Alprazolam Stada

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Package leaflet: Information for the user

Alprazolam Stada^¹0.25 mg, 0.5 mg and 1 mg tablets

Alprazolam

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What Alprazolam Stada is and what it is used for

2. What you need to know before you take Alprazolam Stada

3. How to take Alprazolam Stada

4. Possible side effects

How to store Alprazolam Stada

6. Contents of the pack and other information

1. What Alprazolam Stada is and what it is used for

Alprazolam Stada belongs to a group of medicines called “benzodiazepines” (sedatives).

Alprazolam Stada is used for treatment of anxiety symptoms which are severe, disabling or causing the patient great distress.

The tablets are for short-term use only.

2. What you need to know before you take Alprazolam Stada

DO NOT take Alprazolam Stada and tell your doctor if:

you are allergic to alprazolam, other benzodiazepines or any of the other ingredients of this medicine (listed in section 6)
you suffer from a condition known as ‘sleep apnoea’ where you occasionally stop breathing for a short time while you are sleeping.
you have the muscle disease Myasthenia Gravis
you have severe breathing problems
you have severe liver problems
you have an acute intoxication caused by alcohol or other drugs which affect the central nervous system

Tell your doctor if you are not sure about any of the above.

Warnings and precautions

Talk to your doctor or pharmacist before taking Alprazolam Stada

if you abuse or have been abusing alcohol, drugs or medicines.
if you have been taking Alprazolam Stada for a long time as the effect may decrease.
if you have problems with your lungs, kidneys or liver.

Use of Alprazolam Stada may lead to physical and mental dependence on the medicine. The risk for dependence is increased by dose and time of treatment. Therefore the duration of treatment must be as short as possible. You notice psychological dependence by not wanting to stop taking the medicine. Physical dependence means that withdrawal symptoms occur when the treatment with this medicine is stopped suddenly. The risk is also greater in patients who abuse or have been abusing alcohol and medicines (see also section 3 “If you stop taking Alprazolam Stada“).

During treatment with Alprazolam Stada your memory may be disturbed.

This usually occurs several hours after the product has been taken. Please ask your doctor if you notice such a symptom.

If you suffer from psychosis, a severe mental illness which disturbs your behaviour, actions and self-control, then Alprazolam Stada is not appropriate.

The treatment with Alprazolam Stada may increase the risk to develop thoughts of harming or killing yourself if you suffer from:

severe depression
anxiety associated with severe depression.

Please ask your doctor before starting treatment with Alprazolam Stada.

If treatment with Alprazolam Stada is necessary and if you are severely depressed or have previously had thoughts about killing or harming yourself your doctor will monitor you closely. If you develop thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away.

Children and adolescents

Alprazolam Stada is not recommended for children and adolescents under the age of 18 years.

Other medicines and Alprazolam Stada

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

The effect of the treatment may be affected if Alprazolam Stada is used together with other medicines to treat the listed conditions. Your doctor may need to adjust your dosage.

mental problems (antipsychotic medicines including clozapine)
sleep disorders (sleeping tablets)
allergies or hay fever (some antihistamines)
if you undergo major surgery (anaesthetics)
severe pain (narcotic analgesics)
therapy against drug addiction (substitutive treatment)
problems such as anxiety or depression, including certain antidepressants containing fluoxetine, fluvoxamine or nefazodone
heart failure (digoxin)
infections (antibiotics) containing erythromycin, clarithromycin or telithromycin
fungal infections (itraconazole, fluconazole, ketoconazole, posaconazole, voriconazole)
medicines to treat angina pectoris and high blood pressure, such as diltiazem
HIV and AIDS called HIV-protease inhibitors
heartburn and stomach ulcer, such as cimetidine
asthma and bronchitis such as theophylline
epilepsy, such as carbamazepine
muscle relaxant medicines. When used together with alprazolam there may be an increase of the muscle relaxing effect and a risk of falling.

Alprazolam Stada with food, drink and alcohol

You should not drink alcohol when taking Alprazolam Stada as the combination may make you sleepy.

