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LEGAL ACTS OF THE REPUBLIC OF LATVIA
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The translation of this document is outdated.
Translation validity: 30.09.2016.–17.01.2019.
Amendments not included: 15.01.2019., 09.06.2020., 10.12.2020., 01.06.2021.

Text consolidated by Valsts valodas centrs (State Language Centre) with amending regulations of:

1 April 2008 (No. 213) [shall come into force from 5 April 2008];
9 April 2013 (No. 194) [shall come into force from 26 April 2013];
30 July 2013 [shall come into force from 3 August 2013];
2 February 2016 [shall come into force from 1 March 2016];
27 September 2016 [shall come into force from 30 September 2016].

If a whole or part of a paragraph has been amended, the date of the amending regulation appears in square brackets at the end of the paragraph. If a whole paragraph or sub-paragraph has been deleted, the date of the deletion appears in square brackets beside the deleted paragraph or sub-paragraph.


Republic of Latvia

Cabinet
Regulation No. 57

Adopted 17 January 2006

Regulations Regarding Procedures for the Labelling of Medicinal Products and the Requirements to Be Set for the Package Leaflet of Medicinal Products

Issued pursuant to
Section 5, Clauses 3 and 12
of the Pharmaceutical Law

I. General Provisions

1. This Regulation prescribes the procedures for the labelling of medicinal products and the requirements to be set for the package leaflet of medicinal products (hereinafter - the package leaflet).

2. The Regulation shall not apply to:

2.1. veterinary medicinal products;

2.2. intermediate products intended for further processing carried out by a licensed medicinal product manufacturer;

2.3. medicinal products intended for research and production investigation, except for the requirements that arise from the laws and regulations regarding the procedures for conducting clinical trials and observations on the use of medicinal products;

2.4. radionuclides (radioactive isotopes) in the form of sealed radiation sources;

2.5. whole blood, plasma or blood cells of human origin, except for industrially prepared plasma.

3. Information in the labelling of the immediate packaging (which has direct contact with the medicinal product) and the outer packaging (into which the immediate packaging is placed) of medicinal products, as well as information in the package leaflet shall be specified in accordance with the requirements laid down in the Official Language Law.

4. The package leaflet shall be included (placed or attached) in all packaging of medicinal products, unless all the information referred to in Sub-paragraph 7.3, Paragraphs 14, 14.1, and 15 of this Regulation is already clearly laid out on the outer or on the immediate packaging.

[2 February 2016]

5. If for medicinal products which are brought into Latvia information on the labelling and in the package leaflet is not indicated in the official language, then, upon distributing the medicinal products, an adhesive label shall be attached to the packaging of the medicinal products with translation of the information provided on the labelling in the official language, and the package leaflet in the official language shall be placed in the outer packaging or attached to the outer or immediate packaging of the medicinal products (shall not apply to medicinal products which are distributed in retail in order to export them to the third countries or to supply to another Member State of the European Economic Area). If the outer packaging is closed in such a manner that it cannot be opened without damaging the packaging (for example, glued), the package leaflet in the official language shall be attached to the outside of the packaging. Attaching of the abovementioned adhesive label and package leaflet to the packaging or placing in the outer packaging shall be deemed re-packaging of medicinal products which is carried out by a person who, in accordance with the laws and regulations regarding the procedures for licensing pharmaceutical activity, has a special authorisation (licence) for the manufacturing of medicinal products issued by the State Agency of Medicines.

[2 February 2016]

6. The requirements referred to in Paragraph 5 of this Regulation shall not apply to:

6.1. unauthorised medicinal products which are provided for individual patients and which, in accordance with the laws and regulations regarding the procedures for distribution and quality control of medicinal products, have been brought in on the basis of an authorisation issued by the State Agency of Medicines for distribution of unauthorised medicinal products to medicinal products granted individually, and to which, upon distributing them in a pharmacy, at least the following information in the official language is appended:

6.1.1. the name of the medicinal product;

6.1.2. the name and quantity of the active substance, and excipients;

6.1.3. the pharmaceutical form and content;

6.1.4. instructions for use and route of administration;

6.1.5. special warnings regarding storing of medicinal products out of the reach and sight of children and other special warnings (if indicated);

6.1.6. the expiry date;

6.1.7. storage conditions (if indicated);

6.1.8. the batch number;

6.1.9. special precautionary measures upon destroying non-utilised medicinal products or utilised materials which have come into contact with such medicinal products (if indicated);

6.1.10. the name and address of the marketing authorisation holder, name and address of the manufacturer of medicinal products;

6.1.11. possible adverse reactions (if indicated);

6.2. medicinal products which are supplied for use to a medical treatment institution, if the consignment of the particular medicinal product has at least one translation of the labelling of the relevant medicinal product and a package leaflet in the official language. The supplier of the medicinal product shall ensure the necessary number of translations of the labelling and package leaflets in the official language according to the request of the medical treatment institution.

[2 February 2016]

7. Labelling and the package leaflet shall meet the following requirements:

7.1. information in the labelling and package leaflet of the medicinal products subject to marketing authorisation shall be provided in accordance with the documentation submitted for the marketing authorisation of the medicinal products and with the requirements laid down in this Regulation. Differences in the labelling and package leaflet of parallelly imported medicinal products shall be permitted in conformity with the requirements laid down in Sub-paragraph 7.11 of this Regulation. Information on the labelling and in package leaflet of medicinal products, in addition to the official language, may be indicated in another foreign language which is different from the foreign language used in the labelling and package leaflet of the medicinal products authorised in Latvia;

7.2. the labelling data referred to in Paragraphs 10 and 11, and in Sub-paragraph 7.3 of this Regulation shall be easily legible, clearly comprehensible and indelible;

7.3. symbols (designations) or pictograms (information signs in the form of a stylised picture) shall be permitted on the outer packaging and in the package leaflet, in order to make clearer the information referred to in Paragraph 10 or Paragraphs 14 and 15 of this Regulation and any other information related to the summary of product characteristics, which is useful for a patient, nevertheless excluding any advertising elements;

