Leaflet:information for the user

Ferupantil90 mg film-coated tablets EFG

Ferupantil360 mg film-coated tablets EFG

deferasirox

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, ask yourdoctororpharmacist.

-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.

1.What Ferupantil is and what it is used for

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

3.How to take Ferupantil

4.Possible side effects

5Storage of Ferupantil

6.Contents of the pack and additional information

What is deferasirox

This medication contains an active ingredient called deferasirox. It is an iron chelator, a medication used to eliminate excess iron from the body (also known as iron overload). It captures and eliminates excess iron, which is then mainly excreted in the feces.

What is deferasirox used for

Repeated blood transfusions may be necessary in patients with various types of anemia (for example, thalassemia, sickle cell anemia, or myelodysplastic syndromes (MDS)). However, repeated blood transfusions can cause an accumulation of excess iron. This is because blood contains iron and the body does not have a natural way to eliminate excess iron obtained through blood transfusions. In patients with non-transfusion-dependent thalassemic syndromes, iron overload can also appear over time, mainly due to an increase in iron absorption from the diet in response to low blood cell counts. Over time, excess iron can damage important organs such as the liver and heart. Medications callediron chelatorsare used to eliminate excess iron and reduce the risk of causing damage to organs.

Deferasirox is used to treat chronic iron overload caused by frequent blood transfusions in patients with beta-thalassemia major, aged 6 years or older.

Deferasirox is also used to treat chronic iron overload when treatment with deferoxamine is contraindicated or not suitable in patients with beta-thalassemia major with iron overload caused by infrequent blood transfusions, in patients with other types of anemia, and in children aged 2 to 5 years.

Deferasirox is also used to treat patients aged 10 years or older who have iron overload associated with thalassemic syndromes, but who are not dependent on transfusions, when treatment with deferoxamine is contraindicated or not suitable.

Do not take Ferupantil

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

If this is the case, inform your doctor before taking deferasirox.Inform your doctor before taking deferasiroxIf you think you may be allergic, consult your doctor.

• if you have moderate or severe kidney disease,
• if you are currently taking any other iron chelating medicine.

Ferupantil is not recommended

• if you are in an advanced stage of myelodysplastic syndrome (SMD, reduction in blood cell production by the bone marrow) or have advanced cancer.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Ferupantil if:

• you have a kidney or liver problem,
• you have heart problems due to iron overload,
• you notice a significant decrease in the amount of urine you eliminate (sign of a kidney problem),
• you develop a severe rash, or difficulty breathing and dizziness or swelling mainly of the face and throat (signs of a severe allergic reaction, see also section 4 "Possible side effects"),
• you experience a combination of any of the following symptoms: a rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, high fever, flu-like symptoms, swollen lymph nodes (signs of a severe skin reaction, see also section 4 "Possible side effects"),
• you notice a combination of drowsiness, upper right abdominal pain, yellow or more yellow skin or eyes, and dark urine (signs of liver problems),
• you notice difficulty thinking, remembering information, or solving problems, or you are less conscious or awake or feel drowsy and weak (signs of high ammonia levels in the blood, which may be associated with liver or kidney problems, see also section 4 "Possible side effects"),
• you experience vomiting with blood and/or black stools,
• you experience frequent abdominal pain, particularly after eating or taking deferasirox,
• you experience frequent heartburn,
• you have a low platelet or white blood cell count in your blood test,
• you have blurry vision,
• you have diarrhea or vomiting.

If you are in any of these situations, inform your doctor immediately.

Control of your treatment with Ferupantil

During treatment, regular blood and urine tests will be performed. These tests will control the amount of iron in your body (blood ferritin level) to observe how the treatment with deferasirox is working. The tests will also control kidney function (blood creatinine level, presence of protein in the urine) and liver function (blood transaminase levels). Your doctor may ask you to undergo a kidney biopsy if they suspect significant kidney damage. They may also perform MRI scans to determine the amount of iron in your liver. Your doctor will take these tests into account to decide on the most suitable dose of deferasirox for you and will use these tests to decide when to stop your treatment with deferasirox.

Your vision and hearing will be checked annually during treatment as a precaution.

Other medicines and Ferupantil

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medicine. This includes in particular:

• other iron chelating medicines, which should not be taken with deferasirox,
• antacids (medicines used to treat heartburn) containing aluminum, which should not be taken at the same time of day as deferasirox,
• ciclosporin (used to prevent organ transplant rejection or for other diseases such as rheumatoid arthritis or atopic dermatitis),
• simvastatin (used to lower cholesterol levels),
• some analgesics or anti-inflammatory medicines (e.g. aspirin, ibuprofen, corticosteroids),
• oral bisphosphonates (used to treat osteoporosis),
• blood thinners (used to prevent or treat blood clots),
• hormonal contraceptives (medicines for birth control),
• bepridilo, ergotamine (used for heart problems and migraines),
• repaglinida (used to treat diabetes),
• rifampicin (used to treat tuberculosis),
• phenytoin, phenobarbital, carbamazepine (used to treat epilepsy),
• ritonavir (used to treat HIV infection),
• paclitaxel (used to treat cancer),
• theophylline (used to treat respiratory diseases such as asthma),
• clozapine (used to treat psychiatric disorders such as schizophrenia),
• tizanidine (used as a muscle relaxant),
• colestiramine (used to reduce cholesterol levels in the blood),
• busulfan (used as a pre-transplant treatment to destroy the original bone marrow before transplant).

