Prospect: Information for the Patient
Uptravi 200microgram film-coated tablets
Uptravi 400microgram film-coated tablets
Uptravi 600microgram film-coated tablets
Uptravi 800microgram film-coated tablets
Uptravi 1,000microgram film-coated tablets
Uptravi 1,200microgram film-coated tablets
Uptravi 1,400microgram film-coated tablets
Uptravi 1,600microgram film-coated tablets
selexipag
This medicine is subject to additional monitoring, which will speed up the detection of new information about its safety. You can contribute by reporting any adverse effects you may experience. The final part of section 4 includes information on how to report these adverse effects.
Read this prospect carefully before taking this medicine, as it contains important information for you.
1.What is Uptravi and for what it is used
2.What you need to know before starting to take Uptravi
3.How to take Uptravi
4.Possible adverse effects
5.Storage of Uptravi
6.Contents of the package and additional information
Uptravi is a medication that contains the active ingredient selexipag. It acts on blood vessels in a similar way to the natural substance prostacyclin, causing them to relax and dilate.
Uptravi is used for the long-term treatment of pulmonary arterial hypertension (PAH) in controlled adult patients who are insufficiently treated with other types of PAH medications known as endothelin receptor antagonists and phosphodiesterase type 5 inhibitors. Uptravi can be used alone if the patient is not a candidate for these medications.
Pulmonary arterial hypertension (PAH) is a disease characterized by high blood pressure that affects the blood vessels that transport blood from the heart to the lungs (the pulmonary arteries). In people with PAH, these arteries are narrower, so the heart must work harder to pump blood. This can cause fatigue, dizziness, difficulty breathing, or other symptoms.
In the same way that prostacyclin does, Uptravi dilates the pulmonary arteries and reduces their hardening. This makes it easier for the heart to pump blood along the pulmonary arteries. It alleviates PAH symptoms and improves the course of the disease.
Do not take Uptravi
Warnings and precautions
Consult your doctor or nurse before starting to take Uptravi if you:
If you experience any of the above signs or your condition changes, report immediately to your doctor.
Children and adolescents
Do not administer this medicine to children under 18 years of age, as Uptravi has not been evaluated in children.
Older adults
There is limited experience with Uptravi in patients over 75 years of age. Uptravi should be used with caution in patients in this age group.
Other medicines and Uptravi
Inform your doctor if you are taking, have taken recently, or plan to take any other medicine.
Taking other medicines may affect the functioning of Uptravi.
Inform your doctor or nurse specializing in HAP if you are taking any of the following medicines:
Pregnancy and breastfeeding
Uptravi is not recommended during pregnancy and breastfeeding. If you are a woman and may become pregnant, use a reliable contraceptive method while taking Uptravi. If you are pregnant, breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before taking this medicine.
Driving and operating machinery
Uptravi may cause side effects such as headaches and decreased blood pressure (see section 4), which may affect your ability to drive; your disease symptoms may also reduce your ability to drive.
The treatment with Uptravi should be initiated and monitored by a doctor who has experience in treating pulmonary arterial hypertension (PAH). Follow exactly the administration instructions of this medication indicated by your doctor. In case of doubt, consult your doctor again.
Inform your doctor if you experience any adverse effects, as they may recommend changing your Uptravi dose.
Inform your doctor if you are taking other medications, as they may recommend taking Uptravi only once a day.
If you have poor vision or experience any type of blindness, ask someone else to help you take Uptravi during the dose adjustment period.
Dose adjustment tailored to you
At the beginning of treatment, you will take the lowest dose. This is 200 micrograms in the morning and another 200 micrograms at night. Treatment should start at night. Your doctor will indicate that you should gradually increase the dose. This is what is called dose adjustment, and it allows your body to adapt to the new medication. The goal of dose adjustment is to reach the most suitable dose. This will be the highest dose you can tolerate, which may reach a maximum dose of 1,600 micrograms in the morning and 1,600 micrograms at night.
The first pack of tablets you receive will contain the yellowish-colored tablets of 200 micrograms.
Your doctor will indicate that you should increase the dose in phases, usually every week, although the interval between increments may be longer.
In each phase, you will add one 200 microgram tablet to the morning dose and another 200 microgram tablet to the night dose. The first intake of the increased dose should be taken at night. The following diagram shows the number of tablets you should take each morning and each night in the first 4 phases.
If your doctor indicates that you should continue increasing the dose and proceed to phase 5, you can do so by taking one green tablet of 800 micrograms and one yellowish-colored tablet of 200 micrograms in the morning and one green tablet of 800 micrograms and one yellowish-colored tablet of 200 micrograms at night.
