PRAMIPEXOL PENSA 1.05 mg PROLONGED-RELEASE TABLETS

2. What you need to know before taking Pramipexole Pensa

Do not take Pramipexole Pensa

• if you are allergic to pramipexole or any of the other components of this medication (listed in section 6).

Warnings and precautions

Consult your doctor before starting to take Pramipexole Pensa. Inform your doctor if you have or have had any disease or symptom, especially any of the following:

• Kidney disease.
• Hallucinations (seeing, hearing, or feeling things that are not present). Most hallucinations are visual.
• Dyskinesia (e.g., abnormal involuntary movements of the limbs).

If you have advanced Parkinson's disease and are also using levodopa, you may experience dyskinesia during the gradual increase in the dose of Pramipexole Pensa.

• Dystonia (inability to maintain the trunk and neck straight and upright (axial dystonia)). In particular, you may experience forward flexion of the head and neck (also called antecollis), forward curvature of the lumbar region (also called camptocormia), or curvature of the back to the sides (also called pleurothotonus or Pisa syndrome). In this case, your doctor may choose to modify your treatment.

• Somnolence and episodes of sudden sleep.
• Psychosis (e.g., similar to symptoms of schizophrenia).
• Visual impairment. You should undergo regular eye exams during treatment with Pramipexole Pensa.
• Severe heart or blood vessel disease. You should undergo regular blood pressure checks, especially at the beginning of treatment, to avoid postural hypotension (a drop in blood pressure when standing up).

Inform your doctor if you, your family, or caregivers notice that you are developing impulses or urges to behave in an unusual way for you and that you cannot resist the impulse, instinct, or temptation to perform certain activities that may harm you or others. This is called impulse control disorder and may include behaviors such as gambling addiction, excessive eating or spending, abnormally high sexual appetite, or concern about an increase in sexual thoughts and feelings. Your doctor may need to adjust or stop the dose.

Inform your doctor if you, your family, or caregivers notice that you are developing mania (agitation, feeling elated or overexcited) or delirium (decreased consciousness, confusion, loss of contact with reality). Your doctor may need to adjust or interrupt your dose.

Inform your doctor if you notice symptoms such as depression, apathy, anxiety, fatigue, sweating, or pain when stopping or reducing treatment with Pramipexole Pensa. If the problems persist for more than a few weeks, your doctor may need to adjust your treatment.

Children and adolescents

Pramipexole Pensa is not recommended for use in children or adolescents under 18 years of age.

Using Pramipexole Pensa with other medications

Inform your doctor or pharmacist if you are using, have recently used, or may need to use any other medication. This includes medications, herbal remedies, natural foods, or nutritional supplements that you have obtained without a prescription.

You should avoid using Pramipexole Pensa with antipsychotic medications.

Be cautious if you are using the following medications:

• cimetidine (for the treatment of excess acid and stomach ulcers);
• amantadine (which may be used in the treatment of Parkinson's disease);
• mexiletine (for the treatment of irregular heartbeats, a condition known as ventricular arrhythmia);
• zidovudine (which may be used to treat acquired immunodeficiency syndrome (AIDS), a disease of the human immune system);
• cisplatin (for the treatment of various types of cancer);
• quinine (which may be used to prevent painful leg cramps that occur at night and to treat a type of malaria known as falciparum malaria (malignant malaria));
• procainamide (for the treatment of irregular heartbeat).

If you are using levodopa, it is recommended to reduce the dose of levodopa when starting treatment with Pramipexole Pensa.

Be cautious if you are using sedative medications (with a sedative effect) or if you drink alcohol. In these cases, Pramipexole Pensa may affect your ability to drive and operate machinery.

Taking Pramipexole Pensa with food, drinks, and alcohol

You should be cautious if you drink alcohol during treatment with Pramipexole Pensa. You can take Pramipexole Pensa with or without food.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medication.

