FrancophonIA/ELRC3.0 huggingface dataset:
English: For both infants, children aged from one month to 18 years old, the CHMP agreed that, as for adults, the vancomycin dose should be individually adapted according to weight, age and the underlying type and severity of infection and clinical response; the initial vancomycin doses should be calculated based on the body weight.
Slovenian: Odbor je za dojenčke in otroke v starosti od enega meseca do 18 let menil, da je treba odmerek vankomicina individualno prilagoditi glede na telesno maso, starost, vrsto in resnost osnovne okužbe ter klinični odziv, kot velja za odrasle bolnike.
English: 1 ESCMID guidelines: https://www.escmid.org/escmid_publications/medical_guidelines/escmid_guidelines/ 2 ESCMID guideline https://www.escmid.org/fileadmin/src/media/PDFs/4ESCMID_Library/2Medical_Guidelines/ESCMID_Guidelines/Eu_Rec_Antimicrobal.pdf 3 IDSA guideline http://www.idsociety.org/Guidelines/Patient_Care/IDSA_Practice_Guidelines/Antimicrobial_Agent_Use/Vancomycin/Vancomycin/ 4 Bacterial meningitis:ESCMID guideline for bacterial meningitis: http://www.clinicalmicrobiologyandinfection.com/article/S1198743X(16)00020-3/abstract
Slovenian: 4 Bakterijski meningitis: Smernice ESCMID za bakterijski meningitis: http://www.clinicalmicrobiologyandinfection.com/article/S1198743X(16)00020-3/abstract.
English: • the CHMP considered that vancomycin represent a crucial therapeutic option in the context of the treatment of serious infections (complicated skin and soft tissue infections, bone and joint infections, community acquired pneumonia, hospital acquired pneumonia including ventilatorassociated pneumonia, infective endocarditis, acute bacterial meningitis, bacteraemia that occurs in association with, or is suspected to be associated with, any of the above, perioperative antibacterial prophylaxis, peritoneal dialysis-associated peritonitis and treatment of Clostridium difficile infection) caused by Gram-positive pathogens, particularly those caused by MRSA,
Slovenian: • Odbor CHMP je menil, da vankomicin predstavlja ključno terapevtsko možnost pri zdravljenju hudih okužb (zapletenih okužb kože in mehkih tkiv; okužb kosti in sklepov; zunajbolnišnične pljučnice; bolnišnično pridobljene pljučnice, vključno z ventilatorsko pljučnico; infektivnega endokarditisa, akutnega bakterijskega meningitisa; bakteriemije, ki se pojavi v povezavi s katerim koli od zgoraj navedenih stanj ali v primeru suma takšne povezave; pri perioperativni antibakterijski profilaksi, pri zdravljenju peritonitisa, povezanega s peritonealno dializo in zdravljenju okužbe s Clostridium difficile z grampozitivnimi povzročitelji, zlasti MRSA;
English: • Treatment of Clostridium difficile infection (CDI), for vancomycin given by oral route of administration.
Slovenian: • Zdravljenje okužb s Clostridium difficile z vankomicinom, uporabljenim peroralno.
English: • Treatment of: complicated skin and soft tissue infections, bone and joint infections, community acquired pneumonia, hospital acquired pneumonia including ventilator-associated pneumonia, infective endocarditis, bacteraemia that occurs in association with, or is suspected to be associated with any of the above (particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA)), perioperative antibacterial prophylaxis.
Slovenian: • Zdravljenje: zapletenih okužb kože in mehkih tkiv; okužb kosti in sklepov; zunajbolnišnične pljučnice; bolnišnično pridobljene pljučnice, vključno z ventilatorsko pljučnico; infektivnega endokarditisa; bakteriemije, ki se pojavi v povezavi s katerim koli od zgoraj navedenih stanj (zlasti če je povzročitelj proti meticilinu odporna bakterija Staphylococcus aureus (MRSA)) oziroma obstaja sum takšne povezave; perioperativna antibakterijska profilaksa.
