Valsartan-NAN
International non-proprietary name: Valsartan
Read carefully before use
Valsartan-NAN
Valsartan
Film-coated tablets
Round, biconvex, scored, pink, film-coated tablets. 80 mg tablets can be divided into equal halves. 160 mg tablets do not have a score line.
Each tablet contains:
Active substances: valsartan 80 mg or 160 mg;
Excipients: microcrystalline cellulose, pregelatinized corn starch, croscarmellose sodium, povidone, anhydrous colloidal silicon dioxide, magnesium stearate, lactose monohydrate;
Shell composition: hydroxypropyl methylcellulose, titanium dioxide (E171), copovidone, polydextrose, polyethylene glycol, medium chain triglycerides, red iron oxide (E172).
Angiotensin II antagonists.
C09CA03
Valsartan has a hypotensive effect. A specific blocker of AT1 angiotensin II receptors (ARB II), when taken, the development of dry cough is unlikely. In the treatment of arterial hypertension, valsartan reduces blood pressure (BP) without affecting the heart rate (HR).
The antihypertensive effect develops 2 hours after ingestion, reaches its maximum within 4-6 hours and persists for more than 24 hours. After regular intake, the maximum reduction in blood pressure is achieved after 2-4 weeks.
The use of Valsartan-NAN leads to a decrease in hospitalizations for heart failure, a slowdown in the progression of heart failure, an improvement in NYHA functional class, an increase in ejection fraction, as well as a decrease in signs and symptoms of heart failure and an improvement in quality of life compared with placebo.
- Arterial hypertension in adults and children from 6 to 18 years;
- Recent myocardial infarction (treatment of clinically stable patients with clinical manifestations of heart failure or asymptomatic left ventricular systolic dysfunction after a previous (12 hours – 10 days) myocardial infarction);
- Heart failure (treatment of heart failure with clinical symptoms, when it is impossible to use ACE inhibitors or as an additional therapy to ACE inhibitors when it is impossible to use beta-blockers, mineralocorticoid receptor antagonists).
Tablets are taken orally, without chewing, with a sufficient amount of water, regardless of the meal.
Arterial hypertension
The recommended dose of Valsartan-NAN for adults is 80 mg once a day. The antihypertensive effect develops within 2 weeks of treatment. The maximum effect is achieved after 4 weeks. If necessary, the daily dose of valsartan may be increased to 160 mg, or to a maximum daily dose of 320 mg. Combination with other antihypertensive drugs, including diuretics is possible.
Post-infarction condition
In stable patients, therapy can be started as early as 12 hours after myocardial infarction. The initial dose of Valsartan-NAN is 20 mg 2 times a day. Then the dose should be increased to 40 mg, 80 mg and 160 mg twice a day over the next few weeks.
This dosage form is not intended for initial therapy in the regimen of 20 mg 2 times a day. For this purpose it is necessary to use another medicine that ensures the achievement of the required single dose.
The target maximum daily dose is 160 mg 2 times a day. It is recommended to reach the dose level of 80 mg 2 times a day for 2 weeks after the start of treatment. The target maximum dose should be reached within 3 months, based on patient tolerance of valsartan during the dose titration period. If symptomatic hypotension or renal dysfunction occurs, dose reduction should be considered.
Valsartan-NAN can be prescribed as part of post-infarction combination therapy, for example, in combination with thrombolytics, acetylsalicylic acid, beta-blockers, statins and diuretics. It is not recommended to combine treatment with Valsartan-NAN with ACE inhibitors, as well as the simultaneous use of an ACE inhibitor, beta-blocker and Valsartan-NAN. Evaluation of patients after myocardial infarction should always include monitoring of renal function.
Heart failure
The recommended starting dose of Valsartan-NAN is 40 mg twice daily. Gradually increasing the dose to 80 mg 2 times a day and then to 160 mg 2 times a day should be carried out at intervals of at least 2 weeks until the maximum dose tolerated by the patient is reached. When a patient is given a diuretic at the same time, the feasibility of a possible dose reduction of the diuretic should be considered. The maximum daily dose of Valsartan-NAN is 160 mg 2 times a day.
Valsartan-NAN can be used in conjunction with other drugs for the treatment of heart failure. It is not recommended to simultaneously take an ACE inhibitor, a beta-blocker (or a K-sparing diuretic) and Valsartan-NAN. Evaluation of patients with heart failure should always include monitoring of renal function.
