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ELENOXY 20MG PROLONGED-RELEASE TABLETS

Active substance(s): OXYCODONE HYDROCHLORIDE

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Information for the user

Elenoxy® 5 mg prolonged-release tablets
Elenoxy® 10 mg prolonged-release tablets
Elenoxy® 20 mg prolonged-release tablets
Elenoxy® 40 mg prolonged-release tablets
Oxycodone hydrochloride














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


1. What Elenoxy® is and what it is used for

Elenoxy is indicated in adults and adolescents (from 12 years of age).
Elenoxy contains the active ingredient oxycodone hydrochloride, which
is a strong analgesic or “painkiller” and belongs to a group of medicines
called opioids.
It is used for the relief of severe pain, which can be adequately managed
only with opioid analgesics.
Do not take this medicine other than prescribed by your doctor. It is not
for use on an “as-needed” basis for relief of mild pain, ordinary aches, or
the symptoms of colds or the flu.

2. What you need to know before you take Elenoxy®
Do not take Elenoxy:
- if you are allergic to oxycodone hydrochloride or any of the other
ingredients of this medicine (listed in section 6),
- if you suffer from severe breathing problems, such as severe
respiratory depression (where you breathe more slowly or weakly
than expected),
- if you suffer from elevated carbon dioxide levels in the blood
(hypercapnia),
- if you suffer from a severe lung disease associated with narrowing of
the airways (chronic obstructive airways disease),
- if you have a heart problem caused by long-term lung disease
(cor pulmonale),
- if you suffer from severe bronchial asthma,
- if you have a condition where the small bowel does not work properly
(paralytic ileus),
Warnings and precautions
Talk to your doctor or pharmacist before taking Elenoxy:
- if you are elderly or weak,
- if you have severe lung, liver or kidney problems,
- if you have a disease of the thyroid gland (myxoedema) or

underactive thyroid gland (hypothyroidism),
- if your adrenal glands are not producing enough hormones (adrenal
insufficiency, Addison’s disease),
- if you have an enlarged prostate gland (prostate hypertrophy),
- if you have a mental disorder as a result of an intoxication caused by,
for example, alcohol (toxic psychosis),
- if you suffer from a state of violent mental agitation caused by alcohol
poisoning (alcoholism, delirium tremens),
- if you have known opioid dependence,
- if you have inflammation of the pancreas (pancreatitis),
- if you have gallstones (biliary calculi),
- if you have obstructive and inflammatory intestinal diseases. Stop
taking Elenoxy immediately if you think your intestines have stopped
working properly (paralytic ileus),
- if you have conditions involving increased brain (cerebral) pressure,
- if you have problems with your circulatory system, if you have
epilepsy or are prone to fits (convulsions),
- if you use MAO inhibitors.
If any of the above applies to you or has in the past, talk to your doctor.
The most serious side effect of an opioid overdose is a condition
where you breathe more slowly or weakly than expected (respiratory
depression). This occurs most commonly in elderly or vulnerable
patients.
Opioids may also cause a severe drop in blood pressure in susceptible
individuals. If you are affected by these side effects, consult a doctor
immediately.
If you are going to have an operation, make sure you tell your doctor that
you are taking Elenoxy.
This medicine should be avoided in patients with a history of, or present
alcohol and drug abuse.
Long-term use/Dependence
Patients may develop a tolerance with long-term use of Elenoxy.
Therefore they may require higher doses of Elenoxy to achieve the
desired pain control. Prolonged use of Elenoxy in chronic pain patients
may lead to physical dependence. If treatment is stopped abruptly
withdrawal symptoms that include yawning, mydriasis, lacrimation,
rhinorrhoea, tremor, hyperhidrosis, anxiety, agitation, palpitations,
convulsions and insomnia may occur. When therapy with Elenoxy is no
longer necessary, it may be advisable to reduce the daily dose gradually
in order to prevent withdrawal symptoms.
Elenoxy has a primary dependence potential. When used as instructed
in chronic pain patients, the risk of physical and mental dependence is
clearly reduced and must be assessed correspondingly relative to the
benefits. Please discuss this with your doctor.
Athletes should be aware that this medicine may cause a positive
reaction to “anti-doping tests”. Use of Elenoxy as a doping agent may
become a health hazard.
Children
Elenoxy has not been tested in children under 12 years of age. Therefore
safety and efficacy are not established and Elenoxy is not recommended
in children under 12 years of age.
Other medicines and Elenoxy
Tell your doctor or pharmacist if you are taking, have recently taken or
might take any other medicines.