If your doctor indicates that you should continue increasing the dose, you will add one 200 microgram tablet to the morning dose and one 200 microgram tablet to the night dose in each new phase. The first intake of the increased dose should be taken at night. The maximum dose of Uptravi is 1,600 micrograms in the morning and 1,600 micrograms at night. However, not all patients will reach this dose, as each patient requires a different dose.
The following diagram shows the number of tablets you should take each morning and each night in each phase, starting from phase 5.
The dose adjustment pack also contains a guide that provides information on the dose adjustment process and allows you to record the number of tablets you take daily.
Remember to record the number of tablets you take each day in your dose adjustment diary.The dose adjustment phases usually last approximately 1 week. If your doctor indicates that you should prolong each dose adjustment phase beyond 1 week, you have additional pages in the diary that allow you to do so.Remember to communicate with your doctor or PAH specialist nurse periodically during the dose adjustment phase.
Dose reduction due to adverse effects
During the dose adjustment phase, you may experience adverse effects such as headache, diarrhea, nausea, vomiting, jaw pain, muscle pain, lower limb pain, joint pain, or facial flushing (see section 4). If these adverse effects are difficult to tolerate, consult your doctor on how to control or treat them. There are treatments available to help alleviate these adverse effects. For example, analgesics such as paracetamol can help treat pain and headache.
If the adverse effects cannot be treated or do not improve gradually with the dose you are taking, your doctor may adjust the dose by reducing the number of yellowish-colored tablets of 200 micrograms you take, removing one tablet in the morning and one tablet at night. The following scheme shows how to reduce the dose. This should only be done if your doctor indicates so.
If the adverse effects you experience can be controlled after reducing the dose, your doctor may decide that you should maintain that dose. For additional information, see the following section on Maintenance dose.
Maintenance dose
The highest dose you can tolerate during the dose adjustment phase will become your maintenance dose. Your maintenance dose is the dose you should take habitually.
Your doctor will prescribe a single tablet with the appropriate potency for your maintenance dose.This allows you to take one tablet in the morning and one tablet at night, instead of several tablets each time.
To consult the complete description of Uptravi tablets, including colors and engraving, see section 6 in this prospectus.
Over time, your doctor may adjust your maintenance dose if necessary.
If, at any time, after taking the same dose for a long period, you experience adverse effects that you cannot tolerate or adverse effects that affect daily activities, contact your doctor, as you may need to reduce the dose. Your doctor may, in this case, prescribe a single tablet with a lower concentration. Remember to discard unused tablets (see section 5).
Take Uptravi once in the morning and once at night, with an interval of approximately 12 hours.
Take the tablets with meals, as this may help you tolerate the medication better. Swallow the tablets whole with a glass of water.
If you take more Uptravi than you should
If you take more tablets than you should, consult your doctor immediately.
If you forget to take Uptravi
If you forget to take Uptravi, take a dose as soon as you remember, and then continue taking the tablets at the usual time. If it is almost time to take your next dose (within 6 hours of the time you usually take it), you should stop taking the missed dose and continue taking the medication at the usual time. Do not take a double dose to compensate for the missed dose.
If you interrupt treatment with Uptravi
Stopping treatment with Uptravi abruptly may worsen your symptoms.Do not stop taking Uptravi unless your doctor tells you to.Your doctor may indicate that you should gradually reduce the dose before stopping treatment completely.
If, for any reason, you stop taking Uptravi for more than 3 consecutive days (if you have forgotten 3 morning doses and 3 night doses, or 6 consecutive doses or more),contact your doctor immediately, as you may need to adjust the dose to avoid adverse effects. Your doctor may decide to restart treatment at a lower dose, gradually increasing it to reach your maintenance dose.
If you have any other questions about the use of this medication, ask your doctor or nurse.
Like all medications, Uptravi may cause adverse effects. You may experience adverse effects not only during the dose adjustment phase, when your dose is being increased, but also later on, after taking the same dose for a long period.
If you experience any of the following adverse effects: headache, diarrhea, feeling unwell (nausea), feeling sick (vomiting), jaw pain, muscle pain, lower limb pain, joint pain, or facial redness, that you cannot tolerate or is not treatable, you must contact your doctor, as the dose you are taking may be too high for you and may require a reduction.