7.4. the information referred to in Paragraphs 10, 14, and 15, and Sub-paragraph 7.3 of this Regulation on the labelling, also on the adhesive label, may be in several foreign languages, in addition to the official language, observing the condition that the data provided are the same in all the languages. The data referred to in Paragraph 10 of this Regulation in the labelling of medicinal products intended for the treatment of specific rare diseases (medicinal products, to which such status has been allocated in accordance with the provisions and conditions of Regulation (EC) No 141/2000 of the European Parliament and of the Council of 16 December 1999 on orphan medicinal products), upon a substantiated request, may be provided in only one of the official languages of the European Union;

7.5. the package leaflet shall be written and arranged in a clear and comprehensible way. Where necessary, a user may turn for assistance to a health care professional. The package leaflet shall be clearly legible. Such leaflet may be printed in several languages, observing the condition that the information provided is the same in all the languages;

7.6. The State Agency of Medicines is entitled to specify specific measures and to release the marketing authorisation holder of medicinal products and the medicinal product wholesaler from the duty of indicating specific data on the labelling and package leaflet of authorised medicinal products which are referred to on the labelling of marketing authorisation documentation of and package leaflet of medicinal products, as well as to completely or partially release from the duty of ensuring the labelling and package leaflet of medicinal products in the official language, if it is not intended to supply the medicinal products directly to the patient or there is an emergency situation in relation to essential complications as regards access to medicinal products and essential danger to the health or life of inhabitants;

7.7. the special conditions referred to in Sub-paragraph 15.1 of this Regulation for the users of several categories of medicinal products (patients with specific pathologies) may be specified in the final part of a package leaflet, which part is intended exclusively for medical practitioners. Prior to handing the package leaflet to a patient, a medical practitioner or pharmacist shall remove the final part of the package leaflet;

7.8. the package leaflet shall reflect the results acquired from the consultations with the target groups of patients (users of medicinal products) in order to ensure that the package leaflet is clearly legible, precise and easy to use;

7.9. the accompanying information (for example, an adhesive label, a package leaflet attached to the packaging of the medicinal product) shall not cover the name of the medicinal product, the expiry date, and the manufacturing batch number of the medicinal product indicated on the packaging. Addition of information (including placement of the package leaflet in the outer packaging of a medicinal product or attachment thereof to the packaging) may not affect the quality of the medicinal product;

7.10. it is prohibited to print the package leaflet on the inside of the outer packaging of medicinal products;

7.11. if the labelling on the packaging of the parallelly imported medicinal products contains therapeutic indications which are approved by another Member State but are not approved in respect of the medicinal products included in the Register of Medicinal Products of the Republic of Latvia, such information shall be covered with an adhesive label. The labelling and the package leaflet of parallelly imported medicinal products as to their content shall conform to the labelling and the package leaflet of the medicinal products included in the Register of Medicinal Products of the Republic of Latvia in respect of which the parallel import has been performed (hereinafter - the reference medicinal products), allowing for the following differences in the labelling and package leaflet:

7.11.1. in the name of medicinal products referred to in Sub-paragraphs 10.1 and 14.1.1 of this Regulation - if the name of the reference medicinal products differs from the name of the parallelly imported medicinal products in the country, from which the medicinal products are imported;

7.11.2. in specifying the information set out in Sub-paragraphs 10.4 and 14.6.4 of this Regulation - if the parallelly imported medicinal products contain other excipients or colouring matters with a colour code which differs from that of the reference medicinal products and if that affects the degradation period of the medicinal products;

7.11.3. in specifying the information set out in Sub-paragraph 14.6.7 of this Regulation - if the name and address of the manufacturer of the parallelly imported medicinal products differs from that specified in the package leaflet of the reference medicinal products.

[9 April 2013; 2 February 2016; 27 September 2016]

7.1 The following information shall be indicated on the adhesive label on the outer packaging or, if none, on the immediate packaging of parallelly imported medicinal products:

7.1 1. "Paralēli importētas zāles" [Parallelly imported medicinal products];

7.1 2. the number of the authorisation for distribution of parallelly imported medicinal products assigned by the State Agency of Medicines;

7.1 3. the name and address of the holder (owner) of the authorisation for distribution of parallelly imported medicinal products;

7.1 4. if medicinal products have been re-packaged - the batch number of re-packaging, as well as the name and address of the manufacturer (re-packager) of the medicinal products, if the holder (owner) of the authorisation for distribution of parallelly imported medicinal products is not the re-packager of the medicinal products;

7.1 5. the differences from the medicinal products included in the Register of Medicinal Products of the Republic of Latvia in relation to which parallel import has been performed, if such exist.

[2 February 2016]

8. Free samples of medicinal products in addition to the requirements prescribed by this Regulation shall be labelled with an inscription in the official language "Zāļu bezmaksas paraugs - nav paredzēts pārdošanai" [Free medical sample - not for sale] or with another notice conveying the same meaning. The marketing authorisation holder (owner) of the medicinal product or his or her authorised person shall provide the relevant labelling.

9. The requirements laid down in this Regulation apply also to medicinal products which, in accordance with Council Regulation (EEC) No 918/83 of 28 March 1983 setting up a Community system of reliefs from customs duty, are imported by State institutions or public benefit organisations from the third countries, as well as to medicinal products which in accordance with the procedures prescribed by laws and regulations have been purchased in the European Union Member States or imported from the third countries for funds of foreign financial assistance in accordance with an agreement entered into by the government of the Republic of Latvia, an international agreement or international project registered in the Ministry of Finance, and have been supplied to the assistance beneficiary in Latvia. The recipient of such medicinal products shall provide the additional notice on the labelling "Bez maksas" [Free of charge]. Such notice indicates that the medicinal product may not be distributed in return for payment.

9.1 A medical treatment institution has the right to perform additional labelling of the packaging of the medicinal products, indicating their belonging to a specific medical treatment institution.

[27 September 2016]

9.2 The requirement referred to in Paragraphs 12 and 16 of this Regulation need not be applied to the medicinal products which are referred to in Sub-paragraph 6.1 of this Regulation and to the medicinal products which are distributed in wholesale in order to export them to the third countries or to supply to another Member State of the European Economic Area.

