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Diacomit 500 mg hard capsulesPatient’s LeafletSummary for th
2014-07-03 22:40:33 来源: 作者: 【 】 浏览:371次 评论:0

For doctors

 

What is it and how is it used?

Diacomit belongs to a group of medicines called antiepileptics.

It is used in conjunction with clobazam and valproate to treat a certain form of epilepsy called severe myoclonic epilepsy in infancy (Dravet’s syndrome), which affects children. Your child’s doctor has prescribed this medicine to help treat your child’s epilepsy. It should always be taken in combination with other prescribed antiepileptic medicines under the direction of a doctor.

What do you have to consider before using it?

Your child must NOT take Diacomit
• if your child is allergic (hypersensitive) to stiripentol or to any of the other ingredients of Diacomit.
• if your child has ever experienced attacks of delirium.

Take special care with Diacomit if your child has kidney or liver problems. if your child is using medicines containing --------- cisapride used to treat symptoms of night time heartburn pimozide used to treat the symptoms of Tourettes syndrome e.g. vocal outbursts and uncontrolled, repeated movements of the body ergotamine used to treat migraine dihydroergotamine used to relieve the signs and symptoms of decreased mental capacity due to the aging process halofantrine an antimalarial drug quinidine used to treat abnormal heart rhythms bepridil used to control chest pain cyclosporine, tacrolimus, sirolimus all three used to prevent rejections of liver, kidney and heart transplants statins simvastatin and atorvastatin, both used to reduce the amount of cholesterol in blood.

---if your child uses one of the following products antiepileptic medicines containing phenobarbital, primidone, phenytoin, carbamazepine, diazepam. medicines containing midazolam or triazolam drugs used to reduce anxiety and sleeplessness in combination with Diacomit they may make your child very sleepy chlorpromazine used for mental illness such as psychosis. medicines, beverages and foods containing caffeine or theophylline these substances help restore mental alertness. The combination with Diacomit should be avoided as it may increase their blood levels, leading to digestive disorders, racing heart and insomnia.

Using other medicines
If your child needs to use other medicines, please see above “Take special care with Diacomit”.

Please tell your child’s doctor or pharmacist if your child is using or has recently used any other medicines, including medicines obtained without a prescription.

Taking Diacomit with food and drink
Your child should take Diacomit with food, it should NOT be taken on an empty stomach. Do NOT take Diacomit with milk or dairy products (yoghurt, soft cream cheeses, etc), fruit juice, fizzy drinks or food and drinks that contain caffeine or theophylline (for example cola, chocolate, coffee, tea and energy drinks).

Pregnancy
During pregnancy, effective antiepileptic treatment must NOT be stopped. If your child may be or is pregnant, please ask your child’s doctor for advice.

Ask your child’s doctor or pharmacist for advice before taking any medicine.

Breast-feeding
Breast-feeding is not recommended during treatment with this medicine.

Ask your child’s doctor or pharmacist for advice before taking any medicine.

Driving and using machines
This medicine may make your child feel sleepy.
Your child should not use any tools, machines, ride or drive if affected in this way. Check with your child’s doctor.

How is it used?

Your child should always take these capsules exactly as your child’s doctor has told you. You should check with your child’s doctor or pharmacist if you are not sure.

Dosage
The dose is adjusted by the doctor according to your child’s condition, generally 50 mg per kg bodyweight and per day.

How to take the Diacomit capsules
These capsules should be swallowed whole with water. The capsules should not be chewed. For food and drinks to be avoided, see the section “Taking Diacomit with food and drink” above.

When to take Diacomit
Your child should take this medicine two or three times a day at regular intervals as directed by your child’s doctor.

Dose adjustment
Any increase in dose should be gradual over 3 days while the dose of the other antiepileptic medicine(s) is reduced at the same time. Your child’s doctor will tell you the new dose of the other antiepileptic medicine(s).

If you have the impression that the effect of this medicine is too strong or too weak, talk to your child’s doctor or pharmacist. The dose will be adjusted by the doctor according to your child’s condition.

Please consult your child’s doctor in the event of any side effects as the doctor may have to adjust the dose of this medicine and the other antiepileptic medicine(s).

There are slight differences between the Diacomit capsules and powder for oral suspension. If your child experiences any problems when switching from taking the capsules to the powder for oral suspension or vice versa please inform your doctor.

If your child takes more Diacomit than he or she should
Contact your child’s doctor if you know or think your child has taken more medicine than he or she should have.

If your child forgets to take Diacomit
It is important that your child takes this medicine regularly at the same time each day. If your child forgets to take a dose, he or she should take it as soon as you remember unless it is time for the next dose. In that case carry on with the next dose as normal. Your child should not take a double dose to make up for a forgotten individual dose.

If your child stops taking Diacomit
Your child must not stop taking this medicine unless the doctor tells you to. Stopping treatment suddenly can lead to an outbreak of seizures.

If you have any further questions on the use of this product, ask your child’s doctor or pharmacist.

What are possible side effects?

Like all medicines, Diacomit can cause side effects, although not everybody gets them.

Very common side effects (more than one in 10 patients):
• loss of appetite, weight loss (especially when combined with the antiepileptic medicine sodium valproate);
• insomnia (sleeplessness), drowsiness;
• ataxia (inability to coordinate muscle movements), hypotonia (low muscle strength), dystonia (muscle disorders).

fatigue tiredness.

To eliminate these side effects, your child’s doctor may have to change the dose of concomitant medicines, or the dosage of Diacomit.

If any of these side effects persists or gets serious, or if you notice any side effects not listed in this leaflet, please tell your child’s doctor or pharmacist.

