GEFFER*OS GRAT EFF 24SACH 5G

Geffer effervescent granules

What it is and what it is used for
Geffer belongs to the therapeutic category of prokinetics (medicines that accelerate gastric emptying): it is a combination medicine for the treatment of disorders resulting from gastric hyperacidity (excess acid in the stomach), overeating, abnormal presence of air and gas in the stomach, and digestive difficulties.
Geffer is used for the treatment of hyperacidity symptoms (stomach pain and heartburn), when accompanied by slowed gastric transit (slow digestion), nausea, aerophagia, and meteorism (conditions characterized by an abnormal accumulation of gas in the stomach or intestine, causing belching, abdominal tension, and bloating).

Consult your doctor if you do not feel better or if you feel worse after 3 days.

What you need to know before taking the medicine
Do not take Geffer
- if you are allergic to the active ingredients or any of the other ingredients of this medicine (listed in section 6);
- if you are pregnant or breastfeeding (see Pregnancy and breastfeeding);
- if you are under 16 years of age (see Children and adolescents);
- if you are taking medicines belonging to the anticholinergic group (medicines that inhibit the effects of acetylcholine, a neurotransmitter);
- in cases where stimulation of intestinal motility may be dangerous, for example, in the presence of gastrointestinal bleeding, perforation, mechanical obstruction (blockage of the intestinal tract).

- If you suffer from any of the following diseases:
• glaucoma (an eye disease characterized by increased eye pressure),
• pheochromocytoma (tumor of the adrenal gland),
• epilepsy,
• Parkinson's disease and other extrapyramidal conditions (disorders of involuntary movements),
• porphyria, a rare disease in which the activity of particular enzymes is altered,
• metabolic or respiratory alkalosis (conditions in which the blood pH reaches a value higher than normal),
• hypocalcemia (low calcium levels in the blood).

Warnings and precautions
Talk to your doctor or pharmacist before taking Geffer.

If you are an elderly person, you should not exceed 3 consecutive days of treatment and must adhere to the minimum dosages indicated (see How to take Geffer and Possible side effects).

Stop treatment and contact your doctor or pharmacist immediately if you experience any of the following symptoms during therapy with Geffer: high fever, high blood pressure, seizures, sweating, saliva production. These may be signs of a disorder called neuroleptic malignant syndrome.

High doses or prolonged use of Geffer can cause metabolic or respiratory alkalosis (changes in blood pH).

Consult your doctor before taking Geffer:
- if you suffer from hypokalemia (low potassium levels in the blood), because this medicine can worsen alkalosis;
- if you suffer from conditions that cause edema (fluid retention in the body) such as congestive heart failure and reduced kidney function;
- if you suffer from hyperaldosteronism (excessive production of the hormone aldosterone);
- if you suffer from kidney problems (renal insufficiency).

Children and adolescents
Geffer should not be administered to children under 16 years of age (see Do not take Geffer).

Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

Side effects due to the presence of metoclopramide in the medicine:
• Uncommon (may affect up to 1 in 100 patients):
- visual disturbances and involuntary eye deviation
• Rare (may affect up to 1 in 1,000 patients):
- hyperprolactinemia (increase in blood prolactin levels, a hormone secreted by endocrine glands);
- menstrual cycle disorders;
- galactorrhea (secretion of milk in males or in non-nursing women);
- gynecomastia (breast development) in men;
- drowsiness;
- fatigue;
- dizziness;
- porphyria (a rare disease in which the activity of particular enzymes is altered);
- extrapyramidal reactions of various types, normally dystonic. These may include facial spasms, trismus (jaw spasm that prevents opening the mouth), abnormal head positions; these reactions usually resolve within 24 hours of stopping treatment.

In patients with pheochromocytoma (adrenal gland tumor), hypertensive crises, sometimes fatal, have been reported; therefore, the use of Geffer is contraindicated in these patients (see Do not take Geffer).

In some elderly patients treated for prolonged periods, the development of tardive dyskinesia (severe extrapyramidal reaction characterized by involuntary body movements), potentially irreversible, has been reported; therefore, elderly patients should absolutely avoid therapies lasting more than 3 days.

• Frequency unknown (frequency cannot be estimated from the available data):
- high fever, high blood pressure, seizures, sweating, saliva production. These may be symptoms of a disorder called neuroleptic malignant syndrome (see Warnings and precautions)
- Very high blood pressure

Side effects due to the presence of citrate salts in the medicine:
• Frequency unknown (frequency cannot be estimated from the available data):
Gastrointestinal disorders
Oral administration of excessive doses of citrate salts may have a laxative effect.

Effects due to the presence of sodium bicarbonate in the medicine:
• Frequency unknown (frequency cannot be estimated from the available data):
Metabolism and nutrition disorders
Decreased blood potassium levels (hypokalemia), increased blood sodium levels (hypernatremia), metabolic alkalosis (symptoms may include shortness of breath, muscular effects such as weakness, muscle hypertonicity, involuntary contractions, muscle spasms, especially with decreased calcium levels, and effects on the central nervous system).

Following the instructions in the package leaflet reduces the risk of side effects.
These side effects are generally transient. However, if they occur, you should consult your doctor or pharmacist.

Reporting of side effects
If you get any side effects, including any not listed in this leaflet, talk to your doctor or pharmacist. You can also report side effects directly via the national reporting system at: https://www.aifa.gov.it/content/segnalazionireazioni-avverse.
By reporting side effects, you can help provide more information on the safety of this medicine.