Aceclofenac 100 mg film-coated tablets – patient leaflet, side effects, dosage

1. What Aceclofenac Tablets is and what it is used for

Aceclofenac Tablets belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They have anti-inflammatory and painkiller properties causing a lowering of swelling, redness (inflammation) and pain. The medicine/active ingredient of Aceclofenac Tablets is aceclofenac.

Aceclofenac Tablets works by blocking the production of hormone-like substances called prostaglandins. Prostaglandins have many functions in the body including an important role in both the way the body responds to inflammation and also the reabsorption of calcium in some diseases of the bone.

Aceclofenac Tablets is used to relieve pain and reduce redness and swelling (inflammation) in patients suffering from:

• arthritis of the joints (osteoarthritis). This commonly occurs in patients over the age of 50 and causes the loss of the cartilage and bone tissue next to the joint.
• autoimmune disease that causes chronic inflammation of the joints (rheumatoid arthritis).
• arthritis of the spine which can lead to the fusion of the vertebrae (ankylosing spondylitis).

2. What you need to know before you take Aceclofenac Tablets

Do not take Aceclofenac Tablets:

• if you are allergic to aceclofenac or any of the other ingredients of this medicine (listed in section 6). if you are allergic to aspirin or any other NSAIDs (such as ibuprofen, naproxen or diclofenac).
• if you have taken aspirin or any other NSAIDs and experienced one of the following:
• asthma attack causing tightness in the chest wheezing and difficulty breathing.
• runny nose, itching and/or sneezing (irritation of the nose).
• raised red circular patchy rash on the skin which may have felt itchy or like a sting or burn.
• a severe allergic reaction known as anaphylactic shock. The symptoms may be life threatening and include difficulty breathing, wheezing, abdominal pain and vomiting.
• if you have a history of, suffer from, or suspect that you have a stomach ulcer or have vomited blood or passed blood in your faeces (black tarry stools).
• if you have severe kidney disease.
• if you have established heart disease and /or cerebrovascular disease e.g. if you have had a heart attack, stroke, mini-stroke (TIA) or blockages to blood vessels to the heart or brain or an operation to clear or bypass blockages.
• if you have or have had problems with your blood circulation (peripheral arterial disease).
• if you suffer from, or suspect that you have severe liver failure.
• if you suffer from bleeding or any type of blood clotting disorders.
• if you are pregnant (unless your doctor considers it essential for you to continue to take this medicine)

Aceclofenac Tablets is not recommended for use in children.

Warnings and precautions:

Before you start taking Aceclofenac Tablets, tell your doctor:

• if you suffer from any other form of kidney or liver disease.
• if you have any of the following disorders, as they may worsen:
• Disorders of the stomach or gut/bowel
• inflammatory bowel disease (ulcerative colitis)
• chronic inflammatory bowel disease (Crohn’s disease)
• ulceration, bleeding or perforation of the stomach or bowel
• if you have, or have ever had problems with the circulation of the blood to your brain.
• if you suffer from asthma or any other breathing problems.
• if you suffer from a rare inherited disorder known as porphyria.
• if you smoke
• if you have diabetes
• if you have angina, blood clots, high blood pressure, raised cholesterol or other raised body fats such as triglycerides
• if you suffer from an autoimmune condition known as systemic lupus erythematosus or other connective tissue disorders.
• if you are infected with chicken pox, the use of this medicine should be avoided because a rare serious infection of the skin may develop.
• if you are recovering from major surgery.
• if you are elderly (your doctor will prescribe you the lowest effective dose over the shortest duration).

Hypersensitivity reactions can occur and very rarely, very serious allergic reactions are appearing (see section 4. Possible side effects). The risk is higher in the first month of treatment. Aceclofenac Tablets should be stopped immediately at the first onset of symptoms such as tightness of the chest, breathing difficulties, fever, skin rashes , soreness of the skin lining the mouth and other mucous membranes causing ulcers, or any signs of hypersensitivity.

Medicines such as Aceclofenac Tablets may be associated with a small increased risk of heart attack ("myocardial infarction”). Any risk is more likely with high doses and prolonged treatment.

Do not exceed the recommended dose or duration of treatment.

