What is a Patient Information Leaflet and why is it useful?

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged.

Below is a text only representation of the Patient Information Leaflet. The original leaflet can be viewed using the link above.

The text only version may be available in large print, Braille or audio CD. For further information call emc accessibility on 0800 198 5000. The product code(s) for this leaflet is: PL 00093/0022.


Natrilix

Package leaflet: Information for the user

natrilix ® 2.5 mg Tablets

indapamide

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. See section 4.

What is in this leaflet

1. What Natrilix is and what it is used for
2. What you need to know before you take Natrilix
3. How to take Natrilix
4. Possible side effects
5. How to store Natrilix
6. Contents of the pack and other information

1. What Natrilix is and what it is used for

Natrilix is a film-coated tablet containing indapamide as active ingredient.

This medicine is intended to reduce high blood pressure (hypertension) in adults.

lndapamide is a diuretic. Most diuretics increase the amount of urine produced by the kidneys. However, indapamide is different from other diuretics, as it only causes a slight increase in the amount of urine produced.

In addition, indapamide widens blood vessels so that blood passes through more easily. This helps to lower blood pressure.

2. What you need to know before you take Natrilix

Do not take Natrilix

  • if you are allergic to indapamide or any other sulfonamide or to any of the other ingredients of this medicine (listed in section 6),
  • if you have severe kidney disease,
  • if you have severe liver disease or suffer from a condition called hepatic encephalopathy (liver problems which affect the brain and central nervous system),
  • if you have low potassium levels in your blood.

Warnings and precautions

Talk to your doctor or pharmacist before taking Natrilix:

  • if you have liver problems,
  • if you have diabetes,
  • if you suffer from gout,
  • if you have any heart rhythm problems or problems with your kidneys,
  • if you need to have a test to check how well your parathyroid gland is working.

You should tell your doctor if you have had photosensitivity reactions.

Your doctor may give you blood tests to check for low sodium or potassium levels or high calcium levels.

If you think any of these situations may apply to you or you have any questions or doubts about taking your medicine, you should consult your doctor or pharmacist.

Athletes should be aware that this medicine contains an active ingredient, which may give a positive reaction in doping tests.

Other medicines and Natrilix

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

You should not take Natrilix with lithium (used to treat depression) due to the risk of increased levels of lithium in the blood.

Make sure to tell your doctor if you are taking any of the following medicines, as special care may be required:

  • medicines used for heart rhythm problems (e.g. quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, ibutilide, dofetilide, digitalis),
  • medicines used to treat mental disorders such as depression, anxiety, schizophrenia (e.g. tricyclic antidepressants, antipsychotic drugs, neuroleptics),
  • bepridil (used to treat angina pectoris, a condition causing chest pain),
  • cisapride (used to treat reduced movement of the gullet and stomach),
  • diphemanil (used to treat gastro-intestinal problems such as ulcers, too much acid, overactive digestive system),
  • sparfloxacin, moxifloxacin, erythromycin by injection (antibiotics used to treat infections),
  • vincamine by injection (used to treat symptomatic cognitive disorders in elderly including memory loss),
  • halofantrine (antiparasitic drug used to treat certain types of malaria),
  • pentamidine (used to treat certain types of pneumonia),
  • mizolastine (used to treat allergic reactions, such as hay fever),
  • non-steroidal anti-inflammatory drugs for pain relief (e.g. ibuprofen) or high doses of acetylsalicylic acid,
  • angiotensin converting enzyme (ACE) inhibitors (used to treat high blood pressure and heart failure),
  • amphotericin B by injection (anti-fungal medicines),
  • oral corticosteroids used to treat various conditions including severe asthma and rheumatoid arthritis,
  • stimulant laxatives,
  • baclofen (to treat muscle stiffness occurring in diseases such as multiple sclerosis),
  • allopurinol (for the treatment of gout),
  • potassium-sparing diuretics (amiloride, spironolactone, triamterene),
  • metformin (to treat diabetes),
  • iodinated contrast media (used for tests involving X-rays),
  • calcium tablets or other calcium supplements,
  • ciclosporin, tacrolimus or other medicines to depress the immune system after organ transplantation, to treat autoimmune diseases, or severe rheumatic or dermatological diseases,
  • tetracosactide (to treat Crohn's disease).

Pregnancy and breast-feeding

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

This medicine is not recommended during pregnancy. When a pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible. Please tell your doctor it you are pregnant or wish to become pregnant.

The active ingredient is excreted in milk. Breast-feeding is not advisable it you are taking this medicine.

Driving and using machines

This medicine can cause side effects such as dizziness or tiredness due to lowering of the blood pressure (see section 4).

These side effects are more likely to occur after initiation of the treatment and after dose increases. If this occurs, you should refrain from driving and other activities requiring alertness. However, under good control, these side effects are unlikely to occur.

