RABEPRAZOL 10 mg Gastro-Resistant Tablets

2. What you need to know before you take rabeprazol cinfa

Do not take rabeprazol cinfa

• If you are allergic to rabeprazole sodium or any of the other ingredients of this medicine (listed in section 6).
  • If you are pregnant or think you may be pregnant.
  • If you are breast-feeding

Do not take rabeprazol if you are in any of the above situations. If you are not sure, consult your doctor or pharmacist before taking rabeprazol.

Warnings and precautions

Consult your doctor or pharmacist before starting to take rabeprazol cinfa

• If you are allergic to proton pump inhibitors or to “substituted benzimidazoles”.

• If liver and blood problems have been seen in some patients but often improve when treatment with rabeprazol is interrupted.
• If you have a stomach tumor.
• If you have ever had liver problems.
• If you are taking atazanavir, a medicine for HIV infection.
• If you have reduced body stores or have risk factors associated with reduced amounts of B12 and receive long-term treatment with rabeprazole sodium. As with all acid-reducing agents, rabeprazole sodium may lead to reduced absorption of vitamin B12.

• If you have ever had a skin reaction after treatment with a medicine similar to rabeprazol to reduce stomach acidity.
• If you get a skin rash, especially in areas of the skin exposed to the sun, consult your doctor as soon as possible, as it may be necessary to interrupt treatment with rabeprazol. Remember to mention any other symptoms you may notice, such as joint pain.
• If you are scheduled to have a specific blood test (Chromogranin A).

If you are in doubt about any of the above, consult your doctor or pharmacist before taking rabeprazol.

During treatment with rabeprazol, kidney inflammation may occur. The signs and symptoms include: decreased urine volume or blood in the urine and/or hypersensitivity reactions such as fever, skin rash, and joint stiffness. You should report these signs to your doctor.

Children

Rabeprazol should not be given to children.

If you experience severe diarrhea (watery or bloody) with symptoms such as fever, abdominal pain, or sensitivity, stop taking rabeprazol and see your doctor immediately.

Taking a proton pump inhibitor like rabeprazol, especially for a period of more than a year, may slightly increase the risk of fracture in the hip, wrist, or spine. Inform your doctor if you have osteoporosis or if you are taking corticosteroids (which may increase the risk of osteoporosis).

Taking rabeprazol cinfa with other medicines

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

In particular, tell your doctor or pharmacist if you are taking any of the following medicines:

• Ketoconazole or itraconazole, medicines for fungal infections. Rabeprazol may decrease the amount of these medicines in your blood. Your doctor may need to adjust your dose.

• Atazanavir, a medicine used to treat HIV infection. Rabeprazol may decrease the amount of this type of medicine in your blood, so they should not be used together.
• Methotrexate (a chemotherapy medicine used at high doses to treat cancer) – if you are taking a high dose of methotrexate, your doctor may temporarily stop your treatment with rabeprazol.

If you are in doubt about any of the above, consult your doctor or pharmacist before taking rabeprazol.

Taking rabeprazol cinfa with food and drinks

The tablets should be swallowed with a little water. If daily treatment is required, the tablets should be taken preferably before breakfast.

Pregnancy, breast-feeding, and fertility

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

• Do not take rabeprazol if you are pregnant or if you think you may be pregnant.
• Do not take rabeprazol during breast-feeding or if you plan to start breast-feeding.

Driving and using machines

Rabeprazol is unlikely to affect your ability to drive or use machines. However, if you feel drowsy, avoid driving or using machines.

Rabeprazol cinfa contains sodium

This medicine contains less than 23 mg of sodium (1 mmol) per tablet; this is essentially “sodium-free”.

3. How to take rabeprazol cinfa

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

Taking this medicine

• Only remove a tablet from the blister when it is time to take your medicine.
• Swallow the tablet whole with a little water. Do not crush or chew the tablet.
• Your doctor will tell you the number of tablets you should take and the duration of your treatment, which will depend on your indication.
• If you are taking this medicine for a long time, your doctor will want to monitor you.

