Fosrenol 750 mg chewable tablets

Package leaflet: Information for the user

Introduction

Package leaflet: Information for the patient

FOSRENOL 750 mg chewable tablets

lanthanum

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 you must not give it 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 Fosrenol is and what it is used for
2. What you need to know before taking Fosrenol
3. How to take Fosrenol
4. Possible side effects
5. How to store Fosrenol
6. Contents of the pack and other information

1. What Fosrenol is and what it is used for

Fosrenol is used to reduce blood phosphorus levels in adult patients with chronic kidney disease.

Patients whose kidneys do not function properly are unable to control the concentration of phosphorus in the blood. As a result, the amount of phosphorus in the blood increases (your doctor may refer to this condition as hyperphosphatemia).

Fosrenol is a medicine that reduces the body's absorption of phosphorus from food by binding to it in the digestive tract. Phosphorus bound to Fosrenol cannot be absorbed through the intestinal wall.

2. What you need to know before taking Fosrenol

Do not take Fosrenol

? if you are allergic to hydrated lanthanum carbonate or to any of the other ingredients of this medicine (listed in section 6).

? if you have low levels of phosphate in your blood (hypophosphataemia).

? if you have intestinal obstruction.

Warnings and precautions

Consult your doctor or pharmacist before taking Fosrenol if you know you have or have previously had any of the following conditions:

• stomach or intestinal cancer
• inflammatory bowel disease including ulcerative colitis or Crohn's disease
• abdominal surgery or infection or inflammation of the abdomen/intestine (peritonitis)
• gastric or intestinal ulcers
• intestinal obstruction or slow intestinal transit (e.g., constipation and stomach complications due to diabetes)
  ? reduced liver or kidney function.

It is very important to chew Fosrenol tablets thoroughly and not to swallow them whole or incompletely chewed. This will reduce the risk of gastrointestinal adverse complications such as intestinal wall rupture, intestinal obstruction, or constipation (see section 4).

If you have reduced kidney function, your doctor may decide to periodically monitor your blood calcium levels. If these levels are too low, you may be given additional calcium.

If you are due to have an X-ray, inform your doctor that you are taking Fosrenol, as it may affect the results.

If you are due to have a gastrointestinal endoscopy, inform your doctor that you are taking Fosrenol (lanthanum), as the endoscopist may detect lanthanum accumulation in the gastrointestinal tract.

Taking Fosrenol with other medicines

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

Fosrenol may affect how certain medicines are absorbed in the gastrointestinal tract. If you are taking chloroquine (for rheumatism and malaria), ketoconazole (for fungal infections), or antibiotics of the tetracycline or doxycycline group, you should not take these drugs within 2 hours before or after taking Fosrenol.

Oral fluoroquinolone antibiotics (including ciprofloxacin) are not recommended to be taken within 2 hours before or 4 hours after taking Fosrenol.

If you are taking levothyroxine (for underactive thyroid), you should not take this medicine within 2 hours before or after taking Fosrenol. Your doctor may wish to monitor your thyroid-stimulating hormone (TSH) blood levels more closely.

Taking Fosrenol with food and drink

Fosrenol should be taken together with or immediately after meals. See section 3 for instructions on how to take Fosrenol.

Pregnancy and breastfeeding

Fosrenol should not be used during pregnancy. If you are pregnant or breastfeeding, think you might be pregnant, or are planning to become pregnant, consult your doctor or pharmacist before using this medicine.

Since it is unknown whether the medicine passes into breast milk, you should not continue breastfeeding while taking Fosrenol. If you are breastfeeding, consult your doctor or pharmacist before using any medicine.

Driving and using machines

Dizziness and vertigo (a sensation of dizziness or spinning) are uncommon adverse reactions reported by patients treated with Fosrenol. If you experience these symptoms, they may affect your ability to drive or operate machinery.

Fosrenol contains glucose

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

3. How to take Fosrenol

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

You should take Fosrenol with food or immediately after eating. Adverse effects such as nausea and vomiting are more likely if you take Fosrenol before meals.

The tablets must be completely chewed and must not be swallowed whole. To aid chewing, the tablets may be crushed. No additional liquid is necessary.

If you have difficulty chewing the tablets, inform your doctor, as this medicine is also available as an oral powder.

Your doctor will tell you how many tablets to take with each meal (your daily dose will be divided between meals). The number of tablets you take will depend on the following:

? your diet (the amount of phosphorus in the foods you eat)

? your blood phosphorus level.

Initially, the usual daily dose of Fosrenol will be 1 tablet per meal (3 tablets per day).

Every 2–3 weeks your doctor will check your blood phosphorus levels and may increase your dose until your blood phosphorus level is appropriate for you.

