Solifenacin/tamsulosin Alter 6 mg/0.4 mg modified-release tablets EFG

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Solifenacin/Tamsulosin Alter 6 mg/0.4 mg modified-release tablets EFG

solifenacin succinate/tamsulosin hydrochloride

Read the entire leaflet carefully before you start using 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; do not give it to others, even if they have the same symptoms as you, as it may harm them.
• If you experience any adverse effects, consult your doctor or pharmacist, even if such effects are not listed in this leaflet. See section 4.

Leaflet contents

1. What Solifenacina/Tamsulosina Alter is and what it is used for
2. What you need to know before using Solifenacina/Tamsulosina Alter
3. How to use Solifenacina/Tamsulosina Alter
4. Possible adverse effects
5. Storage of Solifenacina/Tamsulosina Alter
6. Contents of the pack and other information

1. What Solifenacin/Tamsulosin Alter is and what it is used for

Solifenacin/Tamsulosin Alter is a combination of two different medicines called solifenacin and tamsulosin in one tablet. Solifenacin belongs to a group of medicines known as anticholinergics, and tamsulosin belongs to a group of medicines called alpha-blockers.

Solifenacin/Tamsulosin is used in men to treat both moderate to severe filling symptoms and lower urinary tract voiding symptoms caused by bladder problems and enlarged prostate (benign prostatic hyperplasia). Solifenacin/tamsulosin is used when prior treatment with monotherapy for this condition did not provide adequate symptom relief.

When the prostate gland enlarges, urinary problems (voiding symptoms) may occur, such as delayed urination (difficulty starting to pass urine), reduced urine flow (weak stream), dribbling, and a sensation of incomplete bladder emptying. At the same time, the bladder may also be affected and contract spontaneously at times when urination is not desired. This leads to filling symptoms such as changes in bladder sensation, urgency (a sudden, strong need to pass urine without warning), and increased frequency of urination.

Solifenacin reduces involuntary contractions of the bladder and increases the amount of urine that your bladder can hold. Therefore, you may be able to wait longer before needing to go to the bathroom. Tamsulosin helps urine to pass more easily through the urethra and facilitates urination.

2. What you need to know before using Solifenacin/Tamsulosin Alter

Do not use Solifenacin/Tamsulosin Alter if:

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

• you are undergoing renal dialysis.

• you have severe liver disease.

• you have severe renal disease AND at the same time are being treated with medicines that may reduce the elimination of solifenacin/tamsulosin from the body (e.g. ketoconazole, ritonavir, nelfinavir, itraconazole). Your doctor or pharmacist will inform you if this applies to you.

• you have moderate liver disease AND at the same time are being treated with medicines that may reduce the elimination of solifenacin/tamsulosin from the body (e.g. ketoconazole, ritonavir, nelfinavir, itraconazole). Your doctor or pharmacist will inform you if this applies to you.

• you have a severe stomach or intestinal disorder (including toxic megacolon, a complication associated with ulcerative colitis).

• you have a muscle disorder called myasthenia gravis, which can cause extreme weakness of certain muscles.

• you have increased pressure in the eyes (glaucoma), with gradual loss of vision.

• you experience fainting due to a drop in blood pressure when changing posture (sitting or standing up); this is known as orthostatic hypotension.

Inform your doctor if you think you may have any of these conditions.

Warnings and precautions

Talk to your doctor or pharmacist before taking solifenacin/tamsulosin if:

• you have difficulty passing urine (urinary retention).
• you have any obstruction of the gastrointestinal tract.
• you are at risk of reduced gastrointestinal motility (stomach and intestinal movements). Your doctor will inform you if this applies to you.
• you have a diaphragmatic tear (hiatal hernia) or heartburn and/or are simultaneously taking medicines that may cause or worsen esophagitis.
• you have a certain type of nerve disorder (autonomic neuropathy).
• you have severe renal disease.
• you have moderate liver disease.

Regular medical check-ups are necessary to monitor the condition for which you are being treated.

Solifenacin/Tamsulosin may affect blood pressure, which could cause dizziness, lightheadedness, or rarely fainting (orthostatic hypotension). If you experience any of these symptoms, you should sit or lie down until they resolve.

