FrancophonIA/ELRC3.0 huggingface dataset:
English: • The PRAC considered the procedure under Article 31 of Directive 2001/83/EC for domperidonecontaining medicinal products.
Slovenian: • odbor PRAC je obravnaval napotitev v skladu s členom 31 Direktive 2001/83/ES za zdravila, ki vsebujejo domperidon;
English: The International Birth Date for domperidone has been designated as March 1978, based on the first approval of domperidone in Belgium.
Slovenian: Za mednarodni rojstni dan (International Birth Date) domperidona je bil na podlagi njegove prve odobritve v Belgiji določen marec 1978.
English: In view of the cardiac risk, off-label use should be monitored.
Slovenian: Zaradi tveganja za bolezni srca je treba nenamensko uporabo spremljati.
English: In October 2011 the PhVWP agreed on amendments to the product information, and the Marketing Authorisation Holder of the originator product was requested to conduct a pharmacoepidemiological study and a thorough QTc study.
Slovenian: Skupina PhVWP se je oktobra 2011 dogovorila o spremembah informacij o zdravilu in od imetnika dovoljenja za promet z originatorskim zdravilom zahtevala, da izvede farmakoepidemiološko študijo ter poglobljeno študijo intervala QTc.
English: Domperidone is not approved in all Member States for paediatric use in the subpopulation under 12 years of age and adolescents weighing <35 kg.
Slovenian: Domperidon v nekaterih državah članicah ni odobren za pediatrično uporabo pri podskupini bolnikov, mlajših od 12 let, in mladostnikih, ki tehtajo manj kot 35 kg.
English: In light of the above, on 01 March 2013 Belgium informed the European Medicines Agency, pursuant to Article 31 of Directive 2001/83/EC, of their decision to trigger an Art. 31 referral procedure to ask for the PRAC's recommendation on whether the balance of benefits and risks for these products is still positive in the approved indications, and whether the marketing authorisations for medicinal products containing domperidone should be maintained, varied, suspended or withdrawn.
Slovenian: Zaradi vsega navedenega je Belgija 1. marca 2013 v skladu s členom 31 Direktive 2001/83/ES obvestila Evropsko agencijo za zdravila o svoji odločitvi, da sproži napotitveni postopek v skladu s členom 31 in zaprosi odbor PRAC, da poda priporočilo v zvezi s tem, ali je razmerje med tveganji in koristmi za ta zdravila pri odobrenih indikacijah še vedno pozitivno in ali se lahko dovoljenja za promet z zdravili, ki vsebujejo domperidon, ohranijo ali pa jih je treba spremeniti, začasno preklicati ali umakniti.
English: Whenever available, paediatric patients should make use of other formulations that allow for more accurate dosing (e.g. oral solution) and these should be supplied with an appropriate measuring device.
Slovenian: Če so na voljo, morajo pediatrični bolniki uporabljati druge farmacevtske oblike, ki omogočajo natančnejše odmerjanje (npr. peroralno raztopino), te pa morajo imeti priložen primeren odmerni pripomoček.
English: The CMDh highly recommends that MAHs collaborate in order to avoid unnecessary duplication of studies.
Slovenian: Skupina CMDh zelo priporoča, da imetniki dovoljenja za promet z zdravilom med seboj sodelujejo, da preprečijo nepotrebno podvajanje študij;
English: The data in support of the paediatric use in relief of symptoms of nausea and vomiting is limited.
Slovenian: Podatki v podporo pediatrični uporabi za lajšanje simptomov slabosti in bruhanja so omejeni.
English: • Nausea and vomiting induced by:
Slovenian: • slabost in bruhanje, ki ju povzročijo:
English: • Extend the timeframe for the submission of the final study report on condition 1 (generation of paediatric efficacy data).
Slovenian: • podaljša rok za predložitev končnega poročila o študiji za izpolnitev pogoja 1 (pridobitev podatkov o učinkovitosti pri pediatrični populaciji).
English: The PRAC nevertheless considered appropriate that further studies be performed to document the efficacy of domperidone in children in this indication and in the newly recommended posology.
