Leaflet: information for the user

Risperidona Stada 0.5 mg film-coated tablets

Risperidona Stada 1 mg film-coated tablets EFG

Risperidona Stada 3 mg film-coated tablets EFG

Risperidona Stada 6 mg film-coated 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 or pharmacist, even if they are not listed in this leaflet. See section 4.

Contents of the leaflet:

1. What Risperidona Stada is and what it is used for
2. What you need to know before you start taking Risperidona Stada
3. How to take Risperidona Stada
4. Possible side effects
5. Storage of Risperidona Stada

6. Contents of the pack and additional information

Risperidona belongs to a group of medicines called “antipsychotics”.

Risperidona is used to treat the following:

• Schizophrenia, with which you may see, hear, or feel things that are not there, believe in something that is not true, or feel particularly suspicious or confused.
• Mania, with which you may feel very excited, elated, agitated, enthusiastic, or hyperactive. Mania appears in a disease called “bipolar disorder”.
• Short-term treatment (up to 6 weeks) of persistent aggression in people with Alzheimer's disease type dementia, who harm themselves or others. They must have tried alternative treatments (non-pharmacological) previously.
• Short-term treatment (up to 6 weeks) of persistent aggression in intellectually disabled children (at least 5 years old) and adolescents with behavioral disorders.

Risperidona may help reduce the symptoms of your disease and prevent them from coming back.

Do not take Risperidona Stada:

• If you are allergic to risperidone or any of the other ingredients in this medication (listed in section 6).

If you are unsure, consult your doctor or pharmacist before starting to take risperidone.

Warnings and precautions

Consult your doctor or pharmacist before taking risperidone if:

• You have any heart problems. Examples include heart rhythm disturbances, or if you are prone to having low blood pressure or if you are taking blood pressure medications. Risperidone may lower your blood pressure. You may need to have your dose adjusted.
• You know of any factor that may make you prone to having a stroke, such as high blood pressure, cardiovascular disease, or problems with the blood vessels in your brain.
• You have ever had involuntary movements of the tongue, mouth, and face.
• You have ever had symptoms that include fever, muscle stiffness, sweating, or a decrease in level of consciousness (also known as Neuroleptic Malignant Syndrome).
• You have Parkinson's disease or dementia.
• You have had low white blood cell counts in the past (which may or may not have been caused by other medications).
• You are diabetic.
• You have epilepsy.
• You are male and have ever had an erection that lasted too long or was painful.
• You have difficulty controlling your body temperature or feel excessive heat.
• You have kidney problems.
• You have liver problems.
• You have an abnormally high level of prolactin in your blood or if you have a tumor that may be dependent on prolactin.
• You or a family member has a history of blood clotting problems, as antipsychotics have been associated with blood clotting.

If you are unsure about whether the above information affects you, consult your doctor or pharmacist before taking risperidone.

Because in very rare cases, a dangerously low number of a type of white blood cell necessary to fight infections in the blood has been observed in patients treated with risperidone, your doctor may check your white blood cell count.

Risperidone may cause you to gain weight. A significant weight gain may negatively affect your health. Your doctor will regularly monitor your weight.

Because diabetes mellitus or worsening of pre-existing diabetes mellitus has been seen in patients taking risperidone, your doctor should check for signs of elevated blood sugar. In patients with pre-existing diabetes mellitus, blood sugar should be regularly monitored.

Risperidone frequently increases levels of a hormone called prolactin. This may cause adverse effects such as menstrual disorders or fertility problems in women or breast enlargement in men (see Possible Adverse Effects). If these adverse effects appear, it is recommended to evaluate prolactin levels in the blood.

During cataract surgery, the pupil (the black circle in the middle of the eye) may not dilate as needed. Additionally, the iris (the colored part of the eye) may become flaccid during surgery and this may cause eye damage. If you are planning eye surgery, make sure to inform your ophthalmologist that you are taking this medication.

Patients with advanced age and dementia

In patients with advanced age and dementia, there is an increased risk of having a stroke. Do not take risperidone if you have dementia caused by a stroke.

