Minirin melt

Package leaflet: Information for the patient

MINIRIN Melt, 60 micrograms, oral lyophilisate
MINIRIN Melt, 120 micrograms, oral lyophilisate
MINIRIN Melt, 240 micrograms, oral lyophilisate
Desmopressinum
Please read this leaflet carefully before taking the medicine, as it contains
important information for the patient.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, please consult your doctor.
• This medicine has been prescribed for a specific individual. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If the patient experiences any adverse reactions, including any not listed in this leaflet, inform your doctor. See section 4.

Table of contents:

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

1. What Minirin Melt is and what it is used for

Minirin Melt contains desmopressin, which acts similarly to the natural pituitary hormone,
arginine vasopressin. Desmopressin has a significantly prolonged antidiuretic effect (reducing urine production) and completely lacks vasoconstrictive activity at therapeutic doses.
Minirin Melt is used to treat:

• central diabetes insipidus;
• primary monosymptomatic nocturnal enuresis in children above 6 years of age with normal urine concentrating ability;
• nocturia in adults associated with nocturnal polyuria (nocturnal urine output exceeds bladder capacity).

2. Important information before using Minirin Melt

When not to use Minirin Melt

• if the patient is allergic to desmopressin acetate or any of the other ingredients of this medicine (listed in section 6);
• if the patient has been diagnosed with psychogenic or habitual polydipsia (excessive thirst);
• if the patient has circulatory failure or other conditions requiring treatment with diuretics;
• if the patient has moderate or severe renal impairment with creatinine clearance below 50 ml/min;
• if the patient has hyponatremia (low sodium levels in the blood);
• if the patient has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Warnings and precautions
Before starting treatment with Minirin Melt, discuss this with your doctor.
Your doctor should exercise caution in the following cases:

• if Minirin Melt is used concomitantly with other medicines; see section "Concomitant use with other medicines";
• if the patient is over 65 years of age;
• if the patient has low serum sodium levels;
• if increased intracranial pressure may occur;
• if the patient has a disturbance in water and/or electrolyte balance.

Before starting treatment, severe bladder dysfunction and infravesical obstruction should be ruled out.
Special caution is required in patients with renal impairment and cardiovascular diseases.
If acute illnesses associated with fluid and electrolyte disturbances occur, such as systemic infection,
febrile conditions, or gastroenteritis, administration of Minirin Melt should be discontinued and
medical advice sought.

Children
Minirin Melt is used for the treatment of central diabetes insipidus and primary nocturnal enuresis in children over 6 years of age who have normal urine concentrating ability.

Minirin Melt and other medicines
Inform your doctor about any medicines the patient is currently taking, has recently taken, or plans to take. In particular, inform your doctor if the patient is taking any of the following:

• tricyclic antidepressants;
• selective serotonin reuptake inhibitors (SSRIs);
• chlorpromazine;
• carbamazepine;
• antidiabetic sulfonylureas, such as chlorpropamide;
• non-steroidal anti-inflammatory drugs (NSAIDs);
• loperamide.

These medicines may lead to excessive water retention in the body or decreased blood sodium levels.

Minirin Melt with food and drink
During treatment of primary nocturnal enuresis in children and nocturia in adults, fluid intake should be minimized from 1 hour before administration of Minirin Melt up to 8 hours after administration. Use of Minirin Melt without restricting fluid intake may lead to excessive water retention or decreased blood sodium levels, which may, but does not necessarily, manifest as headache, nausea, vomiting, weight gain, or in severe cases, seizures.

The above warning does not apply to patients using Minirin Melt for the treatment of central diabetes insipidus.

Taking Minirin Melt with food may reduce the strength and duration of its effect.

Minirin Melt in patients with renal and/or hepatic impairment
Consult your doctor before using this medicine.

Minirin Melt in elderly patients
Initiation of treatment for nocturia is not recommended in patients over 65 years of age.

Pregnancy, breastfeeding, and fertility
If the patient is pregnant, breastfeeding, suspects she may be pregnant, or is planning to have a child, she should consult her doctor before using this medicine.

Driving and operating machinery
Minirin Melt has no effect or negligible effect on the ability to drive and operate machinery.

3. How to use Minirin Melt

This medicine should always be used exactly as directed by your doctor. If in doubt, consult your
doctor.
Place Minirin Melt under the tongue, where it dissolves without the need to drink water.

Use of Minirin Melt in the treatment of central diabetes insipidus
Your doctor will determine the dosage individually for each patient, but the total daily dose usually
ranges from 120 to 720 micrograms administered sublingually.
Treatment in children and adults usually starts with a sublingual dose of 60 micrograms of desmopressin
three times daily. Subsequent doses are adjusted by the doctor depending on the patient's response. In most
patients, the maintenance dose is 60 to 120 micrograms of desmopressin sublingually, three times daily.

Use of Minirin Melt in the treatment of primary nocturnal enuresis in children
Treatment usually starts with a dose of 120 micrograms. The medicine is administered sublingually once
daily before bedtime. If this dose is insufficient, the doctor may prescribe an increase in dose
to 240 micrograms.
Fluid intake should be restricted to a minimum from 1 hour before taking the medicine until 8
hours after taking it.
After three months of treatment, the doctor should advise stopping the medicine for at least one
week and assess whether further treatment is necessary.

