PATIENT INFORMATION LEAFLET

Loitin 150 mg Hard Capsules

Fluconazole

Read this leaflet carefully before you start to take 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 your doctor, pharmacist or nurse.
• 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, pharmacist or nurse, even if they are not listed in this leaflet. See section 4.

Loitinis one of the medications in the group called “antifungals”. The active ingredient is fluconazole.

Loitin is used to treat infections caused by fungi, and it may also be used to prevent the appearance of an infection byCandida. The most common cause of fungal infections is a yeast calledCandida.

Adults

Your doctor may prescribe this medication to treat the following types of fungal infections:

• Cryptococcal meningitis – a fungal infection in the brain.
• Coccidioidomycosis – a disease of the bronchopulmonary system.
• Infections caused byCandidalocated in the bloodstream, in organs of the body (e.g. heart, lungs) or in the urinary tract.
• Mucosal candidiasis – an infection that affects the mucous membrane of the mouth, throat, or associated with dental prostheses.
• Genital candidiasis – an infection of the vagina or penis.
• Skin infections – e.g. athlete's foot, ringworm, inguinal ringworm, nail infection.

Your doctor may also prescribe Loitin for:

• To prevent the recurrence of cryptococcal meningitis.
• To prevent the recurrence of mucosal infections.
• To reduce the recurrence of vaginal infections caused byCandida.
• To prevent the transmission of infections caused byCandida(if your immune system is weak and does not function properly).

Children and adolescents (0 to 17 years)

Your doctor may prescribe this medication to treat the following types of fungal infections:

• Mucosal candidiasis – an infection that affects the mucous membrane of the mouth or throat.
• Infections caused byCandidalocated in the bloodstream, in organs of the body (e.g. heart, lungs) or in the urinary tract.
• Cryptococcal meningitis – a fungal infection in the brain.

Your doctor may also prescribe Loitin for:

• To prevent the transmission of infections caused byCandida(if your immune system is weak and does not function properly).
• To prevent the recurrence of cryptococcal meningitis.

Do not take Loitin

• if you are allergic (hypersensitive) to fluconazole, other medications you have taken to treat fungal infections, or any of the other components of Loitin. Symptoms may include itching, skin redness, or difficulty breathing.
• if you are taking astemizole, terfenadine (antihistamines for treating allergies).
• if you are taking cisapride (used to treat stomach discomfort).
• if you are taking pimozide (used to treat mental illnesses).
• if you are taking quinidine (used to treat heart arrhythmias).
• if you are taking erythromycin (an antibiotic for treating infections).

Warnings and precautions

Consult your doctor or pharmacist before starting to take Loitin

- if you have liver or kidney problems.

- if you have a heart disease, including heart rhythm problems.

- if you have abnormal levels of potassium, calcium, or magnesium in your blood.

- if you experience severe skin reactions (itching, skin redness, or difficulty breathing).

- if you experience symptoms of “adrenal insufficiency”, where the adrenal glands do not produce enough of certain hormones, such as cortisol (chronic fatigue or prolonged weakness, muscle weakness, loss of appetite, weight loss, abdominal pain).

- if you have ever experienced severe skin eruptions or skin peeling, blisters, and/or mouth sores after taking Loitin.

Severe skin reactions, including drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in relation to Loitin treatment. Stop taking Loitin and seek medical attention immediately if you notice any of the symptoms related to these severe skin reactions described in section 4.

Speak with your doctor or pharmacist if the fungal infection does not improve, as alternative antifungal treatment may be necessary.

Other medications and Loitin

Inform your doctor or pharmacist if you are using, have used recently, or may need to use any other medication.

Inform your doctor immediately if you are taking astemizole, terfenadine (an antihistamine for treating allergies), cisapride (used for stomach discomfort), pimozide (used to treat mental illnesses), quinidine (used to treat heart arrhythmias), or erythromycin (an antibiotic for treating infections), as these medications should not be taken with Loitin (see section: “Do not take Loitin”).

There are some medications that may interact with Loitin.

