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Zeldox

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Document: Zeldox capsule, hard ENG PL change



PACKAGE LEAFLET


Package leaflet: Information for the user


Zeldox

20 mg, 40 mg, 60 mg, 80 mg capsules, hard

Ziprasidone


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


What is in this leaflet:

1. What Zeldox capsules are and what they are used for

2. What you need to know before you use Zeldox capsules

3. How to take Zeldox capsules

4. Possible side effects

5. How to store Zeldox capsules

6. Contents of the pack and other information


1. What Zeldox Capsules are and what are they used for


Zeldox capsules belong to a group of medicines called antipsychotics.


Zeldox capsules are used for the treatment of schizophreniain adults - a mental disorder characterised by the following symptoms: to hear, see and feel things that do not exist, to believe in something not true, to feel unusual suspicions, to be absent and have difficulty in establishing social relationships, nervousness, depression or anxiety.


Zeldox capsules are also used for the treatment of manic or mixed episodes of moderate severity in bipolar disorder in adults and children and adolescents aged 10-17 years - a mental disorder characterised by alternate stages of euphoric (mania) or depressed mood states. During mania episodes, the most characteristic symptoms are: elated behaviour, exaggerated self-esteem, increase in energy, decreased need for sleeping, lack of concentration or hyperactivity and repeated high risk-taking behaviour.


2. What you need to know before you use Zeldox Capsules


Do not take Zeldox Capsules


Also refer to the section “Other medicines and Zeldox Capsules” below.


Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Zeldox capsules


Contact your doctor immediately if you experience any of the following:

Severe skin reactions such as rash with blisters which could include ulcers in the mouth, skin shedding, fever and target-like spots on the skin that could be symptoms of Stevens-Johnson syndrome. These skin reactions could potentially be life-threatening.


Tell your doctor that you are taking Zeldox capsules before you have a laboratory test (such as blood, urine, liver function, heart rate etc) because it may alter the results of the test.


Other medicines and Zeldox Capsules

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines, including medicines obtained without a prescription.


Do not take Zeldox capsules if you take medicines for heart rhythm problems or medicines that may affect the heart’s rhythm, such as:

Class IA and III antiarrhythmics, arsenic trioxide, halofantrine, levomethadyl acetate, mesoridazine, thioridazine, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, dolasetron mesilate, mefloquine, sertindole or cisapride. These medicines affect the heart rhythm by prolonging the QT interval. If you have any further questions about this you should speak to your doctor.


Talk to your doctor or pharmacist before taking Zeldox Capsules


Please tell your doctor or pharmacist if you are taking or have recently taken medicines for the treatment of:

- bacterial infections; these medicines are known as antibiotics; e.g. macrolide antibiotics or rifampin;

- mood swings (ranging from depressive mood to euphoria), agitation and irritation; these are known as mood stabilising medicines e.g. lithium, carbamazepine, valproate;

- depression, including certain serotonergic medicines e.g. SSRI’s such as fluoxetine, paroxetine, sertraline;or herbal medicines or natural remedies containing St John´s Wort;

- epilepsy e.g. phenytoin, phenobarbital, carbamazepine, ethosuximide;

- Parkinson’s disease e.g. levodopa, bromocriptine, ropinirol, pramipexole;

- or if you are taking or have recently taken the following medicines:verapamil, quinidine, itraconazole or ritonavir.


Also refer to the section “Do not take Zeldox Capsules” above.


Zeldox capsules with food and drink

Zeldox capsules MUST BE TAKEN DURING A MAIN MEAL.

You should not drink alcohol during treatment with Zeldox capsules, as this may increase the risk of side effects.


Pregnancy and breast-feeding


Pregnancy
You should not take Zeldox capsules during pregnancy unless you are told otherwise by your doctor because there is a risk that this medicine may harm your baby. Always use effective contraception. Tell your doctor immediately if you become pregnant or are planning to become pregnant whilst taking Zeldox capsules.


The following symptoms may occur in newborn babies, of mothers that have used Zeldox in the last trimester (last three months of their pregnancy): shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.


Breast-feeding
Do not breast-feed if you are taking Zeldox capsules. This is because small amounts may pass into the mother’s milk. If you are planning to breast-feed talk to your doctor before taking this medicine.


Ask your doctor or pharmacists for advice before taking any medicine.


Driving and using machines

Taking Zeldox capsules may make you feel drowsy. If you experience this symptom, you should not drive or use tools or machinery until the drowsiness disappears.


Zeldox capsules contain lactose

Zeldox capsules contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking Zeldox capsules.


3. How to use Zeldox Capsules


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


The capsules should be swallowed whole, not chewed and must be taken with meals. It is important not to chew the capsules as it may affect the extent to which the medicine is absorbed by the gut.


Zeldox capsules should be taken twice daily, one capsule in the morning during a full ‘breakfast’ and one in the evening during the ‘evening meal’ (see the blister pack). You should take this medicine at the same time every day.