Taking Elenoxy at the same time as the following medicines may increase
the side effects of Elenoxy (particularly breathing problems):
• medicines acting on the central nervous system, such as sleeping
and calming medicines (sedatives, hypnotics),
• other medicines which affect the nervous system (phenothiazines,
neuroleptics),
• antidepressants,
• medicines for allergies or vomiting (antihistamines, anti-emetics),
• other strong painkillers (opioids),
• alcohol.
Taking Elenoxy at the same time as the following medicines may intensify
specific side effects of Elenoxy (such as constipation, dry mouth or
problems urinating):
• medicines with anti-cholinergic effects, such as other medicines
which act upon the nervous system (medicines to treat psychiatric
or mental disorders), medicines for allergies or vomiting

(antihistamines, antiemetics),
• medicines for Parkinson’s disease.
If you are taking Elenoxy at the same time as medicines that thin your
blood (coumarin-type anti-coagulants), your blood clotting time may be
speeded up or slowed down. This is measured by a test called the INR
that checks how long it takes for your blood to clot.
Antibiotics (such as clarithromycin, erythromycin and telithromycin),
antifungal medicines (such as ketoconazole, voriconazole, itraconazole
and posaconazole), protease inhibitors (such as boceprevir, ritonavir,
indinavir, nelfinavir and saquinavir), cimetidine (gastric acid inhibitor - a
medicine for stomach ulcers, indigestion or heartburn) and grapefruit
juice as well as paroxetine and quinidine may prevent the metabolism of
oxycodone hydrochloride.
Some medicines, such as rifampicin, carbamazepin, phenytoin and St
John’s Wort may induce the metabolism of oxycodone hydrochloride.
These tablets must not be used together with a monoamine oxidase
inhibitor, or if you have taken this type of medicine in the last two weeks.
Elenoxy with food, drink and alcohol
You can take Elenoxy with or without food.
Drinking alcohol whilst taking Elenoxy may make you feel more sleepy or
increase the risk of serious side effects such as shallow breathing with a
risk of stopping breathing, and loss of consciousness. It is recommended
not to drink alcohol while you’re taking Elenoxy.
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 this medicine.
Elenoxy should not be taken during pregnancy unless clearly necessary.
There are only limited data from the use of oxycodone hydrochloride in
pregnant women. Oxycodone hydrochloride crosses the placenta into
the blood circulation of the unborn child. The long-term use of Elenoxy
during pregnancy may lead to withdrawal symptoms in newborn infants.
If taken during birth, breathing problems (respiratory depression) may
occur in the child.
You should not take Elenoxy if you are breast-feeding as oxycodone
passes into breast milk.
Driving and using machines
Elenoxy may impair your ability to drive or operate machinery. This is
particularly likely:
• when you start the treatment with Elenoxy,
• after a dose increase or product rotation (the use of alternative
medicines, to reduce side effects),
• if Elenoxy is combined with alcohol or with medicines, which act
on the central nervous system.
General driving restrictions may not apply during stable treatment; your
doctor makes this decision based upon the individual situation. Please
discuss with your doctor whether or not, or under which conditions you
may drive.
The medicine can affect your ability to drive as it may make you sleepy
or dizzy.
• Do not drive while taking this medicine until you know how it
affects you.
• It is an offence to drive if this medicine affects your ability to drive.
• However, you would not be committing an offence if:
-
the medicine has been prescribed to treat a medical or

dental problem and
-
you have taken it according to the instructions given by

the prescriber or in the information provided with the

medicine and
-
it was not affecting your ability to drive safely
Talk to your doctor or pharmacist if you are not sure whether it is safe for
you to drive while taking this medicine.

