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Package leaflet: Information for the user

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 Elmino XL is and what it is used for
2. What you need to know before you take Elmino XL
3. How to take Elmino XL
4. Possible side effects
5. How to store Elmino XL
6. Contents of the pack and other information
Elmino XL Prolonged Release Capsules (called Elmino XL throughout this leaflet) is an anti-dementia
medicine used to treat the symptoms of mild to moderately severe dementia of the Alzheimer type, a
disease that alters brain function.
The symptoms of Alzheimer’s disease include increasing memory loss, confusion and behavioral changes.
As a result, it becomes more and more difficult to carry out normal daily activities.
These symptoms are believed to be due to a lack of acetylcholine, a substance responsible for sending
messages between brain cells. Elmino XL increases the amount of acetylcholine in the brain and so could
improve the symptoms of the disease.
Do not take Elmino XL:
• If you are allergic to galantamine or any of the other ingredients of this medicine (listed in section 6)
• If you have severe liver and/or severe kidney disease
Warnings and precautions
Talk to you doctor or pharmacist before taking Elmino XL.
Elmino XL should be used in Alzheimer’s disease and not other forms of memory loss or confusion.
Medicines are not always suitable for everyone. Your doctor needs to know before you take Elmino XL if
you suffer from or have suffered in the past from any of the following conditions:
• liver or kidney problems
• a heart disorder (e.g. angina, heart attack, heart failure, slow or irregular pulse)
• electrolyte disturbances (e.g. decreased/increased blood potassium levels)
• peptic (stomach) ulcer disease
• acute abdominal pain
• a disorder of the nervous system (like epilepsy or Parkinson’s disease)
• a respiratory disease or infection that interferes with breathing (like asthma, obstructive pulmonary
disease, or pneumonia)
• if you recently had an operation on the gut or bladder
• if you have difficulties passing urine
If you need an operation which requires a general anaesthetic, you should inform the doctor that you are
taking Elmino XL.
Your doctor will then decide whether treatment with Elmino XL is suitable for you or if the dose needs to be
Other medicines and Elmino XL
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Elmino XL should not be used with medicines that work in a similar way, these include:
• donepezil or rivastigmine (for Alzheimer’s disease)
• ambenonium, neostigmine or pyridostigmine (for severe muscular weakness)
• pilocarpine (for dry mouth or dry eyes) if taken by mouth.
Some medicines can affect the way Elmino XL works, or Elmino XL itself can reduce the effectiveness of
other medicines taken at the same time. These include:
• paroxetine or fluoxetine (antidepressants)
• quinidine (used for heart rhythm problems)
• ketoconazole (antifungal)
• erythromycin (antibiotic)
• ritonavir (antiviral - HIV protease inhibitor).
Your doctor may prescribe a smaller dose of Elmino XL if you are also taking any of the medicines listed above.
Some medicines can increase the number of side effects caused by Elmino XL, these include:
• non-steroidal anti-inflammatory painkillers (e.g. ibuprofen) which can increase the risk of ulcers
• medicines taken for heart disorders or high blood pressure (e.g. digoxin, amiodarone, atropine,
beta-blockers, or calcium channel blocking agents). If you take medicines for an irregular heart-beat, your
doctor may consider an electrocardiogram (ECG).
If you need an operation which requires a general anaesthetic, you should inform the doctor that you are
taking Elmino XL.
Your doctor will also check your weight regularly, whilst you are taking Elmino XL.
If you have any questions, speak to your doctor or pharmacist for advice.
Elmino XL with food and drink
Elmino XL should be taken with food if possible.
See section 3 of this leaflet for full details about how to take this medicine.
Pregnancy and breastfeeding
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.
You should not breast-feed while you are taking Elmino XL.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
Elmino XL may cause dizziness or drowsiness, especially during the first few weeks of treatment. If you
experience these symptoms, do not drive or use any tools or machinery.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
Elmino XL is started at a low dose. Your doctor may then tell you to slowly increase the dose of Elmino XL
that you take to find the most suitable dose for you.
1. The treatment is started with 8 mg taken once daily. After 4 weeks of treatment, the dose is increased.
2. You would then take 16 mg once daily. After another 4 weeks of treatment at the earliest, your doctor
may decide to increase the dose again.
3. You would then take 24 mg once daily.
Your doctor will explain what dose to start with and when the dose should be increased.
Your doctor will need to see you regularly to check that this medicine is working for you and to discuss how
you are feeling.
Liver or kidney disease
• If you have mild liver or kidney disease, treatment is started with an 8 mg capsule once daily in the morning.
• If you have moderate liver or kidney disease, treatment is started with an 8 mg capsule once every
other day in the morning. After one week, begin taking an 8 mg capsule once daily in the morning. Do
not take more than 16 mg once daily.
• If you have severe liver and/or kidney disease, do not take Elmino XL.
How do I switch from taking Galantamine immediate release tablets or oral solution to Elmino XL
prolonged release capsules?
If you are currently taking Galantamine immediate release tablets or oral solution, your doctor may decide
to switch you to Galantamine prolonged-release capsules.
• Take your last dose of Galantamine immediate release tablets or oral solution in the evening
• The next morning, take your first dose of Elmino XL prolonged-release capsules.
DO NOT take more than one capsule in a day. While you are taking once-daily Elmino XL, DO NOT take
Galantamine immediate release tablets or oral solution.
Use in children
Elmino XL is not recommended for children.
Method of administration
Elmino XL should be swallowed whole, NOT chewed or crushed. Elmino XL should be taken in the
morning, with water or other liquids, and preferably with food. Drink plenty of liquids during your treatment
with Elmino XL, to keep yourself hydrated.

