Tuesday 11 September 2012

Axorid modified-release capsules






Axorid 100 mg/20 mg,
Axorid 150 mg/20 mg,
Axorid 200 mg/20 mg,
modified-release capsules


Ketoprofen / Omeprazole




Read all of this leaflet carefully before you start taking this medicine.



  • Keep this leaflet. You may need to read it again.


  • If you have any further questions, ask your doctor or pharmacist.


  • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.


  • If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.



In this leaflet:


  • 1. What Axorid is and what it is used for

  • 2. Before you take Axorid

  • 3. How to take Axorid

  • 4. Possible side effects

  • 5. How to store Axorid

  • 6. Further Information




What Axorid Is And What It Is Used For


Your medicine contains two active ingredients called ketoprofen and omeprazole.


Ketoprofen is a non-steroidal anti-inflammatory agent (NSAID) which reduces inflammation. Omeprazole is a « proton pump inhibitor » which reduces the amount of acid produced in your stomach.


Axorid is used in adults and adolescents over the age of 15 years for treating the symptoms of rheumatoid arthritis, a condition called “ankylosing spondylitis” and osteoarthritis.


You will be given this medicine if you need to be treated with an anti-inflammatory medicine and:


  • you have a history of stomach or duodenal ulcers,

  • you are at risk of developing these types of ulcers



BEFORE YOU TAKE Axorid



Do not take Axorid


  • if you are allergic to ketoprofen or to omeprazole

  • if you are allergic to any of the other ingredients in this medicine (these are listed in section 6, Further Information),

  • if you are in the last trimester (from the 7th month) of pregnancy,

  • if you have a history of asthma caused by ketoprofen or similar substances, such as aspirin or other non-steroidal anti-inflammatory medicines (NSAIDs),

  • if you have severe liver, kidney or heart disease,

  • if you have an active peptic ulcer,

  • if you have bleeding in your stomach, intestine (gut) or brain,

  • if you are under 15 years old.



Take special care with Axorid


Tell your doctor before taking this medicine if you:


  • have asthma or a history of asthma – this medicine may cause an asthma attack

  • have previously had a severe skin reaction caused by sunlight ,

  • have a history of Crohn’s disease or “ulcerative colitis” (Your doctor will have told you),

  • have liver, kidney or heart disease,

  • are pregnant or are trying to get pregnant.

Medicines such as ketoprofen may be associated with a small increased risk of heart attack (“myocardial infarction”) or stroke. Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment.


If you have heart problems, previous stroke or think that you might be at risk of these conditions (for example if you have high blood pressure, diabetes or high cholesterol or are a smoker) you should discuss your treatment with your doctor or pharmacist.


If you are taking this medicine for a long period of time, your doctor may need to do blood tests e.g. kidney and liver function tests, and blood counts.


Your doctor may also check your hearing and eyesight.


If you have any sign of bleeding in the stomach or intestine (gut), stop taking the capsules and tell your doctor immediately.




Taking other medicines


Do not take Axorid if you are taking the following medicines:


  • atazanavir (anti-HIV medicine)

  • a herbal remedy called St John’s wort

  • an antibiotic called clarithromycin if you have liver problems

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.


Tell your doctor before taking Axorid if you are being treated with any of the following:


  • aspirin or other non steroidal anti inflammatory agents (for treating pain and inflammation),

  • medicines used to reduce clotting of the blood (called thrombolytics, anticoagulants and anti-platelet agents),

  • corticosteroid anti-inflammatory medicines (to reduce inflammation),

  • phenytoin (used to treat epilepsy),

  • methotrexate (used to treat cancer),

  • lithium or medicines called “selective serotonin reuptake inhibitors” (SSRIs), which are used to treat some psychiatric disorders,

  • medicines to treat high blood pressure (called diuretics, ACE inhibitors and beta-blockers)

  • zidovudine (used to treat HIV infection),

  • ciclosporine and tacrolimus (used after an organ transplant to prevent rejection),

  • an intrauterine contraceptive device (“coil”),

  • medicines to treat depression and/or sleeping disorders (e.g. diazepam, triazolam, flurazepam, antidepressants and barbiturates),

  • disulfiram (used to treat chronic alcoholism),

  • digoxin (used to treat heart disorders),

  • ketoconazole and itraconazole (used to treat fungal infections),

  • vitamin B12 (taken by mouth) for treating vitamin B12 deficiency.



Taking Axorid with food and drink


The capsules should always be swallowed whole with a glass of water. They should also be taken with food e.g. at meal times




Pregnancy


Your doctor may prescribe this medicine for you during the first 6 months of your pregnancy, when strictly necessary.