Slovenian: Odbor PRAC je vseeno menil, da bi bilo primerno izvesti dodatne študije, da se dokumentira učinkovitost domperidona pri otrocih pri tej indikaciji in novem priporočenem odmerjanju.
English: However, in order to ensure that the study will provide relevant data, MAHs are requested to submit the protocols for agreement to the National Competent Authorities.
Slovenian: Da pa bi zagotovili, da se bodo s študijo pridobili ustrezni podatki, morajo imetniki dovoljenja za promet z zdravilom predložiti protokole v potrditev pristojnim nacionalnim organom.
English: When considering existing data in support of the efficacy of domperidone, the PRAC concluded that overall there is sufficient evidence1,2,3 in support of the use in a general indication in the relief of symptoms of nausea and vomiting in adults.
Slovenian: Potem ko je odbor PRAC proučil obstoječe podatke v podporo učinkovitosti domperidona, je zaključil, da je na splošno dovolj dokazov1,2,3, ki podpirajo uporabo pri splošni indikaciji za lajšanje simptomov slabosti in bruhanja pri odraslih.
English: Domperidone is a peripheral dopamine D2-receptor antagonist with gastrokinetic and anti-emetic properties.
Slovenian: Domperidon je antagonist perifernih dopaminskih receptorjev D2 s prokinetičnimi in antiemetičnimi lastnostmi.
English: It is used in the treatment of symptoms of nausea and vomiting of variable origin.
Slovenian: Uporablja se za zdravljenje simptomov slabosti in bruhanja različnega izvora.
English: Domperidone is authorised also as a fixed-dose combination product with cinnarizine and indicated for the prevention and treatment of symptoms associated with motion sickness.
Slovenian: Domperidon je odobren tudi kot zdravilo s fiksno kombinacijo odmerkov s cinarizinom ter indicirano za preprečevanje in zdravljenje simptomov, povezanih z morsko boleznijo.
English: 2 - Detailed explanation for the differences from the PRAC recommendation
Slovenian: 2 - Podrobna obrazložitev odstopanj od priporočila odbora PRAC
English: Domperidone is marketed in several formulations, for oral or rectal administration under various trade names.
Slovenian: Domperidon se trži v različnih farmacevtskih oblikah za peroralno ali rektalno uporabo in pod različnimi trgovskimi imeni.
English: • The dyspeptic symptom complex that is often associated with delayed gastric emptying, gastro-oesophageal reflux, and oesophagitis:
Slovenian: • dispeptični simptomi, ki so pogosto povezani z upočasnjenim praznjenjem želodca, gastroezofagealnim refluksom in ezofagitisom:
English: As a consequence of the new maximum recommended doses, the PRAC considered that certain formulations such as tablets dosed at 20 mg and suppositories dosed at 60 mg have a negative benefit-risk balance and should therefore be revoked.
Slovenian: Zaradi novih največjih priporočenih odmerkov je odbor PRAC menil, da imajo nekatere farmacevtske oblike, kot so na primer tablete, ki vsebujejo 20 mg domperidona, in svečke, ki vsebujejo 60 mg domperidona, negativno razmerje med tveganji in koristmi in jih je zato treba ukiniti.
English: However, the CMDh considered that changes were necessary to proposed conditions to the Marketing Authorisations (Annex IV).
Slovenian: Vendar pa je menila, da so potrebne spremembe predlaganih pogojev dovoljenj za promet z zdravili (Priloga IV).
English: o Is not favourable for high dose rectal formulations (60 mg) or rectal formulations approved for paediatric use (10 mg).