Other medicines and Aceclofenac Tablets:

Tell your doctor or pharmacist if you are taking , have recently taken or might take any other medicines. Please tell your doctor if you are taking:

• medicines used to treat mental health problems like depression (selective serotonin-reuptake inhibitors (SSRIs) such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline) or manic depression (lithium)
• medicines used to treat heart failure and irregular heart beats (cardiac glycosides such as digoxin)
• medicines used to treat high blood pressure (antihypertensives: ACE inhibitors such as enalopril, lisinopril; angiotensin II receptor antagonists such as losartan, candesartan; also hydralazine, methyldopa, clonidine, moxonidine, propranalol)
• medicines to treat infection (quinolone antibiotics such as ciprofloxacin, ofloxacin, levofloxacin moxifloxacin)
• drugs used to increase the rate of urine excretion (diuretics such as thiazides,furosemide amiloride hydrochloride)
• medicines that stop blood clotting (anticoagulants) such as warfarin, heparin
• methotrexate which is used to treat cancer and autoimmune disorders such as arthritis and skin conditions
• mifepristone

• any steroids for the treatment of swelling and inflammation (glucocorticoids such as

  hydrocortisone, prednisolone,)

• medicines used to suppress the immune system after organ transplant (ciclosporin or tacrolimus)
• medicines used to treat HIV (zidovudine)
• medicines used to lower blood sugar levels in diabetes (antidiabetics such as glibenclamide, glicazide, tolbutamide)
• any other painkiller NSAID drugs (aspirin, ibuprofen, naproxen, COX-2 inhibitors such as celecoxib and etoricoxib)
• antiplatelet drugs such as clopidogrel.

Aceclofenac Tablets with food and drink

Aceclofenac Tablets must be taken preferably with or after food.

Pregnancy,breast-feeding and fertility

If you are pregnant or breast-feeding, 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 inform your doctor if you have problems becoming pregnant. NSAIDs may make it more difficult to become pregnant.

Do not take Aceclofenac Tablets if you are pregnant or think you are pregnant. The safety of this medicine for use during pregnancy is not known. It is not recommended for use in pregnancy unless considered essential by your doctor. (it must not be used during the last three months of pregnancy).

Aceclofenac Tablets should not be used if you are breast-feeding. It is not known if this medicine passes into breast milk. It is not recommended for use during breast-feeding unless considered essential by your doctor.

Do not take Aceclofenac Tablets if you are in the last 3 months of pregnancy as it could harm your unborn child or cause problems at delivery. It can cause kidney and heart problems in your unborn baby. It may affect your and your baby’s tendency to bleed and cause labour to be later or longer than expected. You should not take Aceclofenac Tablets during the first 6 months of pregnancy unless absolutely

necessary and advised by your doctor. If you need treatment during this period or

while you are trying to get pregnant, the

lowest dose for the shortest time possible should be used. If taken for more than a

few days from 20 weeks of pregnancy

onward, Aceclofenac can cause kidney

problems in your unborn baby that may

lead to low levels of amniotic fluid that

surrounds the baby (oligohydramnios) or narrowing of a blood vessel (ductus arteriosus) in the heart of the baby. If you need treatment for longer than a few days, your doctor may recommend additional monitoring.

Driving and using machines:

If you are taking Aceclofenac Tablets and you experience dizziness, drowsiness, vertigo, tiredness or any difficulty with your eyesight, you must not drive or use machinery. Sodium This medicine contains less than 1mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium free’.

3. How to take Aceclofenac Tablets

Always take this medicine exactly as your doctor or pharmacist has told you. You will be prescribed the lowest effective dose over the shortest duration to reduce side effects. Check with your doctor or pharmacist if you are not sure.

The recommended dose in adults is 200 mg a day. One 100mg tablet should be taken in the morning and one in the evening.

Children:

Aceclofenac Tablet is not recommended for use in children under the age of 18.

Tablets should be swallowed whole with plenty of water and should be taken with or after food. Do not crush or chew the tablets.

Do not exceed the stated daily dose.

Elderly

If you are elderly, you are more likely to experience serious side effects (listed in section 4 ‘Possible Side Effects). If your doctor prescribes Aceclofenac Tablets for you, you will be given the lowest effective dose over the shortest duration of treatment.

Method and route of administration:

Swallow the tablet whole with a glass of water. Do not crush or chew the tablets. Never change the dose of your medicine without talking to your doctor first. Continue to take your tablets for as long as your doctor recommends.

If you take more Aceclofenac Tablets than you should

If you accidentally take too many Aceclofenac Tablets, contact your doctor immediately or go to your nearest hospital casualty department. Please take this leaflet or the box the Aceclofenac Tablets came in, with you to the hospital so that they will know what you have taken.

If you forget to take Aceclofenac Tablets

If you miss a dose, do not worry, just take the next dose at the usual times. Do not take a double dose to make up for a forgotten dose.

If you stop taking Aceclofenac Tablets

Do not stop taking Aceclofenac Tablets unless your doctor advise you.