Additional tests may be needed to control the levels of some of these medicines in the blood.

Older patients (65 years and older)

Deferasirox can be used by people over 65 years old at the same dose as other adults. Older patients may experience more side effects (especially diarrhea) than younger patients. The doctor should closely monitor side effects that may require dose adjustment.

Children and adolescents

Deferasirox can be used in children and adolescents aged 2 years and older who receive regular blood transfusions and in children and adolescents aged 10 years and older who do not receive regular blood transfusions. As the patient grows, the doctor will adjust the dose.

Deferasirox is not recommended for children under 2 years old.

Pregnancy and breastfeeding

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

Deferasirox treatment is not recommended during pregnancy unless clearly necessary.

If you are currently using oral contraceptives or patches to prevent pregnancy, you should use an additional or different contraceptive method (e.g. condom), as deferasirox may reduce the effectiveness of oral contraceptives and patches.

Deferasirox treatment is not recommended during breastfeeding.

Driving and operating machinery

If you feel dizzy after taking deferasirox, do not drive or operate tools or machinery until you feel normal again.

The treatment with deferasirox will be supervised by a doctor with experience in treating iron overload caused by blood transfusions.

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

How much Ferupantil should be taken

The dose of deferasirox is related to body weight for all patients. Your doctor will calculate the dose you need and tell you how many tablets you should take per day.

• The normal daily dose of deferasirox film-coated tablets at the start of treatment for patients who receive periodic blood transfusions is 14 mg per kilogram of body weight. Your doctor may recommend a higher or lower dose depending on your individual treatment needs.
• The normal daily dose of deferasirox film-coated tablets at the start of treatment for patients who do not receive periodic blood transfusions is 7 mg per kilogram of body weight.
• Depending on how you respond to treatment, your doctor may later adjust your treatment to a higher or lower dose.
• The maximum recommended daily dose of deferasirox film-coated tablets is:

• 28 mg per kilogram of body weight for patients who receive periodic blood transfusions,
• 14 mg per kilogram of body weight for adult patients who do not receive periodic blood transfusions,
• 7 mg per kilogram of body weight for children and adolescents who do not receive periodic blood transfusions.

Deferasirox can also be found in "dispersible" tablets. If you switch from dispersible tablets to these film-coated tablets, you will need a dose adjustment.

When to take Ferupantil

• Take deferasirox once a day, every day, at the same time with some water.
• Take deferasirox film-coated tablets on an empty stomach or with light meals.

Taking deferasirox at the same time every day will also help you remember when to take your tablets.

Patients with difficulty swallowing tablets can crush deferasirox film-coated tablets and take the powder with a soft food, such as yogurt or apple sauce (apple puree). You must consume the entire dose immediately, without saving any for later.

How long to take Ferupantil

Continue taking deferasirox every day for the time your doctor tells you.This is a long-term treatment, which may last for months or years. Your doctor will monitor your situation periodically to check that the treatment is having the desired effect (see also in section 2: "Monitoring your treatment with Deferasirox Sandoz").

If you have doubts about how long you should take deferasirox, consult your doctor.

If you take more Ferupantil than you should

If you have taken too much Ferupantil, or if someone else has taken your tablets by mistake, contact your doctor or go to the hospital immediately. Show the doctor the packaging of the tablets. You may need urgent medical treatment. You may notice effects such as abdominal pain, diarrhea, nausea, and vomiting, and kidney or liver problems, which could be serious.

In case of overdose or accidental ingestion, consult your doctor or pharmacist, go to the hospital immediately, or call the Toxicology Information Service. Phone 915 620 420, indicating the medication and the amount used. You may need medical treatment.

If you forget to take Ferupantil

If you have forgotten to take a dose, take it as soon as you remember on the same day. Take the next dose according to the normal schedule. Do not take a double dose the next day to compensate for the missed dose(s).

If you interrupt treatment with Ferupantil

Do not stop taking deferasirox unless your doctor tells you to. If you stop taking it, the excess iron will not be eliminated from your body (see also the previous section "How long to take Ferupantil").

Like all medicines, this medicine can cause side effects, although not everyone will experience them. Most side effects are mild or moderate and usually disappear within a few days or weeks of treatment.

Some side effects can be serious and require immediate medical attention.

