PRIMPERAN 10 mg TABLETS

2. What you need to know before you take Primperan

Do not take Primperan

• if you are allergic to metoclopramide or any of the other ingredients of this medicine (listed in section 6)
• if you have bleeding, obstruction or perforation in the stomach or intestine
• if you have or could have a rare tumor of the adrenal gland, which is near the kidney (pheochromocytoma)
• if you have ever had involuntary muscle spasms (tardive dyskinesia) when you have been treated with a medicine
• if you have epilepsy
• if you have Parkinson's disease
• if you are taking levodopa (a medicine for Parkinson's disease) or dopaminergic agonists (see below "Using Primperan with other medicines")
• if you have ever had abnormal levels of blood pigments (methemoglobinemia) or NADH cytochrome b5 reductase deficiency.

Do not give Primperan to children under 1 year of age (see below "Children and adolescents").

Do not take Primperan if any of the above applies to you. If you are not sure, consult your doctor, pharmacist, or nurse before taking Primperan.

Warnings and precautions

Consult your doctor, pharmacist, or nurse before taking Primperan if:

• you have a history of abnormal heartbeats (prolonged QT interval) or any other heart problem
• you have problems with salt levels in your blood, such as potassium, sodium, and magnesium
• you are using other medicines known to affect the way your heart beats
• you have any neurological problem (brain)
• you have liver or kidney problems. The dose may need to be reduced (see section 3).

Your doctor may perform blood tests to check your blood pigment levels. In cases of abnormal levels (methemoglobinemia), treatment should be stopped immediately and permanently.

You should wait at least 6 hours between each dose of metoclopramide, even in the case of vomiting or rejection of the dose, to avoid overdose.

Do not exceed 3 months of treatment due to the risk of involuntary muscle spasms.

Children and adolescents

Uncontrollable movements (extrapyramidal disorders) may occur in children and young adults. This medicine should not be used in children under 1 year of age due to the high risk of uncontrollable movements (see above "Do not take Primperan").

Using Primperan with other medicines

Tell your doctor, pharmacist, or nurse if you are taking, have recently taken, or might take any other medicines. This is because some medicines may affect the way Primperan works or Primperan may affect the way other medicines work. These medicines include:

• levodopa or other medicines used to treat Parkinson's disease (see above "Do not take Primperan")
• anticholinergics (medicines used to relieve stomach spasms or cramps)
• opioid derivatives (medicines used to treat severe pain)
• sedatives
• any medicine used to treat mental health problems
• digoxin (a medicine used to treat heart failure)
• cyclosporin (a medicine used to treat some problems of the immune system)
• mivacurium and suxamethonium (medicines used to relax muscles)
• fluoxetine and paroxetine (medicines used to treat depression).
• rifampicin (a medicine used to treat tuberculosis or other infections), may reduce the amount of metoclopramide in the blood if administered at the same time.

Using Primperan with alcohol

Do not drink alcohol during treatment with metoclopramide because it increases the sedative effect of Primperan.

Pregnancy and breastfeeding

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

Primperan can be taken during pregnancy if necessary. Your doctor will decide whether or not to administer this medicine.

Primperan is not recommended if you are breastfeeding because metoclopramide passes into breast milk and may affect your baby.

Driving and using machines

After taking Primperan, you may feel drowsy, dizzy, or have uncontrollable movements of tics, twitches, or torsion and muscle tone that causes body distortion. This may affect your vision and also interfere with your ability to drive and use machines.

Primperan 10 mg tablets contain lactose

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

3. How to take Primperan

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

All indications (adult patients)

A single dose of 10 mg is recommended, which can be repeated up to three times a day.

The maximum recommended daily dose is 30 mg or 0.5 mg/kg of body weight.

The maximum treatment duration is 5 days.

To prevent delayed nausea and vomiting that may occur after chemotherapy (children 1-18 years of age)

The recommended dose is 0.1 to 0.15 mg/kg of body weight, which can be repeated up to three times a day, taken orally.

The maximum dose in 24 hours is 0.5 mg/kg of body weight.

Dosing Table

Do not take this medicine for more than 5 days to prevent delayed nausea and vomiting that may occur after chemotherapy.

Primperan tablets are not suitable for use in children with a weight below 61 kg. Other pharmaceutical forms/doses may be more suitable for administration (e.g., oral solution or injectable solution).

Method of administration

You should wait at least 6 hours between each dose of metoclopramide, even in the case of vomiting or rejection of the dose, to avoid overdose.

Special populations

Elderly population

The dose may need to be reduced depending on kidney problems, liver problems, and general health problems.

Other pharmaceutical forms/doses may be more suitable for administration (e.g., oral solution or injectable solution).

Adults with renal problems

Tell your doctor if you have kidney problems. The dose should be reduced if you have moderate to severe kidney problems.

