What Reminyl XL Capsules is used for and how to use it
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Reminyl XL Capsules - Consumer Medicine Information

Manufacture: Shire US, Inc.
Country: Great Britain
Condition: Dementia
Class: Cholinesterase inhibitors
Form: Capsules
Ingredients: galantamine hydrobromide, diethyl phthalate, ethylcellulose, hypromellose, non-pareil beads, Opadry clear OY-7240 (ARTG No 3234), gelatin, titanium dioxide, iron oxide red, iron oxide yellow, TekPrint SW-9008 Black Ink (ARTG No 2328), OPACODE monogramming ink S-1-27794 BLACK.

galantamine

What Reminyl XL is and what it is Used For

Reminyl XL contains the active substance "galantamine" an antidementia medicine. It is used in adults to treat the symptoms of mild to moderately severe Alzheimer’s disease, a type of dementia that alters brain function.

Alzheimer’s disease causes increasing memory loss, confusion and behavioural changes which make it increasingly difficult to carry out normal daily activities. These effects are thought to be caused by a lack of "acetylcholine", a substance responsible for sending messages between brain cells. Reminyl increases the amount of acetylcholine in the brain and treats the signs of the disease.

The capsules are made in a "prolonged-release" form. This means that they release the medicine slowly.

What You Need to know Before You Take Reminyl XL

Do not take Reminyl XL

  • if you are allergic to galantamine or to any of the other ingredients of this medicine (listed in section Contents of the Pack and Other Information)
  • if you have severe liver or severe kidney disease

Warnings and Precautions

Talk to your doctor or pharmacist before taking Reminyl XL. This medicine is only used in Alzheimer"s disease, and is not recommended for other types of memory loss or confusion.

Serious side effects

Reminyl XL can cause serious skin reactions, heart problems, fits (seizures). You must be aware of these side effects while you are taking Reminyl. See Look out for Serious Side Effects in section Possible Side Effects.

Before you take Reimyl XL, your doctor needs to know if you have, or have had, any of the following:

  • liver or kidney problems
  • a heart condition (such as chest discomfort that is often brought on by physical activity, a heart attack, heart failure, slow or uneven heart beat)
  • changes in ‘electrolyte’ levels ( naturally occurring chemicals in the blood, such as potassium)
  • a peptic (stomach) ulcer
  • blockage of the stomach or intestines
  • a disorder of the nervous system (such as epilepsy or Parkinson’s disease)
  • a respiratory disease or infection that affects breathing (such as asthma, obstructive pulmonary disease, or pneumonia)
  • problems passing urine

Your doctor will decide if Reminyl XL is suitable for you, or if the dose needs to be changed

Also tell your doctor if you recently had an operation on the stomach, intestines or bladder. Your doctor may decide that Reminyl XL is not suitable for you.

Reminyl XL can cause weight loss. Your doctor will check your weight regularly while you are taking Reminyl XL.

Children and Adolescents

Reminyl XL is not recommended for children and adolescents.

Other Medicines and Reminyl XL

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Reminyl XL should not be used with medicines that work in a similar way. These include:

  • donepezil or rivastigmine (for Alzheimer’s disease)
  • ambenonium, neostigmine or pyridostigmine (for severe muscle weakness)
  • pilocarpine (when taken by mouth for dry mouth or dry eyes)

Some medicines can make side effects more likely in people taking Reminyl XL. These include:

  • paroxetine or fluoxetine (antidepressants)
  • quinidine (for uneven heart beat)
  • ketoconazole (an antifungal)
  • erythromycin (an antibiotic)
  • ritonavir (for human immunodeficiency virus or ‘HIV’).
  • non-steroidal anti-inflammatory painkillers (such as ibuprofen) which can increase the risk of ulcers.
  • medicines taken for heart conditions or high blood pressure (such as digoxin, amiodarone, atropine, beta-blockers, or calcium channel blocking agents). If you take medicines for an uneven heart-beat, your doctor may check your heart using an electrocardiogram (ECG).

Your doctor may give you a lower dose of Reminyl XL if you are also taking some of these medicines.

Reminyl XL may affect some anaesthetics. If you are going to have an operation under a general anaesthetic, tell the doctor that you are taking Reminyl, well in advance.

If you have any questions, talk to your doctor or pharmacist for advice.

Pregnancy and Breast-Feeding

If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

You should not breastfeed while you are taking Reminyl XL.

Driving and Using Machines

Reminyl XL may make you feel dizzy or sleepy, especially during the first few weeks of treatment. If Reminyl XL affects you, do not drive or use any tools or machinery.

Reminyl XL contains Sucrose

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

How to Take Reminyl XL Capsules

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

If you are currently taking Reminyl tablets or oral solution and have been told by your doctor to switch to Reminyl XL prolonged-release capsules, carefully read the instructions under ‘Switching from taking Reminyl tablets or oral solution to Reminyl capsule in this section.

