A. MANUFACTURER RESPONSIBLE FOR BATCH RELEASE

Name and address of the manufacturer responsible for batch release

Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg

Germany

• B. CONDITIONS OR RESTRICTIONS REGARDING SUPPLY AND USE

  
  

Medicinal product subject to medical prescription.

OTHER CONDITIONS AND REQUIREMENTS OF THE MARKETIN AUTHORISATION

Periodic Safety Update Reports

The marketing authorisation holder shall submit periodic safety update reports for this product in accordance with the requirements set out in the list of Union reference dates (EURD list) provided for under Article 107c(7) of Directive 2001/83/EC and published on the European medicines web-portal.

D. CONDITIONS OR RESTRICTIONS WITH REGARD TO THE SAFE AND EFFECTIVE USE OF THE MEDICINAL PRODUCT

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

CARTON OF UNIT PACK

1. NAME OF THE MEDICINAL PRODUCT

7 film-coated tablets

14 film-coated tablets

28 film-coated tablets

30 film-coated tablets

56 film-coated tablets

90 film-coated tablets

98 film-coated tablets

280 film-coated tablets

Oral use.

• 6. SPECIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT OF THE SIGHT AND REACH OF CHILDREN

Keep out of the sight and reach of children.

• 7. OTHER SPECIAL WARNING(S), IF NECESSARY

• 8. EXPIRY DATE

EXP

• 9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF APPROPRIATE

  
  

  • 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDE

• 12. MARKETING AUTHORISATION NUMBER(S)

• 15. INSTRUCTIONS ON USE

• 16. INFORMATION IN BRAILLE

Imprida 5 mg/80 mg

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

INTERMEDIATE CARTON OF MULTIPACK (WITHOUT BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

THE MEDICINAL PRODUCT MUST BE STORED OUT CH OF CHILDREN

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­34 280 film-coated tablets (4×70)

EU/1/06/373/0­37 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

OUTER CARTON OF MULTIPACK (WITH BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

Imprida 5 mg/80 mg film-coated tablets

amlodipine/val­sartan

Multipack: 280 (4 packs of 70) film-coated tablets

Multipack: 280 (20 packs of 14) film-coated tablets

EXP

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­34 280 film-coated tablets (4×70)

EU/1/06/373/0­37 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

  MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS

  
  

  BLISTERS

  
  

  1. NAME OF THE MEDICINAL PRODUCT

  
  

  Imprida 5 mg/80 mg film-coated tablets amlodipine/val­sartan

  
  
  
  

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

CARTON OF UNIT PACK

1. NAME OF THE MEDICINAL PRODUCT

7 film-coated tablets

14 film-coated tablets

28 film-coated tablets

• 30 film-coated tablets

• 56 film-coated tablets

• 90 film-coated tablets

• 98 film-coated tablets

280 film-coated tablets

Oral use.

• 6. SPECIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT OF THE SIGHT AND REACH OF CHILDREN

Keep out of the sight and reach of children.

• 7. OTHER SPECIAL WARNING(S), IF NECESSARY

• 8. EXPIRY DATE

EXP

• 9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF APPROPRIATE

  
  

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

  
  

Novartis Europharm Limited Frimley Business Park Camberley GU16 7SR United Kingdom

• 12. MARKETING AUTHORISATION NUMBER(S)

EU/1/06/373/009

EU/1/06/373/010

EU/1/06/373/011

EU/1/06/373/012

EU/1/06/373/013

EU/1/06/373/014

EU/1/06/373/015

EU/1/06/373/016

EU/1/06/373/028

EU/1/06/373/029

EU/1/06/373/030

L CLASSIFICATION FOR SUPPLY product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

• 16. INFORMATION IN BRAILLE

Imprida 5 mg/160 mg

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

INTERMEDIATE CARTON OF MULTIPACK (WITHOUT BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

THE MEDICINAL PRODUCT MUST BE STORED OUT CH OF CHILDREN

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­35 280 film-coated tablets (4×70)

EU/1/06/373/0­38 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

OUTER CARTON OF MULTIPACK (WITH BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

Imprida 5 mg/160 mg film-coated tablets

amlodipine/val­sartan

Multipack: 280 (4 packs of 70) film-coated tablets

Multipack: 280 (20 packs of 14) film-coated tablets

EXP

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­35 280 film-coated tablets (4×70)

EU/1/06/373/0­38 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS

BLISTERS

1. NAME OF THE MEDICINAL PRODUCT

Imprida 5 mg/160 mg film-coated tablets amlodipine/val­sartan

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

CARTON OF UNIT PACK

1. NAME OF THE MEDICINAL PRODUCT

7 film-coated tablets

14 film-coated tablets

28 film-coated tablets

30 film-coated tablets

56 film-coated tablets

90 film-coated tablets

98 film-coated tablets

280 film-coated tablets

CIAL WARNING THAT THE MEDICINAL PRODUCT MUST BE STORED OUT THE SIGHT AND REACH OF CHILDREN

Keep out of the sight and reach of children.

• 7. OTHER SPECIAL WARNING(S), IF NECESSARY

• 8. EXPIRY DATE

EXP

• 9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF APPROPRIATE

  
  

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

  
  

Novartis Europharm Limited Frimley Business Park Camberley GU16 7SR United Kingdom

• 12. MARKETING AUTHORISATION NUMBER(S)

EU/1/06/373/017

EU/1/06/373/018

EU/1/06/373/019

EU/1/06/373/020

EU/1/06/373/021

EU/1/06/373/022

EU/1/06/373/023

EU/1/06/373/024

EU/1/06/373/031

EU/1/06/373/032

EU/1/06/373/033

L CLASSIFICATION FOR SUPPLY product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

• 16. INFORMATION IN BRAILLE

Imprida 10 mg/160 mg

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

INTERMEDIATE CARTON OF MULTIPACK (WITHOUT BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

THE MEDICINAL PRODUCT MUST BE STORED OUT CH OF CHILDREN

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­36 280 film-coated tablets (4×70)

EU/1/06/373/0­39 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

PARTICULARS TO APPEAR ON THE OUTER PACKAGING

OUTER CARTON OF MULTIPACK (WITH BLUE BOX)

1. NAME OF THE MEDICINAL PRODUCT

Imprida 10 mg/160 mg film-coated tablets

amlodipine/val­sartan

Multipack: 280 (4 packs of 70) film-coated tablets

Multipack: 280 (20 packs of 14) film-coated tablets

EXP

9. SPECIAL STORAGE CONDITIONS

Do not store above 30°C.

Store in the original package in order to protect from moisture.

• 11. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

_____________­__________¿a

• 12. MARKETING AUTHORISATION NUMBER(S) ____

EU/1/06/373/0­36 280 film-coated tablets (4×70)

EU/1/06/373/0­39 280 film-coated tablets (20×14)

• 13. BATCH NUMBER

LOt

• 14. GENERAL CLASSIFICATION FOR SUPPLY

Medicinal product subject to medical prescription.

• 15. INSTRUCTIONS ON USE

MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS

BLISTERS

1. NAME OF THE MEDICINAL PRODUCT

Imprida 10 mg/160 mg film-coated tablets amlodipine/val­sartan

Package leaflet: information for the user

Imprida 5 mg/80 mg film-coated tablets amlodipine/val­sartan

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• – 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 only. Do not pass it on to others. It may harm them,

even if their signs of illness are the same as yours.

