Prospect: information for the user

YANTIL retard 200 mg prolonged-release tablets

Tapentadol

Read this prospect carefully before starting to take this medicine,because it contains

important information for you.

• Keep this prospect, as you may need to read it again.

• If you have any doubts, consult your doctor or pharmacist.

• This medicine has been prescribed only for you and should not be given to others even if they have the same symptoms as you, as it may harm them.

• If you experience any adverse effects, consult your doctor or pharmacist,even if they are not listed in this prospect.See section 4.

1.What is YANTIL retard 200 mg and what is it used for

2.What you need to know before starting to take YANTIL retard 200 mg

3.How to take YANTIL retard 200 mg

4.Possible adverse effects

5.Storage of YANTIL retard 200 mg

6.Contents of the pack and additional information

Tapentadol - the active ingredient of YANTIL retard - is a potent analgesic that belongs to the class of opioids. YANTIL retard 200 mg is used for the treatment of

• intense chronic pain in adults, which can only be adequately treated with an opioid analgesic,
• intense chronic pain in children over 6 years and adolescents, which can only be adequately treated with an opioid analgesic.

Do not take YANTIL retard 200 mg:

Warnings and precautions

Consult your doctor or pharmacist before starting to take YANTIL retard 200 mg:

• if your breathing is slow or shallow,
• if you have increased intracranial pressure or altered consciousness to even coma,
• if you have had a head injury or brain tumors,
• if you have liver or kidney disease (see section “How to take YANTIL retard 200 mg”),
• if you have pancreatitis (inflammation of the pancreas) or bile duct disease,
• if you are taking medications called mixed opioid agonist/antagonists (e.g., pentazocine, nalbuphine) or partial opioid agonists (e.g., buprenorphine),
• if you are prone to epilepsy or seizures, or if you are taking other medications known to increase the risk of seizures, as the risk of seizures may increase,
• if you or a family member has a history of alcohol abuse, prescription medication abuse, or illicit substance abuse (“addiction”),
• if you smoke,
• if you have ever had mood problems (depression, anxiety, or personality disorder) or have received psychiatric treatment for other mental health conditions.

This medication contains tapentadol, which is an opioid medication. Repeated use of opioid analgesics can reduce the effectiveness of the medication (you may become accustomed to it). It can also lead to dependence and abuse, which can result in a potentially fatal overdose.It is essential to inform your doctor if you think you may have developed dependence onYANTIL retard 200 mg. Your use (even at therapeutic doses) may cause physical dependence, which may lead to withdrawal symptoms and a recurrence of your problems if you stop taking this medication abruptly.

YANTIL retard 200 mg can cause physical and psychological addiction. If you have a tendency to abuse medications or have medication dependence, you should take these tablets only for short periods under strict medical supervision.

Children and adolescents

Children and adolescents with obesity should be closely monitored, and the maximum recommended dose should not be exceeded.

Do not administer this medication to children under 6 years old.

Respiratory problems related to sleep

YANTIL retard 200 mgmay cause respiratory problems related to sleep such as sleep apnea (pauses in breathing during sleep) and sleep-related hypoxemia (low oxygen levels in the blood). Symptoms may include pauses in breathing during sleep, nocturnal awakenings due to difficulty breathing, difficulty maintaining sleep, or excessive daytime somnolence. If you or someone else observes these symptoms, consult your doctor. Your doctor may consider reducing the dose.

Taking YANTIL retard 200 mg with other medications

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

The risk of side effects increases if you are taking medications that can cause seizures (e.g., certain antidepressants or antipsychotics). The risk of seizures increases if you take YANTIL retard 200 mg simultaneously with these medications. Your doctor will tell you if YANTIL retard 200 mg is suitable for you.

