Document Details

Generated Narrative: Bundle TEST PURPOSES ONLY - exforge

Document Subject

Generated Narrative: MedicinalProductDefinition mpa87aeb4164e26122eca456ab1e8b7c21

identifier: http://ema.europa.eu/identifier/EU/1/09/569/001-012

type: Medicinal Product

domain: Human use

status: active

legalStatusOfSupply: Medicinal product subject to medical prescription

name

productName: Exforge HCT 5 mg/160 mg/12.5 mg film-coated tablets

type: Full name

part

part: nan

type: Invented name part

part

part: nan

type: Scientific name part

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part: nan

type: Strength part

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part: nan

type: Pharmaceutical dose form part

Usages

-	Country	Jurisdiction	Language
*	EU	EU	en

Document Content

Generated Narrative: Composition composition-en-a87aeb4164e26122eca456ab1e8b7c21

identifier: http://ema.europa.eu/identifier/EU/1/09/569/001-012

status: Final

type: Package Leaflet

category: Raw

date: 2022-02-16 13:28:17+0000

author: Organization ACME industry

title: TEST PURPOSES ONLY - exforge

Attesters

What is in this leaflet

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

Exforge HCT tablets contain three substances called amlodipine, valsartan and hydrochlorothiazide. All of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called calcium channel blockers . Amlodipine stops calcium from moving into the blood vessel wall, which stops the blood vessels from tightening.

Valsartan belongs to a group of substances called angiotensin-II receptor antagonists . Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

Hydrochlorothiazide belongs to a group of substances called thiazide diuretics . Hydrochlorothiazide increases urine output, which also lowers blood pressure. As a result of all three mechanisms, the blood vessels relax and blood pressure is lowered.

Exforge HCT is used to treat high blood pressure in adult patients whose blood pressure is already controlled while taking amlodipine, valsartan and hydrochlorothiazide and who may benefit from taking one tablet containing all three substances.

Do not take Exforge HCT

if you are more than 3 months pregnant. (It is also recommended to avoid Exforge HCT in early pregnancy see Pregnancy section.)

if you are allergic to amlodipine or to any other calcium channel blockers, valsartan, hydrochlorothiazide, sulphonamide-derived medicines (medicines used to treat chest or urinary infections), or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, do not take Exforge HCT and talk to your doctor.

if you have liver disease, destruction of the small bile ducts within the liver (biliary cirrhosis) leading to the build up of bile in the liver (cholestasis).

if you have severe kidney problems or if you are having dialysis.

if you are unable to produce urine (anuria).

if the level of potassium or sodium in your blood is too low despite treatment to increase the potassium or sodium levels in your blood.

if the level of calcium in your blood is too high despite treatment to reduce the calcium levels in your blood.

if you have gout (uric acid crystals in the joints).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren. If any of the above applies to you, do not take Exforge HCT and talk to your doctor.

Warnings and precautions Talk to your doctor or pharmacist before taking Exforge HCT

if you have a low level of potassium or magnesium in your blood (with or without symptoms such as muscle weakness, muscle spasms, abnormal heart rhythm).

if you have a low level of sodium in your blood (with or without symptoms such as tiredness, confusion, muscle twitching, convulsions).

if you have a high level of calcium in your blood (with or without symptoms such as nausea, vomiting, constipation, stomach pain, frequent urination, thirst, muscle weakness and twitching).

if you have kidney problems, have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have liver problems.

if you have or have had heart failure or coronary artery disease, particularly if you are prescribed the maximum dose of Exforge HCT (10 mg/320 mg/25 mg).

if you have experienced a heart attack. Follow your doctor s instructions for the starting dose carefully. Your doctor may also check your kidney function.

if your doctor has told you that you have a narrowing of the valves in your heart (called aortic or mitral stenosis ) or that the thickness of your heart muscle is abnormally increased (called obstructive hypertrophic cardiomyopathy ).

if you suffer from aldosteronism. This is a disease in which the adrenal glands make too much of the hormone aldosterone If this applies to you, the use of Exforge HCT is not recommended.