English: It is currently made clear that TDM frequency needs to be individualised based on the clinical situation and response to treatment; specific recommendations are made for hemodynamically stable and unstable patients, patients with normal renal function and patients on intermittent haemodialysis.
Slovenian: Priporočila so specifična za hemodinamsko stabilne in nestabilne bolnike, bolnike z normalnim delovanjem ledvic in bolnike na intermitentni hemodializi.
English: The guidance provides treatment recommendations for initial and recurrent CDI.
Slovenian: Smernice vsebujejo priporočila za začetno zdravljenje in zdravljenje ponavljajočih se okužb s Clostridium difficile.
English: will enter into force, the limits of the impurities in the drug substance and final drug products will need to be revised accordingly, where applicable.
Slovenian: Ko začne v Evropski farmakopeji veljati monografija o vankomicinu, bo treba po potrebi ustrezno popraviti mejne vrednosti nečistoč v zdravilni učinkovini in končnih zdravilih.
English: Regarding the administration of vancomycin as a continuous infusion in paediatric patients, PDCO confirmed that it is being used in some countries for neonates (and children) with severe infections such as patients with central nervous system infections and/or associated bacteremia.
Slovenian: Odbor PDCO je potrdil, da se v nekaterih državah pri novorojenčkih (in otrocih) s hudimi okužbami (kot so okužbe centralnega živčnega sistema in/ali povezano bakteriemijo) uporablja dajanje vankomicina v obliki neprekinjenega infundiranja.
English: However, the CHMP noted that the 2 g/day dose often results in Ctrough values below the target of 10 to 20 mg/l; therefore in order to achieve the optimal target concentration, the CHMP agreed that the vancomycin dose should be individually adapted according to weight, age and the underlying type and severity of infection and clinical response; the initial vancomycin doses should be calculated based on the body weight.
Slovenian: Odbor je menil, da je treba za doseganje optimalne ciljne koncentracije odmerek vankomicina individualno prilagoditi glede na telesno maso, starost, vrsto in resnost osnovne okužbe ter klinični odziv.
English: Food enhances the absorption.
Slovenian: Hrana poveča absorpcijo.
English: Macrogol 3350
Slovenian: Makrogol 3350
English: Do not eat, drink or smoke while handling the product.
Slovenian: Ne jejte, pijte ali kadite, ko delate z zdravilom.
English: Renal clearance is the minor route of elimination.
Slovenian: Renalni očistek je manj pomembni način eliminacije.
English: If the tablet is not taken up voluntarily by the dog it can also be given with food or directly into the mouth.
Slovenian: Če pes ne vzame tablete prostovoljno, jo lahko daste tudi s hrano ali direktno v gobec.
English: Individual variation in Cmax and t1/2 was observed.
Slovenian: Opazovali so posamezno variacijo Cmax in t1/2.
English: Interaction with other medicinal products and other forms of interaction: None known.
Slovenian: Medsebojno delovanje z drugimi zdravili in druge oblike interakcij: Niso znane.
English: The chewable tablets should not be broken or divided.
Slovenian: Žvečljivih tablet ne smete drobiti ali deliti.
English: CONTENTS BY WEIGHT, BY VOLUME OR BY NUMBER OF DOSES
Slovenian: VSEBINA PO TEŽI, VOLUMNU ALI ŠTEVILU ODMERKOV
English: In some cases, soap and water is not sufficient to remove the product spilled on the fingers, therefore gloves must be used.
Slovenian: V nekaterih primerih milo in voda ne zadoščata za odstranitev zdravila, ki se je razlilo na prstih, zato je treba uporabiti rokavice.
English: Use with caution in dogs with pre-existing epilepsy.
Slovenian: Uporabljajte previdno pri psih z že obstoječo epilepsijo.