• – If you get any side effects, talk to your doctor or pharmacist. This includes any possible side

effects not listed in this leaflet.

What Imprida is and what it is used for

What you need to know before you take Imprida

How to take Imprida

Possible side effects

How to store Imprida

Contents of the pack and other information

What Imprida is and what it is used for

Imprida tablets contain two substances called amlodipine and valsartan. Both of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from

tightening.

Valsartan belongs to a group of substances called “angiotensin-II receptor antagonists”.

Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

This means that both of these substances help to stop the blood vessels tightening. As a result, the blood vessels relax and blood pressure is lowered.

Imprida is used to treat high blood pressure in adults whose blood pressure is not controlled enough with either amlodipine or valsartan on its own.

ou need to know before you take Imprida e Imprida

u are allergic to amlodipine or to any other calcium channel blockers. This may involve itching, reddening of the skin or difficulty in breathing.

if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, talk to your doctor before taking Imprida.

if you have severe liver problems or bile problems such as biliary cirrhosis or cholestasis.

if you are more than 3 months pregnant. (It is also better to avoid Imprida in early pregnancy, see Pregnancy section).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

• – if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, do not take Imprida and talk to your doctor.

Warnings and precautions

Talk to your doctor before taking Imprida:

if you have been sick (vomiting or diarrhoea).

if you have liver or kidney problems.

if you have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have a condition affecting the renal glands called “primary hyperaldostero­nism”.

if you have had heart failure or have experienced a heart attack. Follow your doctor’s

instructions for the starting dose carefully. Your doctor may also check your kidney function. if your doctor has told you that you have a narrowing of the valves in your heart (called “aortic or mitral stenosis”) or that the thickness of your heart muscle is abnormally increased (called “obstructive hypertrophic cardiomyopathy”).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Imprida and contact your doctor straight away. You should never take Imprida again.

if you are taking any of the following medicines used to tre

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Imprida”.

If any of these apply to you, tell your doctor before taking Imprida.

Children and adolescents

The use of Imprida in children and adolescents is not recommended (aged below 18 years old).

Other medicines and Imprida

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below:

• – ACE inhibitors or aliskiren (see also information under the headings “Do not take Imprida” and “Warnings and precautions”);

• – diuretics (a type of medicine also called “water tablets” which increases the amount of urine you produce);

• – lithium (a medicine used to treat some types of depression);

• – potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium and other substances that may increase potassium levels;

• – certain types of painkillers called non-steroidal anti-inflammatory medicines (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors). Your doctor may also check your kidney function;

• – anticonvulsant agents (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);

• – St. John’s wort;

• – nitroglycerin and other nitrates, or other substances called “vasodilators”;

• – medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);

• – medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);

medicines used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, talithromycin);

verapamil, diltiazem (heart medicines);

simvastatin (a medicine used to control high cholesterol levels);

dantrolene (infusion for severe body temperature abnormalities);

medicines used to protect against transplant rejection (ciclosporin).

Imprida with food and drink

Grapefruit and grapefruit juice should not be consumed by people who are taking Imprida. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowering effect of Imprida.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Imprida before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Imprida. Imprida is not recommended in early pregnancy (first 3 months), and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breas recommended for mothers who are breast-feeding, and your you if you wish to breast-feed, especially if your baby is

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

Driving and using machines

This medicine may make you feel dizzy. This can affect how well you can concentrate. So, if you are not sure how this medicine will affect you, do not drive, use machinery, or do other activities that you need to concentrate on.

3. How to take Imprid

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Imprida is one tablet per day.

It is preferable to take your medicine at the same time each day.

Swallow the tablets with a glass of water.

You can take Imprida with or without food. Do not take Imprida with grapefruit or grapefruit juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

Imprida and older people (age 65 years or over)

Your doctor should exercise caution when increasing your dose.

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

If you take more Imprida than you should

If you have taken too many tablets of Imprida, or if someone else has taken your tablets, consult a doctor immediately.

If you forget to take Imprida

If you forget to take this medicine, take it as soon as you remember. Then take your next dose at its usual time. However, if it is almost time for your next dose, skip the dose you missed. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Imprida

Stopping your treatment with Imprida may cause your disease to get worse. Do not stop taking yo medicine unless your doctor tells you to.

4. Possible side effects

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

Some side effects can be serious and need immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 people). If any of the following happen, tell your doctor straight away:

Allergic reaction with symptoms such as rash, itching, swelling of face or lips or tongue, difficulty breathing, low blood pressure (feeling of faintness, light-headedness).

Other possible side effects of Imprida:

Common (may affect up to 1 in 10 people): Influenza (flu); blocked nose, sore throat and discomfort when swallowing; headache; swelling of arms, hands, legs, ankles or feet; tiredness; asthenia (weakness); redness and warm feeling of the face and/or neck.

Uncommon (may affect up to 1 in 100 people): Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling or numbness of the hands or feet; vertigo; fast heart beat including palpitations; dizziness on standing up; cough; diarrhoea; constipation; skin rash, redness of the skin; joint swelling, back pain; pain in joints.

Rare (may affect up to 1 in 1,000 people): Feeling anxious; ringing in the ears (tinnitus); fainting; passing more urine than normal or feeling more of an urge to pass urine; inability to get or maintain an erection; sensation of heaviness; low blood pressure with symptoms such as dizziness, lightheadedness; excessive sweating; skin rash all over your body; itching; muscle spasm.

If any of these affect you severely, tell your doctor.

Side effects reported with amlodipine or valsartan alone and either not observed with Imprida or observed with a higher frequency than with Imprida:

Amlodipi neC^

Consult a doctor immediately if you experience any of the following very rare, severe side effects after taking this medicine:

• – Sudden wheeziness, chest pain, shortness of breath or difficulty in breathing.

• – Swelling of eyelids, face or lips.

• – Swelling of the tongue and throat which causes great difficulty breathing.

• – Severe skin reactions including intense skin rash, hives, reddening of the skin over your whole

body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson Syndrome) or other allergic reactions.

• – Heart attack, abnormal heart beat.

• – Inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling

of being very unwell.

The following side effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Common (may affect up to 1 in 10 people): Dizziness, sleepiness; palpitations (awareness of your heart beat); flushing, ankle swelling (oedema); abdominal pain, feeling sick (nausea).

Uncommon (may affect up to 1 in 100 people): Mood changes, anxiety, depression, sleeplessness, trembling, taste abnormalities, fainting, loss of pain sensation; visual disturbances, visual impairment, ringing in the ears; low blood pressure; sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis); indigestion, vomiting (being sick); hair loss, increased sweating, itchy skin, skin discolouration; disorder in passing urine, increased need to urinate at night, increased number of times of passing urine; inability to obtain an erection, discomfort or enlargement of the breasts in men, pain, feeling unwell, muscle pain, muscle cramps; weight increase or decrease.

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

Very rare (may affect up to 1 in 10,000 people): Decreased number of white blood cells, decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage); excess sugar in blood (hyperglycaemia); swelling of the gums, abdominal bloating (gastritis); abnormal liver function, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; increased muscle tension; inflammation of blood vessels often with skin rash, sensitivity to light; disorders combining rigidity, tremor and/or movement disorders.

Valsartan

Not known (frequency cannot be estimated from the available data): Decrease in red blood cells, fever, sore throat or mouth sores due to infections; spontaneous bleeding or bruising; high level of potassium in the blood; abnormal liver test results; decreased renal functions and severely decreased renal functions; swelling mainly of the face and the throat; muscle pain; rash, purplish-red spots; fever; itching; allergic reaction; blistering skin (sign of a condition called dermatitis bullous).

If you experience any of these, tell your doctor straight away.

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 By reporting side efects you can help provide more information on the safety of this medicine.

5. How to store Imprida

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.

Do not store above 30°C.

Store in the original package in order to protect from moisture.

Do not use any Imprida pack that is damaged or shows signs of tampering.

«er

6. Contents of the pack and other information

What Imprida contains

• – The active substances of Imprida are amlodipine (as amlodipine besylate) and valsartan. Each tablet contains 5 mg amlodipine and 80 mg valsartan.

• – The other ingredients are cellulose microcrystalline; crospovidone type A; silica, colloidal anhydrous; magnesium stearate; hypromellose; macrogol 4000; talc, titanium dioxide (E171); iron oxide, yellow (E172).

What Imprida looks like and contents of the pack

Imprida 5 mg/80 mg tablets are round and dark yellow with “NVR” on one side and “NV” on the other side.

Imprida is available in packs containing 7, 14, 28, 30, 56, 90, 98 or 280 tablets and in multipacks comprising 4 cartons, each containing 70 tablets, or 20 cartons, each containing 14 tablets. All packs are available with standard blisters; the 56, 98 and 280 tablet packs are additionally available with perforated unit dose blisters. Not all pack sizes may be available in your country.

Marketing Authorisation Holder

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

Manufacturer

Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg

Germany

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgiqu­e/Belgien

Novartis Pharma N.V.

Tél/Tel: +32 2 246 16 11

Efc^rapufl

Novartis Pharma Services Inc.

Luxembourg/Lu­xemburg

Novartis Pharma N.V.

Ten.: +359 2 976 98 28

Tél/Tel: +32 2 246 16 11

Česká republika

Novartis s.r.o.

Tel: +420 225 775 111

Danmark

Novartis Healthcare A/S

Tlf: +45 39 16 84 00

E/^á^a

Novartis (Hellas) A.E.B.E.

Tql: +30 210 281 17 12

Norge

Novartis Norge AS

Tlf: +47 23 05 20 00

Österreich

Novartis Pharma GmbH

Tel: +43 1 86 6570

España

Novartis Farmacéutica, S.A.

Tel: +34 93 306 42 00

Polska

Novartis Poland Sp. z o.o

Tel.: +48 22 375 4888

Package leaflet: information for the user

Imprida 5 mg/160 mg film-coated tablets amlodipine/val­sartan

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• – 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 only. Do not pass it on to others. It may harm them,

even if their signs of illness are the same as yours.

• – If you get any side effects, talk to your doctor or pharmacist. This includes any possible side

effects not listed in this leaflet.

What Imprida is and what it is used for

What you need to know before you take Imprida

How to take Imprida

Possible side effects

How to store Imprida

Contents of the pack and other information

What Imprida is and what it is used for

Imprida tablets contain two substances called amlodipine and valsartan. Both of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from

tightening.

Valsartan belongs to a group of substances called “angiotensin-II receptor antagonists”.

Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

This means that both of these substances help to stop the blood vessels tightening. As a result, the blood vessels relax and blood pressure is lowered.

Imprida is used to treat high blood pressure in adults whose blood pressure is not controlled enough

with either amlodipine or valsartan on its own.

ou need to know before you take Imprida e Imprida

u are allergic to amlodipine or to any other calcium channel blockers. This may involve itching, reddening of the skin or difficulty in breathing.

if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, talk to your doctor before taking Imprida.

if you have severe liver problems or bile problems such as biliary cirrhosis or cholestasis.

if you are more than 3 months pregnant. (It is also better to avoid Imprida in early pregnancy, see Pregnancy section).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

• – if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, do not take Imprida and talk to your doctor.

Warnings and precautions

Talk to your doctor before taking Imprida:

if you have been sick (vomiting or diarrhoea).

if you have liver or kidney problems.

if you have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have a condition affecting the renal glands called “primary hyperaldostero­nism”.

if you have had heart failure or have experienced a heart attack. Follow your doctor’s

instructions for the starting dose carefully. Your doctor may also check your kidney function. if your doctor has told you that you have a narrowing of the valves in your heart (called “aortic or mitral stenosis”) or that the thickness of your heart muscle is abnormally increased (called “obstructive hypertrophic cardiomyopathy”).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Imprida and contact your doctor straight away. You should never take Imprida again.

if you are taking any of the following medicines used to tre

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Imprida”.

If any of these apply to you, tell your doctor before taking Imprida.

Children and adolescents

The use of Imprida in children and adolescents is not recommended (aged below 18 years old).

Other medicines and Imprida

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below:

• – ACE inhibitors or aliskiren (see also information under the headings “Do not take Imprida” and “Warnings and precautions”);

• – diuretics (a type of medicine also called “water tablets” which increases the amount of urine you produce);

• – lithium (a medicine used to treat some types of depression);

• – potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium and other substances that may increase potassium levels;

• – certain types of painkillers called non-steroidal anti-inflammatory medicines (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors). Your doctor may also check your kidney function;

• – anticonvulsant agents (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);

• – St. John’s wort;

• – nitroglycerin and other nitrates, or other substances called “vasodilators”;

• – medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);

medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);

medicines used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, talithromycin);

verapamil, diltiazem (heart medicines);

simvastatin (a medicine used to control high cholesterol levels);

dantrolene (infusion for severe body temperature abnormalities);

medicines used to protect against transplant rejection (ciclosporin).

Imprida with food and drink

Grapefruit and grapefruit juice should not be consumed by people who are taking Imprida. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowerin effect of Imprida.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Imprida before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Imprida. Imprida is not recommended in early pregnancy (first 3 months), and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start br eas g. Imprida is not

recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

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

Driving and using machines

This medicine may make you feel dizzy. This can affect how well you can concentrate. So, if you are not sure how this medicine will affect you, do not drive, use machinery, or do other activities that you need to concentrate on.

3. How to take Imprida

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Imprida is one tablet per day.

• – It is pre ferable to take your medicine at the same time each day.

• – s Swallow the tablets with a glass of water.

• – You can take Imprida with or without food. Do not take Imprida with grapefruit or grapefruit

juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

Imprida and older people (age 65 years or over)

Your doctor should exercise caution when increasing your dose.

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

If you take more Imprida than you should

If you have taken too many tablets of Imprida, or if someone else has taken your tablets, consult a doctor immediately.

If you forget to take Imprida

If you forget to take this medicine, take it as soon as you remember. Then take your next dose at its usual time. However, if it is almost time for your next dose, skip the dose you missed. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Imprida

Stopping your treatment with Imprida may cause your disease to get worse. Do not stop taking yo medicine unless your doctor tells you to.

4. Possible side effects

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

Some side effects can be serious and need immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 people). If any of the following happen, tell your doctor straight away:

Allergic reaction with symptoms such as rash, itching, swelling of face or lips or tongue, difficulty breathing, low blood pressure (feeling of faintness, light-headedness).

Other possible side effects of Imprida:

Common (may affect up to 1 in 10 people): Influenza (flu); blocked nose, sore throat and discomfort when swallowing; headache; swelling of arms, hands, legs, ankles or feet; tiredness; asthenia (weakness); redness and warm feeling of the face and/or neck.

Uncommon (may affect up to 1 in 100 people): Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling or numbness of the hands or feet; vertigo; fast heart beat including palpitations; dizziness on standing up; cough; diarrhoea; constipation; skin rash, redness of the skin; joint swelling, back pain; pain in joints.

Rare (may affect up to 1 in 1,000 people): Feeling anxious; ringing in the ears (tinnitus); fainting; passing more urine than normal or feeling more of an urge to pass urine; inability to get or maintain an erection; sensation of heaviness; low blood pressure with symptoms such as dizziness, lightheadedness; excessive sweating; skin rash all over your body; itching; muscle spasm.

If any of these affect you severely, tell your doctor.

Side effects reported with amlodipine or valsartan alone and either not observed with Imprida

or observed with a higher frequency than with Imprida:

Consult a doctor immediately if you experience any of the following very rare, severe side effects after taking this medicine:

• – Sudden wheeziness, chest pain, shortness of breath or difficulty in breathing.

• – Swelling of eyelids, face or lips.

• – Swelling of the tongue and throat which causes great difficulty breathing.

• – Severe skin reactions including intense skin rash, hives, reddening of the skin over your whole

body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson Syndrome) or other allergic reactions.

• – Heart attack, abnormal heart beat.

Inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling of being very unwell.

The following side effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Common (may affect up to 1 in 10 people): Dizziness, sleepiness; palpitations (awareness of your heart beat); flushing, ankle swelling (oedema); abdominal pain, feeling sick (nausea).

Uncommon (may affect up to 1 in 100 people): Mood changes, anxiety, depression, sleeplessness, trembling, taste abnormalities, fainting, loss of pain sensation; visual disturbances, visual impairment, ringing in the ears; low blood pressure; sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis); indigestion, vomiting (being sick); hair loss, increased sweating, itchy skin, skin discolouration; disorder in passing urine, increased need to urinate at night, increased number of times of passing urine; inability to obtain an erection, discomfort or enlargement of the breasts in men, pain, feeling unwell, muscle pain, muscle cramps; weight increase or decrease.

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

Very rare (may affect up to 1 in 10,000 people): Decreased number of white blood cells, decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage); excess sugar in blood (hyperglycaemia); swelling of the gums, abdominal bloating (gastritis); abnormal liver function, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; increased muscle tension; inflammation of blood vessels often with skin rash, sensitivity to light; disorders combining rigidity, tremor and/or movement disorders.

Valsartan

Not known (frequency cannot be estimated from the available data): Decrease in red blood cells, fever, sore throat or mouth sores due to infections; spontaneous bleeding or bruising; high level of potassium in the blood; abnormal liver test results; decreased renal functions and severely decreased renal functions; swelling mainly of the face and the throat; muscle pain; rash, purplish-red spots; fever; itching; allergic reaction; blistering skin (sign of a condition called dermatitis bullous).

If you experience any of these, tell your doctor straight away.

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 By reporting side efects you can help provide more information on the safety of this medicine.

5. How to store Imprida

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.

Do not store above 30°C.

Store in the original package in order to protect from moisture.

Do not use any Imprida pack that is damaged or shows signs of tampering.

«er

6. Contents of the pack and other information

What Imprida contains

• – The active substances of Imprida are amlodipine (as amlodipine besylate) and valsartan. Each

tablet contains 5 mg amlodipine and 160 mg valsartan.

• – The other ingredients are cellulose microcrystalline; crospovidone type A; silica, colloidal

anhydrous; magnesium stearate; hypromellose; macrogol 4000; talc, titanium dioxide (E171); iron oxide, yellow (E172).

What Imprida looks like and contents of the pack

Imprida 5 mg/160 mg tablets are oval and dark yellow “NVR” on one side and “ECE” on the other side.

Imprida is available in packs containing 7, 14, 28, 30, 56, 90, 98 or 280 tablets and in multipacks comprising 4 cartons, each containing 70 tablets, or 20 cartons, each containing 14 tablets. All packs are available with standard blisters; the 56, 98 and 280 tablet packs are additionally available with perforated unit dose blisters. Not all pack sizes may be available in your country.

Marketing Authorisation Holder

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

Manufacturer

Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg

Germany

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

România

Novartis Pharma Services Romania SRL

Tel: +40 21 31299 01

Slovenija

Novartis Pharma Services Inc.

Tel: +386 1 300 75 50

Slovenská republika

Novartis Slovakia s.r.o.

Tel: +421 2 5542 5439

Suomi/Finland

Novartis Finland Oy

Puh/Tel: +358 (0)10 6133 200

Sverige

Novartis Sverige AB

Tel: +46 8 732 32 00

United Kingdom

Novartis Pharmaceuticals UK Ltd.

Tel: +44 1276 698370

\O

on the European Medicines Agency web site:

Package leaflet: information for the user

Imprida 10 mg/160 mg film-coated tablets amlodipine/val­sartan

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• – 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 only. Do not pass it on to others. It may harm them,

even if their signs of illness are the same as yours.

• – If you get any side effects, talk to your doctor or pharmacist. This includes any possible side

effects not listed in this leaflet.

What Imprida is and what it is used for

What you need to know before you take Imprida

How to take Imprida

Possible side effects

How to store Imprida

Contents of the pack and other information

What Imprida is and what it is used for

Imprida tablets contain two substances called amlodipine and valsartan. Both of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from

tightening.

Valsartan belongs to a group of substances called “angiotensin-II receptor antagonists”.

Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

This means that both of these substances help to stop the blood vessels tightening. As a result, the blood vessels relax and blood pressure is lowered.

Imprida is used to treat high blood pressure in adults whose blood pressure is not controlled enough

with either amlodipine or valsartan on its own.

ou need to know before you take Imprida e Imprida

u are allergic to amlodipine or to any other calcium channel blockers. This may involve itching, reddening of the skin or difficulty in breathing.

if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, talk to your doctor before taking Imprida.

if you have severe liver problems or bile problems such as biliary cirrhosis or cholestasis.

if you are more than 3 months pregnant. (It is also better to avoid Imprida in early pregnancy, see Pregnancy section).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

• – if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, do not take Imprida and talk to your doctor.

Warnings and precautions

Talk to your doctor before taking Imprida:

if you have been sick (vomiting or diarrhoea).

if you have liver or kidney problems.

if you have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have a condition affecting the renal glands called “primary hyperaldostero­nism”.

if you have had heart failure or have experienced a heart attack. Follow your doctor’s

instructions for the starting dose carefully. Your doctor may also check your kidney function. if your doctor has told you that you have a narrowing of the valves in your heart (called “aortic or mitral stenosis”) or that the thickness of your heart muscle is abnormally increased (called “obstructive hypertrophic cardiomyopathy”).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Imprida and contact your doctor straight away. You should never take Imprida again.

if you are taking any of the following medicines used to tre

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Imprida”.

If any of these apply to you, tell your doctor before taking Imprida.

Children and adolescents

The use of Imprida in children and adolescents is not recommended (aged below 18 years old).

Other medicines and Imprida

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below:

• – ACE inhibitors or aliskiren (see also information under the headings “Do not take Imprida” and “Warnings and precautions”);

• – diuretics (a type of medicine also called “water tablets” which increases the amount of urine you produce);

• – lithium (a medicine used to treat some types of depression);

• – potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium and other substances that may increase potassium levels;

• – certain types of painkillers called non-steroidal anti-inflammatory medicines (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors). Your doctor may also check your kidney function;

• – anticonvulsant agents (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);

• – St. John’s wort;

• – nitroglycerin and other nitrates, or other substances called “vasodilators”;

• – medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);

medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);

medicines used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, talithromycin);

verapamil, diltiazem (heart medicines);

simvastatin (a medicine used to control high cholesterol levels);

dantrolene (infusion for severe body temperature abnormalities);

medicines used to protect against transplant rejection (ciclosporin).

Imprida with food and drink

Grapefruit and grapefruit juice should not be consumed by people who are taking Imprida. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowerin effect of Imprida.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Imprida before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Imprida. Imprida is not recommended in early pregnancy (first 3 months), and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start br eas g. Imprida is not

recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

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

Driving and using machines

This medicine may make you feel dizzy. This can affect how well you can concentrate. So, if you are not sure how this medicine will affect you, do not drive, use machinery, or do other activities that you need to concentrate on.

3. How to take Imprida

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Imprida is one tablet per day.

• – It is pre ferable to take your medicine at the same time each day.

• – s Swallow the tablets with a glass of water.

• – You can take Imprida with or without food. Do not take Imprida with grapefruit or grapefruit

juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

Imprida and older people (age 65 years or over)

Your doctor should exercise caution when increasing your dose.

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

If you take more Imprida than you should

If you have taken too many tablets of Imprida, or if someone else has taken your tablets, consult a doctor immediately.

If you forget to take Imprida

If you forget to take this medicine, take it as soon as you remember. Then take your next dose at its usual time. However, if it is almost time for your next dose, skip the dose you missed. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Imprida

Stopping your treatment with Imprida may cause your disease to get worse. Do not stop taking yo medicine unless your doctor tells you to.

4. Possible side effects

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

Some side effects can be serious and need immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 people). If any of the following happen, tell your doctor straight away:

Allergic reaction with symptoms such as rash, itching, swelling of face or lips or tongue, difficulty breathing, low blood pressure (feeling of faintness, light-headedness).

Other possible side effects of Imprida:

Common (may affect up to 1 in 10 people): Influenza (flu); blocked nose, sore throat and discomfort when swallowing; headache; swelling of arms, hands, legs, ankles or feet; tiredness; asthenia (weakness); redness and warm feeling of the face and/or neck.

Uncommon (may affect up to 1 in 100 people): Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling or numbness of the hands or feet; vertigo; fast heart beat including palpitations; dizziness on standing up; cough; diarrhoea; constipation; skin rash, redness of the skin; joint swelling, back pain; pain in joints.

Rare (may affect up to 1 in 1,000 people): Feeling anxious; ringing in the ears (tinnitus); fainting; passing more urine than normal or feeling more of an urge to pass urine; inability to get or maintain an erection; sensation of heaviness; low blood pressure with symptoms such as dizziness, lightheadedness; excessive sweating; skin rash all over your body; itching; muscle spasm.

If any of these affect you severely, tell your doctor.

Side effects reported with amlodipine or valsartan alone and either not observed with Imprida or observed with a higher frequency than with Imprida:

Amlodipi neC^

Consult a doctor immediately if you experience any of the following very rare, severe side effects after taking this medicine:

• – Sudden wheeziness, chest pain, shortness of breath or difficulty in breathing.

• – Swelling of eyelids, face or lips.

• – Swelling of the tongue and throat which causes great difficulty breathing.

• – Severe skin reactions including intense skin rash, hives, reddening of the skin over your whole

body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson Syndrome) or other allergic reactions.

• – Heart attack, abnormal heart beat.

• – Inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling

of being very unwell.

The following side effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Common (may affect up to 1 in 10 people): Dizziness, sleepiness; palpitations (awareness of your heart beat); flushing, ankle swelling (oedema); abdominal pain, feeling sick (nausea).

Uncommon (may affect up to 1 in 100 people): Mood changes, anxiety, depression, sleeplessness, trembling, taste abnormalities, fainting, loss of pain sensation; visual disturbances, visual impairment, ringing in the ears; low blood pressure; sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis); indigestion, vomiting (being sick); hair loss, increased sweating, itchy skin, skin discolouration; disorder in passing urine, increased need to urinate at night, increased number of times of passing urine; inability to obtain an erection, discomfort or enlargement of the breasts in men, pain, feeling unwell, muscle pain, muscle cramps; weight increase or decrease.

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

Very rare (may affect up to 1 in 10,000 people): Decreased number of white blood cells, decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage); excess sugar in blood (hyperglycaemia); swelling of the gums, abdominal bloating (gastritis); abnormal liver function, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; increased muscle tension; inflammation of blood vessels often with skin rash, sensitivity to light; disorders combining rigidity, tremor and/or movement disorders.

Valsartan

Not known (frequency cannot be estimated from the available data): Decrease in red blood cells, fever, sore throat or mouth sores due to infections; spontaneous bleeding or bruising; high level of potassium in the blood; abnormal liver test results; decreased renal functions and severely decreased renal functions; swelling mainly of the face and the throat; muscle pain; rash, purplish-red spots; fever; itching; allergic reaction; blistering skin (sign of a condition called dermatitis bullous).

If you experience any of these, tell your doctor straight away.

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 By reporting side efects you can help provide more information on the safety of this medicine.

5. How to store Imprida

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.

Do not store above 30°C.

Store in the original package in order to protect from moisture.

Do not use any Imprida pack that is damaged or shows signs of tampering.

«er

6. Contents of the pack and other information

What Imprida contains

• – The active substances of Imprida are amlodipine (as amlodipine besylate) and valsartan. Each tablet contains 10 mg amlodipine and 160 mg valsartan.

• – The other ingredients are cellulose microcrystalline; crospovidone type A; silica, colloidal anhydrous; magnesium stearate; hypromellose; macrogol 4000; talc, titanium dioxide (E171); iron oxide, yellow (E172), iron oxide, red (E172).

What Imprida looks like and contents of the pack

Imprida 5 mg/80 mg tablets are round and dark yellow with “NVR” on one side and “NV” on the other side.

Imprida is available in packs containing 7, 14, 28, 30, 56, 90, 98 or 280 tablets and in multipacks comprising 4 cartons, each containing 70 tablets, or 20 cartons, each containing 14 tablets. All packs are available with standard blisters; the 56, 98 and 280 tablet packs are additionally available with perforated unit dose blisters. Not all pack sizes may be available in your country.

Marketing Authorisation Holder

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

Manufacturer

Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg

Germany

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgiqu­e/Belgien

Novartis Pharma N.V.

Tél/Tel: +32 2 246 16 11

Efc^rapufl

Novartis Pharma Services Inc.

Luxembourg/Lu­xemburg

Novartis Pharma N.V.

Ten.: +359 2 976 98 28

Tél/Tel: +32 2 246 16 11

Česká republika

Novartis s.r.o.

Tel: +420 225 775 111

Danmark

Novartis Healthcare A/S

Tlf: +45 39 16 84 00

E/^á^a

Novartis (Hellas) A.E.B.E.

Tql: +30 210 281 17 12

Norge

Novartis Norge AS

Tlf: +47 23 05 20 00

Österreich

Novartis Pharma GmbH

Tel: +43 1 86 6570

España

Novartis Farmacéutica, S.A.

Tel: +34 93 306 42 00

Polska

Novartis Poland Sp. z o.o

Tel.: +48 22 375 4888

Package leaflet: information for the user

Imprida 5 mg/160 mg film-coated tablets amlodipine/val­sartan

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• – 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 only. Do not pass it on to others. It may harm them,

even if their signs of illness are the same as yours.

• – If you get any side effects, talk to your doctor or pharmacist. This includes any possible side

effects not listed in this leaflet.

What Imprida is and what it is used for

What you need to know before you take Imprida

How to take Imprida

Possible side effects

How to store Imprida

Contents of the pack and other information

What Imprida is and what it is used for

Imprida tablets contain two substances called amlodipine and valsartan. Both of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from

tightening.

Valsartan belongs to a group of substances called “angiotensin-II receptor antagonists”.

Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

This means that both of these substances help to stop the blood vessels tightening. As a result, the blood vessels relax and blood pressure is lowered.

Imprida is used to treat high blood pressure in adults whose blood pressure is not controlled enough

with either amlodipine or valsartan on its own.

ou need to know before you take Imprida e Imprida

u are allergic to amlodipine or to any other calcium channel blockers. This may involve itching, reddening of the skin or difficulty in breathing.

if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, talk to your doctor before taking Imprida.

if you have severe liver problems or bile problems such as biliary cirrhosis or cholestasis.

if you are more than 3 months pregnant. (It is also better to avoid Imprida in early pregnancy, see Pregnancy section).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

• – if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, do not take Imprida and talk to your doctor.

Warnings and precautions

Talk to your doctor before taking Imprida:

if you have been sick (vomiting or diarrhoea).

if you have liver or kidney problems.

if you have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have a condition affecting the renal glands called “primary hyperaldostero­nism”.

if you have had heart failure or have experienced a heart attack. Follow your doctor’s

instructions for the starting dose carefully. Your doctor may also check your kidney function. if your doctor has told you that you have a narrowing of the valves in your heart (called “aortic or mitral stenosis”) or that the thickness of your heart muscle is abnormally increased (called “obstructive hypertrophic cardiomyopathy”).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Imprida and contact your doctor straight away. You should never take Imprida again.

if you are taking any of the following medicines used to tre

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Imprida”.

If any of these apply to you, tell your doctor before taking Imprida.

Children and adolescents

The use of Imprida in children and adolescents is not recommended (aged below 18 years old).

Other medicines and Imprida

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below:

• – ACE inhibitors or aliskiren (see also information under the headings “Do not take Imprida” and “Warnings and precautions”);

• – diuretics (a type of medicine also called “water tablets” which increases the amount of urine you produce);

• – lithium (a medicine used to treat some types of depression);

• – potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium and other substances that may increase potassium levels;

• – certain types of painkillers called non-steroidal anti-inflammatory medicines (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors). Your doctor may also check your kidney function;

• – anticonvulsant agents (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);

• – St. John’s wort;

• – nitroglycerin and other nitrates, or other substances called “vasodilators”;

• – medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);

medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);

medicines used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, talithromycin);

verapamil, diltiazem (heart medicines);

simvastatin (a medicine used to control high cholesterol levels);

dantrolene (infusion for severe body temperature abnormalities);

medicines used to protect against transplant rejection (ciclosporin).

Imprida with food and drink

Grapefruit and grapefruit juice should not be consumed by people who are taking Imprida. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowerin effect of Imprida.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Imprida before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Imprida. Imprida is not recommended in early pregnancy (first 3 months), and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start br eas g. Imprida is not

recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

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

Driving and using machines

This medicine may make you feel dizzy. This can affect how well you can concentrate. So, if you are not sure how this medicine will affect you, do not drive, use machinery, or do other activities that you need to concentrate on.

3. How to take Imprida

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Imprida is one tablet per day.

• – It is pre ferable to take your medicine at the same time each day.

• – s Swallow the tablets with a glass of water.

• – You can take Imprida with or without food. Do not take Imprida with grapefruit or grapefruit

juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

Imprida and older people (age 65 years or over)

Your doctor should exercise caution when increasing your dose.

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

If you take more Imprida than you should

If you have taken too many tablets of Imprida, or if someone else has taken your tablets, consult a doctor immediately.

If you forget to take Imprida

If you forget to take this medicine, take it as soon as you remember. Then take your next dose at its usual time. However, if it is almost time for your next dose, skip the dose you missed. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Imprida

Stopping your treatment with Imprida may cause your disease to get worse. Do not stop taking yo medicine unless your doctor tells you to.

4. Possible side effects

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

Some side effects can be serious and need immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 people). If any of the following happen, tell your doctor straight away:

Allergic reaction with symptoms such as rash, itching, swelling of face or lips or tongue, difficulty breathing, low blood pressure (feeling of faintness, light-headedness).

Other possible side effects of Imprida:

Common (may affect up to 1 in 10 people): Influenza (flu); blocked nose, sore throat and discomfort when swallowing; headache; swelling of arms, hands, legs, ankles or feet; tiredness; asthenia (weakness); redness and warm feeling of the face and/or neck.

Uncommon (may affect up to 1 in 100 people): Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling or numbness of the hands or feet; vertigo; fast heart beat including palpitations; dizziness on standing up; cough; diarrhoea; constipation; skin rash, redness of the skin; joint swelling, back pain; pain in joints.

Rare (may affect up to 1 in 1,000 people): Feeling anxious; ringing in the ears (tinnitus); fainting; passing more urine than normal or feeling more of an urge to pass urine; inability to get or maintain an erection; sensation of heaviness; low blood pressure with symptoms such as dizziness, lightheadedness; excessive sweating; skin rash all over your body; itching; muscle spasm.

If any of these affect you severely, tell your doctor.

Side effects reported with amlodipine or valsartan alone and either not observed with Imprida

or observed with a higher frequency than with Imprida:

Consult a doctor immediately if you experience any of the following very rare, severe side effects after taking this medicine:

• – Sudden wheeziness, chest pain, shortness of breath or difficulty in breathing.

• – Swelling of eyelids, face or lips.

• – Swelling of the tongue and throat which causes great difficulty breathing.

• – Severe skin reactions including intense skin rash, hives, reddening of the skin over your whole

body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson Syndrome) or other allergic reactions.

• – Heart attack, abnormal heart beat.

Inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling of being very unwell.

The following side effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Common (may affect up to 1 in 10 people): Dizziness, sleepiness; palpitations (awareness of your heart beat); flushing, ankle swelling (oedema); abdominal pain, feeling sick (nausea).

Uncommon (may affect up to 1 in 100 people): Mood changes, anxiety, depression, sleeplessness, trembling, taste abnormalities, fainting, loss of pain sensation; visual disturbances, visual impairment, ringing in the ears; low blood pressure; sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis); indigestion, vomiting (being sick); hair loss, increased sweating, itchy skin, skin discolouration; disorder in passing urine, increased need to urinate at night, increased number of times of passing urine; inability to obtain an erection, discomfort or enlargement of the breasts in men, pain, feeling unwell, muscle pain, muscle cramps; weight increase or decrease.

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

Very rare (may affect up to 1 in 10,000 people): Decreased number of white blood cells, decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage); excess sugar in blood (hyperglycaemia); swelling of the gums, abdominal bloating (gastritis); abnormal liver function, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; increased muscle tension; inflammation of blood vessels often with skin rash, sensitivity to light; disorders combining rigidity, tremor and/or movement disorders.

Valsartan

Not known (frequency cannot be estimated from the available data): Decrease in red blood cells, fever, sore throat or mouth sores due to infections; spontaneous bleeding or bruising; high level of potassium in the blood; abnormal liver test results; decreased renal functions and severely decreased renal functions; swelling mainly of the face and the throat; muscle pain; rash, purplish-red spots; fever; itching; allergic reaction; blistering skin (sign of a condition called dermatitis bullous).

If you experience any of these, tell your doctor straight away.

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 By reporting side efects you can help provide more information on the safety of this medicine.

5. How to store Imprida

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.

Do not store above 30°C.

Store in the original package in order to protect from moisture.

Do not use any Imprida pack that is damaged or shows signs of tampering.

«er

6. Contents of the pack and other information

What Imprida contains

• – The active substances of Imprida are amlodipine (as amlodipine besylate) and valsartan. Each

tablet contains 5 mg amlodipine and 160 mg valsartan.

• – The other ingredients are cellulose microcrystalline; crospovidone type A; silica, colloidal

anhydrous; magnesium stearate; hypromellose; macrogol 4000; talc, titanium dioxide (E171); iron oxide, yellow (E172).

What Imprida looks like and contents of the pack

Imprida 5 mg/160 mg tablets are oval and dark yellow “NVR” on one side and “ECE” on the other side.

Imprida is available in packs containing 7, 14, 28, 30, 56, 90, 98 or 280 tablets and in multipacks comprising 4 cartons, each containing 70 tablets, or 20 cartons, each containing 14 tablets. All packs are available with standard blisters; the 56, 98 and 280 tablet packs are additionally available with perforated unit dose blisters. Not all pack sizes may be available in your country.

Marketing Authorisation Holder

Novartis Europharm Limited

Frimley Business Park

Camberley GU16 7SR

United Kingdom

Manufacturer

Novartis Pharma GmbH

Roonstraße 25

D-90429 Nuremberg

Germany

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

România

Novartis Pharma Services Romania SRL

Tel: +40 21 31299 01

Slovenija

Novartis Pharma Services Inc.

Tel: +386 1 300 75 50

Slovenská republika

Novartis Slovakia s.r.o.

Tel: +421 2 5542 5439

Suomi/Finland

Novartis Finland Oy

Puh/Tel: +358 (0)10 6133 200

Sverige

Novartis Sverige AB

Tel: +46 8 732 32 00

United Kingdom

Novartis Pharmaceuticals UK Ltd.

Tel: +44 1276 698370

\O

on the European Medicines Agency web site:

Package leaflet: information for the user

Imprida 10 mg/160 mg film-coated tablets amlodipine/val­sartan

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• – 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 only. Do not pass it on to others. It may harm them,

even if their signs of illness are the same as yours.

• – If you get any side effects, talk to your doctor or pharmacist. This includes any possible side

effects not listed in this leaflet.

What Imprida is and what it is used for

What you need to know before you take Imprida

How to take Imprida

Possible side effects

How to store Imprida

Contents of the pack and other information

What Imprida is and what it is used for

Imprida tablets contain two substances called amlodipine and valsartan. Both of these substances help to control high blood pressure.

Amlodipine belongs to a group of substances called “calcium channel blockers”. Amlodipine stops calcium from moving into the blood vessel wall which stops the blood vessels from

tightening.

Valsartan belongs to a group of substances called “angiotensin-II receptor antagonists”.

Angiotensin II is produced by the body and makes the blood vessels tighten, thus increasing the blood pressure. Valsartan works by blocking the effect of angiotensin II.

This means that both of these substances help to stop the blood vessels tightening. As a result, the blood vessels relax and blood pressure is lowered.

Imprida is used to treat high blood pressure in adults whose blood pressure is not controlled enough

with either amlodipine or valsartan on its own.

ou need to know before you take Imprida e Imprida

u are allergic to amlodipine or to any other calcium channel blockers. This may involve itching, reddening of the skin or difficulty in breathing.

if you are allergic to valsartan or any of the other ingredients of this medicine (listed in section 6). If you think you may be allergic, talk to your doctor before taking Imprida.

if you have severe liver problems or bile problems such as biliary cirrhosis or cholestasis.

if you are more than 3 months pregnant. (It is also better to avoid Imprida in early pregnancy, see Pregnancy section).

if you have severe low blood pressure (hypotension).

if you have narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition where your heart is unable to supply enough blood to the body).

if you suffer from heart failure after a heart attack.

• – if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.

If any of the above applies to you, do not take Imprida and talk to your doctor.

Warnings and precautions

Talk to your doctor before taking Imprida:

if you have been sick (vomiting or diarrhoea).

if you have liver or kidney problems.

if you have had a kidney transplant or if you had been told that you have a narrowing of your kidney arteries.

if you have a condition affecting the renal glands called “primary hyperaldostero­nism”.

if you have had heart failure or have experienced a heart attack. Follow your doctor’s

instructions for the starting dose carefully. Your doctor may also check your kidney function. if your doctor has told you that you have a narrowing of the valves in your heart (called “aortic or mitral stenosis”) or that the thickness of your heart muscle is abnormally increased (called “obstructive hypertrophic cardiomyopathy”).

if you have experienced swelling, particularly of the face and throat, while taking other medicines (including angiotensin converting enzyme inhibitors). If you get these symptoms, stop taking Imprida and contact your doctor straight away. You should never take Imprida again.

if you are taking any of the following medicines used to tre

an ACE inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.

aliskiren.

Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.

See also information under the heading “Do not take Imprida”.

If any of these apply to you, tell your doctor before taking Imprida.

Children and adolescents

The use of Imprida in children and adolescents is not recommended (aged below 18 years old).

Other medicines and Imprida

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Your doctor may need to change your dose and/or to take other precautions. In some cases you may have to stop taking one of the medicines. This applies especially to the medicines listed below:

• – ACE inhibitors or aliskiren (see also information under the headings “Do not take Imprida” and “Warnings and precautions”);

• – diuretics (a type of medicine also called “water tablets” which increases the amount of urine you produce);

• – lithium (a medicine used to treat some types of depression);

• – potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium and other substances that may increase potassium levels;

• – certain types of painkillers called non-steroidal anti-inflammatory medicines (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors). Your doctor may also check your kidney function;

• – anticonvulsant agents (e.g. carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone);

• – St. John’s wort;

• – nitroglycerin and other nitrates, or other substances called “vasodilators”;

• – medicines used for HIV/AIDS (e.g. ritonavir, indinavir, nelfinavir);

medicines used to treat fungal infections (e.g. ketoconazole, itraconazole);

medicines used to treat bacterial infections (such as rifampicin, erythromycin, clarithromycin, talithromycin);

verapamil, diltiazem (heart medicines);

simvastatin (a medicine used to control high cholesterol levels);

dantrolene (infusion for severe body temperature abnormalities);

medicines used to protect against transplant rejection (ciclosporin).

Imprida with food and drink

Grapefruit and grapefruit juice should not be consumed by people who are taking Imprida. This is because grapefruit and grapefruit juice can lead to an increase in the blood levels of the active substance amlodipine, which can cause an unpredictable increase in the blood pressure lowerin effect of Imprida.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Imprida before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Imprida. Imprida is not recommended in early pregnancy (first 3 months), and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start br eas g. Imprida is not

recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

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

Driving and using machines

This medicine may make you feel dizzy. This can affect how well you can concentrate. So, if you are not sure how this medicine will affect you, do not drive, use machinery, or do other activities that you need to concentrate on.

3. How to take Imprida

Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. This will help you get the best results and lower the risk of side effects.

The usual dose of Imprida is one tablet per day.

• – It is pre ferable to take your medicine at the same time each day.

• – s Swallow the tablets with a glass of water.

• – You can take Imprida with or without food. Do not take Imprida with grapefruit or grapefruit

juice.

Depending on how you respond to the treatment, your doctor may suggest a higher or lower dose.

Do not exceed the prescribed dose.

Imprida and older people (age 65 years or over)

Your doctor should exercise caution when increasing your dose.

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

If you take more Imprida than you should

If you have taken too many tablets of Imprida, or if someone else has taken your tablets, consult a doctor immediately.

If you forget to take Imprida

If you forget to take this medicine, take it as soon as you remember. Then take your next dose at its usual time. However, if it is almost time for your next dose, skip the dose you missed. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Imprida

Stopping your treatment with Imprida may cause your disease to get worse. Do not stop taking yo medicine unless your doctor tells you to.

4. Possible side effects

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

Some side effects can be serious and need immediate medical attention:

A few patients have experienced these serious side effects (may affect up to 1 in 1,000 people). If any of the following happen, tell your doctor straight away:

Allergic reaction with symptoms such as rash, itching, swelling of face or lips or tongue, difficulty breathing, low blood pressure (feeling of faintness, light-headedness).

Other possible side effects of Imprida:

Common (may affect up to 1 in 10 people): Influenza (flu); blocked nose, sore throat and discomfort when swallowing; headache; swelling of arms, hands, legs, ankles or feet; tiredness; asthenia (weakness); redness and warm feeling of the face and/or neck.

Uncommon (may affect up to 1 in 100 people): Dizziness; nausea and abdominal pain; dry mouth; drowsiness, tingling or numbness of the hands or feet; vertigo; fast heart beat including palpitations; dizziness on standing up; cough; diarrhoea; constipation; skin rash, redness of the skin; joint swelling, back pain; pain in joints.

Rare (may affect up to 1 in 1,000 people): Feeling anxious; ringing in the ears (tinnitus); fainting; passing more urine than normal or feeling more of an urge to pass urine; inability to get or maintain an erection; sensation of heaviness; low blood pressure with symptoms such as dizziness, lightheadedness; excessive sweating; skin rash all over your body; itching; muscle spasm.

If any of these affect you severely, tell your doctor.

Side effects reported with amlodipine or valsartan alone and either not observed with Imprida or observed with a higher frequency than with Imprida:

Amlodipi neC^

Consult a doctor immediately if you experience any of the following very rare, severe side effects after taking this medicine:

• – Sudden wheeziness, chest pain, shortness of breath or difficulty in breathing.

• – Swelling of eyelids, face or lips.

• – Swelling of the tongue and throat which causes great difficulty breathing.

• – Severe skin reactions including intense skin rash, hives, reddening of the skin over your whole

body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson Syndrome) or other allergic reactions.

• – Heart attack, abnormal heart beat.

• – Inflamed pancreas, which may cause severe abdominal and back pain accompanied with feeling

of being very unwell.

The following side effects have been reported. If any of these cause you problems or if they last for more than one week, you should contact your doctor.

Common (may affect up to 1 in 10 people): Dizziness, sleepiness; palpitations (awareness of your heart beat); flushing, ankle swelling (oedema); abdominal pain, feeling sick (nausea).

Uncommon (may affect up to 1 in 100 people): Mood changes, anxiety, depression, sleeplessness, trembling, taste abnormalities, fainting, loss of pain sensation; visual disturbances, visual impairment, ringing in the ears; low blood pressure; sneezing/runny nose caused by inflammation of the lining of the nose (rhinitis); indigestion, vomiting (being sick); hair loss, increased sweating, itchy skin, skin discolouration; disorder in passing urine, increased need to urinate at night, increased number of times of passing urine; inability to obtain an erection, discomfort or enlargement of the breasts in men, pain, feeling unwell, muscle pain, muscle cramps; weight increase or decrease.

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

Very rare (may affect up to 1 in 10,000 people): Decreased number of white blood cells, decrease in blood platelets which may result in unusual brusing or easy bleeding (red blood cell damage); excess sugar in blood (hyperglycaemia); swelling of the gums, abdominal bloating (gastritis); abnormal liver function, inflammation of the liver (hepatitis), yellowing of the skin (jaundice), liver enzyme increase which may have an effect on some medical tests; increased muscle tension; inflammation of blood vessels often with skin rash, sensitivity to light; disorders combining rigidity, tremor and/or movement disorders.

Valsartan

Not known (frequency cannot be estimated from the available data): Decrease in red blood cells, fever, sore throat or mouth sores due to infections; spontaneous bleeding or bruising; high level of potassium in the blood; abnormal liver test results; decreased renal functions and severely decreased renal functions; swelling mainly of the face and the throat; muscle pain; rash, purplish-red spots; fever; itching; allergic reaction; blistering skin (sign of a condition called dermatitis bullous).

If you experience any of these, tell your doctor straight away.

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 By reporting side efects you can help provide more information on the safety of this medicine.

5. How to store Imprida

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.

Do not store above 30°C.

Store in the original package in order to protect from moisture.

Do not use any Imprida pack that is damaged or shows signs of tampering.

«er

6. Contents of the pack and other information

What Imprida contains

• – The active substances of Imprida are amlodipine (as amlodipine besylate) and valsartan. Each tablet contains 10 mg amlodipine and 160 mg valsartan.

• – The other ingredients are cellulose microcrystalline; crospovidone type A; silica, colloidal anhydrous; magnesium stearate; hypromellose; macrogol 4000; talc, titanium dioxide (E171); iron oxide, yellow (E172), iron oxide, red (E172).