Patient leaflet - Adalat 5 mg soft capsules,Nifedipine 5 mg soft capsules
What Adalat capsules are and what they are used for What you need to know before you take Adalat capsules
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How to take Adalat capsules
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Other medicines and Adalat capsules
Possible side effects
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Tell your doctor if you are taking, have recently taken or might take any other medicines.
How to store Adalat capsules
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Contents of the pack and other information
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Some medicines may affect the way Adalat capsules work. Tell your doctor if you are taking:
* Other medicines to treat high blood pressure.
* Rifampicin (an antibiotic).
What Adalat capsules are and what they are used for
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* Cimetidine (to treat stomach ulcers).
* Digoxin, diltiazem, quinidine or beta-blockers (to treat heart conditions).
Adalat capsules contain nifedipine, which belongs to a group of medicines called calcium antagonists.
* Quinupristin/dalfopristin (a combination antibiotic).
* Phenytoin, carbamazepine or valproic acid (to treat epilepsy). * Cisapride (to treat reduced movements of the gullet and stomach). * Magnesium sulphate injections during pregnancy (may cause a severe fall in blood pressure).
Adalat capsules are used to treat high blood pressure, angina
(chest pain) or a condition called Raynaud’s phenomenon which causes discolouration (often whitening) of the fingers and toes.
* Erythromycin (an antibiotic).
For high blood pressure: Adalat capsules work by relaxing and expanding the blood vessels. This makes the blood flow more easily and lowers blood pressure. Lower blood pressure reduces the strain on your heart.
* Ketoconazole, itraconazole or fluconazole (anti-fungal medicines). * Indinavir, nelfinavir, ritonavir, saquinavir or amprenavir (to treat HIV). * Fluoxetine or nefazodone (to treat depression).
* Tacrolimus (to prevent the rejection of transplanted organs). * Phenobarbital (usually used to treat insomnia or anxiety).
For angina: Adalat capsules work by relaxing and expanding the arteries supplying the heart. This allows more blood and oxygen to reach the heart and decreases the strain on it. Your angina attacks will be less severe and less frequent if there is less strain on the heart.
Adalat capsules with food and drink
You can take Adalat capsules either with or without food.
Adalat capsules can increase the risk of serious heart problems in patients with high blood pressure or angina. Because of this, Adalat capsules are only used in these patients if no other treatments are appropriate.
Do not drink grapefruit juice or eat grapefruit while taking Adalat capsules.
Do not start taking Adalat capsules within 3 days of drinking grapefruit juice or eating grapefruit. Tell your doctor if you have had grapefruit or grapefruit juice in this time. Also, do not drink grapefruit juice or eat grapefruit whilst taking Adalat capsules. Grapefruit juice is known to increase the blood levels of the active ingredient, nifedipine. This effect can last for at least 3 days.
For Raynaud’s phenomenon: Adalat capsules work by relaxing and expanding the blood vessels in the fingers and toes. This helps ensure a good blood supply.
What you need to know before you take Adalat capsules
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Pregnancy and breast-feeding
If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.
Do not take Adalat capsules:
* If you have had a heart attack within the last month.
You may be able to use Adalat capsules but only after special consideration and agreement by your doctor.
* If you get a sudden angina attack. Adalat capsules will not help relieve symptoms of angina quickly.
* If you have unstable angina.
Do not take Adalat capsules if you are breast-feeding. If you need to take Adalat capsules while breast-feeding, tell your doctor before taking this medicine.
* If you are allergic to nifedipine, any other similar medicines (known as dihydropyridines) or any of the other ingredients of this medicine (listed in section 6).
* If you are taking rifampicin, an antibiotic.
Driving and using machines
* If you have been told that you have a narrowing of the aortic heart valve (stenosis).
Adalat capsules may make you feel dizzy, faint, extremely tired or have visual disturbances. Do not drive or operate machinery if you are affected in this way.
* If you have ever had a collapse caused by a heart problem (cardiogenic shock), during which you became breathless, pale and had a cold sweat and dry mouth.
This may be more likely when you first start treatment, if you change tablets, or if you have drunk alcohol.
* If your blood pressure continues to rise despite treatment (malignant hypertension).
Adalat capsules contains Yellow orange S (E110)
Tell your doctor and do not take Adalat capsules if any of these apply to you.
May cause allergic reactions
Warnings and precautions
Talk to your doctor before taking Adalat capsules
How to take Adalat capsules
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* If you have low blood pressure. Your blood pressure may be decreased further by this treatment.
Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.
* If you have a heart condition where your heart cannot cope with increased strain (poor cardiac reserve).
* The recommended starting dose is one 5 mg capsule every 8 hours. This allows your doctor to monitor how you are responding so that the best long-term dose can be identified.
* If you are pregnant.
* If you are breast-feeding
* If you are a diabetic. The treatment for your diabetes may need to be adjusted. If you have any questions about this, ask your doctor. * If you are on kidney dialysis. If you have a very high blood pressure and a low blood volume, you might experience a sudden drop in blood pressure when you take Adalat capsules.
* The dose can be increased to a maximum of 20 mg every 8 hours. * Lower doses may be prescribed for older patients or for patients who have liver problems.
* Swallow the capsules whole with a little water.
* If your liver is not working properly. Your doctor may need to do some blood tests. You may also be given a lower dose of Adalat capsules.
Talk to your doctor before you take Adalat capsules if any of these apply to you.
