Tadalafil Mylan 20 mg film-coated tablets EFG

Package leaflet: Information for the user

Introduction

Package leaflet: information for the patient

Tadalafil Mylan 20 mg film-coated tablets EFG

Tadalafil

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

• Keep this leaflet. You may need to read it again.
• If you have any further 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 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 Tadalafil Mylan is and what it is used for
2. What you need to know before taking Tadalafil Mylan
3. How to take Tadalafil Mylan
4. Possible side effects
5. How to store Tadalafil Mylan
6. Contents of the pack and other information

1. What is Tadalafil Mylan and what is it used for?

Tadalafil Mylan is indicated for the treatment of erectile dysfunction in adult men. This condition occurs when a man is unable to achieve or maintain a firm erection suitable for satisfactory sexual activity. Tadalafil Mylan has demonstrated a significant improvement in the ability to achieve a durable penile erection suitable for sexual activity.

Tadalafil Mylan contains the active substance tadalafil, which belongs to a group of medicines called phosphodiesterase type 5 inhibitors. Following sexual stimulation, Tadalafil Mylan works by helping to relax the blood vessels in your penis, allowing blood to flow into the penis. The result is improved erectile function. Tadalafil Mylan will not help you if you do not have erectile dysfunction.

It is important to inform you that Tadalafil Mylan is not effective in the absence of sexual stimulation. Therefore, you and your partner must engage in the same kind of stimulation as you would if you were not taking a medicine for erectile dysfunction.

2. What you need to know before taking Tadalafil Mylan

Do not take Tadalafil Mylan

• if you are allergic to tadalafil or to any of the other ingredients of this medicine (listed in section 6).
• if you are taking any type of organic nitrates or nitric oxide donors such as amyl nitrite. This is a group of medicines (“nitrates”) used to treat angina pectoris (“chest pain”). Tadalafil Mylan has been shown to increase the effects of these medicines. If you are taking any type of nitrate or are unsure, tell your doctor.
• if you have a severe heart condition or have recently had a heart attack (within the last 90 days).
• if you have had a stroke within the last 6 months.
• if you have low blood pressure or uncontrolled high blood pressure.
• if you have ever experienced vision loss due to non-arteritic anterior ischemic optic neuropathy (NAION), a condition described as “stroke of the eye”.
• if you are taking riociguat. This medicine is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs caused by blood clots). PDE5 inhibitors, such as Tadalafil Mylan, have been shown to increase the hypotensive effect of this medicine. If you are taking riociguat or are unsure, consult your doctor.

Warnings and precautions

Talk to your doctor before taking Tadalafil Mylan.

Be aware that sexual activity involves a possible risk for patients with heart problems, due to the additional strain placed on the heart. If you have a heart condition, consult your doctor.

Before taking the tablets, inform your doctor if you have:

• sickle cell anemia (an abnormality of red blood cells).
• multiple myeloma (a cancer of the bone marrow).
• leukemia (a cancer of blood cells).
• any deformity of the penis.
• a severe liver problem.
• a severe kidney problem.

It is not known whether Tadalafil Mylan is effective in patients who have undergone:

• pelvic surgery.
• a surgical procedure in which the prostate has been partially or completely removed and the nerves to the prostate have been severed (radical prostatectomy without neurovascular bundle preservation).

If you experience a sudden decrease or loss of vision, or if your vision becomes distorted or dimmed while taking Tadalafil Mylan, stop taking Tadalafil Mylan and contact your doctor immediately.

Sudden decrease or loss of hearing has been reported in some patients taking tadalafil. Although it is not known whether this event is directly related to tadalafil, if you experience sudden decrease or loss of hearing, stop treatment with Tadalafil Mylan and contact your doctor immediately.

Tadalafil Mylan is not intended for use in women.

Children and adolescents

Tadalafil Mylan must not be used in children or adolescents under 18 years of age.

Other medicines and Tadalafil Mylan

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

Do not take Tadalafil Mylan if you are already using nitrates.

Some medicines may be affected by Tadalafil Mylan or may affect how well Tadalafil Mylan works. Inform your doctor or pharmacist if you are taking:

• an alpha-blocker (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia).
• other medicines to treat high blood pressure.
• riociguat.
• a 5-alpha reductase inhibitor (used to treat benign prostatic hyperplasia).
• medicines such as ketoconazole tablets (for treatment of fungal infections) and protease inhibitors for the treatment of AIDS or HIV infection.
• phenobarbital, phenytoin, and carbamazepine (anticonvulsant medicines).
• rifampicin, erythromycin, clarithromycin, or itraconazole.
• other treatments for erectile dysfunction.

Taking Tadalafil Mylan with food and alcohol

Grapefruit juice may affect how well Tadalafil Mylan works and should be used with caution. Consult your doctor for further information.

Alcohol consumption may temporarily lower your blood pressure. If you have taken or are planning to take Tadalafil Mylan, avoid excessive alcohol consumption (blood alcohol level of 0.08% or higher), as it may increase the risk of dizziness upon standing.

Fertility

In dogs treated with tadalafil, a reduction in sperm production by the testes was observed. Some men have shown reduced sperm count. These effects are unlikely to result in infertility.