This presentation is not suitable for administration. Other pharmaceutical forms/doses may be more suitable for administration (e.g., oral solution or injectable solution).

Adults with hepatic problems

Tell your doctor if you have liver problems. The dose should be reduced if you have severe liver problems.

This presentation is not suitable for administration. Other pharmaceutical forms/doses may be more suitable for administration (e.g., oral solution or injectable solution).

Children and adolescents

Metoclopramide should not be used in children under 1 year of age (see section 2).

If you take more Primperan than you should

Contact your doctor or pharmacist immediately. You may experience uncontrollable movements (extrapyramidal disorders), feel drowsy, have some consciousness problems, be confused, have hallucinations, and heart problems. Your doctor may prescribe a treatment for these effects if necessary.

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

If you forget to take Primperan

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

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

4. Possible side effects

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

• Frequency not known(frequency cannot be estimated from the available data) allergic reactions (such as anaphylaxis, angioedema, and urticaria).

Symptoms may include rash, itching, difficulty breathing, shortness of breath, swelling of the face, lips, throat, or tongue, cold, sweaty skin, palpitations, dizziness, weakness, or fainting.

Contact your doctor or another healthcare professional or go to the emergency department of the nearest hospital immediately.

Stop treatment and inform your doctor, pharmacist, or nurse immediately if you experience one of the following signs while taking this medicine:

• uncontrollable movements (which often affect the head and neck). These can occur in children and young adults and particularly when high doses are used. These signs usually appear at the beginning of treatment and can even occur after a single administration. These movements will stop when treated properly.
• high fever, high blood pressure, convulsions, sweating, saliva production. These can be signs of a condition called malignant neuroleptic syndrome.
• itching and skin rashes, facial swelling, lip or throat swelling, difficulty breathing. These can be signs of an allergic reaction, which can be severe.

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

• feeling drowsy.

Common(may affect up to 1 in 10 people)

• depression
• uncontrollable movements such as tics, twitches, torsion movements, or muscle contractions (stiffness, rigidity)
• symptoms similar to Parkinson's disease (stiffness, tremor)
• feeling restless
• decreased blood pressure (particularly with intravenous administration)
• diarrhea
• feeling weak.

Uncommon(may affect up to 1 in 100 people)

• high levels in the blood of a hormone called prolactin that can produce: milk production in men and women who are not breastfeeding
• irregular periods
• hallucinations
• decreased level of consciousness
• slow heart rate (particularly with intravenous administration)
• allergy
• visual disturbances and involuntary deviation of the eyeball.

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

• confusion
• convulsions (especially in patients with epilepsy).

Frequency not known(frequency cannot be estimated from the available data)

• abnormal levels of blood pigments: which can change the color of your skin
• abnormal development of the breasts (gynecomastia)
• involuntary muscle spasms after prolonged use, particularly in elderly patients
• high fever, high blood pressure, convulsions, sweating, saliva production. These can be signs of a condition called malignant neuroleptic syndrome
• changes in heartbeats, which can be seen on an ECG (electrocardiogram)
• cardiac arrest (particularly with intravenous administration)
• shock (sharp drop in blood pressure) (particularly with intravenous administration)
• fainting (particularly with intravenous administration)
• very high blood pressure
• suicidal thoughts.

Reporting of side effects

If you experience any side effects, consult your doctor or pharmacist, even if it is possible side effects 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 help provide more information on the safety of this medicine.

5. Storage of Primperan

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

Store below 25°C.

Do not use Primperan after the expiration date stated on the packaging after EXP. The expiration date is the last day of the month indicated.

Medicines should not be disposed of via wastewater or household waste. Dispose of the packaging and any unused medicine in the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Contents of the pack and other information

Composition of Primperan 10 mg tablets

• The active ingredient is metoclopramide hydrochloride. Each tablet contains 10 mg of metoclopramide hydrochloride.

• The other ingredients are: lactose monohydrate, microcrystalline cellulose, corn starch, anhydrous colloidal silica, and magnesium stearate.

Appearance of the product and packaging contents

They are flat, scored, white to off-white tablets.

They are packaged in blister packs of 30 and 60 tablets for oral administration.

Other presentations:

Primperan 1 mg/ml oral solution: Bottle with 200 ml

Primperan 10 mg/2 ml injectable solution: Pack with 12 ampoules of 2 ml

Marketing authorization holder

sanofi-aventis, S.A.

C/ Rosselló i Porcel, 21

08016 Barcelona

Spain

Manufacturer

Famar Health Care Services Madrid, S.A.U.

Avda. de Leganés, 62

28923 - Alcorcón (Madrid)

Spain

or

Delpharm Dijon

6, Boulevard de l’Europe

21800 Quetigny

France

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/