Leaflet: information for the user

Aciryl 150 mg hard capsules EFG
pregabalina

Read this leaflet carefully before you start taking this medicine, because it contains important information for you.

-Keep this leaflet, as you may need to read it again.
- If you have any questions, consult your doctor or pharmacist.
- This medicine has been prescribed for you only, and you must not give it to others even if they have the same symptoms as you, as it may harm them.
- If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

4. Possible side effects
5. Storage of Aciryl
6. Contents of the pack and additional information

Pregabalina belongs to a group of medications used for the treatment of epilepsy, neuropathic pain, and generalized anxiety disorder (GAD) in adults.

Peripheral and central neuropathic pain:Pregabalina is used for the treatment of chronic pain caused by nerve damage. Various diseases can cause peripheral neuropathic pain, such as diabetes or herpes. The sensation of pain could be described as heat, burning, pulsating pain, stabbing pain, acute pain, spasms, continuous pain, tingling, numbness, and a sensation of pins and needles. Peripheral and central neuropathic pain could also be associated with mood changes, sleep disturbances, fatigue (tiredness), and can affect physical and social activity and overall quality of life.

Epilepsy:Pregabalina is used in the treatment of certain types of epilepsy (partial seizures with or without secondary generalization) in adults. Your doctor will prescribe pregabalina to treat epilepsy when your current treatment does not control the disease. You must take pregabalina in addition to your current treatment. Pregabalina should not be administered alone, but always used in combination with other antiepileptic treatments.

Generalized anxiety disorder:Pregabalina is used in the treatment of generalized anxiety disorder (GAD). Symptoms of GAD include excessive and prolonged anxiety and worry that are difficult to control. GAD can also produce restlessness or a feeling of excitement or nervousness, feeling easily fatigued (tired), having difficulty concentrating or feeling mentally blank, irritability, muscle tension, or sleep disturbances. This is different from the stress and tensions of everyday life.

Do not take Aciryl

If you are allergic to pregabalin or any of the other ingredients of this medication (listed in section 6).

Warnings and precautions

Consult your doctor or pharmacist before starting to take pregabalin.

·Some patients treated with pregabalin have reported symptoms that suggest an allergic reaction. These symptoms include swelling of the face, lips, tongue, and throat, as well as widespread skin rash. If you experience any of these symptoms, you should seek immediate medical attention.

·Severe skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, have been associated with pregabalin treatment. Stop taking pregabalin and seek medical attention immediately if you observe any of the symptoms related to these severe skin reactions described in section 4.

·Pregabalin has been associated with dizziness and somnolence, which may increase the risk of accidental injuries (falls) in elderly patients. Therefore, you should exercise caution until you become familiar with the effects of the medication.

·Pregabalin may cause blurred vision, loss of vision, or other changes in vision, many of which are transient. If you experience any alteration in your vision, you should inform your doctor immediately.

·Patients with diabetes who gain weight while taking pregabalin may need to change their diabetes medications.

·Certain adverse effects, such as somnolence, may be more frequent since patients with spinal cord injury may be taking other medications for treatment, such as pain or spasticity (tense or rigid muscles), with similar adverse effects to pregabalin, so the intensity of these effects may increase when taken together.

·Severe cases of heart failure have been reported in some patients treated with this medication. Most of them were elderly patients with cardiovascular diseases.Before using this medication, you should inform your doctor if you have a history of heart disease.

·Severe cases of kidney failure have been reported in some patients treated with this medication. If during treatment with pregabalin you notice a decrease in your ability to urinate, you should inform your doctor as the interruption of treatment may improve this situation.

·Some patients treated with antiepileptic drugs such as pregabalin have had thoughts of self-harm or suicide or have shown suicidal behavior. If at any time you experience these thoughts or have shown such behavior, contact your doctor as soon as possible.

·Certain adverse effects, such as constipation, may be more frequent when pregabalin is taken with other medications that can cause constipation (such as some types of pain medications). Inform your doctor if you experience constipation, especially if you are prone to this problem.

