Estomil Flas 15 mg orodispersible tablets

Patient Information Leaflet

Introduction

Package Leaflet: Information for the Patient

Estomil Flas 15 mg orodispersible tablets

Lansoprazole

Read the entire leaflet carefully before you start taking this medicine, as 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 must not be given to other people, even if they have the same symptoms as you, because it could harm them.
• If you experience any adverse effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet. See section 4.

Leaflet Contents

1. What Estomil Flas is and what it is used for
2. What you need to know before taking Estomil Flas
3. How to take Estomil Flas
4. Possible side effects
5. How to store Estomil Flas
6. Contents of the pack and other information

1. What Estomil Flas is and what it is used for

The active substance in Estomil Flas is lansoprazole, a proton pump inhibitor. Proton pump inhibitors reduce the amount of acid produced by the stomach.

Your doctor may prescribe Estomil Flas for the following conditions:

• Treatment of duodenal and gastric ulcers
• Treatment of inflammation of the oesophagus (reflux esophagitis)
• Prevention of reflux esophagitis
• Treatment of heartburn and acid regurgitation
• Treatment of infections caused by the bacterium Helicobacter pylori, in combination with antibiotics
• Treatment or prevention of duodenal or gastric ulcers in patients requiring ongoing treatment with non-steroidal anti-inflammatory drugs (NSAIDs) (NSAID therapy is used for pain or inflammation)
• Treatment of Zollinger-Ellison syndrome

Your doctor may have prescribed Estomil Flas for a different indication or at a different dose than those stated in this leaflet. Follow your doctor's instructions regarding how to take the medicine.

Consult a doctor if your condition worsens or does not improve after 14 days.

2. What you need to know before taking Estomil Flas

Do not take Estomil Flas

• if you are allergic to lansoprazole or to any of the other components of this medicine (listed in section 6)

Warnings and precautions

Talk to your doctor or pharmacist before taking Estomil Flas:

• if you have reduced body stores of vitamin B12 or risk factors for this, and are receiving long-term treatment with lansoprazole. Like all medicines that reduce acid levels, Estomil Flas may reduce the absorption of vitamin B12,
• if you are scheduled to have a specific blood test (chromogranin A),
• if you have ever had a skin reaction after treatment with a medicine similar to Estomil Flas used to reduce stomach acidity,
• if you develop a skin rash, especially in areas of skin exposed to sunlight, consult your doctor as soon as possible, as it may be necessary to discontinue treatment with Estomil Flas. Remember to mention any other symptoms you may notice, such as joint pain.

When taking lansoprazole, inflammation of the kidneys may occur. Signs and symptoms may include decreased urine volume or presence of blood in the urine and/or hypersensitivity reactions such as fever, skin rash, and joint stiffness. You should report these signs to your doctor.

Inform your doctor if you have severe liver disease. Your doctor may need to adjust your dose.

Your doctor may perform or may have already performed an additional test called endoscopy to diagnose your condition and/or rule out malignant disease.

If you experience diarrhea during treatment with Estomil Flas, contact your doctor immediately, as Estomil Flas has been associated with a slight increase in infectious diarrhea.

If your doctor has prescribed Estomil Flas along with other medicines for the treatment of Helicobacter pylori infection (antibiotics) or together with anti-inflammatory drugs for pain or rheumatism, please also read the package leaflets of these medicines carefully.

Taking a proton pump inhibitor such as Estomil Flas, especially for more than one year, may slightly increase the risk of hip, wrist, or vertebral fractures. Inform your doctor if you have osteoporosis or if you are taking corticosteroids (which may increase the risk of osteoporosis).

If you have been taking Estomil Flas for a long time (more than 1 year), your doctor will likely monitor you regularly. During visits to your doctor, you should report any new or unusual symptoms or circumstances.

Other medicines and Estomil Flas

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

In particular, inform your doctor if you are taking medicines containing any of the following active substances, as Estomil Flas may affect their action:

• HIV protease inhibitors such as atazanavir and nelfinavir (used in HIV treatment)

• methotrexate (used to treat autoimmune diseases and cancer)

• ketoconazole, itraconazole, rifampicin (used to treat infections)

• digoxin (used to treat heart problems)

• warfarin (used to treat blood clots)

• theophylline (used to treat asthma)

• tacrolimus (used to prevent transplant rejection)

• fluvoxamine (used to treat depression and other psychiatric disorders)

• antacids (used to treat heartburn or acid regurgitation)

• sucralfate (used to heal ulcers)

• St. John's wort (Hypericum perforatum) (used to treat mild depression)

Taking Estomil Flas with food and drink

For optimal effectiveness, take Estomil Flas at least 30 minutes before meals.