if you suffer from a disease called systemic lupus erythematosus (also called lupus or SLE ).

if you have diabetes (high level of sugar in your blood).

if you have high levels of cholesterol or triglycerides in your blood.

if you experience skin reactions such as rash after sun exposure.

if you had an allergic reaction to other high blood pressure medicines or diuretics (a type of medicine also known as water tablets ), especially if you suffer from asthma and allergies

if you have been sick (vomiting or diarrhoea).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Exforge HCT and contact your doctor straight away. You should never take Exforge HCT again.

if you experience dizziness and/or fainting during treatment with Exforge HCT, tell your doctor as soon as possible.

if you experience a decrease in vision or eye pain. These could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase of pressure in your eye and can happen within hours to a week of taking Exforge HCT. This can lead to permanent vision impairment, if not treated.

if you are taking any of the following medicines used to treat high blood pressure:

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

if you have had skin cancer or if you develop an unexpected skin lesion during the treatment. Treatment with hydrochlorothiazide, particularly long term use with high doses, may increase the risk of some types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Exforge HCT.

if you experienced breathing or lung problems (including inflammation or fluid in the lungs) following hydrochlorothiazide intake in the past. If you develop any severe shortness of breath or difficulty breathing after taking Exforge HCT, seek medical attention immediately.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading Do not take Exforge HCT .

If any of these apply to you, talk to your doctor.

Children and adolescents The use of Exforge HCT in children and adolescents under 18 years of age is not recommended.

Elderly people (age 65 years and older) Exforge HCT can be used by people aged 65 years and over at the same dose as for other adults and in the same way as they have already taken the three substances called amlodipine, valsartan and hydrochlorothiazide. Elderly patients, particularly those taking the maximum dose of Exforge HCT (10 mg/320 mg/25 mg), should have their blood pressure checked regularly.

Other medicines and Exforge HCT Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop using one of the medicines. This is especially important if you are using any of the medicines listed below:

Do not take together with:

• lithium (a medicine used to treat some types of depression);
• medicines or substances that increase the amount of potassium in your blood. These include potassium supplements or salt substitutes containing potassium, potassium-sparing medicines and heparin;
• ACE inhibitors or aliskiren (see also information under the headings Do not take Exforge HCT and Warnings and precautions ).

Caution should be used with:

• alcohol, sleeping pills and anaesthetics (medicines allowing patients to undergo surgery and other procedures);
• amantadine (anti-Parkinson therapy, also used to treat or prevent certain illnesses caused by viruses);
• anticholinergic agents (medicines used to treat a variety of disorders such as gastrointestinal cramps, urinary bladder spasm, asthma, motion sickness, muscular spasms, Parkinson's disease and as an aid to anaesthesia);
• anticonvulsant medicines and mood-stabilising medicines used to treat epilepsy and bipolar disorder (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);
• cholestyramine, colestipol or other resins (substances used mainly to treat high levels of lipids in the blood);
• simvastatin (a medicine used to control high cholesterol levels);
• ciclosporin (a medicine used in transplantation to prevent organ rejection or for other conditions, e.g: rheumatoid arthritis or atopic dermatitis);
• cytotoxic medicines (used to treat cancer), such as methotrexate or cyclophosphamide;
• digoxin or other digitalis glycosides (medicines used to treat heart problems);
• verapamil, diltiazem (heart medicines);
• iodine contrast media (agents used for imaging examinations);
• medicines for the treatment of diabetes (oral agents such as metformin or insulins);
• medicines for the treatment of gout, such as allopurinol;
• medicines that may increase blood sugar levels (beta blockers, diazoxide);
• medicines that may induce torsades de pointes (irregular heart beat), such as antiarrhythmics (medicines used to treat heart problems) and some antipsychotics;
• medicines that may reduce the amount of sodium in your blood, such as antidepressants, antipsychotics, antiepileptics;
• medicines that may reduce the amount of potassium in your blood, such as diuretics (water tablets), corticosteroids, laxatives, amphotericin or penicillin G;
• medicines to increase blood pressure such as adrenaline or noradrenaline;
• medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);
• medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);
• medicines used for oesophageal ulceration and inflammation (carbenoxolone);
• medicines used to relieve pain or inflammation, especially non-steroidal anti-inflammatory agents (NSAIDs), including selective cyclooxygenase-2 inhibitors (Cox-2 inhibitors);
• muscle relaxants (medicines to relax the muscles which are used during operations);
• nitroglycerin and other nitrates, or other substances called vasodilators ;
• other medicines to treat high blood pressure, including methyldopa;
• rifampicin (used, for example, to treat tuberculosis), erythromycin, clarithromycin (antibiotics);
• St. John s wort;
• dantrolene (infusion for severe body temperature abnormalities);
• vitamin D and calcium salts.