Valsartan-NAN can be used to treat hypertension in patients with impaired glucose tolerance and risk of cardiovascular insufficiency.
Special populations
Elderly patients
There is no need for dose adjustment in elderly patients.
Adult patients with impaired renal function
There is no need for dose adjustment in adult patients with creatinine clearance >10 ml/min. Monitoring of potassium and creatinine levels is recommended in moderate renal failure.
The simultaneous use of Valsartan-NAN with aliskiren is contraindicated in patients with diabetes mellitus or with renal insufficiency (GFR < 60 ml / min / 1.73 m2) (see Section Contraindications).
Adult patients with impaired liver function
Valsartan is contraindicated in patients with severe hepatic impairment, including biliary cirrhosis, and in patients with cholestasis. In patients with mild to moderate hepatic impairment without cholestasis, the dose of valsartan should not exceed 80 mg per day.
Patients with diabetes
The simultaneous use of Valsartan-NAN with aliskiren is contraindicated in patients with diabetes mellitus (see Section Contraindications).
Children and adolescence
Arterial hypertension in children and adolescents
Patients 6 to 18 years old
For children weighing less than 35 kg, the initial dose is 40 mg once a day. For children weighing 35 kg or more, the initial dose is 80 mg once a day. The dose should be adjusted depending on the effect on blood pressure and tolerability. The maximum doses studied in clinical trials are shown in the table below. Doses higher than those indicated have not been studied and are therefore not recommended.
| Body Weight | Maximum Doses (clinically proven) |
| ≥ 18 kg … < 35 kg | 80 mg |
| ≥ 35 kg … < 80 kg | 160 mg |
| ≥ 80 kg … ≤ 160 kg | 320 mg |
Children under 6
The safety and efficacy of Valsartan-NAN in children under 6 years of age have not been established.
Patients 6 to 18 years old with impaired renal function
The use in children with creatinine clearance <30 ml/min or on dialysis has not been studied, therefore valsartan is not recommended for such patients. Dose adjustment is not required in children with creatinine clearance >30 ml/min. Kidney function and serum potassium levels should be closely monitored (see Sections Warnings and precautions and Pharmacokinetics).
Patients 6 to 18 years old with impaired liver function
Valsartan is contraindicated in patients (including children and adolescents) with severe hepatic impairment, including biliary cirrhosis, and in patients with cholestasis. There is limited clinical experience with valsartan in pediatric patients with mild to moderate hepatic impairment. In patients with mild to moderate hepatic impairment without cholestasis, the dose of valsartan should not exceed 80 mg per day.
Heart failure and recent myocardial infarction in patients aged 6 to 18 years
Valsartan is not recommended for the treatment of heart failure or recent myocardial infarction in children and adolescents under 18 years of age due to a lack of safety and efficacy data.
Frequency of side effects: very common (≥ 1/10); common (≥ 1/100, but < 1/10); uncommon (≥ 1/1000, but < 1/100); rare (≥ 1/10000 but < 1/1000), very rare (< 1/10000).
The following side effects are possible when using valsartan for the treatment of arterial hypertension:
Blood and lymphatic system disorders: a decrease in the concentration of hemoglobin and hematocrit, thrombocytopenia (frequency unknown).
Immune system disorders: hypersensitivity reactions, including serum sickness (frequency unknown).
Metabolism and nutrition disorders: an increased concentration of potassium in the blood serum, hyponatremia (frequency unknown).
Ear and labyrinth disorders: vertigo (uncommon).
Cardiovascular disorders: vasculitis (frequency unknown).
Respiratory, thoracic and mediastinal disorders: cough (uncommon).
Gastrointestinal disorders: abdominal pain (uncommon).
Hepatobiliary disorders: an increase in indicators characterizing liver function, including an increase in the level of liver enzymes, the concentration of bilirubin in the blood serum (frequency unknown).
Skin and subcutaneous tissue disorders: angioedema, bullous dermatitis, skin rash, pruritus (frequency unknown).
Musculoskeletal and connective tissue disorders: myalgia (frequency unknown).
Renal and urinary disorders: impaired renal function, renal failure, increased serum creatinine concentration (frequency unknown).
General disorders: increased fatigue (uncommon).
Side effects when using valsartan for the treatment of post-infarction and/or heart failure (studied only in adult patients):
Blood and lymphatic system disorders: thrombocytopenia (frequency unknown).