3. How to take Elenoxy®
Always take this medicine exactly as your doctor or pharmacist has told
you. Check with your doctor or pharmacist if you are not sure.
Your doctor will adjust the dosage to the intensity of the pain and to your
personal sensitivity. Take the prescribed number of prolonged-release
tablets twice daily.
Use in adults and adolescents (from 12 years of age)
The usual starting dose is 10 mg oxycodone hydrochloride every 12 hours.
Take 1 prolonged-release tablet in the morning and 1 prolonged-release
tablet in the evening.
While symmetric (same dose in the morning and in the evening), aroundthe-clock, 12 hourly dosing is appropriate for the majority of patients,
some patients may benefit from asymmetric dosing (different dose in the
morning and in the evening) tailored to their pain pattern. Your doctor
will decide on the best treatment schedule to suit your needs.
Your doctor will decide on any necessary dose adjustments during
treatment depending on your previous dosage. If you have already been
treated with opioids, your treatment with Elenoxy may be started at a
higher dose.
Some patients taking Elenoxy on a fixed time schedule require a
fast-acting painkiller for quick relief from breakthrough pain. Elenoxy
prolonged-release tablets are not intended for the treatment of
breakthrough pain.

Your doctor will monitor you regularly to ensure you receive the best
possible pain relief treatment. Treatment of side effects and the need to
continue treatment will also be monitored.
Please speak to your doctor or pharmacist if you feel that the effect of
Elenoxy is too strong or too weak.
Tumour and non-tumour related pain
For the treatment of non-tumour related pain, 40 mg of oxycodone
hydrochloride is normally a sufficient daily dose; however, higher doses
may be necessary. Patients with tumour related pain normally require
doses of 80 to 120 mg of oxycodone hydrochloride, which, in exceptional
cases, may be increased up to 400 mg of oxycodone hydrochloride.
Older people
In elderly patients without kidney and/or liver problems, dosage
adjustment is usually not necessary.
High-risk patients
Patients with kidney and/or liver problems who have not received
opioids before should initially take half of the recommended adult dose.
This also applies to patients with low body weight and patients who
metabolise medications at slower rates.
Children
Elenoxy has not been tested in children under 12 years of age. Therefore
safety and efficacy are not established and Elenoxy is not recommended
in children under 12 years of age.
Method of administration and duration of use
Elenoxy is for oral use only. The tablets should never be injected as this
may lead to serious side effects, which may be fatal.
Swallow the prolonged-release tablets with sufficient liquid (half a glass
of water) in the morning and evening in accordance to a fixed time
schedule (e.g. in the morning at 8 a.m., in the evening at 8 p.m.). You can
take your tablets with or without food.
Elenoxy should not be taken with alcoholic beverages.
Swallow the tablets whole, and do not cut, break, chew, crush, or
dissolve the tablets. Taking cut, broken, chewed, crushed or dissolved
tablets leads to speedier release of the active substance and to the
absorption of a potentially lethal dose of the active substance oxycodone
hydrochloride (see under “If you take more Elenoxy than you should”).
Oxycodone should not to be administered for longer than absolutely
necessary. If long-term pain treatment is necessary in view of the nature
and severity of the illness, careful and regular monitoring should be
carried out to establish whether and to what extent further treatment is
necessary. When the patient no longer requires opioid therapy, it may be
advisable to taper the dose gradually to prevent symptoms of withdrawal.
If you take more Elenoxy than you should
If you have taken more medicine than prescribed, you should inform your
doctor immediately.
The following may occur:
• narrowed pupils,
• respiratory depression,
• somnolence progressing up to stupor or loss of consciousness
(coma),
• decreased tension of skeletal muscles,
• slowed pulse rate and drop in blood pressure,
• loss of consciousness (coma), water retention in the lung and
circulatory collapse may occur in more severe cases and may lead
to death.
Never engage in situations which require a high degree of concentration,
such as driving.
Accidental overdose by a child is dangerous and may be fatal.
If you forget to take Elenoxy
If you take a smaller dose of Elenoxy than prescribed, or if you have
completely forgotten to take your dose, this will lead to unsatisfactory
and/or insufficient pain relief.
If you have forgotten to take your dose, and your next usual dose is
scheduled more than 8 hours later: Take the forgotten dose. You may
then continue to follow your usual schedule.
If the time until your next dose is less than 8 hours, take your dose but
postpone the next dose by 8 hours.
As a matter of principle, you should never take more than one dose of
Elenoxy within any 8 hour period.
Do not take a double dose to make up for a forgotten dose.
If you stop taking Elenoxy
Do not stop taking Elenoxy without consulting your doctor.
If treatment with Elenoxy is no longer necessary, gradual reduction of the
daily dosage may be advisable. If treatment is stop abruptly, withdrawal
symptoms may occur.
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.
The most common side effects are nausea (especially at the beginning of
therapy) and constipation. Constipation may be countered by preventive
measures (such as drinking plenty of fluids, nutrition, rich in fibre); your
doctor may prescribe a treatment to overcome this problem. If you
experience nausea or vomiting, your doctor may prescribe medication
for you.
Important side effects or signs to look out for. If you are affected by
these side effects, consult a doctor immediately:
• The most serious side effect is a condition where you breathe more
slowly or weakly than expected (respiratory depression). It can
occur most commonly in elderly or vulnerable patients. Opioids
may cause a severe drop in blood pressure in susceptible individuals.