During treatment with risperidone, you should see your doctor frequently.

If you or your caregiver notice a sudden change in your mental state or the sudden appearance of weakness or numbness in the face, arms, or legs, especially on one side, or if you speak confusedly, even for a short time, seek immediate medical treatment. This may be a sign of a stroke.

Children and adolescents

Other causes of aggressive behavior should be ruled out before starting treatment for behavioral disorders.

If during treatment with risperidone you experience fatigue, changing the administration times may improve your difficulties with attention.

Before starting treatment, your weight or that of your child may be measured, and this should be regularly monitored during treatment.

A small, inconclusive study has reported an increase in the height of children who took risperidone, but it is unknown whether this is a side effect of the medication or due to another reason.

Other medications and Risperidona Stada

Inform your doctor or pharmacist if you are taking, have recently taken, or may need to take any other medication.

It is especially important to talk to your doctor or pharmacist if you are taking any of the following:

• Medications that act on your brain, such as those used to calm down (benzodiazepines), or some pain medications (opioids), allergy medications (some antihistamines), as risperidone may increase their sedative effect.
• Medications capable of modifying the electrical activity of your heart, such as those used for malaria, heart rhythm problems, allergies (antihistamines), some antidepressants, or other medications for mental health problems.
• Medications that cause a slow heart rate.
• Medications that cause low potassium levels in the blood (such as some diuretics).
• Medications for high blood pressure. Risperidone may lower blood pressure.
• Medications for Parkinson's disease (such as levodopa).
• Medications that increase the activity of the central nervous system (psychoestimulants, such as methylphenidate)
• Diuretics, which are used for heart problems or to treat swelling in some parts of the body due to fluid retention (such as furosemide or chlorothiazide). Risperidone, taken alone or with furosemide, may increase the risk of stroke or death in elderly patients with dementia.

The following medications may reduce the effect of risperidone:

• Rifampicin (a medication for treating some infections).
• Carbamazepine, phenytoin (medications for epilepsy).
• Phenobarbital.

If you start or stop taking these medications, you may need a different dose of risperidone.

The following medications may increase the effect of risperidone:

• Quinidine (used for certain types of heart disease).
• Antidepressants such as paroxetine, fluoxetine, tricyclic antidepressants.
• Beta-blockers (used to treat high blood pressure).
• Phenothiazines (such as medications used to treat psychosis or as sedatives).
• Cimetidine, ranitidine (acid blockers).
• Itraconazole and ketoconazole (medications used to treat fungal infections).
• Some medications used to treat HIV/AIDS, such as ritonavir.
• Verapamil, a medication used to treat high blood pressure and/or abnormal heart rhythm.
• Sertraline and fluvoxamine, medications used to treat depression and other psychiatric disorders.

If you start or stop taking these medications, you may need a different dose of risperidone.

If you are unsure about whether the above information affects you, consult your doctor or pharmacist before taking risperidone.

Taking Risperidona Stada with food, drinks, and alcohol

You can take this medication with or without food. You should avoid consuming alcohol while taking risperidone.

Pregnancy, breastfeeding, and fertility

•If you are pregnant or breastfeeding, or if you think you may be pregnant, consult your doctor or pharmacist before taking this medication. Your doctor will decide if you can take it.

•The following symptoms may occur in newborn babies of mothers who were treated with risperidone in the last trimester of pregnancy (last three months of pregnancy): tremors, stiffness, and/or muscle weakness, drowsiness, agitation, breathing problems, and difficulty feeding. If your baby develops any of these symptoms, you should contact your doctor.

•Risperidone may increase levels of a hormone called "prolactin" that may affect fertility (see Possible Adverse Effects).

Driving and using machines

Risperidone may cause symptoms such as drowsiness, dizziness, or visual disturbances, and may decrease your reaction time. These effects, as well as the underlying condition, may impair your ability to drive vehicles or operate machines. Therefore, do not drive, operate machines, or engage in other activities that require special attention until your doctor assesses your response to this medication.

