Pregabalin Sun 25 mg hard capsules EFG

Package leaflet: Information for the user

Introduction

Package leaflet: Information for the patient

Pregabalin SUN 25 mg hard capsules EFG

Read all of this 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 others, 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.

Leaflet contents:

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

1. What is Pregabalin SUN and what is it used for?

Pregabalin SUN belongs to a group of medicines used for the treatment of epilepsy, neuropathic pain, and generalized anxiety disorder (GAD) in adults.

Peripheral and central neuropathic pain: Pregabalin SUN is used to treat chronic pain caused by nerve damage. Various medical conditions can cause peripheral neuropathic pain, such as diabetes or herpes. The sensation of pain may be described as heat, burning, throbbing, shooting, stabbing, sharp pain, spasms, continuous pain, tingling, numbness, and prickling sensations. Peripheral and central neuropathic pain may also be associated with mood changes, sleep disturbances, fatigue (tiredness), and may affect physical and social activities and overall quality of life.

Epilepsy: Pregabalin SUN is used in the treatment of certain types of epilepsy (partial seizures with or without secondary generalization) in adults. Your doctor will prescribe pregabalin if your current treatment does not adequately control your condition. You should take Pregabalin SUN as an add-on to your current therapy. Pregabalin SUN must not be used as monotherapy, but should always be used in combination with other antiepileptic treatments.

Generalized anxiety disorder: Pregabalin SUN is used in the treatment of generalized anxiety disorder (GAD). Symptoms of GAD include excessive and prolonged anxiety and worry that are difficult to control. GAD may also cause restlessness or a feeling of being keyed up or on edge, easy fatigue, difficulty concentrating or mind going blank, irritability, muscle tension, or sleep disturbance. This is different from the everyday stress and worries of normal life.

2. What you need to know before starting Pregabalina SUN

Do not take Pregabalina SUN

If you are allergic to pregabalin 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 Pregabalina SUN

• Some patients treated with pregabalin have reported symptoms indicating an allergic reaction. These symptoms include swelling of the face, lips, tongue, and throat, as well as development of widespread skin rash. If you experience any of these symptoms, you must seek immediate medical attention.
• Serious skin rashes, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported in association with pregabalin treatment. Stop taking pregabalin and seek immediate medical attention if you notice any symptoms related to these serious skin reactions described in section 4.
• Pregabalin has been associated with dizziness and somnolence, which may increase the risk of accidental injuries (falls) in elderly patients. Therefore, you should exercise caution until you become familiar with the effects this medicine may have on you.
• Pregabalin may cause blurred vision, vision loss, or other changes in eyesight, many of which are transient. If you experience any visual disturbances, you must inform your doctor immediately.
• Some diabetic patients who gain weight while taking pregabalin may require adjustments in their diabetes medications.
• Certain adverse effects, such as somnolence, may be more frequent because patients with spinal cord injury may be taking other medications for conditions such as pain or spasticity (tight or rigid muscles), which have similar adverse effects to pregabalin, so the intensity of these effects may increase when taken together.
• Cases of heart failure have been reported in some patients treated with pregabalin. Most of these patients were elderly with cardiovascular disease. Before using this medicine, you must inform your doctor if you have a history of heart disease.
• Cases of kidney problems (renal failure) have been reported in some patients treated with this medicine. If during treatment with pregabalin you notice a decrease in your ability to urinate, inform your doctor, as discontinuation of treatment may improve this condition.
• Some patients taking antiepileptic medicines such as pregabalin have had thoughts of harming themselves or of suicide, or have exhibited suicidal behavior. If at any time you experience such thoughts or have exhibited such behavior, contact your doctor as soon as possible.
• Gastrointestinal problems (e.g., constipation and intestinal blockage or paralysis) may occur when pregabalin is taken together with other medicines that can cause constipation (such as certain types of pain medicines). Inform your doctor if you suffer from constipation, especially if you are prone to this problem.
  • Before taking this medicine, inform your doctor if you have a history of alcoholism or of abuse or dependence on medicines or illegal drugs, as this may indicate a higher risk of becoming dependent on pregabalin.
• Seizures have been reported during treatment with pregabalin or shortly after stopping treatment with this medicine. If you experience seizures, contact your doctor immediately.
• Cases of reduced brain function (encephalopathy) have been reported in some patients taking pregabalin who also had other medical conditions. Inform your doctor if you have a history of any serious illness, including liver or kidney disease.
• Cases of difficulty breathing have been reported. If you have disorders of the nervous system, respiratory disorders, renal failure, or are over 65 years of age, your doctor may prescribe a different dose. Contact your doctor if you experience breathing difficulties or shallow breathing.