From the 7th month of pregnancy, you must not under any circumstances take this medicine on your own initiative, as it may have serious consequences for your child’s health, particularly for the child’s heart, lungs and kidneys, even after only one dose.


Nevertheless, your gynaecologist might prescribe this medicine for you in certain very special cases. If this happens, you should follow strictly your doctor’s prescription.


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




Breast-feeding


This medicine passes into breast milk. You should therefore avoid taking the capsules if you are breast-feeding a baby.




Fertility


Ketoprofen may impair fertility and is not recommended in women attempting to conceive.


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




Driving and using machines


This medicine may cause sleepiness/ drowsiness, dizziness and visual disturbances.


If you are affected, you should not drive or operate machinery.




Important information about some of the ingredients of Axorid


This medicine contains, sucrose, propyl-p-hydroxybenzoate (E216) and methyl-p-hydroxy benzoate (E218) (parahydroxybenzoates)


  • If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine,

  • Parahydroxybenzoates may cause allergic reactions (possibly delayed).




How To Take Axorid


Always take Axorid exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.


The capsules should not be chewed or crushed; they should always be swallowed whole with a glass of water. The capsules should also be taken with food e.g. at meal times.


Your doctor may prescribe:


  • One 100 mg/20 mg capsule daily

  • One 150 mg/20 mg capsule daily

  • One 200 mg/20 mg capsule daily

The dose depends on the severity of your symptoms. The maximum daily dose is one 200 mg/20 mg capsule.


An initial dose of one 100 mg/20 mg capsule is recommended in elderly patients, and in patients with liver, kidney or heart disorders. The dose may be increased by your doctor up to one 200 mg/20 mg capsule if necessary.



If you take more Axorid than you should


Contact your doctor or pharmacist immediately.




If you forget to take Axorid


Take it as soon as you remember. However, if it is almost time for your next dose, do not take a double dose to make up for forgotten individual doses, just take the next dose on time.





Possible Side Effects


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



If you experience any of the following side effects, tell your doctor immediately or go to your nearest hospital casualty department.



  • Serious allergic reaction which causes difficulty in breathing or dizziness, or swelling of the face or throat


  • Blistering of the skin, mouth, eyes and genitals


  • Red patches on the back of your hands and arms


  • Inflammation of the blood vessels, often with a rash


  • An asthma attack (breathing difficulties)


  • Fever, severe chills, sore throat, mouth ulcers, bleeding or bruising easily (you may have a blood disorder)


  • Blood in your stools


The following side effects have also been reported. If any of these get troublesome or serious, talk to your doctor.



Common side effects


(probably affecting less than 1 in 10 people):


  • Sleepiness/ drowsiness

  • Trouble sleeping

  • Spinning sensation

  • Headache

  • Gastrointestinal effects included: nausea, vomiting, diarrhoea, constipation, flatulence (wind), abdominal pain, gastrointestinal discomfort and pain


Uncommon side effects


(probably affecting less than 1 in 100 people):


  • Visual disturbances (e.g. blurred vision, problems focusing)

  • Ringing in the ears (tinnitus) and deafness

  • Changes in levels of liver enzymes in your blood

  • Taste disorders

  • Itching and skin rashes

  • Unusual hair loss

  • Skin sensitivity to light

  • Increased sweating

  • Swelling of the ankles, feet or hands

  • Mood disorders


Rare side effects


(probably affecting less than 1 in 1,000 people)


  • Changes in red blood cells

  • Pins and needles

  • Light headedness

  • Mental confusion and hearing sounds or seeing things that are not real

  • Brownish-black discoloration of the tongue whilst also taking clarithromycin (an antibiotic)

  • Muscle weakness

  • Muscle pain, joint pain

  • Heart failure

  • High blood pressure

  • Gastrointestinal ulcer

  • Gastrointestinal bleeding

  • Kidney or liver problems

  • Worsening of chronic urticaria (hives).


Very rare side effects


(probably affecting less than 1 in 10,000 patients)


  • Nettle rash (hives)

  • Fever

  • Agitation and depression

  • Dry mouth or inflammation of the mouth

  • Thrush

  • Inflammation of the pancreas which causes severe pain in the abdomen and back

  • Low blood sodium

  • Development of breasts in men

Medicines including Ketoprofen may be associated with a small increased risk of heart attack (“myocardial infarction”) or stroke.


Although not known with oral omeprazole, blindness and deafness have been reported with the injectable form.



If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.