Driving and using machines

Some men who took Tadalafil Mylan during clinical trials experienced dizziness. Carefully assess how you react when taking the tablets before driving or operating machinery.

Tadalafil Mylan contains lactose

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

Tadalafil Mylan contains sodium

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

3. How to take Tadalafil Mylan

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

The recommended starting dose is one 10 mg tablet before sexual activity. However, you have been prescribed a dose of one 20 mg tablet because your doctor has decided that the recommended 10 mg dose is too weak for you.

When you take Tadalafil Mylan, you may begin sexual activity at least 30 minutes after taking the tablet.

Tadalafil Mylan may remain effective up to 36 hours after taking the tablet.

Do not take Tadalafil Mylan more than once a day. Tadalafil Mylan 10 mg and 20 mg are to be used prior to anticipated sexual activity and are not recommended for continuous daily use.

Tadalafil Mylan tablets are for oral use only in men. Swallow the tablet whole with a little water. The tablets may be taken with or without food.

If you take more Tadalafil Mylan than you should

Consult your doctor. You may experience adverse effects described in section 4.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, Tadalafilo Mylan may produce adverse effects, although not everyone experiences them. These effects are generally mild to moderate in intensity.

If you experience any of the following adverse effects, stop using the medicine and seek immediate medical help:

• allergic reactions including rashes (uncommon).
• chest pain – do not use nitrates, but seek immediate medical help (uncommon).
• priapism, a prolonged and possibly painful erection after using tadalafil (rare frequency). If you experience this type of erection, which may last continuously for more than 4 hours, you must contact a doctor immediately.
• sudden loss of vision (rare frequency), blurred central vision, distorted vision, dimmed vision, or sudden decrease in vision (frequency not known).

Other adverse effects that have been reported:

Common (may affect up to 1 in 10 people)

• headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion.

Uncommon (may affect up to 1 in 100 people)

• dizziness, stomach pain, nausea, vomiting, reflux, blurred vision, eye pain, difficulty breathing, presence of blood in urine, prolonged erection, palpitations, rapid pulse, high blood pressure, low blood pressure, nosebleeds, tinnitus (ringing in the ears), swelling of the hands, feet or ankles, and feeling tired.

Rare (may affect up to 1 in 1000 people)

• fainting, seizures, and transient memory loss, eyelid swelling, red eyes, sudden decrease or loss of hearing, urticaria (red, itchy welts on the skin), bleeding from the penis, presence of blood in semen, and increased sweating.

Rare cases of heart attack and stroke have also been reported in men taking Tadalafilo Mylan. Most of these men had pre-existing heart problems before taking this medicine.

Rare cases of partial, transient or permanent decrease or loss of vision in one or both eyes have been reported.

Some additional rare adverse effects have been reported in men taking Tadalafilo Mylan that were not observed during clinical trials. These include:

• migraine, facial swelling, severe allergic reaction causing swelling of the face or throat, severe skin rashes, certain disorders affecting blood flow to the eyes, irregular heartbeat, angina, and sudden cardiac death.
• blurred central vision, distorted vision, dimmed vision, or sudden decrease in vision (frequency not known).

The most frequently reported adverse effect in men over 75 years of age taking Tadalafilo Mylan has been dizziness. Cases of diarrhea were more frequently reported in patients over 65 years of age taking Tadalafilo Mylan.

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 through the national reporting system included in Appendix V. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Tadalafil Mylan

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

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

This medicine does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to properly dispose of medicines and packaging you no longer need. This will help protect the environment.

6. Contents of the pack and other information

Composition of Tadalafil Mylan

• The active substance is tadalafil. Each tablet contains 20 mg of tadalafil.
• The other components are:

Tablet core: anhydrous lactose (see section 2 “Tadalafil Mylan contains lactose”), poloxamer 188, microcrystalline cellulose (pH101), povidone (K-25), sodium croscarmellose, magnesium stearate, sodium lauryl sulfate, colloidal anhydrous silica.

Film coating: monohydrate lactose, hypromellose (E464), titanium dioxide (E171), yellow iron oxide (E172), triacetin.

Appearance of the product and contents of the pack

Tadalafil Mylan 20 mg is a light yellow, film-coated, round, biconvex tablet, marked with an “M” on one side and “TL4” on the other.

Tadalafil Mylan 20 mg is available in blister packs containing 2, 4, 8, 12 and 24 tablets.

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Mylan Pharmaceuticals Limited
Damastown Industrial Park,
Mulhuddart, Dublin 15,
DUBLIN
Ireland

Manufacturers

McDermott Laboratories Ltd. trading as Gerard Laboratories
35/36 Baldoyle Industrial Estate, Grange Road
Dublin 13
Ireland

Mylan Hungary Kft.
Mylan utca 1
Komárom, 2900
Hungary

Mylan Germany GmbH
Zweigniederlassung Bad Homburg v. d. Hoehe, Benzstrasse 1
Bad Homburg v. d. Hoehe
Hessen, 61352
Germany

For further information about this medicinal product, please contact the local representative of the Marketing Authorization Holder.

Date of the most recent review of this leaflet:

Other sources of information

Detailed information on this medicinal product is available on the website of the European Medicines Agency: http://www.ema.europa.eu and on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS, http://www.aemps.gob.es/).