FrancophonIA/ELRC3.0 huggingface dataset:
English: Patient exposure to flupirtine was greater in Germany and has increased steadily from 7,9 million DDD in 2001 to 28,1 million DDD in 2011.
Slovenian: Izpostavljenost bolnikov flupirtinu je bila večja v Nemčiji in je enakomerno naraščala od 7,9 milijona DDD leta 2001 do 28,1 milijona DDD leta 2011.
English: In fact, available efficacy designed studies are for periods no longer than 8 weeks.
Slovenian: Dejansko nobena od razpoložljivih študij, zasnovanih za spremljanje učinkovitosti, ni trajala več kot 8 tednov.
English: What you need to know before you use < product name > [The wording below should be inserted in the relevant sections]
Slovenian: Kaj morate vedeti, preden boste uporabili zdravilo < ime zdravila > [Besedilo, navedeno spodaj, je treba vstaviti v ustrezna poglavja]
English: Having reviewed the PRAC recommendation, the CMDh agreed with the overall scientific conclusions and grounds for recommendation.
Slovenian: Potem ko je pregledala priporočilo, ki ga je izdal PRAC, se je skupina CMDh strinjala s splošnimi znanstvenimi zaključki in podlago za priporočilo.
English: Whereas,
Slovenian: Ob upoštevanju:
English: It also acts as functional N-methyl-Daspartate (NMDA) receptor antagonist.
Slovenian: Poleg tega deluje tudi kot funkcionalni antagonist receptorja N-metil-D-aspartata (NMDA).
English: The 400 mg modified release tablets, although only authorised in Germany, is the most prescribed formulation in the Union since 2007.
Slovenian: 400-miligramske tablete s prirejenim sproščanjem so, čeprav so odobrene samo v Nemčiji, najpogosteje predpisana farmacevtska oblika v Evropski uniji od leta 2007.
English: 4 Puls F, Agne C, Klein F et al.
Slovenian: 4 Puls F, Agne C, Klein F in sod.
English: • The PRAC also concluded that there was need for further risk minimisation measures such as information to patients and healthcare professionals.
Slovenian: • PRAC je zaključil tudi, da so potrebni dodatni ukrepi za zmanjšanje tveganja, na primer informacije za bolnike in zdravstvene delavce.
English: The PRAC also recommended that Periodic Safety Update Reports should be submitted yearly.
Slovenian: Prav tako je priporočil, da se vsako leto predloži redno posodobljeno poročilo o varnosti zdravila.
English: The 100 mg immediate release capsules are available in all MSs.
Slovenian: 100-miligramske kapsule s takojšnjim sproščanjem so na voljo v vseh državah članicah.
English: The German National Competent Authority (BfArM) identified a growing number of hepatotoxicity reactions (probably idiosyncratic) reported in association with flupirtine.
Slovenian: Nemški pristojni nacionalni organ (BfArM) je opazil naraščanje števila hepatotoksičnih reakcij (najverjetneje idiosinkratičnih), o katerih poročajo v povezavi s flupirtinom.
English: Based on the current available data as described above, the PRAC concluded that flupirtine is associated with an increased risk of hepatotoxicity.
Slovenian: Na podlagi trenutno razpoložljivih podatkov, opisanih zgoraj, je PRAC zaključil, da je flupirtin povezan s povečanim tveganjem za hepatotoksičnost.
English: Overall, 11.8 million patients have been treated with flupirtine containing medicinal products since
Slovenian: Od leta 1999 je bilo z zdravili, ki vsebujejo flupirtin, zdravljenih skupno 11,8 milijona bolnikov.
English: The PRAC considers that there is sufficient evidence on efficacy in the acute (nociceptive) pain indication (mild, moderate and severe).
Slovenian: Meni, da obstaja dovolj dokazov o učinkovitosti pri indikaciji akutne (nociceptivne) bolečine (blage, zmerne in hude).
English: The reporting rate for hepatic cases with flupirtine (regardless of causality) is of 15,2 cases/100 000 patients years (based on a patient exposure of 893, 000 patients year).