Pregnancy and breastfeeding

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

Driving and using machines

Patients taking Estomil Flas may occasionally experience side effects such as dizziness, vertigo, fatigue, and visual disturbances. If you experience any of these side effects, you should exercise caution, as your reaction ability may be impaired.

You are solely responsible for deciding whether you are fit to drive or perform activities requiring high concentration. Due to its potential effects or adverse reactions, the use of medicines may be one of the factors that reduce your ability to safely carry out these tasks.

Descriptions of these effects can be found in the following sections.

Please read the information in this leaflet carefully.

If you have any doubts, ask your doctor or pharmacist.

Estomil Flas contains sucrose and sodium hydroxide.

This medicine contains sucrose. If your doctor has informed you that you have an intolerance to certain sugars, consult with him before taking this medicine.

This medicine contains less than 23 mg of sodium (1 mmol) per orodispersible tablet; thus, it is essentially "sodium-free".

3. How to take Estomil Flas

Follow exactly the instructions for administering this medicine as given by your doctor or pharmacist. If in doubt, consult your doctor or pharmacist again.

Place the tablet on the tongue and suck it slowly. The tablet dissolves rapidly in the mouth, releasing microgranules that should be swallowed without chewing. Alternatively, the whole tablet may be swallowed with a glass of water.

Your doctor may give you instructions for administering the tablet using a syringe if you have serious difficulty swallowing.

Follow the instructions below for administration using a syringe:

It is important to ensure that the syringe selected is appropriate.

• Remove the plunger from the syringe (at least a 5 ml syringe for the 15 mg tablet and a 10 ml syringe for the 30 mg tablet).
• Place the tablet into the barrel.
• Replace the plunger into the syringe.
• For the 15 mg tablet: fill the syringe with 4 ml of water.
• For the 30 mg tablet: fill the syringe with 10 ml of water.
• Invert the syringe and pull the plunger to draw in 1 ml of air.
• Gently shake the syringe for 10–20 seconds until the tablet has dispersed.
• The contents can be emptied directly into the mouth.
• Refill the syringe with 2–5 ml of water to remove any residue from the syringe and empty it into the mouth.

If you take Estomil Flas once daily, try to take it at the same time each day. You may achieve better results if you take Estomil Flas in the morning.

If you take Estomil Flas twice daily, take the first dose in the morning and the second in the evening.

The dose of Estomil Flas depends on your general condition. The usual doses of Estomil Flas for adults are indicated below. Occasionally, your doctor may prescribe a different dose and advise a different treatment duration.

Treatment of heartburn and acid regurgitation: one orodispersible tablet of 15 mg or 30 mg daily for 4 weeks. If symptoms persist, inform your doctor. If symptoms do not improve after 4 weeks, consult your doctor.

Treatment of duodenal ulcer: one orodispersible tablet of 30 mg daily for 2 weeks.

Treatment of gastric ulcer: one orodispersible tablet of 30 mg daily for 4 weeks.

Treatment of inflammation of the oesophagus (reflux oesophagitis): one orodispersible tablet of 30 mg daily for 4 weeks.

Long-term prevention of reflux oesophagitis: one orodispersible tablet of 15 mg daily; your doctor may adjust your dose to one orodispersible tablet of 30 mg daily.

Treatment of Helicobacter pylori infection: The usual dose is one orodispersible tablet of 30 mg together with two different antibiotics in the morning and one orodispersible tablet of 30 mg together with two different antibiotics in the evening. Treatment is normally daily for 7 days.

The recommended antibiotic combinations are as follows:

• 30 mg of Estomil Flas with 250–500 mg of clarithromycin and 1,000 mg of amoxicillin
• 30 mg of Estomil Flas with 250 mg of clarithromycin and 400–500 mg of metronidazole

If you are receiving anti-infective treatment for an ulcer, the ulcer is unlikely to recur if the infection is successfully treated. To obtain the best results from your medicine, take it at the correct time and do not miss any doses.

Treatment of duodenal or gastric ulcer in patients requiring continuous NSAID therapy: one orodispersible tablet of 30 mg daily for 4 weeks.

Prevention of duodenal or gastric ulcer in patients requiring continuous NSAID therapy: one orodispersible tablet of 15 mg daily; your doctor may adjust your dose to one orodispersible tablet of 30 mg daily.

Zollinger-Ellison syndrome: The usual initial dose is two orodispersible tablets of 30 mg daily; subsequently, depending on your response to treatment with Estomil Flas, your doctor will decide the best dose for you.

Use in children

Estomil Flas must not be given to children.

If you take more Estomil Flas than you should

If you take more Estomil Flas than prescribed, contact your doctor immediately or call the Toxicology Information Service at telephone number 915 620 420.

