VIRVIRILO 20 mg FILM-COATED TABLETS

2. What you need to know before you take Virvirilo

Do not takeVirvirilo if:

• you are allergic to tadalafil or any of the other ingredients of this medicine (listed in section 6).

• you are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of medicines (“nitrates”) used in the treatment of angina pectoris (“chest pain”). Tadalafil has been shown to increase the effects of these medicines.

• you have a severe heart or liver problem.

• you have recently had a heart attack (within the last 90 days).

• you have had a stroke (including a 'mini-stroke' or transient ischaemic attack) within the last 6 months.

• you have low blood pressure or uncontrolled high blood pressure.

• you have ever had loss of vision due to non-arteritic anterior ischaemic optic neuropathy (NAION), a condition described as “stroke of the eye”.

• you are taking riociguat. This medicine is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs due to blood clots). Phosphodiesterase 5 inhibitors, such as tadalafil, have been shown to increase the effects of this medicine. If you are taking riociguat or are unsure, consult your doctor.

Warnings and precautions

Consult your doctor or pharmacist before taking Virvirilo.

Be aware that sexual activity carries a possible risk to patients with heart problems because it puts an extra strain on your heart. If you have a heart problem, tell your doctor.

Before taking the tablets, tell your doctor if you have:

• sickle cell anaemia (a disease of the red blood cells).
• multiple myeloma (cancer of the bone marrow).
• leukaemia (cancer of the blood cells).
• any deformation of your penis.
• a severe liver problem.
• a severe kidney problem.

It is not known if tadalafil is effective in patients who have had:

• pelvic surgery.
• a surgery to remove your prostate gland in which your doctor has cut the nerve around it (radical prostatectomy without nerve-sparing).

If you experience sudden decrease or loss of vision, stop taking Virvirilo and contact your doctor immediately.

A sudden decrease or loss of hearing has been reported in some patients taking tadalafil. Although it is not known if these events are directly related to tadalafil, if you experience a sudden decrease or loss of hearing, stop taking Virvirilo and contact your doctor immediately.

Virvirilo is not intended for use by women.

Children and adolescents

Virvirilo should not be used in children and adolescents under 18 years of age.

Use ofVirvirilowith other medicines

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

Do not take Virvirilo if you are already taking nitrates (see “Do not take Virvirilo” above).

Some medicines may be affected by Virvirilo or may affect how well tadalafil works. Tell your doctor or pharmacist if you are taking:

• an alpha blocker (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia).
• other medicines for high blood pressure.
• riociguat.
• a 5-alpha reductase inhibitor (used to treat benign prostatic hyperplasia).
• medicines such as ketoconazole tablets (for fungal infections) and protease inhibitors for the treatment of AIDS or HIV infection.
• phenobarbital, phenytoin and carbamazepine (medicines for epilepsy).
• rifampicin, erythromycin, clarithromycin or itraconazole.
• other treatments for erectile dysfunction.

TakingVirvirilowith food and drink

Information about the effect of alcohol is in section 3. Grapefruit juice may affect how well Virvirilo works and should be taken with caution. Consult your doctor for further information.

Fertility

In dogs treated with tadalafil, a decrease in sperm production was observed. A reduction in sperm count has been observed in some men. These effects are unlikely to lead to infertility.

Driving and using machines

Some men taking tadalafil during clinical trials experienced dizziness. Check carefully how you react to the tablets before driving or using machines.

Virvirilocontains lactose

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

Virvirilo cinfamedcontains sodium

This medicine contains less than 1 mmol sodium (23 mg) per tablet, i.e., essentially “sodium-free”.

3. How to take Virvirilo

Take this medicine exactly as your doctor or pharmacist has told you. If you are not sure, ask your doctor or pharmacist.

The tablets are for oral use only in men. Swallow the tablet whole with some water. The tablets can be taken with or without food.

The recommended dose isone 10 mg tablet taken before sexual activity. However, you have been given the dose of one 20 mg tablet because your doctor has decided that the recommended dose of 10 mg is too weak.

When you take Virvirilo, you may be able to have sexual intercourse from at least 30 minutes after taking the tablet.

Virvirilo may still be effective up to 36 hours after taking the tablet.

