Gravitate Health FHIR Implementation Guide, published by Gravitate Health Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/joofio/test-epi-composition/ and changes regularly. See the Directory of published versions
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Generated Narrative: Bundle TEST PURPOSES ONLY - tacforius
Language: en
Profile: Bundle - ePI
Final Document at 2022-02-16 13:28:17+0000 by Organization ACME industry for Bundle: identifier = http://ema.europa.eu/identifier#None; type = document; timestamp = 2023-06-27 10:09:22+0000
Document Subject
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identifier: http://ema.europa.eu/identifier
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domain: Human use
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Document Content
Generated Narrative: Composition composition-en-dff98a1057e854dd22ade83cc61ef07f
Language: en
Profile: Composition (ePI)
identifier: http://ema.europa.eu/identifier
/EU/1/17/1244/001
status: Final
type: Package Leaflet
category: Raw
date: 2022-02-16 13:28:17+0000
author: Organization ACME industry
title: TEST PURPOSES ONLY - tacforius
Mode | Time |
Official | 2022-02-16 13:28:17+0000 |
What is in this leaflet
Tacforius contains the active substance tacrolimus. It is an immunosuppressant. Following your organ transplant (liver, kidney), your body s immune system will try to reject the new organ. Tacforius is used to control your body s immune response, enabling your body to accept the transplanted organ.
You may also be given Tacforius for an ongoing rejection of your transplanted liver, kidney, heart or other organ when any previous treatment you were taking was unable to control this immune response after your transplantation.
Tacforius is used in adults.
Do not take Tacforius
Warnings and precautions Tacrolimus immediate release capsules (e.g, Tacni) and Tacforius prolonged-release capsules both contain the active substance, tacrolimus. However, Tacforius prolonged-release capsules are taken once daily, whereas the immediate release capsules are taken twice daily. This is because Tacforius capsules allow for a prolonged-release (more slow release over a longer period) of tacrolimus. Tacforius prolonged-release capsules and tacrolimus immediate release capsules are not interchangeable.
Talk to your doctor or pharmacist before taking Tacforius:
Please avoid taking any herbal remedies, e.g., St. John s wort (Hypericum perforatum) or any other herbal products as this may affect the effectiveness and the dose of Tacforius that you need to receive. If in doubt please consult your doctor prior to taking any herbal products or remedies.
Your doctor may need to adjust your dose of Tacforius.
You should keep in regular contact with your doctor. From time to time, your doctor may need to do blood, urine, heart, eye tests, to set the right dose of Tacforius.
You should limit your exposure to the sun and UV (ultraviolet) light whilst taking Tacforius. This is because immunosuppressants could increase the risk of skin cancer. Wear appropriate protective clothing and use a sunscreen with a high sun protection factor.
Precaution for handling: Direct contact with any part of your body like your skin or eyes, or breathing in of the powder contained in the capsules should be avoided. If such contact occurs, wash the skin and eyes.
Children and adolescents The use of Tacforius is not recommended in children and adolescents under 18 years.
Other medicines and Tacforius Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines.
It is not recommended that Tacforius is taken with ciclosporin (another medicine used for the prevention of transplant organ rejection).
If you need to attend a doctor other than your transplant specialist, tell the doctor that you are taking tacrolimus. Your doctor may need to consult your transplant specialist if you should use another medicine that could increase or decrease your tacrolimus blood level.
Tacforius blood levels can be affected by other medicines you take, and blood levels of other medicines can be affected by taking Tacforius, which may require interruption, an increase or a decrease in Tacforius dose.