Risperidona Stada film-coated tablets contain lactose and sodium

This medication contains lactose. If your doctor has told you 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".

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

The recommended dose is as follows:

For the treatment of schizophrenia

Adults

• The usual initial dose is 2 milligrams per day, which can be increased to 4 milligrams per day on the second day.
• Your doctor may adjust your dose depending on how you respond to treatment.
• Most people feel better with daily doses of 4 to 6 milligrams.
• This total daily dose can be divided into one or two doses per day. Your doctor will tell you what is best for you.

Older adults

• The initial dose will be 0.5 milligrams twice a day, normally.
• Your doctor may increase your dose gradually from 1 to 2 milligrams twice a day.
• Your doctor will tell you what is best for you.

For the treatment of mania

Adults

• The initial dose will be 2 milligrams once a day, normally.
• Your doctor may adjust your dose gradually depending on your response to treatment.
• Most people feel better with doses of 1 to 6 milligrams once a day.

Older adults

• The initial dose will be 0.5 milligrams twice a day, normally.
• Your doctor may adjust your dose gradually from 1 milligram to 2 milligrams twice a day depending on your response to treatment.

For the treatment of long-term aggression in people with Alzheimer's disease

Adults (including older adults)

•The initial dose will be 0.25 milligrams twice a day, normally.

•Your doctor may adjust your dose gradually depending on your response to treatment.

•Most people feel better with doses of 0.5 milligrams twice a day. Some patients may need 1 milligram twice a day.

•The duration of treatment in patients with Alzheimer's disease should not exceed 6 weeks.

Use in children and adolescents

•Children and adolescents under 18 years old should not receive risperidone treatment for schizophrenia or mania.

For the treatment of behavioral disorders

The dose will depend on your child's weight:

If they weigh less than 50 kilograms

•The initial dose will be 0.25 milligrams once a day, normally.

•The dose can be increased one day yes and one day no in increments of 0.25 milligrams per day.

•The usual maintenance dose is 0.25 milligrams to 0.75 milligrams once a day.

If they weigh 50 kilograms or more

•The initial dose will be 0.5 milligrams once a day, normally.

•The dose can be increased one day yes and one day no in increments of 0.5 milligrams per day.

•The usual maintenance dose is 0.5 milligrams to 1.5 milligrams once a day.

The duration of treatment in patients with behavioral disorders should not exceed 6 weeks.

Children under 5 years old should not receive risperidone treatment for behavioral disorders.

Patients with kidney or liver problems

Unless the disease being treated is considered, all initial doses and subsequent doses of risperidone should be reduced by half. Dose increases should be made more slowly in these patients.

Risperidone should be used with caution in this group of patients.

Administration form

Oral route

Risperidone Stada film-coated tablets

•You should take the medication with a glass of water.

•The 0.5 mg, 1 mg, and 3 mg tablets can be divided into equal doses.

If you take more Risperidone Stada than you should

In case of overdose, you may feel drowsy or tired, experience abnormal body movements, have difficulty standing and walking, feel dizzy due to decreased blood pressure, or have irregular heartbeats or seizures.

Consult your doctor, pharmacist, or call the Toxicology Information Service at 91.562.04.20, indicating the medication and the amount taken. It is recommended to bring the packaging and the medication leaflet to the healthcare professional.

If you forget to take Risperidone Stada

•If you forget to take a dose, take it as soon as you remember. But if it's almost time for your next dose, skip the missed one and continue as usual.

•Do not take a double dose (two doses at once) to make up for the missed dose.

If you interrupt treatment with Risperidone Stada

Do not stop taking this medication unless your doctor tells you to. Symptoms may reappear. If your doctor decides to stop this treatment, your dose may be gradually reduced over a few days.

If you have any other questions 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.

Inform your doctor immediately if you experience any of the following rare side effects (may affect up to 1 in 100 patients):

•You have dementia and experience a sudden change in your mental state or sudden weakness or numbness in your face, arms, or legs, especially on one side, or it's hard for you to speak even for a short period of time.This may be a sign of a stroke.