English: Use only accordingly to the benefit/risk assessment by the responsible veterinarian.
Slovenian: Zdravilo uporabite le v skladu z oceno korist/tveganje odgovornega veterinarja .
English: Bravecto is a chewable tablet and is well accepted by most dogs.
Slovenian: Bravecto je žvečljiva tablet in jo večina psov dobro sprejme.
English: 1210 Vienna
Slovenian: 1210 Dunaj
English: Detailed information on this veterinary medicinal product is available on the website of the European Medicines Agency (http://www.ema.europa.eu/).
Slovenian: Podrobne informacije o tem zdravilu so na voljo na spletni strani Evropske agencije za zdravila (European Medicines Agency) (http://www.ema.europa.eu/.)
English: The major route of elimination is the excretion of unchanged fluralaner in faeces (~90% of the dose).
Slovenian: Pomembnejši način eliminacije je izločanje nespremenjenega fluralanerja v fecesu (~90% odmerka).
English: Intervet UK Limited Walton Manor, Walton, Milton Keynes, Buckinghamshire, MK7 7AJ UNITED KINGDOM
Slovenian: Intervet UK Limited Walton Manor, Walton, Milton Keynes, Buckinghamshire, MK7 7AJ Združeno kraljestvo
English: Convulsions and lethargy has been reported very rarely in spontaneous reports.
Slovenian: O konvulzijah in letargiji so poročali zelo redko v spontanih poročilih.
English: People with a sensitive skin or known allergy in general e.g. to other veterinary medicinal products of this type should handle the veterinary medicinal product as well as treated animals with caution.
Slovenian: Ljudje z občutljivo kožo ali znano alergijo na splošno, npr. na druga zdravila za uporabo v veterinarski medicini tega tipa morajo z zdravili za uporabo v veterinarski medicini in z zdravljenimi živalmi ravnati previdno.
English: Incompatibilities: None known.
Slovenian: Inkompatibilnosti: Niso znane.
English: No treatment-related clinical signs were observed.
Slovenian: Z zdravljenjem povezanih kliničnih znakov niso opazili.
English: Major incompatibilities: None known.
Slovenian: Glavne inkompatibilnosti: Niso znane.
English: If you notice any side effects, even those not already listed in this package leaflet or you think the medicine has not worked, please inform your veterinary surgeon.
Slovenian: Če opazite kakršne koli resne stranske učinke, tudi tiste, ki niso navedeni v tem navodilu za uporabo ali mislite, da zdravilo ni delovalo, obvestite svojega veterinarja.
English: Light to dark brown tablet with a smooth or slightly rough surface and circular shape.
Slovenian: Svetla do temno rjava tableta z gladko ali rahlo grobo površino okrogle oblike.
English: Do not wash or allow the dog to become immersed in water or swim in water courses within 3 days after treatment.
Slovenian: Ne umivajte psa oz. ne dovolite psu, da se kopa ali plava v vodi 3 dni po zdravljenju.
English: Do not allow recently treated animals to groom each other.
Slovenian: Ne dovolite ravnokar zdravljenim mačkam da negujejo ena drugo.
English: The cap will stay on the pipette; it is not possible to remove it.
Slovenian: Zaporka bo ostala na kapalki; ni je mogoče odstraniti.
English: Fluralaner is systemically distributed and reaches the highest concentrations in fat, followed by liver, kidney and muscle.
Slovenian: Fluralaner se sistemsko porazdeli in doseže najvišje koncentracije v maščobi, nato sledijo jetra, ledvice in mišice.
English: This product is for topical use and should not be administered orally.
Slovenian: To zdravilo je za lokalno uporabo in se ne sme dajati peroralno.
English: In case of spillage onto, for example table or floor surfaces, remove excess product using paper tissue and clean the area with detergent.
Slovenian: V primeru razlitja, na primer po mizi ali po tleh, poberite odvečno zdravilo s papirnati brisačo in očistite površino z detergentom.
