Livazo 2 mg film-coated tablets

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Livazo 1 mg, 2 mg and 4 mg film-coated tablets

pitavastatin

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 should 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 effects, consult your doctor or pharmacist, even if they are adverse effects not listed in this leaflet. See section 4.

Contents of the leaflet:

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

1. What Livazo is and what it is used for

Livazo contains a substance called pitavastatin. It belongs to a group of medicines known as 'statins'. Livazo is used to correct levels of fatty substances (lipids) in the blood and can be taken by both children from the age of 6 years and adults. An imbalance of fats, especially cholesterol, can sometimes lead to a heart attack or stroke.

You have been prescribed Livazo because you have an imbalance of fats, and changes in diet and lifestyle have not been sufficient to correct it. You must continue with a cholesterol-lowering diet and lifestyle changes while taking Livazo.

2. What you need to know before taking Livazo

Do not take Livazo:

• if you are allergic to pitavastatin or any of the other ingredients of this medicine (listed in section 6).
• if you are pregnant or breastfeeding.
• if you are a woman who could become pregnant and are not using an effective method of contraception (see 'Pregnancy and breastfeeding').
• if you currently have liver problems.
• if you are taking cyclosporine, a medicine used after organ transplantation.
• if you have repeated or unexplained muscle pain.

If in doubt, consult your doctor or pharmacist before starting to take Livazo.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Livazo if:

• you have severe respiratory insufficiency (serious breathing problems);
• you have ever had kidney problems;
• you have previously had liver problems. 'Statins' may affect the liver in some people. Your doctor will usually perform blood tests (to check how your liver is functioning) before and during treatment with Livazo;
• you have ever had thyroid problems;
• you or a family member have a history of muscle disorders;
• you have previously experienced muscle problems when taking other cholesterol-lowering medicines (e.g., statins or fibrates);
• you drink large amounts of alcohol;
• you are taking or have taken within the last 7 days an oral or injectable medicine containing fusidic acid (used to treat bacterial infection). The combination of fusidic acid and Livazo may cause serious muscle problems (rhabdomyolysis);
• you have or have had myasthenia (a disease characterized by generalized muscle weakness, which in some cases affects the muscles used for breathing) or ocular myasthenia (a disease causing weakness of the eye muscles), as statins may sometimes worsen these conditions or trigger the onset of myasthenia (see section 4).

If any of the above apply to you (or if you have any doubts), consult your doctor or pharmacist before starting to take Livazo. Also inform your doctor or pharmacist if you experience persistent muscle weakness. Additional tests and treatments may be needed to diagnose and manage this condition.

While taking this medicine, your doctor will monitor whether you have diabetes or are at risk of developing diabetes. This risk is higher if you have high levels of sugar and fats in the blood, are overweight, or have high blood pressure.

Children and adolescents

Livazo must not be given to children under 6 years of age.

Before taking Livazo, adolescent girls should receive counseling and advice regarding contraception.

Other medicines and Livazo

Inform your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicines. Some medicines may interfere with the effectiveness of others.

Specifically, inform your doctor or pharmacist if you are taking any of the following medicines:

• other medicines called 'fibrates', such as gemfibrozil and fenofibrate;
• erythromycin or rifampicin, antibiotics used to treat infections;
• warfarin or any other medicine used to thin the blood;
• HIV medicines called 'protease inhibitors' (e.g., ritonavir, lopinavir, darunavir, atazanavir) and 'non-nucleoside reverse transcriptase inhibitors' (e.g., efavirenz);
• niacin (vitamin B3);
• if you need to take oral fusidic acid to treat a bacterial infection, you must stop taking this medicine. Your doctor will advise you when you can restart treatment with Livazo. Taking Livazo with fusidic acid may cause muscle weakness, tenderness, or pain (rhabdomyolysis). For further information on rhabdomyolysis, see section 4;
• if you are taking medicines containing glecaprevir and pibrentasvir, medicines used to treat hepatitis C. Your doctor may need to adjust your Livazo dose.

If any of the above apply to you (or if you have any doubts), consult your doctor or pharmacist before starting to take Livazo.

Taking Livazo with food and drink

You may take Livazo with or without food.

Pregnancy, breastfeeding, and fertility

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

If you are a woman who could become pregnant, you must use an effective method of contraception while taking Livazo. If you become pregnant while taking Livazo, stop taking it immediately and contact your doctor.

If you are pregnant or breastfeeding, consult your doctor or pharmacist before taking any medicine.

Driving and using machines

Livazo is not expected to affect your ability to drive or operate machinery. However, if you experience dizziness or drowsiness while taking Livazo, do not drive or operate machinery or tools.

Livazo contains lactose

Livazo contains lactose (a type of sugar). If your doctor has diagnosed you with an intolerance to certain sugars, consult with them before taking this medicine.

3. How to take Livazo

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

How to take this medicine

Swallow the tablet whole with water, with or without food. You may take it at any time of day. However, try to take the tablet at the same time each day.

How much to take

• Initially, the usual dose is 1 mg once daily. After a few weeks, your doctor may decide to increase your dose. The maximum dose in adults and children over 10 years of age is 4 mg per day.
• If you have liver problems, you should not take more than 2 mg per day.

Use in children

• The maximum dose in children under 10 years of age is 2 mg per day.
• If necessary, the tablets may be dispersed in a glass of water immediately before taking; then rinse the glass with more water and drink immediately. Do not use fruit juices or milk to disperse the tablets.
• The use of Livazo is not recommended in children under 6 years of age.

Other things you need to know while taking Livazo

• If you go to hospital or receive treatment for another condition, inform medical staff that you are taking Livazo.
• Your doctor may carry out regular blood tests to monitor your cholesterol levels.
• Do not stop taking Livazo without first talking to your doctor. Your cholesterol levels may rise.

If you take more Livazo than you should

If you take more Livazo than you should, inform your doctor or go to a hospital immediately. Take the medicine packaging with you.

If you forget to take Livazo

Do not worry; take your next dose at the usual time. Do not take a double dose to make up for forgotten doses.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them. This medicine may cause the following adverse effects:

Stop taking Livazo and see a doctor immediately if you notice any of the following serious adverse effects, as you may require urgent medical treatment:

• Allergic reaction: some signs include difficulty breathing, swelling of the face, lips, tongue or throat, trouble swallowing, intense itching of the skin (with hives).

• Unexplained muscle pain or weakness, especially if you do not feel well, have a fever, or your urine is red-brown in color. In rare cases (in fewer than 1 in 1,000 people), Livazo may cause bothersome muscle effects. If these effects are not investigated, they may lead to serious problems such as abnormal muscle breakdown (rhabdomyolysis), which can cause kidney problems.

• Breathing problems including persistent cough and/or shortness of breath or fever.

• Liver problems that may cause yellowing of the skin and eyes (jaundice).

• Pancreatitis (severe abdominal and back pain).

Other adverse effects include:

Common (affects less than 1 in 10 people)

• Joint pain, muscle pain
• Constipation, diarrhea, indigestion, nausea
• Headache

Uncommon (affects less than 1 in 100 people)

• Muscle spasms
• Weakness, fatigue or malaise
• Swelling of the ankles, feet or fingers
• Stomach pain, dry mouth, vomiting, loss of appetite, altered taste
• Paleness and weakness or shortness of breath (anemia)
• Itching or skin rash
• Ringing in the ears
• Dizziness or drowsiness, insomnia (or other sleep disorders, including nightmares)
• Increased need to urinate (urinary frequency)
• Numbness and reduced sensation in the fingers, toes, legs and face

Rare (affects less than 1 in 1,000 people)

• Skin redness, hives and itching
• Visual impairment
• Tongue pain
• Unpleasant sensation or discomfort in the stomach
• Enlargement of the breasts in men (gynaecomastia)

Frequency not known (cannot be estimated from available data)

• Persistent muscle weakness

• Lupus-like syndrome (with rash, joint disorders and effects on blood cells)

• Myasthenia gravis (a disease causing generalized muscle weakness, which in some cases affects the muscles used for breathing).

• Ocular myasthenia (a disease causing weakness of the eye muscles).

• Consult your doctor if you experience weakness in the arms or legs that worsens after periods of activity, double vision or drooping eyelids, difficulty swallowing, or difficulty breathing.

Other possible adverse effects

• Memory loss
• Sexual dysfunction
• Depression
• Diabetes. This is more likely if you have high levels of sugar and fats in the blood, are overweight, or have high blood pressure. Your doctor will monitor you while you are taking this medicine.

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 may 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 Livazo

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

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

Do not store above 25°C. Keep the blister pack in the outer packaging to protect it from light.

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

6. Contents of the pack and other information

Composition of Livazo

The active substance is pitavastatin calcium, equivalent to 1 mg, 2 mg or 4 mg of pitavastatin.

The other components are lactose monohydrate, LS-hydroxypropylcellulose, hypromellose (E464), titanium dioxide (E171), triethyl citrate (E1505), magnesium aluminometasilicate, magnesium stearate and anhydrous colloidal silica.

Appearance of the product and contents of the pack

Livazo film-coated tablets are available in packs of 7, 28, 30, 90 or 100 tablets. Only certain pack sizes may be marketed.

The tablets are round, white, and have the letters ‘KC’ engraved on one side. To help identify the different strengths, they are of different sizes and have ‘1’, ‘2’ or ‘4’ engraved on the other side.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder:

Kowa Pharmaceutical Europe GmbH.

Görreshof 151, 53347 Alfter

Germany

Manufacturer:

Pierre Fabre Médicament Production*,

Rue du Lycée, 45502 Gien Cedex

France

Or

Recordati Industria Chimica e Farmaceutica S.p.A.*

Via M. Civitali, 1, 20148 Milan

Italy

Local Representative:

Casen Recordati, S.L.

Autovía de Logroño, Km 13.300

50180 Utebo (Zaragoza)

Spain

Date of latest revision of this leaflet: April 2023.

Other sources of information

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/