Slovenian: Stopnja poročanja o boleznih jeter, povezanih z uporabo flupirtina (ne glede na vzrok), je 15,2 primera/100 000 bolnikov na leto (na podlagi izpostavljenosti bolnikov 893.000 bolnikov na leto).
English: The two long term clinical studies presented (which became available since the granting of the initial Marketing Authorisation) were uncontrolled and regarded the use of flupirtine over a period of 2 - 6 months study5 and a one-year6,7.
Slovenian: Dve predloženi dolgoročni klinični študiji (ki sta bili objavljeni po odobritvi prvega dovoljenja za promet z zdravilom) sta bili nenadzorovani in sta bili namenjeni spremljanju uporabe flupirtina v obdobju od 2-6 mesecev5 in enega leta6,7.
English: The WHO defined daily dose (DDD) for flupirtine oral is 400 mg.
Slovenian: Definirani dnevni odmerek (defined daily dose - DDD) po SZO za flupirtin za peroralno uporabo je 400 mg.
English: • The PRAC considered the procedure under Article 107i of Directive 2001/83/EC, for flupirtine containing medicinal products.
Slovenian: • PRAC je obravnaval postopek v skladu s členom 107i Direktive 2001/83/ES za zdravila, ki vsebujejo flupirtin;
English: It is authorised in the European Union since 1984 as an alternative analgesic to opioids and NonSteroidal Anti-Inflammatory Drugs (NSAIDs) for the treatment of acute and chronic pain (such as painful muscle tenseness, tension headaches, cancer pain, dysmenorrhoea and pain following trauma or orthopaedic surgery or injuries).
Slovenian: V Evropski uniji je od leta 1984 odobren kot analgetik, ki predstavlja alternativo opioidom in nesteroidnim protivnetnim zdravilom (NSPVZ) za zdravljenje akutnih in kroničnih bolečin (na primer boleče mišične napetosti, tenzijskih glavobolov, bolečin pri raku, dismenoreje in bolečin po poškodbi ali ortopedskem kirurškem posegu).
English: Furthermore the PRAC agreed on additional pharmacovigilance activities and risk minimisation measures.
Slovenian: Poleg tega se je PRAC dogovoril o dodatnih dejavnostih farmakovigilance in ukrepih za zmanjšanje tveganja.
English: Cases possible related to flupirtine treatment, and with re-challenge reported, had reoccurrence or worsening of the symptoms in 93% of the cases.
Slovenian: Pri primerih, ki so bili verjetno povezani z zdravljenjem s flupirtinom in pri katerih so poročali o ponovni uporabi zdravila, so v 93 % primerov opazili ponoven pojav ali poslabšanje simptomov.
English: Overall summary of the scientific evaluation of flupirtine containing medicinal products by PRAC
Slovenian: Splošni povzetek znanstvenega vrednotenja zdravil, ki vsebujejo flupirtin, odbora PRAC
English: Flupirtine is available as 100 mg immediate release capsules, 400 mg modified release tablet, 75 mg and 150 mg suppositories and as solution for injection (100 mg).
Slovenian: Flupirtin je na voljo v obliki 100-miligramskih kapsul s takojšnjim sproščanjem, 400-miligramskih tablet s prirejenim sproščanjem, 75- in 150-miligramskih svečk ter raztopine za injiciranje (100 mg).
English: Flupirtine is a ‘selective neuronal potassium channel opener' (SNEPCO) that acts by reducing the excessive electrical activity that leads to many pain states.
Slovenian: Flupirtin je „selektivni odpiralec kalijevih kanalčkov v živčnih celicah“ (selective neuronal potassium channel opener - SNEPCO), ki deluje tako, da zmanjša prekomerno električno aktivnost v možganih, ki je vzrok za številne boleče motnje.
English: The PRAC also noted that according to the current scientific knowledge including the Note for Guidance on clinical investigation of medicinal products for treatment of nociceptive pain (CPMP/EWP/612/00) clinical data of at least 3 months for the treatment of mild to moderately severe chronic back pain is required.
Slovenian: PRAC je upošteval tudi, da so glede na trenutna znanstvena dognanja, ki vključujejo smernice za klinične raziskave zdravil za zdravljenje nociceptivne bolečine (CPMP/EWP/612/00), potrebni klinični podatki za najmanj 3 mesece zdravljenja blagih do zmerno hudih kroničnih bolečin v hrbtu.
