Label: information for the user

CARDYL 20mg film-coated tablets

atorvastatina

Read this label carefully before starting to take this medicine,because it contains important information for you.

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

1.What Cardyl is and for what it is used

2.What you need to know before starting to take Cardyl

3.How to take Cardyl

4.Possible adverse effects

5.Storage of Cardyl

6.Contents of the package and additional information

Cardyl belongs to a group of medications known as statins, which aremedications that regulate lipidlevels (fats).

Cardyl is used to reduce lipids such as cholesterol and triglycerides in the blood when a low-fat diet and lifestyle changes on their own have failed.If you have a high risk of heart disease,Cardylmay also be used to reduce this risk even if your cholesterol levels are normal. During treatment, a standard low-cholesterol dietmust be followed.

Do not take Cardyl

• if you are allergic to atorvastatin or any of the other ingredients of this medicine (listed in section 6).
• if you have or have had any liver disease.
• if you have or have had abnormal liver function test results.
• if you are a fertile woman and do not use adequate contraceptive measures.
• if you are pregnant or trying to become pregnant.
• if you are breastfeeding.
• if you are taking the combination of glecaprevir/pibrentasvir for the treatment of hepatitis C.

Warnings and precautions

Consult your doctor, pharmacist or nurse before starting to take Cardyl.

• if you have severe respiratory insufficiency.
• if you are taking or have taken within the last 7 days a medicine called fusidic acid (a medicine used to treat bacterial infections) by mouth or injection. The combination of fusidic acid and Cardyl may cause severe muscle problems (rhabdomyolysis).
• if you have had a previous stroke with bleeding in the brain, or have small fluid collections in the brain due to previous strokes.
• if you have kidney problems.
• if you have a thyroid gland with low activity (hypothyroidism).
• if you have repeated or unjustified muscle pain, personal or family history of muscle problems.
• if you have had muscle problems during previous treatment with other medicines to reduce lipids (e.g. with another statin or fibrates).
• if you regularly drink large amounts of alcohol.
• if you have a history of liver problems.
• if you are over 70 years old.
• if you have or have had myasthenia (a disease that causes generalized muscle weakness that, in some cases, affects the muscles used for breathing) or ocular myasthenia (a disease that causes weakness of the eye muscles), as statins may sometimes worsen the disease or cause myasthenia (see section 4).

In any of these cases, your doctor may instruct you to have blood tests before and possibly during treatment with Cardyl to predict the risk of adverse effects related to muscle. It is known that the risk of adverse effects related to muscle (e.g. rhabdomyolysis) increases when certain medicines are taken at the same time (see section 2 “Use of Cardyl with other medicines”).

Also inform your doctor or pharmacist if you experience persistent muscle weakness. Further tests and additional medications may be necessary to diagnose and treat this problem.

While taking this medicine, your doctor will check if you have diabetes or are at risk of developing diabetes. This risk of diabetes increases if you have high levels of sugars and fats in your blood, overweight and high blood pressure.

Other medicines and Cardyl

Inform your doctor or pharmacist if you are taking, have taken recently or may need to take any other medicine. There are some medicines that may affect the proper functioning of Cardyl or the effects of these medicines may be modified by Cardyl. This type of interaction may reduce the effect of one or both medicines. Alternatively, this combined use may increase the risk or severity of adverse effects, including the important muscle deterioration, known as rhabdomyolysis described in section 4:

• Medicines used to modify the functioning of your immune system, e.g. ciclosporin.
• Certain antibiotics or antifungal medicines, e.g. erythromycin, clarithromycin, telithromycin, ketoconazole, itraconazole, voriconazole, fluconazole, posaconazole, rifampicin, fusidic acid.
• Other medicines to regulate lipid levels, e.g. gemfibrozil, other fibrates, colestipol.
• Some calcium channel blockers used in the treatment of angina or hypertension, e.g. amlodipine, diltiazem; medicines to regulate your heart rhythm, e.g. digoxin, verapamil, amiodarone.
• Letermovir, a medicine that helps prevent diseases caused by cytomegalovirus.
• Medicines used in the treatment of HIV/AIDS, e.g. ritonavir, lopinavir, atazanavir, indinavir, darunavir, tipranavir combined with ritonavir, etc.
• Other medicines known to interact with Cardyl include ezetimibe (which reduces cholesterol), warfarin (which reduces blood clotting), oral contraceptives, and stiripentol (an anticonvulsant for treating epilepsy), cimetidine (used for heartburn and stomach ulcers), phenazone (a painkiller), colchicine (used for treating gout) and antacids (products for indigestion containing aluminium or magnesium)

• Over-the-counter medicines: St. John's Wort.
• If you need to take oral fusidic acid to treat a bacterial infection, you will need to stop taking this medicine temporarily. Your doctor will instruct you when it is safe to restart treatment with Cardyl. Taking Cardyl in combination with fusidic acid may rarely cause muscle weakness, tenderness or pain (rhabdomyolysis). For more information on rhabdomyolysis, see section 4.
• Daptomycin (a medicine used to treat skin and soft tissue infections and bacteria present in the blood).

