Leaflet: information for the user

Alprazolam pensa 0.50 mg tablets EFG

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, pharmacist or nurse, even if they are not listed in this leaflet. See section 4.

1. What Alprazolam pensa is and for what it is used

2. What you need to know before starting to take Alprazolam pensa

3. How to take Alprazolam pensa

4. Possible side effects

5. Storage of Alprazolam pensa

6. Contents of the pack and additional information

Alprazolam pensa belongs to a group of medicines called benzodiazepines (anxiolytic medicines).

Alprazolam pensa is used in adults for the treatment of severe, debilitating, or highly distressing anxiety symptoms.

This medicine is only for short-term use.

Do not take Alprazolam think

if you have a disease calledmyasthenia gravischaracterized by muscle weakness

Warnings and precautions

Consult your doctor or pharmacist before starting to take Alprazolam think

• If you have any lung, liver, or kidney problems.
• If you have felt or feel so depressed that you have had thoughts or ideas of suicide.
• After prolonged use of alprazolam, tolerance may be detected.
• There is a risk of developing addiction/dependence when using alprazolam.
• If during treatment you notice symptoms of mania (state of overexcitement, feeling of euphoria, or irritability) or hypomania (state of excitement and excessive activity).
• The treatment with benzodiazepines, including alprazolam, may cause dependence, mainly after taking the medication continuously for a long time. To minimize the risk of dependence, the following precautions should be taken
• • The use of benzodiazepines should be made only under medical prescription (never because they have worked in other patients) and never recommended to others.
  • Do not increase the prescribed doses, or prolong the treatment longer than recommended.
  • Consult your doctor regularly to decide if you should continue with the treatment.
  • Do not combine several benzodiazepines regardless of their indication.
• When stopping treatment with alprazolam, rebound-like symptoms may appear similar to those that led to starting treatment with alprazolam. To avoid this, it is recommended not to stop treatment abruptly, but to gradually reduce the dose, according to the doctor's instructions (see section "If you stop taking Alprazolam think").
• The use of alprazolam with opioid-type medications may cause deep sedation, respiratory depression, coma, and death.
• Benzodiazepines may cause memory loss and reactions such as: restlessness, agitation, irritability, aggression, delirium, anger attacks, nightmares, hallucinations, psychosis, inappropriate behavior, and other adverse effects on behavior. If this occurs, treatment should be suspended and your doctor consulted.
• It is very important to inform your doctor if you have a history of drug and alcohol consumption.

Other medications and Alprazolam think

Inform your doctor or pharmacist if you are using, have used recently, or may need to use any other medication, even those purchased without a prescription. This is extremely important because the simultaneous use of multiple medications may increase or decrease their effect.

Alprazolam may interact with other medications. Inform your doctor if you are taking any of the following medications:

Central nervous system depressants, as they may potentiate the sedative effect of alprazolam:

• major tranquilizers (antipsychotics)
• sleep inducers (hypnotics)
• medications used to treat depression
• medications used to treat epilepsy (antiepileptics)
• narcotic analgesics and opioids (morphine derivatives), as they may increase the feeling of euphoria, leading to increased psychological dependence
• anxiolytics/sedatives used to treat anxiety
• anesthetics
• sedating antihistamines (allergy medications)
• The concomitant use of alprazolam and opioids (potent analgesics, medication for opioid addiction treatment, and some cough medications) increases the risk of drowsiness, difficulty breathing (respiratory depression), coma, and may be potentially fatal. Therefore, concomitant use should only be considered when other treatment options are not possible. However, if your doctor prescribes alprazolam with opioids, the dose and duration of concomitant treatment should be limited by your doctor
• Inform your doctor about all opioid medications you are taking and follow your doctor's dosage recommendation closely. It may be helpful to inform friends or family members to be aware of the symptoms mentioned above. Contact your doctor if you experience any of these symptoms.

There are some groups of medications that, due to their action in the body (inhibitors of cytochrome P450), may interact with alprazolam and, in some cases, increase its activity. Some of the medications that interact with alprazolam are:

• medications used to treat fungal infections such as ketoconazole, itraconazole, posaconazole, or voriconazole. It is not recommended to take them at the same time as alprazolam
• the following antidepressants: nefazodone, fluvoxamine, and fluoxetine
• gastric protectors such as cimetidine
• dextropropoxyphene (narcotic analgesic)
• oral contraceptives
• diltiazem (anti-hypertensive)
• macrolide antibiotics such as erythromycin, troleandomycin, clarithromycin, and telithromycin
• medications used to treat HIV/AIDS such as ritonavir, etc.
• digoxin (medication used to suppress or prevent heart rhythm disturbances)

Taking Alprazolam think with food, drinks, and alcohol

During treatment, avoid alcoholic beverages. The effect of alcohol may potentiate sedation and affect your alertness (see section "Driving and using machines").