Very Common Adverse Effects(may affect more than 1 in 10people)
Common Adverse Effects(may affect up to 1 in 10people)
Uncommon Adverse Effects (may affect up to 1 in 100people)
Increased heart rate
Reporting Adverse Effects
If you experience any type of adverse effect, consult your doctor, even if it is a possible adverse effect not listed in this prospectus.You can also report them directlythrough thenational reporting system included in theAppendix V. By reporting adverse effects, you can contribute to providing more information about the safety of this medication.
Keep this medication out of the sight and reach of children.
Do not use Uptravi after the expiration date that appears on the box and on the blister after "CAD". The expiration date is the last day of the month indicated.
This medication does not require special storage conditions.
No special precautions are required for disposal.
Composition of Uptravi
-The active ingredient is selexipag.
Uptravi 200microgram tablets coated with a film contain 200micrograms of selexipag
Uptravi 400microgram tablets coated with a film contain 400micrograms of selexipag
Uptravi 600microgram tablets coated with a film contain 600micrograms of selexipag
Uptravi 800microgram tablets coated with a film contain 800micrograms of selexipag
Uptravi 1.000microgram tablets coated with a film contain 1.000micrograms of selexipag
Uptravi 1.200microgram tablets coated with a film contain 1.200micrograms of selexipag
Uptravi 1.400microgram tablets coated with a film contain 1.400micrograms of selexipag
Uptravi 1.600microgram tablets coated with a film contain 1.600micrograms of selexipag
-The other components are:
In the core of the tablets:
Manitol (E421), cornstarch, low-substituted hydroxypropylcellulose, hydroxypropylcellulose, and magnesium stearate.
In the film coating:
Hydroxypropylmethylcellulose, propylene glycol, titanium dioxide (E171), carnauba wax, and iron oxides (see below).
Uptravi 200microgram tablets coated with a film contain iron oxide yellow (E172).
Uptravi 400microgram tablets coated with a film contain iron oxide red (E172).
Uptravi 600microgram tablets coated with a film contain iron oxide red and iron oxide black (E172).
Uptravi 800microgram tablets coated with a film contain iron oxide yellow and iron oxide black (E172).
Uptravi 1.000microgram tablets coated with a film contain iron oxide red and iron oxide yellow (E172).
Uptravi 1.200microgram tablets coated with a film contain iron oxide black and iron oxide red (E172).
Uptravi 1.400microgram tablets coated with a film contain iron oxide yellow (E172).
Uptravi 1.600microgram tablets coated with a film contain iron oxide black, iron oxide red, and iron oxide yellow (E172).
Appearance of Uptravi and contents of the package
Uptravi 200microgram tablets coated with a film: Film-coated tablets of yellowish color, round, marked with a «2» on one face.
Uptravi 400microgram tablets coated with a film:Film-coated tablets of red color, round, marked with a «4» on one face.
Uptravi 600microgram tablets coated with a film:Film-coated tablets of light violet color, round, marked with a «6» on one face.
Uptravi 800microgram tablets coated with a film:Film-coated tablets of green color, round, marked with an «8» on one face.
Uptravi 1.000microgram tablets coated with a film:Film-coated tablets of orange color, round, marked with a «10» on one face.
Uptravi 1.200microgram tablets coated with a film:Film-coated tablets of dark violet color, round, marked with a «12» on one face.
Uptravi 1.400microgram tablets coated with a film:Film-coated tablets of dark yellow color, round, marked with a «14» on one face.
Uptravi 1.600microgram tablets coated with a film:Film-coated tablets of brown color, round, marked with a «16» on one face.
Uptravi 200microgram tablets coated with a film are supplied in blister packs containing 10 or 60 tablets and 60 or 140 tablets (dose adjustment packs).
Uptravi 400microgram, 600microgram, 800microgram, 1.000microgram, 1.200microgram, 1.400microgram, and 1.600microgram tablets coated with a film are supplied in blister packs containing 60 tablets.
It is possible that not all formats will be marketed.