These side effects areinfrequent(may affect up to 1 in 100 people) orrare(may affect up to 1 in 1,000 people):

• if you have a severe rash,or difficulty breathing and dizziness or swelling, especially on the face and throat (signs of a severe allergic reaction),
• if you experience a combination of any of the following symptoms: rash, skin redness, blisters on the lips, eyes, or mouth, skin peeling, high fever, flu-like symptoms, swollen lymph nodes (signs of a severe skin reaction),
• if you notice a pronounced decrease in urine volume (sign of a kidney problem),
• if you notice a combination of drowsiness, upper right abdominal pain, yellow or darker skin or eyes, and dark urine (signs of liver problems),
• if you notice difficulty thinking, remembering information, or solving problems, or are less conscious or awake, or feel drowsy and weak (signs of high ammonia levels in the blood, which may be associated with liver or kidney problems and cause changes in brain function),
• if you experience vomiting with blood and/or black stools,
• if you experience frequent abdominal pain, particularly after eating or taking deferasirox,
• if you experience frequent heartburn,
• if you experience partial loss of vision,
• if you experience intense pain in the upper abdomen (pancreatitis),

Stop taking the medicine and inform your doctor immediately.

Some side effects can be serious.

These side effects areinfrequent:

• if you experience blurry vision,
• if you lose hearing ability,

Inform your doctor as soon as possible.

Other side effects

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

• changes in kidney function tests.

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

• gastrointestinal changes, such as nausea, vomiting, diarrhea, abdominal pain, swelling, constipation, poor digestion,
• rashes,
• headaches,
• changes in liver function tests,
• itching,
• changes in urine tests (protein in urine).

If you experience any of these side effects severely, inform your doctor.

Infrequent(may affect up to 1 in 100 people):

• dizziness,
• fever,
• sore throat,
• swelling in arms and legs,
• skin color changes,
• anxiety,
• sleep disturbances,
• fatigue.

If you experience any of these side effects severely, inform your doctor.

Unknown frequency(cannot be calculated from available data):

• decrease in the number of cells involved in blood clotting (thrombocytopenia), the number of red blood cells (worsening anemia), the number of white blood cells (neutropenia) or the number of all types of blood cells (pancytopenia),
• hair loss,
• kidney stones,
• low urine production
• rupture of the stomach or intestine wall that may be painful and cause nausea
• severe pain in the upper abdomen (pancreatitis)
• abnormal levels of acid in the blood.

Reporting of side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse, 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 use this medication after the expiration date that appears on the blister and on the packaging after CAD/EXP. The expiration date is the last day of the month indicated.

Do not use any packaging that is damaged or shows signs of manipulation.

Medications should not be thrown down the drain or in the trash. Dispose of the packaging and medications you no longer need at the SIGRE collection point of the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and medications you no longer need. In this way, you will help protect the environment.

Composition of Ferupantil

• The active ingredient is deferasirox.

Ferupantil 90 mg film-coated tablets

Each tablet contains 90 mg of deferasirox.

Ferupantil 360 mg film-coated tablets

Each tablet contains 360 mg of deferasirox.

• The other components are:

in the tablet core:microcrystalline cellulose, crospovidone, magnesium stearate, povidone, poloxamer, anhydrous colloidal silica,

in the tablet coating: opadry blue:hypromellose,di oxide titanium (E171),macrogol,talcoy aluminium lake of indigotin (E132).

Appearance of the product and contents of the package

Ferupantil 90 mg film-coated tablets

Blue clear film-coated, oval, biconvex, bisected tablets with the impressions “NVR” on one face and “90” slightly inclined upwards in the middle of two curved lines on the other face. Approximate dimensions 10.7 mm x 4.2 mm.

Ferupantil 360 mg film-coated tablets

Dark blue film-coated, oval, biconvex, bisected tablets with the impressions “NVR” on one face and “360” slightly inclined upwards in the middle of two curved lines on the other face. Approximate dimensions 17 mm x 6.7 mm.

The tablets are packaged in PVC/PVDC-Aluminium blisters or PA/AL/PVC-Aluminium blisters.

Each blister contains 30, 90, 100 or 300 film-coated tablets. The multiple packs contain 300 film-coated tablets (10 packs of 30).

Only some package sizes may be marketed.

Marketing authorisation holder and responsible manufacturer

Marketing authorisation holder

Bexal Farmacéutica, S.A.

Centro Empresarial Parque Norte

Edificio Roble

C/ Serrano Galvache, 56

28033 Madrid

Spain

Responsible manufacturer

Novartis Pharma GmbH

Roonstrasse 25

90429 Nürnberg, Bayern

Germany

or

Sandoz S.R.L

7A Livezeni Street

Targu Mures, 540472

Romania

This medicinal product is authorised in the member states of the European Economic Area and in the United Kingdom (Northern Ireland) with the following names:

Last revision date of thisleaflet:March 2021

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