Some patients have experienced increases in tacrolimus blood levels while taking other medicines. This could lead to serious side effects, such as kidney problems, nervous system problems, and heart rhythm disturbances (see section 4). An effect on the Tacforius blood levels may occur very soon after starting the use of another medicine, therefore frequent continued monitoring of your Tacforius blood level may be needed within the first few days of starting another medicine and frequently while treatment with the other medicine continues. Some other medicines may cause tacrolimus blood levels to decrease, which could increase the risk of rejecting the transplanted organ. In particular, you should tell your doctor if you are taking or have recently taken medicines like:
Tell your doctor if you are receiving treatment for hepatitis C. The drug treatment for hepatitis C may change your liver function and may affect blood levels of tacrolimus. Tacrolimus blood levels may fall or may increase depending on the medicines prescribed for hepatitis C. Your doctor may need to closely monitor tacrolimus blood levels and make necessary adjustments of Tacforius dose after you start treatment for hepatitis C.
Tell your doctor if you are taking or need to take ibuprofen (used to treat fever, inflammation and pain), antibiotics (cotrimoxazole, vancomycin, or aminoglycoside antibiotics such as gentamicin), amphotericin B (used to treat fungal infections) or antivirals (used to treat viral infections e.g. aciclovir, ganciclovir, cidofovir, foscarnet). These may worsen kidney or nervous system problems when taken together with Tacforius.
Tell your doctor if you are taking sirolimus or everolimus. When tacrolimus is taken together with sirolimus or everolimus, the risk of developing thrombotic microangiopathy, thrombotic thrombocytopenic purpura, and haemolytic uraemic syndrome may increase (see section 4).
Your doctor also needs to know if you are taking potassium supplements or certain diuretics used for heart failure, hypertension and kidney disease, (e.g. amiloride, triamterene, or spironolactone), or the antibiotics trimethoprim or cotrimoxazole that may increase levels of potassium in your blood, non- steroidal anti-inflammatory medicines (NSAIDs, e.g. ibuprofen) used for fever, inflammation and pain, anticoagulants (blood thinners), or oral medicines for diabetes, while you take Tacforius. If you need to have any vaccinations, please tell your doctor before.
Tacforius with food and drink Avoid grapefruit (also as juice) while on treatment with Tacforius, since it can affect its levels in the blood.
Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you might be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine. Tacrolimus passes into breast milk. Therefore, you should not breast-feed whilst using Tacforius.
Driving and using machines Do not drive or use any tools or machines if you feel dizzy or sleepy, or have problems seeing clearly after taking Tacforius. These effects are more frequent if you also drink alcohol.
Tacforius contains lactose If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Tacforius 5 mg capsules contains ponceau 4R This may cause allergic reactions.
Always take this medicine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. This medicine should only be prescribed to you by a doctor with experience in the treatment of transplant patients.
Make sure that you receive the same tacrolimus medicine every time you collect your prescription, unless your transplant specialist has agreed to change to a different tacrolimus medicine. This medicine should be taken once a day. If the appearance of this medicine is not the same as usual, or if dosage instructions have changed, speak to your doctor or pharmacist as soon as possible to make sure that you have the right medicine.
The starting dose to prevent the rejection of your transplanted organ will be determined by your doctor calculated according to your body weight. Initial daily doses just after transplantation will generally be in the range of
0.10 - 0.30 mg per kg body weight per day
depending on the transplanted organ. When treating rejection, these same doses may be used.
Your dose depends on your general condition and on which other immunosuppressive medication you are taking.
Following the initiation of your treatment with Tacforius, frequent blood tests will be taken by your doctor to define the correct dose. Afterwards regular blood tests by your doctor will be required to define the correct dose and to adjust the dose from time to time. Your doctor will usually reduce your Tacforius dose once your condition has stabilised. Your doctor will tell you exactly how many capsules to take.
You will need to take Tacforius every day as long as you need immunosuppression to prevent rejection of your transplanted organ. You should keep in regular contact with your doctor.
Tacforius is taken orally once daily in the morning. Take Tacforius on an empty stomach or 2 to 3 hours after a meal. Wait at least 1 hour until the next meal. Take the capsules immediately following removal from the blister. The capsules should be swallowed whole with a glass of water. Do not swallow the desiccant contained in the foil pouch.