Natrilix contains lactose monohydrate

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

3. How to take Natrilix

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 dose is one tablet each day, preferably in the morning.

The tablets can be taken with or without food. They should be swallowed whole with water.

Treatment for high blood pressure is usually life-long.

If you take more Natrilix than you should

If you have taken too many tablets, contact your doctor or pharmacist immediately.

A very large dose of Natrilix could cause nausea (feeling sick), vomiting, low blood pressure, cramps, dizziness, drowsiness, confusion and changes in the amount of urine produced by the kidneys.

If you forget to take Natrilix

If you forget to take a dose of your medicine, take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose.

If you stop taking Natrilix

As the treatment for high blood pressure is usually life-long, you should discuss with your doctor before stopping this medicinal product.

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

4. Possible side effects

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

Stop taking the medicinal product and see a doctor immediately, if you experience any of the following side effects:

  • Angioedema and/or urticaria. Angioedema is characterised by swelling of the skin of extremities or face, swelling of the lips or tongue, swelling of the mucous membranes of the throat or airways resulting in shortness of breath or difficulty of swallowing. If this occurs, contact your doctor immediately (Very rare) (may affect up to 1 in 10,000 people)
  • Severe skin reactions including intense skin rash, reddening of the skin over your whole body, severe itching, blistering, peeling and swelling of the skin, inflammation of mucous membranes (Stevens Johnson Syndrome) or other allergic reactions (Very rare) (may affect up to 1 in 10,000 people)
  • Life-threatening irregular beat (Not known)
  • inflamed pancreas which may cause severe abdominal and back pain accompanied with feeling very unwell (Very rare) (may affect up to 1 in 10,000 people)
  • Disease of the brain caused by liver illness (Hepatic encephalopathy) (Not known)
  • Inflammation of the liver (Hepatitis) (Not known)

In decreasing order of frequency, other side effects can include:

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

  • Red raised skin rash;
  • Allergic reactions, mainly dermatological, such as skin rashes in subjects with a predisposition to allergic and asthmatic reactions.

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

  • Vomiting;
  • Red pinpoints on skin (Purpura).

Rare (may affect up to 1 in 1000 people):

  • Feeling of tiredness, headache, pins and needles (paraesthesia), vertigo;
  • Gastro-intestinal disorders such as nausea (feeling sick) or constipation, dry mouth.

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

  • Changes in blood cells, such as thrombocytopenia (decrease in the number of platelets which causes easy bruising and nasal bleeding), leucopenia (decrease of white blood cells which may cause unexplained fever, soreness of the throat or other flu-like symptoms - it this occurs, contact your doctor) and anaemia (decrease in red blood cells);
  • High level of calcium in blood;
  • Heart rhythm irregularities (causing palpitations, feeling of the heart pounding), low blood pressure;
  • Kidney disease (causing symptoms of tiredness, increased need to urinate, itchy skin, feeling sick, swollen extremities):
  • Abnormal hepatic function.

Not known:

  • Fainting;
  • lf you suffer from systemic lupus erythematosus (a type of collagen disease), this might get worse;
  • Cases of photosensitivity reactions (change in skin appearance) after exposure to the sun or artificial UVA have also been reported;
  • Short sightedness (myopia);
  • Blurred vision;
  • Visual impairment;
  • Changes may occur in your blood and your doctor may need to give you blood tests to check your condition. The following changes in your blood test results may occur:
    • low potassium in the blood,
    • low sodium in the blood that may lead to dehydration and low blood pressure,
    • increase in uric acid, a substance which may cause or worsen gout (painful joint(s) especially in the feet),
    • increase in blood glucose levels in diabetic patients,
    • increased levels of liver enzymes;
  • Abnormal ECG heart tracing.

Reporting of side effects

lf 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 Yellow Card scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Natrilix

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

Do not store above 25°C.

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

6. Contents of the pack and other information

What Natrilix contains

The active substance is indapamide. Each tablet contains 2.5 mg of indapamide.

The other ingredients are:

  • tablet core: lactose monohydrate, maize starch, magnesium stearate (E470B), talc (E553B), povidone
  • film-coating: glycerol (E422), white beeswax (E901), sodium lauryl sulfate (E514), hypromellose (E464), macrogol 6000, magnesium stearate (E470B), titanium dioxide (E171).

What Natrilix looks like and contents of the pack

This medicine is a white, round film-coated tablet.

The tablets are available in blisters of 30 or 60 tablets packed in a cardboard box. Not all pack sizes may be marketed.

Marketing Authorisation Holder and manufacturer

Marketing Authorisation Holder

Servier Laboratories Ltd
Sefton Park
Stoke Poges
SL2 4JS
United Kingdom

Manufacturers

Les Laboratoires Servier lndustrie
905 route de Saran
45520 Gidy
France

and

Servier (Ireland) Industries Ltd
Gorey Road
Co. Wicklow
Arklow
Ireland

This leaflet was last revised in 01/2018