Exforge HCT with food, drink and alcohol Grapefruit and grapefruit juice should not be consumed by people who are prescribed Exforge HCT. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowering effect of Exforge HCT. Talk to your doctor before drinking alcohol. Alcohol may make your blood pressure fall too much and/or increase the possibility of dizziness or fainting.

Pregnancy and breast-feeding Pregnancy You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Exforge HCT before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Exforge HCT. Exforge HCT is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding Tell your doctor if you are breast-feeding or about to start breast-feeding. Amlodipine has been shown to pass into breast milk in small amounts. Exforge HCT is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is a newborn, or was born prematurely.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines This medicine may make you feel dizzy, drowsy, nauseous or have a headache. If you experience these symptoms, do not drive or use tools or machines.

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Exforge HCT is one tablet per day.

It is best to take the tablet at the same time each day. Morning is the best time.

Swallow the tablet whole with a glass of water.

You can take Exforge HCT with or without food. Do not take Exforge HCT with grapefruit or grapefruit juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

If you take more Exforge HCT than you should If you have accidentally taken too many Exforge HCT tablets, talk to a doctor immediately. You may require medical attention. Excess fluid may accumulate in your lungs (pulmonary oedema) causing shortness of breath that may develop up to 24-48 hours after intake.

If you forget to take Exforge HCT If you forget to take a dose of this medicine, take it as soon as you remember and then take the next dose at its usual time. If it is almost time for your next dose you should simply take the next tablet at the usual time. Do not take a double dose (two tablets at once) to make up for a forgotten tablet.

If you stop taking Exforge HCT Stopping your treatment with Exforge HCT may cause your disease to get worse. Do not stop taking your medicine unless your doctor tells you to.

Always take this medicine, even if you are feeling well People who have high blood pressure often do not notice any signs of the problem. Many feel normal. It is very important that you take this medicine exactly as your doctor tells you to get the best results and reduce the risk of side effects. Keep your appointments with the doctor even if you are feeling well.

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

Like all medicines, this medicine can cause side effects, although not everybody gets them.

As for any combination containing three active substances, side effects associated with each individual component cannot be excluded. The side effects reported with Exforge HCT or one of its three active substances (amlodipine, valsartan and hydrochlorothiazide) are listed below and may occur with the use of Exforge HCT.

Some side effects can be serious and need immediate medical attention. Consult a doctor immediately if you experience any of the following serious side effects after taking this medicine: Common (may affect up to 1 in 10 people):

• dizziness
• low blood pressure (feeling of faintness, light-headedness, sudden loss of consciousness)

Uncommon (may affect up to 1 in 100 people):

• severely decreased urine output (decreased kidney function)

Rare (may affect up to 1 in 1,000 people):

• spontaneous bleeding
• irregular heart beat
• liver disorder

Very rare (may affect up to 1 in 10,000 people):

• sudden wheeziness, chest pain, shortness of breath or difficulty breathing
• swelling of eyelids, face or lips
• swelling of the tongue and throat which causes great difficulty breathing
• severe skin reactions including intense skin rash, hives, reddening of the skin over your whole body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis) or other allergic reactions
• acute respiratory distress (signs include severe shortness of breath, fever, weakness, and confusion)
• heart attack
• inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling of being very unwell
• weakness, bruising, fever and frequent infections
• stiffness

Other side effects may include: Very common (may affect more than 1 in 10 people):