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, or if you think you may be pregnant, consult your doctor or pharmacist before using this medication.

Alprazolam is not recommended during pregnancy or breastfeeding, unless, in the doctor's opinion, the benefits outweigh the risks for the baby.

If, by the doctor's decision, alprazolam is administered during a late stage of pregnancy or during delivery, the following effects may appear in the newborn: decreased body temperature (hypothermia), decreased muscle tone (hypotonia), and moderate respiratory depression. Babies born to mothers who take benzodiazepines chronically during the last stage of pregnancy may develop physical dependence, which may trigger a withdrawal syndrome in the postnatal period.

Children and adolescents (under 18 years)

Alprazolam is not recommended for children and adolescents under 18 years. Benzodiazepines should not be administered to children unless it is strictly necessary and prescribed by a doctor. The efficacy and safety of alprazolam in children under 18 years have not been established.

Use in elderly patients (over 65 years)

Alprazolam may affect this group of patients more than young patients. If you belong to this group, your doctor may reduce the dose and check your response to treatment. Please follow their instructions carefully (see section "How to take Alprazolam think").

Benzodiazepines and related products should be used with caution in elderly patients, due to the risk of sedation and/or muscle weakness that may cause falls, often with serious consequences in this population.

Special patient groups

If your liver or kidneys do not function well, consult your doctor, who may advise you to use a lower dose of alprazolam.

If you have respiratory problems, inform your doctor.

Driving and using machines

Alprazolam think may impair your ability to drive or operate machinery, as it may cause drowsiness, decrease your attention, or decrease your reaction time. These effects are more likely to occur at the beginning of treatment or when the dose is increased. Do not drive or use machines if you experience any of these effects.

These effects may be potentiated if you consume alcohol at the same time.

Alprazolam think contains lactose, sodium, and yellow FDC No. 6 lake (E-110)

This medication contains lactose. If your doctor has indicated that you have an intolerance to certain sugars, consult with them before taking this medication.

This medication contains less than 1 mmol of sodium (23 mg) per tablet; it is essentially "sodium-free".

This medication may cause allergic reactions because it containsyellow FDC No. 6 lake (E-110).It may cause asthma, especially in patients allergic to acetylsalicylic acid.

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

Dosage

The tablet or its part will be ingested without chewing, with the help of a little liquid. Your doctor will prescribe the alprazolam presentation most suitable for you, according to the dose you need.

The recommended doses are as follows:

• The initial dose is 0.25 mg to 0.5 mg of alprazolam three times a day.
• The usual dose ranges from 0.5 mg to a maximum of 4 mg per day, divided into 2 or 3 doses.

In elderly patients, with chronic respiratory insufficiency, liver or kidney impairment, the recommended initial dose is 0.25 mg of alprazolam, 2 or 3 times a day, with a total daily dose of 0.5 mg to 0.75 mg in divided doses, which can be gradually increased as needed and well tolerated.

Each individual dose should not exceed the indicated limits, and the total daily dose should not either, unless your doctor indicates otherwise.

Duration and discontinuation of treatment

The maximum duration of treatment should not exceed 2-4 weeks. Long-term treatment is not recommended. If your doctor considers that in your case it is necessary to prolong the treatment, they will do so for limited periods and will frequently monitor your situation.

You should never discontinue treatment abruptly. Your doctor will indicate the duration of treatment depending on the evolution of your disease and will explain how to gradually reduce the dose until the end of treatment.

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

If you take more Alprazolam than you should

If you have taken more alprazolam than you should, consult your doctor or pharmacist immediately or go to the nearest hospital with this leaflet.

Benzodiazepine overdose generally manifests by different degrees of central nervous system depression, ranging from drowsiness to coma.

Symptoms include drowsiness (somnolence), speech disorders (dysarthria), coordination disturbances, confusion, lethargy (prolonged and deep sleep), muscle tone decrease (hypotonia), blood pressure drop, respiratory depression, rarely coma, and very rarely death. Serious sequelae are rare, unless alprazolam is taken with other medications or alcohol.

In case of overdose or accidental ingestion, consult the Toxicological Information Service Tel. 91 562 04 20, indicating the product and the amount ingested.

If you forget to takeAlprazolam

Do not take a double dose to compensate for the missed doses.If the missed dose is recent, take your dose immediately and if not, wait for the next dose without taking a double dose to compensate.

If you interrupt treatment with Alprazolam

Treatment with alprazolam can cause dependence, so when discontinuing alprazolam administration abruptly, withdrawal symptoms may appear.