Slovenian: o ni ugodno za visokoodmerne farmacevtske oblike za rektalno uporabo (60 mg) in farmacevtske oblike za rektalno uporabo, odobrene za pediatrično uporabo (10 mg),
English: The CMDh, having considered the PRAC recommendation dated 6 March 2014 pursuant to Article 107k(1) and (2) of Directive 2001/83/EC, reached a position on the variation or revocation as applicable of the marketing authorisations of domperidone-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 proučitve priporočila odbora PRAC z dne 6. marca 2014 v skladu s členom 107k(1) in (2) Direktive 2001/83/ES sprejela stališče glede spremembe oziroma odvzema dovoljenj za promet z zdravili, ki vsebujejo domperidon, 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: In this respect, the PRAC further noted that not only the efficacy data is limited but it does not actually demonstrate the superiority of the combination over the single component product.
Slovenian: Pri tem je izpostavil tudi, da podatki o učinkovitosti niso samo omejeni, ampak dejansko tudi ne potrjujejo, da bi bila kombinacija superiorna v primerjavi z zdravilom z eno sestavino.
English: o Is not favourable for the combination domperidone/cinnarizine.
Slovenian: o ni ugodno za kombinacijo domperidona in cinarizina.
English: The authorized indications of domperidone, as listed in the Company Core Data Sheet of the originator, are presented below:
Slovenian: Odobrene indikacije domperidona, navedene v krovnem dokumentu farmacevtske družbe za originatorsko zdravilo, so naštete v nadaljevanju:
English: • The PRAC was of the opinion that existing data, although limited, are indicative of efficacy in the indication ‘relief of symptoms of nausea and vomiting'.
Slovenian: • odbor PRAC je menil, da obstoječi podatki (čeprav so omejeni) kažejo na učinkovitost pri indikaciji „lajšanje simptomov slabosti in bruhanja“;
English: Procedure on Domperidone the CMDh confirmed that the benefit-risk ratio for indication ‘relief of the symptoms of nausea and vomiting' (including in the paediatric population) remains positive.
Slovenian: Skupina CMDh je ob upoštevanju sklepa Komisije v zvezi z napotitvijo po členu 30 za domperidon potrdila, da je razmerje med tveganji in koristmi za indikacijo „lajšanje simptomov slabosti in bruhanja“ (vključno pri pediatrični populaciji) še naprej pozitivno.
English: • The PRAC considered that the risk of serious cardiac adverse drug reactions can be minimised by using lower doses of domperidone, limiting treatment duration and contraindicating treatment for patients at particularly high risk (patients with moderate or severe hepatic impairment, patients who have known existing prolongation of cardiac conduction intervals, particularly QTc, patients with significant electrolyte disturbances or underlying cardiac diseases such as congestive heart failure) and patients concurrently taking QT-prolonging drugs or potent CYP3A4 inhibitors.
Slovenian: • odbor PRAC je menil, da je tveganje za resne neželene učinke na srce mogoče zmanjšati z uporabo manjših odmerkov domperidona, omejitvijo trajanja zdravljenja in kontraindikacijo zdravljenja pri bolnikih, pri katerih je tveganje še posebno veliko (to so bolniki z zmerno ali hudo okvaro jeter, bolniki z znanimi obstoječimi podaljšanimi intervali prevajanja v srcu, zlasti intervalom QTc, bolniki z večjimi motnjami elektrolitov ali obstoječimi boleznimi srca, kot je kongestivno srčno popuščanje), ter pri bolnikih, ki sočasno uporabljajo zdravila, ki podaljšajo interval QT, ali močne zaviralce CYP3A4.
English: The PRAC, as a consequence, concluded that the benefit-risk balance of domperidone-containing medicinal products remains favourable subject to the conditions to the marketing authorisations, and taking into account the amendments to the product information and other risk minimisation measures recommended.
Slovenian: Odbor PRAC je posledično zaključil, da je razmerje med tveganji in koristmi zdravil, ki vsebujejo domperidon, še naprej ugodno pod pogojem, da se upoštevajo pogoji dovoljenj za promet z zdravili ter spremembe informacij o zdravilu in drugi priporočeni ukrepi za zmanjšanje tveganja.
English: • The PRAC considered that the data supporting the efficacy of domperidone in the paediatric population are limited and recommended that further data be generated to confirm the efficacy in this patient population.
