Leaflet: information for the user

Escarpilo 400 mg EFG tablets

eslicarbazepine, acetate

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.

This medication contains the active ingredient eslicarbazepine acetate.

This medication belongs to a group of medications called antiepileptics, used to treat epilepsy, a disease where the affected person has seizures or repeated convulsive crises.

This medication is used:

• as a single medication (monotherapy) in adult patients with newly diagnosed epilepsy;
• along with other antiepileptic medications (adjunctive therapy) in adult, adolescent, and children over 6 years old who suffer from epileptic seizures (convulsions) affecting a part of the brain (partial seizures). These seizures may be followed or not by a seizure affecting the entire brain (secondary generalization).

Your doctor has prescribed this medication to reduce the number of seizures.

Do not take Escarpilo:

• if you are allergic to eslicarbazepine acetate, other carboxamide derivatives (such as carbamazepine or oxcarbazepine, used for the treatment of epilepsy), or any of the other components of this medication (listed in section 6);
• if you have a certain type of heart rhythm disorder (second- or third-degree atrioventricular (AV) block).

Warnings and Precautions

Consult your doctor or pharmacist before starting to take this medication

Inform your doctor immediately:

• if you experience blisters or peeling of the skin and/or mucous membranes, rash, difficulty swallowing or breathing, swelling of the lips, face, eyelids, throat, or tongue. These may be signs of an allergic reaction;
• if you experience confusion, worsening of seizures, or decreased consciousness, which may be signs of low blood levels of salts.

Inform your doctor:

• if you have kidney problems. Your doctor may need to adjust the dose. This medication is not recommended for patients with severe kidney disease;
• if you have liver problems. This medication is not recommended for patients with severe liver disease;
• if you are taking any medication that may cause an abnormality in the ECG (electrocardiogram) called an increased PR interval. If you are unsure whether the medications you are taking may cause this effect, discuss it with your doctor;
• if you have heart disease such as heart failure or myocardial infarction, or any alteration of heart rhythm;
• if you have seizures that begin with a generalized electrical discharge affecting both sides of the brain.

A small number of people taking antiepileptic medications have had thoughts of self-harm or suicide. If this occurs while taking this medication, contact your doctor immediately.

This medication may cause dizziness and/or disorientation, particularly at the start of treatment. Be extra careful while taking this medication to avoid accidental injuries, such as falls.

Be extra careful with this medication

In the post-marketing experience, severe skin reactions and potentially life-threatening reactions, including Stevens-Johnson syndrome/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), have been reported in patients treated with this medication.

If you develop a severe rash or other skin symptoms (see section 4), stop taking this medication and consult your doctor or seek medical attention immediately.

In patients of Thai and Chinese Han ethnic origin, the risk of severe skin reactions associated with carbamazepine or chemically related compounds may be predicted by blood analysis of these patients. Your doctor may advise on the need for this blood test before taking this medication.

Children

This medication should not be administered to children under 6 years of age.

Other Medications and Escarpilo

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication. This is to ensure that none of them interfere with the way this medication works, or that this medication interferes with the effect of such medications. Inform your doctor if you are taking:

• phenytoin (a medication used for the treatment of epilepsy), as you may need to adjust the dose;
• carbamazepine (a medication used for the treatment of epilepsy), as you may need to adjust the dose, and the following side effects of this medication may occur more frequently: double vision, abnormal coordination, and dizziness;
• hormonal contraceptives (such as the birth control pill), as this medication may reduce the effectiveness of these;
• simvastatin (a medication used to reduce cholesterol levels), as you may need to adjust the dose;
• rosuvastatin, a medication used to reduce cholesterol levels;
• the anticoagulant warfarin;
• tricyclic antidepressants, such as amitriptyline;
• do not take oxcarbazepine (a medication used for the treatment of epilepsy) with this medication, as it is unknown whether it is safe to take these two medications together.

See the section “Pregnancy and Breastfeeding” for recommendations on contraception.

Pregnancy and Breastfeeding

This medication is not recommended for pregnant women, as the effects of this medication on pregnancy and the fetus are unknown.

If you intend to become pregnant, discuss this with your doctor before stopping your contraceptive method and before becoming pregnant. Your doctor may decide to change your treatment.

There is limited data on the use of eslicarbazepine acetate in pregnant women. Research has shown an increased risk of congenital defects and neurological development problems (brain development) in the children of women taking antiepileptic medications, particularly when taking more than one antiepileptic medication at a time.

If you are or think you may be pregnant, inform your doctor immediately. Do not stop taking your medication until you have discussed this with your doctor. Stopping your medication without consulting your doctor may cause seizures, which can be hazardous to you and your unborn child. Your doctor may decide to change your treatment.

