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Kalma

contains the active ingredient alprazolam
CONSUMER MEDICINE INFORMATION

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. This page contains answers to some common questions about Kalma. It does not contain all the information that is known about Kalma. It does not take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Your doctor has weighed the risk of you using this medicine against the benefits he/she expects it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. Bookmark or print this page, you may need to read it again.

What Kalma is used for

Kalma is used for the treatment of anxiety. Anxiety or tension associated with the normal stress of everyday life usually does not require treatment with medicines.
Kalma is also used to treat panic attacks.
Ask your doctor if you have any questions about why Kalma has been prescribed for you.
Your doctor, however, may have prescribed Kalma for another reason.
Kalma belongs to a group of medicines called benzodiazepines. These medicines are thought to work by their action on brain chemicals.
In general, benzodiazepines such as Kalma are taken for short periods only (for example 2 to 4 weeks). Continuous long term use is not recommended unless advised by your doctor. The use of benzodiazepines may lead to dependence on the medicine.
If you take Kalma for too long, it may become habit-forming. Benzodiazepines may lead to physical or psychological dependence. If you have any concerns, you should discuss this with your doctor.
Kalma is available only with a doctor's prescription.

Before you take Kalma

When you must not take it

Do not take Kalma if you are allergic to:
medicines containing alprazolam
any other benzodiazepine medicine
any of the ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include skin rash, itching or hives, swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing, wheezing or shortness of breath.
Do not take Kalma if you have:
severe and chronic lung disease
myasthenia gravis, a condition which causes severe muscle weakness.
Do not take this medicine if you are pregnant.
Kalma may affect your unborn baby if you take it during pregnancy.
Your doctor will discuss the risks and benefits of taking Kalma during pregnancy.
Do not take Kalma if you are breastfeeding.
Kalma passes into the breast milk and may cause drowsiness, weight loss and feeding difficulties in the infant.
Do not give this medicine to a child unless advised by the child's doctor.
The safety and effectiveness of Kalma in children have not been established.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it

Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.
Tell your doctor if you have, any medical conditions, especially the following:
depression, psychosis or schizophrenia
borderline personality disorder (BPD)
post-traumatic stress disorder (PTSD)
epilepsy (fits or convulsions)
liver, kidney or lung problems
glaucoma (increased eye pressure)
hypotension (low blood pressure)
Tell your doctor if you are pregnant or planning to become pregnant or are breastfeeding.
Your doctor can discuss with you the risks and benefits involved.
Tell your doctor if you have a history of alcohol or drug abuse, or find it difficult to stop taking medicines, drugs or drinking alcohol.
Your doctor may want to give you extra support when you need to stop taking Kalma.
Tell your doctor if you plan to have surgery.
If you have not told your doctor about any of the above, tell them before you start taking Kalma.

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including any that you buy with or without a prescription from a pharmacy, supermarket or health food shop.
Some medicines may be affected by Kalma or may affect how well Kalma works. You may need different amounts of your medicines, or you may need to take different medicines. Your doctor will advise you.
Tell your doctor or pharmacist if you are taking any of the following:
other sleeping tablets, sedatives (medicines used to produce calmness) or tranquillisers
muscle relaxants
medicines for depression
lithium, a medicine used to treat mood swings and some types of depression
medicines used to treat epilepsy (fits and seizures) such as barbiturates
some medicines used to treat high blood pressure
antihistamines, medicines for allergies, hay fever or colds, some pain relievers, especially strong pain relievers such as codeine, morphine or propoxyphene
disulfiram, a medicine used in the treatment of alcohol dependence
cimetidine, a medicine commonly used to treat reflux and ulcers.
some antibiotics such as erythromycin or clarithromycin
oral contraceptives (birth control pill)
HIV protease inhibitors, medicines used to treat HIV infection
some antifungals, medicines used to treat fungal infections, such as ketoconazole or itraconazole
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Kalma.

How to take Kalma

How much to take

Follow all directions given to you by your doctor and pharmacist carefully.
They may differ from the information contained in this leaflet.
The dose varies from patient to patient.
Your doctor will tell you how much to take. Take Kalma exactly as directed by your doctor. Your doctor will decide the right dose for you.
Elderly patients and people with liver or kidney problems may need smaller doses.
If you do not understand the instructions on the bottle, ask your doctor or pharmacist for help.

