Zerinotuss

Patient Information Leaflet

ZERINOTUSS 30 mg/5 ml syrup

Levodropropizine
Please read all of 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 instructed you.

• Keep this leaflet. You may need to read it again.
• If you need 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 your symptoms worsen after 2 weeks of treatment.

Contents of this leaflet:

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

1. What ZERINOTUSS is and what it is used for

ZERINOTUSS contains the active substance levodropropizine, which belongs to a group of medicines called cough suppressants.
This medicine is indicated for the treatment of cough symptoms.
Consult your doctor if you do not feel better or if you feel worse after 2 weeks of treatment.

2. What you need to know before taking ZERINOTUSS

Do not take ZERINOTUSS

• if you are allergic to levodropropizine or to any of the other ingredients of this medicine (listed in section 6);
• if you suffer from a bronchial disease characterized by excessive mucus production (bronchial hypersecretion);
• if you have been born with certain respiratory mucosal disorders characterized by reduced ability to expel mucus (Kartagener syndrome, ciliary dyskinesia);
• if you are pregnant or breastfeeding (see section “Pregnancy and breastfeeding”). Do not administer this medicine to children under two years of age (see section “Children”).

Warnings and precautions
Talk to your doctor or pharmacist before taking ZERINOTUSS.
Take this medicine with caution and inform your doctor:

• if you have severe kidney problems (severe renal insufficiency with creatinine clearance below 35 ml/min);
• if you are elderly, as sensitivity to various medicines may be altered in older people;
• if you are taking sedative medicines for the treatment of anxiety and you are a particularly sensitive individual (see section “Other medicines and ZERINOTUSS”).

Cough suppressants treat only the symptoms and should be used only while awaiting diagnosis of the underlying cause and/or the effect of treatment for the underlying disease.
Therefore, do not use for prolonged treatments. If after a short period of treatment (2 weeks) there is no noticeable improvement, consult your doctor.
ZERINOTUSS does not contain gluten and is therefore not contraindicated if you have coeliac disease.
Children
Do not give this medicine to children under 2 years of age (see section “Do not take ZERINOTUSS”).
Other medicines and ZERINOTUSS
Inform your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Take this medicine with caution and inform your doctor if you are taking sedative medicines used for the treatment of anxiety.
Pregnancy and breastfeeding
If you are pregnant, think you may be pregnant or are planning to become pregnant, or if you are breastfeeding, ask your doctor or pharmacist for advice before taking this medicine.
Do not take ZERINOTUSS if you are pregnant (presumed or confirmed) or breastfeeding (see section “Do not take ZERINOTUSS”).
Driving and using machines
This medicine may cause drowsiness (see section 4 “Possible side effects”). If you experience this symptom, avoid driving or operating machinery.
ZERINOTUSS contains sucrose and parahydroxybenzoates
This medicine contains 4 g of sucrose per dose (10 ml). If your doctor has diagnosed you with an intolerance to certain sugars, contact him/her before taking this medicine.
This should be taken into consideration in patients with diabetes mellitus.
This medicine contains parahydroxybenzoates (methyl-parahydroxybenzoate, propyl-parahydroxybenzoate) which may cause allergic reactions (including delayed reactions) such as contact dermatitis, and rarely immediate reactions with urticaria and bronchospasm (narrowing of the airways, which may cause breathing difficulties).

3. How to take ZERINOTUSS

Take this medicine exactly as stated in this leaflet or as directed by your doctor or pharmacist. If you have any doubts, consult your doctor or pharmacist.
Continue taking this medicine until symptoms disappear. If you do not notice any improvement after 2 weeks of treatment, stop taking it and consult your doctor.
Recommended doses:
Adults
10 ml of syrup, up to 3 times daily, with at least 6 hours between each dose.
Use in children over 2 years of age:
The recommended dose, based on the child's body weight, is:

• 3 ml of syrup if the child weighs between 10 and 20 kg;
• 5 ml of syrup if the child weighs between 20 and 30 kg. The syrup may be administered up to 3 times daily, with at least 6 hours between each dose.