• low level of potassium in the blood
• increase of lipids in the blood

Common (may affect up to 1 in 10 people):

• sleepiness
• palpitations (awareness of your heart beat)
• flushing
• ankle swelling (oedema)
• abdominal pain
• stomach discomfort after meal
• tiredness
• headache
• frequent urination
• high level of uric acid in the blood
• low level of magnesium in the blood
• low level of sodium in the blood
• dizziness, fainting on standing up
• reduced appetite
• nausea and vomiting
• itchy rash and other types of rash
• inability to achieve or maintain erection

Uncommon (may affect up to 1 in 100 people):

• fast heart beat
• spinning sensation
• vision disorder
• stomach discomfort
• chest pain
• increase of urea nitrogen, creatinine and uric acid in the blood
• high level of calcium, fat or sodium in the blood
• decrease of potassium in the blood
• breath odour
• diarrhoea
• dry mouth
• weight increase
• loss of appetite
• disturbed sense of taste
• back pain
• joint swelling
• muscle cramps/weakness/pain
• pain in extremity
• inability to either stand or walk in a normal manner
• weakness
• abnormal coordination
• dizziness on standing up or after exercising
• lack of energy
• sleep disturbances
• tingling or numbness
• neuropathy
• sudden, temporary loss of consciousness
• low blood pressure on standing up
• cough
• breathlessness
• throat irritation
• excessive sweating
• itching
• swelling, reddening and pain along a vein
• skin reddening
• trembling
• mood changes
• anxiety
• depression
• sleeplessness
• taste abnormalities
• fainting
• loss of pain sensation
• visual disturbances
• visual impairment
• ringing in the ears
• sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis)
• altered bowel habits
• indigestion
• hair loss
• itchy skin
• skin discolouration
• disorder in passing urine
• increased need to urinate at night
• increased number of times of passing urine
• discomfort or enlargement of the breasts in men
• pain
• feeling unwell
• weight decrease

Rare (may affect up to 1 in 1,000 people):

• low level of blood platelets (sometimes with bleeding or bruising underneath the skin)
• sugar in the urine
• high level of sugar in the blood
• worsening of the diabetic metabolic state
• abdominal discomfort
• constipation
• liver disorders which can occur together with yellow skin and eyes, or dark-coloured urine (haemolytic anaemia)
• increased sensitivity of skin to sun
• purple skin patches
• kidney disorders
• confusion

Very rare (may affect up to 1 in 10,000 people):

• decreased number of white blood cells
• decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage)
• swelling of the gums
• abdominal bloating (gastritis)
• inflammation of the liver (hepatitis)
• yellowing of the skin (jaundice)
• liver enzyme increase which may have an effect on some medical tests
• increased muscle tension
• inflammation of blood vessels often with skin rash
• sensitivity to light
• disorders combining rigidity, tremor and/or movement disorders
• fever, sore throat or mouth ulcers, more frequent infections (lack or low level of white blood cells)
• pale skin, tiredness, breathlessness, dark-coloured urine (haemolytic anaemia, abnormal breakdown of red blood cells either in the blood vessels or elsewhere in the body)
• confusion, tiredness, muscle twitching and spasm, rapid breathing (hypochloraemic alkalosis)
• severe upper stomach ache (inflammation of the pancreas)
• difficulty breathing with fever, coughing, wheezing, breathlessness (respiratory distress, pulmonary oedema, pneumonitis)
• facial rash, joint pain, muscle disorder, fever (lupus erythematosus)
• inflammation of blood vessels with symptoms such as rash, purplish-red spots, fever (vasculitis)
• severe skin disease that causes rash, red skin, blistering of the lips, eyes or mouth, skin peeling, fever (toxic epidermal necrolysis)

Not known (frequency cannot be estimated from the available data):

• changes in blood tests for kidney function, increase of potassium in your blood, low level of red blood cells
• abnormal red blood cell test
• low level of a certain type of white blood cell and blood platelet
• increase of creatinine in the blood
• abnormal liver function test
• severely decreased urine output
• inflammation of blood vessels
• weakness, bruising and frequent infections (aplastic anaemia)
• decrease in vision or pain in your eyes due to high pressure (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma)
• breathlessness
• severely decreased urine output (possible signs of renal disorder or renal failure)
• severe skin disease that causes rash, red skin, blistering of the lips, eyes or mouth, skin peeling, fever (erythema multiforme)
• muscle spasm
• fever (pyrexia)
• blistering skin (sign of a condition called dermatitis bullous)
• skin and lip cancer (non-melanoma skin cancer)

Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

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 carton and blister after EXP. The expiry date refers to the last day of that month.

