PACKAGE LEAFLET PACKAGE LEAFLET: INFORMATION FOR THE USER. chloroprocaine hydrochloride

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Page 1 PACKAGE LEAFLET PACKAGE LEAFLET: INFORMATION FOR THE USER Ampres 10 mg/ml solution for injection chloroprocaine hydrochloride Read all of this leaflet carefully before you are given 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. - If you get any side effects, talk to your doctor, or pharmacist. This includes any possible side effects not listed in this leaflet. What is in this leaflet 1. What Ampres is and what it is used for 2. What you need to know before you are given Ampres 3. How Ampres is used 4. Possible side effects 5. How to store Ampres 6. Contents of the pack and other information 1. What Ampres is and what it is used for Ampres is a type of medicine called local anaesthetic, belonging to the category of the esters, and is a solution for injection. Ampres is used to anaesthetise (numb) specific parts of the body and prevent pain during surgery. Ampres is indicated in adults only. 2. What you need to know before you are given Ampres Do not use Ampres: - if you are allergic to chloroprocaine hydrochloride, other ester-type local anaesthetics or any of the other ingredients of this medicine (listed in section 6), - if you have serious problems with cardiac conduction, - if you suffer from severe anaemia, It is also necessary to take into consideration general and specific contraindications for the technique of spinal anaesthesia = intrathecal anaesthesia (decompensated cardiac insufficiency, hypovolemic shock). Warnings and precautions If you suffer of any of these, you should discuss it with your doctor before being given this medicine. - if you have ever had a bad reaction to an anaesthetic in the past - if you have signs of skin infection or inflammation at or near the proposed site of the injection - if you are suffering from any of the following:

Page 2 - diseases of the central nervous system such as meningitis, polio and problems with your spinal cord due to anaemia - a severe headache - brain, spine or any other tumours - tuberculosis of the spine - recent trauma to your spine - very low blood pressure or low blood volume - problems with clotting of your blood - acute porphyria - fluid in your lungs - septicaemia (blood poisoning) - if you have a heart condition - if you suffer from neurological disorder, such as multiple scleroris, hemiplegia, paraplegia or neuromuscular disorders Other medicines and Ampres Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. In particular if you are taking any medicines for an irregular heartbeat (class III antiarrhythmics agents) and for pain relief. Ampres with food and drink It is not recommanded to assume any food or drink prior to use Ampres. Pregnancy, breast-feeding and fertility If you are pregnant or you think you may be pregnant, you have to inform your doctor. Ampres is not recommended for local or regional anaesthesia during pregnancy and it should be given in pregnancy only if absolutely necessary. This does not preclude the use of Ampres during childbirth. It is not known whether chloroprocaine passes into breast milk. If you are breast-feeding you should inform your doctor who will decide whether or not you should be given Ampres. Driving and using machines Ampres has a major influence on the ability to drive and use machines. Your doctor is responsible for deciding in each case if you can drive or use machines. Ampres contains sodium This medicinal product contains less than 1 mmol sodium (23 mg) per dose (maximum dose equal to 5 ml of Ampres solution for injection), so it is essentially sodium-free. 3. How Ampres is used Ampres is injected via intrathecal (spinal) route where the planned surgical procedure should not exceed 40 minutes. This medicine will be given to you by your doctor who will decide what dose is right for you. This will normally be between 4 5 ml (40 50 mg chloroprocaine hydrochloride). For patients in a compromised general condition (e.g. vascular occlusion, arteriosclerosis, diabetic polyneuropathy), a reduced dose is indicated.

Page 3 Use in children and adolescents Ampres must not be used in children and adolescents. Equipment, drugs and personnel capable of dealing with an emergency, must be immediately available. Rare cases of severe reactions have been reported after using local anaesthetics, even in the absence of individual hypersensitivity in the patient s case history. If you have any further questions on the use of this medicine, ask your doctor or pharmacist. 4. Possible side effects Like all medicines, Ampres can cause side effects, although not everybody gets them. You may feel sick, have lowered blood pressure or a slow heart beat. Other possible effects are headache after surgery, vomiting and difficulty in passing urine. These are the possible side effects: Very common: may affect more than 1 in 10 people Lowered blood pressure, feeling sick (nausea) Common: may affect up to 1 in 10 people Anxiety, restlessness, paresthesia, dizziness, vomiting. Uncommon: may affect up to 1 in 100 people Drop in arterial blood pressure (with high doses), slow heart beat, shaking, convulsions, numbness of the tongue, hearing problems, visual problems, speech problems, loss of consciousness. Rare: may affect up to 1 in 1,000 people Allergic reactions such as itching, erythema (redness of skin), edema (swelling), sneezing, vomiting, dizziness, excessive sweating, elevated temperature, anaphylactic reactions. Neuropathy, drowsiness, merging into unconsciousness and respiratory arrest, spinal block (including total spinal block), lowered blood pressure consequently to spinal block, loss of bladder and bowels control, loss of perineal sensation and sexual function, arachnoiditis, persistent motor, sensory and/or autonomic (sphincter control) deficit of some lower spinal segments with slow recovery (several months), cauda equina syndrome and permanent neurological injury. Diplopia, irregular heartbeat. Depression of myocardium, cardiac arrest (the risk is increased by high doses or unintended intravascular injection). Respiratory depression. Reporting of side effects If you get any side effects, talk to your doctor or nurse. 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. By reporting side effects you can help provide more information on the safety of this medicine. 5. How to store Ampres

Page 4 Keep out of the sight and reach of children. Do not use Ampres after the expiry date which is stated on the ampoules and the outer carton. The expiry date refers to the last day of that month. Do not refrigerate or freeze. Please do not store above 25 C. Store in original package in order to protect from light. Use immediately after first opening. For single use only. Ampres should not be administred if noticed that the solution is not clear and free from particles. Any unused medicinal product or waste material should be disposed of in accordance with local requirements. As it is limited to hospital use the waste drug elimination is carried out directly by the hospital. These measures will help to protect the environment. 6. Contents of the pack and other information What Ampres contains The active substance is chloroprocaine hydrochloride. 1 ml of solution for injection contains 10 mg of chloroprocaine hydrochloride. 1 ampoule with 5 ml solution, contains 50 mg of chloroprocaine hydrochloride. The other ingredients are hydrochloric acid 1N (for ph adjustment), sodium chloride, water for injection. What Ampres looks like and contents of the pack This medicinal product is presented as a solution for injection. The solution is a clear, colourless solution. It comes in Type I clear colourless glass ampoules. Box of 10 ampoules each containing 5 ml of solution for injection Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder Sintetica Limited, 30th Floor, 40 Bank Street, Canary Wharf, London, E14 5NR, United Kingdom Manufacturer Sirton Pharmaceuticals S.P.A. Piazza XX Settembre 2 22079 Villa Guardia Italy This medicinal product is authorised in the Member States of the EEA under the following names: Member State Austria Product Name Ampres 10mg/ml Injektionslösung

Page 5 Belgium France Ampres 10mg/ml Solution for injection - Oplossing voor injectie Solution injectable - Injektionslösung Clorotekal 10mg/ml solution pour injection Germany Ampres 10mg/ml Injektionslösung Ireland Ampres 10mg/ml solution for injection Italy Decelex Poland Ampres Spain Ampres 10mg/ml solución inyectable United Kingdom Ampres 10mg/ml solution for injection This leaflet was last revised in 03/2017