FrancophonIA/ELRC3.0 huggingface dataset:
English: In addition, all Leflunomide Apotex products for these markets are manufactured at the same manufacturing site, Apotex Inc., Toronto (Canada), according to the same manufacturing process.
Danish: Endvidere finder al produktion af Leflunomide Apotex til disse markeder sted på samme fremstillingssted, nemlig Apotex Inc. i Toronto (Canada) efter samme fremstillingsproces.
English: The AUC, Cmax and Tmax of the US and Canadian fasting studies were comparable to the values obtained in the European study, which was also performed in fasting state.
Danish: AUC, Cmax og Tmax i de amerikanske og canadiske fastende undersøgelser var sammenlignelige med resultaterne fra den europæiske undersøgelse, der ligeledes blev udført i fastende tilstand.
English: Although the company did not discuss any other potential safety signals, the CHMP acknowledged that there are no signals of increased adverse events when compared to the reference product, based on the data in the last PSUR (reporting period 28-10-2010 until 27-10-2011).
Danish: Virksomheden havde ikke taget stilling til andre potentielle sikkerhedssignaler, men CHMP tilsluttede sig, at der ikke er signaler om større forekomst af bivirkninger end med referencelægemidlet i den seneste PSUR (indberetningsperiode 28. oktober 2010 til 27. oktober 2011).
English: The CHMP also noted the safety assessment carried out by the MAH but carried out a separate search of EudraVigilance, identifying 14 cases of lack of efficacy specifically for generic products.
Danish: CHMP tog endvidere den af indehaveren af markedsføringstilladelsen udførte sikkerhedsvurdering til efterretning, men foretog en separat søgning i EudraVigilance og fandt derved 14 tilfælde af manglende virkning specifikt for generiske lægemidler.
English: Leflunomide Apotex contains leflunomide, a pyrimidine synthesis inhibitor belonging to the DMARD (disease-modifying antirheumatic drug) class of drugs, which are chemically and pharmacologically very heterogeneous.
Danish: Leflunomide Apotex indeholder leflunomid, der er en pyrimidinsyntesehæmmer tilhørende klassen DMARD (sygdomsmodificerende antireumatiske lægemidler, som kemisk og farmakologisk er meget forskellige).
English: Of the four remaining cases potentially attributable to Leflunomide Apotex, two involved arthralgia and swollen joints not related to rheumatoid arthritis (RA) while one was confounded by the concomitant use of other drugs while the last suggested concomitant use of TNF-alpha inhibitors.
Danish: Af de fire resterende tilfælde, der potentielt kunne tilskrives Leflunomide Apotex, vedrørte de to artralgi og hævede led uden sammenhæng med reumatoid arthritis, ét tilfælde var konfunderet ved samtidig brug af andre lægemidler, og i det sidste tilfælde var der tegn på samtidig brug af TNF-alfa-hæmmere.
English: It is therefore plausible that the same quality active substance and excipients are used, although these bioequivalence studies were conducted using different sources of the reference product and no evidence was presented to confirm whether the reference product is indeed the same in all the studies.
Danish: Det er derfor sandsynligt, at både det aktive indholdsstof og hjælpestofferne er af samme kvalitet, skønt de pågældende bioækvivalensundersøgelser blev udført med referencelægemiddel fra forskellige kilder, og det ikke blev dokumenteret, at referencelægemidlet rent faktisk var det samme i alle undersøgelserne.
English: The fact that the qualitative compositions of the EU and non-EU Leflunomide Apotex products are fully identical and that the products are manufactured at the same manufacturing facility via the same manufacturing process can only be considered as supportive evidence.
Danish: Det forhold, at den kvalitative sammensætning af Leflunomide Apotex som henholdsvis EU-lægemiddel og ikke-EU-lægemiddel er helt identisk, og at lægemidlerne fremstilles på samme fremstillingssted efter samme fremstillingsproces, kan kun betragtes som støttende evidens.
English: One case report reported lack of efficacy, where the product was used for lupus mixed connective tissue disease, which is not an approved indication.
Danish: Én caserapport beskrev manglende virkning, hvor lægemidlet var anvendt til lupus/blandet bindevævssygdom (MTCD), som ikke er en godkendt indikation.
English: The CHMP noted that such dissolution results were not provided.
Danish: CHMP konstaterede, at der ikke var forelagt sådanne opløselighedsundersøgelser.
English: Leflunomide Apotex is available as 10 mg and 20 mg tablets.
Danish: Leflunomide Apotex leveres som 10-mg-tabletter og 20-mg-tabletter.
English: 102 case reports related to leflunomide were identified, out of which 10 could be identified as lack of effect /drug ineffective case reports, all related to Leflunomide Apotex.
Danish: Der blev fundet 102 caserapporter vedrørende leflunomid, hvoraf 10 kunne fastslås at vedrøre manglende virkning/behandlingssvigt, alle med sammenhæng med Leflunomide Apotex.
English: The CHMP also noted the PSUR data, which did not indicate any safety concerns; however this is insufficient to confirm the bioequivalence of the product.
Danish: CHMP tog til efterretning, at PSUR-dataene ikke viste nogen sikkerhedsmæssige problemer, hvilket dog er utilstrækkeligt til at bekræfte lægemidlets bioækvivalens.
English: The CHMP noted the data from the bioequivalence studies performed with the US and Canadian product and identified some minor protocol violations.
Danish: CHMP tog dataene fra bioækvivalensundersøgelserne med det amerikanske og canadiske lægemiddel til efterretning og konstaterede visse protokolbrud af mindre betydning.
English: The annual PSUR (data lock point 27 October 2011) submitted to the European authorities did not identify any lack of efficacy cases reported globally and the MAH therefore concluded that there was no change to the benefit risk ratio of Leflunomide Apotex.
Danish: Den årlige PSUR (dataslutpunkt den 27. oktober 2011), der blev indgivet til de europæiske myndigheder, indeholdt på globalt plan ingen indberetninger om tilfælde af manglende virkning, og indehaveren af markedsføringstilladelsen konkluderede derfor, at benefit/risk-forholdet for Leflunomide Apotex ikke var ændret.
English: The CHMP also noted that due to the lack of availability of samples, it was not possible to reanalyse the samples from the clinical study in order to check the validity of the original findings.
Danish: CHMP konstaterede endvidere, at det som følge af manglende prøver ikke var muligt at analysere prøverne fra den kliniske undersøgelse igen for at efterprøve validiteten de oprindelige resultater.
English: Therefore, given the serious doubts regarding the reliability and the correctness of the data from the critical pivotal bioequivalence study B050309, submitted in support of the marketing authorisation, and in the absence of a reliable bioequivalence study specifically designed to establish the bioequivalence of Leflunomide Apotex to its EU reference product, the CHMP was unable to conclude on the bioequivalence of Leflunomide Apotex.
Danish: På baggrund af den alvorlige tvivl om pålideligheden og korrektheden af dataene fra den afgørende bioækvivalenshovedundersøgelse B050309, der var forelagt til støtte for markedsføringstilladelsen, og i mangel af en pålidelig bioækvivalensundersøgelse, der er udformet specifikt med henblik på at fastslå, hvorvidt Leflunomide Apotex er bioækvivalent med det tilsvarende EUreferencelægemiddel, var CHMP ude af stand til at drage konklusioner om bioækvivalensen for Leflunomide Apotex.
English: • The Committee considered that the available data gave rise to serious doubts as to the evidence of the bioequivalence of Leflunomide Apotex and associated names with the EU reference product in view of concerns on the reliability of the data, due to the findings of the inspection of the Cetero Research facilities.
Danish: • udvalget fandt, at de foreliggende data gav anledning til alvorlig tvivl om dokumentationen for bioækvivalensen af Leflunomide Apotex og relaterede navne med EU-referencelægemidlet på baggrund af betænkeligheder med hensyn til pålideligheden af dataene som følge af inspektionsresultaterne for Cetero Research,
English: Regarding the comparative dissolution testing, the CHMP was of the view that bioequivalence studies are pivotal to demonstrate bioequivalence for oral tablets.
Danish: Vedrørende den sammenlignende opløselighedstest var det CHMP's opfattelse, at bioækvivalensundersøgelser er afgørende for påvisning af bioækvivalensen af orale tabletter.
English: For six of the reports, quality assurance investigations were conducted by the MAH and no problems were identified with Leflunomide Apotex.
Danish: For seks af rapporternes vedkommende udførte indehaveren af markedsføringstilladelsen kvalitetssikringsundersøgelser, uden at der blev fundet problemer med Leflunomide Apotex.
English: Finally, the CHMP noted that the MAH did not plan to perform a new bioequivalence study, as it considered the provided additional data sufficient to confirm the validity of the studies for the EU applications in which Cetero Research was involved.
Danish: Endelig konstaterede CHMP, at indehaveren af markedsføringstilladelsen ikke havde til hensigt at udføre en ny bioækvivalensundersøgelse, da de forelagte supplerende oplysninger blev anset for tilstrækkelige til at bekræfte validiteten af de undersøgelser fra EU-ansøgningerne, som Cetero Research var inddraget i.
English: In conclusion, the MAH was of the opinion that the results from the pivotal bioequivalence study supporting the marketing authorisation application are confirmed by the other studies not conducted at, or analysed by, Cetero Research, which all showed a high degree of similarity between Leflunomide Apotex and the US and Canadian reference product.
Danish: Som konklusion var indehaveren af markedsføringstilladelsen af den opfattelse, at resultaterne af bioækvivalenshovedundersøgelsen fra ansøgningen om markedsføringstilladelse bekræftes af andre undersøgelser, der ikke var udført eller analyseret af Cetero Research, og som alle viste udtalt lighed mellem Leflunomide Apotex og det amerikanske og canadiske referencelægemiddel.
English: Based on the available safety data, the CHMP was therefore of the view that no signal of lack of efficacy was identified.
Danish: CHMP fandt derfor, at de foreliggende sikkerhedsdata ikke indeholdt signaler om manglende virkning.
English: As the results from the bioequivalence study for the European product are in line with the results for US and Canadian products, in particular with regard to the blood plasma level results, the MAH considered the US and Canadian bio-equivalence data to support the data from the questioned EU bio-equivalence study.
Danish: Idet resultaterne af bioækvivalensundersøgelsen for det europæiske lægemiddel svarer til resultaterne for både det amerikanske og det canadiske lægemiddel, navnlig hvad angår plasmaværdierne, mente indehaveren af markedsføringstilladelsen, at de amerikanske og canadiske bioækvivalensdata underbygger dataene fra den betvivlede EU-bioækvivalensundersøgelse.
English: As further evidence of the bioequivalence of Leflunomide Apotex with the reference product, the MAH provided an overview of the qualitative and quantitative composition of its 10 and 20 mg tablets intended for the US, Canadian and European market, considering them to be identical.
Danish: Som yderligere dokumentation af bioækvivalensen af Leflunomide Apotex med referencelægemidlet forelagde indehaveren af markedsføringstilladelsen en gennemgang af den kvalitative og kvantitative sammensætning af virksomhedens 10- og 20-mg-tabletter, der er bestemt til markedet i USA, Canada og Europa og anses for at være identiske.
English: The results of the pivotal bioequivalence study showed that the 90% confidence intervals were within the 80% to 125% limits for AUC0-72 and Cmax and the pharmacokinetic data was therefore considered to demonstrate that the Leflunomide Apotex 20 mg tablets and the reference product 20 mg tablets were bioequivalent under fasting conditions.
Danish: Bioækvivalenshovedundersøgelsen viste, at 90-%-konfidensintervallerne lå mellem grænserne på 80 % til 125 % for AUC0-72 og Cmax, og de farmakokinetiske data ansås derfor for at påvise bioækvivalens mellem Leflunomide Apotex 20-mg-tabletter og referencelægemidlet som 20-mgtabletter i fastende tilstand.
English: The CHMP noted that although f2 calculations were not provided, the MAH conclusion was supported based on the studies in the two media.
Danish: CHMP bemærkede, at der ikke var forelagt beregninger af f2, men at indehaveren af markedsføringstilladelsens konklusion understøttedes af undersøgelserne i de to opløsningsmedier.
English: Finally, the MAH provided comparative dissolution profiles between Leflunomide Apotex 10 and 20 mg, tablets and reference product 10 and 20 mg tablets from various markets, supporting the MAH view that the dissolution profiles of Leflunomide Apotex and the reference product are similar.
Danish: Endelig fremlagde indehaveren af markedsføringstilladelsen sammenlignende opløselighedsprofiler for Leflunomide Apotex 10- og 20-mg-tabletter og referencelægemidlet som 10- og 20-mgtabletter fra forskellige markeder som støtte for, at opløsningsprofilerne for Leflunomide Apotex og referencelægemidlet svarer til hinanden.
English: In response to the CHMP list of questions, the MAH submitted a review of the benefit-risk balance of Leflunomide Apotex.
Danish: Til besvarelse af listen med spørgsmål fra CHMP forelagde indehaveren af markedsføringstilladelsen en gennemgang af benefit/risk-forholdet for Leflunomide Apotex.
English: The MAH stated that plasma samples are no longer available and that there is therefore no possibility to reanalyse the data.
Danish: Indehaveren af markedsføringstilladelsen oplyste imidlertid, at plasmaprøverne ikke længere foreligger, og det derfor ikke er muligt at foretage en ny analyse.
English: Therefore, the CHMP did not consider the available data to be sufficient to support the bioequivalence of the EU formulation of Leflunomide Apotex to the EU reference product.
Danish: CHMP fandt derfor ikke de foreliggende oplysninger tilstrækkelige som dokumentation for bioækvivalensen af EU-formuleringen af Leflunomide Apotex med det tilsvarende EUreferencelægemiddel.
English: The single pivotal bioequivalence study B050309 conducted to support the marketing authorization application was a comparative, parallel, three arm study to compare the relative bioavailability of Leflunomide Apotex 20 mg tablets with that of the EU reference product Arava 20 mg tablets in healthy, adult volunteers under fasting conditions.
Danish: Bioækvivalenshovedundersøgelse B050309, som blev udført til støtte for ansøgningen om markedsføringstilladelse, var en sammenlignende undersøgelse med tre parallelle arme, hvor den relative biotilgængelighed af Leflunomide Apotex, tabletter, 20 mg, blev bestemt i forhold til EU-referencelægemidlet Arava, tabletter, 20 mg, hos raske, voksne, fastende forsøgspersoner.
English: The MAH therefore considered that the pharmacokinetic data demonstrate that the EU Leflunomide Apotex is bioequivalent to both the US and Canadian reference products under fasting and fed conditions.
Danish: Indehaveren af markedsføringstilladelsen fandt således, at de farmakokinetiske data påviste, at EU-versionen af Leflunomide Apotex er bioækvivalent med både det amerikanske og det canadiske referencelægemiddel i fastende og ikkefastende tilstand.
English: • The Committee is of the opinion that considering the serious doubts in respect of the evidence of bioequivalence, the benefit-risk of Leflunomide Apotex and associated names cannot be confirmed.
Danish: • udvalget er af den opfattelse, at det på baggrund af de alvorlige betænkeligheder med hensyn til dokumentationen af bioækvivalens ikke er muligt at fastlægge benefit/risk-forholdet for Leflunomide Apotex og relaterede navne,
English: The MAH also provided details of 4 bio-equivalence studies, conducted to support the marketing authorisation application in the United States and Canada, comparing Leflunomide Apotex with their reference product, under fasting and fed conditions.
Danish: Indehaveren af markedsføringstilladelsen redegjorde desuden for fire bioækvivalensundersøgelser, der var udført til støtte for ansøgningen om markedsføringstilladelse i USA og Canada, hvor Leflunomide Apotex blev sammenlignet med det tilsvarende referencelægemiddel i fastende og ikkefastende tilstand.
English: However, the CHMP stated that bioequivalence studies performed with a non-EU reference products cannot be accepted as evidence of bioequivalence and that any evidence of product similarity between EU and non-EU products can only be considered as supportive.
Danish: CHMP fastslog imidlertid, at bioækvivalensundersøgelser foretaget med et referencelægemiddel, som ikke er et EU-lægemiddel, ikke kan godtages som dokumentation for bioækvivalens, og at dokumentation for lighed mellem EU-lægemidler og andre lægemidler kun kan betragtes som støttedokumentation.
English: The MAH therefore concluded that the deficiencies identified at the Cetero Research Houston facility do not impact the benefit-risk balance of Leflunomide Apotex.
Danish: Indehaveren af markedsføringstilladelsen konkluderede derfor, at de konstaterede mangler hos Cetero Research-afdelingen i Houston ikke berørte benefit/risk-forholdet for Leflunomide Apotex.
English: Overall, the CHMP stated that bioequivalence studies performed with a non-EU reference products cannot be accepted as evidence of bioequivalence and that any evidence of product similarity between EU and non-EU products can only be considered as supportive.
Danish: Overordnet fastslog CHMP, at bioækvivalens med et referencelægemiddel, som ikke er et EUlægemiddel, ikke kan godtages som dokumentation for bioækvivalens, og at dokumentation for lighed mellem EU-lægemidler og andre lægemidler kun kan anses for støttedokumentation.
English: The MAH considered that the data described in this PSUR did not change the benefit-risk balance of Leflunomide Apotex.
Danish: Indehaveren af markedsføringstilladelsen fandt, at dataene i denne PSUR ikke ændrede benefit/risk-forholdet for Leflunomide Apotex.
English: • The Committee considered that the responses of the MAH are not adequate to refute the serious doubts as to the evidence of the bioequivalence of Leflunomide Apotex and associated names with the EU reference product.
Danish: • udvalget fandt, at besvarelsen fra indehaveren af markedsføringstilladelsen ikke fyldestgørende afviser de alvorlige betænkeligheder vedrørende dokumentationen for, at Leflunomide Apotex og relaterede navne er bioækvivalent med EU-referencelægemidlet,
English: The Committee, as a consequence, recommended the suspension of the marketing authorisations for Leflunomide Apotex and associated names, pursuant to Article 116 of Directive 2001/83/EC; as a. the risk-benefit balance cannot be considered favourable and b. the particulars supporting the application as provided in Article 10 of Directive 2001/83/EC cannot be considered correct
Danish: anbefalede udvalget, at markedsføringstilladelserne for Leflunomide Apotex og relaterede navne suspenderes i henhold til artikel 116 i direktiv 2001/83/EF, eftersom:
English: Regarding the safety profile of Leflunomide Apotex, the MAH performed a search for lack of effect / drug ineffectiveness in all case reports for leflunomide in the MAH's global pharmacovigilance database, from the date of first authorization of Leflunomide Apotex (08 September 2004) to 08
Danish: Vedrørende sikkerhedsprofilen for Leflunomide Apotex foretog indehaveren af markedsføringstilladelsen en søgning efter manglende virkning/behandlingssvigt i alle caserapporter for leflunomid i sin globale database over lægemiddelovervågning.
English: According to the bioequivalence guideline, dissolution studies to compare the proposed product with the reference product can be submitted as supportive of the results of bioequivalence studies, to evaluate whether there may still be differences between the formulations that might be relevant for efficacy and safety.
Danish: Ifølge vejledningen vedrørende bioækvivalens kan der forelægges sammenlignende opløselighedsundersøgelser af det ansøgte lægemiddel og referencelægemidlet til støtte for resultaterne af bioækvivalensundersøgelser.
English: Therefore, and in the absence of a reliable bioequivalence study specifically designed to establish the bioequivalence of Leflunomide Apotex to its EU reference product, the benefit-risk balance of Leflunomide Apotex cannot be considered to be favourable.
Danish: Leflunomide Apotex er bioækvivalent med det tilsvarende EU-referencelægemiddel, kan benefit/risk-forholdet for Leflunomide Apotex ikke anses for tilfredsstillende.
English: Package Leaflet 1.
Danish: Indlægsseddel 1.
English: The product information may be subsequently updated by the Member State competent authorities, in liaison with the Reference Member State, as appropriate, in accordance with the procedures laid down in Chapter 4 of Title III of Directive 2001/83/EC.
Danish: Produktinformation kan efterfølgende blive opdateret af myndighededen i den enkelte medlemsstat, i samarbejde med reference medlemsstaten,hvor det er hensigtsmæssigt, i overensstemmelse med den procedurer der er fastlagt i Kapitel 4 artikel III i Direktiv 2001/83/EC.
English: Therefore, your doctor will need to check your blood pressure regularly during the first days of treatment.
Danish: Derfor vil lægen kontrollere dit blodtryk regelmæssigt de første dage af behandlingen.
English: Bromocriptine should not routinely be used to stop breast milk production.
Danish: Bromocriptin bør ikke anvendes til rutinemæssigt at stoppe mælkeproduktionen.
English: If you have just given birth you may be more at risk of certain conditions.
Danish: Hvis du lige har født, er der større risiko for, at du udvikler visse bivirkninger.
English: Do not take bromocriptine if:
Danish: Tag ikke bromocriptin hvis:
English: This Summary of Product Characteristics, labelling and package leaflet is the outcome of the referral procedure.
Danish: Bemærk: Dette produktresumé, denne mærkning og indlægsseddel er resultatet af en referral procedure.
English: - You have, or have ever had, heart disease, or other severe blood vessel disease - You have, or have ever had, serious mental health problems
Danish: - du har eller har haft hjertesygdom eller alvorlig sygdom i blodkarrene - du har eller har haft alvorlige psykiske problemer
English: In some patients the development of seizures or stroke was preceded by severe headache and/or transient visual disturbances.
Danish: Hos nogle patienter var udvikling af krampeanfald og slagtilfælde forudgået af svær hovedpine og/eller forbigående synsforstyrrelser.
English: Speak immediately to your doctor if you experience high blood pressure, chest pain or unusually severe or persistent headache (with or without vision problems).
Danish: Tal straks med lægen, hvis du oplever højt blodtryk, smerter i brystet eller usædvanlig kraftig eller vedvarende hovedpine (med eller uden synsforstyrrelser).
English: Blood pressure should be carefully monitored, especially during the first days of therapy.
Danish: Blodtrykket skal monitores omhyggeligt, især i starten af behandlingen.
English: [The existing product information shall be amended (insertion, replacement or deletion of the text as appropriate) to reflect the agreed wording as provided below]
Danish: [Den aktuelt godkendte produktinformation skal ændres (ved indsættelse, erstatning eller sletning som passende) for at gengive den vedtagede ordlyd, som er givet nedenfor]
English: Prevention or suppression of post-partum physiological lactation only where medically indicated (such as in case of intrapartum loss, neonatal death, HIV infection of the mother…).
Danish: Forebyggelse eller hæmning af fysiologisk post-partum laktation, hvor der er medicinsk indikation (såsom i tilfælde af tab intrapartum, neonatal død, HIV-infektion hos moderen...).
English: These are very rare, but may include high blood pressure, heart attack, convulsion, stroke or mental problems.
Danish: Disse bivirkninger er meget sjældne, men omfatter højt blodtryk, hjertetilfælde, kramper, slagtilfælde eller psykiske forstyrrelser.