The concomitant use ofYANTIL retard 200 mgand sedatives such as benzodiazepines or related medications (certain sleeping pills or tranquilizers [e.g., barbiturates] or painkillers like opioids, morphine, and codeine [also as a cough medication], antipsychotics, H1 antihistamines, alcohol) increases the risk of drowsiness, respiratory difficulties (respiratory depression), coma, and may be potentially fatal. Therefore, only consider concomitant use when other treatment options are not possible.

However, if your doctor prescribesYANTIL retard 200 mgwith sedatives, you should limit the dose and duration of concomitant treatment.

The concomitant use of opioids and medications used to treat epilepsy, nerve pain, or anxiety (gabapentin and pregabalin) increases the risk of opioid overdose, respiratory depression, and may be potentially fatal.

Inform your doctorif you aretaking gabapentin or pregabalin or anyother sedative, and follow your doctor's dosage recommendations exactly. It may be helpful to inform your friends and family about the symptoms mentioned above. Inform your doctor if you experience any of these symptoms.

If you are taking a type of medication that affects serotonin levels (e.g., certain antidepressants), talk to your doctor before taking YANTIL retard 200 mg, as there have been cases of “serotonin syndrome.” Serotonin syndrome is a rare but potentially fatal condition. Symptoms may include involuntary muscle contractions, including those that control eye movement, agitation, excessive sweating, tremors, exaggerated reflexes, increased muscle tension, and a body temperature above 38°C. Your doctor may provide additional information.

The concomitant administration ofYANTIL retard 200 mgwith other types of medications called mixed opioid agonist/antagonists (e.g., pentazocine, nalbuphine) or partial opioid agonists (e.g., buprenorphine) has not been studied. It is possible that YANTIL retard 200 mg may not be as effective if taken with one of these medications. Inform your doctor if you are currently being treatedwith one of these medications.

The administrationof YANTIL retard 200 mgwith potent inhibitors or inducers (e.g., rifampicin, phenobarbital, St. John's wort) of certain enzymes necessary for the elimination of tapentadol from your body may affect the efficacy of tapentadol or cause adverse effects, especially when starting or stopping this other type ofmedication. Inform your doctor about all the medications you are taking.

YANTIL retard200 mg should not be taken with MAO inhibitors (medications for depression treatment). Inform your doctor if you are taking MAO inhibitors or ifyou have taken them in the last 14 days.

Taking YANTILretard 200 mg with food, drinks, and alcohol

Do not consume alcohol while taking YANTIL retard 200 mg, as some of its adverse effects, such as drowsiness, may increase. Taking food does not affect the effect of this medication.

Pregnancy and breastfeeding

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

Do not take this medication:

• if you are pregnant, unless your doctor has indicated it, as tapentadol may cause withdrawal symptoms in the newborn if used for extended periods during pregnancy, which can put the newborn's life at risk if not detected and treated by a doctor,

• during delivery, as it may cause slow or shallow breathing to dangerous levels (respiratory depression) in the newborn,
• during breastfeeding, as it may be excreted in breast milk.

Driving and operating machinery

Ask your doctor if you can drive or operate machinery during treatment with YANTIL retard. It is essential to observe how this medication affects you before driving or operating machinery. Do not drive or operate machinery if you feel drowsy, dizzy, have blurred vision, or have difficulty concentrating. Be especially careful at the start of treatment, after a dose change, and when taking it with alcohol or tranquilizers.

YANTIL retard 200 mg contains lactose

If your doctor has told you that you have an intolerance to certain sugars, consult with them before taking this medication.

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.

Your doctor will adjust the dose based on the intensity of your pain and your personal sensitivity to pain. Generally, you should take the minimum effective dose to relieve pain.

Adults

The usual starting dose is 50 mg every 12 hours.

Your doctor may prescribe a different dose or dosing regimen if necessary. If you think the effect of these tablets is too strong or too weak, consult your doctor or pharmacist.

Do not recommend total daily doses exceeding 500 mg of tapentadol.