Slovenian: • odbor PRAC je menil, da so podatki v podporo učinkovitosti domperidona pri pediatrični populaciji omejeni, in priporočil, naj se pridobijo dodatni podatki, ki bodo potrdili učinkovitost pri tej populaciji bolnikov;
English: In addition, the data supporting the efficacy of the combination domperidone/cinnarizine for motion sickness are limited, do not demonstrate the superiority of the combination over the single component product and therefore do not justify exposing patients to the additional risk associated to a combination product.
Slovenian: Poleg tega so podatki v podporo učinkovitosti kombinacije domperidona in cinarizina pri morski bolezni omejeni in ne potrjujejo superiornosti kombinacije v primerjavi z enokomponentnim zdravilom, kar pomeni, da ne upravičujejo izpostavitve bolnikov dodatnemu tveganju, povezanemu s kombiniranim zdravilom;
English: • The PRAC considered the totality of the data submitted in support of the safety and efficacy of domperidone.
Slovenian: • odbor PRAC je proučil vse predložene podatke, ki naj bi dokazovali varnost in učinkovitost domperidona;
English: The CMDh considered the request from one MAH with regards to the timelines to fulfil some of the conditions as proposed by the PRAC.
Slovenian: Skupina CMDh je proučila zahtevo enega od imetnikov dovoljenja za promet z zdravilom v zvezi z roki za izpolnitev nekaterih pogojev, ki jih je predlagal odbor PRAC.
English: In addition, the CMDh took the opportunity to introduce the following clarification to the description of the products for which revocation is recommended:
Slovenian: Poleg tega je skupina CMDh izkoristila priložnost, da v opis zdravil, za katera se priporoča odvzem dovoljenja za promet, vključi naslednja pojasnila:
English: • Extend the timeframe for the submission of the final study report on condition 2 (pharmacokinetic study to generate data to allow for a comparison between the rectal and oral formulations).
Slovenian: • podaljša rok za predložitev končnega poročila o študiji za izpolnitev pogoja 2 (farmakokinetična študija za pridobitev podatkov, ki bodo omogočili primerjavo med farmacevtskimi oblikami za rektalno in peroralno uporabo);
English: The CMDh considered the below PRAC recommendation with regards to domperidone-containing medicinal products:
Slovenian: Skupina CMDh je proučila spodnje priporočilo odbora PRAC v zvezi z zdravili, ki vsebujejo domperidon:
English: For all indications other than “relief of symptoms of nausea and vomiting”, there is extremely limited evidence of efficacy of domperidone, and therefore the potential benefits are considered to be outweighed by the identified cardiac risk.
Slovenian: Za vse indikacije, razen za „lajšanje simptomov slabosti in bruhanja“, je na voljo izredno malo dokazov o učinkovitosti domperidona, zato je odbor menil, da ugotovljena tveganja za bolezni srca odtehtajo možne koristi.
English: • The PRAC considered that domperidone is associated with an increased risk of serious cardiac adverse drug reaction, including QT prolongation and sudden cardiac death.
Slovenian: • odbor PRAC je menil, da je domperidon povezan s povečanim tveganjem za resne neželene učinke na srce, ki vključujejo podaljšanje intervala QT in nenadno srčno smrt.
English: • The variation to the terms of the marketing authorisation for the remaining domperidonecontaining medicinal products referred to in Annex I, for which the relevant sections of the summary of product characteristics and package leaflet are set out in Annex III of the PRAC recommendation.
Slovenian: • spremembo pogojev dovoljenja za promet z zdravilom za druga zdravila, ki vsebujejo domperidon in so navedena v Prilogi I, skladno z besedili ustreznih poglavij povzetka glavnih značilnosti zdravila in navodila za uporabo, opredeljenimi v Prilogi III k priporočilu odbora PRAC.
English: In addition, in order to ensure that National Competent Authorities are informed of the study progress, MAHs are required to submit yearly updates on progress with recruitment to the study.
