Leaflet: information for the user

Primperan 10 mg/2 ml injectable solution

Metoclopramide hydrochloride

Read this leaflet carefully before you start using 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.

6. Contents of the pack and additional information

Primperan is an antiemetic. It contains a medication called “metoclopramide”. It acts on an area of the brain that prevents nausea or vomiting.

Adult population

Primperan is used in adults:

• to prevent nausea and vomiting that may appear after surgery
• to treat nausea and vomiting, including nausea and vomiting that may appear with a migraine
• to prevent nausea and vomiting caused by radiation therapy.

Pediatric population

Primperan is used in children (1-18 years of age) only if other treatments do not work or cannot be used:

• to prevent delayed nausea and vomiting that may appear after chemotherapy
• to treat nausea and vomiting that may appear after surgery.

Do not use Primperan

• if you are allergic to metoclopramide or any of the other components of this medication (listed in section 6)
• if you have bleeding, obstruction, or perforation in the stomach or intestine
• if you have or may have a rare tumor of the adrenal gland, which is near the kidney (pheochromocytoma)
• if you have ever had involuntary muscle spasms (tardive dyskinesia) when treated with a medication
• if you have epilepsy
• if you have Parkinson's disease
• if you are taking levodopa (medication for Parkinson's disease) or dopamine agonists (see below “Use of Primperan with other medications”)
• if you have ever had abnormal levels of blood pigments (methemoglobinemia) or deficiency of NADH cytochrome b5 reductase.

Do not administer Primperan to children under 1 year (see below “Children and adolescents”).

Do not use Primperan if any of the above cases apply to you. If you are unsure, consult your doctor, pharmacist, or nurse before using Primperan.

Warnings and precautions

Consult your doctor, pharmacist, or nurse before using Primperan if:

• you have a history of abnormal heartbeats (prolongation of the QT interval) or any other heart problem
• you have problems with the levels of salts in your blood, such as potassium, sodium, and magnesium
• you are taking other medications known to affect the way your heart beats
• you have any neurological problem (brain)
• you have problems in the liver or kidneys. The dose may be reduced (see section 3).

Your doctor may perform blood tests to monitor your levels of blood pigments. In cases of abnormal levels (methemoglobinemia), treatment should be stopped immediately and permanently.

Do not exceed 3 months of treatment due to the risk of involuntary muscle spasms.

Children and adolescents

Uncontrolled movements (extrapyramidal disorders) may appear in children and young adults. This medication should not be used in children under 1 year due to the high risk of uncontrolled movements (see above “Do not use Primperan”).

Use of Primperan with other medications

Inform your doctor, pharmacist, or nurse if you are taking, have taken recently, or may need to take any other medication. This is because some medications may affect the way Primperan works or Primperan may affect the way other medications work. These medications include:

• levodopa or other medications used to treat Parkinson's disease (see above “Do not use Primperan”)
• anticholinergics (medications used to relieve stomach spasms or cramps)
• morphine derivatives (medications used to treat intense pain)
• sedatives
• any medication used to treat mental health problems
• digoxin (medication used to treat heart failure)
• ciclosporin (medication used to treat some immune system problems)
• mivacurium and suxamethonium (medications used to relax muscles)
• fluoxetine and paroxetine (medications used to treat depression)
• rifampicin (medication used to treat tuberculosis or other infections), which may reduce the amount of metoclopramide in the blood if taken at the same time.

Use of Primperan with alcohol

Do not consume alcohol during treatment with metoclopramide because it increases the sedative effect of Primperan.

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 medication.

Primperan may be used during pregnancy if necessary. Your doctor will decide whether to administer this medication.

Primperan is not recommended during breastfeeding because metoclopramide passes into breast milk and may affect your baby.

Driving and operating machinery

After using Primperan, you may feel drowsy, dizzy, or have involuntary movements of tics, jerks, or torsion and abnormal muscle tone that cause distortion of your body. This may affect your vision and also interfere with your ability to drive and operate machinery.

Primperan 10 mg/2 ml injectable solution contains sodium

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

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

This medication will be administered normally by a doctor or nurse. It will be administered as a slow injection into a vein (at least over 3 minutes) or as a muscle injection.

Adult patients

For the treatment of nausea and vomiting, including nausea and vomiting that may appear with migraine, and for the prevention of nausea and vomiting caused by radiation therapy: a single dose of 10 mg is recommended, which can be repeated up to 3 times a day.

The maximum recommended daily dose is 30 mg or 0.5 mg/kg of body weight.

For the prevention of nausea and vomiting that may appear after surgery: a single dose of 10 mg is recommended.

All indications (pediatric patients 1-18 years old)

The recommended dose is 0.1 to 0.15 mg/kg of body weight, which can be repeated up to 3 times a day, administered slowly into a vein.