·Before taking this medication, inform your doctor if you have ever abused or had dependence on alcohol, prescription medications, or illegal drugs; this may mean that you have a higher risk of becoming dependent on pregabalin.

·Severe cases of seizures have been reported during treatment with pregabalin or shortly after stopping treatment with this medication. If you experience seizures, contact your doctor immediately.

·Severe cases of encephalopathy (brain dysfunction) have been reported in some patients who were taking pregabalin and had other serious diseases. Inform your doctor if you have a history of any serious disease, including liver or kidney disease.

·Severe cases of respiratory difficulty have been reported. If you have neurological disorders, respiratory disorders, kidney failure, or are over 65 years old, your doctor may prescribe a different dose. Contact your doctor if you experience breathing problems or shallow breathing.

Dependence

Some people may become dependent on pregabalin (need to continue taking the medication). They may experience withdrawal effects when they stop using pregabalin (see section 3, "How to take Aciryl" and "If you stop taking Aciryl"). If you are concerned that you may become dependent on pregabalin, it is essential to consult your doctor.

If you notice any of the following signs while taking pregabalin, it could be a sign that you have become dependent:

• You need to take the medication for a longer time than recommended by your doctor.
• You feel the need to take more of the recommended dose.
• You are using the medication for reasons other than those prescribed.
• You have made repeated and unsuccessful attempts to stop or control the use of the medication.
• When you stop taking the medication, you experience discomfort and feel better once you take the medication again.

If you notice any of these signs, talk to your doctor to analyze the best plan of care for you, including when it is appropriate to stop treatment and how to do it safely.

Children and adolescents

The safety and efficacy of pregabalin have not been established in children and adolescents (under 18 years), so pregabalin should not be used in this age group.

Other medications and Aciryl

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.

Pregabalin and certain medications may exert a mutual influence on each other (interactions). When pregabalin is used with certain medications that have a sedative effect (including opioids), these effects may be potentiated, and may lead to respiratory failure, coma, and death. The degree of dizziness, somnolence, and decreased concentration may increase if pregabalin is taken with other medications that contain:

Oxycodone – (used as an analgesic)

Lorazepam – (used to treat anxiety)

Alcohol

This medication can be taken with oral contraceptives.

Taking Aciryl with food, drinks, and alcohol

Pregabalin capsules can be taken with or without food.

It is recommended not to take alcohol during treatment with pregabalin.

Pregnancy, breastfeeding, and fertility

You should not take pregabalin during pregnancy or lactation, unless your doctor has told you to. The use of pregabalin during the first 3 months of pregnancy may cause congenital anomalies in the fetus that require medical treatment. In a study that reviewed data from women in Nordic countries who took pregabalin during the first 3 months of pregnancy, 6 out of 100 babies had such congenital anomalies. This contrasts with 4 out of 100 babies born to women not treated with pregabalin in the study. Congenital anomalies of the face (cleft palate), eyes, nervous system (including the brain), kidneys, and genitals have been reported.

A reliable contraceptive method should be used in women of childbearing age.If you are pregnant or breastfeeding, believe you may be pregnant, or intend to become pregnant, consult your doctor or pharmacist before using this medication.

Driving and operating machinery

Pregabalin may cause dizziness, somnolence, and decreased concentration. You should not drive, operate heavy machinery, or engage in other potentially hazardous activities until you know if this medication affects your ability to perform these activities.

Follow exactly the administration instructions of this medication as indicated by your doctor.

In case of doubt, consult your doctor or pharmacist again. Do not take more medication than prescribed.

Your doctor will determine the appropriate dose for you.

Pregabalin is exclusively for oral use.

Peripheral and central neuropathic pain, epilepsy, or generalized anxiety disorder:

•Take the number of capsules as indicated by your doctor.
•The dose, adjusted for you and your condition, will generally be between 150 mg and 600 mg per day.
•Your doctor will tell you to take pregabalin two or three times a day. In the case of twice a day, take pregabalin once in the morning and once at night, approximately at the same time every day. In the case of three times a day, take pregabalin in the morning, at noon, and at night, approximately at the same time every day.

If you estimate that the action of pregabalin is too strong or too weak, inform your doctor or pharmacist.