English: Based on the above safety concerns and further to consideration of the current evidence of efficacy of flupirtine in the treatment of chronic and acute pain, the BfArM considered the benefit-risk not to be favourable in the treatment of chronic pain and potential favourable in acute pain subject to effective implementation of risk minimisation measures (e.g. limited duration of treatment, closely liver monitoring) and therefore on 28 February 2013 initiated an urgent union procedure under Article 107i of Directive 2001/83/EC.
Slovenian: Na podlagi zgoraj navedenih zadržkov, povezanih z varnostjo, in preučitve trenutno razpoložljivih podatkov o učinkovitosti flupirtina pri zdravljenju kroničnih in akutnih bolečin je BfArM menil, da razmerje med tveganji in koristmi pri zdravljenju kroničnih bolečin ni pozitivno, pri zdravljenju akutnih bolečin pa je lahko pozitivno pod pogojem, da se učinkovito izvajajo ukrepi za zmanjšanje tveganja (npr. omejeno trajanje zdravljenja, natančno spremljanje jeter), zato je dne 28. februarja 2013 sprožil nujni postopek Unije v skladu s členom 107i Direktive 2001/83/ES.
English: Overall, the oral and suppositories formulations are indicated for the treatment of acute and chronic pain while the injectable is indicated for short-term use for acute pain such as post-operative pain.
Slovenian: Na splošno so peroralne farmacevtske oblike in svečke indicirane za zdravljenje akutnih in kroničnih bolečin, medtem ko je raztopina za injiciranje indicirana za kratkoročno uporabo pri akutnih bolečinah, na primer po operaciji.
English: If liver function tests show pathological results your doctor will ask you to discontinue intake/use of <Product Name> immediately.
Slovenian: Če bo zdravnik pri preverjanju delovanja jeter opazil patološke spremembe, vam bo predlagal, da nemudoma prekinete jemanje/uporabo zdravila <ime zdravila>.
English: Detailed explanation for the differences from the PRAC recommendation
Slovenian: Podrobna obrazložitev odstopanj od priporočila PRAC
English: Most studies presented are in management of pain in short term use only and management of chronic pain is intended for long term use in most cases.
Slovenian: V večini predloženih študij so preučevali samo obvladovanje bolečin pri kratkoročni uporabi, medtem ko je v večini primerov za obvladovanje kroničnih bolečin potrebna dolgoročna uporaba.
English: For the treatment of acute pain, the PRAC recommended that the benefit still outweighs the hepatotoxicity risk when treatment with other analgesics (e.g. non-steroidal anti-inflammatory drugs, weak opioids) is contraindicated.
Slovenian: V zvezi z zdravljenjem akutnih bolečin je PRAC menil, da so koristi še vedno večje od tveganja za hepatotoksičnost, kadar je zdravljenje z drugimi analgetiki (npr. nesteroidnimi protivnetnimi zdravili, šibkimi opioidi) kontraindicirano.
English: Liver transplantation or fatal cases resulting from liver failure were seen after 3-5 weeks of treatment in 25% of the cases and the remaining after 60 days of treatment (information is only available from 8 cases of the total of 15 fatal cases).
Slovenian: Presaditev jeter ali smrtne primere zaradi odpovedi jeter so pri 25 % primerov zabeležili po 3-5 tednih zdravljenja, pri ostalih pa po 60 dneh zdravljenja (podatki so bili na voljo samo za 8 od skupno 15 primerov s smrtnim izidom).
English: These have been requested by PRAC for submission within the risk management plan.
Slovenian: PRAC je zahteval, da se gradivo predloži v okviru načrta za obvladovanje tveganja.
English: The PRAC considered that in the short term use studies, the efficacy of flupirtine in acute pain was at least comparable to the comparators.
Slovenian: PRAC je menil, da je bila v študijah kratkoročne uporabe učinkovitost flupirtina pri akutnih bolečinah vsaj primerljiva z učinkovitostjo primerjalnih zdravilnih učinkovin.
English: As part of the risk minimisation measures the PRAC recommended amendments to the product information for all flupirtine containing medicinal products.