Taking Cardyl with food, drinks and alcohol

See section 3 for instructions on how to take Cardyl. Please note the following:

Orange juice

Do not take more than one or two small glasses of orange juice per day as large amounts of orange juice may alter the effects of Cardyl.

Alcohol

Avoid drinking large amounts of alcohol while taking this medicine. See details in section 2 “Warnings and precautions”.

Pregnancy, breastfeeding and fertility

Do not take Cardyl if you are pregnant, think you may be pregnant or intend to become pregnant.

Do not take Cardyl if you are fertile and do not use adequate contraceptive measures.

Do not take Cardyl if you are breastfeeding your child.

Cardyl has not been shown to be safe during pregnancy and breastfeeding.

Consult your doctor or pharmacist before using any medicine.

Driving and operating machinery

This medicine usually does not affect your ability to drive or operate machinery. However, do not drive if this medicine affects your ability to drive. Do not operate tools or machinery if this medicine affects your ability to operate them.

Cardyl contains lactose

If your doctor has told you that you have a certain sugar intolerance, consult with him before taking this medicine.

Cardyl contains sodium

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

Cardyl contains benzoic acid

This medicine contains 0.00008 mg of benzoic acid per tablet.

Before starting treatment, your doctor will put you on a low-cholesterol diet, which you must also follow during treatment with Cardyl.

The usual initial dose of Cardyl is 10 mg once a day in adults and children aged 10 years and above. Your doctor may increase it if necessary to reach the dose you need. Your doctor will adjust the dose at intervals of 4 weeks or more. The maximum dose of Cardyl is 80 mg once a day.

Cardyl tablets should be swallowed whole with a glass of water and can be taken at any time of the day with or without food. However, try to take your tablet every day at the same time.

Follow exactly the administration instructions for this medication indicated by your doctor or pharmacist. If in doubt, consult your doctor or pharmacist again.

Your doctor will decide the duration of treatment with Cardyl.

Ask your doctor if you think the effect of Cardyl is too strong or too weak.

If you take more Cardyl than you should

If you accidentally take too many Cardyl tablets (more than your usual daily dose), consult your doctor or the nearest hospital or call the Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount taken. Bring the remaining tablets, the packaging, and the complete box so that the hospital staff can easily identify the medication you have taken.

If you forget to take Cardyl

If you forget to take a dose, take the next scheduled dose at the correct time. Do not take a double dose to compensate for the missed doses.

If you interrupt treatment with Cardyl

If you have any other questions about the use of this medication or want to interrupt treatment, ask your doctor or pharmacist.

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

If you notice any of the following side effects or severe symptoms, stop taking these tablets and inform your doctor immediately or visit the nearest hospital emergency service.

Rare: may affect up to 1 in 1,000 people

• Severe allergic reaction causing swelling of the face, tongue, and throat that may cause severe difficulty breathing.

• Severe disease with severe peeling and inflammation of the skin; blisters on the skin, mouth, genitals, and eyes, and fever. Skin rash with pink-red spots, especially on the palms of the hands or soles of the feet that may form blisters.

• Muscle weakness, pain on palpation, Pain, urine discoloration or brownish-red color, and especially if you have discomfort or high fever, it may be due to abnormal muscle breakdown (rhabdomyolysis). Abnormal muscle breakdown may not always disappear, even after stopping atorvastatin, and may be fatal and cause kidney problems.

Very rare: may affect up to 1 in 10,000 people

• If you experience unexpected or unusual bleeding or bruising, this may suggest liver problems. You should consult your doctor as soon as possible.
• Lupus-like syndrome (including rash, joint disorders, and effects on blood cells).