Marketing Authorization Holder
Janssen-Cilag International NV
Turnhoutseweg 30
B-2340 Beerse
Belgium
Responsible for manufacturing
Actelion Manufacturing GmbH
Emil-Barell-Strasse 7
79639 Grenzach-Wyhlen
Germany
Actelion Pharmaceuticals Belgium NV
Bedrijvenlaan 1
2800 Mechelen
Belgium
You can request more information about this medicine by contacting the local representative of the marketing authorization holder:
België/Belgique/Belgien Actelion, a division of Janssen-Cilag International NV Tél/Tel:+32-(0)15 284 777 | Lietuva Actelion, a division of Janssen-Cilag International NV Tel.: +370 5 278 68 88 | |
???????? Actelion, a division of Janssen-Cilag International NV Te?.: +359 2 489 94 00 | Luxembourg/Luxemburg Actelion, a division of Janssen-Cilag International NV Tél/Tel:+32-(0)15 284 777 | |
Ceská republika Actelionn, a division of Janssen-Cilag International NV Tel.: +420 221 968 006 | Magyarország Actelion, a division of Janssen-Cilag International NV Tel.: +36-1-413-3270 | |
Danmark Actelion, a division of Janssen-Cilag International NV Tlf: +453694 45 95 | Malta Actelion, a division of Janssen-Cilag International NV Tel.: +356 2397 6000 | |
Deutschland Actelion, a division of Janssen-Cilag International NV Tel.: +49 761 45 64 0 | Nederland Actelion, a division of Janssen-Cilag International NV Tel.: +31(0)348 435950 | |
Eesti Actelion, a division of Janssen-Cilag International NV Tel.: +372 617 7410 | Norge Actelion, a division of Janssen-Cilag International NV Tlf: +4722480370 | |
Ελλ?δα Actelion, a division of Janssen-Cilag International NV Τηλ: +30 210 675 25 00 | Österreich Actelion, a division of Janssen-Cilag International NV Tel.: +43 1 505 4527 | |
España Actelion, a division of Janssen-Cilag International NV Tel.: +34 93 366 43 99 | Polska Actelion, a division of Janssen-Cilag International NV Tel.: +48 (22) 262 31 00 | |
France Actelion, a division of Janssen-Cilag International NV Tél: +33 (0)1 55 00 26 66 | Portugal Actelion, a division of Janssen-Cilag International NV Tel.: +351 214 368 600 | |
Hrvatska Actelion, a division of Janssen-Cilag International NV Tel.: + 385 1 6610 700 | România Actelion, a division of Janssen-Cilag International NV Tel.: + 40 21 207 1800 | |
Irlanda Actelion, a division of Janssen-Cilag International NV Tel.: +353 1 800 709 122 | Slovenija Actelion, a division of Janssen-Cilag International NV Tel.: +386 1 401 18 00 | |
Ísland Actelion, a division of Janssen-Cilag International NV Sími: +46 8 544 982 50 | Slovenská republika Actelion, a division of Janssen-Cilag International NV Tel.: +420 221 968 006 | |
Italia Actelion, a division of Janssen-Cilag International NV Tel.: +39 0542 64 87 40 | Suomi/Finland Actelion, a division of Janssen-Cilag International NV Puh/Tel:+3589 2510 7720 | |
Κ?προς Actelion, a division of Janssen-Cilag International NV Τηλ: +30 210 675 25 00 | Sverige Actelion, a division of Janssen-Cilag International NV Tel.: +46 8 544 982 50 | |
Latvija Actelion, a division of Janssen-Cilag International NV Tel.: +371 678 93561 | United Kingdom Janssen-Cilag Ltd. Tel: +44 1 494 567 444 |
Last update of this leaflet: November 2018
More detailed information about this medicine is available on the website of the European Medicines Agency:http://www.ema.europa.eu.