Do not take Virvirilo more than once a day. Virvirilo 10 mg and 20 mg will be taken before anticipated sexual activity and is not recommended for continuous daily use.

It is important to note thattadalafil will not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.

Drinking too much alcohol can reduce your ability to get an erection and may temporarily lower your blood pressure. If you have taken or are planning to take tadalafil, avoid excessive drinking of alcohol (blood alcohol level of 0.08 % or greater), as this may increase the risk of dizziness when standing up.

If you take moreVirvirilothan you should

Consult your doctor. You may experience side effects described in section 4.

In case of overdose, contact your doctor or pharmacist or go to the emergency department of the nearest hospital. Take the medicine pack with you.

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

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

If you experience any of the following side effects, stop taking the medicine and seek medical help immediately:

• allergic reactions including skin rash (uncommon).
• chest pain - do not use nitrates, but seek medical help immediately (uncommon).
• prolonged and possibly painful erections after taking Virvirilo (rare). If you have an erection that lasts for more than 4 hours, contact a doctor immediately.
• sudden loss of vision (rare), distorted vision, blurred vision, or sudden loss of vision (frequency not known)

Other side effects that have been reported include:

Common(seen in 1 to 10 in every 100 patients)

• headache
• back pain
• muscle aches
• pain in arms and legs
• flushing
• nasal congestion
• indigestion

Uncommon(seen in 1 to 10 in every 1,000 patients)

• dizziness
• stomach ache
• nausea
• vomiting
• reflux
• blurred vision
• eye pain
• difficulty breathing
• blood in urine
• prolonged erections
• palpitations, rapid heartbeat, high blood pressure, low blood pressure
• nasal bleeding and ringing in the ears
• swelling of hands, feet or ankles
• feeling tired

Rare(seen in 1 to 10 in every 10,000 patients)

• fainting
• seizures
• temporary memory loss
• swelling of the eyelids, red eyes, sudden decrease or loss of hearing and hives (itchy red welts on the surface of the skin)
• bleeding from the penis
• presence of blood in the semen
• increased sweating

Additionally, the following rare side effects have been reported in men taking tadalafil that were not seen in clinical trials:

• migraine
• swelling of the face
• serious allergic reaction which causes swelling of the face or throat
• severe skin rashes
• certain disorders affecting blood flow to the eyes
• irregular heartbeats
• angina pectoris
• sudden death
• distorted vision, blurred vision, or sudden loss of vision (frequency not known)

In men over 75 years old treated with Virvirilo, dizziness was more common. In men over 65 years old treated with Virvirilo, the side effect most frequently reported was diarrhoea.

Reporting of side effects

If you get 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 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 Virvirilo

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 and blister after EXP. The expiry date refers to the last day of that month.

This medicine does not require any special storage conditions.

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 to protect the environment.

6. Contents of the pack and further information

Composition ofVirvirilo

• The active substance is tadalafil. Each tablet contains 20 mg of tadalafil.
• The other ingredients are:

Core of the tablet: lactose monohydrate, sodium lauryl sulfate, povidone, crospovidone type B, and sodium stearyl fumarate.

Coating of the tablet: polyvinyl alcohol, macrogol, titanium dioxide (E171), talc, and yellow iron oxide (E172).

Appearance of the product and contents of the pack

Virvirilo 20 mg is a yellow-orange, oval, film-coated tablet, 15.0 mm x 9.0 mm in size, double-scored on one side and marked with “20” on the other.

The tablet can be divided into two and/or four equal doses.

Virvirilo 20 mg is available in packs of 4, 8, or 12 film-coated tablets.

Not all pack sizes may be marketed.

Marketing authorisation holder and manufacturer

Marketing authorisation holder

INDUSTRIA QUÍMICA Y FARMACÉUTICA VIR, S.A.

C/ Laguna 66-68-70. Polígono Industrial Urtinsa II.

28923 Alcorcón (Madrid)

Spain

Manufacturer

TEVA Pharmaceutical Industries, 18 Eli Hurvitz Street, Industrial Zone, Kfar-Saba 44102, ISRAEL

TEVA PHARMA, S.L.U. Polígono Industrial Malpica, C/C, nº4

50016, Zaragoza, SPAIN

Date of last revision of this leaflet: November 2023

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