If you are a fertile woman and are not planning to become pregnant, you should use an effective contraceptive method during treatment with Escarpilo.

This medication may affect the functioning of hormonal contraceptives, such as the birth control pill, and make them less effective in preventing pregnancy.

Therefore, it is recommended that you use other safe and effective contraceptive methods while taking Escarpilo.

Discuss this with your doctor, who will discuss with you the type of contraceptive most suitable for use while taking this medication. If you stop taking this medication, you should continue using an effective contraceptive method until the end of the current menstrual cycle.

If you take Escarpilo during pregnancy, your baby may also be at risk of bleeding problems immediately after birth. Your doctor may give you and your baby a medication to prevent this.

Do not breastfeed while taking this medication. It is unknown whether it passes into breast milk.

Driving and Operating Machinery

This medication may cause dizziness, disorientation, and affect your vision, particularly at the start of treatment. If this occurs, do not drive or operate any tools or machinery.

This medication contains sodium

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 indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.

Adults

Initial treatment dose

400 mg once a day for one or two weeks, before increasing to the maintenance dose. Your doctor will decide if you should take this dose for one or two weeks.

Maintenance dose

The usual maintenance dose is 800 mg once a day.

Depending on how you respond to this medication, the dose may be increased to 1,200 mg once a day. If you are taking eslicarbazepine alone (monotherapy), your doctor may consider increasing your dose to 1,600 mg once a day.

Patients with kidney problems

If you have kidney problems, you will usually be given a lower dose of this medication. Your doctor will determine the correct dose for you. This medication is not recommended if you have severe kidney problems.

Patients over 65 years old

If you are an older person and taking this medication in monotherapy, the dose of 1,600 mg is not suitable for you.

Children over 6 years old

Initial treatment dose

The initial dose is 10 mg per kg of body weight once a day for one or two weeks, before increasing to the maintenance dose.

Maintenance dose

Depending on your response to this medication, the dose may be increased by 10 mg per kg of body weight, at intervals of one or two weeks, up to 30 mg per kg of body weight. The maximum dose is 1,200 mg once a day.

Children ≥ 60 kg

Children with a body weight of 60 kg or more should take the same dose as adults.

Form and route of administration

This medication is administered orally. Swallow the tablet with a glass of water. This medication can be taken with or without food.

If you have difficulty swallowing the entire tablet, you can crush it and mix it with water or apple sauce, and take it immediately.

The tablet can be divided into equal doses.

Overdose of Escarpilo

If you accidentally take more Escarpilo than you should, you are at risk of having more seizures; or you may feel that your heartbeat is irregular or faster. Contact your doctor or go immediately to a hospital if you experience any of these symptoms. Bring the medication packaging with you, so the doctor knows what you have taken.

You can also call the Toxicology Information Service, Tf: 915620420, indicating the medication and the amount ingested.

Missing a dose of Escarpilo

If you forget to take a tablet, take it as soon as you remember and continue as usual. Do not take a double dose to compensate for the missed dose.

Stopping treatment with Escarpilo

Do not suddenly stop taking the tablets. If you do, you are at risk of having more seizures. Your doctor will decide for how long you should take this medication. If your doctor decides to stop your treatment with this medication, you will usually be gradually reduced the dose. It is essential that you complete the treatment as instructed by your doctor; otherwise, your symptoms may worsen.

If you have any other doubts 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.

The following side effects can be very serious. If they occur, stop taking this medicine and inform your doctor or go to the hospital immediately, as you may need urgent medical treatment:

• blistering or peeling of the skin and/or mucous membranes, rash, difficulty swallowing or breathing, swelling of the lips, face, eyelids, throat, or tongue. These could be signs of an allergic reaction.

The very common side effects (may affect more than 1 in 10 people) are:

•dizziness or drowsiness

The common side effects (may affect up to 1 in 10 people) are:

• feeling unsteady, or like you are spinning or floating

• nausea or vomiting
• headache
• diarrhea
• double or blurred vision
• difficulty concentrating
• feeling tired or decreased energy
• tremor
• skin rash
• blood tests showing low sodium levels
• decreased appetite
• difficulty sleeping
• difficulty coordinating movements (ataxia).
• weight gain.

