Febuxostat Cinfa 120 mg film-coated tablets EFG

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

febuxostat cinfa 120 mg film-coated tablets EFG

Read the entire leaflet carefully before you start taking this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only, and you must not give it to other people, even if they have the same symptoms as you, because it may harm them.
• If you experience any adverse reactions, consult your doctor or pharmacist, even if they are adverse reactions not listed in this leaflet. See section 4.

Contents of the leaflet

1. What febuxostat cinfa is and what it is used for

2. What you need to know before taking febuxostat cinfa

3. How to take febuxostat cinfa

4. Possible side effects

5. Storage of febuxostat cinfa

6. Contents of the container and other information

1. What febuxostat cinfa is and what it is used for

Febuxostat cinfa tablets contain the active substance febuxostat and are used to treat gout, which is associated with an excess in the body of a chemical compound called uric acid (urate). In some people, uric acid accumulates in the blood to the point where it can no longer dissolve. When this occurs, urate crystals form both within and around the joints and kidneys. These crystals can cause sudden and severe pain, redness, warmth, and swelling in the joints (this is known as gout attacks). If left untreated, large deposits called tophi may form around and within the joints. Tophi can damage joints and bones.

Febuxostat cinfa works by reducing the concentration of uric acid. Keeping uric acid levels low by taking febuxostat once daily helps prevent the formation of crystals and, over time, reduces symptoms. If uric acid levels are kept low for a sufficient period, the size of tophi also decreases.

Febuxostat cinfa 120 mg tablets are also used for the treatment and prevention of high levels of uric acid in the blood that may occur when starting chemotherapy for blood cell cancers.

When chemotherapy is administered, cancer cells are destroyed, leading to an increase in uric acid levels in the blood unless its formation is prevented.

Febuxostat cinfa is for use in adults.

2. What you need to know before taking febuxostat cinfa

Do not take febuxostat cinfa

• if you are allergic to febuxostat or to any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor or pharmacist before starting febuxostat cinfa:

• if you have or have had heart failure, heart problems, or stroke
• if you have or have had kidney disease and/or severe allergic reactions to allopurinol (a medicine used to treat gout)
• if you have or have had liver disease or impaired liver function
• if you are being treated for high levels of uric acid due to Lesch-Nyhan syndrome (a rare inherited condition in which there is too much uric acid in the blood)
• if you have thyroid problems.

If you experience allergic reactions to febuxostat, stop taking this medicine (see also section 4). Possible symptoms of allergic reactions may include:

• rash including severe forms (e.g., blisters, nodules, exfoliative rashes causing itching), itching
• swelling of the limbs or face
• difficulty breathing
• fever with swollen lymph nodes
• also severe allergic reactions that may be life-threatening, associated with circulatory arrest.

Rare cases of life-threatening skin rashes (Stevens-Johnson syndrome) have been reported with the use of febuxostat. These rashes typically start on the trunk as reddish target-shaped spots or circular lesions, often with a blister in the center. They may also include mouth, throat, nose, or genital ulcers and conjunctivitis (red, swollen eyes). The rash may progress to widespread blisters or skin peeling.

If you have developed Stevens-Johnson syndrome while taking febuxostat, you must never restart treatment. If you develop a rash or these skin symptoms, seek immediate medical attention and inform your doctor that you are taking this medicine.

If you are experiencing a gout attack (sudden, severe pain accompanied by tenderness, redness, warmth, and swelling in a joint), wait until the attack subsides before starting treatment with febuxostat.

Some people may experience gout attacks when starting certain medicines that control uric acid levels. Not everyone experiences these attacks, but they may occur even while taking febuxostat, especially during the first weeks or months of treatment. It is important to continue taking febuxostat even if you have a gout attack, as this medicine continues to work to reduce uric acid. If you continue taking febuxostat daily, gout attacks will become less frequent and less painful over time.

If needed, your doctor may prescribe additional medicines to prevent or treat symptoms of gout attacks (such as joint pain and swelling).

In patients with very high urate levels (e.g., those undergoing chemotherapy for cancer), treatment with medicines to lower uric acid may lead to xanthine accumulation in the urinary tract, potentially causing kidney stones. However, this has not been observed in patients treated with febuxostat for Tumor Lysis Syndrome.