How much to Take

You will start treatment with Reminyl XL at a low dose. The usual starting dose is 8 mg, taken once a day. Your doctor may gradually increase your dose, every 4 weeks or more until you reach a dose that is suitable for you. The maximum dose is 24 mg, taken once day.

Your doctor will explain what dose to start with and when the dose should be increased. If you are not sure what to do, or find the effect of Reminyl XL is too strong or too weak, talk to your doctor or pharmacist.

Your doctor will need to see you regularly, to check that this medicine is working and to discuss how you are feeling.

If you have a liver or kidney problem, your doctor may give you a reduced dose of Reminyl XL, or may decide this medicine is not suitable for you.

Switching from taking Reminyl tablets or oral solution to Reminyl XL capsules

If you are currently taking Reminyl tablets or oral solution, your doctor may decide you should switch to Reminyl XL prolonged-release capsules. If this applies to you:

  • Take your last dose of Reminyl tablets or oral solution in the evening.
  • The next morning, take your first dose of Reminyl XL prolonged-release capsule.

DO NOT take more than one capsule in a day. While you are taking once daily Reminyl XL capsules, Do NOT take Reminyl tablets or oral solution.

How to Take

Reminl XL capsules must be swallowed whole and NOT chewed or crushed. Take your dose of Reminyl XL once a day in the morning, with water or other liquids. Try to take Reminyl XL with food.

Drink plenty of liquids while you are taking Reminyl XL, to keep yourself hydrated.

If You Take More Reminyl XL than You Should

If you take too much Reminyl XL, contact a doctor or hospital straight away. Take any remaining capsules and the packaging with you. The signs of overdose may include,

  • severe nausea and vomiting.
  • weak muscle, slow heart beat, fits (seizures) and loss of consciousness.

If You Forget to Take Reminyl XL

If you forget to take one dose, miss out the forgotten dose completely and take the next dose at the normal time. Do not take a double dose to make up for a forgotten dose.

If you forget to take more than one dose, contact your doctor.

If You Stop Taking Reminyl XL

Check with your doctor before you stop taking Reminyl XL. It is important to continue taking this medicine to treat your condition.

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

Possible Side Effects

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

Look out for Serious Side Effects

Stop taking Reminyl and see a doctor or go to your nearest emergency department immediately if you notice any of the following.

Skin reactions, including:

  • Severe rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome).
  • Red rash covered with small pus-filled bumps that can spread over the body, sometimes with a fever (acute generalized exanthematous pustulosis).
  • Rash that may blister, with spots that look like small targets.These skin reactions are rare in people taking Reminyl (may affect up to 1 in 1,000 people).

Heart problems, including changes in heart beat (such as a slow beat, extra beats) or palpitations (heart beat feels fast or uneven). Heart problems may show as an abnormal tracing on an electrocardiogram (ECG), and can be common in people taking Reminyl XL (may affect up to 1 in 10 people).

Fits (seizures). These are uncommon in people taking Reminyl XL (may affect up to 1 in 100 people).

You must stop taking Reminyl and get help immediately if you notice any of the side effects above.

Other Side Effects

Very Common side effects (may affects more than 1 in 10 people)

  • Nausea and vomiting. These side effects are more likely to happen in the first few weeks of treatment or when the dose is increased. They tend to disappear gradually as the body gets used to the medicines and generally only last for a few days. If you have these effects, your doctor may recommend that you drink more liquids and, may prescribe a medicine to stop you being sick.

Common side effects (may affect more than 1 in 10 people):

  • Decreased appetite; weight loss
  • Seeing, feeling, or hearing things that are not there (hallucinations)
  • Depression
  • Feeling dizzy or fainting
  • Muscle tremors or spasms
  • Headache
  • Feeling very tired ,weak or generally unwell
  • Feeling very sleepy with low energy
  • High blood pressure
  • Stomach pain or discomfort
  • Diarrhoea
  • Indigestion
  • Falls
  • Wounds

Uncommon side effects (may affect more than to 1 in 100 people):

  • Allergic reaction
  • Not enough water in the body (dehydration)
  • Tingling or numb feeling of the skin (pins and needles)
  • Change in sense of taste
  • Daytime sleepiness
  • Blurred vision
  • Ringing in the ears that does not go away (tinnitus)
  • Low blood pressure
  • Flushing
  • Feeling the need to vomit (retch)
  • Excessive sweating
  • Weak muscles
  • Increased level of liver enzymes in the blood

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

  • Inflamed liver (hepatitis)

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 (see details below). By reporting side effects you help provide more information on the safety of this medicine.

Ireland
HPRA Pharmacovigilance
Earlsfort Terrace
IRL - Dublin 2
Tel: +353 1 6764971
Fax: +353 1 6762517
Website: www.hpra.ie/
e-mail: medsafety@hpra.ie

United Kingdom
Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard

How to Store Reminyl XL

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 foil after EXP. The expiry date refers to the last day of that month.