[2 February 2016]

II. Information in the Labelling

10. Labelling on the outer packaging or, if there is no outer packaging, on the immediate packaging shall specify:

10.1. the name of the medicinal product followed by the strength of the product (the content of the active substances expressed quantitatively per dosage unit, per unit of volume or weight according to the dosage form) and the pharmaceutical form shall be specified, as well as, if necessary, a statement whether the medicinal product is intended for infants, children or adults. If the medicinal product contains not more than three active substances, the international non-proprietary name (INN) shall also be specified, or, if such does not exist, the common name. The medicinal products may have:

10.1.1. the invented name which may not be confused with the common name (the international non-proprietary name (INN) recommended by the World Health Organisation or, if such has not been recommended, the usual common name); or

10.1.2. the common or scientific name supplemented by the trademark or the name of the marketing authorisation holder (owner);

10.2. a statement of the active substances expressed qualitatively and quantitatively per dosage unit or according to the form of administration for a given volume or weight, using their common names;

10.3. the pharmaceutical form and the contents by weight, by volume or by number of doses of the product;

10.4. a list of those excipients known to have a recognised effect and included in the Annex of this Regulation. All excipients shall be specified for injectable medicinal products and medicinal products intended for topical use (for example, on skin, mucous membrane) or for ophthalmologic use;

10.5. the method of administration and, if necessary, the route of administration. A space shall be provided for the prescribed dose to be indicated or for an adhesive label of the pharmacy;

10.6. a special warning that the medicinal product must be stored out of the reach and sight of children;

10.7. other special warnings (if necessary);

10.8. the expiry date, specifying the month and year;

10.9. special storage conditions (if necessary);

10.10. special precautionary measures to be observed in the disposing of the unused medicinal products or waste resulting therefrom (if necessary), as well as an indication that the unused medicinal products shall be delivered to the pharmacy (if special circumstances are necessary for the disposal of the medicinal products);

10.11. the name and address of the marketing authorisation holder (owner) of the medicinal product and the name of the representative of the marketing authorisation holder (owner), if such has been assigned;

10.12. the medicinal product marketing authorisation number in the Register of Medicinal Products of the Republic of Latvia or an appropriate authorisation number of the European Medicines Agency if the medicinal product has been authorised under the centralised authorisation procedure in accordance with Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying down Community procedures for the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency (hereinafter - Regulation (EC) No 726/2004);

10.13. the manufacturing batch number of the medicinal product. If the medicinal products have been re-packaged or re-wrapped - also the batch number of the re-packaging or re-wrapping;

10.14. for non-prescription medicinal products - instructions regarding the use of the medicinal product;

10.15. the name and address of the manufacturer (re-packager or re-wrapper) of the medicinal products if the medicinal products have been re-packaged or re-wrapped.

[9 April 2013; 2 February 2016]

11. The information referred to in Paragraph 10 of this Regulation need not be specified on the immediate packaging in the following cases:

11.1. the immediate packaging, for example, blister packs, is placed in the outer packaging which bears the information specified in Sub-paragraph 7.3 and Paragraph 10 of this Regulation, but the immediate packaging bears at least the following information:

11.1.1. the name of the medicinal product in conformity with Sub-paragraph 10.1 of this Regulation;

11.1.2. the name of the marketing authorisation holder (owner) of the medicinal product;

11.1.3. the expiry date;

11.1.4. the manufacturing batch number of the medicinal product;

11.2. on small immediate packaging units, where it is impossible to specify the information referred to in Sub-paragraph 7.3 and Paragraph 10 of this Regulation, except for the following information:

11.2.1. the name of the medicinal product in conformity with Sub-paragraph 10.1 of this Regulation and, if necessary, the route of administration of the medicinal product;

11.2.2. the method of administration;

11.2.3. the expiry date;

11.2.4. the manufacturing batch number of the medicinal product;

11.2.5. the contents by weight, by volume or by unit.

12. The name and strength of the medicinal products referred to in Sub-paragraph 10.1 of this Regulation on the outer packaging or, if such does not exist, on the immediate packaging shall be specified also in Braille. If a marketing authorisation has been issued only for a single strength of the medicinal product, only the invented name shall be specified in Braille. The referred-to condition does not apply to medicinal products the administration of which is provided by a medical practitioner in a medical treatment institution, for example, to vaccines.

III. Information in the Package Leaflet

13. The marketing authorisation holder of the medicinal products shall ensure that information is indicated in the package leaflet according to the description of the medicinal products.

[2 February 2016]

14. The package leaflet shall specify in the following order:

14.1. information for the identification of the medicinal product:

14.1.1. the name of the medicinal product followed by the strength of the medicinal product and the pharmaceutical form (if necessary) shall be specified, indicating whether the medicinal product is intended for infants, children or adults. The common name shall be specified if the medicinal product contains only one active substance and if its name is the invented name;

14.1.2. the pharmaco-therapeutic group or type of activity (in a manner comprehensible for the patient);

14.2. the therapeutic indications;

14.3. information, which is necessary to be known before taking the medicinal product:

14.3.1. contra-indications;

14.3.2. precautionary measures to be observed in the use of the medicinal product;

14.3.3. the interaction with other medicinal products and other forms of interaction (for example, alcohol, tobacco, food) which may affect the effects of the medicinal product;

14.3.4. special warnings;

14.4. the necessary and useful instructions for the correct use of the medicinal product, in particular the following:

14.4.1. the dosage;

14.4.2. the method of administration and, if necessary, route of administration;

14.4.3. the frequency of use, specifying, if necessary, the time when the medicinal product may or should be used;

14.4.4. if necessary, taking into account the nature of the medicinal product, the following shall be specified:

14.4.4.1. the duration of treatment, where limitations are specified;

14.4.4.2. the action to be taken in the case of an overdose of the medicinal product (for example, symptoms, emergency measures);

14.4.4.3. the possible course of action when one or more doses have not been taken;

14.4.4.4. indications regarding the consequences caused by the suspension of the use of the medicinal product (if necessary);

14.4.4.5. special recommendations to consult a doctor or pharmacist to clarify any uncertainties regarding the use of the medicinal product;

14.5. the undesirable effects which may occur when using the medicinal product in conformity with the package leaflet, and, where appropriate, the action to be taken in such situation;

14.6. a reference to the expiry date indicated in the labelling, specifying the following information:

14.6.1. a warning not to use the medicinal product after the expiry date;

14.6.2. regarding special precautionary measures during the storage of the medicinal product (if necessary);

14.6.3. regarding some visible signs of deterioration of the medicinal product (if necessary);

14.6.4. the full qualitative composition (specifying active substances and excipients) and the quantitative composition of the active substances using the common names - for each presentation of the medicinal product;

14.6.5. the pharmaceutical form and content in weight, volume or units of dosage - for each presentation of the medicinal product;

14.6.6. the name and address of the marketing authorisation holder (owner) and the names of the representatives of the marketing authorisation holder (owner) in the Member States (if such representatives exist);

14.6.7. the name and address of the manufacturer of the medicinal product;

14.7. the name of the medicinal product authorised in each Member State, if the medicinal product in accordance with the provisions for the authorisation of medicinal products has been authorised in the procedure of mutual recognition of the medicinal product authorisation and is permitted with different names in the corresponding Member States;

14.8. the date on which the package leaflet was last revised.

