Pil remifemin plus 04_2012

Package leaflet: information for the user
Remifemin® plus
Coated tablets, dry extract of St. John’s Wort and Cimicifuga rhizome
Read all of this leaflet carefully because it contains important information for you.
This medicine is available without prescription. However, you still need to take Remifemin®
plus carefully to get the best results from it.
-
Keep this leaflet. You may need to read it again. Ask your pharmacist if you need more information or advice. You must contact a doctor if your symptoms worsen or do not improve after 4 to 6 weeks. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:

1. What Remifemin® plus is and what it is used for
2. Before you take Remifemin® plus
3. How to take Remifemin® plus
4. Possible side effects
5. How to store Remifemin® plus
6. Further information
What Remifemin® plus is and what it is used for
Remifemin® plus is a herbal medicine to relieve menopausal complaints.
Remifemin® plus is used to relieve the menopausal complaints (climacteric) such as:
hot flushes, sweating, depressive moods and psychovegetative disturbances such as
dejection, inner tension, irritability, lack of concentration, insomnia, anxiety and/or
nervous restlessness, premenstrual psychovegetative disorders.
Before you take Remifemin® plus
Do not take Remifemin® plus
 if you are concomitantly treated with another medicine containing one of the following medicinal agents or a medicinal agent of one of the following substance groups: Medicine for suppression of transplant rejections - ciclosporin - tacrolimus for internal use - sirolimus Medicinal drugs for treatment of HIV-infections or AIDS - proteinase inhibitors such as indinavir - non-nucleosid-reverse-transcriptase-inhibitors such as nevirapin Cytostatics such as - imatinib - irinotecan with the exception of monoclonal antibodies  if you are hypersensitive to Cimicifugae rhizome or St. John’s Wort or any of the other  if you know about existing photohypersensitivity of the skin. Take special care with Remifemin® plus:

Medicinal products like Remifemin® plus containing St. John's Wort (Hypericum) may interact with other medicinal agents: active substances of Hypericum may accelerate the excretion of other medicinal agents and thus reduce the efficacy of these other substances. As far as a concomitant use of Remifemin® plus with other medicinal products is regarded as necessary, your doctor has to consider the possible interactions: Reduction of effects of digoxin, verapamil, simvastatin, midazolam, anticoagu-lants (phenprocoumon, warfarin). Women taking oral contraceptives should be advised of the possibility of interac-tion causing intermenstrual bleeding and of the need for additional contraceptive measures, as the reliability of the contraceptive can possibly be reduced. If you experience any menstrual problems or your menstruation reappears. Also if unclear symptoms persist or new symptoms appear you should consult a doctor. This is because they may be evidence of illnesses that require investiga-tion by a doctor. If you take oestrogens concurrently this should be done only under medical su-pervision. Consult your doctor. If you already have liver injury. Then Remifemin® plus should only be taken after consultation with your doctor. If signs and symptoms suggesting a liver injury (yellowing of the skin or eyes, dark urine, upper stomach pain, nausea, loss of appetite, tiredness) occur. You should stop taking Remifemin® plus immediately and consult a doctor. if you have been treated or you are undergoing treatment for breast cancer or other hormone-dependent tumours, you should not use Remifemin® without med-ical advice. if the symptoms worsen during the use of Remifemin®, you should consult a doc-tor or a pharmacist. Taking Remifemin® plus with other medicines:
Remifemin® plus may interact with various other medicines in such a way that the
concentration of these substances in the blood is reduced and thus possibly their effi-
cacy, too. The following medicinal agents belong to these substances:
- anticoagulants (phenprocoumon, warfarin)
- digoxin
- verapamil
- simvastatin
- midazolam
- hormonal oral contraceptives (occurrence of intermenstrual bleedings)
- different agents against depression such as amitriptyline and nortriptyline.
In case of simultaneous intake of certain active agents for treatment of depression (trazodone, paroxetine, sertraline) adverse reactions (such as e.g. nausea, vomiting, anxiety, restlessness, confusion) may increasingly occur in single cases. If given simultaneously with other medicines which increase skin photosensitivity, an increase in the phototoxic effects (see section on ”undesirable effects”) is possible. Please tell your doctor or pharmacist if you are taking or have recently taken any oth-er medicines, including medicines obtained without a prescription. Pregnancy and breast-feeding:
There are no adequate data on the use of Remifemin® plus during pregnancy and breast-feeding. Remifemin® plus should therefore not be taken during pregnancy and breast-feeding. Driving and using machines:
There are no special precautions necessary. Important information about some of the ingredients of Remifemin®plus:
This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. How to take Remifemin® plus
Always take Remifemin® plus exactly as directed in this package leaflet. You should
check with your doctor or pharmacist if you are not sure.
Unless otherwise prescribed, the usual dose is:
Take 1 coated tablet twice a day, if necessary 2 coated tablets twice a day.
Take the coated tablets in the morning and evening unchewed with some liquid.
You can take the coated tablets independently from the meals.
Method of administration:
Remifemin® plus is for oral use. Duration of use:
As the results of treatment improve further on prolonged administration, Remifemin®
plus should be taken over a longer period. In order to avoid overlooking of other ill-
nesses, a doctor should be consulted after 6 months.
Please consult your doctor or pharmacist if you have the impression that the effect of
Remifemin® plus is too strong or too weak.
If you take more Remifemin® plus than you should:
In the event of overdose of Remifemin® plus, the listed side effects may increasingly
occur. If this happens, you should stop taking the medicine and consult a doctor.
If you forget to take Remifemin® plus:
Do not take a double dose to make up for a forgotten tablet.
If you have any further questions on the use of this product, ask your doctor or phar-macist. Possible side effects
Like all medicines, Remifemin® plus can cause side effects, although not everybody
gets them.
Assessment of side effects is based on the following frequency rates:
frequency not assessable on the basis of the available data
Possible side effects:
gastrointestinal disorders (upper abdominal disorders, diar- allergic skin reactions (urticaria, pruritis, skin rash) increase in liver enzymes (transaminases) very rare:
particularly in light-skinned persons, due to the increased sensi- 10,000 treated tivity of the skin (photosensitisation): sunburn-like reactions in patients, or parts of the skin which have been exposed to strong light (sun, reports of liver injury during the use of medicines containing Ci- micifuga rhizome. No definite causal connection with these medicines has been proved at present.
In these cases, you should stop taking the medicine and consult your doctor.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. How to store Remifemin® plus
Keep out of the reach and sight of children. Do not use the medicine after the expiry date which is stated on the side flap of this pack. The expiry date refers to the last day of that month. Do not store above 25°C! Further information
What Remifemin® plus contains:
The active substances are:
Hyperici herb. extr. sicc. (dry extract of St. John's Wort) corresponding to total hyperi-
cin (standard.) = 0.25 mg
and
Cimicifugae rhiz. extr. sicc. (dry extract of Black Cohosh) corresponding to triterpene
glycosides calculated as 27-Deoxyactein (standard.) = 1.0 mg

The other ingredients are:
Microcrystalline cellulose, ironoxid E 172, glyceryl behenate, glyceryl alconate, colloi-
dal anhydrous silica, indigotin E 132. potato starch, lactose, macrogol mw=6000,
magnesium stearate, methylhydroxypropyl cellulose, talc

What Remifemin® plus looks like and contents of the pack:

Round-convex, dark-green- coloured coated tablets
Remifemin® plus is available in packs containing 60, 100 and 120 coated tablets.
Marketing authorisation holder and manufacturer
Schaper & Brümmer GmbH & Co. KG
Bahnhofstraße 35
38259 Salzgitter
Germany
Tel: (0 53 41) 3 07-0
Fax: (0 53 41) 3 07-124
info@schaper-bruemmer.de
http://www.schaper-bruemmer.com
This leaflet was last revised in: April 2012.

Source: http://www.remifemin.de/fachkreise/pdf/gifRemifeminPlus_en.pdf