Leaflet: information for the user

Crisomet 50 mg chewable/dispersible tablets

lamotrigine

Read this leaflet carefully before you start taking this medicinebecause it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do 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.

1.What is Crisomet and what it is used for

2.What you need to know before you start taking Crisomet

3.How to take Crisomet

4.Possible side effects

5.Storage of Crisomet

6.Contents of the pack and additional information

Crisomet belongs to a group of medications known asantiepilepticdrugs. It can be used to treat two diseases: epilepsy and bipolar disorder.

Crisomet is used to treat epilepsy becauseit blocks the signals in the brain that trigger epileptic seizures (attacks).

• In adults and children 13 years of age and older, Crisomet can be used alone or in combination with other medications to treat epilepsy. Crisomet can also be used with other medications to treat seizures caused by a condition called Lennox-Gastaut Syndrome.
• In children between 2 and 12 years of age, Crisomet can be used in combination with other medications to treat the same diseases. It can also be used without combining with other medications to treat a type of epilepsy called typical absence seizures.

Crisomet is also used to treat bipolar disorder.

People with bipolar disorder (formerly known as manic-depressive disorder) experience radical mood swings, with periods of mania (excitement or euphoria) alternating with periods of depression (deep sadness or desperation). In adults 18 years of age and older, Crisomet can be used to prevent the periods of depression that occur in bipolar disorder, either alone or in combination with other medications. The exact mechanism of action of Crisomet in the brain is not known.

Do not take Crisomet:

• if you are allergic(hypersensitive) to lamotrigine or any of the other ingredients inthis medicine(including those listed in section 6).

If this is the case:

?Inform your doctorand do not take Crisomet.

Warnings and precautions

Be especially careful with Crisomet

Consult your doctor or pharmacist before startingto take Crisomet:

• if you have any kidney problems
• if you have ever had a skin eruptionafter taking lamotrigine or other medicines for bipolar disorder or epilepsy
• if you suffer from skin eruptions or sunburn after taking lamotrigine and exposure to the sun or artificial light (for example, in a solarium). Your doctor will check your treatment and may advise you to avoid sunlight or protect yourself from the sun (for example, use a sun protection cream and/or protective clothing)
• if you have ever had meningitis after taking lamotrigine(read the description of these symptoms in section 4 of this leaflet:Very rare side effects)
• if you are already taking medicines that contain lamotrigine
• if you have a condition called Brugada Syndrome or other heart problems.Lamotrigine may cause abnormalities in the electrocardiogram (ECG) that can lead to arrhythmias (abnormal heart rhythm).

If this is the case:

?Inform your doctor, who will decide to reduce the dose or determine that Crisomet is not suitable for you.

Important information about potentially life-threatening reactions

A small number of people taking Crisomet have had allergic reactions or skin reactions thatpotentiallycan be life-threatening, which can lead to more serious problems if not treated.These reactions may include Stevens-Johnson syndrome (SSJ), toxic epidermal necrolysis (NET), and drug reaction with eosinophilia and systemic symptoms (DRESS).It is essential that you know the symptoms of these reactions andbe aware of them while taking Crisomet.This risk may be associated with a genetic variant in people of Asian origin (mainly Chinese Han and Thai). If you are of such origin and have been detected with this genetic variant (HLA-B*1502), talk to your doctor before taking Crisomet.

?Read the description of these symptoms in section 4 of this leaflet“Reactions that potentially can be life-threatening: consult your doctor immediately”.

Lymphohistiocytosis hemophagocytic (LHH)

Cases of a rare but severe immune system reaction have been reported in patients taking lamotrigine.

• Contact your doctor or pharmacist immediatelyif you experience any of the following symptoms while taking lamotrigine: fever, rash, neurological symptoms (e.g., spasms or tremors, confused state, cerebral function alterations).

Thoughts of self-harm or suicide

Antiepileptic drugs, including Crisomet, are used to treat various conditions, including epilepsy and bipolar disorder. People with bipolar disorder mayoccasionallyhave thoughts of self-harm or suicide.If you have bipolar disorder, you may be more likely to have these thoughts in the following situations:

• when starting treatment
• if you have had thoughts of self-harm or suicide before
• if you are under 25 years old.

?Consult your doctor as soon as possible or go to the nearest hospital.

It may be helpful for you to explain to a family member, carer, or close friend that you may become depressed or experience significant mood changes, and ask them to read this leaflet. You can ask them to tell you if they are concerned about your depression or other changes in your behavior.

A reduced number of people who were treated with antiepileptic drugs like Crisomet have also had thoughts of self-harm or suicide. If you ever have these thoughts, contact your doctor immediately.

