PACKAGE LEAFLET: INFORMATION FOR THE USER Phenindione 10 mg Tablets, Phenindione 25 mg Tablets Read all of this leaflet carefully before you start Tell your doctor if any of the above applies to you as taking this medicine because it contains they may alter the effect of Phenindione Tablets and important information for you. require an adjustment of the dose. - Keep this leaflet. You may need to read it again. Other medicines and Phenindione Tablets Tell your doctor or pharmacist if you are taking, have - If you have any further questions, ask your recently taken or might take any other medicines, doctor, pharmacist or nurse. including medicines obtained without a prescription or - This medicine has been prescribed for you only. herbal remedies. Phenindione Tablets may affect or be Do not pass it on to others. It may harm them, affected by any of the medicines below which are used even if their signs of illness are the same as to treat the following conditions: yours. • heart problems e.g. amiodarone and propafenone - If you get any side effects, talk to your doctor, • prevent the formation of blood clots e.g. pharmacist or nurse. This includes any possible clopidogrel, bivalirudin, dabigatran, heparin, side effects not listed in this leaflet. See section 4. fondaparinux, rivaroxaban, danaparoid • clot dissolving medications (e.g. streptokinase, The name of your medicine is Phenindione 10 mg alteplase) Tablets, Phenindione 25 mg Tablets. It will be referred to • problems with platelet aggregation (blood cells as ‘Phenindione Tablets’ for ease hereafter. sticking together) e.g. dipyridamole, eptifibatide, What is in this leaflet tirofiban and abciximab, prostacyclin 1. What Phenindione Tablets are and what they are • depression e.g. amitriptyline, nortriptyline, used for citalopram, venlafaxine 2. What you need to know before you take • pain and inflammation e.g. paracetamol, aspirin, Phenindione Tablets ibuprofen, piroxicam, flurbiprofen, indometacin, 3. How to take Phenindione Tablets sulindac, azapropazone, diflunisal, 4. Possible side effects corticosteroids 5. How to store Phenindione Tablets • high levels of lipids (fats) in the blood and drugs 6. Contents of the pack and other information which lower cholesterol levels e.g. clofibrate • infection e.g. antibiotics such as ciprofloxacin, 1. WHAT PHENINDIONE TABLETS ARE metronidazole, norfloxacin, co-trimoxazole, AND WHAT THEY ARE USED FOR erythromycin, tetracyclines, cefamandole, Phenindione Tablets (either 10 or 25 mg) belong to a chloramphenicol, rifampicin, neomycin, group of medicines called anticoagulants. These aztreonam, sulfamethoxazole medicines increase the time it takes for your blood to • fungal infections e.g. miconazole clot. • stomach ulcers or excessive production of Phenindione is used to prevent and treat blood clots stomach acid e.g. cimetidine, sucralfate, in the veins and arteries, for example clots in the legs, cholestyramine lungs, brain or heart. • diabetes e.g. tolbutamide, phenformin and The tablets come in two strengths: 10 mg (creamy glucagon white) and 25 mg (green). • various inflammatory problems such as asthma e.g. prednisolone, zafirlukast 2. WHAT YOU NEED TO KNOW BEFORE • gout e.g. allopurinol, sulfinpyrazone YOU TAKE PHENINDIONE TABLETS • cancer e.g. ipilimumab, dasatinib and imatinib • difficulty in sleeping e.g. phenobarbital Do not take Phenindione Tablets • osteoarthritis pain (glucosamine) • if you are allergic to Phenindione or any of the • chronic alcoholism e.g. disulfiram other ingredients of this medicine (listed in • thyroid problems e.g. thyroxine section 6) • epilepsy e.g. barbiturates, carbamazepine, • if you have severe liver or kidney problems primidone, phenytoin • if you are pregnant or trying for a baby • joint and muscular pain (feprazone, • if you within the last 72 hours have had an oxyphenbutazone and phenylbutazone) operation or you have given birth within the last • pain killers (dextropropoxyphene) 48 hours • obesity e.g. orlistat • if you are currently breast-feeding • stress (ACTH, released in the body in response to • if you suffer from any unusual bruising or bleeding biological stress). • if you suffer from uncontrolled high blood If you are taking the following, tell your doctor pressure • oral contraceptives • if you have an infection of the tissues lining the • anabolic steroids such as stanozolol (used to heart called bacterial endocarditis promote muscle growth) • if you have a rare problem of sugar intolerance • vitamin supplements e.g. Vitamin K or Cod Liver • if your doctor has told you that you have bleeding Oil (or other dietary intake high in fats or oils). within the brain (hemorrhagic stroke). The dose of Phenindione Tablets will need to be Warnings and precautions checked regularly if any other medicines are also Talk to your doctor, pharmacist or nurse before taking used at the same time. Many medications interact Phenindione Tablets with Phenindione, so please inform your