Immune system disorders: hypersensitivity reactions, including serum sickness (frequency unknown).
Metabolism and nutrition disorders: hyperkalemia (uncommon); an increased concentration of potassium in the blood serum, hyponatremia (frequency unknown).
Nervous system disorders: dizziness, including postural (common); fainting, headache (uncommon).
Ear and labyrinth disorders: vertigo (uncommon).
Cardiovascular disorders: hypotension, orthostatic hypotension (common); heart failure (uncommon); heart failure (frequency unknown).
Respiratory, thoracic and mediastinal disorders: cough (uncommon).
Gastrointestinal disorders: nausea, diarrhea (uncommon).
Hepatobiliary disorders: an increase in indicators characterizing liver function (frequency unknown).
Skin and subcutaneous tissue disorders: angioedema (uncommon); bullous dermatitis, skin rash, pruritus (frequency unknown).
Musculoskeletal and connective tissue disorders: myalgia (frequency unknown).
Renal and urinary disorders: renal failure and functional deterioration (common); acute renal failure, increased serum creatinine concentration (uncommon); increase in blood urea nitrogen (frequency unknown).
General disorders: asthenia, fatigue (uncommon).
If any of the side effects listed in this leaflet get worse, or if you notice any other side effects not listed in this leaflet, inform your healthcare provider.
- Hypersensitivity to valsartan or to any other component of Valsartan-NAN;
- Severe liver dysfunction, biliary cirrhosis, cholestasis;
- Second and third trimester of pregnancy, breast-feeding;
- Children under 6 years of age;
- Simultaneous use of ARB II, including valsartan, or ACE inhibitors with aliskiren in patients with diabetes mellitus or renal insufficiency (GFR < 60 ml/min / 1.73 m2).
When taking a larger dose than prescribed by a healthcare provider, immediately seek medical advice for timely medical assistance!
Symptoms: an overdose of valsartan can cause severe hypotension, which in turn can lead to impaired consciousness, circulatory collapse and/or shock.
Treatment: therapeutic measures depend on the time passed since the overdose and the severity of the observed symptoms. The most important measure is stabilization of the cardiovascular system. If Valsartan-NAN has been taken recently, then vomiting should be induced. With development of arterial hypotension, it is necessary to give the patient a supine position and take measures to adjust the volume of circulating blood. Removal of valsartan by hemodialysis is scarcely probable.
If you forget to take Valsartan-NAN, do not make up for the missed dose by taking a double dose. Just take your regular dose of Valsartan-NAN.
Do not stop taking Valsartan-NAN without consulting your healthcare provider. Sudden discontinuation of Valsartan-NAN is not accompanied by a sharp rise in blood pressure or other undesirable clinical consequences.
Lithium: reversible increases in serum lithium concentration and onsets of toxic effects have been reported with simultaneous administration of lithium preparations with ACE inhibitors. Due to the lack of experience in prescribing lithium preparations with valsartan, simultaneous administration is not recommended. If the simultaneous administration of such medicines is necessary, careful monitoring of lithium concentration in the blood serum is recommended.
Drugs affecting CYP 450
Since valsartan does not undergo significant metabolism, no clinically significant interactions with other medicines in the form of metabolic induction or inhibition of the cytochrome P450 system were observed when administrated together with valsartan. Despite the fact that valsartan has a high degree of binding to plasma proteins, in vitro studies have not shown any interaction at this level with a number of molecules that also have a high degree of protein binding, namely diclofenac, furosemide and warfarin.
Potassium-sparing diuretics, potassium preparations, salt substitutes containing potassium, and other drugs that can increase potassium level: concomitant use with potassium-sparing diuretics (e.g. spironolactone, triamterene, amiloride), potassium preparations or salt substitutes containing potassium may lead to an increase in serum potassium concentration. Simultaneous administration is not recommended. Concentration of potassium in the blood serum should be monitored if joint administration of such medicines is necessary.
Non-steroidal anti-inflammatory drugs (NSAIDs), including selective cyclooxygenase-2 (COX-2) inhibitors, acetylsalicylic acid (more than 3 g/day) and other non-selective NSAIDs: with simultaneous administration, a weakening of the antihypertensive effect is possible, as well as an increased risk of kidney function worsening and an increase in the concentration of potassium in the blood serum. If it is necessary to use such a combination, adequate hydration of patients and monitoring of renal function should be ensured from the start of treatment.