[9 April 2013]

14.1 In addition to the information referred to in Paragraph 14 of this Regulation, the following information shall be indicated in the package leaflet:

14.1 1. for medicinal products, which require additional monitoring and which are included in the lists referred to in Article 23 of Regulation (EC) No 726/2004, an indication "Šīs zāles tiek papildu uzraudzītas" [Medicines under additional monitoring] shall be added. The approved black symbol and standardised explanatory text shall be inserted before the indication according to Article 23 of Regulation (EC) No 726/2004 and Commission Implementing Regulation (EU) No 198/2013 of 7 March 2013 on the selection of a symbol for the purpose of identifying medicinal products for human use that are subject to additional monitoring (hereinafter - Commission Implementing Regulation (EU) No 198/2013);

14.1 2. information that unequivocally urges the patients to notify their physician, dentist, physician's assistant, nurse, pharmacist or, using directly the spontaneous reporting system, the State Agency of Medicines regarding any potential undesirable effects, as well as indicate the potential types of reporting in accordance with the laws and regulations regarding the procedures for pharmacovigilance.

[9 April 2013]

15. When providing the information referred to in Sub-paragraph 14.3 of this Regulation, the following shall be specified:

15.1. the special conditions for certain categories of users of the medicinal products (children, pregnant or breastfeeding women, the elderly, persons with specific pathologies);

15.2. the potential effects on the ability to drive vehicles or to operate machinery (if necessary);

15.3. those excipients, the knowledge of which is important for the safe and effective use of the medicinal product and which are included in the Annex of this Regulation.

16. The holder (owner) of the marketing authorisation shall ensure that, upon the request of those organisations that represent blind and partially-sighted patients, the information provided in the package leaflet is available in a form appropriate for the blind and visually impaired.

IV. Labelling and Package Leaflet of Homeopathic Medicinal Products Registered According to the Simplified Registration Procedure, Traditional Herbal Medicinal Products and Radiopharmaceuticals and Their Starting Materials

17. If homeopathic medicinal products are registered by a simplified registration procedure, the labelling and, if necessary, the package leaflet thereof, in addition to a clearly visible inscription "Homeopātiskas zāles" [Homeopathic medicinal products], shall include the following information:

17.1. the scientific name of the homeopathic stock or stocks, using the symbols (designations) of the European Pharmacopoeia or, in the absence thereof, of the pharmacopoeia currently used officially in the Member States, followed by the degree of dilution. If a homeopathic medicinal product contains two or more homeopathic stocks, the scientific names of the homeopathic stocks in the labelling may be supplemented by the invented name;

17.2. the name and address of the holder (owner) of the registration certificate (marketing authorisation) and, if necessary, of the manufacturer;

17.3. the method of use and, if necessary, the route of administration of the medicinal product;

17.4. the expiry date, specifying the month and year;

17.5. the pharmaceutical form;

17.6. the size of the sales packaging;

17.7. special storage conditions (if necessary);

17.8. special warnings (if necessary);

17.9. the manufacturing batch number of the medicinal product;

17.10. the registration number of the medicinal product in the Register of Medicinal Products of the Republic of Latvia;

17.11. an indication - "Homeopātiskās zāles bez apstiprinātām terapeitiskām indikācijām" [homeopathic medicinal product without approved therapeutic indications];

17.12. a recommendation to the user to consult a doctor if the symptoms persist during the use of the medicinal product.

18. Packaging for the transportation and containers of radiopharmaceuticals (medicinal products which, when ready for use, contain one or more radionuclides (radioactive isotopes) intended for medical purposes) shall be labelled in accordance with the requirements prescribed by the laws and regulations regarding protection against ionising radiation when transporting radioactive materials. In addition, the labelling of such preparations shall conform to the requirements laid down in Paragraphs 10 and 19 of this Regulation.

19. In labelling radiopharmaceuticals, the following additional conditions shall be observed:

19.1. the labelling of the immediate packaging (vial) shall include:

19.1.1. the name or code of the medicinal product, including the name or the chemical symbol of the radionuclide;

19.1.2. the batch identification data and expiry date;

19.1.3. the radiation symbol;

19.1.4. the name and address of the manufacturer;

19.1.5. the radioactivity referred to in Sub-paragraph 19.2 of this Regulation in a dose or vial;

19.2. the labelling of the outer packaging shall provide an explanation regarding the meaning of the codes specified on the immediate packaging (vial) and, if necessary, indicate the radioactivity per dose or vial at a certain time and date, as well as the number of capsules or for liquids - millilitres.

20. A package leaflet containing the information in accordance with Paragraphs 14 and 15 of this Regulation shall be enclosed in the packaging of radiopharmaceuticals, radionuclide generators (any system used in radiopharmaceuticals incorporating a fixed parent radionuclide from which a daughter radionuclide is produced by elution or by any other method), kits (any preparation to be reconstituted or combined with radionuclides in the final radiopharmaceutical, usually prior to its administration) or any other radionuclides manufactured for radiolabelling of some other substance before its use, and in addition all precautionary measures shall be specified in such leaflets which are to be observed by a user and patient in preparing and using the relevant preparations, as well as the special precautionary measures to be observed in disposing of the packaging and its unused content.

21. The labelling and the package leaflet of traditional herbal medicinal products (herbal medicinal products, which conform to the criteria of traditional medicinal products prescribed by laws and regulations regarding the provisions for the registration of medicinal products and which have been registered according to the simplified registration procedure) shall, in addition to the requirements laid down in Paragraphs 10, 14 and 15 of this Regulation, contain the following information:

21.1. a statement that the specific product is a traditional herbal medicinal product with specific indications exclusively based upon long-standing use;

21.2. a statement that the user should consult a doctor or a qualified health care specialist if the symptoms persist during the use of the medicinal product or if adverse effects not mentioned in the package leaflet occur;

21.3. a statement regarding the traditional use of the herbal medicinal product.

