Domion

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia.

Consumer Medicine Information (CMI) summary
The full CMI on the next page has more details. If you have any questions about using this medicine, speak to your doctor or pharmacist.

Why am I using DOMION?

DOMION contains the active ingredient agomelatine. DOMION is used in the treatment of depression and the prevention of relapse of depression. DOMION is also used in the treatment of anxiety. It is only available with a doctor's prescription. For more information, see Section 1. Why am I using DOMION? in the full CMI.

What should I know before I use DOMION?

Do not use if you have ever had an allergic reaction to DOMION or any of the ingredients listed at the end of the CMI.
Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding. Do not use DOMION if you suffer from liver disease or you know your liver does not work properly (hepatic impairment). For more information, see Section 2. What should I know before I use DOMION? in the full CMI.

What if I am taking other medicines?

There are a few medicines may interfere with DOMION and affect how it works. A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

How do I use DOMION?

The usual dose of DOMION is one tablet at bedtime. In some cases your doctor may prescribe two tablets (50 mg) to be taken together at bedtime. You should not take more than the maximum recommended dose of two tablets daily. Do not change your dose without the advice of your doctor even if you feel better. DOMION can be taken with or without food. More instructions can be found in Section 4. How do I use DOMION? in the full CMI.

What should I know while using DOMION?

Things you should do
Remind any doctor, dentist or pharmacist you visit that you are using DOMION.
Have blood tests to check your liver function before the start of treatment and before a dose increase to 50mg (dose should only be increased by your doctor), and then around: 3, 6, 12 and 24 weeks.
Things you should not do
You should not take DOMION together with certain medications such as: fluvoxamine (another medicine used in the treatment of depression) or ciprofloxacin (an antibiotic).
Driving or using machines
As with all medications used to treat depression or anxiety, you should make sure that you know how you react to DOMION before you drive or operate machinery.
Drinking alcohol
It is recommended to avoid drinking alcohol while taking any antidepressant including DOMION.
People who drink excessive quantities of alcohol should not take DOMION. Excessive alcohol may cause liver problems and may make depression or anxiety worse.
Looking after your medicine
Keep your tablets in the pack until it is time to take them. Keep them in a cool, dry place where it stays below 30°C. Keep them where children cannot reach them.
For more information, see Section 5. What should I know while using [insert medicine]? in the full CMI.

Are there any side effects?

DOMION is usually well tolerated, however all medications may have unwanted effects in some people. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention. Severe liver reactions (especially with excessive alcohol consumption and/or with any other medication processed by your liver) and severe allergic reactions have very rarely been reported. Medical attention or hospitalisation may then be required and should be sought urgently from a doctor or Accident and Emergency at the nearest hospital. For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.
Active ingredient: Agomelatine (pronounced a-go-mel-a-tin)
Consumer Medicine Information (CMI)
This leaflet provides important information about using DOMION. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using DOMION.
Where to find information in this leaflet:

Why am I using DOMION?

DOMION contains the active ingredient agomelatine.
DOMION is used in the treatment of depression and the prevention of relapse of depression. DOMION is also used in the treatment of generalised anxiety disorder.
The symptoms of depression vary from one person to another, but a depressive episode commonly includes persistent sadness, loss of interest in favourite activities, feelings of worthlessness, sleep problems, feeling of being slowed down, feelings of anxiety or changes in appetite and weight. Changes in your daily sleep and appetite patterns are examples of disturbances of your 'body clock' that occur commonly in depression.
Generalised anxiety disorder is a chronic feeling of excessive worry or nervousness and difficulties to control them. It is commonly associated with increased irritability, sleep disturbances, concentration difficulties, and physical symptoms such as fatigue or muscle tension.
DOMION can help regulate your 'body clock' (circadian rhythm) with positive benefits on mood and sleep in depression and/or anxiety.
Your doctor may prescribe DOMION for another purpose other than the treatment of your depression and/or anxiety.
Ask your doctor if you have any questions about why DOMION has been prescribed for you.
DOMION is not addictive.
DOMION does not cause discontinuation symptoms on stopping treatment and can be stopped without the need to taper dose.
In clinical studies DOMION had no effect on sexual function.
DOMION is not recommended for children, adolescents (under 18 years old) or elderly patients:
with major depression aged 75 or older
with generalised anxiety aged over 65.

What should I know before I use DOMION?

There are some people who shouldn't take DOMION. Please read the list below. If you think any of these situations apply to you or you have any questions, please see your doctor.