Method of administration
A measuring cup with markings corresponding to 3, 5, and 10 ml is included in the package.
To open the bottle, press down firmly on the cap and simultaneously turn it counterclockwise.
The syrup should be taken orally.
It is recommended to take and administer the medicine away from meals.
Warning: Do not exceed the recommended doses.
If you take more ZERINOTUSS than you should
In case of accidental ingestion or overdose of ZERINOTUSS, contact your doctor immediately or go to the nearest hospital.
If you take an excessive dose of this medicine, you may experience mild abdominal pain and vomiting.
If you forget to take ZERINOTUSS
Do not take a double dose to make up for the missed dose.
If you have any doubts about how to use this medicine, consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everyone experiences them.
Most of the adverse reactions observed following administration of levodropropizine were not severe, and symptoms resolved upon discontinuation of therapy and, in some cases, with specific pharmacological treatment.
The adverse reactions reported have an unknown frequency (the frequency cannot be estimated from the available data):

• mydriasis (dilation of the pupil of the eye), bilateral blindness (affecting both eyes);
• allergic and anaphylactoid reactions, eyelid edema (swelling of the eyelid), angioneurotic edema (swelling of the deep dermis and subcutaneous tissue, which may also affect mucous membranes), urticaria;
• nervousness, somnolence, personality alteration, personality disorder;
• syncope (transient loss of consciousness), dizziness, vertigo, tremors, paresthesia (abnormal skin sensation, tingling), tonic-clonic seizure (grand mal) and petit mal seizure, hypoglycemic coma (loss of consciousness caused by a severe reduction in blood glucose levels);
• palpitations, tachycardia (accelerated heartbeat), atrial bigeminy (irregular heartbeat);
• hypotension (low blood pressure);
• dyspnea (difficulty breathing), cough, edema (swelling) of the respiratory tract;
• stomach pain, abdominal pain, nausea, vomiting, diarrhea;
• cholestatic hepatitis (liver inflammation due to impaired bile excretion);
• urticaria, erythema (redness of the skin), exanthema (skin rash), pruritus, angioedema (swelling of the face and mucous membranes), skin reactions, glossitis (inflammation of the tongue), and aphthous stomatitis (painful mouth ulcers);
• epidermolysis (rare and potentially serious skin disorders);
• weakness of the lower limbs;
• general malaise, generalized edema (swelling), asthenia (physical weakness).

Additional side effects in breastfed newborns whose mothers have taken levodropropizine
One case of somnolence, hypotonia (reduced muscle tone), and vomiting has been reported in a newborn following maternal intake of levodropropizine. Symptoms appeared after breastfeeding and resolved spontaneously after temporarily suspending breastfeeding for a few feeds.
Following the instructions provided in this leaflet reduces the risk of side effects.
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: www.agenziafarmaco.gov.it/it/responsabili. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store ZERINOTUSS

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 "Exp.".
The expiry date refers to the last day of that month.
The product is valid for 6 weeks after first opening the bottle.
Store below 25°C.
Do not dispose of any medicine via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Package contents and other information

What ZERINOTUSS contains

• The active substance is levodropropizine. Each 100 ml of solution contains 600 mg of levodropropizine.
• The other components are: sucrose, methyl p-hydroxybenzoate, propyl p-hydroxybenzoate, citric acid monohydrate, sodium hydroxide, cherry flavour, purified water.

Description of the appearance of ZERINOTUSS and package contents
ZERINOTUSS is available in a 200 ml bottle with a graduated dosing cup.
Marketing Authorization Holder
Zentiva Italia S.r.l. - Viale Luigi Bodio 37/b - 20158 Milan (MI)
Manufacturer
Doppel Farmaceutici S.r.l. - Via Martiri delle Foibe, 1 - 29016 Cortemaggiore (PC) - Italy

Patient information leaflet

ZERINOTUSS 60 mg/ml oral drops, solution

Levodropropizine
Generic medicine
Please read this leaflet carefully before taking this medicine because it contains important information for you.

• Keep this leaflet. 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. Do not give it to others, even if their symptoms are the same as yours, as it could be harmful.
• If you experience any adverse reaction, including those not listed in this leaflet, contact your doctor or pharmacist. See section 4.