Your doctor will indicate if you should continue treatment with Pramipexole Pensa. The effect of Pramipexole Pensa on the fetus is not known. Therefore, do not take Pramipexole Pensa if you are pregnant unless your doctor indicates it.

Pramipexole Pensa should not be used during breastfeeding. Pramipexole Pensa may decrease milk production. Additionally, it may pass into breast milk and reach your baby. If the use of Pramipexole Pensa is essential, breastfeeding should be interrupted.

Consult your doctor or pharmacist before using any medication.

Driving and using machines

Pramipexole Pensa may cause hallucinations (seeing, hearing, or feeling things that are not present). If this happens, do not drive or operate machinery.

Pramipexole Pensa has been associated with somnolence and episodes of sudden sleep, especially in patients with Parkinson's disease. If you experience these side effects, do not drive or operate machinery. Inform your doctor if this happens to you.

3. How to take Pramipexole Pensa

Follow the instructions for administration of this medication indicated by your doctor. In case of doubt, consult your doctor again. Your doctor will indicate the correct dosage.

Take Pramipexole Pensa prolonged-release tablets once a day, at the same time every day.

You can take Pramipexole Pensa with or without food. The tablets should be swallowed whole with water.

During the first week, the usual daily dose is 0.26 mg of pramipexole. This dose will be increased every 5-7 days according to your doctor's instructions, until your symptoms are controlled (maintenance dose).

The usual maintenance dose is 1.05 mg per day. However, it may be necessary to increase your dose further. If necessary, your doctor may increase your dose of tablets up to a maximum of 3.15 mg of pramipexole per day. It is also possible to reduce the maintenance dose to 1 prolonged-release tablet of Pramipexole Pensa 0.26 mg per day.

Patient with kidney disease

If you have kidney disease, your doctor may advise you to take the usual starting dose of 0.26 mg prolonged-release tablets on alternate days during the first week. Then, your doctor may increase the frequency of administration to 1 prolonged-release tablet of 0.26 mg per day. If it is necessary to increase your dose further, your doctor may adjust the dose in levels of 0.26 mg of pramipexole.

If you have severe kidney disease, your doctor may consider it necessary to switch to a different pramipexole medication. If your kidney problems worsen during treatment, contact your doctor as soon as possible.

If you are switching from Pramipexole Pensa immediate-release tablets

Your doctor will base your dose of Pramipexole Pensa prolonged-release tablets on the dose of Pramipexole Pensa immediate-release tablets you were taking.

The day before the switch, take your Pramipexole Pensa immediate-release tablets as you normally would. The next morning, take your Pramipexole prolonged-release tablet and do not take any more Pramipexole immediate-release tablets.

If you take more Pramipexole Pensa than you should

If you accidentally ingest too many tablets, you may experience vomiting, restlessness, or any of the side effects described in section 4 (Possible side effects).

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, phone: 91 562 04 20, indicating the medication and the amount ingested.

If you forget to take Pramipexole Pensa

If you forget to take the dose of Pramipexole Pensa, but you remember to take it within 12 hours of your usual time, take your tablet and continue with the next tablet at the usual time.

If you forget to take the dose after more than 12 hours, simply take the next dose at your usual time. Do not take a double dose to make up for the missed dose.

If you stop taking Pramipexole Pensa

Do not stop your treatment with Pramipexole Pensa without consulting your doctor first. If you need to stop your treatment with this medication, your doctor will gradually reduce your dose. This reduces the risk of worsening symptoms.

If you have Parkinson's disease, you should not stop your treatment with Pramipexole suddenly. Sudden interruption can cause the appearance of a disorder called neuroleptic malignant syndrome, which can be a serious risk to your health. These symptoms include:

• akinesia (loss of muscle movement)
• muscle rigidity
• fever
• unstable blood pressure
• tachycardia (increased heart rate)
• confusion
• decreased level of consciousness (e.g., coma)

If you stop or reduce treatment with Pramipexole Pensa, you may also experience a medical disorder called dopamine agonist withdrawal syndrome. The symptoms include depression, apathy, anxiety, fatigue, sweating, or pain. If you experience these symptoms, you should contact your doctor.