If you are scheduled for or undergoing eye surgery due to lens opacity (cataracts) or increased eye pressure (glaucoma), please inform your ophthalmologist that you have previously used, are currently using, or plan to use Solifenacin/Tamsulosin. The specialist can then take appropriate precautions regarding medication and surgical techniques. Ask your doctor whether you should delay or temporarily discontinue taking this medicine prior to undergoing eye surgery for cataracts or increased eye pressure (glaucoma).

Children and adolescents

Do not give this medicine to children or adolescents.

Other medicines and Solifenacin/Tamsulosin Alter

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

It is especially important that you inform your doctor if you are taking:

• medicines such as ketoconazole, erythromycin, ritonavir, nelfinavir, itraconazole, verapamil, diltiazem, and paroxetine, which reduce the rate at which solifenacin/tamsulosin is eliminated from the body.
• other anticholinergic medicines, as their effects and adverse effects may be intensified when taking two medicines of the same type.
• cholinergics, as they may reduce the effect of solifenacin/tamsulosin.
• medicines such as metoclopramide and cisapride, which may accelerate gastrointestinal motility. Solifenacin/tamsulosin may reduce their effect.
• other alpha-blockers, as they may cause an undesirable drop in blood pressure.
• medicines such as bisphosphonates, which may cause or worsen inflammation of the esophagus (esophagitis).

Use of Solifenacin/Tamsulosin Alter with food and drink

Solifenacin/tamsulosin may be taken with or without food, according to your preference.

Pregnancy, breastfeeding and fertility

Solifenacin/Tamsulosin is not indicated for use in women.

In men, abnormal ejaculation (ejaculation disorder) has been reported. This means that semen does not exit through the urethra but instead enters the bladder (retrograde ejaculation), or that the ejaculated volume is reduced or absent (ejaculatory insufficiency). This phenomenon is harmless.

Driving and using machines

Solifenacin/Tamsulosin may cause dizziness, blurred vision, fatigue, and less frequently, somnolence. If you experience these adverse effects, do not drive or operate machinery.

Solifenacin/Tamsulosin Alter contains sodium croscarmellose

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

3. How to use Solifenacin/Tamsulosin Alter

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

The maximum daily dose is one tablet containing 6 mg of solifenacin and 0.4 mg of tamsulosin, taken orally. It can be taken with or without food, depending on your preference. Do not crush or chew the tablet.

If you take more Solifenacin/Tamsulosin Alter than you should

If you have taken more tablets than prescribed, or if someone else accidentally takes your tablets, contact your doctor, pharmacist, or hospital immediately for advice.

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 medicine and the amount ingested.

In case of overdose, your doctor may treat you with activated charcoal; emergency gastric lavage may be useful if performed within one hour of the overdose. Do not induce vomiting.

Symptoms of overdose may include: dry mouth, dizziness and blurred vision, seeing things that are not there (hallucinations), over-excitability, seizures, difficulty breathing, increased heart rate (tachycardia), inability to completely or partially empty the bladder or to urinate (urinary retention), and/or unwanted increase in blood pressure.

If you forget to take Solifenacin/Tamsulosin Alter

Take your next dose of solifenacin/tamsulosin at the usual time. Do not take a double dose to make up for forgotten doses.

If you stop using Solifenacin/Tamsulosin Alter

If you stop taking this medicine, your original symptoms may return or worsen. Always consult your doctor if you are considering stopping 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, solifenacin/tamsulosin may produce adverse effects, although not everyone experiences them.

The most serious adverse effect observed infrequently (which may affect up to 1 in 100 men) during clinical studies with solifenacin/tamsulosin is acute urinary retention, characterized by a sudden inability to urinate. If you think you may be experiencing this, seek immediate medical attention. You may need to stop taking this medicine.

Solifenacin/tamsulosin may cause allergic reactions:

• Uncommon signs of allergic reactions may include rash (which may be itchy) or hives (urticaria).
• Rare symptoms include swelling of the face, lips, mouth, tongue, or throat, which may cause difficulty swallowing or breathing (angioedema). Angioedema has been reported rarely with tamsulosin and very rarely with solifenacin. In case of angioedema, treatment with solifenacin/tamsulosin must be immediately and permanently discontinued.

If you experience an allergic crisis or a severe skin reaction (for example, blistering and peeling of the skin), you must inform your doctor immediately and stop using solifenacin/tamsulosin. Appropriate treatment and/or measures should be applied.