•You experience tardive dyskinesia (involuntary spasms or movements that cannot be controlled in your face, tongue, or other parts of your body). Inform your doctor immediately if you experience involuntary rhythmic movements of your tongue, mouth, and face. You may need to discontinue risperidone.

Inform your doctor immediately if you experience any of the following rare side effects (may affect up to 1 in 1,000 patients):

•You experience blood clots in your veins, especially in your legs (symptoms include swelling, pain, and redness of the leg), which can travel through the blood vessels to your lungs, causing chest pain and difficulty breathing. If you notice any of these symptoms, seek medical advice immediately.

•You experience fever, muscle stiffness, sweating, or a decrease in your level of consciousness (a condition known as "Neuroleptic Malignant Syndrome"). You may need immediate medical treatment.

•You are a man and experience a prolonged or painful erection. This is known as priapism. You may need immediate medical treatment.

•You experience a severe allergic reaction characterized by fever, swelling of the mouth, face, lips, or tongue, difficulty breathing, itching, skin rash, or low blood pressure.

You may also experience the following side effects:

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

•Difficulty staying or falling asleep.

•Parkinsonism: This condition may include slow or altered movement, a feeling of stiffness or tension in your muscles (making sudden movements), and sometimes a feeling of "freezing" of movement that is then restarted. Other signs of parkinsonism include walking slowly with your feet dragging, resting tremor, increased saliva and/or drooling, and loss of facial expression.

•You feel drowsy or less attentive.

•Headache.

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

•Pneumonia, chest infection (bronchitis), common cold symptoms, sinusitis, urinary tract infection, ear infection, feeling like you have the flu.

•Increased levels of a hormone called "prolactin" that is detected in blood tests (which may or may not cause symptoms). Symptoms of increased prolactin occur rarely and may include in men, breast swelling, difficulty achieving or maintaining erections, decreased libido, or other sexual dysfunction. In women, they may include breast discomfort, milk secretion, loss of menstrual periods, or other problems with the menstrual cycle or fertility.

•Weight gain, increased appetite, decreased appetite.

•Sleep disturbances, irritability, depression, anxiety, restlessness.

•Dystonia: This is a condition that involves involuntary slow or continuous muscle contractions. Although it can affect any part of the body (and may cause abnormal postures), dystonia often affects the muscles of the face, including abnormal movements of the eyes, mouth, tongue, or jaw.

•Dizziness.

•Dyskinesia: This condition involves involuntary muscle movements and may include repetitive, spasmodic, or writhing movements, or spasms.

•Tremor (shakiness).

•Blurred vision, eye infection, or "red eye."

•Fast heart rate, increased blood pressure, labored breathing.

•Sore throat, cough, nasal bleeding, nasal congestion.

•Abdominal pain, discomfort, vomiting, nausea, constipation, diarrhea, indigestion, dry mouth, toothache.

•Rash, skin redness.

•Muscle spasms, bone or muscle pain, back pain, joint pain.

•Urinary incontinence.

•Swelling of the body, arms, or legs, fever, chest pain, weakness, fatigue (tiredness), pain.

•Falls.

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

•Respiratory tract infection, urinary tract infection, eye infection, tonsillitis, fungal nail infection, skin infection, localized infection in a single area of the skin or part of the body, viral infection, skin inflammation caused by mites.

•Decreased white blood cell count, decreased white blood cell count, decreased platelet count, anemia, decreased red blood cell count, increased eosinophil count in the blood.

•Allergic reaction.

•Diabetes or worsening of diabetes, high blood sugar, excessive water intake.

•Weight loss, decreased appetite that causes malnutrition and weight loss.

•Increased cholesterol in the blood.

•Euphoria (mania), confusion, decreased libido, nervousness, nightmares.

•Lack of response to stimuli, loss of consciousness, decreased level of consciousness.