• The active substance oxycodone hydrochloride can cause
respiratory depression, narrowing of the pupils, cramping of the
bronchial muscles, as well as a depression of the cough reflex.

Other possible side effects:
Very Common (may affect more than 1 in 10 people):
- Constipation, vomiting, nausea
- Fatigue and/or drowsiness (sedation), dizziness, headache
- Itching (pruritus)
Common (may affect up to 1 in 10 people):
- Abdominal pain, diarrhoea, dry mouth, hiccups, indigestion (dyspepsia)
- Decreased appetite up to loss of appetite
- Altered mood and personality changes (e.g. anxiety, depression,
euphoric mood), decreased activity, restlessness, increased activity,
agitation, nervousness, insomnia, abnormal thinking, confusion
- Loss of consciousness (syncope), tingling or numbness in the hands
or feet (paraesthesia), shaking (tremor)
- Drop in blood pressure (hypotension)
- Difficulty breathing (dyspnoea, bronchospasm)
- Skin reactions/rash
- Urinary retention, difficulty or pain on passing urine (dysuria),
increased urge to urinate
- Chills, general weakness, sweating, hyperhidrosis
190mm x 380mm. Elenoxy - PIL proof. 08/04/15

Uncommon (may affect up to 1 in 100 people):
- Physical dependence including withdrawal symptoms, pain (e.g. chest
pain), a general feeling of unease or lack of health (malaise), swelling
from excessive accumulation of fluid (edema), peripheral edema, thirst
- Injuries from accidents
- Allergic reactions (hypersensitivity)
- Perception disturbances (e.g. hallucination, derealisation ), reduced
libido, affect lability, drug dependence
- Difficulty in concentrating, migraine, distorted sense of taste
(dysgeusia), increased muscle tension (hypermyotonia), involuntary
muscle contractions, reduced sense of touch (hypoaesthesia),
abnormal coordination, epileptic seizures (especially in persons
with epileptic disorder or predisposition to seizures), amnesia,
speech disorder
- Visual impairment, miosis
- Hearing difficulty, vertigo
- Increase in pulse rate (tachycardia), palpitations (in the context of
withdrawal syndrome)
- Vasodilatation
- Vocal changes (dysphonia), cough, respiratory depression
- Oral ulcers, inflammation in the mouth (stomatitis), flatulence, difficult
swallowing (dysphagia), eructation, blockage of the intestine (ileus)
- Erectile dysfunction
- Dehydration
- Increase of liver enzymes levels
- Dry skin
- A need to take increasingly higher doses to obtain the same level of
pain relief (tolerance)
Rare (may affect up to 1 in 1,000 people):
- Melaena (abnormally dark tarry faeces containing blood), dental
changes, gum bleeding
- Herpes simplex
- Increased appetite
- Weight increase, weight decrease
- Orthostatic hypotension
- Itching rash (urticaria)
Not known (frequency cannot be estimated from the available data):
- Suppression of cough reflex
- Biliary colic (gallstones), cholestasis
- Amenorrhoea (abnormal lack of menstruation)
- Exaggerated allergic reaction (anaphylactic reaction)
- Aggression
- Hyperalgesia
- Dental caries
As with all strong painkillers, there is a risk that you may become
addicted or reliant on these tablets.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. 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
By reporting side effects you can help provide more information on the
safety of this medicine.