If you take more Elmino XL than you should
If you take too much Elmino XL, contact a doctor or hospital straight away. Take along any remaining
capsules and the packaging with you. Signs or symptoms of overdose may include, among others: severe
nausea, vomiting, muscle weakness, slow heart beat, seizures and loss of consciousness.
If you forget to take Elmino XL
If you forget to take one dose, miss out the forgotten dose completely and take the next dose at the normal
Do not take a double dose to make up for a forgotten dose.
If you forget to take more than one dose, you should contact your doctor.
If you stop taking Elmino XL
You should consult your doctor before you stop taking Elmino XL. It is important to continue taking this
medicine to treat your condition.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Some of these effects may be due to the disease itself.
Stop taking your medicine and see a doctor immediately if you experience;
• Heart problems including changes in heart beat (slow or irregular)
• Palpitations (pounding heart beat)
• Conditions like blackout
• An allergic reaction. The signs may include a rash, swallowing or breathing problems, or swelling of
your lips, face, throat or tongue
Side effects include:
Very common (may affect more than 1 in 10 people):
• Feeling sick and/or vomiting. If these undesired effects occur, they are mainly experienced early on in
the treatment or when the dose is increased. They tend to disappear gradually as the body gets used to
the treatment and generally will not last for more than a few days. If you have these effects, your doctor
may recommend that you drink more liquids and, if necessary, may prescribe a medicine to stop you
being sick.
Common (may affect up to 1 in 10 people):
• Weight loss
• Loss of appetite
• Decreased appetite
• Slow heart beat
• Feeling faint
• Dizziness
• Trembling
• Headache
• Drowsiness
• Abnormally tired
• Stomach pain or discomfort
• Diarrhoea
• Indigestion
• Increased sweating
• Muscle spasms
• Falling
• High blood pressure
• Feeling weak
• General feeling of discomfort
• Seeing, feeling, or hearing things that are not real (hallucinations)
• Feeling sad (depression).
Uncommon (may affect up to 1 in 100 people):
• Increased liver enzymes in the blood (laboratory test result that tells how well your liver is working)
• Possible skipped heart beat
• Disturbance in the mechanism of conducting impulses in the heart
• Sensation of abnormal heart beats (palpitations)
• Tingling, pricking, or numbness of the skin
• Change in the sense of taste
• Excessive sleepiness
• Seizures
• Blurred vision
• Ringing or buzzing in the ears (tinnitus)
• Feeling the need to vomit
• Muscle weakness
• Excessive water loss in the body
• Low blood pressure
• Reddening of the face
• Allergic reaction
Rare (may affect up to 1 in 1000 people):
• Inflammation of the liver (hepatitis).
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.
Also you can help to make sure that medicines remain as safe as possible by reporting any unwanted side
effects via the internet at Alternatively you can call Freephone 0808 100 3352
(available from 10 a.m. to 2 p.m. Mondays to Fridays) or fill in a paper form available from your local pharmacy.
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 foil after the letters
EXP. The expiry date refers to the last day of that month.
This medicinal product 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 to protect the environment.
What Elmino XL contains:
The active substance is galantamine.
• Each Elmino XL 8 mg prolonged-release hard capsule contains 8 mg galantamine (as hydrobromide)
• Each Elmino XL 16 mg prolonged-release hard capsule contains 16 mg galantamine (as hydrobromide)
• Each Elmino XL 24 mg prolonged-release hard capsule contains 24 mg galantamine (as hydrobromide)
The other ingredients are:
Capsule content (Prolonged release capsules)
Cellulose microcrystalline, Hypromellose, Ethylcellulose, Magnesium stearate
Capsule shell
8 mg: Gelatin, Titanium dioxide (E171)
16 mg: Gelatin, Titanium dioxide (E171), Red iron oxide (E172).
24 mg: Gelatin, Titanium dioxide (E171), Indigo carmine (E132), Erythrosin (E127), Red iron oxide (E172),
Yellow iron oxide (E172).
What Elmino XL looks like and contents of the pack
Elmino XL prolonged-release capsules are available in three strengths, each of which can be recognised
by its colour:
8mg: White capsules containing one round biconvex prolonged-release tablet
16mg: Pale pink capsules containing two round biconvex prolonged-release tablets
24mg: Orange capsules containing three round biconvex prolonged-release tablets
The capsules are made in a ‘prolonged-release’ form. This means that they release the medicine more
The 8 mg, 16 mg and 24 mg capsules are available in the following blister packs 7, 10, 14, 28, 30, 56, 60,
84, 119, 120, 300 prolonged release capsules
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Zentiva, One Onslow Street, Guildford, Surrey, GU1 4YS, UK.
Pharmathen S.A.
Dervenakion 6
Pallini 15351
Attiki Greece
Pharmathen International S.A.
Industrial Park Sapes,
Rodopi Prefecture, Block No 5,
Rodopi 69300,
This leaflet was last revised in May 2013

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