Adults and elderly patients

For “gastroesophageal reflux disease” (GERD)

Treatment of moderate to severe symptoms (symptomatic GERD)

The recommended dose is one 10 mg rabeprazol tablet once a day for up to 4 weeks

• Take the tablet in the morning before eating
• If your symptoms come back after 4 weeks of treatment, your doctor will tell you to take one 10 mg rabeprazol tablet as needed (“on demand”)

Treatment of more severe symptoms (erosive or ulcerative GERD)

• The recommended dose is one 20 mg rabeprazol tablet once a day for 4 to 8 weeks
• Take the tablet in the morning before eating

Long-term treatment of symptoms (maintenance GERD)

• The recommended dose is one 10 mg or 20 mg rabeprazol tablet once a day for as long as your doctor has indicated
• Take the tablet in the morning before eating
• Your doctor will want to see you at regular intervals to check your symptoms and dose

For stomach ulcers (peptic ulcers)

• The recommended dose is one 20 mg rabeprazol tablet once a day for 6 weeks
• Take the tablet in the morning before eating
• Your doctor may tell you to take rabeprazol for another 6 weeks if your symptoms do not improve.

For duodenal ulcers

• The recommended dose is one 20 mg rabeprazol tablet once a day for 4 weeks
• Take the tablet in the morning before eating
• Your doctor may tell you to take rabeprazol for another 4 weeks if your symptoms do not improve

For ulcers caused by H. pylori infection and to prevent recurrence

• The recommended dose is one 20 mg rabeprazol tablet twice a day for 7 days
• Your doctor will also tell you to take antibiotics called amoxicillin and clarithromycin

For more information on the other medicines used to treat H. pylori, read the package leaflet of each of them.

Zollinger-Ellison syndrome where there is an excess of acid in the stomach

• The recommended dose is three 20 mg rabeprazol tablets once a day initially
• The dose may be adjusted by your doctor depending on how you respond to treatment. If you are on long-term treatment, you will need to see your doctor at regular intervals for dose and symptom review

Patients with liver problems.Consult your doctor, who will take special care when starting and during treatment with rabeprazol.

If you take more rabeprazol cinfa than you should

If you take more rabeprazol than you should, talk to your doctor or go to a hospital immediately. Take the medicine with you.

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

If you forget to take rabeprazol cinfa

• If you forget to take a tablet, take one as soon as you remember and then continue as usual.
• However, if it is almost time to take the next tablet, simply skip the missed tablet and continue as usual.
• If you forget to take your medicine for more than 5 days, consult your doctor before taking more medicine

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

If you stop taking rabeprazol cinfa

Relief of symptoms usually occurs before the ulcer is completely healed. It is important that you do not stop treatment until your doctor tells you to.

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.

Side effects are usually mild and improve without you stopping treatment.

Stop taking rabeprazol and see your doctor immediately if you notice any of the following side effects – you may need urgent medical treatment:

• Allergic reactions – the signs may include: sudden swelling of your face, difficulty breathing, or low blood pressure that can cause fainting or collapse
• Frequent infections, such as sore throat or high temperature (fever), or ulcers in your mouth or throat
• Bruising or easy bleeding.

These side effects are rare (may affect up to 1 in 1,000 patients)

• Severe skin blistering or ulcers or ulcers in your mouth and throat.

These side effects are very rare (may affect up to 1 in 10,000 patients)

Other possible side effects:

Common (may affect up to 1 in 10 patients)

• Infections
• Difficulty sleeping
• Headache or dizziness
• Cough, runny nose, or sore throat (pharyngitis)
• Effects on your stomach or intestine such as stomach pain, diarrhea, gas (flatulence), feeling sick (nausea), being sick (vomiting), or constipation
• Pain or back pain
• Weakness or flu-like symptoms
• Benign polyps in the stomach.