V. Labelling of Medicinal Products Prepared in Pharmacies

22. If medicinal products are prepared in a pharmacy in accordance with a prescription issued by a medical practitioner for a specific patient or a request of a medical treatment institution (formula magistralis) or such medicinal products are prepared in conformity with pharmacopoeia monographs and they are intended for distribution to patients served by the relevant pharmacy (formula officinalis), the labelling thereof shall contain the following information:

22.1. the name, address and telephone number of the pharmacy;

22.2. the given name and surname of the patient (for children under 14 years of age also the age shall be specified) or the name of the medical treatment institution and department;

22.3. the composition of the medicinal product;

22.4. the conditions for use specified in the prescription of the medicinal product (dose, method of use, route of administration, frequency of use);

22.5. the date of preparation and issuance of the medicinal product;

22.6. the expiry date of the medicinal product (date, month, year);

22.7. the given name, surname and signature of the issuer of the medicinal product;

22.8. special warnings referred to in Paragraph 23 of this Regulation (if necessary);

22.9. an indication - "Glabāt bērniem nepieejamā un neredzamā vietā" [Keep out of the reach and sight of children];

22.10. special storage conditions;

22.11. the number of the prescription or the number of the request of the medical treatment institution;

22.12. the retail selling price (does not apply to medicinal products prepared upon the request of medical treatment institutions).

23. The labelling of medicinal products prepared by pharmacies shall contain the following special warnings:

23.1. "Pirms lietošanas saskalot" [Shake before use] (for mixtures and suspensions) - green letters on a white background;

23.2. "Sargāt no gaismas. Uzglabāt temperatūrā 8o-15oC [Keep away from light. Store at a temperature of 8o-15oC] (for mixtures, suspensions, ointments, drops taken internally) - white letters on a blue background;

23.3. "BĒRNAM" [FOR CHILDREN] (for medicinal products intended for children under 14 years of age) - black letters on a green background;

23.4. "Lietot uzmanīgi!" [Use with care] (for medicinal products which contain narcotic substances, atropine sulphate, silver nitrate, arsenious acid anhydride, sodium arsenate, dicaine, ephedrine, pseudo-ephedrine, phenobarbital, trihexyphenidyl) - red letters on a white background;

23.5. "Sargāt no uguns!" [Keep away from open flame] (for medicinal products which contain flammable or explosive substances) - white letters on a red background.

24. The labelling of medicinal products prepared by pharmacies shall contain the following notices and signal colours:

24.1. for orally administered medicinal products - green signal colour with a notice "IEKŠĶĪGI" [ORALLY] in white letters;

24.2. for externally administered medicinal products - orange signal colour with a notice "ĀRĪGI" [EXTERNALLY] in white letters;

24.3. for eye drops and eye ointments - pink signal colour with a notice "ACU PILIENI" [EYE DROPS] or "ACU ZIEDE" [EYE OINTMENT] in black letters.

25. The information referred to in Paragraph 22 of this Regulation shall be on the immediate or outer packaging, and such information shall be clearly legible, comprehensible and indelible.

26. The labelling shall be printed typographically or by using computer hardware. The labelling shall be attached to the immediate packaging (if this does not affect the quality of the medicinal product) or to the outer packaging of medicinal products.

VI. Division and Labelling of Industrially Manufactured Medicinal Products in a Pharmacy

27. A pharmacy the annex of the special authorisation (licence) of which contains the condition of the special activity - the preparation of medicinal products - shall be permitted to divide industrially manufactured medicinal products which are given to an individual patient according to a prescription issued by a medical practitioner and the amount of which in the packaging does not conform to the amount specified in the prescription. A pharmacy the appendix of the special licence of which does not contain the condition of the special activity - the preparation of medicinal products - shall be permitted to divide industrially manufactured medicinal products in conformity with the conditions specified in the prescription, provided that the immediate packaging of the medicinal product is not damaged.

[2 February 2016]

28. In dispensing medicinal products in conformity with Paragraph 27 of this Regulation, the pharmacist shall ensure the compliance of the labelling of the medicinal products with the requirements laid down in Paragraph 10 of this Regulation, as well as attach the package leaflet.

29. If unauthorised medicinal products in the Republic of Latvia, which are brought in on the basis of a prescription issued by a medical practitioner to an individual patient in accordance with Section 10, Sub-clause 7a of the Pharmaceutical Law, are dispensed to a patient, the pharmacist shall inform the patient regarding the instructions for use of the medicinal product referred to in Sub-paragraph 14.4 of this Regulation.

[2 February 2016]

VII. Supervision and Control

30. If there are changes in the labelling or package leaflet of the medicinal products included in the Register of Medicinal Products of the Republic of Latvia which are related to the performance of the requirements of this Regulation, but are not related to the changes in the description of medicinal products, an application shall be submitted to the State Agency of Medicines by the marketing authorisation holder of the medicinal products attaching a specimen or mock-up of the immediate and outer packaging of the medicinal products, as well as a draft package leaflet thereto. The State Agency of Medicines shall review such application within a period of one month. If additional information is necessary, the State Agency of Medicines shall request such information in accordance with the procedures prescribed by the Administrative Procedure Law, taking into account that the final decision must be taken within a period of 90 days after the receipt of an application. If within a period of 90 days after the receipt of an application no decision of the State Agency of Medicines containing the objections against the intended changes has been received, the applicant may introduce the intended changes.

[2 February 2016]

31. The State Agency of Medicines shall examine the compliance of the translation of the text of the labelling into the official language with the information provided in the labelling of the medicinal product and the conformity of the translation of the package leaflet with the information provided in the package leaflet and the summary of product characteristics by the medicinal product manufacturer, as well as with the requirements laid down in this Regulation.

[2 February 2016]

32. Expenses which are related to checking the translation of the labelling and package leaflet of the medicinal products shall be included in authorisation fee of the medicinal products or in the fee for an authorisation for distribution of parallelly imported medicinal products, or in the fee for expert-examination of the application and documentation for the receipt of an authorisation for distribution of medicinal products authorised in a country of the European Economic Area, but not authorised in the Republic of Latvia which has been specified in the laws and regulations regarding the price list of paid services of the State Agency of Medicines.

