InfoCons Consumer Protection informs you – Sycrest – Package Leaflet

Before anything else

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, pharmacist or nurse.
• 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, pharmacist or nurse. Th is includes any possible side effects not listed in this leaflet. See section 4.

ℹ️ 1. What Sycrest is and what it is used for

Sycrest contains the active substance asenapine . This medicine belongs to a group of medicines called antipsychotics. Sycrest is used to treat moderate to severe manic episodes associated with bipolar I disorder in adults. Antipsychotic medicines affect the chemicals that allow communication between nerve cells (neurotransmitters). Illnesses that affect the brain, such as bipolar I disorder, may be due to certain chemicals in the brain, such as dopamine and serotonin, being out of balance and these imbalances may cause some of the symptoms you may be ex periencing. Exactly how this medicine works is unknown, however, it is believed to adjust the balance of these chemicals.

Manic episodes associated with bipolar I disorder is a condition with symptoms such as feeling “high”, having excessive amounts of en ergy, needing much less sleep than usual, talking very quickly with racing ideas and sometimes severe irritability.

⚠️ 2. What you need to know before you take Sycrest

Do not take Sycrest

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

Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Sycrest.

Sycrest has not been studied in elderly patients with dementia. However, elderly patients with dementia, who are treated with ot her similar types of medicine, may have an increased risk of stroke or death. Sycrest is not approved for the treatment of elderly patients with dementia and is not recommended for use in this particular group of patients.

Sycrest may cause low blood pre ssure. In the early stages of treatment, some people may faint, especially when getting up from a lying or sitting position. This will usually pass on its own but if it does not, tell your doctor. Your dose may need to be adjusted.

40 Asenapine may cause sleepiness, sudden drops in blood pressure when you stand up, dizziness and changes in your ability to move and balance, which may lead to falls and, consequently, fractures or other injuries. Patients at risk for fall should be evaluated prior to prescribing asenapine.

Tell your doctor immediately if you experience − involuntary rhythmic movements of the tongue, mouth and face. Withdrawal of Sycrest may be needed. − fever, severe muscle stiffness, sweating or a lowered level of consciousness (a dis order called “neuroleptic malignant syndrome”). Immediate medical treatment may be needed.

Check with your doctor or pharmacist before taking Sycrest: − if you have ever been diagnosed with a condition whose symptoms include high body temperature and muscl e stiffness (also known as neuroleptic malignant syndrome). − if you have ever experienced abnormal movements of the tongue or face (tardive dyskinesia).

You should be aware that both of these conditions may be caused by this type of medicine. − if you have a heart disease or a treatment for heart disease that makes you prone to low blood pressure − if you are diabetic or prone to diabetes − if you have Parkinson’s disease or dementia − if you have epilepsy (seizures) − if you experience any difficulty in swallowing (d ysphagia) − if you have severe liver problems. If you do, you should not take Sycrest − if you have difficulty controlling core body temperature − if you have thoughts of suicide − if you have abnormally high levels of prolactin in the blood ( hyperprolactinaemia) Be sure to tell your doctor if you meet any of these conditions as he/she may want to adjust your dose or monitor you for a while. Also contact your doctor immediately if any of these conditions develops or worsens while using Sycrest .

Children and adolescents

Sycrest is not recommended for use in patients below the age of 18 years .

Other medicines and Sycrest

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Some medicines may reduce or increase the effect of Sycrest.

If you are taking other medicines, Sycrest should be taken last.

You should tell your doctor if you are taking antidepressant medicines (specifically fluvoxamine, paroxetine or fluoxetine), as it ma y be necessary to change your Sycrest or antidepressant medicine dose.

You should tell your doctor if you are taking medicines for Parkinson’s disease (such as levodopa), as this medicine may make them less effective.

Since Sycrest works primarily in the brain, interference from other medicines (or alcohol) that work in the brain could occur due to an additive effect on brain function.

Since Sycrest can lower blood pressure, care should be taken when Sycrest is taken with other medicines that lower blood pressure.

Sycrest with food, drink and alcohol

Do not eat or drink for 10 minutes after taking this medicine.

You should avoid drinking alcohol when taking this medicine.

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.

Do not take Sycrest while you are pregnant, unless your doctor tells you so. If you are taking this medicine and you become pregnant or you plan to get pregnant, ask your doctor as soon as possible whether you may continue taking Sycrest.

The following symptoms may occur in newborn babies, of mothers that have used Sycrest in the last trimester (l ast three months of their pregnancy): shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.

Do not breast -feed when taking Sycrest.

Driving and using machines

Sycrest may cause sleepiness or sedation . Therefore, make sure your concentration and alertness are not affected before you drive or operate machinery.

