Package leaflet: Information for the patient

ESPERIS 500 mg film-coated tablets

Micronized flavonoids, as diosmin and other flavonoids expressed as hesperidin
Please read this leaflet carefully before taking this medicine because it contains important information for you.
Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you to do.

Keep this leaflet. You may need to read it again.
If you want more information or advice, consult your pharmacist.
If you experience any side effects, including those not listed in this leaflet, contact your doctor or pharmacist. See section 4.
Contact your doctor if you do not notice any improvement or if you experience worsening of symptoms after 7 days.

Contents of this leaflet:

What ESPERIS is and what it is used for
What you need to know before taking ESPERIS
How to take ESPERIS
Possible side effects
How to store ESPERIS
Contents of the pack and other information

1. What ESPERIS is and what it is used for

ESPERIS is a vasoprotective agent: it increases venous tone and the resistance of small blood vessels.
ESPERIS is indicated in adults for the treatment:

of symptoms related to chronic venous insufficiency of the lower limbs: heaviness, swelling, pain or cramps in the legs;
capillary fragility (easy rupture of capillaries, which become visible on the skin and may cause spots and bruising);
functional symptoms associated with acute haemorrhoidal crisis, such as pain, bleeding and swelling in the anal region.
Consult your doctor if you do not feel better or if you feel worse after one week of treatment.

2. What you need to know before taking ESPERIS

Do not take ESPERIS
If you are allergic to the active substances or to any of the other ingredients of this medicine (listed in
section 6).

Warnings and precautions
Talk to your doctor or pharmacist before taking ESPERIS.

Chronic venous disease
If your condition worsens during treatment, with symptoms such as inflammation of the skin or veins, hardening of the subcutaneous tissue, severe pain, skin ulcers, or atypical symptoms such as sudden swelling of one or both legs, contact your doctor immediately.
ESPERIS does not help reduce swelling of the lower limbs if this is caused by heart, kidney, or liver diseases.
In case of venous insufficiency, treatment should be combined with a healthy lifestyle to achieve the best results. Avoid exposure to sunlight and heat, prolonged standing, and being overweight.
Walking and wearing special compression stockings improve circulation.

Acute haemorrhoidal disease
If you have an acute haemorrhoid attack, you may take ESPERIS only for a limited period of 7 days. If symptoms of acute haemorrhoidal attack do not disappear within 7 days, consult your doctor.
If your condition worsens during treatment—for example, if you notice increased rectal bleeding, blood in the stools, or have doubts about haemorrhoidal bleeding—contact your doctor immediately.
Treatment with ESPERIS does not replace specific treatment for other anal disorders.
If you have any questions, ask your doctor or pharmacist.

Children and adolescents
The use of ESPERIS is not recommended in children and adolescents.

Other medicines and ESPERIS
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
No interactions with other medicines are currently known.

Pregnancy and breastfeeding
If you are pregnant, think you may be pregnant, planning a pregnancy, or are breastfeeding, consult your doctor or pharmacist before taking this medicine.
This medicine is not recommended during pregnancy and breastfeeding due to the lack of clinical data.

Driving and using machines
This medicine does not affect or has negligible influence on the ability to drive vehicles or operate machinery.

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

3. How to take ESPERIS

Take this medicine exactly as described in this leaflet or as instructed by your doctor or pharmacist. If you have any doubts, consult your doctor or pharmacist.
Chronic venous insufficiency
The recommended dose for adults is 2 tablets daily, taken with the main meals (lunch and dinner), also in case of haemorrhoids.
Do not exceed the maximum daily dose.
Treatment may last up to 8 weeks. Contact your doctor if you do not feel better or if you feel worse; your doctor will evaluate whether treatment should continue.
Acute haemorrhoidal attack
During the first 4 days of treatment, the recommended dose for adults is 3 tablets twice daily (6 tablets per day). During the following 3 days, the dose is 2 tablets twice daily (4 tablets per day).
Do not exceed the maximum daily dose.
Take these tablets with meals.
If you are taking ESPERIS to treat symptoms of an acute haemorrhoidal condition, consult your doctor or pharmacist if you do not feel better or if you feel worse after 7 days.
If you take more ESPERIS than you should
If you have taken more ESPERIS than you should, contact your doctor or pharmacist.
Experience with overdose of micronized flavonoids is limited. Possible adverse effects in case of overdose may include diarrhoea, nausea, abdominal pain, pruritus, and skin rash.
If you forget to take ESPERIS
Do not take a double dose to make up for the missed dose.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everyone experiences them.
The following side effects may occur with the frequency described below:
Common (may affect up to 1 in 10 people)
Nausea, vomiting, diarrhoea, indigestion (dyspepsia).
Uncommon (may affect up to 1 in 100 people)
Inflammation of the colon (colitis).
Rare (may affect up to 1 in 1,000 people)
Headache, dizziness, malaise, skin rash, itching, urticaria.
Not known (frequency cannot be estimated from the available data)
Abdominal pain, abnormally low platelet count (thrombocytopenia), swelling of the face, lips or eyelids (oedema) associated with allergic symptoms. In rare cases, rapidly developing swelling of the face, lips, mouth, tongue or throat may occur, which may be accompanied by breathing difficulties (angioedema/Quincke's oedema).

Reporting of side effects
If you experience any side effect, including those not listed in this leaflet, talk to your doctor or pharmacist. You can also report side effects directly via the national reporting system at https://www.aifa.gov.it/content/segnalazioni-reazioni-avverse.
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store ESPERIS

Keep this medicine out of the sight and reach of children.
OPA/AL/PVC blister packs: This medicine does not require any special storage conditions.
PVC/AL blister packs: Store below 25°C.
Do not use this medicine after the expiry date stated on the packaging after "Exp". The expiry date refers to the last day of that month.
Do not dispose of medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer in use. This will help protect the environment.

6. Package contents and other information

What ESPERIS contains
The active substance is micronized flavonoids, consisting of diosmin and other flavonoids expressed as hesperidin. Each film-coated tablet contains 500 mg of micronized flavonoids, including 450 mg of diosmin and 50 mg of other flavonoids expressed as hesperidin.
The other components are:
Tablet core: gelatin, sodium lauryl sulfate, sodium starch glycolate (type A), microcrystalline cellulose, magnesium stearate, talc.
Coating: hypromellose (E464), titanium dioxide (E171), glycerol (E422), magnesium stearate (E470b), yellow iron oxide (E172), red iron oxide (E172), macrogol (E1521).
Description of the appearance of ESPERIS and contents of the pack
ESPERIS is presented in a cardboard box containing blisters in OPA/AL/PVC or PVC/AL with 30, 60 or 120 film-coated tablets, salmon-red in colour and oblong in shape.
Not all pack sizes may be marketed.
Marketing Authorization Holder
Epifarma S.r.l. - Via San Rocco, 6 – 85033 Episcopia (PZ), Italy
Manufacturer
Doppel Farmaceutici S.r.l. – Via Volturno, 48 – 20089 Quinto De’ Stampi - Rozzano (MI), Italy