What is Efient used for?

You have been prescribed Efient because you have already had a heart attack or unstable angina and you have been treated with a procedure to open blocked arteries in the heart. You may also have had one or more stents placed to keep open a blocked or narrowed artery supplying blood to the heart. Efient reduces the chances of you having a further heart attack or stroke or of dying from one of these atherothrombotic events. Your doctor will also give you aspirin, another anti-platelet agent.

How to take Efient

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

The usual dose of Efient is 10 mg per day. You will start the treatment with a single dose of 60 mg. If you weigh less than 60 kg or are more than 75 years of age, the dose is 5 mg Efient per day. Your doctor will also tell you the exact dose of Aspirin that you need to take.

You may take Efient with or without food. Take your dose at around the same time every day. Do not break or crush the tablet.

It is important that you tell your doctor, dentist and pharmacist, that you are taking Efient.

Do not take Efient

• If you are allergic to the ingredients of this medicine: an allergic reaction may be recognised as a rash, itching, a swollen face, swollen lips or shortness of breath. If this has happened to you, tell your doctor immediately.
• If you have a medical condition that is currently causing bleeding, such as bleeding from your stomach or intestines.
• If you have ever had a stroke or a transient ischaemic attack (TIA).
• If you have severe liver disease.

Warnings and precautions
You should tell your doctor before taking Efient if you have an increased risk of bleeding such as:

• age of 75 years or older
• a recent serious injury
• recent surgery (including some dental procedures)
• recent or recurrent bleeding from the stomach or intestines
• body weight of less than 60 kg. Your doctor should prescribe a daily dose of 5 mg of Efient
  if you weigh less than 60 kg
• kidney disease or moderate liver problems
• planned surgery (including some dental procedures) in the next seven days.

Children and adolescents

Efient should not be used in children and adolescents below 18 years of age.

Other medicines and Efient

Tell your doctor if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription, dietary supplements and herbal remedies. It is particularly important to tell your doctor if you are being treated with:

• clopidogrel (an anti-platelet agent),
• warfarin (an anti-coagulant),
• “non steroidal anti inflammatory drugs” for pain and fever (such as ibuprofen, naproxen, etoricoxib). If given together with Efient these medicines may increase the risk of bleeding.
• morphine or other opioids (used to treat severe pain).

Only take other medicines while you are on Efient if your doctor tells you that you can.

Pregnancy and breast-feeding

Tell your doctor if you become pregnant or are trying to become pregnant while you are taking Efient. You should use Efient only after discussing with your doctor the potential benefits and any potential risks to your unborn child.
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.

If you take more Efient than you should

Contact your doctor or hospital straight away, as you may be at risk of excessive bleeding. You should show the doctor your pack of Efient.

If you forget to take Efient

If you miss your scheduled daily dose, take Efient when you remember. If you forget your dose for an entire day, just resume taking Efient at its usual dose the next day. Do not take a double dose to make up for a forgotten dose.

If you stop taking Efient

Do not stop taking Efient without consulting your doctor; if you stop taking Efient too soon, your risk of a heart attack may be higher.

Possible side effects

Stroke is an uncommon side effect of Efient in patients who have never had a stroke or transient ischaemic attack (TIA), therefore contact your doctor immediately if you notice any of the following:

• Sudden numbness or weakness of the arm, leg or face, especially if only on one side of the
  body.
• Sudden confusion, difficulty speaking or understanding others.
• Sudden difficulty in walking or loss of balance or co-ordination.
• Sudden dizziness or sudden severe headache with no known cause.

Also contact your doctor immediately if you notice any of the following:

• Fever and bruising under the skin that may appear as red pinpoint dots, with or without unexplained extreme tiredness, confusion, yellowing of the skin or eyes (jaundice).
• A rash, itching, or a swollen face, swollen lips/tongue, or shortness of breath. These may be signs of a severe allergic reaction.

Tell your doctor promptly if you notice any of the following:

• Blood in your urine.
• Bleeding from your rectum, blood in your stools or black stools.
• Uncontrollable bleeding, for example from a cut.

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

• Bleeding in the stomach or bowels
• Bleeding from a needle puncture site
• Nose bleeds
• Skin rash
• Small red bruises on the skin (ecchymoses)
• Blood in urine
• Haematoma (bleeding under the skin at the site of an injection, or into a muscle, causing swelling)
• Low haemoglobin or red blood cell count (anaemia)
• Bruising

REFERENCES:

https://www.medicines.org.uk/emc/product/6466/smpc

https://www.medicines.org.uk/emc/product/6466/pil

https://www.ema.europa.eu/en/medicines/human/EPAR/efient

https://www.medicines.ie/medicines/efient-5mg-10mg-film-coated-tablets-eli-lilly-and-company-ltd-daiichi-sankyo-uk-ltd--31966/patient-info