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Package leaflet: information for the user
Enantyum 25 mg oral solution in sachet
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
What Enantyum is and what it is used for
What you need to know before you take Enantyum
How to take Enantyum
Possible side effects
How to store Enantyum
Contents of the pack and other information


What Enantyum is and what it is used for

Enantyum is a pain killer from the group of medicines called non-steroidal anti-inflammatory drugs
It is used for short term symptomatic treatment of mild to moderate acute pain, such as acute muscular pain
or joint pain, painful periods (dysmenorrhoea), toothache. Enantyum is indicated in adult patients.


What you need to know before you take Enantyum

Do not take Enantyum

If you are allergic to dexketoprofen or any of the other ingredients of this medicine (listed in section 6);

If you are allergic to acetylsalicylic acid or to other non-steroidal anti-inflammatory medicines;

If you have asthma or have suffered attacks of asthma, acute allergic rhinitis (a short period of inflamed
lining of the nose), nasal polyps (lumps within the nose due to allergy), urticaria (skin rash), angioedema
(swollen face, eyes, lips, or tongue, or respiratory distress) or wheezing in the chest after taking aspirin
or other non-steroidal anti-inflammatory medicines;

If you have suffered from photoallergic or phototoxic reactions (a particular form of reddening and/or
blistering of the skin exposed to sunlight) while taking ketoprofen (a non-steroidal anti-inflammatory
drug) or fibrates (drugs used to lower the level of fats in the blood);

If you have a peptic ulcer/stomach or bowel bleeding or if you have suffered in the past from stomach or
bowel bleeding, ulceration or perforation.

If you have chronic digestive problems (e.g. indigestion, heartburn);

If you have suffered in the past from stomach or bowel bleeding or perforation, due to previous use of
non-steroidal anti-inflammatory drugs (NSAIDs) used for pain;

If you have bowel disease with chronic inflammation (Crohn’s disease or ulcerative colitis);

If you have serious heart failure, moderate or serious kidney problems or serious liver problems;

If you have a bleeding disorder or a blood clotting disorder;

If you are severely dehydrated (have lost a lot of body fluids) due to vomiting, diarrhoea or insufficient
intake of fluids;

If you are in the third trimester of pregnancy or breast feeding;

Warnings and precautions
Talk to your doctor or pharmacist before taking Enantyum:

If you suffer from allergy, or if you have had allergy problems in the past;

If you have kidney, liver or heart problems (hypertension and/or heart failure) as well as fluid retention,
or have suffered from any of these problems in the past;

If you are taking diuretics or you suffer from very poor hydration and reduced blood volume due to an
excessive loss of fluids (e.g. from excessive urination, diarrhoea or vomiting);

If you have heart problems, previous stroke or think that you might be at risk of these conditions (for
example if you have high blood pressure, diabetes or high cholesterol or are a smoker) you should
discuss your treatment with your doctor or pharmacist. Medicines such as Enantyum may be associated
with a small increased risk of heart attack ("myocardial infarction") or cerebrovascular accident (stroke).
Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose
or duration of treatment;

If you are elderly: you may be more likely to suffer from side effects (see section 4). If any of these
occur, consult your doctor immediately;

If you are a woman with fertility problems (Enantyum may impair your fertility, therefore you should
not take it if you are planning to become pregnant or you are doing fertility tests);

If you suffer from a disorder in the formation of blood and blood cells;

If you have systemic lupus erythematosus or mixed connective tissue disease (immune system disorders
that affect connective tissue);

If you have suffered in the past from a chronic inflammatory disease of the bowel (ulcerative colitis,
Crohn’s disease);

If you have or have suffered in the past from other stomach or bowel problems;

If you have varicella (chickenpox), since exceptionally NSAIDs could worsen the infection;

If you are taking other medicines that increase the risk of peptic ulcer or bleeding, e.g. oral steroids,
some antidepressants (those of the SSRI type, i.e. Selective Serotonin Reuptake Inhibitors), agents that
prevent blood clots such as aspirin or anticoagulants such as warfarin. In such cases, consult your doctor
before taking Enantyum: he/she may want you to take an additional medicine to protect your stomach
(e.g. misoprostol or medicines that block the production of stomach acid).