Dependence

Some people may become dependent on pregabalin (a need to keep taking this medicine). They may experience withdrawal effects when they stop taking pregabalin (see section 3 “How to take Pregabalina SUN” and “If you stop taking Pregabalina SUN”).

If you are concerned that you may become dependent on pregabalin, it is important that you consult your doctor.

If you notice any of the following symptoms while taking Pregabalina SUN, this could be a sign that you have become dependent:

• You need to take this medicine for longer than prescribed by your doctor
• You feel the need to take a higher dose than recommended
• You use this medicine for reasons other than those prescribed
• You have made repeated, unsuccessful attempts to stop or control use of this medicine
• You feel unwell when you stop taking this medicine, and feel better when you take it again

If you experience any of these symptoms, speak with your doctor to discuss the best treatment for you, including when it may be appropriate to stop taking this medicine and how to do so safely.

Children and adolescents

The safety and efficacy of pregabalina have not been established in children and adolescents (under 18 years of age), therefore pregabalin should not be used in this age group.

Taking Pregabalina SUN with other medicines

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

Pregabalin and certain medicines may affect each other (interactions). When pregabalin is used together with certain medicines that have a sedative effect (including opioids), these effects may be intensified, potentially leading to respiratory failure, coma, and death. Dizziness, drowsiness, and reduced concentration may increase if pregabalin is taken together with other medicines containing:

Oxycodone – (used as an analgesic)
Lorazepam – (used to treat anxiety)
Alcohol

Pregabalina SUN can be taken with oral contraceptives.

Taking Pregabalina SUN with food, drinks, and alcohol

Pregabalina SUN capsules can be taken with or without food.

It is advised not to consume alcohol during treatment with pregabalin.

Pregnancy, breastfeeding, and fertility

You should not take pregabalin during pregnancy or breastfeeding unless your doctor has instructed you to do so.

The use of pregabalin during the first 3 months of pregnancy may cause congenital malformations in the fetus that require medical treatment. In a study reviewing data from women in Nordic countries who took pregabalin during the first 3 months of pregnancy, 6 out of 100 babies had such congenital malformations. This contrasts with 4 out of 100 babies born to women not treated with pregabalin in the study. Malformations reported include facial clefts, eyes, the nervous system (including the brain), kidneys, and genitals.

An effective method of contraception should be used in women of childbearing potential. 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.

Driving and using machines

Pregabalin may cause dizziness, drowsiness, and reduced concentration. You should not drive, operate heavy machinery, or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.

Pregabalina SUN contains sodium and mannitol

This medicine contains less than 1 mmol of sodium (23 mg) per hard capsule; therefore, it is essentially “sodium-free”.

Mannitol may have a mild laxative effect.

3. How to take Pregabaline SUN

Follow exactly the dosage instructions given by your doctor for this medicine. If in doubt, consult your doctor or pharmacist again. Do not take more than the prescribed dose.

Your doctor will determine the appropriate dose for you.

Pregabalin is for oral use only.

Neuropathic pain (peripheral and central), epilepsy, or generalized anxiety disorder:

• Take the number of capsules indicated by your doctor.
• The dose, adjusted according to your condition, is generally between 150 mg and 600 mg daily.
• Your doctor will instruct you to take pregabalin two or three times a day. If twice daily, take pregabalin once in the morning and once at night, approximately at the same time each day. If three times daily, take pregabalin in the morning, at midday, and at night, approximately at the same time every day.

If you feel that the effect of this medicine is too strong or too weak, inform your doctor or pharmacist.

If you are an elderly patient (over 65 years of age), you should take pregabalin as usual, unless you have kidney problems.

Your doctor may prescribe a different dosing regimen and/or different doses if you have kidney problems.

Swallow the capsule whole with water.

Continue taking pregabalin until your doctor tells you to stop.

If you take more Pregabalin SUN than you should

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

As a result of taking more pregabalin than prescribed, you may feel drowsy, confused, agitated, or restless. Seizures and loss of consciousness (coma) have also been reported.