How to take it

Swallow the tablets with a full glass of water.
Kalma 0.25 mg, 0.5 mg and 1 mg tablets can be divided in half along the scoreline if your doctor has prescribed half a tablet. Kalma 2 tablets can also be quartered.

When to take it

Take your tablet at about the same time each day.
Your doctor will tell you how many times a day you should take your medicine, but taking it at the same time each day will have the best effect. It will also help you remember to take it.
Kalma can be taken with or without food.
However, taking the tablets immediately after food may reduce the sleepiness or drowsiness you may experience with Kalma.

How long to take it

Do not take Kalma for longer than your doctor has directed.
In general, benzodiazepines such as Kalma are taken for short periods only (for example 2 to 4 weeks).
Continuous long-term use is not recommended unless advised by your doctor.
The use of benzodiazepines may lead to dependence on the medicine.
Continue taking your medicine for as long as your doctor tells you to and always see your doctor before you stop taking it.
Your dose will need to be reduced gradually to prevent unwanted side effects.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take the missed dose as soon as you remember, and then go back to taking your tablets as you would normally.
Do not take a double dose to make up for the dose you missed.
If you are not sure what to do, ask your doctor or pharmacist.
If you have any questions about this, check with your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think you or anyone else may have taken too much Kalma.
Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
Tell the doctor, nurse or pharmacist about any alcohol or other medicines which you have taken.
If you take too much Kalma, you may feel drowsy, tired, confused, dizzy; have a fast heart beat, difficulty breathing; feel weak or become unconscious.

While you are taking Kalma

Things you must do

Before starting any new medicine, tell your doctor or pharmacist that you are taking Kalma.
Tell all the doctors, dentists and pharmacists who are treating you that you are taking Kalma.
If you become pregnant while taking Kalma, tell your doctor.
If you plan to have surgery, including dental surgery, tell your doctor or dentist that you are taking Kalma.
If you become pregnant while you are taking this medicine, tell your doctor.
If you are about to have any blood tests, tell your doctor that you are taking this Kalma.
If you have to have any clinical tests such as an EEG (electroencephalogram), tell your doctor that you are taking Kalma.
Kalma may affect the results of some tests.
Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed.
Otherwise your doctor may think that it was not effective and change your treatment unnecessarily.
If you feel Kalma is not helping your condition, tell your doctor.
Visit your doctor regularly so they can check on your progress and determine whether you need to keep taking Kalma.
Always discuss with your doctor any problems or difficulties during or after taking Kalma. If you are being treated for anxiety, be sure to tell your doctor how you feel, especially if your anxiety attacks are getting worse or more frequent.
This will help your doctor determine the best treatment for you.
Do not run out of your medicine.
It is important that you take your medicine as prescribed.

Things you must not do

Do not use Kalma to treat any other conditions unless your doctor tells you to.
Do not give Kalma to anyone else, even if they have the same condition as you.
Do not drive or operate machinery until you know how Kalma affects you.
This medicine may cause drowsiness, dizziness or lightheadedness in some people. If any of these occur, do not drive, operate machinery or do anything else that could be dangerous.
Even if you take Kalma at night, you may still be drowsy or dizzy the next day.
Do not take Kalma for longer than your doctor has prescribed.
Kalma should be taken for short periods only (for example 2 to 4 weeks), unless advised otherwise by your doctor.
Do not increase your dose of Kalma, without first checking with your doctor.
If your symptoms have returned even though you are taking the same dose, you should speak to your doctor, who will determine whether a dose adjustment is required.
Do not stop taking Kalma, or change the dose, without checking with your doctor.
Stopping Kalma suddenly may make your condition worse and cause other unwanted effects such as trouble sleeping, irritability and nervousness. Your doctor may want you to gradually reduce the amount of Kalma you are taking before stopping completely.
Do not suddenly stop taking Kalma if you suffer from epilepsy.
Stopping this medicine suddenly may make your epilepsy worse.