Use of Minirin Melt in the treatment of nocturia in adults
Treatment usually starts with a dose of 60 micrograms. The medicine is administered sublingually once
daily before bedtime. If this dose is not sufficiently effective after one week of use, the doctor may
recommend increasing the dose to 120 micrograms and then to 240 micrograms, with weekly intervals between
dose increases.
Fluid intake should be restricted to a minimum from 1 hour before taking the medicine until 8
hours after taking it.

Use of a higher than recommended dose of Minirin Melt
Taking a higher than recommended dose increases the risk of excessive water retention
in the body or decreased blood sodium concentration, which may, but does not necessarily, manifest as headache,
nausea, vomiting, weight gain, or in severe cases, seizures.
If a higher than recommended dose has been taken, seek medical advice immediately.

Missed dose of Minirin Melt
Do not take a double dose to make up for a missed dose.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

In adults:
The following very common adverse effects occur in more than 1 in every 10 treated patients:

• headache.

The following common adverse effects occur in 1 to 10 in every 100 treated patients:

• hyponatraemia (low sodium concentration in blood serum);
• dizziness;
• hypertension;
• nausea;
• abdominal pain;
• diarrhoea;
• constipation;
• vomiting;
• symptoms related to the urinary bladder and urethra;
• oedema;
• feeling of fatigue.

The following uncommon adverse effects occur in 1 to 10 in every 1,000 treated patients:

• insomnia;
• somnolence;
• paraesthesia (tingling, pricking, or numbness sensation);
• impaired vision;
• balance disorders;
• palpitations;
• orthostatic hypotension (decrease in blood pressure upon changing from a lying to a standing position);
• dyspnoea;
• indigestion;
• flatulence;
• bloating;
• sweating;
• skin itching;
• rash;
• urticaria;
• muscle cramps;
• muscle pain;
• malaise;
• chest pain;
• influenza-like symptoms;
• increased body weight;
• increased liver enzyme levels;
• hypokalaemia (low potassium concentration in blood serum).

The following rare adverse effects occur in 1 to 10 in every 10,000 treated patients:

• confusion;
• allergic dermatitis.

Frequency unknown (cannot be estimated from available data):

• anaphylactic reactions;
• dehydration;
• hypernatraemia (high sodium concentration in blood serum);
• seizures;
• weakness;
• coma.

In children and adolescents:
The following common adverse effects occur in 1 to 10 in every 100 treated patients:

• headache.

The following uncommon adverse effects occur in 1 to 10 in every 1,000 treated patients:

• emotional instability;
• aggression;
• abdominal pain;
• nausea;
• vomiting;
• diarrhoea;
• symptoms related to the urinary bladder and urethra;
• peripheral oedema;
• feeling of fatigue.

The following rare adverse effects occur in 1 to 10 in every 10,000 treated patients:

• restlessness;
• nightmares;
• mood swings;
• somnolence;
• hypertension;
• irritability.

Frequency unknown (cannot be estimated from available data):

• anaphylactic reactions;
• hyponatraemia;
• abnormal behaviour;
• emotional disorders;
• depression;
• hallucinations;
• insomnia;
• attention disturbance;
• psychomotor hyperactivity;
• seizures;
• nosebleeds;
• allergic dermatitis;
• rash;
• sweating;
• urticaria.

Reporting of adverse effects
If any adverse effects occur, including any not listed in this leaflet, inform your doctor. Adverse effects can be reported directly to the Department of Monitoring Adverse Drug Reactions of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products: Aleje Jerozolimskie 181C, 02-222 Warsaw, Phone: +48 22 49 21 301, Fax: +48 22 49 21 309, Website: https://smz.ezdrowie.gov.pl. Reporting adverse effects helps to provide more information on the safety of this medicine.

5. How to store Minirin Melt
Keep this medicine out of sight and reach of children.
Store in the original packaging to protect from moisture and light.
Do not use this medicine after the expiry date stated on the packaging after the word "EXP".
The expiry date refers to the last day of the stated month.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and other information

What Minirin Melt contains

• The active substance is desmopressin in a quantity of 60, 120 or 240 micrograms.
• The other ingredients are: gelatin, mannitol, anhydrous citric acid.

What Minirin Melt looks like and contents of the pack
Minirin Melt 60 micrograms is a white tablet with a single drop-shaped mark on one side.
Minirin Melt 120 micrograms is a white tablet with a double drop-shaped mark on one side.
Minirin Melt 240 micrograms is a white tablet with a triple drop-shaped mark on one side.
One pack of Minirin Melt contains 30 or 100 orodispersible tablets.

Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Ferring-Léčiva, a.s.
K Rybníku 475
252-42 Jesenice u Prahy
Czech Republic

Manufacturer:
Ferring GmbH
Wittland 11
D-24109 Kiel
Germany

For further information, please contact the representative of the Marketing Authorisation Holder.
Ferring Pharmaceuticals Poland Sp. z o.o.
Szamocka 8 Street
01-748 Warsaw
Phone: +48 22 246 06 80, Fax: +48 22 246 06 81

Instructions for removing the orodispersible tablets from the blister
The orodispersible tablets are fragile. Do not push them through the blister foil, as they may break.
The tablets should be removed from the blister after first removing the aluminium foil, as shown in the figures below:

1. Completely peel off the end strip of the blister, starting from the corner with the printed hand symbol.

2. Tear off the blister unit along the perforation line.

3. Peel back the foil starting from the corner with the printed arrow and gently remove the orodispersible tablet.

4. Repeat steps 2 and 3 to access the next orodispersible tablet.