If you forget to take Estomil Flas

If you forget to take a dose, take it as soon as possible unless it is nearly time for your next dose. In that case, skip the missed dose and take the next tablets as usual. Do not take a double dose to make up for forgotten doses.

If you stop taking Estomil Flas

Do not stop treatment prematurely even if symptoms improve. Your condition may not be completely cured, and symptoms may return if you do not complete the full course of treatment.

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

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone experiences them.

Frequent adverse effects.

May affect up to 1 in 10 people.

• headache, dizziness
• diarrhoea, constipation, stomach pain, nausea and vomiting, flatulence, dryness or pain in mouth or throat
• skin rash, itching
• changes in liver function test values
• fatigue
• benign gastric polyps

Uncommon adverse effects.

May affect up to 1 in 100 people.

• depression
• joint or muscle pain
• fluid retention or swelling
• changes in blood cell counts
• risk of fracture of hip, wrist, or spine

Rare adverse effects.

May affect up to 1 in 1,000 people.

• fever
• restlessness, drowsiness, confusion, hallucinations, insomnia, visual disturbances, dizziness
• taste disturbances, loss of appetite, inflammation of the tongue (glossitis)
• skin reactions such as burning or itching sensation under the skin, bruising, redness and excessive sweating
• light sensitivity
• hair loss
• tingling sensation (paraesthesia), tremor
• anaemia (pallor)
• kidney problems
• pancreatitis
• liver inflammation (may present as yellowing of the skin or eyes)
• breast swelling in males, impotence
• candidiasis (fungal infection, may affect skin or mucosa)
• angioedema; contact your doctor immediately if you experience symptoms of angioedema, such as swelling of the face, tongue or throat, difficulty swallowing, hives and breathing difficulties

Very rare adverse effects.

May affect up to 1 in 10,000 people.

• severe hypersensitivity reactions, including anaphylactic shock. Symptoms of hypersensitivity reactions may include fever, rash, swelling and, occasionally, a drop in blood pressure
• inflammation of the mouth (stomatitis)
• colitis (inflammation of the intestine)
• changes in laboratory values, such as levels of sodium, cholesterol and triglycerides
• very severe skin reactions with redness, blisters, severe swelling and skin loss
• in very rare cases, Estomil Flas may cause a reduction in the number of white blood cells, which can lead to decreased resistance to infections. If you develop an infection with symptoms such as fever and severe deterioration in your general condition, or fever with signs of local infection such as sore throat/pharynx/mouth or urinary problems, consult your doctor immediately. A blood test will be performed to check for possible reduction in white blood cells (agranulocytosis)

Frequency not known:

• if you have been taking Estomil Flas for more than three months, your blood magnesium levels may decrease. Low magnesium levels may cause fatigue, involuntary muscle contractions, disorientation, seizures, dizziness and increased heart rate. If you notice any of these symptoms, inform your doctor immediately. Low magnesium levels may also lead to decreased levels of potassium or calcium in the blood. Your doctor will likely request regular blood tests to monitor your magnesium levels
• skin rash, possibly with joint pain
• visual hallucinations

Reporting of adverse effects:

If you experience any type of adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicines: https://www.notificaram.es.

By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Estomil Flas

Keep this medicine out of sight and reach of children.

Do not use this medicine after the expiry date stated on the blister and carton after EXP. The expiry date refers to the last day of the month indicated.

Medicines must not be disposed of via wastewater or household waste. Dispose of unused containers and medicines at the SIGRE point located at your pharmacy. If in doubt, ask your pharmacist how to properly dispose of unused containers and medicines. This will help protect the environment.

6. Contents of the pack and other information

Composition of Estomil Flas

The active substance is lansoprazole.

The other components (excipients) are: sugar spheres (sucrose and maize starch), magnesium carbonate, hypromellose, polysorbate 80, macrogol 6000, triethyl citrate, talc, titanium dioxide (E-171), methacrylic acid and ethyl acrylate copolymer, and sodium hydroxide. The gelatin capsule shell consists of: titanium dioxide (E-171), erythrosine, iron oxide red, and gelatin.

Appearance of the product and contents of the pack

Estomil Flas is presented as greyish orally disintegrating tablets containing microgranules. Each pack contains 28 or 56 orally disintegrating tablets.

Only certain pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Merck, S.L.
María de Molina, 40
28006 Madrid

Manufacturer

Laboratorios Salvat, S.A.
C/Gall 30-36
08950 Esplugues de Llobregat (Barcelona)

Date of the most recent review of this product information: December 2022

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency of Medicines and Health Products (AEMPS) http://www.aemps.gob.es/