Ensure your doctor knows if you are taking any of the following medications, as it may be necessary to adjust the dose or monitor to ensure the medications continue to have the desired effect:

• Rifampicin or rifabutin (antibiotics for infections).
• Abrocitinib (used to treat atopic dermatitis, also known as eczema).
• Alfentanil, fentanil (used as anesthetics).
• Amitriptyline, nortriptyline (used as antidepressants).
• Ampicillin B, voriconazole (antifungals).
• Medications that make blood less viscous to prevent clot formation (warfarin or similar medications).
• Benzodiazepines (midazolam, triazolam, or similar medications) used to help sleep or for anxiety.
• Carbamazepine, phenytoin (used to treat seizures).
• Nifedipine, isradipine, amlodipine, verapamil, felodipine, and losartan (for hypertension – high blood pressure).
• Olaparib (used to treat ovarian cancer).
• Ciclosporin, everolimus, sirolimus, or tacrolimus (to prevent transplant rejection).
• Cyclophosphamide, vinca alkaloids (vincristine, vinblastine, or similar medications) used to treat cancer.
• Halofantrine (used to treat malaria).
• Statins (atorvastatin, simvastatin, and fluvastatin, or similar medications) used to reduce high cholesterol levels.
• Methadone (used for pain).
• Celecoxib, flurbiprofen, naproxen, ibuprofen, lornoxicam, meloxicam, diclofenac (Nonsteroidal Anti-Inflammatory Drugs – NSAIDs).
• Oral contraceptives.
• Prednisone (steroid).
• Zidovudine, also known as AZT; saquinavir (used in patients infected with HIV).
• Medications for diabetes, such as chlorpropamide, glibenclamide, glipizide, or tolbutamide.
• Theophylline (used to control asthma).
• Tofacitinib (used to treat rheumatoid arthritis).
• Tolvaptan (used to treat hyponatremia [low sodium levels in the blood] or to slow the deterioration of kidney function).
• Vitamin A (nutritional supplement).
• Ivacaftor (alone or combined with medications used to treat cystic fibrosis).
• Amiodarone (used to treat irregular heartbeats “arrhythmias”).
• Hidroclorotiazida (diuretic).
• Ibrutinib (used to treat blood cancer).
• Lurasidone (used to treat schizophrenia).

Taking Loitin with food and drinks

You can take the medication with or without food.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before taking any medication.

If you are planning to become pregnant, it is recommended to wait one week after a single dose of fluconazole before becoming pregnant.

For longer fluconazole treatment cycles, consult your doctor about the need to use suitable contraceptive methods during treatment, which should be maintained for one week after the last dose.

You should not take Loitin if you are pregnant, think you may be pregnant, or plan to become pregnant, unless your doctor has told you to do so. If you become pregnant while taking this medication or within one week of the most recent dose, consult your doctor.

Fluconazole taken during the first or second trimester of pregnancy may increase the risk of spontaneous abortion. Fluconazole during the first trimester may increase the risk of congenital anomalies affecting the heart, bones, and/or muscles.

Cases of babies born with congenital anomalies affecting the skull, ears, and leg and arm bones have been reported in women treated for three months or more with high doses (400-800 mg daily) of fluconazole for coccidioidomycosis. The relationship between fluconazole and these cases is unclear.

You can continue breastfeeding after taking a single dose of 150 mg of Loitin. Do not continue breastfeeding if you are taking repeated doses of Loitin.

Driving and operating machinery

When driving or operating machinery, be aware that occasional dizziness or seizures may occur.

Important information about some of the components of Loitin

This medication contains a small amount of lactose (milk sugar). If your doctor has told you that you have a certain sugar intolerance, consult with them before taking this medication.

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

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

The capsules should be swallowed whole with the help of a glass of water. It is better to take your medication at the same time every day.

The following are the recommended doses of this medication for different types of infections:

Adults

Adolescents 12 to 17 years of ageold

Follow the dose indicated by your doctor (adult or pediatric dosage).

Children up to 11 years old

The maximum daily dose for children is 400 mg.

The dose will be based on the child's weight in kilograms.

Use in children 0 to 4 weeks old

Use in children 3 to 4 weeks old:

• The same dose as described in the table, but administered once every 2 days. The maximum dose is 12 mg per kg of body weight every 48 hours.

Use in children under 2 weeks old:

• The same dose as described in the table, but administered once every 3 days. The maximum dose is 12 mg per kg of body weight every 72 hours.

Geriatric patients

The usual adult dose, unless you have kidney problems.

Patients with kidney problems

Your doctor may change your dose, depending on how well your kidneys are functioning.

If you take more Loitin than you should

Taking too many capsules at once may make you feel unwell. Contact your doctor immediately or go to the nearest hospital. You can also call the Toxicology Information Service, phone 91 562 04 20, indicating the medication and the amount taken. Symptoms of a possible overdose may include hearing, seeing, feeling, and thinking things that are not real (hallucinations and paranoid behavior). It may be appropriate to initiate symptomatic treatment (with supportive measures and gastric lavage if necessary).

If you forget to take Loitin

Do not take a double dose to make up for the missed doses. If you forget to take a dose, take it as soon as you remember. If it is almost time for the next dose, do not take the missed dose.