Slovenian: PRAC je v sklopu ukrepov za zmanjšanje tveganja predlagal spremembo informacij o zdravilu za vsa zdravila, ki vsebujejo flupirtin.
English: Herrmann WM: Final report: Investigation of the long-term tolerability of the analgesic flupirtine in patients who require analgesics regularly over long periods of time.
Slovenian: Herrmann WM: Final report: Investigation of the long-term tolerability of the analgesic flupirtine in patients who require analgesics regularly over a long period of time.
English: The PRAC considered that a Direct healthcare professional communication (DHPC) was needed to communicate the outcome of the present review.
Slovenian: PRAC je menil, da je treba izdati neposredno obvestilo zdravstvenim delavcem (DHPC), da se jih seznani z izidom tega pregleda.
English: The PRAC noted that based on clinical and histological features, the hepatotoxicity of flupirtine may be immune-mediated and that hepatotoxicity associated with flupirtine treatment may be type B or idiosyncratic adverse drug reaction.
Slovenian: Odbor PRAC je upošteval, da bi lahko bila glede na klinične in histološke lastnosti hepatotoksičnost flupirtina imunsko pogojena in da bi bila lahko hepatotoksičnost, povezana z zdravljenjem s flupirtinom, neželeni učinek zdravila tipa B ali idiosinkratična reakcija.
English: The PRAC endorsed a Direct Healthcare Professional Communication (DHPC), to communicate the outcome of the present review to the healthcare professionals, in particular, the restricted indication and maximum duration of use and to highlight the risk of hepatotoxicity and the necessary measures needed to minimise this risk.
Slovenian: PRAC je odobril neposredno obvestilo zdravstvenim delavcem (Direct Healthcare Professional Communication - DHPC), da se jih seznani z izidom tega pregleda, zlasti z omejeno indikacijo ter najdaljšim trajanjem zdravljenja, in da se jih opozori na tveganje za hepatotoksičnost ter ukrepe, potrebne za zmanjšanje tega tveganja.
English: In view of the risks of hepatotoxicity the PRAC considered there was a need to recommend further risk minimisation measures to ensure the safety and effective use in acute pain.
Slovenian: V zvezi s tveganjem za hepatotoksičnost je PRAC menil, da bi bilo za zagotovitev varne in učinkovite uporabe pri akutnih bolečinah treba priporočiti dodatne ukrepe za zmanjšanje tveganja.
English: Most cases were reports of increased liver enzymes, jaundice, hepatitis or hepatic failure.
Slovenian: V večini primerov so poročali o povišanih jetrnih encimih, zlatenici, hepatitisu ali odpovedi jeter.
English: The CMDh having considered the PRAC recommendation dated 13 June 2013 pursuant to Article 107k(1) and (2) of Directive 2001/83/EC reached a position on the variation to the terms of the marketing authorisations of flupirtine containing medicinal products for which the relevant sections of the summary of product characteristics and package leaflet are set out in Annex III and subject to the conditions set out in Annex IV.
Slovenian: Skupina CMDh je na podlagi preučitve priporočila, ki ga je dne 13. junija 2013 v skladu s členom 107k(1) in (2) Direktive 2001/83/ES podal PRAC, sprejela stališče o spremembi pogojev dovoljenj za promet z zdravili, ki vsebujejo flupirtin, skladno z besedili ustreznih poglavij povzetka glavnih značilnosti zdravila in navodila za uporabo, opredeljenimi v Prilogi III, in pod pogoji, določenimi v Prilogi IV.
English: Another publication4 described six cases of flupirtine-induced liver injury, including one requiring liver transplantation.
Slovenian: V drugi publikaciji4 je opisanih šest primerov okvare jeter zaradi flupirtina, pri čemer je bila v enem primeru potrebna presaditev jeter.
English: However, three published studies1,2,3 reported elevated transaminases in 3%, 31% and 58.6% respectively, of the patients treated with flupirtine.
Slovenian: povišane vrednosti transaminaz pri 3 %, 31 % oziroma 58,6 % bolnikov, zdravljenih s flupirtinom.