Warnings

Do not use DOMION if:

you are allergic to agomelatine, or any of the ingredients listed at the end of this leaflet.
always check the ingredients to make sure you can use this medicine.
you suffer from liver disease or you know your liver does not work properly (hepatic impairment).
routine blood tests show levels of liver enzymes have increased to more than 3 times the upper limit of normal.
you are currently taking fluvoxamine (a medicine used in the treatment of depression) or ciprofloxacin (an antibiotic used to treat infections).
you have an allergy to DOMION or any of the ingredients (including lactose) listed at the end of this leaflet.
the packaging is torn or shows signs of tampering.
the expiry date (EXP) printed on the pack has passed.

Before you start to use DOMION:

A routine blood test should be performed before treatment to check how your liver is functioning. If you have increased levels of liver enzymes your doctor will decide if DOMION is right for you.
You may be at risk of liver problems if you are overweight, obese or have diabetes or if you are taking medicines known to affect your liver (ask your doctor if you are unsure which medicines these might be).
Tell your doctor if you have ever experienced or develop an episode of bipolar disorder, mania or hypomania (extreme upward mood swings or irritable mood).
Your doctor should be made aware if you have a history of dementia.
Tell your doctor if you are pregnant, plan to become pregnant or are breast-feeding.
Talk to your doctor about how much alcohol you drink. People who drink excessive quantities of alcohol should not take DOMION. Excessive alcohol may cause liver problems and may make depression or anxiety worse.
Tell your doctor if you are smoking more than 15 cigarettes/day.
If you have any doubts or questions about taking DOMION consult with your doctor

Check with your doctor if you:

have ever experienced or develop an episode of bipolar disorder, mania or hypomania (extreme upward mood swings or irritable mood).
have a history of dementia.
are pregnant, plan to become pregnant or are breast-feeding.
drink alcohol. People who drink excessive quantities of alcohol should not take DOMION. Excessive alcohol may cause liver problems and may make depression or anxiety worse.
are smoking more than 15 cigarettes/day.
have any doubts or questions about taking DOMION consult with your doctor.
During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

Check with your doctor if you are pregnant or intend to become pregnant.
Talk to your doctor if you are breastfeeding or intend to breastfeed.

What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may interfere with DOMION and affect how it works. Medicines that may increase the effect of DOMION include:
fluvoxamine (a medicine used in the treatment of depression)
ciprofloxacin (an antibiotic used to treat infections)
propranolol (a medicine sometimes used to treat heart problems)
Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect DOMION.

How do I use DOMION?

Always take DOMION exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

How much to take

The usual dose of DOMION is one tablet in the evening at bedtime. In some cases your doctor may prescribe two tablets (50 mg) to be taken together in the evening at bedtime. You should not take more than the maximum recommended dose of two tablets, i.e. 50 mg daily.
Do not change your dose without the advice of your doctor even if you feel better.
Current experience with DOMION to treat depression or anxiety shows that treatment for at least six months or longer provides the best opportunity of long-term recovery.

When to take DOMION

Always take DOMION exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Swallow DOMION tablets whole with some water in the evening at bedtime.
DOMION can be taken with or without food.

How long to take DOMION

Current experience with DOMION to treat depression or anxiety shows that treatment for at least six months or longer provides the best opportunity of long-term recovery. With DOMION some people may experience improvements within two to four weeks of starting treatment. As people respond differently to medications, do not become discouraged if you do not notice a difference right away.
Continue taking DOMION until your doctor advises you to stop. Even when you are feeling better, your doctor would usually continue to give you DOMION for some time to help to prevent your depression or anxiety from returning.
When you and your doctor have decided to stop DOMION, there is no need to taper the dose as DOMION does not cause discontinuation symptoms after stopping treatment.

If you forget to take DOMION

DOMION should be used regularly at the same time each day.
If you forget to take your DOMION, skip the dose you missed, take your next planned treatment at the usual dose and usual time, then continue as normal. Do not take a double dose to make up for the dose you missed.
To avoid confusion, it is recommended that you leave the tablet you missed in the tablet strip and continue on with the next day's tablet as indicated on the tablet strip calendar.
The calendar printed on the tablet strip should help you remember when you last took a DOMION tablet. It is also a good reminder of how much DOMION you have left so you can get your prescription refilled if you need to.