How should it be stored?

Keep out of the reach and sight of children. Your child should not take Diacomit after the expiry date, which is stated on the label. The expiry date refers to the last day of that month. Store in the original package in order to protect from light.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

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For doctors

What is it?

Diacomit is a medicine that contains the active substance stiripentol. It is available as capsules and sachets (250 and 500 mg). The sachets contain a powder that is used to make up an oral suspension (a liquid with solid particles in it).

What is it used for?

Diacomit is an anti-epileptic medicine. It is used in children with a very rare type of epilepsy called ‘severe myoclonic epilepsy in infancy’ (SMEI), also known as Dravet’s syndrome. This type of epilepsy affects young children. Diacomit is used as an add-on to clobazam and valproate (other anti-epileptic medicines) to treat generalised tonic-clonic seizures (major fits, including loss of consciousness) when these are not adequately controlled with clobazam and valproate. Because the number of patients with SMEI is low, the disease is considered ‘rare’, and Diacomit was designated as an ‘orphan medicine’ (a medicine used in rare diseases) on 5 December 2001. The medicine can only be obtained with a prescription.

How is it used?

Treatment with Diacomit should only be given under the supervision of a doctor who specialises in the diagnosis and management of epilepsy in infants and children (a paediatrician or paediatric neurologist). The normal dose is 50 mg per kilogram body weight, divided into two or three doses during the day. Treatment usually starts with a low dose, which is gradually increased to the recommended dose over three days. After starting Diacomit, the dose of clobazam may need to be reduced. The dose of valproate does not normally need to be adjusted.
The main studies of Diacomit were in children over three years of age. Decisions regarding the use of Diacomit in younger children should be made on a patient-by-patient basis: it can only be given to younger children if the diagnosis of SMEI has been confirmed.
Diacomit should be given at the same time as food, but not with dairy products, carbonated drinks, fruit juice, or food or drinks that contain caffeine or theophylline (a substance found in black and green tea, among other products).

How does it work?

The exact way in which stiripentol, the active substance in Diacomit, acts as an anti-epileptic medicine is not fully understood. It may act by increasing the activity of other anti-epileptic medicines by slowing down the rate at which they are broken down by the liver. It may also increase the levels of a

‘neurotransmitter’ called gamma-aminobutyric acid (GABA) in the gaps between nerve cells in the brain. Neurotransmitters are substances in the body that relay signals from a nerve cell to another cell.

How has it been studied?

The effects of Diacomit were first tested in experimental models before being studied in humans. The two main studies of Diacomit involved 65 children between three and 18 years of age. The studies compared the effectiveness of Diacomit capsules or sachets and placebo (a dummy treatment), when they were added to the children’s existing treatment with clobazam and valproate. The main measure of effectiveness was the number of patients who ‘responded’ to treatment. A patient was classified as a ‘responder’ if the number of seizures in the second month of treatment was at least 50% lower than the number in the month before treatment was started.

What benefits has it shown during the studies?

More patients responded to treatment with Diacomit than to placebo. In the first study, 71% of the patients taking Diacomit responded to treatment (15 out of 21), compared with 5% of the placebo group (1 out of 20). Similar results were seen in the second study, with 67% responding to Diacomit (8 out of 12) and 9% to placebo (1 out of 9). However, it is not clear whether this effect is due to Diacomit itself or to increased levels of the other anti-epileptic medicines.

What is the risk associated?

The most common side effects with Diacomit (seen in more than 1 in 10 patients) are anorexia (loss of appetite), weight loss, insomnia (difficulty sleeping), drowsiness, ataxia (inability to co-ordinate muscle movements), hypotonia (low muscle strength) and dystonia (muscle disorders). For the full list of all side effects reported with Diacomit, see the Package Leaflet.
Diacomit should not be used in people who may be hypersensitive (allergic) to stiripentol or to any of the other ingredients. It must not be used in patients who have had psychoses (a serious mental state with a distorted sense of reality) with attacks of delirium (a mental state with confusion, excitement, restlessness and hallucinations). Care must be taken when Diacomit is used at the same time as other medicines. See the Package Leaflet for the full list of these medicines.

Why has it been approved?

The Committee for Medicinal Products for Human Use (CHMP) concluded that Diacomit had shown its effectiveness in SMEI, albeit in studies that were limited and did not last as long as the Committee expected. It decided that Diacomit’s benefits are greater than its risks for use in conjunction with clobazam and valproate as adjunctive therapy of refractory generalised tonic-clonic seizures in patients with SMEI (or Dravet’s syndrome) whose seizures are not adequately controlled with clobazam and valproate. The Committee recommended that Diacomit be given marketing authorisation. Diacomit has been given ‘Conditional Approval’. This means that there is more evidence to come about the medicine. Every year, the European Medicines Agency (EMEA) will review any new information that may become available and this summary will be updated as necessary.

How has it been studied?

The company that makes Diacomit will carry out a study comparing Diacomit and clobazam, as an add-on to existing treatment in children whose symptoms are not adequately controlled with clobazam and valproate.

Further information

The European Commission granted a marketing authorisation valid throughout the European Union for Diacomit to Biocodex on 4 January 2007.

The summary of opinion of the Committee for Orphan Medicinal Products for Diacomit is available here.

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Name

 

Diacomit 500 mg hard capsules

 

Composition

 

Each capsule contains 500 mg of stiripentol.

Excipients: 0.32 mg sodium per capsule.

For a full list of excipients, see section 6.1.

 

Pharmaceutical Form

 

Hard capsules

Size 0, white capsule

 

Are you an Healthcare Professional? Access professional drug leaflets on Diagnosia.com!

 

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