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

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

Stop taking Loitin and seek medical attention immediately if you notice any of the following symptoms:

• generalized rash, high body temperature, and enlarged lymph nodes (DRESS syndrome or drug hypersensitivity syndrome).

Some people developallergic reactions,although severe allergic reactions are rare.If you experience any side effect, talk to your doctor or pharmacist. This includes any possible side effect not mentioned in this leaflet. If you experience any of the following symptoms,informyour doctor immediately.

• abrupt onset of wheezing, difficulty breathing, or chest tightness.
• swelling of the eyelids, face, or lips.
• itching all over the body, redness of the skin, or red spots with itching.
• skin rash.
• severe skin reactions, such as a rash that causes blisters (this can affect the mouth and tongue).

Loitin may affect your liver. Signs that indicate liver problems include:

-fatigue.

-loss of appetite.

-vomiting.

-yellowing of the skin or the white part of the eyes (jaundice).

If you experience any of these symptoms, stop taking Loitin andinform your doctor immediately.

Other side effects:

In addition, if you consider that any of the side effects you are experiencing are severe or if you notice any side effect not mentioned in this leaflet, inform your doctor or pharmacist.

Frequent side effects (may affect up to 1 in 10 patients) are:

• headache.
• stomach discomfort, diarrhea, nausea, vomiting.
• high levels of liver function tests in blood tests.
• skin rash.

Rare side effects (may affect up to1 in 100 patients) are:

• reduction in red blood cells, which can cause pale skin and weakness or difficulty breathing.
• loss of appetite.
• insomnia, numbness.
• convulsions, dizziness, feeling of spinning, tingling, pins and needles, changes in taste.
• constipation, heavy digestion, gas, dry mouth.
• muscle pain.
• liver damage and yellowing of the skin and eyes (jaundice).
• hives, blisters (pustules), itching, increased sweating.
• fatigue, general feeling of discomfort, fever.

Rare side effects (may affect up to 1 in 1000 patients) are:

• low levels of white blood cells that help us fight infections and blood cells that help stop bleeding.
• red or purple discoloration of the skin, which may be due to low platelet count, other changes in blood cells.
• changes in blood tests (high levels of cholesterol, fats).
• low levels of potassium in the blood.
• shakiness.
• abnormal electrocardiogram (ECG), changes in heart rate or rhythm.
• liver failure.
• allergic reactions (sometimes severe), including widespread rash with blisters and skin peeling, severe allergic reactions, swelling of the lips or face.
• hair loss.

Unknown frequency, but may occur (cannot be estimated from available data):

hypersensitivity reaction with skin rash, fever, swollen glands, increased eosinophils, and inflammation of internal organs (liver, lungs, heart, kidneys, and large intestine) (drug reaction or rash with eosinophilia and systemic symptoms [DRESS]).

Reporting side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse, even if it is a possible side effect not mentioned in this leaflet. You can also report them directly through the Spanish 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.

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 CAD. The expiration date is the last day of the month indicated.

No special storage conditions are required.

Do not dispose of medications through drains or 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 ofLoitin

The active ingredient is fluconazole.

Each hard capsule contains 150 mg of fluconazole.

The other components (excipients) are:

Caplet content: lactose monohydrate (lactose), pregelatinized cornstarch (cornstarch), anhydrous colloidal silica, sodium lauryl sulfate, and magnesium stearate.

Caplet composition: titanium dioxide, quinoline, and carmine lake

Appearance ofLoitin150 mg hard capsules and contents of the packaging

Loitin 150 mg is presented in the form of hard capsules. The body and head of the capsules are opaque green.

It is presented in packaging of 1 and 4 hard capsules and clinical packaging of 100 hard capsules.

Not all packaging may be marketed.

The information in this leaflet only applies to Loitin 150 mg hard capsules. For more information on other hard capsules of Loitin, or on Loitin oral powder for suspension, please read the leaflet for these products.

Other presentations

Loitin50 mg hard capsules: packaging of 7 and 500 capsules.

Loitin100 mg hard capsules: packaging of 7 and 100 capsules.

Loitin200 mg hard capsules: packaging of 7 and 100 capsules.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder:

Dari Pharma, S.L.U.

Gran Via Carles III, 98, 10th floor

08028 Barcelona – Spain

Responsible manufacturer:

Neuraxpharm Pharmaceuticals, S.L.

Avda. Barcelona, 69

08970 SANT JOAN DESPÍ (Barcelona)

Spain

Last review date of this leaflet:April 2024

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