The side effects that are not very common (may affect up to 1 in 100 people) are:

• clumsiness of movements
• allergy
• constipation
• seizures
• underactive thyroid gland. Symptoms include decreased levels of thyroid hormones (detected in blood tests), intolerance to cold, increased size of the tongue, nails, or hair, and low body temperature
• liver problems (such as increased liver enzymes)
• high blood pressure or intense increase in blood pressure
• low blood pressure, or blood pressure decreased when standing up
• blood tests showing low levels of salts (including chloride), or a decrease in the number of red blood cells
• dehydration
• changes in eye movements, blurred vision, or red eyes
• experiencing falls
• thermal burns
• poor memory or forgetfulness
• crying, feeling depressed, nervous, or confused, lack of interest or emotions
• difficulty speaking, writing, or understanding spoken or written language
• agitation
• attention deficit/hyperactivity disorder
• irritability
• changes in mood or hallucinations
• difficulty speaking
• nasal bleeding
• chest pain
• tingling or numbness in any part of the body
• migraine
• burning
• abnormal sensation to touch
• alterations in smell
• ringing in the ears
• difficulty hearing
• swelling of legs and arms
• heartburn, stomach discomfort, abdominal pain, swelling, and discomfort, or dry mouth
• black stools
• inflammation of the gums or pain in the teeth
• sweating or dry skin
• itching
• changes in the skin (for example, redness of the skin)
• hair loss
• urinary tract infection
• general feeling of illness, weakness, or chills
• weight loss
• muscle pain, pain in limbs, muscle weakness
• bone metabolism disorder
• increased bone proteins
• redness (flushing), coldness in extremities
• slower or irregular heartbeats
• extreme drowsiness
• sedation
• neurological motor disorder where muscles contract, causing twisting and repetitive movements or abnormal postures. Symptoms include tremors, pain, and cramps
• medication toxicity
• anxiety.

The side effects of unknown frequency (cannot be estimated from available data) are:

• reduction of platelets that increases the risk of bleeding or bruising.
• intense back or stomach pain (caused by inflammation of the pancreas).
• reduction of white blood cells that makes infections more likely.
• red spots or circular patches often with central blisters on the trunk, peeling of the skin, ulcers in the mouth, throat, nose, genitals, and eyes, red and inflamed eyes, and may be preceded by fever and/or symptoms similar to the flu (Stevens-Johnson syndrome/toxic epidermal necrolysis).
• initially symptoms similar to the flu, rash on the face, generalized rash, elevated body temperature, elevated liver enzymes, blood abnormalities (eosinophilia), enlarged lymph nodes, and other body conditions (drug reaction with eosinophilia and systemic symptoms, also known as DRESS or drug hypersensitivity syndrome).
• severe allergic reaction that causes swelling of the face, throat, hands, feet, ankles, or lower legs.
• urticaria (skin rash with itching).
• lethargy, confusion, muscle spasms, or a significant worsening of seizures (possible symptoms of low sodium levels in the blood due to inadequate secretion of the antidiuretic hormone (ADH)).

The use of eslicarbazepine is associated with an ECG anomaly called increased PR interval. Side effects associated with this ECG anomaly may occur (for example, fainting and slowing of heartbeats).

There have been reports of bone disorders, including osteopenia and osteoporosis (bone thinning) and fractures with antiepileptic drugs related structurally to carbamazepine and oxcarbazepine. Talk to your doctor or pharmacist if you are on long-term treatment with antiepileptics, have a history of osteoporosis, or take steroids.

Reporting of 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 national notification system included in the Spanish System of 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 blister pack, bottle, and box after the letters 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 containers and medications you no longer need at the SIGRE point of your pharmacy. If in doubt, ask your pharmacist how to dispose of the containers and medications you no longer need. By doing so, you will help protect the environment.

Composition of Escarpilo

• The active ingredient is eslicarbazepine acetate. Each tablet contains 400 mg of eslicarbazepine acetate (corresponding to 343.28 mg of eslicarbazepine).
• The other components are povidone K30, sodium croscarmellose, and magnesium stearate.

Appearance of the product and content of the container

Escarpilo 400 mg tablets are white to off-white, oblong, biconvex (16 x 7 mm), scored on one side.

The tablet can be divided into equal doses.

The tablets are packaged in blisters, in cardboard boxes containing 20, 28, 30, or 60 tablets.

Only some container sizes may be marketed.

Holder of the marketing authorization and responsible for manufacturing

Holder of the marketing authorization

Neuraxpharm Spain, S.L.U.

Avda. Barcelona, 69

08970 – Sant Joan Despí

Barcelona – Spain

Responsible for manufacturing

Neuraxpharm Pharmaceuticals, S.L.

Avda. Barcelona, 69

08970 Sant Joan Despí

Barcelona - Spain

or

Neuraxpharm Arzneimittel GmbH

Elisabeth-Selbert-Strasse 23

Langenfeld 40764

Germany

Germany

This medicine is authorized in the Member States of the European Economic Area with the following names:

Portugal:Escarpilo

Spain:Escarpilo 400 mg tablets EFG

Last review date of this leaflet:

December 2022

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.