If you are taking Crisomet for epilepsy

Seizures in some types of epilepsy may occasionally worsen or occur more frequently while taking Crisomet. Some patients may experience severe seizures, which can cause serious health problems. If seizures occur more frequently or if you experience severe seizures while taking Crisomet:

?Go to a doctor immediately.

Crisomet should not be administered to children under 18 years for the treatment of bipolar disorder. Medicines used to treat depression and other mental health problems increase the risk of suicidal thoughts and behaviors in children and adolescents under 18 years.

Other medicines and Crisomet

Inform your doctor or pharmacist if you are taking, have taken recently, ormay have to takeany othermedicine,including herbal medicinesor other medicines obtained without a prescription.

Your doctor needs to know if you are taking other medicines for the treatment of epilepsy or mental health problems. This is to ensure that you take the correct dose of Crisomet. These medicines include:

• oxcarbazepine, felbamate, gabapentin, levetiracetam, pregabalin, topiramate, or zonisamide, used for the treatment ofepilepsy
• lithium, olanzapine, or aripiprazole, used for the treatment ofmental health problems
• bupropion, used for the treatment ofmental health problemsor toquit smoking
• paracetamol,used to treatpainandfever.

?Inform your doctorif you are using any of these medicines.

Some medicines interact with Crisomet or make people more likely to have side effects. These include:

• valproate, used for the treatment ofepilepsyandmental health problems
• carbamazepine, used for the treatment ofepilepsyandmental health problems
• phenytoin, primidone, or phenobarbital, used for the treatment ofepilepsy
• risperidone, used for the treatment ofmental health problems
• rifampicin, which is anantibiotic
• medicines used to treat HIV infection (a combination of lopinavir and ritonavir or atazanavir and ritonavir)
• hormonal contraceptives, such asthe pillcontraceptive(see below).

?Inform your doctorif you are using any of these medicines, or if you start or stop using any of these medicines.

Hormonal contraceptives (such as the pill) may affect the way Crisomet works.

Your doctor may recommend a specific hormonal contraceptive or suggest using a different contraceptive method, such as condoms, diaphragm, or IUD. If you are taking a hormonal contraceptive, such as the pill, your doctor may perform a blood test to check your Crisomet levels. If you are using a hormonal contraceptive or plan to start using one:

?Consult your doctor, who will advise you on the most suitable contraceptive methods for you.

Crisomet may also affect the way hormonal contraceptives work, although it is unlikely to reduce their effectiveness. If you are using a hormonal contraceptive and notice changes in your menstrual cycle, such as intermenstrual bleeding or loss between periods:

?Inform your doctor. These may be signs that Crisomet is affecting the way your contraceptive works.

Pregnancy and breastfeeding

?If you are pregnant, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine.

• Do not stop your treatment without consulting your doctor. This is particularly important if you have epilepsy.
• Pregnancy may modify the effectiveness of Crisomet treatment, so you may need to have a blood test and have your dose adjusted.
• If Crisomet is taken during the first 3 months of pregnancy, there may be a small increase in the risk of birth defects, including cleft lip and/or palate.
• Your doctor may advise you to take folic acid supplements if you are planning to become pregnant and also during pregnancy.

?If you are breastfeeding or plan to start breastfeeding, consult your doctor or pharmacist before using this medicine.Crisomet passes into breast milk and may affect your baby. Your doctor will discuss the risks and benefits of breastfeeding while taking Crisomet and will perform regular checks on your baby if you decide to start breastfeeding, as your baby may experience drowsiness, rash, or poor weight gain. Inform your doctor if you observe any of these symptoms in your baby.

Driving and using machines

Crisomet may cause dizziness and double vision.

?Do not drive or use machines unless you are sure you do not feel these effects.

If you have epilepsy, consult your doctor about the possibility of driving or using machines.

Important information about one of the components of Crisomet

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

Follow exactly the administration instructions of this medication as indicated by your doctor or pharmacist.Consult your doctor or pharmacist again in case of doubt.

How much Crisomet to take

It may take some time for your doctor to find the most appropriate dose of Crisomet for you. The dose you should take will depend on:

• your age
• whether you are taking Crisomet with other medications
• whether you have any liver or kidney problems.

Your doctor will prescribe a low dose at the beginning of treatment and gradually increase the dose over several weeks to reach the most appropriate dose for you (called the effective dose).Never take more Crisomet than your doctor has indicated.

Normally, the effective dose of Crisomet for adults and children 13 years of age and older is between 100 mg and 400 mg per day.

For children between 2 and 12 years of age, the effective dose depends on their body weight, usually between 1 mg and 15 mg per kilogram of the child's weight, up to a maximum maintenance dose of 200 mg per day.

Crisomet is not recommended for children under 2 years of age.

How to take the Crisomet dose

Take your Crisomet dose one or two times a day, as advised by your doctor. They can be taken with or without food.