If you use too much DOMION

It is important that you do not take more DOMION tablets than your doctor has prescribed.
If you think that you have used too much DOMION, you may need urgent medical attention.
The experience of overdoses with DOMION is limited but reported symptoms may include stomach pain, drowsiness, tiredness, agitation, anxiety, dizziness,
blue-ish discolouration of the skin or mucous membranes and/or a general feeling of being unwell.
You should immediately:
phone the Poisons Information Centre (by calling 13 11 26), or
contact your doctor, or
go to the Emergency Department at your nearest hospital.
If anyone accidentally swallows any of your DOMION tablets, call your nearest Poisons Information Centre for advice (Australian telephone: 13 11 26), or go to Accident and Emergency at your nearest hospital. Keep the telephone number for these places handy whilst taking any medications.
You should do this even if there are no signs of discomfort or poisoning.

What should I know while using DOMION?

Your liver function

DOMION is processed by the liver. Before you started taking DOMION a blood test was required to check your liver function. While you are taking DOMION you will need further blood tests to check your liver continues to function properly. These tests should be performed:
before the start of treatment and before a dose increase to 50mg (dose should only be increased by your doctor).
and then around:
3 weeks,
6 weeks,
12 weeks and
24 weeks.
These blood test results will help your doctor decide whether DOMION is suitable for you. DOMION may sometimes affect the results of these blood tests.
You may also have tests to check that your liver is working properly if you start to take medicines that interfere with how the body processes DOMION.
Talk to your doctor about how much alcohol you drink.

Things you should do

To make sure you have the best opportunity of long-term recovery , continue to take DOMION as long as your doctor recommends you to.
Tell your doctor if you have previously experienced a bipolar disorder or develop an episode of extreme upward mood swings or irritable mood.
Check with your doctor that your liver function tests are done as described in the YOUR LIVER FUNCTION section above.
Seek advice from your doctor immediately if you develop signs or symptoms of potential liver problems (such as dark urine, light coloured faeces, yellow skin or eyes, pain in your upper right abdomen, new-onset and unexplained fatigue). Your doctor may advise you to stop taking DOMION.
Tell your doctor immediately if you become pregnant while taking DOMION.
Tell all doctors, dentists and healthcare professionals who are treating you that you are taking DOMION.
Do not take any other medications, whether they require a prescription or not, without first telling your doctor that you are taking DOMION as sometimes the action of one medicine may interfere with another.
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.
Tell your doctor if you feel the tablets are not helping your condition.
Keep all of your doctor's appointments so that your progress can be checked.
If you are being treated for depression, be sure to discuss with your doctor any problems you may have and how you feel, especially any feelings of severe sadness or bursts of unusual energy or anger.

Call your doctor straight away:

If you have any thoughts about suicide or doing harm to yourself call your doctor immediately and also contact someone you trust.
All thoughts or talk about suicide or violence towards others or yourself are serious. Such thoughts may even occur after commencing antidepressant treatment, particularly before the full antidepressant effect is seen. Such thoughts are more likely to occur in young adults under 25 years of age.
If you or someone you know is showing any of the following common warning signs, either contact your doctor or healthcare professional or go to the nearest hospital for treatment:
worsening of symptoms of depression or anxiety
thoughts or talk about death or suicide
thoughts or talk about self-harm or doing harm to others
any recent attempts of self-harm
an increase in aggressive behaviour, irritability or agitation.
If someone you know shows any of these symptoms, suggest they urgently contact a healthcare professional.
In addition to talking to your doctor, confidential support and counselling services are available (in Australia) from LifeLine by calling 13 11 14.
You may find it helpful to tell a relative or close friend that you are depressed or anxious and ask them to read this leaflet. You might ask them to tell you if they think your symptoms are getting worse, or if they are worried about changes in your behaviour.

Things you should not do

Do not stop using this medicine suddenly.
You should not take DOMION together with certain medications (see also under "When you must not take DOMION") such as: fluvoxamine (another medicine used in the treatment of depression) or ciprofloxacin (an antibiotic).
Do not give this medicine to anyone else even if their symptoms seem similar to yours or if they have the same condition as you.

Driving or using machines

As with all medications used to treat depression or anxiety, you should make sure that you know how you react to DOMION before you drive or operate machinery. Speak to your doctor if you have any concerns.

Drinking alcohol

It is recommended to avoid drinking alcohol while taking any antidepressant including DOMION.
Tell your doctor if you drink alcohol. Talk to your doctor about how much alcohol you drink. People who drink excessive quantities of alcohol should not take DOMION. Excessive alcohol may cause liver problems and may make depression or anxiety worse.

