Appearance and packaging

Ifirmasta 75 mg film-coated tablets are white and oval.

Ifirmasta 75 mg film-coated tablets are available in packs of 14, 28, 30, 56, 84, 90, and 98 tablets and in packs of 56 x 1 film-coated tablet in a unit dose blister.

Not all pack sizes may be marketed.

Marketing authorisation holder and manufacturer

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

For further information about this medicine, contact the local representative of the marketing authorisation holder:

Date of last revision of this leaflet: {Month/year}.

Detailed information on this medicine is available on the European Medicines Agency web site http://www.ema.europa.eu/.