Uncommon (may affect up to 1 in 100 patients)

• Feeling nervous or drowsy
• Chest infection (bronchitis)
• Painful and blocked sinuses (sinusitis)
• Dry mouth
• Indigestion or belching
• Skin rash or redness
• Muscle, leg, or joint pain
• Fractures in the hip, wrist, and spine
• Urinary tract infection (urinary tract infection)
• Chest pain
• Chills or fever
• Changes in liver function (shown in blood tests)

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

• Lack of appetite (anorexia)
• Depression
• Hypersensitivity (including allergic reactions)
• Visual disturbances
• Inflamed mouth (stomatitis) or taste disorders
• Stomach disorder or stomach pain
• Liver problems including yellowing of the skin and whites of the eyes (jaundice)
• Itchy rash or blisters
• Sweating
• Kidney problems
• Weight gain
• Changes in white blood cells (shown in blood tests) that can cause frequent infections
• Decreased platelet count that can cause bleeding or bruising more easily than normal

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

• Swelling of the breasts in men
• Fluid retention
• Inflammation of the intestine (leading to diarrhea)
• Low sodium levels in the blood that can cause fatigue and confusion, muscle spasms, convulsions, and coma.
• Patients who have previously had liver problems may very rarely develop encephalopathy (brain disease)
• Skin rash, possibly with joint pain.

If you take rabeprazol for more than three months, it is possible that your blood magnesium levels may decrease. Low magnesium levels can manifest as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, increased heart rate. If you experience any of these symptoms, please inform your doctor immediately. Low magnesium levels can also lead to a reduction in blood potassium or calcium levels. Your doctor may decide to perform periodic blood tests to monitor your magnesium levels.

Do not worry about the list of side effects. You may not experience any of them.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist, even if it is possible side effects that are 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. Storing rabeprazol cinfa

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

Do not store above 25°C.

Store in the original package.

Do not use this medicine after the expiry date which is stated on the carton after “EXP”. The expiry date is the last day of the month shown.

Medicines should not be disposed of via wastewater or household waste. Return the containers and any unused medicines to a pharmacy for safe disposal. If you are in doubt, ask your pharmacist how to dispose of containers and unused medicines. This will help protect the environment.

6. Packaging Content and Additional Information

Composition of Rabeprazole Cinfa

• The active ingredient is sodium rabeprazole.
• The other components are:

Core of the tablet: Mannitol, magnesium oxide (E-530), hydroxypropylcellulose (E-463), magnesium stearate (E-470b).

Intermediate coating: Ethylcellulose, magnesium oxide (E-530).

Enteric coating: Hypromellose phthalate, dibutyl sebacate, talc, titanium dioxide (E-171), red iron oxide (E-172).

Appearance of the Product and Packaging Content

Rabeprazole Cinfais presented in the form of pink, biconvex, film-coated tablets with a "1" on one face of the tablet. Each package contains 14, 28, or 120 (clinical package) tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Cinfa Laboratories, S.A.

Olaz-Chipi Road, 10. Areta Industrial Estate

31620 Huarte (Navarre) - Spain

Manufacturer

Cinfa Laboratories, S.A.

Olaz-Chipi Road, 10. Areta Industrial Estate

31620 Huarte (Navarre) - Spain

LICONSA, S.A.

Miralcampo Avenue, No. 7,

Miralcampo Industrial Estate

(Azuqueca de Henares (Guadalajara))

• 19200 –

Spain

Date of the Last Revision of this Leaflet:September 2022

Detailed 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/.

You can access detailed and updated information about this medicinal product by scanning the QR code included in the leaflet and packaging with your mobile phone (smartphone). You can also access this information at the following internet address https://cima.aemps.es/cima/dochtml/p/72745/P_72745.html

QR code to: https://cima.aemps.es/cima/dochtml/p/72745/P_72745.html