Other possible side effects with Cardyl

Frequent: may affect up to 1 in 10 people

• inflammationof the nasal passages, sore throat, nasal bleeding
• allergic reactions
• increases in blood sugar levels (if you are diabetic, monitor your blood sugar levels), increasedcreatine kinasein blood
• headache
• nausea, constipation, gas, indigestion, diarrhea
• joint pain, muscle pain, and back pain
• abnormal blood test results that may show abnormal liver function

Infrequent: may affect up to 1 in 100 people

• anorexia (loss of appetite), weight gain, decreased blood sugar levels (if you are diabetic, continue to carefully monitor your blood sugar levels)
• nightmares, insomnia
• dizziness, numbness or tingling in the fingers of the hands and feet, reduced sensitivity to pain or touch, changes in taste, memory loss
• blurred vision
• ringing in the ears and/or head
• vomiting, belching, upper and lower abdominal pain, pancreatitis (inflammation of the pancreas that causes stomach pain)
• hepatitis (inflammation of the liver)
• rash, skin rash, and itching, hives, hair loss
• neck pain, muscle fatigue
• fatigue, feeling unwell, weakness, chest pain, inflammation, especially in the ankles (edema), increased temperature
• positive urine tests for white blood cells

Rare:may affect up to 1 in 1,000 people

• vision changes
• unexpected or unusual bleeding or bruising
• cholestasis (yellowing of the skin and white of the eyes)
• tendon injury
• skin rash or ulcers in the mouth (drug reaction)
• skin lesions of purple color (signs of inflammation of blood vessels, vasculitis)

Very rare:may affect up to 1 in 10,000 people

• allergic reaction - symptoms may include sudden hissing while breathing and chest pain or pressure, swelling of the eyelids, face, lips, mouth, tongue, or throat, difficulty breathing, collapse
• hearing loss
• gynecomastia (breast enlargement in men)

Frequency unknown: cannot be estimated from available data:

• constant muscle weakness
• myasthenia gravis (a disease that causes generalized muscle weakness that, in some cases, affects the muscles used for breathing)
• ocular myasthenia (a disease that causes weakness of the eye muscles)

Consult your doctor if you experience weakness in the arms or legs that worsens after periods of activity, double vision or eyelid drooping, difficulty swallowing or difficulty breathing.

The possible side effects of some statins (medicines of the same type):

• sexual difficulties
• depression
• respiratory problems such as persistent cough and/or difficulty breathing or fever
• diabetes. It is more likely if you have high blood sugar and fat levels, obesity, and high blood pressure. Your doctor will monitor you while taking this medication

Reporting 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 prospectus. 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 usethis medicationafter the expiration date that appears on the blister pack and on the packaging after “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. Ask your pharmacist how to dispose of the packaging and medications you no longer need. By doing so, you will help protect the environment.

Cardyl Composition

• The active ingredient is atorvastatina.

Each film-coated tablet contains 20 mg of atorvastatina (as atorvastatina calcium trihydrate).

• The other components (excipients) are:

calcium carbonate, microcrystalline cellulose, lactose monohydrate, sodium croscarmellose, polisorbate 80, hydroxypropylcellulose, and magnesium stearate.

The coating of Cardyl contains hypromellose, macrogol 8000, titanium dioxide (E 171), talc, simethicone emulsion containing simethicone, emulsifying agents (polysorbate 65, magnesium stearate, glyceryl monostearate 40-55), thickeners (methylcellulose, xanthan gum), benzoic acid (E 210), sorbic acid, and sulfuric acid.

Product Appearance and Packaging Contents

Cardyl 20 mg film-coated tablets are white, round, and have a diameter of 7.1 mm. They are marked with 20 on one side and with “ATV” on the other side.

Blister packs are formed by a polyamide/aluminum foil/polyvinyl chloride front part and an aluminum foil/vinyl thermosetting coating back part.

The bottle is made of HDPE, contains a desiccant, and has a child-resistant “push and turn” closure.

Cardyl 20 mg is presented in cartons with blister packs containing 4, 7, 10, 14, 20, 28, 30, 50, 56, 60, 84, 90, 98, and 100 film-coated tablets, and in clinical packs containing 50, 84, 100, 200 (10 x 20), or 500 film-coated tablets, and bottles containing 90 film-coated tablets.

Only some package sizes may be commercially available.

Marketing Authorization Holder and Responsible Manufacturer

Marketing Authorization Holder

Viatris Healthcare Limited

Damastown Industrial Park

Mulhuddart, Dublin 15

Dublin

Ireland

Responsible Manufacturer

Pfizer Manufacturing Deutschland GmbH

Mooswaldallee 1

79108 Freiburg Im Breisgau

Germany

or

A. Menarini Manufacturing Logistics and Services, s.r.l.

Via Campo di Pile

67100 L'Aquila

Italy

or

Menarini-Von Heyden GmbH

Leipziger Strasse 7-13

01097 Dresden

Germany

or

Mylan Hungary Kft.

Mylan utca 1

Komárom, 2900

Hungary

For more information about this medication, please contact the local representative of the marketing authorization holder:

Viatris Pharmaceuticals, S.L.U.

Calle General Aranaz, 86

28027 Madrid

Spain

Last review date of this leaflet: October 2024

For detailed information about this medication, please visit the website of the Spanish Agency of Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/