The tablets should be taken together with some fluid and with or without food.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

There is a risk that the foetus will be affected. During pregnancy, Alprazolam should only be used after a careful benefit / risk consideration by your doctor. Your doctor will decide if the possible benefit of a treatment overweighs the risk to the unborn child and if the tablets are suitable for you.

Alprazolam Stada should not be taken if you are breast-feeding. Alprazolam passes into breast milk.

Driving and using machines

Treatment with Alprazolam Stada may impair your ability to react and concentrate by making you feel drowsy and/or forgetful. Do not drive or operate machinery if you feel affected in this way. Ask your doctor for advice if you´re not sure

Alprazolam Stada contains lactose.

If you have been told by your doctor that you have an intolerance to some sugar, contact your doctor before taking this medicinal product.

3. How to take Alprazolam Stada

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is

Initial dosage: 0.25 – 0.5 mg three times daily
Maintenance dosage: 0.5 mg – 3 mg daily divided in separate doses as your doctor has prescribed. If necessary, your doctor may increase your dose at intervals of 3-4 days. The maximum dose of 3 mg must not be exceeded.

Generally, treatment with Alprazolam Stada will be short-term. The overall length of treatment should not exceed 8-12 weeks, including time for gradual decrease of dose and stopping treatment (see section “If you stop taking Alprazolam Stada”).

The tablets should be taken together with some fluid. The tablets may be divided into two equal parts.

Patients with breathing difficulties

If you suffer from difficulty in breathing (chronic respiratory insufficiency) your doctor may prescribe you a lower dose. Alprazolam STADA must not be used in patients with severe breathing difficulties.

Elderly patients or patients with kidney and/or liver problems

These patients might need a lower dose. Your doctor will determine your individual dose.

The usual dose for these patients is:

Initial dosage: 0.25 mg two to three times daily
Maintenance dosage: 0.5 – 0.75 mg per day in divided doses. Your doctor may increase the dose gradually by no more than 0.5 mg every three days.
Maximum dose: 0.75 mg – 1.5 mg daily.

If you take more Alprazolam Stada than you should

If you accidentally take too many tablets, call your doctor straight away, or go to the nearest hospital casualty department. Always take any leftover tablets with you, as well as the container and label, so that the medical staff knows what you have taken.

Symptoms of overdose can be

dizziness
sleepiness
unconsciousness
muscle weakness
lack of coordination while performing movements (ataxia)
or reactions such as aggressiveness, hallucinations and agitation.

If you forget to take Alprazolam Stada

If you have forgotten to take your medicine at your usual time, take it as soon as you remember. If it is nearly time for your next dose, leave out the forgotten dose and take the next dose as usual. Do not take a double dose to make up for a forgotten tablet. If you are not sure ask your doctor or pharmacist for advice.

If you stop taking Alprazolam Stada

Always check with your doctor before stopping the treatment.

Stopping treatment suddenly may lead to withdrawal symptoms such as headache, muscle pain, severe anxiety, restlessness, confusion, irritation and sleep disorders.

In severe cases the following symptoms may occur: loss of sense of reality, depersonalisation (a feeling that you are outside of your own body), loss of sensation and tingling sensations in arms and legs, oversensitivity to light, sound, and touch, hallucinations and epileptic seizures (fits). Withdrawal symptoms can occur several days after you have stopped taking the tablets.

Also when treatment with alprazolam stops, symptoms that prompted treatment with Alprazolam Stada in the first place can reoccur and with greater intensity than before. Besides the symptoms listed above, this can also lead to mood swings.

Therefore, your doctor will reduce your dose gradually when stopping treatment. He/she will decide about the dose reduction on an individual base, as the dose tapering depends on several factors (e.g. the duration of treatment and your daily dose). In general the dose reduction should be made by 0.5 mg alprazolam per three days or in some patients even more slowly. Please ask your doctor how you should reduce your dose gradually.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Stop taking the medicine and contact your doctor as soon as possible if you notice:

a yellow discolouration of the eye whites or skin (jaundice)
conflicting reactions such as anxiety, restlessness, agitation, irritability, aggression, delusions, attacks of rage, nightmares, increased insomnia, perceptions of things that do not exist (hallucinations), severe mental disorders in which control over one’s own behaviour and actions is disturbed (psychosis), inappropriate behaviour and other behavioural disorders. These conflicting reactions occur more frequently in elderly patients.
a depression/depressive thoughts.