[2 February 2016]

33. The implementation of this Regulation shall be controlled by the Health Inspectorate. In order to verify the performance of the requirements laid down in this Regulation, the Health Inspectorate and the State Agency of Medicines in conformity with their competence shall ensure operative mutual exchange of information.

[1 April 2008]

33.1 The State Agency of Medicines shall carry out the tasks provided for the competent authority in accordance with the requirements laid down by Implementing Regulation No 198/2013.

[9 April 2013]

VIII. Closing Provisions

34. Cabinet Regulation No. 136 of 25 March 2003, Procedures for the Labelling of Medicinal Products and the Requirements to be Made for the Package Leaflet of Medicinal Products (Latvijas Vēstnesis, 2003, No. 49), is repealed.

35. In respect of the medicinal products included in the Register of Medicinal Products of the Republic of Latvia which at the time of coming into force of this Regulation are on the market (released for free circulation) the requirements referred to in Paragraph 12 of this Regulation need not be applied until 31 December 2011.

36. In respect of the medicinal products included in the Register of Medicinal Products of the Republic of Latvia which at the time of coming into force of this Regulation are on the market (released for free circulation) the requirements referred to in Paragraph 16 of this Regulation shall be applied not later than from 1 January 2007.

37. In respect of traditional herbal medicinal products, which were on the market (released for free circulation) prior to the coming into force of this Regulation, the requirements referred to in Paragraph 21 of this Regulation shall be implemented by 30 October 2012.

38. In respect of the medicinal products that are included in the Register of Medicinal Products of the Republic of Latvia and have been placed on the market the requirements laid down in Sub-paragraph 7.8 and Paragraphs 10, 14, 15, 17 and 19 of this Regulation shall be implemented by 30 October 2008.

39. The requirements referred to in Paragraph 9.1 of this Regulation must be introduced by 1 May 2016.

[2 February 2016]

Informative Reference to the European Union Directives

[9 April 2013; 30 July 2013]

This Regulation contains legal norms arising from:

1) Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use;

2) Directive 2004/24/EC of the European Parliament and of the Council of 31 March 2004 amending, as regards traditional herbal medicinal products, Directive 2001/83/EC on the Community code relating to medicinal products for human use;

3) Directive 2004/27/EC of the European Parliament and of the Council of 31 March 2004 amending Directive 2001/83/EC on the Community code relating to medicinal products for human use;

4) Directive 2010/84/EU of the European Parliament and of the Council of 15 December 2010 amending, as regards pharmacovigilance, Directive 2001/83/EC on the Community code relating to medicinal products for human use;

5) Directive 2012/26/EU of the European Parliament and of the Council of 25 October 2012 amending Directive 2001/83/EC as regards pharmacovigilance.

Prime Minister A. Kalvītis

Minister for Health G. Bērziņš

 

Annex
Cabinet Regulation No. 57
17 January 2006

Excipients and Information for the Package Leaflet

[9 April 2013]

No.

Name in Latvian

Name in English

Routine of administration

Threshold (starting from)

Information in the Package Leaflet

Notes

1.

Aprotinīns Aprotinin

Topical

Zero

May cause hypersensitivity or severe allergic reactions. The topical route in this case refers to sites that may have access to the circulation (e.g.wounds, body cavities, etc.).

2.

Arahisa eļļa (zemesriekstu eļļa) Arachis oil (peanut oil)

All

Zero

(Medicinal product) contains arachis oil (peanut oil). If you are allergic to peanut or soya, do not use this medicinal product. Purified arachis oil may contain peanut protein. The PhEur monograph does not contain a test for residual protein. SPC: contraindication.

3.

Aspartāms (E951) Aspartame (E951)

Oral

Zero

Contains a source of phenylalanine. May be harmful for people with phenylketonuria.  

4.

Azokrāsvielas,

piemēram,

E102, tartrazīns,

E110, saulrieta dzeltenais FCF,

E122, azorubīns, karmozīns,

E123, amarants,

E124, kumačs 4R, košenila sarkanais A,

E151, briljanta melnais BN, melnais PN

Azocolouring agents,

for example,

E102, tartrazine

E110, sunset yellow FCF

E122, azorubine, carmoisine

E123, amaranth

E124, ponceau 4R red, cochineal red A

E151, brilliant black BN, black PN

Oral

Zero

May cause allergic reactions.  

5.

Benzalkonija hlorīds Benzalkonium chloride

Ocular

Zero

May cause eye irritation. Avoid contact with soft contact lenses. Remove contact lenses prior to application and wait at least 15 minutes before reinsertion.

Known to discolour soft contact lenses.

 

Topical

Zero

Irritant, may cause skin reactions.  

Respiratory

10 micrograms/ delivered dose

May cause bronchospasm  

6.

Benzoskābe un benzoāti,

piemēram,

E210, benzoskābe,

E211, nātrija benzoāts,

E212, kālija benzoāts

Benzoic acid and benzoates,

for example,

E210, benzoic acid

E211, sodium benzoate

E212, potassium benzoate

Topical

Zero

Mildly irritant to the skin, eyes and mucous membranes  

Parenteral

Zero

May increase the risk of jaundice in new-born babies.  

7.

Benzilspirts Benzyl alcohol

Parenteral

Exposure less than 90 mg/kg/ day

Must not be given to premature babies or neonates.

May cause toxic reactions and allergic reactions in infants and children up to 3 years old.

SPC: 'allergic' should be expressed as 'anaphylactoid'

The amount of benzyl alcohol in mg per <volume> should be stated in the package leaflet and SPC.

90 mg/kg/ day

Must not be given to premature babies or neonates.

Due to the risk of fatal toxic reactions arising from exposure to benzyl alcohol in excess of 90 mg/kg/day, this product should not be used in infants and children up to 3 years old.

The amount of benzyl alcohol in mg per <volume> should be stated in the package leaflet and SPC.

8.

Bergamotes eļļa

Bergaptēns

Bergamot oil

Bergapten

Topical

Zero

May increase sensitivity to UV light (natural and artificial sunlight) Does not apply when bergapten is shown to be absent from the oil

9.