If you forget to take Pregabalin SUN

It is important to take pregabalin capsules regularly at the same time each day. If you forget a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed dose.

If you stop taking Pregabalin SUN

Do not stop taking pregabalin suddenly. If you wish to discontinue pregabalin, discuss this with your doctor first. Your doctor will advise you on how to do so. Treatment should be discontinued gradually over a period of at least one week.

After stopping long-term or short-term treatment with pregabalin, you should be aware that you may experience certain adverse effects known as withdrawal symptoms. These symptoms include sleep disturbances, headache, nausea, feelings of anxiety, diarrhea, flu-like symptoms, seizures, restlessness, depression, thoughts of self-harm or suicide, pain, sweating, and dizziness. These symptoms may occur more frequently or be more severe if you have been taking this medicine for a longer period of time. If you experience withdrawal symptoms, contact your doctor.

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.

Serious adverse effects:

If you experience any of the following serious adverse effects, stop taking Pregabalin SUN and contact your doctor immediately, or go to the nearest hospital, as you may require urgent medical attention.

• Hypersensitivity (uncommon, may affect up to 1 in 100 people) and allergic reactions (which may include facial swelling, tongue swelling, difficulty breathing, itching) (rare, may affect up to 1 in 1,000 people).

• Severe skin reaction characterized by flat red patches, or circular or coin-shaped patches on the chest, often with central blisters, skin peeling, and ulcers in the mouth, throat, nose, genitals, and eyes. These serious skin rashes may be preceded by fever and flu-like symptoms (Stevens-Johnson syndrome, toxic epidermal necrolysis) (rare, may affect up to 1 in 1,000 people).

If you experience swelling of the face or tongue, or if your skin turns red and develops blisters or peeling, you must seek immediate medical help.

• Inflammation of the pancreas (symptoms include severe stomach pain, often with nausea and vomiting) (rare, may affect up to 1 in 1,000 people).

Other adverse effects:

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

• Dizziness, drowsiness, headache

Common (may affect up to 1 in 10 people)

• Increased appetite
• Feeling of euphoria, confusion, disorientation, decreased sexual desire, irritability
• Attention disturbance, lack of coordination, memory impairment, memory loss, tremor, difficulty speaking, tingling sensation, numbness, sedation, lethargy, insomnia, fatigue, abnormal sensation
• Blurred vision, double vision
• Dizziness, balance problems, falls
• Dry mouth, constipation, vomiting, flatulence, diarrhoea, nausea, bloated abdomen
• Erectile dysfunction
• Swelling of the body including limbs
• Feeling of drunkenness, gait disturbances
• Weight gain
• Sore throat
• Muscle cramps, joint pain, back pain, limb pain, neck stiffness
• Sore throat

Uncommon (may affect up to 1 in 100 people)

• Loss of appetite, weight loss, low blood sugar, high blood sugar levels
• Change in self-perception, restlessness, depression, agitation, mood changes, difficulty finding words, hallucinations, strange dreams, panic attacks, apathy, aggression, elevated mood, mental deterioration, difficulty thinking, increased sexual desire, sexual relationship problems including inability to reach climax, delayed ejaculation
• Vision changes, unusual eye movements, visual disturbances including tunnel vision, flashes of light, spasm-like movements – abnormal and uncontrollable limb movements, reduced reflexes, hyperactivity, dizziness when standing, sensitive skin, loss of taste, burning sensation, tremor during movement, decreased consciousness, loss of consciousness, fainting, increased sensitivity to noise, general malaise
• Dry eyes, eye swelling, eye pain, tired eyes, watery eyes, eye irritation
• Changes in heart rhythm, increased heart rate, low blood pressure, high blood pressure, heart failure
• Flushing, hot flushes
• Difficulty breathing, dry nose, nasal congestion
• Cough, facial swelling, hives, itching, runny nose, nosebleeds, snoring
• Increased salivation, burning sensation, numbness around the mouth
• Sweating, rash, chills, fever
• Cold sensation in hands and feet
• Muscle spasms, joint swelling, muscle stiffness, pain including muscle pain, neck pain
• Difficulty or pain when urinating, inability to control urine
• Weakness, thirst, chest tightness
• Breast pain
• Painful menstrual periods
• Generalized swelling
• Changes in blood and liver test results (elevated creatine phosphokinase in blood, elevated alanine aminotransferase, elevated aspartate aminotransferase, decreased platelet count, low blood potassium, increased blood creatinine, neutropenia)