Transporters: In vitro data indicate that valsartan is a substrate of OATP1B1/OATP1B3 and MRP2 transport proteins. Clinical significance of these data has not been established. Co-administration with inhibitors of the OATP1B1/OATP1B3 transporter (rifampin, cyclosporine) or the MRP2 efflux transporter (ritonavir) may enhance the effect of valsartan. Special precautions should be taken at the beginning or end of co-therapy with these medicinal products.
Dual blockade of the renin-angiotensin-aldosterone system (RAAS) with ARB II, ACE inhibitors, or aliskiren: concomitant use of ARB II (including valsartan) with other agents that block the RAAS (i.e. ACE inhibitors or aliskiren) is associated with an increased risk of developing hypotension, hyperkalemia, and impaired renal function (including development of acute renal failure) compared with monotherapy. Regular monitoring of blood pressure, kidney function and electrolytes in the blood is necessary in patients taking simultaneously Valsartan-NAN and other agents that affect the RAAS.
Concomitant use of ARB II, including Valsartan-NAN, or ACE inhibitors with aliskiren is contraindicated in patients with diabetes mellitus or renal insufficiency (glomerular filtration rate < 60 ml/min / 1.73 m2).
Other agents: no clinically significant interactions with agents such as cimetidine, warfarin, furosemide, digoxin, atenolol, indomethacin, hydrochlorothiazide, amlodipine and glibenclamide have been identified.
Children and adolescents
In children and adolescents who have both arterial hypertension and impaired renal function, combined administration of valsartan and other substances that inhibit the renin-angiotensin-aldosterone system should be prescribed with extreme caution. It can lead to an increase in serum potassium. It is necessary to carefully monitor renal function and concentration of potassium in the blood serum.
Your healthcare provider must be informed about all medicines you are taking. Talk to your healthcare provider before you start taking any medicine while you are taking Valsartan-NAN.
Hyperkalemia
Simultaneous administration with potassium preparations, salt substitutes containing potassium, potassium-sparing diuretics, or other agents that can increase concentration of potassium in the blood serum (heparin, etc.) is not recommended. It is recommended to control concentration of potassium in the blood serum.
Impaired kidney function
Dose adjustment is not required in patients with mild to moderate renal insufficiency. Monitoring of potassium and creatinine levels is recommended in moderate renal failure.
Valsartan-NAN is contraindicated in patients with severe renal insufficiency (glomerular filtration rate (GFR) <30 ml/min / 1.73 m2) and patients on dialysis (see Section Contraindications).
Simultaneous use of Valsartan-NAN with aliskiren is contraindicated in patients with renal insufficiency (GFR <60 ml/min / 1.73 m2) (see Sections Contraindications and Dosage and administration).
Impaired liver function
In patients with hepatic insufficiency (mild and moderate) without cholestasis, Valsartan-NAN should be used with caution (see Sections Contraindications and Pharmacokinetics).
Patients with sodium deficiency and/or reduced circulating blood volume (CBV)
In patients with severe sodium deficiency and/or reduced CBV, for example, those receiving high doses of diuretics, in rare cases clinically pronounced arterial hypotension may occur after the start of treatment with valsartan. Before starting treatment, it is necessary to correct the content of sodium and/or CBV in the body, for example, by reducing the dose of the diuretic.
If hypotension occurs, the patient should lie down. Treatment can be continued immediately after stabilization of blood pressure.
Double blockade of the renin-angiotensin-aldosterone system (RAAS)
Hypotension, syncope, stroke, hyperkalemia, renal function disorders (including acute renal failure) have been observed in individuals with hypersensitivity, especially when combining medicines that affect the RAAS. In this regard, a double blockade of the RAAS is not recommended while prescribing aliskiren with ACE inhibitors, or ARB II (including valsartan).
Patients with diabetic nephropathy should not be given an ACE inhibitor with an ARB II.
In some cases, when the combined use of an ACE inhibitor and ARB II is absolutely indicated, careful observation by a specialist and mandatory monitoring of kidney function, water and electrolyte balance, and blood pressure are necessary. It refers to the prescription of valsartan as an additional therapy to ACE inhibitors in patients with chronic heart failure. Conducting a double blockade of the RAAS under the close supervision of a specialist and mandatory monitoring of kidney function, water and electrolyte balance and blood pressure is possible in patients with chronic heart failure with intolerance to aldosterone antagonists (spironolactone), who have persistent symptoms of chronic heart failure, despite delivery of another adequate therapy.