Adults

The recommended dose is 40-80 mg twice daily to be taken with meals.


In long-term treatments, your doctor may adjust the dose. You should not exceed the maximum dose of 160 mg per day.


Children and adolescents with bipolar mania

The usual starting dose is 20 mg to be taken with a meal, after which your doctor will advise on optimal doses for you. You should not exceed the maximum dose of 80 mg per day in children weighing 45 kg or less, or 160 mg per day in children weighing more than 45 kg.

The safety and efficacy of Zeldox in the treatment of schizophrenia in children and adolescents has not been established.


Elderly (over 65 years old)

If you are elderly, your doctor will decide the suitable dose for you. Doses in those over 65 are sometimes lower than those used in younger people. Your doctor will advise you what the right dose is for you.


Patients with liver problems

If you have liver problems you may need to take a lower dose of Zeldox capsules. Your doctor will work out the correct dose for you.


If you take more Zeldox capsules than you should
Contact your doctor or go to the nearest hospital casualty department immediately. Take your box of Zeldox capsules with you.


If you have taken too many Zeldox capsules, you may experience drowsiness, shaking, fits and involuntary movements of the head and neck.


If you forget to take, Zeldox capsules

It is important you take Zeldox capsules regularly at the same time each day. If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. In that case, just take your next dose. Do not take a double dose to make up for a forgotten dose.


If you stop taking Zeldox capsules

Your doctor will tell you how long to take Zeldox capsules for. You should not stop using Zeldox, unless your doctor has told you to.


It is important to continue with your medication, even if you feel better. If you stop the treatment too early, the symptoms may return.


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. However, most side effects are transient. It may often be difficult to distinguish the symptoms of your disease from those of side effects.


STOP taking Zeldox capsules and contact your doctor immediately if you experience any of the following serious side effects:

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

Involuntary/unusual movements, especially in your face or tongue.


Uncommon side effects (may affect up to 1 in 100 people):

Fast or irregular heartbeat, dizziness on standing up which may indicate abnormal functioning of the heart. These could be symptoms of a condition known as postural hypotension.


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


You may experience any of the following side effects listed below. These potential side effects generally are mild to moderate and may resolve with time. However, if the side effect is severe or persistent, you should contact your doctor.


Very Common side effects (may affect more than 1 in 10 people):


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


Uncommon side effects (may affect up to 1 in 100 people):

High levels of prolactin in the blood


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


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

In elderly people with dementia, a small increase in the number of deaths has been reported for patients taking antipsychotics compared with those not receiving antipsychotics.

Blood clots in the veins especially in the legs (symptoms include swelling, pain and redness in the leg), which may travel through blood vessels to the lungs causing chest pain and difficulty in breathing. If you notice any of these symptoms seek medical advice immediately.


If you get any side effects talk toyour doctor, pharmacist or nurse. 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 Zeldox Capsules


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


Do not store above 30ºC.


Do not use this medicine after the expiry date, which is stated on the carton. 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 Zeldox capsules contain

The active substance is ziprasidone. Each capsule contains 20 mg, 40 mg, 60 mg or 80 mg of ziprasidone as ziprasidone hydrochloride monohydrate.


The other ingredients are: lactose monohydrate, pregelatinised maize starch, magnesium stearate, gelatin, titanium dioxide (E171), sodium laurilsulfate (sodium dodecylsulphate) and indigotin (E132) for capsules containing blue (20, 40 and 80 mg), shellac, ethyl alcohol anhydrous, isopropyl alcohol, n-butyl alcohol, propylene glycol, purified water, ammonium hydroxide, potassium hydroxide and black iron oxide (E172).


What Zeldox capsules look like and contents of the pack

Zeldox capsules are hard gelatin capsules.

Zeldox capsules 20 mg are blue/white and marked ”Pfizer” and ZDX 20.

Zeldox capsules 40 mg are blue and marked ”Pfizer” and ZDX 40.

Zeldox capsules 60 mg are white and marked ”Pfizer” and ZDX 60.

Zeldox capsules 80 mg are blue/white and marked ”Pfizer” and ZDX 80.


Pack sizes:

Aluminium PVC/PVA blisters containing 14, 20, 30, 50, 56, 60 or 100 capsules.


Plastic bottle (HDPE) with drying agent and child-proof screw cap containing 100 capsules.

A heat induction seal may be used as a closure, in which case no drying agent is included


Not all pack sizes may be marketed.


Marketing Authorisation Holder

<To be completed nationally>


Manufacturer:

R-Pharm Germany GmbH,Heinrich-Mack-Str. 35, 89257 Illertissen, Germany


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


EU COUNTRIES

Capsules

Austria, Denmark, Finland, Germany, Iceland, Italy, Norway, Portugal, Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia

ZELDOX

Ireland

GEODON

Greece, Spain, Sweden

ZELDOX, GEODON



This leaflet was last revised in 2016-09-29



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