English: Finally educational materials are necessary in order to clearly inform prescribers and patients on the hepatotoxicity risk associated with flupirtine and on the measures necessary to minimise the risk.
Slovenian: Poleg tega je potrebno tudi izobraževalno gradivo, s katerim se bo zdravnike, ki bodo predpisovali zdravilo, in bolnike natančno seznanilo s tveganjem za hepatotoksičnost, povezanim s flupirtinom, in ukrepi, potrebnimi za zmanjšanje tega tveganja.
English: The time to onset of liver failure observed in spontaneous reporting was 25 % for each of the cases after 2-3 weeks, after 3-8 weeks, after 8-13 weeks and after >13 weeks (information on time to onset was available in 35 cases of the total 49 cases).
Slovenian: Čas do pojava odpovedi jeter, zabeležen pri spontanih poročilih, je bil 2-3 tedne, 3-8 tednov, 8-13 tednov in > 13 tednov, pri čemer posamezen čas velja za 25 % primerov (podatki o času do pojava odpovedi so bili na voljo za 35 od skupno 49 primerov).
English: There were no reports of liver failure from published clinical trials.
Slovenian: V objavljenih kliničnih preskušanjih ni poročil o odpovedi jeter.
English: Scientific conclusions and grounds for variation to the terms of the marketing authorisations subject to conditions and detailed explanation for the differences from the PRAC recommendation
Slovenian: Znanstveni zaključki in podlaga za spremembo pogojev dovoljenj za promet z zdravili pod določenimi pogoji ter podrobna obrazložitev odstopanj od priporočila odbora PRAC
English: The PRAC, as a consequence, concluded that pursuant to Article 116 of Directive 2001/83/EC the riskbenefit balance for flupirtine containing medicinal products in the management of chronic pain is not favourable.
Slovenian: je PRAC zaključil, da v skladu s členom 116 Direktive 2001/83/ES razmerje med tveganji in koristmi za zdravila, ki vsebujejo flupirtin, pri obvladovanju kroničnih bolečin ni pozitivno.
English: Your doctor will test liver function every week during treatment with <Product Name> because increased liver enzyme levels, hepatitis and liver failure have been reported in association with flupirtine therapy.
Slovenian: Zdravnik bo v času zdravljenja z zdravilom <ime zdravila> vsak teden preverjal delovanje vaših jeter, saj so v povezavi z uporabo flupirtina poročali o povišanih ravneh jetrnih encimov, hepatitisu in odpovedi jeter.
English: Data on efficacy of flupirtine in the use of chronic pain is very limited.
Slovenian: Podatki o učinkovitosti flupirtina pri zdravljenju kroničnih bolečin, so zelo omejeni.
English: The exact wording recommended by the PRAC to relevant sections of the Summary of Product Characteristics (SmPC) and Package Leaflet (PIL) are found in Annex III of this recommendation.
Slovenian: Točno besedilo za zadevna poglavja povzetka glavnih značilnosti zdravila (SmPC) in navodila za uporabo, ki ga je priporočil PRAC, je navedeno v Prilogi III k temu priporočilu.
English: In addition, the frequency of the observed increase in hepato-biliary markers in clinical studies lead to a higher frequency of occurrence of these adverse drug reactions and consequently amendments to the products information in this regard.
Slovenian: Poleg tega je pogostost porasta označevalcev bolezni jeter, žolčnika in žolčevodov, opaženega v kliničnih študijah, povzročila večjo pojavnost teh neželenih učinkov zdravila, zato so potrebne spremembe informacij o zdravilu v zvezi s tem.
English: Furthermore the PRAC requested that the protocol of a Post Authorisation Safety Study (PASS) should be submitted within the risk management plan submission, to evaluate the effectiveness of the risk minimisation activities.
Slovenian: PRAC je nadalje zahteval, da se v okviru načrta za obvladovanje tveganja predloži študija varnosti zdravila v obdobju trženja (PASS), namenjena oceni učinkovitosti dejavnosti za zmanjšanje tveganja.
English: The PRAC also recommended that the MAH should submit a full risk management plan (RMP) within a certain timeframe.
Slovenian: Prav tako je priporočil, naj imetnik dovoljenja za promet z zdravilom v določenem časovnem okviru predloži celovit načrt za obvladovanje tveganja (RMP).