If you are an elderly patient (over 65 years old), you should take pregabalin normally, except if you have kidney problems.

Your doctor may prescribe a different dosing regimen and/or different doses if you have kidney problems.

Swallow the capsule whole with water.

Continue taking pregabalin until your doctor tells you to stop.

If you take morePregabalin than you should

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.
As a result of taking more pregabalin than you should, you may feel drowsy, confused, agitated, or restless.Seizures and loss of consciousness (coma) have also been reported.

If you forget to takePregabalin

It is essential to take pregabalin capsules regularly at the same time every day. If you forget to take a dose, take it as soon as you remember, unless it is time for the next dose. In that case, continue with the next dose as usual. Do not take a double dose to compensate for the missed doses.

If you interrupt treatment withPregabalin

Do not stop taking pregabalin suddenly. If you want to stop taking pregabalin, talk to your doctor first. He will tell you how to do it. If you are going to stop treatment, this should be done gradually over a minimum of one week.

Once a short- or long-term treatment with pregabalin is completed, you should know that you may experience certain adverse effects called withdrawal effects. These effects include insomnia, headaches, nausea, anxiety, diarrhea, flu-like symptoms, seizures, nervousness, depression, thoughts of self-harm or suicide, pain, sweating, and dizziness. These effects may appear more frequently or severely if you have been taking pregabalin for a longer period. If you experience withdrawal effects, consult your doctor.

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

This medication, like all others, may cause side effects, although not everyone will experience them.

The very common side effects that may affect more than 1 in 10 people are:

·Dizziness, somnolence, headache

The common side effects that may affect more than 1 in 100 people are:

·Increased appetite

·Euphoria, confusion, disorientation, decreased sexual appetite, irritability

·Attention alteration, clumsiness of movement, memory deterioration, memory loss, tremors, difficulty speaking, sensation of paresthesia, numbness, sedation, lethargy, insomnia, fatigue, abnormal sensation

·Blurred vision, double vision

·Dizziness, balance problems, falls

·Dry mouth, constipation, vomiting, flatulence, diarrhea, nausea, swollen abdomen

·Difficulty with erection

·Swelling of the body including extremities

·Sensation of intoxication, alterations in gait

·Weight gain

·Muscle cramp, joint pain, back pain, pain in extremities

·Throat pain

The uncommon side effects that may affect more than 1 in 1,000 people are:

·Loss of appetite, weight loss, low blood sugar, high blood sugar

·Change in self-perception, restlessness, depression, agitation, mood changes, difficulty finding words, hallucinations, strange dreams, anxiety crisis, apathy, aggression, elevated mood, mental deterioration, difficulty thinking, increased sexual appetite,sexual dysfunction including inability to achieve orgasm, delayed ejaculation.

·Changes in vision, abnormal eye movements, changes in vision including tunnel vision, flashes of light, spasmodic movements, decreased reflexes, hyperactivity, dizziness when standing, sensitive skin, loss of taste, burning sensation, tremors when moving, decreased consciousness, loss of consciousness, fainting, increased sensitivity to sounds, general discomfort.

·Eye dryness, eye swelling, eye pain, tired eyes, watery eyes, eye irritation.

·Alterations in heart rhythm, increased heart rate, low blood pressure, high blood pressure, changes in heart rhythm, heart failure.

·Rubor, hot flashes.

·Difficulty breathing, dry nose, nasal congestion.

·Increased saliva production, burning sensation, numbness around the mouth.

·Sweating, rash, chills, fever.

·Muscle spasms, joint swelling, muscle rigidity, pain including muscle pain, neck pain.

·Breast pain.

·Difficulty or pain urinating, inability to hold urine.

·Weakness, thirst, chest oppression.

·Changes in blood and liver test results (elevated creatine phosphokinase in blood, elevated alanine aminotransferase, elevated aspartate aminotransferase, decreased platelet count, neutropenia, elevated creatinine in blood, decreased potassium in blood).

·Hypersensitivity, facial swelling, itching, urticaria, runny nose, nasal bleeding, cough, snoring.