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

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone will experience them. The classification of side effects is based on the following frequencies:

You may experience the following side effects:

Very common:

• dyskinesia (e.g., abnormal involuntary movements of the limbs)
• somnolence
• dizziness
• nausea

Common:

• need to behave in an unusual way
• hallucinations (seeing, hearing, or feeling things that are not present)
• confusion
• fatigue
• insomnia
• excess fluid, usually in the legs (peripheral edema)
• headache
• hypotension (low blood pressure)
• abnormal dreams
• constipation
• visual impairment
• vomiting (nausea)
• weight loss, including loss of appetite

Uncommon:

• paranoia (e.g., excessive concern about your health)
• delirium
• excessive daytime somnolence and episodes of sudden sleep
• amnesia (memory impairment)
• hyperkinesia (increased movement and inability to remain still)
• weight gain
• allergic reactions (e.g., skin rash, itching, hypersensitivity)
• fainting
• heart failure (heart problems that can cause shortness of breath or swelling of the ankles)*
• inadequate secretion of antidiuretic hormone*
• restlessness
• shortness of breath
• hiccups
• pneumonia (lung infection)
• inability to resist the impulse, instinct, or temptation to perform an action that may be harmful to you or others, which may include:

• strong impulse to gamble excessively despite serious personal or family consequences.
• altered or increased sexual interest and concerning behavior for you or others, for example, increased sexual appetite.
• uncontrolled buying or spending.
• binge eating (eating large amounts of food in a short period) or compulsive eating (eating more food than normal and more than needed to satisfy hunger)*

• delirium (decreased consciousness, confusion, loss of contact with reality)

Rare:

• mania (agitation, feeling elated or overexcited)
• spontaneous penile erection

Frequency not known:

After stopping or reducing treatment with Pramipexole Pensa: depression, apathy, anxiety, fatigue, sweating, or pain may occur (known as dopamine agonist withdrawal syndrome or DAWS).

Tell your doctor if you experience any of these behaviors; he will explain how to manage or reduce the symptoms.

For the side effects marked with *, it is not possible to provide an accurate estimate of the frequency, as these side effects were not observed in clinical trials involving 2,762 patients treated with pramipexole. The frequency category is likely not higher than "uncommon".

Reporting side effects:

If you experience side effects, consult your doctor or pharmacist, even if they are 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 Pramipexole Pensa

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

Do not use this medication after the expiration date stated on the packaging and/or blister pack after "EXP". The expiration date is the last day of the month indicated.

This medication does not require any special storage temperature.

Medications should not be disposed of through wastewater or household waste. Deposit the packaging and medications you no longer need in the SIGRE collection point at 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. Package Contents and Additional Information

Pramipexol Pensa Compositionprolonged-release tablets

• The active ingredient is pramipexole.

Each tablet contains 1.05 mg of pramipexole as 1.5 mg of pramipexole dihydrochloride monohydrate.

• The other components are hypromellose, calcium phosphate dibasic, magnesium stearate, anhydrous colloidal silica.

Appearance ofPramipexol Pensa prolonged-release tabletsand package contents

Pramipexol Pensa 1.05 mg prolonged-release tablets: The 10 mm tablets are white or almost white, cylindrical, biconvex, and marked with 105 on one side.

Al/OPA-Al-PVC blister: 10 and 30 prolonged-release tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder

Towa Pharmaceutical, S.A.

C/ de Sant Martí, 75-97

08107 Martorelles (Barcelona)

Spain

Manufacturer

Laboratorios Normon, S.A.

Ronda de Valdecarrizo, 6, Tres Cantos, 28760 Madrid

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Spain: Pramipexol Pensa 1.05 mg Prolonged-Release Tablets EFG

Italy: Pramipexolo Pensa Pharma 1.05 mg prolonged-release tablets

Date of the last revision of this prospectus: October2024

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