The simultaneous use of Valsartan-NAN with aliskiren is contraindicated in patients with diabetes mellitus or renal insufficiency (GFR < 60 ml/min / 1.73 m2).
Pediatric use
Use in children with impaired renal function
The use in children with creatinine clearance < 30 ml/min and in children on dialysis has not been studied. Therefore valsartan is not recommended for such patients. Dose adjustment is not required in children with creatinine clearance > 30 ml/min. Kidney function and serum potassium should be closely monitored. This is especially true when valsartan is used in the presence of other conditions (e.g. fever, and dehydration) that can cause impaired renal function.
Use in children with impaired liver function
As in adults, Valsartan-NAN is contraindicated in children with severe hepatic insufficiency, biliary cirrhosis, and cholestasis. There is limited clinical experience with valsartan in children with mild to moderate hepatic impairment. In such patients, the dose of valsartan should not exceed 80 mg.
Special information on excipients
Valsartan-NAN contains lactose, so Valsartan-NAN is not recommended for patients with lactase deficiency, galactosemia, or glucose-galactose malabsorption syndrome.
You must tell your doctor if you suspect you are (or could be) pregnant. This medicine is not recommended in early pregnancy and is contraindicated (should not be taken) in women more than 3 months pregnant as it can cause serious harm to the baby if taken during this period (see Section Use during pregnancy and breast-feeding).
Renal artery stenosis
There are no data on the safety of valsartan in patients with bilateral or unilateral renal artery stenosis.
Short-term use of valsartan in 12 patients with vasorenal hypertension secondary to unilateral renal artery stenosis did not cause any significant changes in renal hemodynamic parameters, changes in serum creatinine concentration, or an increase in blood urea nitrogen concentration. However, other drugs that affect the RAAS may increase blood urea concentration and serum creatinine concentration in patients with unilateral renal artery stenosis. Based on this, when prescribing valsartan, patients in this group require careful monitoring of renal function.
Kidney transplant
Currently, there are no data on the safety of valsartan in patients who have recently undergone kidney transplantation.
Primary hyperaldosteronism
It is not recommended to prescribe valsartan to patients with primary hyperaldosteronism, since their renin-angiotensin system is not active.
Stenosis of the aortic or mitral valves, and obstructive hypertrophic cardiomyopathy
As with other vasodilators, special care should be taken when prescribing valsartan to patients with aortic or mitral valve stenosisб or hypertrophic obstructive cardiomyopathy.
Post-infarction state / chronic heart failure
Patients with heart failure or a post-infarction condition taking Valsartan-NAN at usual doses experience a slight decrease in blood pressure, but discontinuation of therapy due to prolonged symptomatic hypotension is usually not required if the instructions for dosing Valsartan-NAN are followed (see Section Dosage and administration).
Caution should be exercised when prescribing valsartan to patients in the early post-infarction period and to patients with chronic heart failure that are starting therapy.
Evaluation of the condition of patients with heart failure or in the post-infarction state should always include regular monitoring of kidney function.
The combination of captopril and valsartan did not lead to additional clinical benefits, but led to an increased risk of adverse reactions compared with taking medicines separately. Therefore, a combination of ACE inhibitors and valsartan is not recommended.
In patients whose renal function may be dependent on the activity of the renin-angiotensin-aldosterone system (i.e. patients with severe congestive heart failure), treatment with ACE inhibitors is associated with development of oliguria and/or progressive azotemia and, rarely, acute renal failure and/or death. ACE inhibitors and angiotensin II receptor blockers are not recommended for combination therapy in patients with diabetic nephropathy. Since valsartan is an ARB II, a possibility of developing renal dysfunction in patients cannot be ignored while taking Valsartan-NAN.
In patients with chronic heart failure, the risk of adverse reactions, especially hypotension, hyperkalemia, and reduced renal function (including acute renal failure) is increased when Valsartan-NAN is used in combination with ACE inhibitors. In patients with heart failure, triple therapy with an ACE inhibitor, beta-blocker and valsartan is not recommended. In the absence of additional clinical benefits, this combination increases the risk of adverse reactions. The three-agent combination of an ACE inhibitor, a mineralocorticoid receptor antagonist, and valsartan is not recommended. The use of such combined treatment should be supervised by a specialist, and the patient must be monitored for kidney function, water and electrolyte balance, and blood pressure. Particular attention should be paid during the initiation of therapy in patients with heart failure.