Older patients

In older patients (over 65 years old), the dose usually does not need to be adjusted. However, the elimination of tapentadol may be delayed and slower in certain patients of this age group. If this happens to you, your doctor may prescribe a different dosing regimen.

Liver and kidney diseases (hepatic and renal insufficiency)

Patients with severe liver problems should not take these tablets. If you have moderate liver problems, your doctor will prescribe a different dosing regimen. In case of mild liver problems, no dose adjustment is necessary.

Patients with severe kidney problems should not take these tablets. In case of mild or moderate kidney problems, no dose adjustment is necessary.

Use in children and adolescents

For children and adolescents from 6 years old to less than 18 years old, the dose depends on age and body weight.

The appropriate dose should be prescribed by your doctor.Do not exceed a total daily dose of 500 mg, i.e., 250 mg administered every 12 hours.

Children and adolescents with kidney or liver problems should not use this medication.

YANTIL retard 200 mg is not indicated in children under 6 years old.

How and when to take YANTIL retard 200 mg

YANTIL retard 200 mg should be taken orally.

Always take the tablets whole with a sufficient amount of liquid.

Do not chew, break, or crush them, as this could lead to an overdose, as the active ingredient will be released in your body too quickly.

You can take them on an empty stomach (with an empty stomach) or with meals.

The coating of the tablet may not be completely digested and may appear, apparently unchanged, in the feces. This should not worry you, as the active ingredient of the tablet will have already been absorbed by the body, and what you see is only the empty coating.

For how long should YANTIL retard 200 mg be taken

Do not take the tablets for longer than your doctor has indicated.

If you take more YANTIL retard 200 mg than you should

After taking very high doses, you may experience some of the following effects:

• very small pupils, vomiting, decreased blood pressure, rapid heartbeats, dizziness, altered consciousness or coma (deep loss of consciousness), seizures, slow or shallow breathing to dangerous levels or respiratory arrest.

If any of these things happen to you, call a doctor immediately!

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicological Information Service, phone: 91 562 04 20 indicating the medication and the amount used. It is recommended to bring the packaging and the medication leaflet to the healthcare professional.

If you forgot to take YANTIL retard 200 mg

If you forget to take a tablet, it is likely that you will feel pain again. Do not take a double dose to compensate for the missed doses, but continue taking the tablets as before.

If you interrupt treatment with YANTIL retard 200 mg

If you interrupt or stop treatment too soon, it is likely that you will feel pain again. If you want to interrupt treatment, consult your doctor before doing so.

Generally, patients do not experience any adverse effects after interrupting treatment, but in rare cases, people who have taken the tablets for a long time may feel unwell if they stop taking them suddenly.

The symptoms may be:

• anxiety, watery eyes, runny nose, yawning, sweating, chills, muscle pain, and dilated pupils,
• irritability, anxiety, back pain, joint pain, weakness, abdominal cramps, difficulty sleeping, nausea, loss of appetite, vomiting, diarrhea, and increased blood pressure, respiratory frequency, or heart rate.

If you experience any of these symptoms after interrupting treatment, consult your doctor.

You should not stop taking this medication abruptly, unless your doctor tells you to. If your doctor wants you to stop taking these tablets, they will indicate how to do it, which may involve a gradual reduction in dose.

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

Like all medicines, this medicine may cause side effects, although not everyone will experience them. No additional side effects were observed in children and adolescents compared to adults.

Important side effects or symptoms to be aware of and what to do if you are affected by them:

This medicine may cause allergic reactions. Symptoms may include wheezing (a whistling sound when breathing), difficulty breathing, inflammation of the eyelids, face, or lips, skin rash or itching, especially if it affects the entire body.

Another serious side effect is breathing more slowly or more weakly than normal. It occurs mainly in elderly patients or in weakened patients.

If you experience any of these important symptoms, consult your doctor immediately.

Side effects that may occur:

Very common(may affect more than 1 in 10 people):nausea, constipation, dizziness, drowsiness, headache.