The following side effects may occur during treatment with Alprazolam Stada

You may consult your doctor at regular intervals. Please inform him during these routine examinations, if you experience or experienced one of the following possible side effects.

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

Feeling numb, drowsiness.

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

Decreased appetite, confusion, muscle coordination disorder (ataxia), coordination difficulties, difficulties with speech, concentration disturbances, dizziness, headache, blurred vision, constipation, diarrhoea, nausea, weakness (asthenia), irritability, depression.

A condition in which memory is disturbed can commonly occur. This condition may be accompanied by inappropriate behaviour (see also section 2 “Warnings and precautions”).

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

Skin reactions, inflammation of the skin (dermatitis), vomiting, blood prolactin hormone level increased, disturbances in monthly periods in women, changes in sex drive, sexual dysfunction, aggressiveness, hostile behaviour, hallucinations, attacks of rage, anxiety, agitation, sleep disorders, thinking abnormal, nervousness, stimulation, loss of memory, muscular weakness resulting in a risk of falls, shaking, problems with the liver and jaundice (causing yellowing of skin and whites of the eye), muscular tension, urinary problems, incontinence, change in weight, increased pressure within the eye.

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

Dry mouth.

Not known (frequency cannot be estimated from the available data):

rapid heart beat
reduced alertness, tiredness (fatigue)
low blood pressure
swelling of the ankles, feet or fingers
loss of appetite, stimulation of appetite, swallowing problems
increased saliva
blocked nose
liver inflammation (hepatitis)

Previously unnoticed depression may become apparent in susceptible individuals.

Physical and mental dependence may develop during the treatment. Stopping treatment suddenly can therefore lead to certain symptoms (see also section 3 “If you stop taking Alprazolam Stada”).

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Alprazolam Stada

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

Do not store above +30 °C.

Do not use this medicine after the expiry date which is stated on the package. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Alprazolam Stada contains

The active substance is alprazolam. Each tablet contains 0.25 mg, 0.5 mg or 1 mg alprazolam.
The other ingredients are docusate sodium, sodium benzoate, pregelatinised starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate, colloidal anhydrous silica.

Alprazolam Stada 0.5 mg tablets additionally contain erythrosine aluminium lake (colouring agent E127)

Alprazolam Stada 1.0 mg tablets additionally contain indigo carmine aluminium lake (colouring agent E132)

What Alprazolam Stada looks like and contents of the pack

Alprazolam Stada 0.25 mg: white, oval, scored tablets

Alprazolam Stada 0.5 mg: pink, oval, scored tablets

Alprazolam Stada 1 mg: light blue, oval, scored tablets

Content of the packs: 0.25 mg/0.5 mg: 7, 10, 14, 20, 21, 28, 30, 40, 50, 60, 70, 80, 84, 90, 100, 200, 250, 500 and 1000 tablets in blister.

1 mg: 10, 14, 20, 21, 28, 30, 40, 50, 60, 70, 80, 84, 90, 100, 200, 250, 500 and 1000 tablets in blister.

Marketing Authorisation Holder

[To be completed nationally]

In Sweden:

STADA Arzneimittel AG

Stadastrasse 2-18

61118 Bad Vilbel

Germany

Manufacturer

[To be completed nationally]

This leaflet was last revised in 2015-05-19.

This medicinal product is authorised in the Member States of the EEA under the following names:

Austria: Alprastad 0,5 mg – Tabletten, Alprastad 1 mg – Tabletten

Estonia: Alprasedon 0,25 mg, Alprasedon 0,5 mg, Alprasedon 1 mg

Germany: Alprazolam AL 0,5 mg Tabletten, Alprazolam AL 1 mg Tabletten

Denmark: Alprazolam PCD

Lithuania: Alprasedon 0,25 mg, Alprasedon 0,5 mg, Alprasedon 1 mg

Sweden: Alprazolam STADA

1 used as working title