•Seizures (epileptic crises), fainting.

•Anxiety that causes movement of parts of the body, balance disorder, abnormal coordination, dizziness when standing up, attention disorder, speech problems, loss or alteration of taste, decreased skin sensitivity to pain or touch, sensation of tingling, pinching, or numbness of the skin.

•Increased sensitivity of the eyes to light, dry eyes, increased tear production, eye redness.

•Sensation of spinning (vertigo), ringing in the ears, ear pain.

•Atrial fibrillation (abnormal heart rhythm), interruption of conduction between the upper and lower parts of the heart, abnormal heart activity, prolonged QT interval in the heart, slow heart rate, abnormal heart conduction (electrocardiogram or ECG), sensation of fluttering or pounding in the chest (palpitations).

•Decreased blood pressure, decreased blood pressure when standing up (as a result, some people taking risperidone may feel weakness, dizziness, or loss of consciousness when standing up or sitting down suddenly), flushing.

•Pneumonia caused by aspiration of food, pulmonary congestion, respiratory tract congestion, crackling sounds from the lungs, wheezing, voice disorder, respiratory difficulty.

•Stomach or intestinal infection, fecal incontinence, hard stools, difficulty swallowing, excessive gas or flatulence.

•Hives (urticaria), itching, hair loss, skin thickening, eczema, dry skin, skin discoloration, acne, scaly and itchy skin or scalp, skin disorder, skin injury.

•Increased CPK (creatine phosphokinase) in the blood, an enzyme that is sometimes released with muscle degradation.

•Abnormal posture, joint stiffness, joint swelling, muscle weakness, neck pain.

•Urination frequency, inability to urinate, painful urination.

•Erectile dysfunction, ejaculation disorder.

•Loss of menstrual periods, loss of menstrual periods or other problems with the menstrual cycle (women).

•Male breast development, milk secretion, sexual dysfunction, breast pain, breast discomfort, vaginal discharge.

•Swelling of the face, mouth, eyes, or lips.

•Chills, increased body temperature.

•Change in gait.

•Sensation of thirst, feeling unwell, chest discomfort, feeling "off," discomfort.

•Increased liver enzymes in the blood, increased GGT (a liver enzyme called gamma-glutamyltransferase) in the blood, increased liver enzymes in the blood.

•Pain due to the procedure.

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

•Infection.

•Incorrect secretion of a hormone that controls urine volume.

•Somnambulism.

•Sleep-related eating disorder.

•Sugar in the urine, decreased blood sugar, increased triglycerides in the blood (a type of fat).

•Lack of emotions, inability to achieve orgasm.

•Catatonia (lack of movement or response while awake).

•Problems with blood vessels in the brain.

•Diabetic coma due to uncontrolled diabetes.

•Head agitation.

•Glaucoma (increased pressure in the eyeball), eye movement problems, eye rotation, corneal ulcers.

•Eye problems during cataract surgery. During cataract surgery, there may be a condition called intraoperative floppy iris syndrome (IFIS) if you are taking or have taken risperidone. If you need to undergo cataract surgery, make sure to inform your ophthalmologist if you are taking or have taken this medication.

•Low white blood cell count, a type of white blood cell necessary to fight infections.

•Excessive water intake.

•Irregular heartbeat.

•Respiratory problems during sleep (sleep apnea), rapid, shallow breathing.

•Pancreatitis, intestinal obstruction.

•Swelling of the tongue, cracked lips, skin rash related to the medication.

•Dandruff.

•Muscle fiber rupture and muscle pain (rhabdomyolysis).

•Delayed menstrual periods, breast enlargement, milk secretion.

•Increased insulin (a hormone that controls blood sugar levels) in the blood.

•Skin hardening.

•Decreased body temperature, coldness in arms and legs.

•Medication withdrawal syndrome.

•Yellow skin and eyes (jaundice).

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

•Complications of uncontrolled diabetes, life-threatening.

•Severe allergic reaction with swelling, which can affect the throat, causing respiratory difficulty.