Common(may affect up to 1 in 10 people):loss of appetite, anxiety,depression of mood,difficulty sleeping,nervousness, restlessness, attention disturbances,shakiness,muscle tics,headaches,shortness of breath, vomiting,diarrhea, poor digestion, itching, increased sweating, skin eruptions,sensation of weakness, fatigue, sensation of change in body temperature, dryness of mucous membranes, accumulation of water in tissues (edema).

Uncommon(may affect up to 1 in 100 people):allergic reaction to medication (including hives, urticarial rash, and in severe cases difficulty breathing, decreased blood pressure, collapse, or shock), weight loss, disorientation, confusion, excitability (agitation), perception disturbances, sleep disturbances, euphoric mood, depression of consciousness, memory deterioration, mental deterioration, fainting, sedation, balance disorders, difficulty speaking, numbness, abnormal skin sensations (e.g., tingling, itching), vision disturbances, rapid heartbeats, slow heartbeats, palpitations, decreased blood pressure, abdominal discomfort, hives, delayed urination, frequent urination, sexual dysfunction, drug withdrawal syndrome (see section “If you interrupt treatment withYANTIL retard 200 mg”), feeling unwell, irritability.

Rare(may affect up to 1 in 1,000 people):drug dependence, thought disorder, seizures, feeling of impending fainting, coordination disturbances, slow or shallow breathing to dangerous levels (respiratory depression), gastric emptying disturbances, feeling of intoxication, feeling of relaxation.

Unknown frequency(frequency cannot be estimated from available data):delirium.

In general, the possibility of having suicidal thoughts and behaviors increases in patients with chronic pain. Additionally, some medications for treating depression (affecting the neurotransmitter system in the brain) may increase this risk, especially at the beginning of treatment. Although tapentadol also affects neurotransmitters, through experience in patients it has not been proven to increase this risk.

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 prospectus. You can also report them directly through the Spanish System for 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 medicine.

Keep this medication out of the sight and reach of children.

Do not usethis medicationafter the expiration date that appears on the box and in the blister.The expiration date is the last day of the month indicated.

This medication does not require special conditions for conservation.

Medications should not be thrown down the drains or in the trash.Dispose of the packaging and medications that you no longer needat the PointSIGREof the pharmacy.If in doubt, ask your pharmacist how to dispose of the packaging and medications that you no longer need. By doing so, you will help protect the environment.

Composition of YANTIL retard 200 mg

The active principle is tapentadol.

Each tablet contains 200 mg of tapentadol (as 232.96 mg of tapentadol hydrochloride).

The other components are:

Tablet core: hypromellose, microcrystalline cellulose, anhydrous colloidal silica, magnesium stearate. Tablet coating: hypromellose, lactose monohydrate, talc, macrogol, propylene glycol, titanium dioxide (E 171), yellow iron oxide (E 172), red iron oxide (E172).

Appearance of the product and content of the container

Prolonged-release tablets, coated with a film, pale orange in color, oblong (7 mm x 17 mm), with the Grünenthal logo engraved on one face and “H4” on the other.

The tablets are packaged in blisters and are supplied in containers of 7, 10, 10x1, 14, 14x1, 20, 20x1, 24, 28, 28x1, 30, 30x1, 40, 50, 50x1, 54, 56, 56x1, 60, 60x1, 90, 90x1, 100, and 100x1 tablets.

Only some container sizes may be commercially marketed.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder:

Grünenthal Pharma, S.A.

Doctor Zamenhof, 36 – 28027 Madrid, Spain

Responsible manufacturer:

Grünenthal GmbH

Zieglerstrasse, 6 – D-52078 Aachen, Germany

This medicine is authorized in the member states of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Germany: Tapentadol Libra-Pharm Retard

Austria and Portugal: Ationdo retard

Spain: YANTIL retard

United Kingdom (Northern Ireland): Ationdo SR

Last review date of this leaflet: November 2024

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/