💊 3. How to take Sycrest

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The recommended dose is a sublingual tablet of 5 mg or 10 mg two times a day. One dose should be taken in the morning and one dose should be taken in the evening.

Instructions for use Sycrest is for sublingual use.

Sycrest is not advised if you are unable to take the tablet as described below. If you are unable to take this medicine as is described below, the treatment may not be effective for you .

• Do not remove a sublingual tablet from the blister until ready to take it.
• Use dry hands when touching the tablet.
• Do not push the tablet through the blister. Do not cut or tear the blister.
• Peel back the coloured tab (Figure 1).
• Gently remove the tablet (Figure 2). Do not crush the tablet.
• To ensure optimal absorption, place the tablet under the tongue and wait until it dissolves completely (Figure 3). The tablet will dissolve in saliva within seconds.
• Do not swallow or chew on the tablet.
• Do not eat or drink for 10 minutes after taking th e tablet.

Figure 1 Figure 2 Figure 3

If you take more Sycrest than you should

If you take too much Sycrest, contact a doctor straight away. Take the medicine pack with you. In case of overdose you may feel sleepy or tired, or have abnormal body mov ements, problems with standing and walking, feel dizzy due to low blood pressure and feel agitated and confused.

42 If you forget to take Sycrest Do not take a double dose to make up for a forgotten dose. If you miss one dose, take your next dose as usual. I f you miss two or more doses, contact your doctor or pharmacist.

If you stop taking Sycrest

If you stop taking Sycrest, you will lose the effects of this medicine. You should not stop taking this medicine, unless your doctor tells you as your symptoms may return.

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.

Serious side effects have been reported with this medicine. Seek medical attention immediately if you have any of the following symptoms:

• allergic reactions (These usually involve a combination of effects such as difficulty in breathing or swallowing, swol len face, lips, tongue or throat, skin rash, itching and increased heart rate.)
• sudden increase in body temperature, with sweating, fast heartbeat, severe muscle stiffness, confusion and fluctuating blood pressure which may lead to coma
• convulsions, fits o r seizures
• fainting
• falls which may occur as a result of one or more adverse events such as: sleepiness, sudden drops in blood pressure when you stand up, dizziness and changes in your ability to move and balance.

Tell your doctor right away if you have:

• signs of increased blood sugar levels such as excessive thirst, hunger or urination, weakness or onset of worsening of diabetes
• worm -like movements of the tongue, or other uncontrolled movements of the tongue, mouth, cheeks, or jaw which may progress to arms and legs

Other side effects reported with this medicine include

Very common side effects (may affect more than 1 in 10 people)

• anxiety
• sleepiness

Common side effects (may affect up to 1 in 10 people)

• weight gain
• increased appetite
• slow or sustained muscle contractions
• restlessness
• involuntary muscle contractions
• slow movements, tremor
• sedation
• dizziness
• nausea
• change in taste
• numb feeling of the tongue or in the mouth
• increased saliva (drooling)
• muscle tightness
• fatigue
• increase in the level of liver proteins 43 Uncommon side effects (may affect up to 1 in 100 people)
• abnormal muscle movements: a collection of symptoms known as extrapyramidal symptoms (EPS) which may include one or more of the following: abnormal movements of muscles, tongue, or jaw, slow or sustained muscle contractions, muscle spasms, tremor (shaking), abnormal movements of the eyes, involuntary muscle contractions, slow movements, or restlessness
• unpleasant sensations in the legs (also called restless le gs syndrome)
• speech problems
• abnormal slow or fast heartbeat
• middle heart block
• abnormal electrocardiogram (prolongation of the QT interval)
• low blood pressure upon standing
• low blood pressure
• tingling of the tongue or in the mouth
• swollen or painful tongue
• difficulty in swallowing
• ulcers, soreness, redness, swelling, and blisters within the mouth
• sexual dysfunction
• lack of regular menstrual periods

Rare side effects (may affect up to 1 in 1 ,000 people)

• changes in the levels of white blood cells
• difficulties in focusing with the eyes
• blood clots in blood vessels to the lungs causing chest pain and difficulty in breathing
• muscle disease presenting as unexplained aches and pains
• male breast enlargement
• leakage of milk or fluid from the breast

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 national reporting system listed in Appendix V . By reporting side effects you can help provide more information on the safety of this medicine.

🌡️ 5. How to store Sycrest

Keep this medicine out of the sight and re ach of children.

Do not use this medicine after the expiry date which is stated on the blister and on the carton. The expiry date refers to the last day of that month.

Store this medicine in the original package in order to protect from light and moistur e.