Bronopols Bronopol

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

10.

Butilēts hidroksianizols (E320) Butylated hydroxyanisole (E320)

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis), or irritation to the eyes and mucous membranes.  

11.

Butilēts hidroksitoluols (E321) Butylated hydroxytoluene (E321)

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis), or irritation to the eyes and mucous membranes.  

12.

Cetostearilspirts,

ieskaitot cetilspirtu

Cetostearyl alcohol

including cetyl alcohol

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

13.

Dimetilsulfoksīds Dimethyl sulphoxide

Topical

Zero

May be irritant to the skin.  

14.

Etilspirts Ethanol

Oral and Parenteral

Less than 100 mg per dose

This medicinal product contains small amounts of ethanol (alcohol), less than 100 mg per < dose>. This statement is to provide reassurance to parents and children concerning the low levels of alcohol in the product.

100 mg - 3 g per dose

This medicinal product contains ... vol % ethanol (alcohol), i.e. up to ... mg per dose, equivalent to ... ml beer, ... ml wine per dose.

Harmful for those suffering from addiction to alcohol.

To be taken into account in pregnant or breast-feeding women, children and high-risk groups such as patients with liver disease, or epilepsy.

The package leaflet should give the equivalent volume of beer and wine, nominally calculated assuming 5 % vol and 12% vol ethanol respectively.

Separate warning statements may be needed in different parts of the PL.

Oral and Parenteral

3 g per dose

This medicinal product contains ... vol % ethanol (alcohol), i.e. up to ... mg per dose, equivalent to ... ml beer, ... ml wine per dose.

Harmful for those suffering from addiction to alcohol.

To be taken into account in pregnant or breast-feeding women, children and high-risk groups such as patients with liver disease or epilepsy.

The amount of alcohol in this medicinal product may alter the effects of other medicines.

The amount of alcohol in this medicinal product may impair your ability to drive or use machines.

 

15.

Fenilalanīns Phenylalanine

All

Zero

This medicine contains phenylalanine. May be harmful for people with phenylketonuria  

16.

Formaldehīds Formaldehyde

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

Oral

Zero

May cause stomach upset and diarrhoea  

17.

Fruktoze Fructose

Oral

Parenteral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of fructose intolerance should not take this medicine.

5 g

Contains x g of fructose per dose.

This should be taken into account in patients with diabetes mellitus

 

Oral liquids, lozenges and chewable tablets

Zero

May be harmful to the teeth Information to be included only when the medicinal product may be intended for chronic use, e.g., for 2 weeks or more.

18.

Galaktoze Galactose

Parenteral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of galactose intolerance e.g. galactosaemia should not take this medicine.

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of galactose mintolerance e.g. galacotosaemia, or glucose-galactose

Oral

Parenteral

5 g

Contains x g of galactose per dose.

This should be taken into account in patients with diabetes mellitus

 

19.

Glicerīns Glycerol

Oral

10 g/dose

May cause headache, stomach upset and diarrhoea  

Rectal

1 g

May have a mild laxative effect  

20.

Glikoze Glucose

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare glucose-galactose malabsorption should not take this medicine

Oral

Parenteral

5 g

Contains x g of glucose per dose.

This should be taken into account in patients with diabetes mellitus

 

Oral liquids, lozenges and chewable tablets

Zero

May be harmful to the teeth Information to be included only when the medicinal product may be intended for chronic use, e.g., for 2 weeks or more.

21.

Heparīns

(kā palīgviela)

Heparin

(as an exipient)

Parenteral

Zero

May cause allergic reactions and reduced blood cell counts which may affect the blood clotting system.

Patients with a history of heparin-induced allergic reactions should avoid the use of heparin-containing medicines.

 

22.

Hidrogenēts glikozes sīrups

(vai maltīta šķidrums)

Hydrogenated Glucose syrup

(or Maltitol Liquid)

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. SPC proposal: Patients with rare hereditary problems of fructose intolerance should not take this medicine.

10 g

May have a mild laxative effect.

Calorific value 2.3 kcal/g of hydrogenated glucose syrup.

 

23.

Hlorkrezols Chlorocresol

Topical

Parenteral

Zero

May cause allergic reactions.  

24.

Invertcukurs Invert suger

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of fructose intolerance or glucose-galactose malabsorption should not take this medicine

5 g

Contains x g of a mixture of fructose and glucose per dose.

This should be taken into account in patients with diabetes mellitus

 

Oral liquids, lozenges and chewable tablets

Zero

May be harmful to the teeth Information to be included only when the medicinal product may be intended for chronic use, e.g., for 2 weeks or more.

25.

Kālijs Potassium

Parenteral

Less than 1 mmol per <dose>

This medicine contains potassium, less than 1 mmol (39 mg) per <dose>, i.e. essentially 'potassium-free'. Information relates to a threshold based on the total amount of K+ in the medicinal product.

It is especially relevant to products used in paediatric doses, to provide information to prescribers and reassurance to parents concerning the low level of K+ in the product.

Parenteral

Oral

1 mmol per <dose>

This medicine contains x mmol (or y mg) potassium per <dose>.

To be taken into consideration by patients with reduced kidney function or patients on a controlled potassium diet.

 

Parenteral -intravenous

30 mmol/l

May cause pain at the site of injection  

26.

Ksilīts (E967) Xylitol

Oral

10 g

May have a laxative effect.

Calorific value 2.4 kcal/g xylitol

 

27.

Kviešu ciete Wheat starch

Oral

Zero

Suitable for people with coeliac disease.

Patients with wheat allergy (different from coeliac disease) should not take this medicine.

Wheat Starch may contain gluten, but only in trace amounts, and is therefore considered safe for people with

coeliac disease. (Gluten in wheat starch is limited by the test for total protein described in the PhEur monograph.)

28.

Laktīts (E966) Lactitol (E966)

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC:

Patients with rare hereditary problems of fructose intolerance, galactose intolerance, galactosaemia or glucose-galactose malabsorption should not take this medicine

10 g

May have a mild laxative effect.

Calorific value 2.1 kcal/g lactitol

 

29.

Laktoze Lactose

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

5 g

Contains x g lactose (x/2 g glucose and x/2 g galactose) per dose.

This should be taken into account in patients with diabetes mellitus

 

30.