Looking after your medicine

Follow the instructions in the carton on how to take care of your medicine properly.
Store it in a cool dry place away from moisture, heat or sunlight; for example, do not store it:
in the bathroom or near a sink, or
in the car or on windowsills.
Keep it where young children cannot reach it.

When to discard your medicine

Discard the medicine when the expiry date (EXP) printed on the pack has passed.

Getting rid of any unwanted medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Do not use this medicine after the expiry date.

Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.
DOMION is usually well tolerated, however all medications may have unwanted effects in some people.
Increases in liver enzymes, and rarely inflammation of the liver, have been observed in some patients treated with DOMION. When DOMION was discontinued in these patients, the increases in liver enzymes usually returned to normal levels. This is why your doctor has asked you to have routine blood tests.
Some people taking DOMION have reported the following side effects, which may relate to DOMION, their depression, anxiety, general health or to any of their other treatment(s).
See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.
Do not be alarmed, you may not experience any of these. Other unwanted effects have been uncommonly reported and you should ask your doctor or pharmacist if you want to know more.

Serious side effects

Serious side effects
What to do
Severe liver reactions, especially with excessive alcohol consumption and/or with any other medication processed by the liver, e.g. DOMION.
Symptoms of severe liver reactions may include:
yellow colouring of the skin or whites of the eyes (jaundice)
abnormal bleeding or bruising
confusion, loss of consciousness or hallucinations.
Severe allergic reaction exists with any medication. The following are general signs and symptoms of an allergic reaction:
itching, skin rash or hives
shortness of breath, wheezing or trouble breathing
swelling of the face, lips, tongue or other parts of the body which may cause difficulty in swallowing or breathing.
Call your doctor straight away or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.

Less serious side effects

Less serious side effects
What to do
Psychiatric disorders:
agitation, irritability, restlessness, aggressive behaviour
mania/hypomania (see also under 'Before you start to take DOMION')
suicidal thoughts or behaviour
nightmares
confusion
hallucinations
anxiety
Nervous system disorders:
headache
migraine
dizziness, abnormal dreams
sleepiness (somnolence), difficulty in sleeping (insomnia)
pins and needles in the fingers and toes (paraesthesia), restless legs syndrome (a disorder that is characterised by an uncontrollable urge to move the legs)
inability to remain still (due to physical and mental unrest)
Eye disorders:
blurred vision
Ear disorders:
ringing in the ears
Gastrointestinal Disorders:
feeling sick (nausea), diarrhoea, constipation, abdominal pain, vomiting
Liver disorders:
increased levels of liver enzymes in your blood
hepatitis, yellow coloration of the skin or the whites of the eyes (jaundice), hepatic failure (isolated cases of death or liver transplantation have been reported in patients with hepatic risk factors)
Skin and subcutaneous tissue disorders:
eczema, pruritus, urticaria (hives)
excessive sweating (hyperhidrosis
serious skin eruption (erythematous rash), face oedema (swelling) and angioedema (swelling of the face, lips, tongue and/or throat that may cause difficulty in breathing or swallowing)
Musculoskeletal and connective tissue disorders:
back pain, muscle pain.
Kidney and urinary disorders:
inability to completely empty the bladder.
General disorders:
weight increased.
weight decreased
tiredness.
Ask your doctor or pharmacist if you don’t understand something in this list.
Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.
Other side effects not listed here may occur in some people.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of this medicine.
Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

Product details

This medicine is only available with a doctor's prescription.

What DOMION contains

Active ingredient
(main ingredient)
agomelatine
Other ingredients
(inactive ingredients)
lactose monohydrate, maize starch, povidone, sodium starch glycollate, stearic acid, magnesium stearate, colloidal anhydrous silica, hypromellose, iron oxide yellow, glycerol, macrogol 6000 and titanium dioxide, shellac, indigo carmine and propylene glycol
Do not take this medicine if you are allergic to any of these ingredients.

What DOMION looks like

DOMION is registered on the Australian register of Therapeutic Goods and has the Australian Register number: AUST R 279057.
DOMION 25 mg film-coated tablets are oblong, orange-yellow with blue imprint of the company logo on one side.
DOMION 25 mg tablets are contained in a foil blister strip with a calendar printed on the blister to help you remember when you last took a tablet of DOMION.

Who distributes DOMION

DOMION is a product discovered by Servier Research International. It is distributed in Australia by:
Servier Laboratories (Aust.) Pty. Ltd.
Building 9, Level 4
588A Swan Street
Burnley, 3121, Victoria
Telephone: 1800 153 590
Internet: www.servier.com.au
This leaflet was prepared in May 2022