Fosrenol works by binding to phosphorus from food in your intestine. It is very important to take Fosrenol with every meal. If you change your diet, inform your doctor, as you may need additional Fosrenol. Your doctor will advise you what to do in this case.

If you take more Fosrenol than you should

If you take too many tablets, contact your doctor to assess the risk and receive advice. Symptoms of overdose may include nausea and headache.

If you have taken more Fosrenol than you should, contact your doctor, pharmacist, or call the Toxicology Information Service immediately at telephone: 91-562-0420, stating the medicine and the amount taken.

If you forget to take Fosrenol

It is important that you take Fosrenol with every meal.

If you forget to take your Fosrenol tablets, take the next dose with the following meal. Do not take a double dose to make up for forgotten doses.

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.

Some adverse effects could be serious. If you experience any of the following adverse effects, see your doctor immediately:

• Rupture of the intestinal wall (signs include: severe stomach pain, chills, fever, nausea, vomiting, or abdominal tenderness on palpation). This adverse effect occurs rarely (may affect up to 1 in 1,000 people).
• Intestinal obstruction (signs include: severe bloating, pain, swelling, or cramps in the abdomen, severe constipation). This adverse effect occurs infrequently (may affect up to 1 in 100 people).
• Contact your doctor if you experience a new or severe episode of constipation, as it may be an early sign of intestinal obstruction. Constipation is a common adverse effect (may affect 1 in 10 people).

Other less severe adverse effects include the following:

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

? Nausea, vomiting, diarrhoea, stomach pain, headache, itching, rash.

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

? Heartburn and flatulence.

? Hypocalcaemia (lack of calcium in the blood) is also a common adverse effect; symptoms may include tingling in hands and feet, muscle and abdominal cramps, or spasms of facial and foot muscles.

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

? Fatigue; feeling unwell; chest pain; weakness; swelling of hands and feet; body pain; dizziness; vertigo; burping; inflammation of the stomach and intestine (gastroenteritis); indigestion; irritable bowel syndrome; dry mouth; dental disorders; inflammation of the oesophagus or mouth; soft stools; increases in certain liver enzymes, parathyroid hormone, aluminium, blood calcium, and blood glucose; increase or decrease in blood phosphate levels; thirst; weight loss; joint pain; muscle pain; weakness and loss of bone mass (osteoporosis); loss of appetite and increased appetite; laryngitis; hair loss; increased sweating; taste disturbances; and increased white blood cell count.

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

• Presence of product residue in the gastrointestinal tract

Reporting of adverse effects

If you experience any type of adverse effect, talk to your doctor or pharmacist, even if they are possible adverse effects not listed in this leaflet.

You can also report them directly via the Spanish Pharmacovigilance System for Human Medicinal Products: www.notificaRAM.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Fosrenol

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

This medicine does not require any special storage conditions.

Do not use this medicine after the expiry date stated on the outer packaging and on the label of the bottle 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. Unused medicines and waste materials, including packaging, should be returned to the SIGRE Point at your pharmacy. Ask your pharmacist how to dispose of medicines and packaging that you no longer need. This will help protect the environment.

6. Package contents and other information

Composition of Fosrenol

• The active substance is lanthanum (as hydrated lanthanum carbonate). Each chewable tablet contains hydrated lanthanum carbonate equivalent to 750 mg of lanthanum.
• The other components are dextrates (hydrated), anhydrous colloidal silica, and magnesium stearate.

Appearance of the product and contents of the pack

Fosrenol is presented as a white, round, flat, chewable tablet with bevelled edges, marked with “S405/750” on one side.

The tablets are supplied in plastic bottles containing 20 or 45 tablets, or in multiple pack: 90 tablets (2 packs of 45) chewable tablets.

Only certain pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

The Marketing Authorization Holder is:

Takeda Pharmaceuticals International AG Ireland Branch
Block 2 Miesian Plaza, 50-58 Baggot Street Lower,
Dublin 2, D02 WH68, Ireland
E-mail: [email protected]

The Manufacturer is:

RB NL Brands B.V.
Schiphol Boulevard 207
1118BH, Schiphol
The Netherlands

Further information about this medicinal product can be obtained by contacting the local representative of the Marketing Authorization Holder.

Local representative:

Takeda Farmacéutica España S.A.
Calle Albacete, 5, 9th floor,
Edificio Los Cubos
28027 Madrid
Spain
Tel: +34 91 790 42 22

This medicinal product is authorized in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names:

Date of the most recent review of this leaflet: 04/2025

Detailed information on this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) (http://www.aemps.gob.es/)