Lanolīns

(skat. Vilnas tauki)

Lanolin

(see Wool Fat)

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

31.

Latekss

Dabīgā gumija

Latex

Natural Rubber (latex)

All

Zero

The container of this medicinal product contains latex rubber. May cause severe allergic reactions. Not a typical excipient, but a warning is considered necessary.

32.

Maltīts (E965) un izomalts (E953),

maltīta šķidrums

(skat. Hidrogenēts glikozes sīrups)

Maltitol (E965) and Isomaltitol (E953),

Maltitol Liquid

(see Hydrogenated

Glucose Syrup)

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of fructose intolerance should not take this medicine.

10 g

May have a mild laxative effect.

Calorific value 2.3 kcal/g maltitol (or isomaltitol).

 

33.

Mannīts (E421) Mannitol (E421)

Oral

10 g

May have a mild laxative effect  

34.

Nātrijs Sodium

Parenteral

Less than 1 mmol per <dose>

This medicinal product contains less than 1 mmol sodium (23 mg) per <dose>, i.e. essentially 'sodium- free'. Information relates to a threshold based on the total amount of Na+ in the medicinal product.

It is especially relevant to products used in paediatric doses, to provide information to prescribers and reassurance to parents concerning the low level of Na+ in the product.

Oral

Parenteral

1 mmol per <dose>

This medicinal product contains x mmol (or y mg) sodium per dose.

To be taken into consideration by patients on a controlled sodium diet.

 

35.

Organiskie dzīvsudraba savienojumi,

piemēram,

tiomersāls,

fenildzīvsudraba nitrāts, acetāts, borāts

Organic mercury compounds,

for example,

Thiomersal,

Phenylmercuric nitrate, acetate, borate

Ocular

Zero

May cause allergic reactions. "EMEA Public Statement", 08.07.1999.,

Ref. EMEA/20962/99

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis) and discolouration  

Parenteral

Zero

This medicinal product contains (thiomersal) as a preservative and it is possible that <you/your child> may experience an allergic reaction. Tell your doctor if <you/your child> have/has any known allergies. "EMEA Public Statement", 08.07.1999.,

Ref. EMEA/20962/99

Parenterally (in case of vaccination)

Zero

Tell your doctor if you/your child have/has experienced any health problems after previous administration of a vaccine. Additional statement to be mentioned for vaccines

36.

Parahidroksibenzoāti un to esteri,

piemēram,

E214, etil-p-hidroksibenzoāts

E216, propil-p-hidroksibenzoāts

E217, nātrija propil-p-hidroksibenzoāts

E218, metil-p-hidroksibenzoāts

E219, nātrija metil-p-hidroksibenzoāts

Parahydroxybenzoates

and their esters:

for example,

E214, Ethylhydroxybenzoate

E216, Propyl hydroxybenzoate

E217, Sodium propylhydroxybenzoate

E218, Methyl hydroxybenzoate

E219, Sodium methyl hydroxybenzoate

Oral

Ocular

Topical

Zero

May cause allergic reactions (possibly delayed)  

Parenteral

Respiratory

Zero

May cause allergic reactions (possibly delayed), and exceptionally - bronchospasm  

37.

Peru balzāms Balsam of Peru

Topical

Zero

May cause skin reactions  

38.

Polioksilrīcineļļa

un hidrogenēta polioksilrīcineļļa

Castor oil polyoxyl

and castor oil polyoxyl hydrogenated

Parenteral

Zero

May cause severe allergic reactions.  

Oral

Zero

May cause stomach upset and diarrhoea  

Topical

Zero

May cause skin reactions  

39.

Propilēnglikols un tā esteri Propylene glycol and esters

Topical

Zero

May cause skin irritation  

Oral

Parenteral

400 mg/kg for adults

200 mg/kg for children

May cause alcohol-like symptoms  

40.

Saharoze Sucrose

Oral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of fructose intolerance, glucosegalactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

5 g

Contains x g of sucrose per dose.

This should be taken into account in patients with diabetes mellitus

 

Oral liquids, lozenges and chewable tablets

Zero

May be harmful to the teeth Information to be included only when the medicinal product may be intended for chronic use, e.g., for 2 weeks or more.

41.

Sezameļļa Sesame oil

All

Zero

May rarely cause severe allergic reactions.  

42.

Sojas eļļa

(un hidrogenēta sojas eļļa)

Soya oil

(and Hydrogenated Soya oil)

All

Zero

(Medicinal product) contains soya oil. If you are allergic to peanut or soya, do not use this medicinal product. In line with Arachis oil.

SPC: contraindication.

43.

Sorbīnskābe (E200) un tās sāļi Sorbic acid and salts

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

44.

Sorbīts (E420) Sorbitol (E420)

Oral

Parenteral

Zero

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product SPC proposal: Patients with rare hereditary problems of fructose intolerance should not take this medicine.

Oral

10 g

May have a mild laxative effect.

Energy value 2.6 kcal/g of sorbitol

 

45.

Sulfīti,

ieskaitot metabisulfītus,

piemēram,

E220, sēra dioksīds

E221, nātrija sulfīts

E222, nātrija bisulfīts

E223, nātrija metabisulfīts

E224, kālija metabisulfīts

E228, kālija bisulfīts

Sulphites

including metabisulphites,

for example,

E220, sulphur dioxide

E221, sodium sulphite

E222, sodium bisulphite

E223, sodium metabisulphite

E224, potassium metabisulphite

E228, potassium bisulphite

Oral

Parenteral

Respiratory

Zero

May rarely cause severe hypersensitivity reactions and bronchospasm  

46.

Vilnas tauki

(lanolīns)

Wool Fat

(Lanolin)

Topical

Zero

May cause local skin reactions (e.g., contact dermatitis).  

Minister for Health G. Bērziņš

 


Translation © 2018 Valsts valodas centrs (State Language Centre)

 
Document information
Title: Noteikumi par zāļu marķēšanas kārtību un zāļu lietošanas instrukcijai izvirzāmajām prasībām Status:
In force
in force
Issuer: Cabinet of Ministers Type: regulation Document number: 57Adoption: 17.01.2006.Entry into force: 25.01.2006.Theme: COVID-19Publication: Latvijas Vēstnesis, 14, 24.01.2006.
Language:
LVEN
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