Your doctor may perform blood tests to check that your liver is functioning properly.

Children and adolescents

Do not give this medicine to children under 18 years of age, as the safety and efficacy have not been established.

Taking febuxostat cinfa with other medicines

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

It is especially important to inform your doctor or pharmacist if you are taking medicines containing any of the following active substances, as they may interact with febuxostat and your doctor may need to take special measures:

• Mercaptopurine (used to treat cancer)
• Azathioprine (used to reduce immune response)
• Theophylline (used to treat asthma)

Pregnancy and breastfeeding

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

It is not known whether febuxostat may harm the unborn baby. Febuxostat should not be used during pregnancy. It is not known whether febuxostat passes into breast milk. Do not use febuxostat if you are breastfeeding or planning to breastfeed.

Driving and using machines

Be aware that you may experience dizziness, drowsiness, blurred vision, or numbness and tingling sensations during treatment. If this occurs, do not drive or operate machinery.

This medicine contains sodium.

This medicine contains less than 23 mg of sodium (1 mmol) per tablet; this is essentially “sodium-free”.

3. How to take febuxostat cinfa

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

• The recommended dose is one tablet per day.
• The tablets are taken orally, with or without food.

Gout

Febuxostat is marketed in 80 mg and 120 mg tablets. Your doctor will prescribe the most appropriate dose for you.

Continue taking febuxostat every day, even if you no longer have gout attacks.

Prevention and treatment of high uric acid levels in patients undergoing chemotherapy for cancer

Febuxostat is available in 120 mg tablets.

Start taking febuxostat two days before chemotherapy and continue using it as directed by your doctor. Generally, the treatment is of short duration.

If you take more febuxostat cinfa than you should

In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicology Information Service at telephone number 91 562 04 20, indicating the medication and the amount ingested.

If you forget to take febuxostat cinfa

If you forget a dose of febuxostat, take it as soon as you remember, unless it is almost time for your next dose; in that case, skip the missed dose and take the next one at the regular time. Do not take a double dose to make up for a missed dose.

If you stop taking febuxostat cinfa

Even if you feel better, do not stop taking febuxostat unless instructed by your doctor. If you stop taking febuxostat, uric acid levels may rise again, and symptoms may worsen due to the formation of new urate crystals in the joints and kidneys.

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 will experience them.

Stop taking this medicine and contact your doctor immediately or go to the nearest hospital if you experience any of the following rare adverse effects (may affect up to 1 in 1,000 people), as you may be having a severe allergic reaction:

• anaphylactic reactions, drug hypersensitivity (see also section 2 “Warnings and precautions”)
• skin rashes that may be life-threatening, characterized by blistering and peeling of the skin and mucous membranes (e.g. mouth and genitals), painful ulcers in the mouth and/or genital areas, accompanied by fever, sore throat, and fatigue (Stevens-Johnson syndrome/toxic epidermal necrolysis), or enlarged lymph nodes, liver enlargement, hepatitis (including liver failure), increased number of white blood cells (leukocytes) in blood (drug reaction with eosinophilia and systemic symptoms - DRESS syndrome) (see section 2)
• generalized skin rashes

The frequent adverse effects (may affect up to 1 in 10 people) are the following:

• abnormal liver function test results
• diarrhea
• headache
• rash (including various types of rash; see below under “uncommon” and “rare” sections)
• nausea
• worsening of gout symptoms
• localized swelling due to fluid retention in tissues (edema)

Other adverse effects not mentioned above are listed below.

The uncommon adverse effects (may affect up to 1 in 100 people) are the following:

• decreased appetite, change in blood sugar levels (diabetes), which may present as excessive thirst, increased blood fats, weight gain
• loss of sexual appetite
• difficulty sleeping, drowsiness
• dizziness, numbness, tingling sensation, reduced or altered sensitivity (hypoesthesia, hemiparesis, or paresthesia), altered sense of taste, reduced sense of smell (hyposmia)
• ECG (electrocardiogram) abnormalities, irregular or rapid heartbeat, awareness of heartbeats (palpitations)
• hot flushes or flushing (reddening of the face or neck), increased blood pressure, bleeding (hemorrhage, observed only in patients receiving chemotherapy for blood disorders)
• cough, breathing difficulties, discomfort or chest pain, inflammation of the nasal passages and/or throat (upper respiratory tract infection), bronchitis
• dry mouth, abdominal pain or discomfort or gas, heartburn or indigestion, constipation, increased frequency of bowel movements, vomiting, stomach discomfort
• itching, hives, skin swelling or discoloration, small red or purple spots on the skin, small skin bumps, skin rashes, rashes and spots on the skin, other skin changes
• muscle cramps, muscle weakness, muscle and joint pain, bursitis or arthritis (joint inflammation, usually accompanied by pain, swelling, or stiffness), limb pain, back pain, muscle spasms
• blood in urine, abnormally frequent urination, abnormal urine tests (increased concentration of protein in urine), reduced kidney function
• fatigue, chest pain, chest discomfort
• gallstones or stones in the bile ducts (cholelithiasis)
• increased levels of thyroid-stimulating hormone (TSH) in blood
• changes in blood biochemistry or in the number of blood cells or platelets (abnormal blood test results)
• kidney stones
• erectile dysfunction

The rare adverse effects (may affect up to 1 in 1,000 people) are the following:

• muscle damage, which in rare cases may be severe. It may cause muscle problems and, particularly if you also feel unwell or have a high fever, may be due to abnormal muscle breakdown. Contact your doctor immediately if you experience muscle pain, tenderness, or weakness
• severe swelling of deeper layers of the skin, especially around the lips, eyes, genitals, hands, feet, or tongue, which may cause sudden breathing difficulties
• high fever accompanied by a measles-like rash, enlarged lymph nodes, liver enlargement (including liver failure), increased number of white blood cells in blood (leukocytosis, with or without eosinophilia)
• skin redness (erythema), different types of rash (e.g. itching, with white spots and blisters, with pus-filled blisters, with skin peeling, measles-like rash), generalized erythema, necrosis, blistering detachment of the skin and mucous membranes, leading to exfoliation and possible sepsis (Stevens-Johnson syndrome/toxic epidermal necrolysis)
• nervousness
• sensation of thirst
• ringing in the ears
• blurred vision, changes in vision
• hair loss
• mouth ulcers
• inflammation of the pancreas: common symptoms are abdominal pain, nausea, and vomiting
• increased sweating
• weight loss, increased appetite, uncontrolled loss of appetite (anorexia)
• muscle and/or joint stiffness
• abnormal blood cell count (white blood cells, red blood cells, or platelets)
• urgent need to urinate
• changes or decreased urine volume due to kidney inflammation (tubulointerstitial nephritis)
• liver inflammation (hepatitis)
• yellowing of the skin (jaundice)
• liver damage
• increased levels of creatine phosphokinase in blood (a marker of muscle damage)
• sudden cardiac death

Reporting of adverse effects

If you experience any adverse effect, talk to your doctor or pharmacist, even if it is a possible adverse effect not listed in this leaflet. You may 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 febuxostat cinfa

Keep this medicine out of sight and reach of children.

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

This medicine does not require any special storage conditions.

Medicines must not be disposed of via wastewater or household waste. Dispose of containers and unused medicines at the SIGRE Point in your pharmacy. If in doubt, ask your pharmacist how to dispose of containers and medicines you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of febuxostat cinfa

• The active substance is febuxostat. Each tablet contains 120 mg of febuxostat.

• The other components are:

Tablet core: microcrystalline cellulose, mannitol (E-421), hydroxypropylcellulose, sodium croscarmellose, magnesium stearate, sodium lauryl sulfate, colloidal anhydrous silica.

Tablet coating: partially hydrolyzed poly(vinyl alcohol) (E-1203), titanium dioxide (E-171), macrogol (MW 3350), talc (E-553b), yellow iron oxide (E-172), and red iron oxide (E-172).

Appearance of the product and contents of the pack

Film-coated tablets, yellow to pale yellow in colour, capsule-shaped, smooth on both sides, with the code “F120” engraved on one side.

Febuxostat cinfa 120 mg is available in ALU/ALU or PVC/PE/PVDC blisters containing 28 tablets.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Manufacturer

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

or

G.L. Pharma GmbH

Schlossplatz 1

Lannach 8502

Austria

Date of the most recent review of this leaflet: September 2020

Detailed information on this medicine is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS) http://www.aemps.gob.es/