HOW TO STORE Axorid


Keep out of the reach and sight of children.


Do not store above 25°C. Store in the original container in order to protect from moisture.


Do not take your capsules after the expiry date which is stated on the carton. The expiry date refers to the last day of that 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 to protect the environment.




Further Information


What Axorid contains


  • The active substances are ketoprofen and omeprazole.


    Each 100mg/20mg modified release capsule contains 100 mg of ketoprofen and 20mg of omeprazole.


    Each 150mg/20mg modified release capsule contains 150 mg of ketoprofen and 20mg of omeprazole.


    Each 200mg/20mg modified release capsule contains 200 mg of ketoprofen and 20mg of omeprazole.

  • The other ingredients are:
    Capsule contents:


    sucrose, maize starch, hypromellose, dimethicone emulsion (containing propyl-p-hydroxybenzoate (E216), methyl-p-hydroxybenzoate (E218), sorbic acid, sodium benzoate, polysorbate 20, octylphenoxy polyethoxy ethanol and propylene glycol), polysorbate 80, mannitol, diacetylated monoglycerides, talc, Methacrylic acid-ethyl acrylate copolymer (1:1) dispersion 30%, polyacrylate dispersion 30%, ammonio methacrylate copolymer type A, ammonio methacrylate copolymer type B, triethyl citrate, stearoyl macrogolglycerides, colloidal anhydrous silica,
    Capsule shell:
    • Axorid 100mg/20mg: yellow iron oxide (E 172), titanium dioxide (E 171), gelatin,
    • Axorid 150mg/20mg: black iron oxide (E 172), titanium dioxide (E 171), gelatin,
    • Axorid 200mg/20mg: titanium dioxide (E 171), gelatin.


What Axorid looks like and content of the packs


Axorid comes in three strengths containing 100 mg/20 mg, 150 mg/20 mg and 200 mg/20 mg of Ketoprofen/Omeprazole. Each strength of capsule is a different colour:


  • 100 mg/20 mg capsules have yellow caps and white bodies;

  • 150 mg/20 mg capsules have grey caps and white bodies;

  • 200 mg/20 mg capsules have white caps and bodies.

Axorid comes in a bottle containing 28 and 30 capsules.




Marketing Authorization Holder



Meda Pharmaceuticals Ltd

Skyway House

Parsonage Road

Takeley

Bishop‘s Stortford

CM22 6PU




Manufacturers:



Ethypharm

17/21, rue Saint-Matthieu

F-78550 Houdan

France

Tel:+33 (0) 1 30 80 17 20

Fax:+33 (0) 1 30 88 17 30



Ethypharm

Chemin de la Poudrière

F-76120 Grand-Quevilly

France

Tel:+33 (0) 2 35 18 24 64

Fax:+33 (0) 2 35 18 24 61



Ethypharm

Z.I. de Saint Arnoult

F-28170 Châteauneuf en Thymerais

France

Tel:+33 (0) 2 37 65 88 00

Fax:+33 (0) 2 37 51 02 88



Pierre Fabre Médicament Production

Le Payrat

46000 Cahors

France

Tel:+33-5 65 23 57 00

Fax:+33-5 65 22 67 87



Rottendorf Pharma S.A.R.L

Z.I. No. 2 Batterie 1000

F-59309 Valenciennes

France

Tel:+ 33 / (0) 3 27 43 45 00

Fax:+ 33 / (0) 3 27 43 43 57



Rottendorf Pharma GmbH

Ostenfelder Str. 51-61

D-59320 Ennigerloh

Germany

Tel:+ 49 (0) 25 24 / 2 68 - 0

Fax:+ 49 (0) 25 24 / 2 68 – 100



Meda Pharma GmbH & Co. KG

Benzstrasse 1

D-61352 Bad Homburg

Germany

Tel:+ 49 (0) 6172 888 – 01

Fax:+ 49 (0) 6172 888 – 2740




This medicine is authorised in the member states of the EEA under the following names


UK:


Axorid 100 mg/20 mg, modified-release capsules


Axorid 150 mg/20 mg, modified-release capsules


Axorid 200 mg/20 mg, modified-release capsules


IT:


Axorid 100 mg/20 mg, modified-release capsules


Axorid 150 mg/20 mg, modified-release capsules


Axorid 200 mg/20 mg, modified-release capsules


ES, PL, PT and RO:


Keithon 100 mg/20 mg, modified-release capsules


Keithon 150 mg/20 mg, modified-release capsules


Keithon 200 mg/20 mg, modified-release capsules




This leaflet was last approved in December 2009






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