If you take more Tacforius than you should If you have accidentally taken too many capsules, contact your doctor or nearest hospital emergency department immediately.
If you forget to take Tacforius If you have forgotten to take your capsules in the morning, take them as soon as possible on the same day. Do not take a double dose the next morning.
If you stop taking Tacforius Stopping your treatment with Tacforius may increase the risk of rejection of your transplanted organ. Do not stop your treatment unless your doctor tells you to do so.
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.
Tacforius reduces your body s defence mechanism (immune system), which will not be as good at fighting infections. Therefore, you may be more prone to infections while you are taking Tacforius. Some infections could be serious or fatal and may include infections caused by bacteria, viruses, fungi, parasites, or other infections. Tell your doctor immediately if you get signs of an infection including:
Severe effects may occur, including allergic and anaphylactic reactions. Benign and malignant tumours have been reported following Tacforius treatment. Tell your doctor immediately if you have or suspect you may have any of the following serious side effects:
Serious common side effects (may affect up to 1 in 10 people)
Serious uncommon side effects (may affect up to 1 in 100 people)
Serious rare side effects (may affect up to 1 in 1,000 people)
Serious very rare side effects (may affect up to 1 in 10,000 people)
Serious side effects frequency not known (frequency cannot be estimated from the available data)
The side effects listed below may also occur after receiving Tacforius and could be serious:
Very common (may affect more than 1 in 10 people)
Common (may affect up to 1 in 10 people)
Uncommon (may affect up to 1 in 100 people)
Rare (may affect up to 1 in 1,000 people)
Very rare (may affect up to 1 in 10,000 people)
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.
Store in the original package in order to protect from light and moisture. This medicinal product does not require any special temperature storage conditions.
Use all the prolonged-release hard capsules within 1 year of opening the aluminium wrapping.
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 Tacforius contains
The active substance is tacrolimus. Each capsule of Tacforius 0.5 mg contains 0.5 mg of tacrolimus (as monohydrate). Each capsule of Tacforius 1 mg contains 1 mg of tacrolimus (as monohydrate). Each capsule of Tacforius 3 mg contains 3 mg of tacrolimus (as monohydrate). Each capsule of Tacforius 5 mg contains 5 mg of tacrolimus (as monohydrate).
The other ingredients are: Capsule content Hypromellose 2910, ethylcellulose, lactose, magnesium stearate. Capsule shell Tacforius 0.5 mg / 1 mg / 3 mg prolonged-release hard capsules: red iron oxide (E172), yellow iron oxide (E172), titanium dioxide (E171), gelatin. Tacforius 5 mg prolonged-release hard capsules: red iron oxide (E172), yellow iron oxide (E172), titanium dioxide (E171), black iron oxide (E172), ponceau 4R (E124), gelatin. Printing Ink Shellac, propylene glycol, black iron oxide (E172), potassium hydroxide.
What Tacforius looks like and contents of the pack
Tacforius 0.5 mg prolonged-release hard capsules Hard gelatin capsules imprinted with TR on the light yellow capsule cap and 0.5 mg on the light orange capsule body. Tacforius 1 mg prolonged-release hard capsules Hard gelatin capsules imprinted with TR on the white capsule cap and 1 mg on the light orange capsule body. Tacforius 3 mg prolonged-release hard capsules Hard gelatin capsules imprinted with TR on the light orange capsule cap and 3 mg on the light orange capsule body. Tacforius 5 mg prolonged-release hard capsules Hard gelatin capsules imprinted with TR on the greyish red capsule cap and 5 mg on the light orange capsule body.
Tacforius 0.5 mg / 3 mg / 5 mg prolonged-release hard capsules Supplied in blisters or perforated unit-dose blisters containing 10 capsules within a protective foil pouch, including a desiccant. Packs of 30, 50 and 100 prolonged-release hard capsules are available in blisters and packs of 30x1, 50x1 and 100x1 prolonged-release capsules are available in perforated unit-dose blisters.
