2.	What should I know before I take SAMSCA?
            
         
            
            Do not use if you have ever had an allergic reaction to SAMSCA 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. 
               
            
            
             
         
            
            
3.	What if I am taking other medicines?
            
         
            
            Some medicines may interfere with SAMSCA and affect how it works. 
            
            
             
         
            
            
4.	How do I take SAMSCA?
            
         
            
            
            Take SAMSCA once a day with or without food
            
            The dose can be from 15 mg to 60 mg once a day
            
            
            
             
         
            
            
5.	What should I know while taking SAMSCA?
            
         
            
            
               
                  
                  
               
               
                  
                     
                     | 
                           Things you should do
                            | Remind any doctor, dentist or pharmacist you visit that you are taking SAMSCA Make sure you have access to water and continue to drink when thirsty  | 
                  
                     | 
                           Things you should not do
                            | Do not stop taking SAMSCA or lower the dose unless you notice side effects requiring
                           urgent medical attention or if your doctor tells you to do so Do not use SAMSCA to treat any complaint other than that directed by your doctor Do not give SAMSCA to someone else even if their symptoms are the same | 
                  
                     | 
                           Driving or using machines
                            | SAMSCA may occasionally make you feel dizzy or weak or you may faint for a short period
                            | 
                  
                     | 
                           Drinking alcohol
                            | Tell your doctor if you drink alcohol | 
                  
                     | 
                           Looking after your medicine
                            | Store SAMSCA below 25°C and away from light and moisture  Do not leave it in the car on hot or cold days | 
               
            
            
            
             
         
            
            
6.	Are there any side effects?
            
         
            
            Common side effects are thirst; dry mouth; making large amounts of urine and urinating
               often. Serious side effects include difficulty swallowing and speaking; seizures or
               convulsions; vomiting bright red blood; vomiting dark blood clots, or materials that
               looks like coffee-grounds; passing blood or stool mixed with blood; lethargy/fatigue
               (tiredness); mood changes; difficulty moving arms or legs, or uncontrollable movements.
            
            
            
            
            
            
             
         
            
            
            
         
            
            
               Active ingredient(s):
               tolvaptan (tol-vap-tan)
            
            
            
            
            
            Full Consumer Medicine Information (CMI)
            
            This leaflet provides important information about using SAMSCA. 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 SAMSCA.
               
            
            
               Where to find information in this leaflet:
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
             
         
            
            
1.	Why am I using SAMSCA?
            
         
            
            
               SAMSCA contains the active ingredient tolvaptan. SAMSCA belongs to a group of medicines called vasopressin antagonists. This means
               that it prevents vasopressin having its effect on water retention. This leads to a
               reduction in the amount of water in the body by increasing urine production and as
               a result it increases the concentration of sodium in your blood.
            
            
               SAMSCA is used to treat hyponatraemia in adults, including patients who have conditions
                  such as heart failure, and “syndrome of inappropriate antidiuretic hormone secretion”
                  (SIADH). These conditions result in an inappropriate amount of the hormone vasopressin
                  causing the sodium levels in your blood to get too low (hyponatraemia). That can lead
                  to difficulties in concentration and memory, or in keeping your balance.
               
             
         
            
            
2.	What should I know before I take SAMSCA?
            
         
            
            
Warnings
            
         
            
            Do not take SAMSCA if:
            
            
            you are allergic to tolvaptan, any of the ingredients listed at the end of this leaflet,
               or any other similar medicine such as benzapine derivatives
            
            Always check the ingredients to make sure you can use this medicine.
            
            some of the symptoms of an allergic reaction may include:
               
               
shortness of breath
               
               wheezing or difficulty breathing
               
               swelling of the face, lips, tongue or other parts of the body
               
               rash, itching or hives on the skin
               
               have any of the following medical conditions:
               
               
you cannot replace fluids by drinking
               
               you cannot feel if you are thirsty
               
               you have a condition which is associated with a very low blood volume
               
               you are not producing or passing urine 
               
               you are taking the following medicine(s):
               
               
medicines to treat fungal infections such as ketoconazole or itraconazole
               
               medicines to treat bacterial infections such as clarithromycin or telithromycin
               
               medicines to treat HIV infection such as saquinavir, nelfinavir or ritonavir
               
               medicines to treat depression i.e. nefazodone
               
               you need to increase the sodium level in your blood right away - the safety and efficacy
               in these patients have not been studied
            
             
         
            
            Check with your doctor if you:
            
            
            have any other medical conditions such as:
               
               
you cannot drink enough water or you are fluid restricted 
               
               difficulties in urination or have an enlarged prostate 
               
               liver disease including cirrhosis
               
               diabetes 
               
               hypothyroidism (an underactive thyroid gland)
               
               hypoadrenalism (an underactive adrenal gland)
               
               take any medicines for any other condition
            
            
            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.
             