Frequent adverse effects (may affect up to 1 in 10 men)

• Dry mouth
• Constipation
• Indigestion (dyspepsia)
• Dizziness
• Blurred vision
• Fatigue
• Abnormal ejaculation (ejaculation disorder). This means that semen does not exit through the urethra but goes into the bladder (retrograde ejaculation), or that the ejaculated volume is reduced or absent (ejaculatory insufficiency). This phenomenon is harmless.
• Feeling of dizziness (nausea)
• Abdominal pain

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

• Somnolence
• Itching (pruritus)
• Urinary tract infection, bladder infection (cystitis)
• Disturbance of taste sensation (dysgeusia)
• Dry eyes
• Nasal dryness
• Reflux disease (gastroesophageal reflux)
• Dry throat
• Dry skin
• Difficulty urinating
• Fluid accumulation in the legs (edema)
• Headache
• Rapid or irregular heartbeat (palpitations)
• Feeling of dizziness or weakness, especially when standing up (orthostatic hypotension)
• Runny or blocked nose (rhinitis)
• Diarrhea
• Vomiting
• Tiredness (asthenia)

Rare adverse effects (may affect up to 1 in 1,000 men)

• Accumulation of a large amount of hardened feces in the large intestine (fecal impaction)
• Feeling of fainting (syncope)

Allergic skin reaction causing swelling in the tissue beneath the skin surface (angioedema)

Very rare adverse effects (may affect up to 1 in 10,000 men)

• Hallucinations, confusion
• Skin allergic reaction (erythema multiforme)
• Prolonged and painful erection (usually not during sexual activity) (priapism)

Skin rash, inflammation, and blister formation on the skin and/or mucous membranes of the lips, eyes, mouth, nasal passages, or genitals (Stevens-Johnson syndrome)

Frequency not known (cannot be estimated from available data)

• Decreased appetite
• Elevated blood potassium levels (hyperkalemia), which may cause abnormal heart rhythm
• Increased pressure in the eyes (glaucoma)
• Irregular or abnormal heartbeat (prolongation of QT interval, Torsades de Pointes, atrial fibrillation, arrhythmia)
• Rapid heart rate (tachycardia)
• Breathing difficulty (dyspnea)
• During eye surgery for lens clouding (cataracts) or increased eye pressure (glaucoma), the pupil (the black circle in the center of the eye) may not dilate properly. In addition, the iris (the colored part of the eye) may become floppy during surgery.
• Voice disorder
• Liver disorder
• Muscle weakness
• Kidney disorder
• Vision disturbance
• Nosebleed (epistaxis)

Reporting of adverse effects

If you experience any 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 Medicines: www.notificaRAM.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Solifenacin/Tamsulosin Alter

Keep this medicine out of sight and reach of children.

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

Store below 25 °C.

Medicines must not be disposed of via wastewater or household waste. Dispose of unused medicines and their packaging at a pharmacy’s SIGRE collection point. If in doubt, ask your pharmacist how to properly dispose of unused medicines and their packaging. This helps protect the environment.

6. Contents of the pack and other information

Composition of Solifenacin/Tamsulosin Alter

• The active substances are solifenacin succinate 6 mg and tamsulosin hydrochloride 0.4 mg.
• The other components are microcrystalline cellulose, high molecular weight polyethylene glycol, magnesium stearate, calcium hydrogen phosphate, anhydrous colloidal silicon dioxide, sodium croscarmellose, red iron oxide (E-172), and coating material [hypromellose, polyethylene glycol, red iron oxide (E-172), titanium dioxide (E-171)].

Appearance of the product and contents of the pack

Solifenacin/Tamsulosin Alter 6 mg/0.4 mg tablets are round, biconvex, approximately 9 mm in diameter, film-coated, red in colour, and marked with "T7S" on one side.

Modified-release tablets of Solifenacin/Tamsulosin Alter are available in single-dose cuttable blisters made of oPA/Al/PVC-Aluminum, containing 30 tablets.

Marketing Authorization Holder

Laboratorios Alter, S.A.
C/ Mateo Inurria, 30
28036 Madrid
Spain

Manufacturer

Synthon Hispania S.L.
C/ Castelló, nº1
Sant Boi de Llobregat
08830 Barcelona
Spain

or

Synthon BV
Microweg 22
6545 CM Nijmegen
The Netherlands

or

Synthon s.r.o.
Brnenská 32/cp. 597
678 01 Blansko
Czech Republic

Date of the most recent review of this leaflet:

July 2024

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