• Always take the complete dose that your doctor has prescribed. Never take part of the tablet.

Your doctor may advise you to start or stop taking other medications, depending on the condition being treated and how you respond to treatment.

Crisomet chewable/dispersible tablets can be swallowed whole with a little water, chewed, or water added to dissolve them.Never take just a part of the liquid.

Removing a tablet:

These tablets come in a special container to prevent children from getting them.

Each unit of the blister pack has a number. Take each tablet in order, starting with the tablet number 1.

1. Separate a tablet:scratch along the cutting line to separate one of the units from the blister pack.

1. Remove the outer layer:starting from a corner, lift and remove the sheet that covers the unit.

1. Remove the tablet:gently press one side of the tablet through the sheet to extract it.

Chew the tablet:

You may need to drink a little water to help the tablet dissolve in your mouth. After swallowing it, drink a little more water to make sure you have taken the entire medication.

To dissolve the medication:

• put the tablet in a glass containing enough water to cover the entire tablet
• shake to dissolve or wait until the tablet is completely dissolved
• drink all the liquid
• add a little more water to the glass and drink to make sure there is no medication left in the glass.

If you take more Crisomet than you should

?In case of overdose or accidental ingestion, contact your doctor, pharmacist, or call the Toxicological Information Service, phone: 91 562 04 20 indicating the medication and the amount ingested.

If you take more Crisomet than you should, you may be more prone to severe side effects that can be fatal.

Someone who has taken too much Crisomet may have some of the following symptoms:

• rapid and uncontrolled eye movements (nystagmus)
• clumsiness and loss of coordination, affecting balance (ataxia)
• changes in heart rhythm (usually detected with an ECG)
• loss of consciousness, seizures, or coma.

If you forgot to take a dose of Crisomet

?Do not take a double dose to compensate for the missed doses.Take the next dose at the usual time.

In case of forgetting multiple doses of Crisomet

?Ask your doctor for advice on how to start treatment again.It is essential to do this.

Do not stop taking Crisomet without consulting your doctor

You must take Crisomet for as long as your doctor recommends. Do not stop taking it unless your doctor advises you to.

If you are taking Crisomet for epilepsy treatment

To stop taking Crisomet, it is essential to gradually reduce the dose over approximately 2 weeks. If you stop taking Crisomet suddenly, you may experience a relapse of the epilepsy symptoms or the condition may worsen.

If you are taking Crisomet for bipolar disorder

Crisomet may take time to act, so it is unlikely that you will feel better immediately. If you stop taking Crisomet, you do not need to gradually reduce your dose. However, before interrupting treatment with Crisomet, you should consult your doctor.

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

Reactionsthatpotentiallycan threaten life:consult yourdoctor immediately.

A reduced number of people taking Crisomet have allergic reactions or skin reactions that potentiallycan threaten their life, which can lead to more serious problems if not treated.

It is more likely that these symptoms will appear during the first months of treatment with Crisomet, especially if the initial dose is very high or if the dose increase is very rapid, or if you are taking Crisomet with another medicine calledvalproate. Some of these symptoms are more common in children, so parents should pay special attention.

The symptoms of these reactions include:

• skin rashes or redness, which can lead to skin reactionsthat can be serious or, in some cases, potentially life-threatening, including rash with lesions in the shape of a target (erythema multiforme),widespread rash with blisters andpeeling of theskin, which occurs especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome), peelingin a large area of the skin(more than 30% of the body surface –toxic epidermal necrolysis)or widespread skin rash with liver, blood, and other organ involvement (pharmacological reaction with eosinophilia and systemic symptoms also known as drug reaction with eosinophilia and systemic symptoms (DRESS))
• mouth ulcers, throat, nose, or genital ulcers
• eye pain or having red or swollen eyes (conjunctivitis)
• high temperature (fever), symptoms similar to the flu or drowsiness (somnolence)
• swelling around the face, or inflammationof the lymph nodesin the neck, armpits, or groin
• unexplained bleeding or bruising, or fingers turning blue
• throat pain or having more infections than usual (such as colds)
• increased levels of liver enzymes in blood tests
• increased levels of a type of white blood cell (eosinophils)
• enlarged lymph nodes
• organ damage, including the liver and kidneys.

In many cases, these symptoms can be signs of less severe side effects.But you should be aware that they potentiallycan threaten lifeand can lead to more serious problems, such as organ failure, if not treated. If you notice any of these symptoms:

?Contact your doctor immediately. Your doctor will decide if you need to undergo tests to evaluate the function of the liver, kidneys, or blood and may instruct you to stop taking Crisomet.If you have developed Stevens-Johnson syndrome or toxic epidermal necrolysis, your doctor will instruct you never to take lamotrigine again.