         
            
            It is not known if SAMSCA will harm your unborn baby or if it passes into breast milk.
               This medicine contains sugars as lactose.
            
            If you have been told by your doctor that you have an intolerance to some sugars,
               tell your doctor before taking SAMSCA.
             
         
            
            
3.	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 SAMSCA and affect how it works. These include:
               
            
            
            medicines to treat fungal infections such as ketoconazole, itraconazole or fluconazole
            
            macrolide antibiotics such as clarithromycin or telithromycin or erythromycin
            
            treatments for high blood pressure and chest pain such as diltiazem or verapamil
            
            treatments of irregularities of heart beat and heart failure such as digoxin
            
            treatments for epilepsy/seizures and some sleep disorders such as barbiturates, phenytoin
               or carbamazepine
            
            medicines to treat tuberculosis such as rifampicin rifabutin or rifapentin
            
            medicines to immunosuppressant therapy such as cyclosporine
            
            treatments used to prevent or control bleeding, i.e. vasopressin analogs
            
            treatments of HIV infection such as saquinavir, nelfinavir or ritonavir; and
            
            medicines used to treat depression, i.e. nefazodone or St. John's Wort
            
            other medicines that increase the level of sodium in your blood or which contain large
               amounts of salt, such as tablets that dissolve in water and indigestion remedies
            
            
            These medicines may be affected by SAMSCA or may affect how well it works. You may
               need different amounts of your medicines, or you may need to take different medicines.
            
            Your doctor will have more information on medicines to be careful with or avoid while
               taking SAMSCA.
            
            
               Check with your doctor or pharmacist if you are not sure about what medicines, vitamins
                  or supplements you are taking and if these affect SAMSCA.
               
             
         
            
            
4.	How do I take SAMSCA? 
            
         
            
            
               Treatment with SAMSCA should be started and re-started only in a hospital, where the
                  sodium levels in your blood can be monitored closely.
               
            
            
               If your doctor or pharmacist tells you to keep taking SAMSCA after you leave a hospital,
                  it is important that you do not stop and restart SAMSCA on your own.
               
            
            You may need to go back to a hospital to re-start SAMSCA. Talk to your doctor right
               away if you stop taking SAMSCA for any reason.
            
            It is important to stay under the care of your doctor while taking SAMSCA and follow
               their instructions.
            
            
               If you do not understand the instructions, ask your doctor or pharmacist for help.
               
             
         
            
            How much to take 
            
            
            
               Take SAMSCA once a day
               
            
            You can take SAMSCA with or without food
            
            Tablets should be swallowed without chewing and with a glass of water
            
            
               Do not take SAMSCA with grapefruit juice
               
            
            The dose can be from 15 mg to 60 mg once a day. Your doctor will start with a dose
               of 15 mg and may then increase it to a maximum of 60 mg to achieve the desired level
               of serum sodium.
            
            
               Ask your doctor of pharmacist if you are unsure of the correct dose for you, they
                  will tell you exactly how much to take
               
            
            Follow the instructions provided and use SAMSCA until your doctor tells you to stop
            
            SAMSCA should not be taken for longer than 30 days
            
            If you take the wrong dose, SAMSCA may not work as well and your problem may not improve
            
            
               Do not take more than the dose your doctor has recommended
               
            
             
         
            
            When to take SAMSCA
            
            
            SAMSCA should be taken the same time each day, preferably in the morning
            
            This will help you remember when to take the medicine
            
            Certain medicines or illnesses may keep you from drinking fluids or may cause you
               to lose too much body fluid, such as vomiting or diarrhoea. If you have these problems,
               call your doctor right away.
            
             
         
            
            If you forget to take SAMSCA
            
            SAMSCA should be used regularly at the same time each day. If you miss your dose at
               the usual time, take it as soon as you remember and then go back to taking your medicine
               as you would normally.
            
            
               If it is almost time for your next dose, skip the dose you missed and take your next
                  dose when you are meant to. 
               
            
            
               Do not take a double dose to make up for the dose you missed.
               
            
            
            This may increase the chance of you getting an unwanted side effect
            
            
            If you are not sure what to do, ask your doctor or pharmacist
            
            If you have trouble remembering to take your medicine, ask your pharmacist for some
               hints. 
             
         
            
            If you take too much SAMSCA
            
            If you think that you have taken too much SAMSCA, you may need urgent medical attention.
            
            
               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.
            
            
            
               You should do this even if there are no signs of discomfort or poisoning.
               
            
            You may need urgent medical attention. Remember to take the medicine pack with you
               so that it is clear what you have taken.
            
            Symptoms of an overdose may include:
            
            
            thirst
            
            dehydration
            
            passing more urine than normal
            
            low blood volume causing very low blood pressure
            
            a rise in concentration of sodium concentration the blood
            
            
            If your doctor tells you to stop taking SAMSCA, follow their instructions about limiting
               the amount of fluid you should drink.
             