This medicinal product does not require any special temperature 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 Sycrest contains

• The active substance is asenapine.
• Each Sycrest 5 mg sublingual tablet contains 5 mg asenapine .
• Each Sycrest 10 mg sublingual tablet contains 10 mg asenapine.
• The exact amount is shown on your Sycrest tablet pack.

44 – The other ingredients are gelatin and mannitol (E421).

What Sycrest looks like and contents of the pack

The 5 mg sublingual tablets are round white to off -white tablets marked with “5” on one side.

The 10 mg sublingual tablets are round white to off -white tablets marked with “10” on one side.

The sublingual tablets are provided in peelable blisters containing 10 tablets each. Packs may contain 20, 60 or 100 tablets.

Not all pack sizes may be markete d.

Marketing Authorisation Holder

N.V. Organon Kloosterstraat 6 NL-5349 AB Oss The Netherlands

Manufacturer

Organon Heist bv Industriepark 30 2220 Heist -op-den-Berg, Belgium For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgique/Belgien Organon Belgium Tél/Tel: 0080066550123 (+32 2 2418100) [email protected] Lietuva Organon Pharma B.V. Lithuania atstovybė Tel.: +370 52041693 [email protected] България Органон (И.А.) Б.В. – клон България Тел.: +359 2 806 3030 [email protected] Luxembourg/Luxemburg Organon Belgium Tél/Tel: 0080066550123 (+32 2 2418100) [email protected] Česká republika Organon Czech Republic s.r.o.

Tel: +420 233 010 300 [email protected] Magyarország Organon Hungary Kft.

Tel.: +36 1 766 1963 [email protected] Danmark Organon Denmark ApS Tlf: +45 4484 6800 [email protected] Malta Organon Pharma B .V., Cyprus branch Tel: +356 2277 8116 [email protected] Deutschland Organon Healthcare GmbH Tel.: 0800 3384 726 (+49 (0) 89 2040022 10 ) [email protected] Nederland N.V. Organon Tel: 00800 66550123 (+32 2 2418100 ) [email protected] Eesti Organon Pharma B.V. Estonian RO Tel: +372 66 61 300 [email protected] Norge Organon Norway AS Tlf: +47 24 14 56 60 [email protected] 45 Ελλάδα BIANEΞ Α.Ε .

Τηλ: +30 210 80091 11 [email protected] Österreich Organon Healthcare GmbH Tel: 0800 3384 726 (+49 (0) 89 2040022 10) [email protected] España Organon Salud, S.L.

Tel: +34 91 591 12 79 [email protected] Polska Organon Polska Sp. z o.o.

Tel.: +48 22 105 50 01 [email protected] France Organon France Tél: +33 (0) 1 57 77 32 00 Portugal Organon Portugal, Sociedade Unipessoal Lda.

Tel: +351 218705500 [email protected] Hrvatska Organon Pharma d.o.o.

Tel: +385 1 638 4530 [email protected] România Organon Biosciences S.R.L.

Tel: +40 21 527 29 90 [email protected] Ireland Organon Pharma (Ireland) Limited Tel: +353 15828260 [email protected] Slovenija Organon Pharma B.V., Oss, podružnica Ljubljana Tel: +386 1 300 10 80 [email protected] Ísland Vistor hf .

Sími: +354 535 7000 Slovenská republika Organon Slovakia s. r. o.

Tel: +421 2 44 88 98 88 [email protected] Italia Organon Italia S.r.l.

Tel: +3 9 06 90259059 [email protected] Suomi/Finland Organon Finland Oy Puh/Tel: +358 (0) 29 170 3520 [email protected] Κύπρος Organon Pharma B.V., Cyprus branch Τηλ: +357 22866730 [email protected] Sverige Organon Sweden AB Tel: +46 8 502 597 00 [email protected] Latvija Ārvalsts komersanta “Organon Pharma B.V.” pārstāvniecība Tel: +371 66968876 [email protected] United Kingdom (Northern Ireland) Organon Pharma ( UK) Limited Tel: +44 (0) 208 159 3593 [email protected] This leaflet was last revised in {month/YYYY}.

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu .

📄 Package Leaflet – official source

This article reproduces the information in the official package leaflet, as authorised in the European Union. You can consult the original document here: Product information Sycrest (PDF, ec.europa.eu).

You can check this medicine at any time in the Union Register of medicinal products (EU number EU/1/10/640).

⚠️ Important: This article is for information purposes only and does not replace medical advice or the package leaflet inside the medicine box. Read the leaflet carefully before use. For any questions about your treatment, talk to your doctor or pharmacist. If you experience side effects, tell your doctor or pharmacist and report them through your national reporting system.