5. How to store Elenoxy®
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
blister and carton after “Expiry date”. 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.

6. Contents of the pack and other information
What Elenoxy contains
- The active substance is oxycodone hydrochloride.
Elenoxy 5 mg prolonged-release tablets
Each prolonged-release tablet contains 5 mg of oxycodone
hydrochloride equivalent to 4.5 mg of oxycodone







Elenoxy 10 mg prolonged-release tablets
Each prolonged-release tablet contains 10 mg of oxycodone
hydrochloride equivalent to 9.0 mg of oxycodone.







Elenoxy 20 mg prolonged-release tablets
Each prolonged-release tablet contains 20 mg of oxycodone
hydrochloride equivalent to 17.9 mg of oxycodone







Elenoxy 40 mg prolonged-release tablets
Each prolonged-release tablet contains 40 mg of oxycodone
hydrochloride equivalent to 35.9 mg of oxycodone.



-




The other ingredients are:
Hypromellose, polyvinyl acetate, povidone K30, sodium lauryl
sulphate, silica, microcrystalline cellulose, silicon dioxide, magnesium
stearate, dibutyl sebacate, ethylcellulose, cetyl alcohol, talc.

What Elenoxy looks like and contents of the pack
Elenoxy 5 mg prolonged-release tablets
Elenoxy 5 mg prolonged-release tablets are white to off-white, 9.6 x 4.8
mm, elliptic, biconvex, coated tablet, embossed with “5” on one side and
“LT” on the other side.
Elenoxy 10 mg prolonged-release tablets
Elenoxy 10 mg prolonged-release tablets are white to off-white, 9.6 x 4.8
mm, elliptic, biconvex, coated tablet, embossed with “10” on one side
and “LT” on the other side.
Elenoxy 20 mg prolonged-release tablets
Elenoxy 20 mg prolonged-release tablets are white to off-white, 11 x 5.5
mm, elliptic, biconvex, coated tablet, embossed with “20” on one side
and “LT” on the other side.
Elenoxy 40 mg prolonged-release tablets
Elenoxy 40 mg prolonged-release tablets are white to off-white, 11 x 5.5
mm, elliptic, biconvex, coated tablet, embossed with “40” on one side
and “LT” on the other side.
Elenoxy prolonged release tablets is available in pack sizes of 10, 20, 28,
30, 40, 50, 56, 60, 100 and 112 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder:
DB Ashbourne Ltd
The Rectory, Braybrooke Road
Arthingworth, Market Harborough
LE16 8JT, United Kingdom
Telephone: (01858) 525643
Fax: (01858) 525383
Email: enquiries@medinformation.co.uk

Manufacturer:
ETHYPHARM
Chemin de la Poudrière
76120 Grand Quevilly
France

This medicinal product is authorised in the Member States of the EEA
under the following names:




Germany: Oxylene 5 mg / 10 mg / 20 mg / 40mg Retardtabletten
UK:
Elenoxy 5 mg / 10 mg / 20 mg / 40mg prolonged-release

tablet

This leaflet was last revised in 02/2015.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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