Do not store above 30°C.

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 to protect the environment.

Contents of the Pack and Other Information

What Reminyl XL Contains

  • The active substance is galantamine. Each prolonged release capsule contains 8mg, 16mg or 24 mg of galantamine (as hydrobromide)
  • The other ingredients are:
    Diethyl phthalate, ethylcellulose, hypromellose, macrogol 400, maize starch and sucrose, gelatine, titanium dioxide (E171), iron oxide black (E172), shellac, propylene glycol (E1520)
    The 16 and 24 mg capsules also contain iron oxide red (E172)
    The 24 mg capsule also contain iron oxide yellow (E172)

What Reminyl XL Looks Like and Contents of the Pack

Reminyl XL 8 mg capsules are white and marked "G8". Each pack contains blisters of 7 or 28 capsules or bottles of 300 capsules.

Reminyl XL 16 mg capsules are pink and marked "G16". Each pack contains blisters of 7, 28,56 or 84 capsules.

Reminyl XL 24 mg capsules are caramel and marked "G24". Each pack contains blisters of 7, 28, 56 or 84 capsules or bottles of 300 capsules.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Shire Pharmaceuticals Limited, Hampshire International Business Park, Chineham,
Basingstoke, Hampshire, RG24 8EP, UK.

Manufacturer

Janssen-Cilag SpA, Via C. Janssen, 04100 Borgo San Michele, Latina, Italy or
McGregor Cory Ltd, Exel, Site 1, Middleton Close, Banbury, Oxfordshire, OX16 4RS, UK.

This medicinal product is authorised in the Member States of the EEA under the following names:

AustriaReminyl 8 mg, 16 mg, 24 mg Retardkapseln
BelgiumReminyl 8 mg, 16 mg, 24 mg harde capsules met verlengde afgifte
DenmarkReminyl 8 mg, 16 mg, 24 mg depotkapsler, hårde
FinlandReminyl 8 mg, 16 mg, 24 mg depotkapseli, kova
FranceReminyl LP 8 mg, 16 mg, 24 mg, gélule à libération prolongée
GermanyREMINYL 1x täglich 8 mg, 16 mg, 24 mg Hartkapseln, retardiert
GreeceReminyl 8mg, 16 mg, 24 mg καψάκια παρατεταμένης αποδέσμευσης, σκληρά
IcelandReminyl 8 mg, 16 mg, 24 mg hörð forðahylki
IrelandReminyl XL 8 mg, 16 mg, 24 mg prolonged release capsules
ItalyReminyl 8 mg, 16 mg, 24 mg capsule rigide a rilascio prolungato
LuxembourgReminyl 8 mg, 16 mg, 24 mg, gélules dures à libération prolongée
NetherlandsReminyl retard capsules 1x daags 8 mg, 16 mg, 24 mg, harde capsules met verlengde afgifte
NorwayReminyl 8 mg, 16 mg, 24 mg depotkapsler, hard
PortugalReminyl 8 mg, 16 mg, 24 mg cápsulas de libertação prolongada
SpainReminyl 8 mg, 16 mg, 24 mg cápsulas duras de liberación prolongada
SwedenReminyl 8 mg, 16 mg, 24 mg depotkapslar, hårda
UKReminyl XL 8 mg, 16 mg, 24 mg prolonged release capsules

This leaflet was last revised in December 2015.

More Information

If you are a person with Alzheimer’s disease or are caring for someone, and you are in England, Wales or Northern Ireland, further information, advice and support is available from the Alzheimer’s Helpline 0845 300 0336 Monday - Friday 08.30 - 18.30. The helpline is provided by the Alzheimer’s Society, Gordon House, 10 Greencoat Place, London SW1P 1PH. Telephone: 020 7306 0606, Fax: 020 7306 0808, e-mail: info@alzheimers.org.uk.

If you are in Scotland, further information, advice and support is available from the 24 hour Dementia Helpline on 0808 808 3000. The helpline is provided by Alzheimer Scotland – Action on Dementia, 22 Drumsheugh Gardens, Edinburgh EH3 7RN. Telephone (office): 0131 243 1453, Fax: 0131 243 1450, email: alzheimer@alzscot.org.

If you live in the Republic of Ireland, further information, advice and support is available from: The Alzheimer Society of Ireland, Alzheimer House, 43 Northumberland Avenue, Dun Laoghaire, Co. Dublin. Telephone: (01) 284 6616, Fax: (01) 284 6030, e-mail: info@alzheimer.ie, National Helpline (open Monday to Thursday 10am -4pm): 1 800 341 341 or Western Alzheimer Foundation, Mount Street, Claremorris, Co. Mayo. Telephone: 094 624 80. Fax: 094 62560.

Reminyl is a registered trademark of Shire Pharmaceutical Development Ltd. in the UK and Ireland.