Contents of this leaflet:

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

1. What ZERINOTUSS is and what it is used for

ZERINOTUSS contains the active substance levodropropizine, which belongs to a group of medicines called antitussives (cough suppressants).
This medicine is indicated for the treatment of cough symptoms.
Consult your doctor if you do not feel better or if you feel worse after 2 weeks of treatment.

2. What you need to know before taking ZERINOTUSS

Do not take ZERINOTUSS

• if you are allergic to levodropropizine or to any of the other ingredients of this medicine (listed in section 6);
• if you suffer from a bronchial disease characterized by excessive mucus production (bronchial hypersecretion);
• if you have been born with certain respiratory mucosal disorders characterized by reduced ability to expel mucus (Kartagener syndrome, ciliary dyskinesia);
• if you are pregnant or breastfeeding (see section “Pregnancy and breastfeeding”). Do not administer this medicine to children under two years of age (see section “Children”).

Warnings and precautions
Talk to your doctor or pharmacist before taking ZERINOTUSS.
Take this medicine with caution and inform your doctor:

• if you have severe kidney problems (severe renal impairment with creatinine clearance below 35 ml/min);
• if you are elderly, as sensitivity to various medicines may be altered in older individuals;
• if you are taking sedative medicines for the treatment of anxiety and you are particularly sensitive (see section “Other medicines and ZERINOTUSS”). Cough suppressants treat only the symptoms and should be used only while awaiting diagnosis of the underlying cause and/or the effect of treatment for the underlying disease. Therefore, do not use for prolonged treatments. If after a short period of treatment (2 weeks) there is no noticeable improvement, consult your doctor. This medicine does not affect low-calorie or controlled diets and may be taken even if you have diabetes. ZERINOTUSS does not contain gluten and therefore is not contraindicated in patients with celiac disease.

Children
Do not give this medicine to children under 2 years of age (see section “Do not take ZERINOTUSS”).

Other medicines and ZERINOTUSS
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
Take this medicine with caution and inform your doctor if you are taking sedative medicines used for the treatment of anxiety.

Pregnancy and breastfeeding
If you are pregnant, suspect you may be pregnant, planning to become pregnant, or are breastfeeding, ask your doctor or pharmacist for advice before taking this medicine.
Do not take ZERINOTUSS if you are pregnant (presumed or confirmed) or breastfeeding (see section “Do not take ZERINOTUSS”).

Driving and using machines
This medicine may cause drowsiness (see section 4 “Possible side effects”). If you experience this symptom, avoid driving or operating machinery.

ZERINOTUSS contains parahydroxybenzoates
This medicine contains parahydroxybenzoates which may cause allergic reactions (including delayed reactions), such as contact dermatitis, and rarely immediate reactions manifesting as urticaria and bronchospasm (narrowing of the airways, which may cause breathing difficulties).

3. How to take ZERINOTUSS

Take this medicine exactly as directed by your doctor or pharmacist. If you have
any doubts, consult your doctor or pharmacist.
Continue taking this medicine until symptoms disappear. If you do not notice any improvement after 2 weeks of treatment,
stop taking it and consult your doctor.
Recommended doses are:
Adults
20 drops (corresponding to 60 mg), up to 3 times daily, with at least 6 hours between each
administration, unless otherwise prescribed by the doctor.
Use in children over 2 years of age:
The dose will be determined by the doctor according to the child's weight, as follows:

• 3 drops if the child weighs between 7 and 10 kg;
• 4 drops if the child weighs between 11 and 13 kg;
• 5 drops if the child weighs between 14 and 16 kg;
• 6 drops if the child weighs between 17 and 19 kg;
• 7 drops if the child weighs between 20 and 22 kg;
• 8 drops if the child weighs between 23 and 25 kg;
• 9 drops if the child weighs between 26 and 28 kg;
• 10 drops if the child weighs between 29 and 31 kg;
• 11 drops if the child weighs between 32 and 34 kg;
• 12 drops if the child weighs between 35 and 37 kg;
• 13 drops if the child weighs between 38 and 40 kg;
• 14 drops if the child weighs between 41 and 43 kg;
• 15 drops if the child weighs between 44 and 46 kg;
• 20 drops if the child weighs more than 46 kg. The drops may be administered up to 3 times daily, with at least 6 hours between each administration.

If the doctor treating your child considers it necessary, the dose may be increased up to a
maximum of 20 drops, 3 times daily.
Method of administration
Dilute the drops in half a glass of water.
It is recommended to take and administer the medicine away from meals.
Caution: Do not exceed the recommended doses.
If you take more ZERINOTUSS than you should
In case of accidental ingestion/overdose of ZERINOTUSS, contact your doctor immediately or go to the nearest hospital.
If you take an excessive dose of this medicine, you may experience: abdominal pain and non-severe vomiting.
The doctor will determine the most appropriate treatment for you based on the severity of symptoms.
If you forget to take ZERINOTUSS
Do not take a double dose to make up for a missed dose.
If you have any doubts about how to use this medicine, consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everyone experiences them.
Most of the adverse reactions observed following administration of levodropropizine are mild, and symptoms resolved upon discontinuation of treatment and, in some cases, with specific pharmacological treatment.
The adverse reactions reported have an unknown frequency (the frequency cannot be estimated from the available data):

• mydriasis (dilation of the pupil of the eye), bilateral blindness (affecting both eyes);
• allergic and anaphylactoid reactions, eyelid edema (swelling of the eyelid), angioneurotic edema (swelling of deep dermis and subcutaneous tissue which may also affect mucous membranes), urticaria;
• nervousness, somnolence, personality alteration, personality disorder;
• syncope (transient loss of consciousness), dizziness, vertigo, tremors, paresthesia (abnormal skin sensation, tingling), tonic-clonic seizure (grand mal), petit mal seizure, hypoglycemic coma (loss of consciousness caused by a severe reduction in blood glucose levels);
• palpitations, tachycardia (accelerated heartbeat), atrial bigeminy (irregular heartbeat);
• hypotension (low blood pressure);
• dyspnea (difficulty breathing), cough, edema (swelling) of the respiratory tract;
• stomach pain, abdominal pain, nausea, vomiting, diarrhea;
• cholestatic hepatitis (liver inflammation due to impaired bile excretion);
• urticaria, erythema (redness of the skin), exanthema (skin rash), pruritus, angioedema (facial and mucosal swelling), skin reactions, glossitis (inflammation of the tongue), and aphthous stomatitis (painful mouth ulcers);
• epidermolysis (rare and potentially serious skin disorders);
• weakness of the lower limbs;
• general malaise, generalized edema (swelling), asthenia (physical weakness).

Additional side effects in breastfed newborns whose mothers have taken levodropropizina
One case of somnolence, hypotonia (reduced muscle tone), and vomiting has been reported in a newborn after the breastfeeding mother took levodropropizina. Symptoms appeared after breastfeeding and resolved spontaneously by temporarily withholding breastfeeding for a few feeds.
Following the instructions provided in this leaflet reduces the risk of side effects.
Reporting of side effects
If you experience any side effect, including those not listed in this leaflet, consult your doctor or pharmacist. You may also report side effects directly via the national reporting system at: www.agenziafarmaco.gov.it/it/responsabili. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store ZERINOTUSS

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the packaging after "Exp.".
The expiry date refers to the last day of that month.
The product's shelf life after first opening the bottle is 21 weeks.
Store below 25°C.
Do not dispose of any medicine via wastewater or household waste. Ask your pharmacist how to
dispose of medicines no longer in use. This will help protect the environment.

6. Contents of the pack and other information

What ZERINOTUSS contains

• The active substance is levodropropizine. Each 100 ml of solution contains 6 g of levodropropizine.
• The other components are: propylene glycol, xylitol, sodium saccharinate, methyl parahydroxybenzoate, mixed berry flavor, anise flavor, anhydrous citric acid, purified water.

Description of the appearance of ZERINOTUSS and contents of the pack
ZERINOTUSS is a solution.
ZERINOTUSS is available in a 30 ml bottle with dropper.
Marketing Authorization Holder
Zentiva Italia S.r.l. - Viale Luigi Bodio 37/b - 20158 Milan (MI)
Manufacturer
Doppel Farmaceutici S.r.l. - Via Martiri delle Foibe, 1- 29016 Cortemaggiore (PC) - Italy