doctor if you • if you have a painful skin rash. On rare occasions are taking any other medicines including over the Phenindione Tablets can cause serious skin counter medicines, herbal (St. John's Wart) or vitamin conditions, including one called calciphylaxis that preparations. can start with a painful skin rash but can lead to serious complications. This adverse reaction Regular blood tests occurs more frequently in patients with chronic You will have regular blood tests to see how long it takes for your blood to clot. These blood tests are kidney disease very important to make sure you are taking the right • if you are elderly dose. Blood tests will be more frequent if you have • if you have recently lost or gained a lot of weight had your dose of phenindione changed, if you have • if you have any short term illness started or stopped taking other medicines or have • if you have a problem with your kidneys or liver, liver or kidney problems. which is not classed as severe • if you are being sick or have diarrhea Phenindione Tablets with food, drink and alcohol • if you are changing your diet, which may result in • do not drink large amounts of alcohol when taking an increase or decrease of Vitamin K Phenindione Tablets. Discuss this with your doctor • if you have protein C or S deficiency (blood if you are worried about anything clotting disorders) • avoid drinking Cranberry juice • if you have a disease of the brain and blood • some foods like liver, broccoli, brussels sprouts vessels (cerebrovascular disease) and green leafy vegetables may interfere with the • if you have major heart disease action of Phenindione • if you have low levels of iron in the blood (which • avoid taking any food supplements when taking may lead to pale appearance of the eyes and skin) Phenindione. • if you have had a major injury Pregnancy and breast-feeding • if you have ulcers in your stomach If you are pregnant or breast-feeding, think you may • if you have bleeding in the stomach or intestines be pregnant or are planning to have a baby, ask your • if you have either an increase or decrease in the doctor or pharmacist for advice before taking this levels of thyroid hormone medicine. • if you have cancer Pregnancy • if you have decreased blood supply to a part of Phenindione Tablets should not be taken if you are the brain (ischemic stroke) pregnant, think you are pregnant or are planning to • if you are going to have surgery. The doctor may become pregnant. If you think you may have become have to change your dose or stop your pregnant, contact your doctor as soon as possible. Phenindione treatment Phenindione Tablets can have an adverse effect on • if you have stopped smoking. the unborn child and alternative medicines are The following side-effects have been reported: available. Not known (frequency cannot be estimated from Breast-feeding the available data) Speak to your doctor before taking this medicine if • blood disorders (your doctor will do tests to check you are breast-feeding. this) Driving and using machines • loose stools (Diarrhoea) Phenindione Tablets should not affect your ability to • loss of consciousness, fits, numbness, headache, drive or use machines. dizziness, feeling or being sick, slurred speech, blurred vision. These could be signs that there is Phenindione Tablets contain lactose which is a bleeding or formation of blood clots in your brain form of sugar. If you have been told by your doctor • difficulty in breathing and chest pain due to that you have an intolerance to some sugars, contact collection of blood in the chest your doctor before taking this medicinal product. • bleeding from cuts and wounds or the nose 3. HOW TO TAKE PHENINDIONE • vomiting of blood TABLETS • black or red stools which might be due to bleeding from the stomach, intestine or rectum Always take this medicine exactly as your doctor or • severe stomach or back pain pharmacist has told you. Check with your doctor or • taste disturbance pharmacist if you are not sure. Read the label on the • fever container to see how many Phenindione Tablets to • unusual bleeding from the stomach, intestine or take and how often to take them. rectum The recommended dose for Phenindione 10mg Tablets • pancreatitis presenting as severe stomach or is: back pain • usual starting dose of 200mg (20 tablets) on the • dark red or brown coloured urine which might be first day due to bleeding in your kidneys or bladder • after the first day, the dose is usually reduced to • your urine may turn pink or orange. 100mg (10 tablets) a day. The recommended dose for Phenindione 25mg Tablets Reporting of side effects is: If you get any side effects, talk to your doctor, • usual starting dose of 200mg (8 tablets) on the pharmacist or nurse. This includes any possible side first day effects not listed in this leaflet. You can also report • after the first day, the dose is usually reduced to side effects directly via the Yellow Card Scheme 100mg (4 tablets) a day.