The maximum dose in 24 hours is 0.5 mg/kg of body weight.

Dose table

Treatment should not exceed 48 hours for nausea and vomiting that appear after surgery.

Treatment should not exceed 5 days for the prevention of nausea and vomiting that may appear after chemotherapy.

Special populations

Geriatric population

It may be necessary to reduce the dose depending on kidney problems, liver problems, and general health problems.

Adults with renal problems

Inform your doctor if you have kidney problems. The dose should be reduced if you have moderate to severe kidney problems.

Adults with liver problems

Inform your doctor if you have liver problems. The dose should be reduced if you have severe liver problems.

Children and adolescents

Metoclopramide should not be used in children under 1 year (see section 2).

If you take more Primperan than you should

Contact your doctor or pharmacist immediately. You may experience involuntary movements (extrapyramidal disorders), feel drowsiness, have some consciousness problems, be confused, have hallucinations, and heart problems. Your doctor may prescribe treatment for these effects if necessary.

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

If you forgot to use Primperan

Do not take a double dose to compensate for the missed doses.

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

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

Unknown frequency(frequency that cannot be estimated from available data)

• allergic reactions (such as anaphylaxis, angioedema, and urticaria).

The symptoms may include rash, itching, difficulty breathing, shortness of breath, swelling of the face, lips, throat, or tongue, chills, moist skin, palpitations, dizziness, weakness, or fainting.

Immediately contact your doctor or another healthcare professional or go to the nearest hospital emergency department immediately.

Discontinue treatment and immediately report to your doctor, pharmacist, or nurse if you experience any of the following signs while using this medicine:

• uncontrolled movements (which often affect the head and neck). These may appear in children and young adults and particularly when high doses are used. These signs usually appear at the beginning of treatment and may even occur after a single administration. These movements will cease when properly treated.
• high fever, high blood pressure, seizures, sweating, salivation. These may be signs of a condition called malignant neuroleptic syndrome.
• itching and skin rashes, facial, lip, or throat inflammation, difficulty breathing. These may be signs of an allergic reaction, which can be severe.

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

• feeling drowsy.

Common(may affect up to 1 in 10 people)

• depression
• uncontrolled movements such as tics, jerks, torsion movements, or muscle contractions (rigidity, stiffness)
• symptoms similar to Parkinson's disease (rigidity, tremor)
• feeling restless
• decreased blood pressure (particularly with intravenous administration)
• diarrhea
• feeling weak.

Uncommon(may affect up to 1 in 100 people)

• high levels of a hormone called prolactin in the blood that may cause: milk production in men and women who are not breastfeeding
• irregular periods
• hallucinations
• decreased level of consciousness
• slow heart rate (particularly with intravenous administration)
• allergy
• visual disturbances and involuntary deviation of the eyeball.

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

• confusion
• seizures (especially in patients with epilepsy).

Unknown frequency(frequency that cannot be estimated from available data)

• abnormal levels of blood pigments: which may change the color of your skin
• abnormal development of the breasts (gynecomastia)
• involuntary muscle spasms after prolonged use, particularly in elderly patients
• high fever, high blood pressure, seizures, sweating, salivation. These may be signs of a condition called malignant neuroleptic syndrome
• changes in heartbeats, which may be seen on an ECG (electrocardiogram)
• cardiac arrest (particularly with intravenous administration)
• shock (severe drop in blood pressure) (particularly with intravenous administration)
• fainting (particularly with intravenous administration)
• very high blood pressure
• suicidal thoughts.

Reporting of adverse effects

If you experience any type of adverse effect, consult your doctor, pharmacist, or nurse, even if it is a possible adverse 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 adverse 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.

No special temperature conditions are required, store in the original packaging to protect it from light.

Do not use Primperan after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

Medicines should not be disposed of through drains or in the trash. Dispose of the packaging and medicines 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 medicines you no longer need. In this way, you will help protect the environment.

Composition of Primperan 10 mg/2 ml injectable solution

• The active ingredient is metoclopramide hydrochloride. Each 2 ml ampule contains 10 mg of metoclopramide hydrochloride.

• The other components are: sodium chloride and water for injection preparations.

Appearance of the product and content of the packaging

It is an injectable solution packaged in 2 ml ampules for administration via intramuscular or intravenous route.

Each package contains 12 ampules of 2 ml.

Other presentations:

Primperan 10 mg tablets: Packages with 30 and 60 tablets

Primperan 1 mg/ml oral solution: Bottle with 200 ml

Marketing authorization holder

sanofi-aventis, S.A.

C/ Rosselló i Porcel, 21

08016 Barcelona

Spain

Responsible for manufacturing

Delpharm Dijon

6, Boulevard de l’Europe

21800 Quetigny

France

Last review date of this leaflet: February 2023

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