PACKAGE LEAFLET: INFORMATION FOR THE USER. Anastrozole 1 mg film-coated tablets

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PACKAGE LEAFLET: INFORMATION FOR THE USER Anastrozole 1 mg film-coated tablets 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 Anastrozole is and what it is used for 2. What you need to know before you take Anastrozole 3. How to take Anastrozole 4. Possible side effects 5. How to store Anastrozole 6. Contents of the pack and other information 1. What Anastrozole is and what it is used for Anastrozole 1 mg film-coated tablets contain a substance called anastrozole. Anastrozole belongs to a group of medicines called aromatase inhibitors. Anastrozole is used to treat breast cancer in women who have gone through the menopause. Anastrozole works by cutting down the amount of the hormone called oestrogen that your body makes. It does this by blocking a natural substance (an enzyme) in your body called aromatase. 2. What you need to know before you take Anastrozole Do not take Anastrozole: if you are allergic to anastrozole or any of the other ingredients of this medicine (listed in section 6). if you are pregnant or breast-feeding (see the section called Pregnancy and breast-feeding ). Do not take Anastrozole if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Anastrozole. Warnings and precautions Talk to your doctor or pharmacist before taking Anastrozole - if you still have menstrual periods and have not yet gone through the menopause. - if you are taking a medicine that contains tamoxifen or medicines that contain oestrogen (see the section called Other medicines and Anastrozole ).

- if you have ever had a condition that affects the strength of your bones (osteoporosis). - if you have problems with your liver or kidneys. If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking Anastrozole. If you go into the hospital, let the medical staff know you are taking Anastrozole. Taking Other medicines and Anastrozole Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because Anastrozole can affect the way some medicines work and some medicines can have an effect on Anastrozole. Do not take Anastrozole if you are already taking any of the following medicines: - Certain medicines used to treat breast cancer (selective oestrogen receptor modulators), e.g., medicines that contain tamoxifen. - Medicines that contain oestrogen, such as hormone replacement therapy (HRT). This is because these medicines may stop Anastrozole from working properly. If this applies to you, ask your doctor or pharmacist for advice. Tell your doctor or pharmacist if you are taking the following: - A medicine known as an LHRH analogue. This includes gonadorelin, buserelin, goserelin, leuprorelin and triptorelin. These medicines are used to treat breast cancer, certain female health (gynaecological) conditions, and infertility. Pregnancy and breast-feeding Do not take Anastrozole if you are pregnant or breast-feeding. Stop Anastrozole if you become pregnant and talk to your doctor. Ask your doctor or pharmacist for advice before taking any medicine. Driving and using machines Anastrozole is not likely to affect your ability to drive or use any tools or machines. However, some people may occasionally feel weak or sleepy while taking Anastrozole. If this happens to you, ask your doctor or pharmacist for advice. Anastrozole contains lactose Anastrozole tablets contain lactose which is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars contact your doctor before taking this medicine. 3. How to take Anastrozole

- Always take Anastrozole exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. The recommended dose is one tablet (1 mg anastrozole) taken once daily. - Try to take your tablet at the same time each day. - Swallow the tablet whole with a drink of water. - It does not matter if you take Anastrozole before, with or after food. Keep taking Anastrozole for as long as your doctor tells you to. It is a long-term treatment and you may need to take it for several years. Use in children and adolescents Anastrozole should not be given to children and adolescents. If you take more Anastrozole than you should If you take more Anastrozole than you should, talk to a doctor straight away. If you forget to take Anastrozole If you forget to take a dose, just take your next dose as normal. Do not take a double dose (two doses at the same time) to make up for a forgotten dose. If you stop taking Anastrozole Do not stop taking your tablets unless your doctor tells you to. 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. If any of the following happen, do not take more Anastrozole. Tell your doctor immediately or go to the casualty department at your nearest hospital: Uncommon (may affect up to 1 in 100 people): Inflammation of the liver (hepatitis) with nausea, vomiting, loss of appetite, fever, itching, yellowing of the skin and eyes, light coloured bowel motions or dark coloured urine. Rare (may affect up to 1 in 1,000 people): Skin rash caused by hypersensitivity (this can be from a severe allergic reaction) Inflammation of the small blood vessels causing red or purple colouring of the skin. Very rarely symptoms of joint, stomach, and kidney pain may occur; this is known as Henoch-Schönlein purpura Very rare (may affect up to 1 in 10,000 people): An extremely severe skin reaction with ulcers or blisters on the skin. This is known as Stevens-Johnson syndrome