If you suffer from asthma combined with chronic rhinitis, chronic sinusitis, and/or nasal polyposis as you
have a higher risk of allergy to acetylsalicylic acid and/or NSAIDs than the rest of the population.
Administration of this medicine can cause asthma attacks or bronchospasm, particularly in patients
allergic to acetylsalicylic acid or NSAIDs.
Children and adolescents
Enantyum has not been studied in children and adolescent. Therefore, safety and efficacy have not been
established and the product should not be used in children and adolescents.
Other medicines and Enantyum
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines,
including medicines obtained without a prescription. There are some medicines that should not be taken
together and others that may need a dose adjustment if used together.
Always inform your doctor, dentist or pharmacist if you are using or receiving any of the following
medicines in addition to Enantyum:
Inadvisable combinations:

Acetylsalycilic acid (aspirin), corticostereoids or other anti-inflammatory drugs

Warfarin, heparin or other medicines used to prevent blood clots

Lithium, used to treat certain mood disorders

Methotrexate (anti-cancer medicine or immunosuppressant), used at high doses of 15 mg/week

Hydantoins and phenytoin, used for epilepsy

Sulphametoxazole, used for bacterial infections
Combinations requiring precautions:

ACE inhibitors, diuretics, beta-blockers and angiotensin II antagonists, used for high blood pressure and
heart problems

Pentoxifylline and oxpentifylline, used to treat chronic venous ulcers
Zidovudine, used to treat viral infections
Aminoglycosides antibiotics, used to treat bacterial infections
Chlorpropamide and glibenclamide, used for diabetes
Methotrexate, used at low doses, less than 15 mg/week

Associations to be considered carefully:

Quinolone antibiotics (e.g. ciprofloxacin, levofloxacin) used for bacterial infections

Cyclosporin or tacrolimus, used to treat immune system diseases and in organ transplant

Streptokinase and other thrombolytic or fibrinolytic medicines, i.e. medicines used to break-up blood

Probenecid, used in gout

Digoxin, used to treat chronic heart failure

Mifepristone, used as an abortifacient (to terminate a pregnancy)

Antidepressants of the selective serotonin reuptake inhibitors type (SSRIs)

Anti-platelet agents used to reduce platelet aggregation and the formation of blood clots

Beta-blockers, used for high blood pressure and heart problems
If you have any doubt about taking other medicines with Enantyum, consult your doctor or pharmacist.
Enantyum with food and drink
Take the sachets with food, as it helps to decrease the risk of stomach or bowel side effects. However, if you
have acute pain, take the sachets on an empty stomach, i.e. at least 15 minutes before meals, as this helps the
medicine start working a little faster.
Pregnancy, breast-feeding and fertility
Do not use Enantyum during the final three months of the pregnancy or when breast feeding. If you are
pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice
before taking this medicine,
With regard to potential effects on female fertility, see also section 2, “Warnings and precautions”.
Driving and using machines
Enantyum may slightly affect your ability to drive and handle machines, due to the possibility of dizziness or
drowsiness and visual disturbances as side effects of treatment. If you notice such effects, do not drive or use
machines until the symptoms wear off. Ask your doctor for advice.
Enantyum contains methyl parahydroxybenzoate
This medicine may cause allergic reactions (possibly delayed) as it contains methyl parahydroxybenzoate.
Enantyum contains sucrose
If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before
taking this medicine.
This medicine contains 2.0 g of sucrose per dose. This should be taken into account in patients with diabetes


How to take Enantyum

Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.
The dose of Enantyum that you need depends on the type, severity and duration of your pain. Your doctor
will tell you how many sachets you must take daily, and for how long.
Adults from the age of 18
The recommended dose is generally 1 sachet (25 mg of dexketoprofen) every 8 hours, with no more than 3
sachets daily (75 mg).


If you are elderly, or if you suffer from kidney or liver problems, you should start treatment with a total daily
dose of no more than 2 sachets (50 mg of dexketoprofen).
In elderly this initial dose can later be increased to that generally recommended (75 mg of dexketoprofen) if
Enantyum has been well tolerated.
If your pain is intense and you need quicker relief, take the sachets on an empty stomach (at least 15 minutes
before food) because they will be more easily absorbed (see section 2 “Enantyum with food and drink”).
Use in children and adolescents
This medicine should not be used in children and adolescents (under age 18).
Instructions for a correct use
The oral solution may be taken directly from the sachet or after stirring the whole content in a glass of water.
Once the sachet opens, take all its content.
If you use more Enantyum than you should
If you use too much of this medicine, tell your doctor or pharmacist immediately or go to the emergency
department of your nearest hospital. Please remember to take this medicine pack or this leaflet with you.
If you forget to use Enantyum
Do not take a double dose to make up for a forgotten sachet. Take the next regular dose when it is due
(according to section 3 “How to take Enantyum”).
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.


Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
Possible side effects are listed below according to how likely they are to occur. Because the peak plasma
levels of dexketoprofen for the oral solution formulation are higher than those reported for the tablet
formulation, a potentially increased risk for side (gastrointestinal) effects cannot be excluded.
Common side effects (may affect up to 1 in 10 people):
Nausea and/or vomiting, mainly upper quadrants abdominal pain, diarrhoea, digestive problems (dyspepsia).
Uncommon side effects (may affect up to 1 in 100 people):
Spinning sensation (vertigo), dizziness, sleepiness, disturbed sleep, nervousness, headache, palpitations,
flushing, inflammation of the stomach lining (gastritis), constipation, dry mouth, flatulence, skin rash,
tiredness, pain, feeling feverish and shivering, generally feeling unwell (malaise).
Rare side effects (may affect up to 1 in 1,000 people):
Peptic ulcer, peptic ulcer perforation or bleeding (which may be seen as vomiting blood or black stools),
fainting, high blood pressure, too-slow breathing, water retention and peripheral swelling (e.g. swollen
ankles), laryngeal oedema,, loss of appetite (anorexia), abnormal sensation, itchy rash, acne, increased
sweating, back pain, passing water frequently, menstrual disorders, prostate problems, abnormal liver
function tests (blood tests), liver cell injury (hepatitis), acute renal failure.
Very rare (may affect up to 1 in 10,000 people):
Anaphylactic reaction (hypersensitive reaction which may also lead to collapse), open sores on skin, mouth,
eyes and genital areas (Stevens Johnson and Lyell’s syndromes), face swelling or swelling of the lips and
throat (angioedema), breathlessness due to narrowing of the airways (bronchospasm), shortness of breath,
fast heartbeat, low blood pressure, inflammation of the pancreas , blurred vision, ringing in the ears
(tinnitus), sensitive skin, sensitivity to light, itching, kidney problems. Reduced white blood cell count
(neutropenia), fewer platelets in the blood (thrombocytopenia).


Tell your doctor immediately if you notice any stomach/bowel side effects at the start of treatment (e.g.
stomach pain, heartburn or bleeding), if you have previously suffered from any such side effects due to longterm use of anti-inflammatory drugs, and especially if you are older.
Stop using Enantyum as soon as you notice the appearance of a skin rash, or any lesion inside the mouth or
on the genitals, or any sign of an allergy.
During treatment with non-steroidal anti-inflammatory drugs, fluid retention and swelling (especially in the
ankles and legs), increased blood pressure and heart failure have been reported.
Medicines such as Enantyum may be associated with a small increased risk of heart attack ("myocardial
infarction") or cerebrovascular accident (stroke).
In patients with immune system disorders that affect connective tissue (systemic lupus erythematosus or
mixed connective tissue disease), anti-inflammatory medicines may rarely cause fever, headache and neck
The most commonly-observed adverse events are gastrointestinal in nature. Peptic ulcers, perforation or
gastrointestinal bleeding, sometimes fatal, particularly in the elderly, may occur.
Nausea, vomiting, diarrhoea, flatulence, constipation, dyspepsia, abdominal pain, melaena,
haematemesis, ulcerative stomatitis, worsening of colitis and Crohn’s disease have been reported following
administration. Less frequently, inflammation of the stomach lining (gastritis) has been observed.
As with other NSAIDs aseptic meningitis, which might predominantly occur in patients with systemic lupus
erythematosus or mixed connective tissue disease and haematological reactions (purpura, aplastic and
haemolytic anaemia, and rarely agranulocytosis and medullar hypoplasia) may appear.
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. You can also report side effects directly via the Yellow Card Scheme. Website: By reporting side effects you can help provide more information on the
safety of this medicine.


How to store Enantyum

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 on the sachet after 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 protect the environment.


Contents of the pack and other information

What Enantyum contains

The active substance is dexketoprofen (as dexketoprofen trometamol). Each sachet of oral solution
contains 25 mg of dexketoprofen as dexketoprofen trometamol.
The other ingredients are ammonium glycyrrhizate, neohesperidin-dihydrochalcone, methyl
parahydroxybenzoate (E-218), saccharin sodium, sucrose, macrogol 400, lemon aroma, povidone K90, anhydrous disodium phospate, sodium dihydrogen phosphate dihydrate, purified water.

What Enantyum looks like and contents of the pack
Slightly coloured solution with lemon odour and sweet lemon-citrus flavour.
Enantyum 25 mg oral solution in sachet is supplied in packs containing 2, 4, 10, 20 or 500 sachets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Menarini International Operations Luxembourg S.A.
1, Avenue de la Gare - L-1611 Luxembourg

Alfonso XII 587, 08918-Badalona (Barcelona), SPAIN
This medicinal product is authorised in the Member States of the EEA under the following names:
Austria, Belgium, France, Hungary, Iceland, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain,
Sweden, United Kingdom: Enantyum
Czech Republic, Estonia, Latvia, Lithuania, Slovak Republic, Slovenia: Ketesse
Greece: Viaxal
Norway: Orodek
Poland: Ketesse
This leaflet was last revised in 06/2017


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.