         
            
            
5.	What should I know while taking SAMSCA?
            
         
            
            Things you should do
            
            Make sure you have access to water and continue to drink when thirsty.
            
            
               If you are about to be started on any new medicine, remind your doctor and pharmacist
                  that you are taking SAMSCA. 
               
            
            
               If you are going to have surgery, tell the surgeon or anaesthetist that you are taking
                  this medicine.
               
            
            It may affect other medicines used during surgery.
            
            
               If you are about to have any blood tests, tell your doctor that you are taking this
                  medicine. 
               
            
            It may interfere with the results of some tests.
             
         
            
            Call your doctor straight away if you:
            
            
            become pregnant while taking this medicine
            
            
            Remind any doctor, dentist or pharmacist you visit that you are using SAMSCA.
             
         
            
            Things you should not do
            
            
            Do not use SAMSCA to treat any complaint other than that directed by your doctor
            
            Do not give SAMSCA to someone else even if their symptoms are the same
            
            Do not stop taking SAMSCA or lower the dose unless you notice side effects requiring
               urgent medical attention or if your doctor tells you to do so. This may lead to reoccurrence
               of your low sodium.  
            
             
         
            
            Drinking enough water
            
            
            SAMSCA causes water loss because it increases your urine production. This water loss
               commonly results in dry mouth and thirst, and less commonly severe side effects such
               as kidney problems. It is therefore important that you have access to water and that
               you are able to drink sufficient amounts when you feel thirsty.
            
             
         
            
            Driving or using machines
            
            
               Be careful before you drive or use any machines or tools until you know how SAMSCA
                  affects you.
               
            
            SAMSCA may occasionally make you feel dizzy or weak or you may faint for a short period.
               
             
         
            
            Drinking alcohol
            
            
               Tell your doctor if you drink alcohol.
               
             
         
            
            Looking after your medicine
            
            
            Store SAMSCA below 25°C and away from light and moisture.
            
            Do not leave it in the car on hot or cold days. Heat, cold and dampness can destroy
               some medicines. 
            
            
            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 window sills.
            
            
            
               Keep it where young children cannot reach it.
               
            
            A locked cupboard at least one-and-a-half metres above the ground is a good place
               to store medicines.
            
            Keep SAMSCA in the pack until it is time to take your dose. If it is removed from
               the pack, it may not keep well.
             
         
            
            Getting rid of any unwanted medicine
            
            If your doctor tells you to stop taking SAMSCA or it is out of date, ask your doctor
               what to do with any SAMSCA that is left.
            
            Do not use this medicine after the expiry date.
             
         
            
            
6.	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.
               
            
            See the information below and, if you need to, ask your doctor or pharmacist if you
               have any further questions about side effects.
             
         
            
            Less serious side effects
            
            
            
            
            
            
            
            
             
         
            
            Serious side effects
            
            
            
            
            
            SAMSCA may affect your liver function. Therefore, please inform your doctor at any
               time if you have signs that could indicate potential liver problems such as:
            
            
            unusual exhaustion
            
            loss of appetite
            
            pain in your right upper stomach
            
            dark urine
            
            jaundice (yellowing of your skin or the whites of your eyes)
            
            
            During treatment with SAMSCA, your doctor may arrange blood tests to check for changes
               in your liver function or electrolytes (salts).
            
            
               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.
               
             
         
            
            
7.	Product details
            
         
            
            This medicine is only available with a doctor's prescription.
             
         
            
            What SAMSCA contains
            
            
               
                  
                  
               
               
                  
                     
                     | 
                           Active ingredient 
                            
                           (main ingredient)
                            | tolvaptan | 
                  
                     | 
                           Other ingredients
                            
                           (inactive ingredients)
                            | maize starch  hyprolose lactose monohydrate  magnesium stearate microcrystalline cellulose indigo carmine aluminium lake  | 
                  
                     | 
                           Potential allergens
                            | sugars as lactose | 
               
            
            
            
            
            
               SAMSCA tablets contain 15 mg of tolvaptan.
               
            
            
               Do not take this medicine if you are allergic to any of these ingredients.
               
             
         
            
            What SAMSCA looks like
            
            SAMSCA is supplied as 15 mg tablets in a PVC/aluminium perforated unit dose blister
               pack of 10 tablets.
            
            The 15 mg tablet is blue, triangular, shallow-convex, debossed with “OTSUKA” and “15”
               on one side. 
            
            (Aust R 176602). 
             
         
            
            Who distributes SAMSCA
            
            Otsuka Australia Pharmaceutical Pty Ltd 
            
            Suite 2.03, Level 2
            
            9 Help Street 
            
            Chatswood NSW 2067 
            
            
            
            This leaflet was prepared in June 2022.
            
            
            
            SAMSCA® is a registered trademark of Otsuka Pharmaceutical Co., Ltd.