English: • The PRAC concluded that in view of the currently available safety data in order to maintain a favourable benefit/risk in the management of acute pain, flupirtine containing medicinal products should have treatment duration restricted to 2 weeks, contraindicated in patients with pre-existing liver disease.
Slovenian: • PRAC je na podlagi trenutno razpoložljivih podatkov o varnosti zaključil, da bi bilo treba za ohranitev pozitivnega razmerja med koristmi in tveganji pri obvladovanju akutnih bolečin trajanje zdravljenja z zdravili, ki vsebujejo flupirtin, omejiti na 2 tedna in uporabo kontraindicirati pri bolnikih z že obstoječo boleznijo jeter.
English: • The PRAC reviewed all available data from clinical and non-clinical studies, epidemiological studies, spontaneous reports and published literature on the safety and efficacy of flupirtine containing medicinal products, as well as stakeholders' submissions in particular with regards to the risk of hepatotoxicity.
Slovenian: • PRAC je pregledal vse razpoložljive podatke o varnosti in učinkovitosti zdravil, ki vsebujejo flupirtin, iz kliničnih in predkliničnih študij, epidemioloških študij, spontanih poročil in objavljene literature, ter podatke, ki so jih predložile zainteresirane strani, zlasti v povezavi s tveganjem za hepatotoksičnost;
English: 7 Herrmann WM, Hiersemenzel R, Aigner M et al.: Die Langzeitverträglichkeit von Flupirtin.
Slovenian: Herrmann WM, Hiersemenzel R, Aigner M in sod.
English: The PRAC also agreed on the need of a risk management plan to be submitted together with a protocol for a drug utilisation study aiming to characterise prescribing practices during typical clinical use in representative groups of prescribers.
Slovenian: Prav tako se je PRAC dogovoril, da je treba skupaj z načrtom za obvladovanje tveganja predložiti tudi protokol za študijo uporabe zdravila, s katero bi razjasnili prakse pri predpisovanju med običajno klinično uporabo pri reprezentativni skupini zdravnikov, ki predpisujejo ta zdravila.
English: However, the CMDh considered that changes were necessary to the wording proposed in section 2 of the PL, in order to accurately reflect the PRAC recommended amendments to the SmPC section 4.3 “contraindications”.
Slovenian: Vendar pa je menila, da so potrebne spremembe besedila, predlaganega za 2. poglavje navodila za uporabo, ki bi natančno odražale spremembe, ki jih je PRAC priporočil za poglavje 4.3 „Kontraindikacije” v povzetku glavnih značilnosti zdravila.
English: During the period of 1999 to March 2013 a total of 136 reports of flupirtine drug induced liver injury (DILI, hepatic necrosis, liver failure including fatal cases) have been identified in spontaneous reporting and literature including 15 cases with fatal outcome.
Slovenian: V obdobju od leta 1999 do marca 2013 so iz spontanih poročil in literature ugotovili skupno 136 primerov okvar jeter, povezanih s flupirtinom (z zdravilom povzročena okvara jeter, nekroza jeter, odpoved jeter, vključno s smrtnimi primeri), od tega 15 primerov s smrtnim izidom.
English: • The PRAC is of the opinion that data from safety provide evidence for an increased risk of hepatotoxicity including cases with fatal outcome or resulted in liver transplantation when duration of treatment is longer than 2 weeks.
Slovenian: • PRAC meni, da je iz podatkov o varnosti razvidno, da se pri zdravljenju, ki traja več kot 2 tedna, poveča tveganje za hepatotoksičnost, pri čemer podatki vključujejo tudi primere, ki so se končali s smrtnim izidom ali presaditvijo jeter;
English: Also aiming minimisation of the hepatotoxicity risk associated with flupirtine, close monitoring of the liver function during treatment should be performed and its use contraindicated in patients with preexisting liver disease.
Slovenian: Za zmanjšanje tveganja za hepatotoksičnost, povezanega s flupirtinom, je treba v času zdravljenja opravljati tudi natančne preglede delovanja jeter in kontraindicirati uporabo pri bolnikih z že obstoječo boleznijo jeter.