Do not store above 30 C.

Store in the original package in order to protect from moisture.

Do not use any Exforge HCT pack that is damaged or shows signs of tampering.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

What Exforge HCT contains

Exforge HCT 5 mg/160 mg/12.5 mg film-coated tablets The active substances of Exforge HCT are amlodipine (as amlodipine besylate), valsartan and hydrochlorothiazide. Each film-coated tablet contains 5 mg amlodipine (as amlodipine besylate), 160 mg valsartan and 12.5 mg hydrochlorothiazide.

The other ingredients are cellulose microcrystalline; crospovidone (type A); silica, colloidal anhydrous; magnesium stearate; hypromellose (substitution type 2910 (3 mPa.s)), macrogol 4000, talc, titanium dioxide (E171).

Exforge HCT 10 mg/160 mg/12.5 mg film-coated tablets The active substances of Exforge HCT are amlodipine (as amlodipine besylate), valsartan and hydrochlorothiazide. Each film-coated tablet contains 10 mg amlodipine (as amlodipine besylate),160 mg valsartan, and 12.5 mg hydrochlorothiazide.

The other ingredients are cellulose microcrystalline; crospovidone (type A); silica, colloidal anhydrous; magnesium stearate; hypromellose (substitution type 2910 (3 mPa.s)), macrogol 4000, talc, titanium dioxide (E171), yellow iron oxide (E172), red iron oxide (E172).

Exforge HCT 5 mg/160 mg/25 mg film-coated tablets The active substances of Exforge HCT are amlodipine (as amlodipine besylate), valsartan and hydrochlorothiazide. Each film-coated tablet contains 5 mg amlodipine (as amlodipine besylate), 160 mg valsartan and 25 mg hydrochlorothiazide.

The other ingredients are cellulose microcrystalline; crospovidone (type A); silica, colloidal anhydrous, magnesium stearate, hypromellose (substitution type 2910 (3 mPa.s)), macrogol 4000, talc, titanium dioxide (E171), yellow iron oxide (E172).

Exforge HCT 10 mg/160 mg/25 mg film-coated tablets The active substances of Exforge HCT are amlodipine (as amlodipine besylate), valsartan and hydrochlorothiazide. Each film-coated tablet contains 10 mg amlodipine (as amlodipine besylate), 160 mg valsartan, and 25 mg hydrochlorothiazide.

The other ingredients are cellulose microcrystalline; crospovidone (type A); silica, colloidal anhydrous, magnesium stearate, hypromellose (substitution type 2910 (3 mPa.s)), macrogol 4000, talc, yellow iron oxide (E172).

Exforge HCT 10 mg/320 mg/25 mg film-coated tablets The active substances of Exforge HCT are amlodipine (as amlodipine besylate), valsartan and hydrochlorothiazide. Each film-coated tablet contains 10 mg amlodipine (as amlodipine besylate), 320 mg valsartan, and 25 mg hydrochlorothiazide.

The other ingredients are cellulose microcrystalline; crospovidone (type A); silica, colloidal anhydrous, magnesium stearate, hypromellose (substitution type 2910 (3 mPa.s)), macrogol 4000, talc, yellow iron oxide (E172).

What Exforge HCT looks like and contents of the pack Exforge HCT 5 mg/160 mg/12.5 mg film-coated tablets are white, oval tablets with NVR on one side and VCL on the other side. Approximate size: 15 mm (length) x 5.9 mm (width).