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

• Changes in heartbeat
• Altered sense of smell, oscillating vision, altered depth perception, visual brightness, vision loss
• Dilated pupils, strabismus
• Inflammation of the eyes (keratitis)
• Cold sweat, throat tightness, tongue swelling
• Difficulty swallowing
• Slow or reduced body movement
• Difficulty writing correctly
• Fluid in the lungs
• Seizures
• Changes in the electrocardiogram (ECG) corresponding to disturbances in heart rhythm
• Increased fluid in the abdominal area
• Muscle damage
• Milk secretion, abnormal breast growth, breast enlargement in men
• Interruption of menstrual period
• Kidney problems, reduced urine output, urine retention
• Decreased white blood cell count
• Inappropriate behaviour, suicidal behaviour, suicidal thoughts
• Jaundice (yellowing of the skin and eyes)
• Parkinsonism, symptoms resembling Parkinson’s disease such as tremor, bradykinesia (reduced ability to move), and muscle rigidity

Very rare: may affect up to 1 in 10,000 people

• Liver failure
• Hepatitis (inflammation of the liver)

Not known: frequency cannot be estimated from available data

• Becoming dependent on pregabalin (“drug dependence”)

After stopping short-term or long-term treatment with Pregabalin SUN, you should be aware that you may experience certain adverse effects known as withdrawal symptoms (see “If you stop taking Pregabalin SUN”).

Certain adverse effects, such as drowsiness, may be more frequent because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity (stiff or rigid muscles), which have similar adverse effects to pregabalin, so the intensity of these effects may increase when taken together.

The following adverse reaction has been reported during post-marketing experience: difficulty breathing, shallow breathing.

Reporting of adverse effects

If you experience any kind of adverse effect, talk to your doctor or pharmacist, even if it is an effect not listed in this leaflet. You can also report them directly via the Spanish Pharmacovigilance System for Human Medicinal Products: https://www.notificaram.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Pregabalin SUN

Keep this medicine out of sight and reach of children.

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

No special storage conditions are required.

Bottle: once opened, the capsules should be used within the following 30 days.

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

6. Contents of the pack and other information

Composition of Pregabalina SUN

The active substance is pregabalin. Each hard capsule contains 25 mg of pregabalin.

The other components are:

Contents of the capsule:

Mannitol, talc

Capsule composition:

Gelatin, titanium dioxide (E171), purified water, sodium lauryl sulfate

Printing ink:

Shellac glaze, propylene glycol, black iron oxide (E172), potassium hydroxide

Appearance of the product and contents of the pack

Pregabalina SUN 25 mg hard capsules:

Size “4” hard gelatin capsules with an opaque white cap and an opaque white body, marked with “rbx” in black ink on the cap and “PG25” on the body, containing white or almost white powder. The capsule length is approximately 14.0 – 14.8 mm.

OPA/Al/PVC/Al blister packs:

Pack sizes: 14, 21, 56, 84, 98, 100 or 112 hard capsules

PVC/Aluminum blister packs:

Pack sizes: 14, 21, 56, 84, 98, 100 or 112 hard capsules.

HDPE bottle with child-resistant closure:

Pack sizes: 14, 21, 30, 56, 84, 98, 100 or 112 hard capsules.

HDPE bottle with screw cap:

Pack size: 500 hard capsules

Only some pack sizes may be commercially available.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Sun Pharmaceutical Industries Europe B.V.,

Polarisavenue 87,

2132JH Hoofddorp, The Netherlands

Manufacturer:

Terapia, S.A.

124, Fabricii Street

400 632 – Cluj Napoca

Romania

or

Sun Pharmaceutical Industries Europe B.V.

Polarisavenue 87

2132JH Hoofddorp

The Netherlands

Local representative

Sun Pharma Laboratorios, S.L.

Rambla de Catalunya 53-55

08007 - Barcelona

Spain

+34 93 342 78 90

This medicinal product is authorized in the European Economic Area member states under the following names:

France: PREGABALINE CRISTERS PHARMA 25 mg, gélule

Germany: PREGABALIN BASICS 25 mg Hartkapseln

Date of the most recent review of this leaflet: January 2024

Detailed and up-to-date 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/