·Menstrual cramps.

·Cold sensation in hands and feet.

The rare side effects that may affect less than 1 in 10,000 people are:

·Altered sense of smell, oscillating vision, altered perception of depth, visual brightness, loss of vision

·Dilated pupils, strabismus

·Cold sweat, throat oppression, tongue swelling

·Pancreatitis

·Difficulty swallowing

·Slow or reduced body movement

·Difficulty writing correctly

·Increased fluid in the abdominal area

·Pulmonary edema

·Convulsions

·Changes in electrocardiogram (ECG) corresponding to alterations in heart rhythm

·Muscle damage

·Milk secretion, abnormal breast growth, increased breast size in men

·Menstrual period interruption

·Renal insufficiency, decreased urine output, urinary retention

·Decreased white blood cell count

·Unusual behavior, suicidal behavior, suicidal thoughts

·Severe skin reactions that may include difficulty breathing, eye inflammation (keratitis), and a severe skin reaction characterized byred patches that are not elevated, or circular or coin-shaped patches on the chest, often with central blisters, skin desquamation, mouth, throat, nose, genital, and eye ulcers. These severe skin reactions may be preceded by fever and flu-like symptoms (Stevens-Johnson syndrome, toxic epidermal necrolysis).

·Jaundice (yellow skin and eyes).

·Parkinsonism, Parkinson's disease-like symptoms, including tremor, bradykinesia (decreased ability to move), and muscle rigidity.

The very rare side effects that may affect up to 1 in 10,000 people are:

· Liver insufficiency.

· Liver hepatitis (inflammation of the liver)

The side effects of unknown frequency that cannot be estimated from available data are:

· Dependence on pregabalin (“drug dependence”)

Once a short- or long-term treatment with pregabalin is completed, you should know that you may experience certain side effects, called withdrawal effects (see “If you stop treatment with Aciryl”).

If you experience swelling in the face or tongue, or if your skin becomes red and blisters or peels, you should seek immediate medical assistance.

Certain side effects, such as drowsiness, may be more frequent since patients with spinal cord injury may be taking other medications to treat, for example, pain or spasticity (tense or rigid muscles), with side effects similar to those of pregabalin, so the intensity of these side effects may increase when taken together.

The following adverse reaction has been reported in post-marketing experience: difficulty breathing, shallow breathing.

Reporting of adverse effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use:https://www.notificaram.es.

By reporting adverse effects, you can contribute to providing more information on the safety of this medication.

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

Do not use this medication after the expiration date that appears on the packaging after the abbreviation CAD.The expiration date is the last day of the month indicated.

This medication does not require special storage conditions.

Medications should not be disposed of through drains or in the trash. Dispose of the packaging and medications you no longer need at the SIGRE collection pointat the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. By doing so, you will help protect the environment.

Composition ofAciryl

The active ingredient is pregabalina. Each hard capsule contains 75 mg of pregabalina.

The other components (excipients) are: mannitol (E-421), pregelatinized cornstarch, talc, titanium dioxide (E-171), yellow iron oxide (E-172), red iron oxide (E-172)and gelatine.
The components of the printing ink are: shellac lacquer, black iron oxide (E-172), propylene glycol, strong ammonia solution, and potassium hydroxide.

Appearance of the product and contents of the packaging

Aciryl 75 mg are hard gelatine capsules, opaque, ivory and pink in color and have "75" engraved on them.

Blister packsofPVC/Aluminiumincarton boxescontaining56hard capsules.

Pre-cut single-dose PVC/Aluminium blister packs in carton boxes containing 56 hard capsules.

Possiblethatonlysomepackaging sizesmaybemarketed.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder

Neuraxpharm Spain, S.L.U.

Avda. Barcelona, 69

08970 Sant Joan Despí

Barcelona - Spain

Responsible manufacturer

Pliva Croatia, Ltd.

Prilaz Baruna Filipovica 25

10000 Zagreb

Croatia

or

Merckle GmbH

Ludwig-Merckle Strasse 3

D-89143 Blaubeuren - Weiler

Germany

Last review date of this leaflet: December 2023

The detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/