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

PACKAGE LEAFLET: INFORMATION FOR THE USER Aceclofenac 100 mg film-coated Tablets

Aceclofenac

Front Side

(6010102) Date : 21/07/2021, R-15_10_22

4. Possible side effects

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

Stop taking the medicine and seek medical advice IMMEDIATELY, If you experience any of the following side effects,

• severe allergic reaction (anaphylactic shock). Symptoms may develop quickly and can be life- threatening if not immediately treated and include fever, difficulty breathing, wheezing, abdominal pain, vomiting, swelling of the face and throat.
• severe skin rashes such as Stevens-Johnnson Syndrome and Toxic Epidermal Necrolysis. These are potentially life-threatening and develop quickly forming large blisters and the skin to peel away. The rash can also appear in the mouth, throat or eyes. Fever, headache and aching of the joints usually occur at the same time.
• meningitis. The symptoms include high fever, headache, vomiting, blotchy red rashes, neck stiffness, sensitivity and intolerance to light.
• passing blood in your faeces (stools/motions).
• passing black tarry stools. Vomit any blood or dark particles that look like coffee grounds.
• kidney failure.

Stop taking the medicine and seek medical advice if you experience:

• indigestion or heartburn
• abdominal pain (pains in your stomach) or other abnormal stomach symptoms.
• blood disorders such as reduced production of blood cells, abnormal breakdown of red blood cells known as haemolytic anaemia, low content of iron in the blood, low level of white blood cells, low number of platelet cells, increased blood potassium levels which can irritate the blood vessels causing inflammation known as vasculitis. These disorders can cause you to feel extremely tired, breathless, aching of the joints and be prone to repeated infections and bruising

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

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

• dizziness
• nausea (feeling sick)
• diarrhoea
• increased liver enzymes in the blood

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

• wind
• inflammation or irritation of the lining of the stomach
• constipation
• vomiting
• mouth ulcers
• itching
• rash
• inflammation of the skin
• raised circular red itchy, stinging or burning patches on the skin (hives)
• increase in blood urea levels
• increase in blood creatinine levels

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

• hypersensitivity (allergic reaction)
• problems with eyesight
• heart failure
• high blood pressure shortness of breath
• bleeding from the stomach or bowel
• stomach or bowel ulceration

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

• depression

  • strange dreams
  • inability to sleep
  • tingling, pricking or numbness of skin
  • uncontrollable shaking
  • drowsiness
  • headaches
  • abnormal taste in the mouth
  • sensation of spinning when standing still
  • ringing in the ears
  • heart pounding or racing hot flushes
• difficulty breathing
• high pitched noise when breathing
• inflammation of the mouth
• perforation of either the stomach, large intestine or bowel wall
• worsening of colitis and Crohn’s disease
• inflammation of the pancreas injury of the liver (including hepatitis)
• yellowing of the skin (jaundice)
• spontaneous bleeding into the skin (appears as a rash)
• nephrotic syndrome: a condition which indicates kidney damage and includes large amounts of protein in the urine, low blood albumin levels, high blood cholesterol levels and swelling of the legs, feet or ankles
• water retention and swelling
• tiredness
• leg cramps
• increased blood alkaline phosphatase levels
• weight gain

Other side effects that have been reported with this type of drug (NSAIDs) are:

• hallucinations
• confusion
• blurred, partial or complete loss of vision
• painful movement of the eye
• worsening of asthma
• skin reaction to sunlight
• inflammation of the kidneys
• generally feeling unwell

Serious skin infections may occur in association with chickenpox.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Aceclofenac Tablets

• 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 after (EXP). The expiry date refers to the last day of that month.
• Store below 25°C
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longeruse. These measures will help protect the environment.

6. Contents of the pack and other information

What Aceclofenac Tablets containsThe active substance is aceclofenac. Each tablet contains 100 mg of Aceclofenac.

The other ingredients (excipients) are:

Core tablet: cellulose microcrystalline, croscarmellose sodium, povidone K-30, glyceryl palmitostearate.

Film-coating: Hypromellose 15 cps, macrogol 400 and titanium dioxide (E171).

What Aceclofenac Tablets looks like and contents of the pack:

Aceclofenac Tablets are white to off-white, round shaped, biconvex, film-coated tablet debossed with “100” on one side and plain on the other side.

Aceclofenac Tablets are available in boxes of 10, 20, 30, 40, 60 and 100 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer :

Marketing Authorisation Holder

Accord Healthcare Limited,

Sage House,

319 Pinner road,

North Harrow,

Middlesex HA1 4HF,

United Kingdom

Manufacturer :

Accord Healthcare Limited,

Sage House,

319 Pinner road,

North Harrow,

Middlesex HA1 4HF,

United Kingdom

Accord Healthcare Polska Sp.z o.o., ul. Lutomierska 50,

95-200 Pabianice,

Poland

The leaflet was last revised in 10/2022

Back Side

INP113 10 3668 1 6010102

(6010102) Date : 21/07/2021, R-15_10_22