Tacforius 1 mg prolonged-release hard capsules Supplied in blisters or perforated unit-dose blisters containing 10 capsules within a protective foil pouch, including a desiccant. Packs of 30, 50, 60 and 100 prolonged-release capsules are available in blisters and packs of 30x1, 50x1, 60x1 and 100x1 prolonged-release capsules are available in perforated unit-dose blisters.
Marketing Authorisation Holder Teva B.V. Swensweg 5 2031GA Haarlem Netherlands
Manufacturer
Merckle GmbH Ludwig-Merckle-Strasse 3 89143 Blaubeuren Germany
PLIVA Hrvatska d.o.o. Prilaz baruna Filipovica 10 000 Zagreb Croatia
TEVA Czech Industries s.r.o. Ostravsk 29, .p. Opava - Kom rov 747 Czech Republic
Teva Operations Poland Sp. z o.o. ul. Mogilska 31-546 Krakow Poland
Teva Pharma S.L.U. C/C, n. 4, Poligono Industrial Malpica ES-50016 Zaragoza Spain
Teva Pharmaceutical Works Private Limited Company Pallagi Ut 4042 Debrecen Hungary
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder: Belgi /Belgique/Belgien Teva Pharma Belgium N.V./S.A./AG T l/Tel: +32 38207Lietuva UAB Teva Baltics Tel: +370 52660
: +359 24899Luxembourg/Luxemburg ratiopharm GmbH Allemagne/Deutschland T l/Tel: +49 73140 esk republika Teva Pharmaceuticals CR, s.r.o. Tel: +420 251007Magyarorsz g Teva Gy gyszergy r Zrt Tel: +36 12886Danmark Teva Denmark A/S Tlf: +45 44985Malta Teva Pharmaceuticals Ireland L-Irlanda Tel: +44 2075407Deutschland TEVA GmbH Tel: +49 73140Nederland Teva Nederland B.V. Tel: +31 8000228Eesti UAB Teva Baltics Eesti filiaal Tel: +372 6610Norge Teva Norway AS Tlf: +47 66775
Specifar A.B.E.E. : +30 2118805 sterreich ratiopharm Arzneimittel Vertriebs-GmbH Tel: +43 1970Espa a Nordic Pharma, S.A.U. Tel.: +34 916404Polska Teva Pharmaceuticals Polska Sp. z o.o. Tel: +48 223459France Teva Sant
T l: +33 155917Portugal Teva Pharma - Produtos Farmac uticos, Lda. Tel: +351 214767Hrvatska Pliva Hrvatska d.o.o. Tel: + 385 13720Rom nia Teva Pharmaceuticals S.R.L Tel: +40 212306Ireland Teva Pharmaceuticals Ireland Tel: +44 2075407Slovenija Pliva Ljubljana d.o.o. Tel: +386 15890 sland Teva Pharma Iceland ehf. S mi: +354 5503Slovensk republika TEVA Pharmaceuticals Slovakia s.r.o. Tel: +421 257267Italia Teva Italia S.r.l. Tel: +39 028917Suomi/Finland Teva Finland Oy Puh/Tel: +358 201805
Specifar A.B.E.E. Sverige Teva Sweden AB
: +30 2118805Tel: +46 42121Latvija UAB Teva Baltics fili le Latvij
Tel: +371 67323United Kingdom (Northern Ireland) Teva Pharmaceuticals Ireland Ireland Tel: +44 2075407This leaflet was last revised in
Detailed information on this medicine is available on the European Medicines Agency web site:
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type: Package Leaflet
category: Raw
date: 2022-02-16 13:28:17+0000
author: Organization ACME industry
title: TEST PURPOSES ONLY - tacforius
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Country Jurisdiction Language EU EU en