Exforge HCT 10 mg/160 mg/12.5 mg film-coated tablets are pale yellow, oval tablets with NVR on one side and VDL on the other side. Approximate size: 15 mm (length) x 5.9 mm (width).

Exforge HCT 5 mg/160 mg/25 mg film-coated tablets are yellow, oval tablets with NVR on one side and VEL on the other side. Approximate size: 15 mm (length) x 5.9 mm (width).

Exforge HCT 10 mg/160 mg/25 mg film-coated tablets are brown-yellow, oval tablets with NVR on one side and VHL on the other side. Approximate size: 15 mm (length) x 5.9 mm (width).

Exforge HCT 10 mg/320 mg/25 mg film-coated tablets are brown-yellow, oval tablets with NVR on one side and VFL on the other side. Approximate size: 19 mm (length) x 7.5 mm (width).

Exforge HCT is available in packs containing 14, 28, 30, 56, 90, 98 or 280 film-coated tablets, in multipacks of 280 tablets (comprising 4 cartons, each containing 70 tablets, or 20 cartons, each containing 14 tablets), and in hospital packs containing 56, 98 or 280 tablets in single perforated dose blisters.

Not all pack sizes may be available in your country.

Marketing Authorisation Holder Novartis Europharm Limited Vista Building Elm Park, Merrion Road Dublin 4 Ireland

Manufacturer Novartis Farma S.p.A. Via Provinciale Schito 80058 Torre Annunziata (NA) Italy

Novartis Farmac utica S.A. Gran Via de les Corts Catalanes, 08013 Barcelona Spain

Novartis Pharma GmbH Roonstra e D-90429 Nuremberg Germany

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

Belgi /Belgique/Belgien Novartis Pharma N.V. T l/Tel: +32 2 246 16 Lietuva SIA Novartis Baltics Lietuvos filialas Tel: +370 5 269 16
Novartis Bulgaria EOOD .: +359 2 489 98 Luxembourg/Luxemburg Novartis Pharma N.V. T l/Tel: +32 2 246 16 esk republika Novartis s.r.o. Tel: +420 225 775 Magyarorsz g Novartis Hung ria Kft. Tel.: +36 1 457 65 Danmark Novartis Healthcare A/S Tlf: +45 39 16 84 Malta Novartis Pharma Services Inc. Tel: +356 2122 2Deutschland Novartis Pharma GmbH Tel: +49 911 273 0

Nederland Novartis Pharma B.V. Tel: +31 88 04 52 Eesti SIA Novartis Baltics Eesti filiaal Tel: +372 66 30 Norge Novartis Norge AS Tlf: +47 23 05 20
Novartis (Hellas) A.E.B.E. : +30 210 281 17 sterreich Novartis Pharma GmbH Tel: +43 1 86 6Espa a Novartis Farmac utica, S.A. Tel: +34 93 306 42 Polska Novartis Poland Sp. z o.o. Tel.: +48 22 375 4France Novartis Pharma S.A.S. T l: +33 1 55 47 66 Portugal Novartis Farma - Produtos Farmac uticos, S.A. Tel: +351 21 000 8Hrvatska Novartis Hrvatska d.o.o. Tel. +385 1 6274 Rom nia Novartis Pharma Services Romania SRL Tel: +40 21 31299 Ireland Novartis Ireland Limited Tel: +353 1 260 12 Slovenija Novartis Pharma Services Inc. Tel: +386 1 300 75 sland Vistor hf. S mi: +354 535 7Slovensk republika Novartis Slovakia s.r.o. Tel: +421 2 5542 5Italia Novartis Farma S.p.A. Tel: +39 02 96 54 1 Suomi/Finland Novartis Finland Oy Puh/Tel: +358 (0)10 6133
Novartis Pharma Services Inc. : +357 22 690 Sverige Novartis Sverige AB Tel: +46 8 732 32 Latvija SIA Novartis Baltics Tel: +371 67 887 United Kingdom (Northern Ireland) Novartis Ireland Limited Tel: +44 1276 698This leaflet was last revised in

Other sources of information Detailed information on this medicine is available on the European Medicines Agency web site: