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Vizarsin
sildenafil

Package leaflet: Information for the user


Vizarsin 25 mg film-coated tablets

sildenafil


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

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- If you are taking riociguat. This drug is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs secondary to blood clots). PDE5 inhibitors, such as Vizarsin have been shown to increase the hypotensive effects of this medicine. If you are taking riociguat or are unsure tell your doctor.



You should not use Vizarsin with any other oral or local treatments for erectile dysfunction.


You should not use Vizarsin with treatments for pulmonary arterial hypertension (PAH) containing sildenafil or any other PDE5 inhibitors.


You should not take Vizarsin if you do not have erectile dysfunction. You should not take Vizarsin if you are a woman.

Special considerations for patients with kidney or liver problems

You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you.


Children and adolescents

Vizarsin should not be given to individuals under the age of 18.


Other medicines and Vizarsin

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


Vizarsin tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell your doctor, pharmacist or nurse that you have taken Vizarsin and when you did. Do not take Vizarsin with other medicines unless your doctor tells you that you can.


You should not take Vizarsin if you are taking medicines called nitrates, as the combination of these medicines may lead to a dangerous fall in your blood pressure. Always tell your doctor, pharmacist or nurse if you are taking any of these medicines that are often used for the relief of angina pectoris (or “chest pain”).


You should not take Vizarsin if you are using any of the medicines known as nitric oxide donors such as amyl nitrite (“poppers”) as the combination may also lead to a dangerous fall in your blood pressure.


Tell your doctor or pharmacist if you are already taking riociguat.

If you are taking medicines known as protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of Vizarsin.


Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light-headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking Vizarsin with alpha-blockers. This is most likely to happen within 4 hours after taking Vizarsin.

To reduce the chance that these symptoms might happen, you should be on a regular daily dose of your alpha-blocker before you start Vizarsin. Your doctor may start you on a lower dose (25 mg) of Vizarsin.


Tell your doctor or pharmacist if you are taking medicines containing sacubitril/valsartan, used to treat heart failure.


Vizarsin with food, drink and alcohol

Vizarsin can be taken with or without food. However, you may find that Vizarsin takes longer to start working if you take it with a heavy meal.


Drinking alcohol can temporarily impair your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink excessive amounts of alcohol before taking Vizarsin.


Pregnancy and breast-feeding

Vizarsin is not indicated for use by women.


Driving and using machines

Vizarsin can cause dizziness and can affect vision. You should be aware of how you react to Vizarsin before you drive or use machinery.


Vizarsin contains lactose and sodium

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

This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium- free’.


  1. How to take Vizarsin


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


    The recommended starting dose is 50 mg.


    You should not take Vizarsin more than once a day.


    You should take Vizarsin about one hour before you plan to have sex. Swallow the tablet whole with a glass of water.

    If you feel that the effect of Vizarsin is too strong or too weak, talk to your doctor or pharmacist. Vizarsin will only help you to get an erection if you are sexually stimulated. The amount of time

    Vizarsin takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that Vizarsin takes longer to work if you take it with a heavy meal.


    If Vizarsin does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.


    If you take more Vizarsin than you should

    You may experience an increase in side effects and their severity. Doses above 100 mg do not increase the efficacy.


    You should not take more tablets than your doctor tells you to.


    Contact your doctor if you take more tablets than you should.


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


  2. Possible side effects


    Like all medicines, this medicine can cause side effects, although not everybody gets them. The side effects reported in association with the use of Vizarsin are usually mild to moderate and of a short duration.


    If you experience any of the following serious side effects stop taking Vizarsin and seek medical help immediately:


    • An allergic reaction - this occurs uncommonly (may affect up to 1 in 100 people) Symptoms include sudden wheeziness, difficulty in breathing or dizziness, swelling of the eyelids, face, lips or throat.


    • Chest pains - this occurs uncommonly

      If this occurs during or after intercourse:

      • Get in a semi-sitting position and try to relax.

      • Do not use nitrates to treat your chest pain.


    • Prolonged and sometimes painful erections - this occurs rarely (may affect up to 1 in 1,000 people)

      If you have an erection which lasts for more than 4 hours, you should contact a doctor immediately.


    • A sudden decrease or loss of vision - this occurs rarely


    • Serious skin reactions - this occurs rarely

      Symptoms may include severe peeling and swelling of the skin, blistering of the mouth, genitals

      and around the eyes, fever.


    • Seizures or fits - this occurs rarely Other side effects:

      Very common (may affect more than 1 in 10 people): headache.


      Common (may affect up to 1 in 10 people): nausea, facial flushing, hot flush (symptoms include a sudden feeling of heat in your upper body), indigestion, colour tinge to vision, blurred vision, visual disturbance, stuffy nose and dizziness.


      Uncommon (may affect up to 1 in 100 people): vomiting, skin rash, eye irritation, bloodshot eyes /red eyes, eye pain, seeing flashes of light, visual brightness, light sensitivity, watery eyes, pounding heartbeat, rapid heartbeat, high blood pressure, low blood pressure, muscle pain, feeling sleepy, reduced sense of touch, vertigo, ringing in the ears, dry mouth, blocked or stuffy sinuses, inflammation of the lining of the nose (symptoms include runny nose, sneezing and stuffy nose), upper abdominal pain, gastro-oesophageal reflux disease (symptoms include heartburn), presence of blood in urine, pain in the arms or legs, nosebleed, feeling hot and feeling tired.

      Rare (may affect up to 1 in 1000 people): fainting, stroke, heart attack, irregular heartbeat, temporary decreased blood flow to parts of the brain, feeling of tightening of the throat, numb mouth, bleeding at the back of the eye, double vision, reduced sharpness of vision, abnormal sensation in the eye, swelling of the eye or eyelid, small particles or spots in your vision, seeing halos around lights, dilation of the pupil of the eye, discolouration of the white of the eye, penile bleeding, presence of blood in semen, dry nose, swelling of the inside of the nose, feeling irritable and sudden decrease or loss of hearing.


      From post-marketing experience cases of unstable angina (a heart condition) and sudden death have been reported rarely. Of note, most but not all, of the men who experienced these side effects had heart problems before taking this medicine. It is not possible to determine whether these events were

      directly related to Vizarsin.


      Reporting of side effects

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

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      not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.


  3. How to store Vizarsin


    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 box and blister after EXP. The expiry date refers to the last day of that month.


    This medicine does not require any special storage conditions.


    Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.


  4. Contents of the pack and other information What Vizarsin contains

Tablet core: microcrystalline cellulose (E460), calcium hydrogen phosphate, croscarmellose sodium, hypromellose (E464), magnesium stearate (E470b).

Film coating: lactose monohydrate, hypromellose (E464), titanium dioxide (E171), triacetin

(E1518).

See section 2 “Vizarsin contains lactose and sodium”.


What Vizarsin looks like and contents of the pack

Vizarsin 25 mg film-coated tablets are white, oblong and marked “25” on one side.


Vizarsin 25 mg film-coated tablets are available in boxes of 1 film-coated tablet in blisters and also in boxes of 4 x 1, 8 x 1 or 12 x 1 film-coated tablet in a perforated unit dose blisters.

Not all pack sizes may be marketed.


Marketing Authorisation Holder and Manufacturer

KRKA, d.d., Novo mesto, Šmarješka cesta 6, 8501 Novo mesto, Slovenia


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

België/Belgique/Belgien

KRKA Belgium, SA.

Tél/Tel: + 32 (0) 487 50 73 62

Lietuva

UAB KRKA Lietuva

Tel: + 370 5 236 27 40


България

КРКА България ЕООД Teл.: + 359 (02) 962 34 50

Luxembourg/Luxemburg

KRKA Belgium, SA.

Tél/Tel: + 32 (0) 487 50 73 62 (BE)


Česká republika

KRKA ČR, s.r.o.

Tel: + 420 (0) 221 115 150

Magyarország

KRKA Magyarország Kereskedelmi Kft. Tel.: + 36 (1) 355 8490


Danmark

KRKA Sverige AB

Tlf: + 46 (0)8 643 67 66 (SE)

Malta

E. J. Busuttil Ltd.

Tel: + 356 21 445 885


Deutschland

TAD Pharma GmbH

Tel: + 49 (0) 4721 606-0

Nederland

KRKA Belgium, SA.

Tel: + 32 (0) 487 50 73 62 (BE)


Eesti

KRKA, d.d., Novo mesto Eesti filiaal

Tel: + 372 (0) 6 671 658

Norge

KRKA Sverige AB

Tlf: + 46 (0)8 643 67 66 (SE)


Ελλάδα

KRKA ΕΛΛΑΣ ΕΠΕ

Τηλ: + 30 2100101613

Österreich

KRKA Pharma GmbH, Wien

Tel: + 43 (0)1 66 24 300


España

KERN PHARMA, S.L. Tel: + 34 93 700 25 25

Polska

KRKA-POLSKA Sp. z o.o. Tel.: + 48 (0)22 573 7500


France

KRKA France Eurl

Tél: + 33 (0)1 57 40 82 25

Portugal

KRKA Farmacêutica, Sociedade Unipessoal Lda. Tel: + 351 (0)21 46 43 650


Hrvatska

KRKA - FARMA d.o.o. Tel: + 385 1 6312 100

România

KRKA Romania S.R.L., Bucharest Tel: + 4 021 310 66 05


Ireland

KRKA Pharma Dublin, Ltd.

Tel: + 353 1 413 3710

Slovenija

KRKA, d.d., Novo mesto

Tel: + 386 (0) 1 47 51 100


Ísland

LYFIS ehf.

Sími: + 354 534 3500

Slovenská republika KRKA Slovensko, s.r.o. Tel: + 421 (0) 2 571 04 501


Italia

KRKA Farmaceutici Milano S.r.l. Tel: + 39 02 3300 8841

Suomi/Finland

KRKA Finland Oy

Puh/Tel: + 358 20 754 5330


Κύπρος

KI.PA. (PHARMACAL) LIMITED Τηλ: + 357 24 651 882

Sverige

KRKA Sverige AB

Tel: + 46 (0)8 643 67 66 (SE)

Latvija

KRKA Latvija SIA Tel: + 371 6 733 86 10

United Kingdom (Northern Ireland)

Consilient Health Limited Tel: + 353 (0)1 2057760


This leaflet was last revised in