Slovenian: Poleg tega je treba zagotoviti, da bodo pristojni nacionalni organi obveščeni o napredku študije, zato morajo imetniki dovoljenja za promet z zdravilom enkrat letno oddati poročilo o napredku pri pridobivanju oseb za sodelovanje v študiji.
English: The extrapolation of existing pharmacokinetic data allows for a conclusion that the 30 mg suppository administered twice a day should be equivalent to the 10 mg oral formulation administered 3 times a day.
Slovenian: Na podlagi ekstrapolacije obstoječih farmakokinetičnih podatkov je mogoče zaključiti, da je svečka jakosti 30 mg, ki se daje dvakrat na dan, enakovredna farmacevtski obliki za peroralno uporabo jakosti 10 mg, ki se daje trikrat na dan.
English: • In view of the available data the PRAC also concluded that the benefit-risk balance of domperidone-containing products:
Slovenian: • na podlagi razpoložljivih podatkov je odbor PRAC zaključil tudi, da razmerje med tveganji in koristmi zdravil, ki vsebujejo domperidon:
English: It exerts its action via inhibition of dopamine receptors in the human gut, and in the chemoreceptor trigger zone, which lies outside the blood-brain barrier in the area postrema.
Slovenian: Deluje tako, da zavira dopaminske receptorje v človeškem črevesju in v kemoreceptorski prožilni coni, ki leži zunaj krvno-možganske pregrade v zadnjem delu četrtega prekata (area postrema).
English: Off-label use of domperidone is known to exist for conditions such as GERD, gastroparesis and stimulation of lactation.
Slovenian: Znana je nenamenska uporaba domperidona za bolezni, kot sta GERB in gastropareza, ter za spodbujanje laktacije.
English: o Is not favourable for high dose oral formulations (higher than 10 mg).
Slovenian: o ni ugodno za visokoodmerne farmacevtske oblike (več kot 10 mg),
English: • The PRAC was also of the opinion that existing data on the efficacy of domperidone in indications other than ‘relief of symptoms of nausea and vomiting' are very limited, and therefore the potential benefit is outweighed by the cardiac risk.
Slovenian: • odbor PRAC je prav tako menil, da so obstoječi podatki o učinkovitosti domperidona pri vseh indikacijah, razen indikaciji „lajšanje simptomov slabosti in bruhanja“, zelo omejeni, zaradi česar tveganje za bolezni srca odtehta možne koristi;
English: Oral liquid formulations shall be supplied with an appropriate measuring device.
Slovenian: Tekočim pripravkom za peroralno uporabo mora biti priložen primeren odmerni pripomoček.
English: The risks are increased in patients who are over 60 years of age, who are using high doses and/or who are using concomitant QT-prolonging drugs or products that can increase plasma levels of domperidone.
Slovenian: Tveganje je večje pri bolnikih, ki so starejši od 60 let, ki uporabljajo velike odmerke in/ali ki sočasno uporabljajo zdravila, ki podaljšajo interval QT, ali zdravila, ki lahko zvišajo plazemsko koncentracijo domperidona.
English: • In view of the available data the PRAC concluded, subject to the amendments to the product information and implementation of other risk minimisation measures, that the benefit-risk balance of domperidone-containing products:
Slovenian: • na podlagi razpoložljivih podatkov je odbor PRAC zaključil, da je pod pogojem, da se upoštevajo spremembe informacij o zdravilu in uvedejo drugi ukrepi za zmanjšanje tveganja, razmerje med tveganji in koristmi zdravil, ki vsebujejo domperidon:
English: The available clinical and non-clinical data consistently indicates that there is an increased risk of serious and potentially life-threatening cardiac adverse drug reactions associated with domperidone use.
Slovenian: Razpoložljivi klinični in predklinični podatki dosledno kažejo, da je z uporabo domperidona povezano povečano tveganje za resne in lahko tudi smrtno nevarne neželene učinke na srce.
English: • The PRAC considered that the pharmacokinetic data supporting the rectal formulations is limited, and therefore recommended that further data be generated to allow for a comparison between the oral and rectal formulations.