The withdrawal symptoms that may occur are: headache, muscle pain, anxiety, tension, restlessness, confusion, irritability, general feeling of disgust (dysphoria), insomnia, intolerance to light, sounds, and physical contact, paresthesias and cramps in the extremities and abdomen, vomiting, sweating, tremors, depersonalization, hallucinations, and seizures. In case of this occurring, you should consult your doctor immediately.

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

Like all medicines, this medicine can cause side effects, although not everyone will experience them.

The side effects that may occur during treatment with alprazolam predominantly occur at the beginning of treatment and generally disappear with continued administration or after a reduction in dose.

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

• Depression
• Sedation, drowsiness, coordination disorder (ataxia), memory alteration, difficulty articulating words (dysarthria), dizziness, headache
• Constipation, dry mouth
• Fatigue, irritability

Common side effects(may affect up to 1 in 10 people):

• Feeling of confusion, disorientation, alteration of sexual desire (libido), anxiety, difficulty sleeping (insomnia), nervousness
• Abnormal coordination, balance alteration, difficulty concentrating, excessive sleep (hypersomnia), deep and prolonged somnolence (lethargy), tremor
• Nausea, decreased appetite
• Blurred vision
• Dermatitis
• Sexual dysfunction
• Weight changes

Rare side effects(may affect up to 1 in 100 people):

• Memory loss (amnesia)
• Mental and behavioral disorders (mania), hallucinations, anger reactions, agitation, dependence
• Loss of muscle strength
• Inability to retain urine in the bladder (urinary incontinence)
• Irregular menstruation
• Withdrawal symptoms

Unknown frequency(cannot be estimated from available data):

• Increased levels of prolactin in the blood (hormone responsible for stimulating and maintaining lactation after childbirth)
• Mental and behavioral disorders (hypomania), aggression, hostility, abnormal thinking, psychomotor hyperactivity, drug abuse
• Autonomic nervous system imbalance, involuntary muscle contractions (dystonia)
• Gastrointestinal disorder, hepatitis, liver function alteration, yellowing of the skin and white of the eyes (jaundice)
• Peripheral edema
• Angioedema (swelling under the skin's surface)
• Phototoxicity (exaggerated response to light)
• Urinary retention in the bladder
• Increased intraocular pressure

With the use of benzodiazepines, the following may occur:

• Somnolence, lack of reaction to emotional stimuli (emotional numbing), reduced state of alertness, confusion, fatigue, headache, dizziness, muscle weakness, ataxia, or double vision. These phenomena occur predominantly at the beginning of treatment and generally disappear with continued administration. Occasionally, gastrointestinal alterations, changes in sexual desire, or skin reactions may occur.
• A memory loss (amnesia) may develop, which may be associated with inappropriate behavior.
• The use of benzodiazepines may unmask an existing depression.
• When using benzodiazepines or similar compounds, reactions such as restlessness, agitation, irritability, aggression, delirium, anger attacks, nightmares, hallucinations, psychosis, inappropriate behavior, and other conduct alterations may occur. These reactions can be severe and occur more frequently in children and the elderly.
• The administration of the product (even at usual doses) may lead to the development of physical dependence. Discontinuation of treatment may lead to the development of withdrawal or rebound phenomena. Psychological dependence may occur. Cases of abuse have been reported.

Reporting of side 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 side effects, you can contribute to providing more information on the safety of this medicine.

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

Do not store above 86°F (30°C).

Store in the original packaging to protect it from light.

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

Medications should not be disposed of through drains or in the trash. Dispose of packaging and unused medications at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of unused packaging and medications. By doing so, you will help protect the environment.

Composition of Alprazolam pensa

• The active ingredient is alprazolam. Each tablet contains 0.50 mg of alprazolam.
• The other components (excipients) are lactose, microcrystalline cellulose (E-460i), sodium docusate, sodium benzoate, colloidal silicon dioxide (E-551), cornstarch, magnesium stearate (E-572), and yellow FDC No. 6 lacquer (E-110)

Appearance of the product and content of the packaging

Alprazolam pensa 0.50 mg tablets are presented in the form of scored orange-colored tablets in containers holding 30 tablets.

Other presentations

Alprazolam pensa 0.25 mg tablets: Container holding 30 tablets.

Alprazolam pensa 1 mg tablets: Container holding 30 tablets.

Holder of the marketing authorization and responsible for manufacturing

Holder of the marketing authorization

Towa Pharmaceutical, S.A.

C/ de Sant Martí, 75-97

08107 Martorelles (Barcelona)

Spain

Responsible for manufacturing

Towa Pharmaceutical Europe, S.L.

C/ de Sant Martí 75-97

08107 Martorelles (Barcelona)

Spain

Last review date of this prospectus: November 2022

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