FrancophonIA/ELRC3.0 huggingface dataset:
English: In the study in HBeAg positive patients, HBeAg seroconversion (12 %) and HBeAg loss (24 %) was observed significantly more frequently in patients receiving 10 mg adefovir dipivoxil than in patients receiving placebo (6 % and 11 %, respectively) after 48 weeks of treatment.
Danish: I studiet med HBeAg-positive patienter blev HBeAg-serokonversion (12 %) og HBeAg-tab (24 %) observeret signifikant hyppigere hos patienter, der fik 10 mg adefovirdipivoxil end hos patienter, som fik placebo (hhv. 6 % og 11 %), efter 48 ugers behandling.
English: In patients with decompensated liver disease or cirrhosis, treatment cessation is not recommended (see section 4.4).
Danish: Hos patienter med dekompenseret leversygdom eller cirrose anbefales behandlingsophør ikke (se pkt.
English: In the two studies mentioned above, treatment with 10 mg adefovir dipivoxil was associated with significant reductions in serum HBV DNA (3.52 and 3.91 log10 copies/ml, respectively, versus 0.55 and 1.35 log10 copies/ml), increased proportion of patients with normalisation of ALT (48 and 72 % versus 16 and 29 %) or increased proportion of patients with serum HBV DNA below the limits of quantification (< 400 copies/ml Roche Amplicor Monitor PCR assay) (21 and 51 % versus 0 %) when compared with placebo.
Danish: I de to ovennævnte studier var behandlingen med 10 mg adefovirdipivoxil forbundet med signifikante reduktioner i serum-HBV-dna (hhv. 3,52 og 3,91 log10 kopier/ml sammenlignet med 0,55 og 1,35 log10 kopier/ml), en større procentdel af patienter med ALAT-normalisering (48 og 72 % sammenlignet med 16 og 29 %) eller en større procentdel af patienter med serum-HBV-dna under kvantificeringsgrænserne (< 400 kopier/ml Roche Amplicor Monitor PCR analysen) (21 og 51 % sammenlignet med 0 %) i sammenligning med placebo.
English: No human data on the effect of adefovir dipivoxil on fertility are available.
Danish: Der foreligger ingen humane data vedrørende adefovirdipivoxils virkning på fertiliteten.
English: Hepatic impairment: No dose adjustment is required in patients with hepatic impairment (see section 5.2).
Danish: Nedsat leverfunktion: Der kræves ingen dosisjustering hos patienter med nedsat leverfunktion (se pkt.
English: The efficacy and safety of a daily dose of 0.25 mg/kg to 10 mg adefovir dipivoxil in children (aged from 2 to < 18 years) were examined in a double-blind, randomised, placebo-controlled study in 173 paediatric patients (115 on adefovir dipivoxil, 58 on placebo) who had HBeAg positive chronic hepatitis B, serum ALT levels ≥ 1.5 x upper limit of normal (ULN) and compensated liver disease.
Danish: Virkningen og sikkerheden af en daglig dosis fra 0,25 mg/kg til højst 10 mg adefovirdipivoxil hos børn (i alderen 2 til < 18 år) blev undersøgt i et dobbeltblindt, randomiseret, placebo-kontrolleret klinisk studie med 173 pædiatriske patienter (115 fik adefovirdipivoxil, og 58 fik placebo), som havde HBeAg-positiv kronisk hepatitis B, serum-ALAT-niveauer ≥ 1,5 x øvre normalgrænse (ULN) og kompenseret leversygdom.
English: Paediatric population: The pharmacokinetics of adefovir dipivoxil were studied in an efficacy and safety study of a daily dose of 0.25 mg/kg to 10 mg adefovir dipivoxil in children (aged 2 to < 18 years).
Danish: Pædiatrisk population: Adefovirdipivoxils farmakokinetik blev undersøgt hos børn (i alderen 2 til < 18 år) i et virknings- og sikkerhedsstudie med en daglig dosis fra 0,25 mg/kg til højst 10 mg adefovirdipivoxil.
English: Adefovir dipivoxil is a dipivaloyloxymethyl ester prodrug of the active substance adefovir, an acyclic nucleotide analogue which is actively transported into cells where it is converted by host enzymes to adefovir diphosphate.
Danish: Adefovirdipivoxil er et dipivaloyloxymethylester-prodrug af det aktive stof adefovir, en acyklisk nukleotidanalog, som aktivt transporteres ind i cellerne, hvor det af værtsenzymer omdannes til adefovirdiphosphat.
English: There are no safety and efficacy data to support the use of adefovir dipivoxil in patients with a creatinine clearance < 30 ml/min or on dialysis.
Danish: Der foreligger ingen data vedrørende sikkerhed og virkning, som understøtter anvendelsen af adefovirdipivoxil hos patienter med en kreatininclearance < 30 ml/min eller i dialyse.
English: In the pre-liver transplantation cohort, 25 of 33 (76 %) patients achieved undetectable HBV DNA levels and 84 % of patients had ALT normalisation at 96 weeks.
Danish: I den præ-levertransplanterede kohorte opnåede 25 af 33 (76 %) patienter HBV-dna-niveauer, som ikke kunne påvises, og 84 % af patienterne havde ALAT-normalisering ved uge 96.
English: In the post-liver transplantation cohort, 61 of 94 (65 %) and 35 of 45 (78 %) of patients achieved undetectable HBV DNA levels at 96 and 144 weeks, respectively, and 70 % and 58 % of patients had ALT normalisation at these study visits.
Danish: I den postlevertransplanterede kohorte opnåede 61 af 94 (65 %) og 35 af 45 (78 %) af patienterne HBV-dnaniveauer, som ikke kunne påvises, ved hhv. uge 96 og 144, og 70 % og 58 % af patienterne udviste ALAT-normalisering ved disse besøg.
English: Due to the small sample size and the study design, in particular the lack of treatment arms with pegylated interferon alpha-2a monotherapy and with adefovir monotherapy, it is not possible to draw formal conclusions on the best therapeutic management of HIV co-infected patients with lamivudine-resistant HBV.
Danish: På grund af den ringe populationsstørrelse og undersøgelsens opbygning, især udeladelsen af behandlingsarme med pegyleret interferon alfa-2amonobehandling og adefovir-monobehandling, er det ikke muligt at udlede formelle konklusioner om en optimal behandlingsstrategi hos disse patienter, der har både hiv- og lamivudin-resistent HBV-infektion.
English: Clinical resistance in monotherapy studies in nucleoside naïve patients: In patients receiving adefovir dipivoxil monotherapy (HBeAg negative study) the cumulative probability of developing adefovir-associated resistance mutations was 0 %, 3 %, 11 %, 18 % and 29 % at 48, 96, 144, 192 and 240 weeks respectively.
Danish: Klinisk resistens ved monoterapistudier hos nukleosid-naive patienter: Hos patienter, der fik adefovirdipivoxil som monoterapi (HBeAg-negativ studie) var den kumulative sandsynlighed for udvikling af adefovirforbundne resistensmutationer 0 %, 3 %, 11 %, 18 % og 29 % efter hhv. 48, 96, 144, 192 og 240 uger.
English: Virological response should be closely monitored in patients treated with adefovir dipivoxil, with HBV DNA measured every 3 months.
Danish: Hos patienter, som behandles med adefovirdipivoxil, bør den virologiske respons overvåges nøje med måling af HBV-dna hver 3. måned.
English: Adefovir dipivoxil is not recommended during pregnancy and in women of childbearing potential not using contraception.
Danish: Adefovirdipivoxil bør ikke anvendes under graviditeten eller til kvinder i den fertile alder, som ikke anvender sikker kontraception.
English: Detailed information on this medicinal product is available on the website of the European Medicines Agency http://www.ema.europa.eu
Danish: De kan finde yderligere oplysninger om Hepsera på Det Europæiske Lægemiddelagenturs hjemmeside http://www.ema.europa.eu/.
English: Only keep them if your doctor tells you to. Do not throw away any medicines via wastewater or household waste.
Danish: Behold dem kun, hvis Deres læge beder Dem om det. Spørg på apoteket, hvordan De skal bortskaffe medicinrester.
English: • The other ingredients are: pregelatinised starch, croscarmellose sodium, lactose monohydrate, talc and magnesium stearate.
Danish: • Øvrige indholdsstoffer: pregelatineret stivelse, croscarmellosenatrium, lactosemonohydrat,
English: Treatment with adefovir dipivoxil resulted in improvement in the liver fibrosis from baseline to 96 weeks therapy when analysed using the Ishak score (median change: Δ= -1).
Danish: Behandling i 96 uger med adefovirdipivoxil resulterede i en forbedring af leverfibrosen sammenlignet med baseline ved analyser baseret på Ishaks score (median forandring: Δ= -1).
English: Adefovir dipivoxil
Danish: Adefovirdipivoxil
English: There are limited data on the use of adefovir dipivoxil in pregnant women.
Danish: Graviditet Der er utilstrækkelige data fra anvendelse af adefovirdipivoxil til gravide kvinder.
English: However, 4 patients who discontinued lamivudine treatment developed the rtN236T mutation while receiving adefovir dipivoxil monotherapy and all experienced serum HBV rebound.
Danish: Imidlertid udviklede 4 patienter, der ophørte med lamivudinbehandling, rtN236T-mutationen, mens de fik adefovirdipivoxil som monoterapi.
English: Co-administration of 10 mg adefovir dipivoxil with medicinal products in these patients may lead to an increase in serum concentrations of either adefovir or a co-administered medicinal product.
Danish: Samtidig indgivelse af 10 mg adefovirdipivoxil og andre lægemidler til disse patienter kan føre til en stigning i serumkoncentrationer af enten adefovir eller et samtidig indgivet lægemiddel.
English: • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Danish: • Overfølsomhed over for det aktive stof eller over for et eller flere af hjælpestofferne anført i pkt.
English: Treatment with adefovir dipivoxil may result in renal impairment.
Danish: Behandling med adefovirdipivoxil kan medføre nedsat nyrefunktion.
English: What it is used for
Danish: Hvad bruges Hepsera til?
English: Clinical and laboratory evidence of exacerbations of hepatitis have occurred after discontinuation of treatment with 10 mg adefovir dipivoxil (see section 4.4).
Danish: Kliniske forsøg og laboratorieundersøgelser har påvist forværring af hepatitis efter seponering af behandling med 10 mg adefovirdipivoxil (se pkt.
English: These patients should be closely monitored for possible adverse reactions and to ensure efficacy is maintained (see sections 4.4 and 4.8).
Danish: Disse patienter bør overvåges nøje for eventuelle mulige, uønskede reaktioner og for at sikre, at virkningen opretholdes (se pkt.
English: In the HBeAg negative study patients on adefovir dipivoxil (0-48 weeks) were re-randomised in a blinded-manner to continue on adefovir dipivoxil or receive placebo for an additional 48 weeks.
Danish: I studiet med HBeAg-negative patienter, der blev behandlet med adefovirdipivoxil (0-48 uger), blev der foretaget en blindet re-randomisering med henblik på fortsat behandling med adefovirdipivoxil eller placebo i yderligere 48 uger.
English: At week 48, in children aged 2 to 11 years old, no statistically significant difference was observed in the proportions of patients that achieved the primary endpoint of serum HBV DNA < 1,000 copies/ml and normal ALT levels between the placebo arm and the adefovir dipivoxil arm.
Danish: Ved uge 48 blev der ikke observeret nogen statistisk signifikant forskel mellem placebo-armen og adefovirdipivoxil-armen hos børn i alderen 2 til 11 år blandt de patienter, som nåede det primære endepunkt, som var serum-HBV-dna < 1.000 kopier/ml og normalt ALATniveau.
English: Proximal renal tubulopathy (including Fanconi syndrome) General disorders and administration site conditions: Very common:
Danish: Nyresvigt, unormal nyrefunktion, hypofosfatæmi Ikke almindelige: Proksimal renal tubulopati (herunder Fanconis syndrom) Almene symptomer og reaktioner på administrationsstedet: Meget almindelige:
English: (may affect more than 1 in 10 people)
Danish: (kan forekomme hos flere end 1 ud af 10 personer)
English: Clinical resistance in patients receiving adefovir dipivoxil as monotherapy and in combination with lamivudine: In several clinical studies (HBeAg positive, HBeAg negative, pre- and post-liver transplantation with lamivudine-resistant HBV and lamivudine-resistant HBV co-infected with HIV patients), genotypic analyses were conducted on HBV isolates from 379 of a total of 629 patients, treated with adefovir dipivoxil for 48 weeks.
Danish: Klinisk resistens hos patienter, der fik adefovirdipivoxil som monoterapi og i kombination med lamivudin: I flere kliniske studier (HBeAg-positive, HBeAg-negative, præ- og postlevertransplanterede patienter med lamivudin-resistent HBV og patienter med lamivudin-resistent HBV, der samtidig var inficeret med hiv) blev genotypeanalyser udført på HBV-isolater fra 379 ud af i alt 629 patienter, som var blevet behandlet med adefovirdipivoxil i 48 uger.
English: In a second open-label, one-arm study, 10 mg adefovir dipivoxil and pegylated interferon alpha-2a were added to ongoing lamivudine therapy in 18 HIV/HBV co-infected patients with lamivudine-resistant HBV.
Danish: I et andet åbent, enkeltarmet studie blev der tilføjet 10 mg adefovirdipivoxil og pegyleret interferon alfa-2a til den igangværende lamivudin-behandling af 18 patienter, som havde både hiv- og lamivudinresistent HBV-infektion.
English: Two novel conserved site mutations were identified in the HBV polymerase gene (rtN236T and rtA181V), which conferred clinical resistance to adefovir dipivoxil.
Danish: HBV-polymerasegenet (rtN236T og rtA181V) og medførte klinisk adefovirdipivoxilresistens.
English: (may affect up to 1 in 10,000 people)
Danish: (kan forekomme hos op til 1 ud af 10.000 personer)
English: In clinical studies of wait-listed and post-liver transplantation patients, four percent (19/467) of patients discontinued treatment with adefovir dipivoxil due to renal adverse events.
Danish: I kliniske studier af patienter på venteliste og post-levertransplanterede patienter, blev behandlingen med adefovirdipivoxil seponeret hos 4 % (19/467) af patienterne på grund af uønskede hændelser i nyrerne.
English: Resistance: Resistance to adefovir dipivoxil (see section 5.1) can result in viral load rebound which may result in exacerbation of hepatitis B and, in the setting of diminished hepatic function, lead to liver decompensation and possible fatal outcome.
Danish: 5.1) kan resultere i en forværring af virusmængden, hvilket igen kan resultere i en eksacerbation af hepatitis B. Dette kan, i tilfælde af reduceret leverfunktion, føre til leverdekompensation med risiko for dødeligt udfald.
English: • Kidney failure - common
Danish: • Nyresvigt - almindeligt
English: Hepsera contains lactose monohydrate.
Danish: Hepsera indeholder lactosemonohydrat.
English: Clinical resistance in studies where adefovir dipivoxil was added to ongoing lamivudine in patients with lamivudine-resistance: In an open-label study of pre- and post-liver transplantation patients with clinical evidence of lamivudine-resistant HBV, no adefovir-associated resistance mutations were observed at week 48.
Danish: Klinisk resistens ved studier, hvor adefovirdipivoxil blev føjet til igangværende lamivudinbehandling hos patienter med lamivudinresistens: I et åbent studie af præ- og post-levertransplanterede patienter med kliniske tegn på lamuvidinresistent HBV, blev der ikke observeret adefovirforbundne resistensmutationer ved uge 48.
English: Gilead Sciences Ireland UC IDA Business & Technology Park Carrigtohill Co. Cork Ireland
Danish: Gilead Sciences Ireland UC IDA Business & Technology Park Carrigtohill Co. Cork Irland
English: Tell a doctor or pharmacist if you are worried about any of these.
Danish: Fortæl det til lægen eller apoteket, hvis De er bekymret på grund af nogle af disse bivirkninger.
English: Co-administration of 10 mg adefovir dipivoxil with other medicinal products that are eliminated by tubular secretion or alter tubular function may increase serum concentrations of either adefovir or the co-administered medicinal product (see section 4.4).
Danish: Samtidig indgivelse af 10 mg adefovirdipivoxil og lægemidler, der elimineres ved tubulær sekretion eller som ændrer tubulærfunktionen, kan forhøje serumkoncentrationer af enten adefovir eller det samtidig indgivne lægemiddel (se pkt.
English: Osteomalacia (manifested as bone pain and infrequently contributing to fractures) and myopathy, both associated with proximal renal tubulopathy Renal and urinary disorders: Very common:
Danish: Osteomalaci (manifesterer sig som knoglesmerter og er i sjældne tilfælde medvirkende årsag til frakturer) og myopati, begge forbundet med proksimal renal tubulopati
English: The recommended dosing frequency according to renal function must not be exceeded (see sections 4.4 and 5.2).
Danish: Den anbefalede dosishyppighed i henhold til nyrefunktionen må ikke overskrides (se pkt.
English: Adefovir dipivoxil was mutagenic in the in vitro mouse lymphoma cell assay (with or without metabolic activation), but was not clastogenic in the in vivo mouse micronucleus assay.
Danish: Adefovirdipivoxil var mutagen i in vitro-muselymfomcelleanalysen (med eller uden stofskifteaktivering), men var ikke clastogen i in vivo-musemikronukleusanalysen.
English: For renal safety in patients pre- and post-transplantation with lamivudine-resistant HBV, see section 4.8.
Danish: Angående renal sikkerhed hos præ- og post-transplanterede patienter med lamivudin-resistent HBV se pkt.
English: CARTON AND BOTTLE LABELLING
Danish: ETIKETTERING PÅ ÆSKE OG PÅ BOKS
English: Contents of the pack and other information What Hepsera contains
Danish: Pakningsstørrelser og yderligere oplysninger Hepsera indeholder:
English: Experience in patients with compensated liver disease and lamivudine-resistant HBV: In a double-blind comparative study in chronic hepatitis B patients with lamivudine-resistant HBV (n=58), there was no median reduction in HBV DNA from baseline after 48 weeks of treatment with lamivudine.
Danish: Erfaring med patienter med kompenseret leversygdom og lamivudin-resistent HBV: I et dobbeltblindt, sammenlignende studie af kroniske hepatitis B patienter med lamivudin-resistent HBV (n=58) var der ingen median reduktion i HBV-dna fra baseline efter 48 ugers behandling med lamivudin.
English: The volume of distribution at steady-state following intravenous administration of 1.0 or 3.0 mg/kg/day is 392±75 and 352±9 ml/kg, respectively.
Danish: Distributionsvolumenet ved steady-state efter intravenøs indgivelse af 1,0 eller 3,0 mg/kg/dgl.
English: The effect of peritoneal dialysis on adefovir removal has not been evaluated.
Danish: Udskillelse af adefovir i forbindelse med peritoneal dialyse er ikke blevet evalueret.
English: Caution is advised in patients receiving other medicinal products that may affect renal function or are excreted renally (e.g. cyclosporin and tacrolimus, intravenous aminoglycosides, amphotericin B,
Danish: Det tilrådes, at der udvises forsigtighed hos patienter som får andre lægemidler, der kan påvirke nyrefunktionen, eller som udskilles gennem nyrerne (f.eks. ciclosporin og tacrolimus, intravenøse aminoglykosider, amphotericin B, foscarnet, pentamidin, vancomycin, eller lægemidler, som udskilles renalt via human Organic Anion Transporter 1 (hOAT1), som f.eks. cidofovir).
English: Pharmacokinetic analysis revealed that adefovir exposure was comparable among 3 age groups, 2 to 6 years (0.3 mg/kg), 7 to 11 years (0.25 mg/kg) and 12 to 17 years (10 mg) and all age groups achieved adefovir exposure in the target range (for efficacy results see section 5.1), which was based on adefovir plasma concentrations in adult patients with chronic hepatitis B with established safety and efficacy profiles.
Danish: Farmakokinetiske analyser viste, at adefovirkoncentrationen var sammenlignelig i 3 aldersgrupper, 2 til 6 år (0,3 mg/kg), 7 til 11 år (0,25 mg/kg) og 12 til 17 år (10 mg), og alle aldersgrupper opnåede en adefovirkoncentration i målområdet (se pkt.
English: If you stop taking Hepsera
Danish: Hvis De har taget for mange Hepsera
English: Experience in patients with compensated liver disease: In two placebo-controlled studies (total n=522) in HBeAg positive or in HBeAg negative chronic hepatitis B patients with compensated liver disease, significantly more patients (p < 0.001) in the 10 mg adefovir dipivoxil groups (53 and 64 %,
Danish: Erfaring med patienter med kompenseret leversygdom: I to placebokontrollerede studier (i alt n=522) med HBeAg-positive eller HBeAg-negative kroniske hepatitis B patienter med kompenseret leversygdom, havde signifikant flere patienter (p < 0,001) i 10 mg adefovirdipivoxil-grupperne (hhv.
English: • Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines and herbal products obtained without a prescription.
Danish: • Fortæl altid lægen eller apotekspersonalet, hvis De tager anden medicin eller har gjort det for nylig.
English: This is to make sure that your medicine is fully effective and to reduce the development of resistance to the treatment.
Danish: Sådan skal De tage Hepsera Tag altid lægemidlet nøjagtigt efter lægens anvisning for at være sikker på, at medicinen virker bedst muligt og for at nedsætte risikoen for udvikling af resistens over for behandlingen.
English: Renal impairment: Adefovir is eliminated by renal excretion and adjustments of the dosing interval are required in patients with a creatinine clearance < 50 ml/min or on dialysis.
Danish: Nedsat nyrefunktion: Adefovir elimineres ved renal udskillelse, og hos patienter med kreatininclearance < 50 ml/min eller i dialyse skal dosisintervallet tilpasses.
English: Linearity/non-linearity: The pharmacokinetics of adefovir are proportional to dose when given as adefovir dipivoxil over the dose range of 10 to 60 mg.
Danish: Linearitet/non-linearitet: Adefovirs farmakokinetik er proportional med doser, der gives som adefovirdipivoxil over dosisområdet 10-60 mg. Gentaget dosering af adefovirdipivoxil 10 mg dagligt påvirkede ikke adefovirs farmakokinetik.
English: Experience in patients pre- and post-liver transplantation with lamivudine-resistant HBV: In a clinical study in 394 chronic hepatitis B patients with lamivudine-resistant HBV (pre-liver transplantation (n=186) and post-liver transplantation (n=208)), treatment with 10 mg adefovir dipivoxil resulted in a median reduction in serum HBV DNA of 4.1 and 4.2 log10 copies/ml, respectively, at week 48.
Danish: Erfaring med præ- og post-levertransplanterede patienter med lamivudin-resistent HBV: I en klinisk undersøgelse med 394 kroniske hepatitis B patienter med lamivudin-resistent HBV (prælevertransplanterede (n=186) og post-levertransplanterede (n=208)) resulterede behandling med 10 mg adefovirdipivoxil i en median reduktion i serum-HBV-dna på hhv. 4,1 og 4,2 log10 kopier/ml ved uge 48.
English: Consequently, patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption should not take this medicinal product.
Danish: Bør ikke anvendes til patienter med arvelig galactoseintolerans, en særlig form af hereditær lactasemangel (Lapp Lactase deficiency), eller glucose/galactosemalabsorption.
English: • Stomach pain Contact your doctor at once if you get any of these symptoms.
Danish: Fortæl det omgående til Deres læge, hvis De får nogen af disse symptomer.
English: Elimination: Adefovir is excreted renally by a combination of glomerular filtration and active tubular secretion.
Danish: Elimination: Adefovir udskilles renalt ved en kombination af glomerulusfiltration og aktiv tubulær sekretion.
English: Experience in patients with decompensated liver disease and lamivudine-resistant HBV: In 40 HBeAg positive or HBeAg negative patients with lamivudine-resistant HBV and decompensated liver disease receiving treatment with 100 mg lamivudine, addition of 10 mg adefovir dipivoxil treatment for 52 weeks resulted in a median reduction in HBV DNA of 4.6 log10 copies/ml.
Danish: Erfaring med patienter med dekompenseret leversygdom og lamivudin-resistent HBV: I 40 HBeAgpositive eller HBeAg-negative patienter med lamivudin-resistent HBV og dekompenseret leversygdom, som blev behandlet med 100 mg lamivudin, resulterede tilføjelsen af behandling med 10 mg adefovirdipivoxil i 52 uger i en median reduktion i HBV-dna på 4,6 log10 kopier/ml.
English: (may affect up to 1 in 10 people)
Danish: (kan forekomme hos op til 1 ud af 10 personer)
English: b. Tabulated summary of adverse reactions
Danish: b. Resumé af bivirkninger i tabelform