•Intestinal muscle paralysis causing obstruction.

Frequency unknown: cannot be estimated from available data

•Severe or fatal skin rash with blisters and skin peeling that may start around the mouth, nose, eyes, genitals, and spread to other parts of the body (Stevens-Johnson syndrome or toxic epidermal necrolysis).

The following side effect has appeared with the use of another medication called paliperidone, which is very similar to risperidone, so it is also expected to appear with risperidone: rapid heartbeat when standing up.

Other side effects in children and adolescents

In general, it is expected that side effects in children will be similar to those that appeared in adults.

The following side effects were reported more frequently in children and adolescents (5 to 17 years) than in adults: feeling drowsy or less attentive, fatigue (tiredness), headache, increased appetite, vomiting, common cold symptoms, nasal congestion, abdominal pain, dizziness, cough, fever, tremor (shakiness), diarrhea, and urinary incontinence.

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 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 medication.

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.

This medication does not require special storage conditions.

Medications should not be disposed of through drains or trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and medications you no longer need. This will help protect the environment.

Composition of Risperidona Stada

The active ingredient is risperidone.

Each film-coated tablet of Risperidona Stada 0.5 mg contains 0.5 mg of risperidone.

Each film-coated tablet of Risperidona Stada 1 mg contains 1 mg of risperidone.

Each film-coated tablet of Risperidona Stada 3 mg contains 3 mg of risperidone.

Each film-coated tablet of Risperidona Stada 6 mg contains 6 mg of risperidone.

The other components are:

Core tablet:lactose, cornstarch, pregelatinized cornstarch, sodium lauryl sulfate, microcrystalline cellulose, sodium croscarmellose, hydrated colloidal silica, and magnesium stearate.

Coating:

Risperidona 0.5 mg: hypromellose, titanium dioxide (E 171), iron oxide red (E 172), and macrogol 400.

Risperidona 1 mg:hypromellose, titanium dioxide (E 171), iron oxide yellow (E 172), iron oxide red (E 172), and macrogol 400.

Risperidona 3 mg: hypromellose, titanium dioxide (E 171), iron oxide yellow (E 172), and macrogol 400.

Risperidona 6 mg: hypromellose, titanium dioxide (E 171), iron oxide red (E 172), and macrogol 400.

Appearance of the product and contents of the package

The film-coated tablets of Risperidona Stada 0.5 mg are packaged in Al/Al, PVC/Al blisters.

The film-coated tablets of Risperidona Stada 1, 3, and 6 mg are packaged in Al-Al, PVDC-Al, and PVC-Al blisters.

The 0.5 mg risperidone film-coated tablets are oblong, biconvex, brown in color, with the inscription “0.5” on one face and a groove on the other. The tablet can be divided into two equal halves.

The 1 mg risperidone film-coated tablets are oblong, biconvex, orange in color, with the inscription “1” on one face and a groove on the other. The tablet can be divided into two equal halves.

The 3 mg risperidone film-coated tablets are oblong, biconvex, yellow in color, with the inscription “3” on one face and a groove on the other. The tablet can be divided into two equal halves.

The 6 mg risperidone film-coated tablets are oblong, biconvex, salmon in color, with the inscription “6” on one face.

Package sizes:

The Risperidona Stada 0.5 mg film-coated tablets are available in the following package sizes: 28 or 56 tablets.

The Risperidona Stada 1 mg and 3 mg film-coated tablets are available in the following package sizes: 20 or 60 tablets.

The Risperidona Stada 6 mg film-coated tablets are available in the following package sizes: 30 or 60 tablets.

Only some package sizes may be marketed.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder:

STADA Laboratory, S.L.

Frederic Mompou, 5

08960 Sant Just Desvern (Barcelona)

Spain

[email protected]

Responsible manufacturer:

Neuraxpharm Pharmaceuticals, S.L.

Avda. Barcelona, 69

08970 Sant Joan Despí (Barcelona)

Spain

Last review date of this prospectus:July 2023

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