Lymphohistiocytosis hemophagocytic (LHH)(see section 2. What you need to know before starting to take Crisomet).

Very common side effects

These affectmore than 1 in 10people:

• headache
• skin rash.

Common side effects

These affectup to 1 in 10people:

• aggression or irritability
• feeling sleepy or drowsy
• feeling dizzy
• spasms or tremors
• difficulty sleeping (insomnia)
• feeling agitated
• diarrhea
• dry mouth
• nausea or vomiting
• feeling tired
• back, joint, or other pain.

Rare side effects

These can affectup to 1 in 100people:

• clumsiness and loss of coordination (ataxia)
• double vision or blurred vision
• hair loss or thinning (alopecia)
• skin rash or sunburn after exposure to the sun or artificial light (photosensitivity).

Very rare side effects

These can affectup to 1 in 10,000people:

• a skin reaction that can be life-threatening (toxic epidermal necrolysis) (see also the information at the beginning of section 4)
• drug reaction with eosinophilia and systemic symptoms (DRESS) (see also the information at the beginning of section 4)
• high temperature (fever) (see also the information at the beginning of section 4)
• swelling around the face (edema) or inflammation of the lymph nodes in the neck, groin, or armpits (lymphadenopathy) (see also the information at the beginning of section 4)
• liver function changes, which can be seen in blood tests, or liver failure (see also the information at the beginning of section 4)
• severe blood clotting disorder, which can cause bleeding or unexpected bruising (disseminated intravascular coagulation) (see also the information at the beginning of section 4)
• lymphohistiocytosis hemophagocytic (LHH) (see section 2. What you need to know before starting to take Crisomet)
• blood test changes, including a reduced number of red blood cells (anemia), a reduced number of white blood cells (leucopenia, neutropenia, agranulocytosis), a reduced number of platelets (thrombocytopenia), a reduced number of all types of blood cells (pancytopenia), and a bone marrow disorder called aplastic anemia
• hallucinations (hearing or seeing things that are not really there)
• confusion
• feeling insecure or unstable when moving
• repeated body movements or uncontrollable sounds or words (tics), uncontrollable muscle spasms affecting the eyes, head, and torso (coreoatetosis), or other unusual movements such as twitching, spasms, or rigidity
• in people with epilepsy,more frequent seizures
• in people with Parkinson's disease, worsening of symptoms
• reaction similar to lupus(symptoms can include: back or joint pain, which can sometimes be accompanied by fever and/or generalized illness).

Other side effects

Otherside effects have appeared in a small number of people, but the exact frequencyis unknown:

• bone changes, including osteopenia and osteoporosis (bone thinning) and fractures. Consult your doctor or pharmacist if you have taken antiepileptics for a long time, if you have a history of osteoporosis, or if you are taking steroids
• inflammation of the kidney (interstitial nephritis) or inflammation of the kidney and eye (acute interstitial nephritis and uveitis)
• nightmares
• reduced immunity, due to a decrease in the levels of antibodies called immunoglobulins in the blood that help protect against infection
• red or brown spots on the skin (pseudolymphoma).

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 leaflet. You can also report them directly through theSpanish System for Pharmacovigilance of Medicines for Human Use:www.notificaRAM.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.

Keepthis medicationout of the sight and reach of children.

Do not usethis medicationafter the expiration date that appears on theblister pack, containeror bottle. The expiration date is the last day of the month indicated.

Crisomet does not require special storage conditions.

Medications should not be disposed of through drains or in the trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at your 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 Crisomet 50 mg chewable/dispersible tablets

The active ingredient is lamotrigine. Each chewable/dispersible tablet contains 50 mg of lamotrigine.

The other components are: calcium carbonate, low-substitution hydroxypropylcellulose, aluminium magnesium silicate, sodium carboxymethylcellulose (Type A) from potato, povidone K30, sodium saccharin, magnesium stearate, blackcurrant flavoring.

Appearance of the product and contents of the packaging of Crisomet chewable/dispersible tablets

Crisomet chewable/dispersible tablets are white to off-white in color and may be slightly speckled. The tablets have a blackcurrant odor.

Crisomet 50 mg chewable/dispersible tablets are square with rounded corners. The tablets show the inscription “GSCX7” engraved on one face and the inscription “50” on the other face. Each pack contains blister packs of 56 tablets.

Holder of the marketing authorization and responsible for themanufacturing

Holder of the marketing authorization:

GlaxoSmithKline, S.A.

P.T.M.C/ Severo Ochoa, 2

28760 Tres Cantos (Madrid)

Tel: +34 900 202 700

[email protected]

Responsible for the manufacturing:

Delpharm Poznan Spólka Akcyjna

ul. Grunwaldzka 189

60-322 Poznan

Poland

Date of the last review of thisleaflet:April 2024.

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/