Slovenian: • odbor PRAC je menil, da so farmakokinetični podatki v podporo farmacevtskim oblikam za rektalno uporabo omejeni, in zato priporočil, naj se pridobijo dodatni podatki, ki bodo omogočili primerjavo med farmacevtskimi oblikami za peroralno in rektalno uporabo;
English: It is therefore important that the risk is minimised by restricting the maximum dose (10 mg up to 3 times a day for adults and adolescents 12 years of age and older and weighing ≥ 35 kg), limiting treatment duration to the shortest necessary to control symptoms and contraindicating other drugs that are also known to prolong the QT-interval.
Slovenian: Zato je pomembno, da se tveganje zmanjša, tako da se omeji največji odmerek (na 10 mg največ trikrat na dan za odrasle in mladostnike, ki so stari 12 let ali več in tehtajo ≥ 35 kg), skrajša trajanje zdravljenja na najkrajši čas, ki je potreben za obvladanje simptomov, in kontraindicira druga zdravila, za katera je znano, da prav tako podaljšajo interval QT. Domperidon je treba kontraindicirati tudi pri bolnikih z zmerno ali hudo okvaro jeter in tistih, ki sočasno uporabljajo močne zaviralce CYP3A4, saj bi ti verjetno zvišali plazemsko koncentracijo domperidona.
English: • The PRAC noted that, in the combination domperidone/cinnarizine, domperidone is dosed at a 15 mg which is higher than the newly recommended individual dose.
Slovenian: • odbor PRAC je upošteval, da kombinacija domperidona in cinarizina vsebuje 15 mg domperidona, kar je več od novega priporočenega posameznega odmerka.
English: • The PRAC noted that the rectal formulations approved for paediatric use do not allow for the necessary recommended dose adjustment according to body weight, and therefore are likely to result in exposing paediatric patients to a dose higher than recommended.
Slovenian: • odbor PRAC je upošteval, da farmacevtske oblike za rektalno uporabo, ki so odobrene za pediatrično uporabo, ne omogočajo potrebnega priporočenega prilagajanja odmerka glede na telesno maso, zaradi česar obstaja večja verjetnost, da bi bili pediatrični bolniki izpostavljeni odmerku, večjemu od priporočenega;
English: Grounds for the revocation / variation to the terms of the marketing authorisation
Slovenian: Podlaga za odvzem/spremembo pogojev dovoljenja za promet z zdravilom
English: The PRAC also noted that the rectal formulations dosed at 10 mg and approved for paediatric use do not allow for the recommended dose adjustment according to body weight, and therefore are likely to result in exposing paediatric patients to a dose higher than the newly recommended.
Slovenian: Odbor PRAC je prav tako izpostavil, da farmacevtske oblike za rektalno uporabo, ki vsebujejo 10 mg domperidona in so odobrene za pediatrično uporabo, ne omogočajo priporočenega prilagajanja odmerka glede na telesno maso, zaradi česar obstaja večja verjetnost, da bi bili pediatrični bolniki izpostavljeni odmerku, večjemu od novega priporočenega.
English: Therefore the PRAC concluded that the benefit-risk balance of rectal formulations for paediatric patients is negative due to the potential for overdose.
Slovenian: Zato je zaključil, da je zaradi možnosti prevelikega odmerjanja razmerje med tveganji in koristmi za farmacevtske oblike za rektalno uporabo za pediatrične bolnike negativno.
English: For the reasons mentioned above, it is critical that patients are given the lowest possible effective dose and the PRAC considered that a recommendation for 0.25 mg/kg up to 3 times a day was appropriate.
Slovenian: V državah, v katerih je odobren, pa se trenutno priporočeni odmerki med zdravili razlikujejo in znašajo od 0,25-0,5 mg/kg 3- do 4-krat na dan. Zaradi razlogov, navedenih zgoraj, je ključnega pomena, da bolniki prejmejo najmanjši možni učinkoviti odmerek, pri čemer je odbor PRAC menil, da je primeren priporočeni odmerek 0,25 mg/kg največ trikrat na dan.