Angioedema
There have been reports of cases of angioedema, including swelling of the larynx and glottis, leading to airway obstruction, and/or swelling of the face, lips, pharynx and/or tongue in patients taking valsartan. Some of these patients had a history of angioedema after taking other meicines, including ACE inhibitors. In the event of the development of angioedema in patients, taking Valsartan-NAN should be discontinued. Repeated administration of Valsartan-NAN is not allowed.
Pediatric use
Use in children with impaired renal function
The use in children with creatinine clearance <30 ml/min and in children on dialysis has not been studied. Therefore valsartan is not recommended for such patients. Dose adjustment is not required in children with creatinine clearance > 30 ml/min. Kidney function and serum potassium should be closely monitored. This is especially true when valsartan is used in the presence of other conditions (e.g. fever, and dehydration) that can cause impaired renal function.
Use in children with impaired liver function
As in adults, Valsartan-NAN is contraindicated in children with severe hepatic insufficiency, biliary cirrhosis, and cholestasis. There is limited clinical experience with valsartan in children with mild to moderate hepatic impairment. In such patients, the dose of valsartan should not exceed 80 mg.
Special information on excipients
Valsartan-NAN contains lactose, so Valsartan-NAN is not recommended for patients with lactase deficiency, galactosemia, or glucose-galactose malabsorption syndrome.
Consult your healthcare provider before taking Valsartan-NAN if you have one of the listed diseases or conditions.
The use of ARBs II is not recommended in the first trimester of pregnancy and is contraindicated in the second and third trimesters of pregnancy.
Epidemiological data have shown an increased risk of teratogenic effects with the use of ACE inhibitors in the first trimester of pregnancy. A similar risk may also exist when taking ARB II (including Valsartan-NAN).
Treatment with ARB II (including Valsartan-NAN) should not be initiated during pregnancy. Unless it is not possible to replace valsartan with another alternative therapy, patients planning pregnancy should be switched to antihypertensive therapy with drugs that have a well-established safety profile for pregnant women.
If pregnancy occurs, ARB II (including Valsartan-NAN) should be discontinued immediately and, if necessary, other antihypertensive therapy should be prescribed.
It is known that the use of ARB II in the second and third trimesters of pregnancy causes fetotoxicity (decreased kidney function, oligohydramnios, delayed skull ossification) and neonatal toxicity (renal failure, hypotension, hyperkalemia).
If a woman takes Bra II in the second trimester of pregnancy, an ultrasound control is necessary to control the function of the kidneys and skull of the fetus. Newborns from mothers taking Bra II should be under close medical supervision due to possible hypotension.
There is no data on passage of Valsartan into breast milk. So therapy with Valsartan-NAN is not recommended for breastfeeding women. Such patients should be switched to alternative therapy with medicines having a well-studied safety profile during breastfeeding, especially if the child is a newborn or born premature.
Studies evaluating the effect of Valsartan-NAN on the ability to drive a car and work with mechanisms have not been conducted. When driving vehicles or working with mechanisms, the possibility of dizziness or weakness should be considered.
Within the treatment period, patients must be careful when driving vehicles and during other potentially dangerous activities requiring concentration and speed of psychomotor reactions.
Film-coated tablets, 80 mg.
10 tablets in a blister pack. 3 blister packs with a patient information leaflet in an outer carton.
15 tablets in a blister pack. 2 blister packs with a patient information leaflet in an outer carton.
Film-coated tablets, 160 mg.
10 tablets in a blister pack. 3 blister packs with a patient information leaflet in an outer carton.
14 tablets in a blister pack. 2 blister packs with a patient information leaflet in an outer carton.
15 tablets in a blister pack. 2 blister packs with a patient information leaflet in an outer carton.
Protect from light and moisture. Store at a temperature not exceeding 25°C.
Keep out of the reach of children.
2 years. Do not use after the expiry date.
State enterprise ACADEMPHARM
220141, 5/3 Kuprevicha Street, Minsk, Belarus
Phone / Fax +375 17 268 63 64
production@academpharm.by
To report adverse reactions use the electronic application form on the manufacturer’s website: https://academpharm.by/en