Things to be careful of

Be careful when drinking alcohol while taking Kalma.
Your doctor may suggest you avoid alcohol or reduce the amount of alcohol you drink while you are taking Kalma. Combining Kalma and alcohol can make you more sleepy, dizzy or lightheaded. Also, your tolerance to alcohol may be lower than usual.
Be careful if you are elderly, unwell or taking other medicines.
Some people may experience side effects such as drowsiness, confusion, dizziness and unsteadiness, which may increase the risk of a fall.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Kalma.
This medicine helps most people with anxiety or panic attacks, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
It can be difficult to tell whether side effects are the result of taking Kalma, effects of your condition or side effects of other medicines you may be taking. For this reason it is important to tell your doctor of any change in your condition.
If you are over 65 years of age you may have an increased chance of getting side effects.
Do not be alarmed by the list of possible side effects.
You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if...

Tell your doctor or pharmacist if you notice any of the following and they worry you:
drowsiness, tiredness
dizziness, lightheadedness, confusion
unsteadiness, clumsiness
slurred speech
blurred vision
headache
loss of appetite
nausea (feeling sick)
constipation
dry mouth
stomach upsets
changes in sex drive
urinary problems
menstrual irregularities.
The above list includes the more common or mild side effects of Kalma. They are usually mild and do not last very long.

Tell your doctor as soon as possible if...

Tell your doctor as soon as possible if you notice any of the following:
loss of alertness or concentration, memory loss
abnormal thinking
nervousness or feeling anxious
shakiness or tremor, muscle weakness
involuntary movements
swelling of hands, ankles or feet
yellowing of the skin and whites of the eyes.
The above list serious side effects that may require medical attention. Serious side effects are not common.

Go to hospital if...

Tell your doctor immediately or go to Accident and Emergency at the nearest hospital if you notice any of the following:
aggressive behaviour, hostility, agitation, violent anger, hallucinations
allergic reactions such as swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing; skin rash, hives or itching.
The above list includes serious side effects which may require medical attention. Serious side effects are rare.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some people.

After taking Kalma

Storage

Keep your tablets in the bottle until it is time to take them.
If you take the tablets out of the bottle they may not keep well.
Keep your tablets in a cool dry place, protected from light, where the temperature stays below 25°C.
Do not store Kalma or any other medicine in the bathroom or near a sink. Do not leave Kalma in the car or on window sills.
Heat and dampness can destroy some medicines.
Keep Kalma where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking Kalma, or your tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.

Product description

What it looks like

Kalma comes in 4 strengths:
Kalma 0.25 - white, oval, scored tablet, marked AL|0.25 and G
Kalma 0.5 - pale pink, oval, scored tablet, marked AL|0.5 and G
Kalma 1 - pale blue, oval, scored tablet, marked AL|1.0 and G
Kalma 2 - white, oblong, triple scored tablet, marked |A|L| and |G|2|.
Each pack contains 50 tablets.

Ingredients

The active ingredient in Kalma is alprazolam. Each Kalma tablet contains 0.25 mg, 0.5 mg, 1 mg or 2 mg of alprazolam.
The tablets also contain the following inactive ingredients:
lactose
sodium benzoate (211)
maize starch
magnesium stearate
sodium starch glycollate
microcrystalline cellulose
colloidal anhydrous silica
povidone
docusate sodium
indigo carmine CI 73015 (132)
(Kalma 0.5 mg and Kalma 1 mg only)
erythrosine CI 45430 (127)
(Kalma 0.5 mg only).
The tablets are gluten free.

Manufacturer

Kalma is made in Australia by:
Alphapharm Pty Limited
(ABN 93 002 359 739)
Level 1, 30 The Bond
30 - 34 Hickson Road
Millers Point NSW 2000
Phone: (02) 9298 3999
www.alphapharm.com.au
Australian registration numbers:
Kalma 0.25 - AUST R 46835
Kalma 0.5 - AUST R 46837
Kalma 1 - AUST R 46839
Kalma 2 - AUST R 63993
This leaflet was prepared on
28 May 2015.
Kalma_cmi\May15/00