Allergic (hypersensitivity) reactions with swelling of the throat that may cause difficulty in swallowing or breathing. This is known as angioedema. Other side effects include: Very common: may affect more than 1 in 10 people Headache Hot flushes Feeling sick (nausea) Skin rash Pain or stiffness in your joints Inflammation of the joints (arthritis). Feeling weak Bone loss (osteoporosis). Common: may affect up to 1 to 10 people Loss of appetite Raised or high levels of a fatty substance known as cholesterol in your blood. This would be seen in a blood test Feeling sleepy Carpal tunnel syndrome (tingling, pain, coldness, weakness in parts of the hand) Diarrhoea Being sick (vomiting) Changes in blood test that show how well your liver is working Thinning of your hair (hair loss) Allergic (hypersensitivity) reactions including face, lips or tongue. Bone pain Vaginal dryness Bleeding from the vagina (usually in the first few weeks of treatment if the bleeding continues, talk to your doctor) Muscle pain Uncommon: may affect up to 1 to 100 people Changes in special blood tests that show how your liver is working (gamma-gt and bilirubin) Hives or nettle rash Raised or high levels of calcium in your blood. If you experience nausea, vomiting and thirst, you should tell your doctor or pharmacist as you may need to have blood tests. Trigger finger (a condition in which your finger or thumb catches in a bent position). Rare: may affect up to 1 to 1,000 people Rare inflammation of your skin that may include red patches or blisters, known as erythema multiforme. Effects on your bones Anastrozole lowers the amount of the hormone called estrogen that is in your body. This may lower the mineral content of your bones. Your bones may be less strong and may be more likely to fracture. Your doctor will manage these risks according to

treatment guidelines for managing bone health in women who have gone through the menopause. You should talk to your doctor about the risks and treatment options. 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 at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine. 5. How to store Anastrozole Keep out of the sight and reach of children. This medicinal product does not require any special storage conditions. Do not use this medicine after the expiry date which is stated on the blister foil or carton after EXP. The expiry date refers to the last day of that month. 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 Anastrozole contains The active substance is anastrozole. One tablet contains 1 mg of anastrozole. The other ingredients in the tablet core are lactose monohydrate (see section 2 Anastrozole contains lactose ), sodium starch glycolate, povidone (E1201), and magnesium stearate (E572). The ingredients in the tablet coating are macrogol, hypromellose (E464), and titanium dioxide (E171). What Anastrozole looks like and contents of the pack Anastrozole is a white film-coated round tablet, with the inscriptions ANA and 1 on one side. Anastrozole is available in blisters of 10, 14, 20, 28, 30, 50, 56, 60, 84, 90, 98, 100 or 300 tablets and in hospital blisters of 28, 50, 84, 98, 300 or 500 tablets. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder: Mylan Potters Bar

Hertfordshire EN6 1TL United Kingdom Manufacturers: Synthon BV Microweg 22 6545 CM Nijmegen The Netherlands Synthon Hispania, S.L. C/Castelló, 1 Polígono Las Salinas 08830 Sant Boi de Llobregat Barcelona Spain Mylan Hungary Kft, H-2900 Komaron, Mylan utca 1, Hungary Gerard Laboratories, 35/36 Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland This leaflet was last revised in 11/2018