GUIDE FOR DOSAGE ADJUSTMENT: DOSAGE ADJUSTMENT PACK
Page 1
Uptravi tablets coated with a film selexipag Guide for dosage adjustment Starting treatment with Uptravi Please read the attached leaflet before starting treatment. Inform your doctor if you experience any side effects, as they may recommend changing your Uptravi dose. Inform your doctor if you are taking other medicines, as they may recommend taking Uptravi only once a day. |
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Index How to take Uptravi?..................................................4 How to increase the dose?............................................6 What are the phases?...................................................8 When to decrease the dose?..............................10 Decrease in dose..............................................12 | Change to maintenance dose.........................14 Missed dose..............................................16 Discontinuation of treatment with Uptravi...................17 Dosage adjustment diary ................................18 |
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How to take Uptravi? Uptravi is a medicine that must be takenin the morningandin the eveningfor the treatment of pulmonary arterial hypertension, also known as PAH. The initial dose of Uptravi is 200microgramsin the morning and in the evening. The first dose of Uptravi should be taken in the evening. You should take each dose with a glass of water, preferably during meals. | There are 2 phases of treatment with Uptravi: Dosage adjustment During the first weeks, your doctor will need your cooperation to find the most suitable dose of Uptravi for you. Your doctor may increase your dose from the initial dose. Your doctor may decrease your dose. This process is called dosage adjustment, and allows your body to gradually adapt to the medicine. Maintenance Once your doctor has found the most suitable dose for you, this will be the dose you will take regularly. This is called the maintenance dose. |
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How to increase the dose? Treatment will start at a dose of 200micrograms in the morning and in the evening, and after discussing it with your doctor or nurse, you will increase the dose to the next phase. The first dose of the increased dose should be taken in the evening. Each phase of dosage adjustment usually lasts approximately 1 week. It may take several weeks to find the most suitable dose for you. The goal is to reach the most suitable dose for your treatment. This dose will be your maintenance dose. | Each patient with PAH is different.No two patients will end up with the same maintenance dose. Some patients may take 200micrograms in the morning and in the evening as their maintenance dose, while others may reach the maximum dose of 1.600 micrograms in the morning and in the evening. Others may reach a maintenance dose at some point between the two. What is important is to reach the most suitable dose for your own treatment. |
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Page 10Page 11
↓When to decrease the dose? As with all medicines, you may experience side effects as you increase your dose of Uptravi. Consult your doctor or nurse if you experience any side effects.There are treatments available to help alleviate them. The most common side effects (may affect more than 1 in 10 people) that you may experience while taking Uptravi are: • Headache • Diarrhea • Nausea • Vomiting •Mandibular pain • Muscular pain • Lower limb pain • Joint pain • Facial flushing See the leaflet for the complete list of side effects and additional information. | If you cannot tolerate the side effects even after your doctor or nurse has tried to treat them, they may recommend that you decrease your dose. If your doctor or nurse recommends that you decrease your dose, take one 200 microgram tablet less in the morning and one less in the evening. You should only decrease your dose after consulting with your doctor or nurse. This process of decreasing your dose will help you find the most suitable dose for you, also known as your maintenance dose. |
Page 12Page 13
Page 14Page 15
Change to maintenance dose The highest dose that you can tolerate during the dosage adjustment phase will become yourmaintenance dose.Your maintenance dose is the dose that you should take regularly. Your doctor or nurse will prescribea single tablet with the equivalent potencyfor your maintenance dose. This will allow you to take a single tablet in the morning and another in the evening, instead of several tablets for each dose. | For example, if your highest tolerated dose during the dosage adjustment phase was 1.200 micrograms once in the morning and once in the evening: Over time, your doctor or nurse may adjust your maintenance dose if necessary. |
Page 16Page 17
Missed dose If you miss a dose, take it as soon as you remember, and then continue taking the tablets in the usual schedule. If you remember in the 6 hours before the time you should take the next dose, do not take the missed dose and continue taking the medicine in the usual schedule. Do not take a double dose to compensate for the missed dose. | Discontinuation of treatment with Uptravi Do not stop taking Uptravi unless your doctor or nurse advises you to. If, for any reason, you stop taking Uptravi for more than 3 consecutive days (if you have missed 6 consecutive doses or more),contact your doctor or nurse immediately, as they may need to adjust your dose to prevent side effects. Your doctor or nurse may decide to restart treatment at a lower dose, gradually increasing it to your previous maintenance dose. |
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Dosage adjustment diary Read the instructions in the leaflet carefully. The following pages of the diary will help you keep a record of the number of tablets you should take in the morning and in the evening during the dosage adjustment phase. Use them to record the number of tablets you take in the morning and in the evening. Each phase usually lasts approximately 1 week, unless your doctor or nurse advises you otherwise. If the phases of dosage adjustment last longer than a week, you have additional pages in your diary to record it. Use pages 20 to 27 to record the first weeks of treatment, when you receive only 200 microgram tablets (phases 1-4). If you have been prescribed tablets of both 200 and 800 micrograms, use pages 30 to 37. (phases 5-8) | Remember to communicate with your doctor or nurse specialist in PAH regularly. Record your doctor's or nurse's instructions: Doctor's phone and email: Pharmacist's phone: Notes: |
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Page 22Page 23
Page 24Page 25
Page 26Page 27
Page 28Page 29
Use the following pages of the diary if your doctor or nurse prescribes tablets of 800 micrograms in addition to the 200 microgram tablets. In the diary pages, check that you have takenonetablet of 800 micrograms every day in the morning and in the evening, along with the number of 200 microgram tablets prescribed. | Remember to communicate with your doctor or nurse specialist in PAH regularly. Record your doctor's or nurse's instructions: Doctor's phone and email: Pharmacist's phone: Notes: |
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