®
Adalat 5mg soft capsules
(nifedipine)
Patient Information Leaflet (continued)
Do not take them with grapefruit juice.
You can take Adalat capsules either with or without food.
Use in children and adolescents: Adalat capsules are not recommended for use in children and adolescents below 18 years of age, because there are only limited data on the safety and efficacy in this population.
If you take more Adalat capsules than you should
Get medical help immediately. If possible, take your capsules or the box with you to show the doctor.
Taking too many capsules may cause your blood pressure to become too low and your heartbeats to speed up or slow down. It may also lead to an increase in your blood sugar level or an increase in the acidity of your blood, swelling in the lungs, low blood oxygen levels and disturbances in consciousness, possibly leading to unconsciousness.
If you forget to take Adalat capsules
Take your normal dose immediately and continue taking your capsules as prescribed, waiting 8 hours before taking your next dose.
Do not take a double dose to make up for a forgotten dose.
If you have any further questions on the use of this medicine, ask your doctor
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Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Serious side effects
If you notice:
* severe, sudden generalised allergic reaction including very rarely life-threatening shock (e.g. difficulty in breathing, drop of blood pressure, fast pulse) or swelling (including potentially life-threatening swelling of the airway)
* other allergic reactions causing swelling under the skin (possibly severe and including swelling of the larynx that may result in a life-threatening outcome)
* fast heart beat (tachycardia)
* shortness of breath (frequency not known) or difficulty breathing * mild to moderate allergic reactions
* itching (possibly severe), a rash or hives
Contact your doctor immediately and do not take the next dose as these may be the first signs of allergic reaction which may become severe.
If you develop:
* a skin reaction or blistering/peeling of the skin and/or mucosal reactions (in the mouth/nose or at the penis/vagina) (Toxic Epidermal Necrolysis)
Contact your doctor immediately before you continue treatment as these may be signs of a severe reaction.
Less serious side effects
Apart from the side effects listed above, these are the other side effects of Adalat capsules, starting with the more common ones:
Common side effects
(These may affect up to 1 in 10 people)
* headache
* flushing
* general feeling of being unwell
* constipation
* swelling, particularly of the ankles and legs
Uncommon side effects
(These may affect up to 1 in 100 people)
* stomach pain (abdominal pain)
* unspecific pain
* chills
* low blood pressure when standing up (symptoms include fainting, dizziness, light headedness, occasional palpitations, blurred vision and sometimes confusion)
* fainting
* irregular heartbeat (palpitations)
* dry mouth
* indigestion or upset stomach
* wind (flatulence)
* feeling sick (nausea)
* muscle cramps
* joint swelling
* sleep disorders
* anxiety or nervousness
* reddening of the skin
* nose bleeds
* nasal congestion
* sensation of spinning or whirling motion (vertigo)
* migraine
* dizziness
* trembling
* increase in the need to pass water (urinate)
Ref: LTT0198/090118/1/B
* painful or difficult urination
* inability to achieve or maintain an erection (impotence) * blurred vision
* temporary increase in certain liver enzymes
Rare side effects
(These may affect up to 1 in 1,000 people)
* pins and needles
* inflammation of the gums, tender or swollen gums, bleeding gums
Other side effects
(Frequency not known: frequency cannot be estimated from the available data)
* vomiting
* a reduction in the number of white blood cells (leucopenia) * a more severe decrease in a specific class of white blood cell (agranulocytosis)
* increased blood sugar (hyperglycaemia)
* decreased skin sensitivity (hypoaesthesia)
* drowsiness (somnolence)
* eye pain
* chest pain (angina pectoris)
* heartburn or indigestion (gastroesophageal sphincter insufficiency) * yellowing of the whites of the eyes or skin (jaundice)
* sensitivity to light (photosensitivity allergic reaction)
* small, raised areas of bleeding in the skin (palpable purpura) * joint pain
* muscle pain
All of these symptoms usually go away when treatment with Adalat capsules is stopped.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed on 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.
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How to store Adalat capsules
Keep out of the sight and reach of children.
Store your medicine in its original container.
Protect from strong light and only remove the capsule from the blister strip when you are about to take it.
Do not store above 30ºC.
Do not use after the expiry date which is marked on both the outer carton and on each blister strip of capsules.
If your medicine becomes discoloured or show any other signs of deterioration, ask your pharmacist who will advise you what to do. Medicines should not be disposed of via waterwaste or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
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Contents of the pack and other information
What Adalat capsules contain
Adalat capsules contain the active ingredient, nifedipine. Adalat capsules also contain glycerol, purified water, saccharin sodium, peppermint oil and macrogol 400.
The capsule shell contains gelatine, glycerol, titanium dioxide (E171) and Sunset yellow (E110).
Sunset yellow (E110) may cause allergic reactions.
What Adalat capsules looks like and contents of the pack
Orange, softgel capsule (3 minims oval) containing a yellow viscous fluid. Each pack contains 90 capsules.
Manufacturer and Licence Holder
This medicine is manufactured by Bayer HealthCare Manufacturing S.r.l., Via Delle Groane, 126 20024 Garbagnate Milanese, Italy and is procured from within the EU. Product Licence Holder: LTT Pharma Limited, Unit 18 Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE. Repackaged by Lexon (UK) Limited, B98 0RE.
POM
PL 33723/0198 Adalat 5mg soft capsules
Adalat is a registered trademark of Bayer Aktiengesellschaft.
Revision date: 09/01/18
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