English: Intervet Productions Rue de Lyons 27460 Igoville FRANCE
Slovenian: Kožni nanos, raztopina: Intervet Productions Rue de Lyons 27460 Igoville Francija
English: Convulsions and lethargy has been reported very rarely in spontaneous (pharmacovigilance) reports.
Slovenian: O krčih in letargiji so poročali zelo redko v spontanih (farmakovigilančnih) poročilih.
English: Read package leaflet for full user safety information.
Slovenian: Za popolne varnostne informacije preberite navodilo za uporabo.
English: Do not use directly on skin lesions.
Slovenian: Ne nanašajte neposredno na poškodovano kožo.
English: If skin contact does occur, wash the affected area immediately with soap and water.
Slovenian: Če se pride do stika s kožo, prizadeto območje takoj sperite z milom in vodo.
English: Wear gloves when handling and administering this product.
Slovenian: Pri rokovanju in nanašanju zdravila uporabljajte rokavice.
English: Following oral administration, fluralaner is readily absorbed reaching maximum plasma concentrations within 1 day.
Slovenian: Po peroralnem dajanju se fluralaner zlahka absorbira in doseže maksimalno koncentracijo v plazmi v 1 dnevu.
English: The product can be used as part of a treatment strategy for the control of flea allergy dermatitis (FAD).
Slovenian: To zdravilo se lahko uporablja kot del strategije zdravljenje dermatitisa zaradi alergije na bolhe (FAD).
English: A plateau is seen in plasma between 7 and 63 days post administration, after which concentrations decline slowly.
Slovenian: Visok nivo je viden v krvni plazmi med 7. in 63. dnevom po dajanju, nakar koncentracija počasi pada.
English: In molecular on-target studies on insect GABA receptors of flea and fly, fluralaner is not affected by dieldrin resistance.
Slovenian: V molekularnih ciljanih študijah na GABA receptorjih bolhe in muhe fluralanerja ne prizadene odpornost na dieldrin.
English: In in vitro bio-assays, fluralaner is not affected by proven field resistances against amidines (tick), organophosphates (tick, mite), cyclodienes (tick, flea, fly), macrocyclic lactones (sea lice), phenylpyrazoles (tick, flea), benzophenyl ureas (tick), pyrethroids (tick, mite) and carbamates (mite).
Slovenian: V in vitro biotestih na fluralaner ne vpliva dokazana odpornost na amidine (klop), organofosfate (klop, pršica), ciklodiene (klop, bolha, muha), makrociklične laktone (morske uši), fenilpirazole (klop, bolha), benzofenil uree (klop), piretroide (klop, pršica) in karbamate (pršica).
English: Sodium lauryl sulfate Disodium embonate monohydrate Magnesium stearate Aspartame
Slovenian: Natrijev lavrilsulfat Dinatrijev embonat monohidrat Magnezijev stearat Aspartam
English: and Rhipicephalus sanguineus) and fleas (Ctenocephalides spp.)
Slovenian: Rhipicephalus sanguineus) in bolham (Ctenocephalides spp.)
English: Intervet GesmbH Siemensstrasse 107 1210 Vienna AUSTRIA
Slovenian: Žvečljiva tableta: Intervet GesmbH Siemensstrasse 107 1210 Dunaj Avstrija
English: The dog should be observed during administration to confirm that the tablet is swallowed.
Slovenian: Psa je treba opazovati, da vidite, da je tableto pogoltnil.
English: Step 3: Squeeze the pipette gently and apply the entire contents directly to the dog's skin in one (when volume is small) or several spots along the dog's dorsal line from the shoulder to the base of the tail.
Slovenian: Tretji korak: Rahlo stiskajte merilno kapalko in nanesite njeno celotno vsebino neposredno na kožo na eno (če je volumen majhen) ali več mestih vzdolž hrbtenice od ramen do korena repa.
English: on the cat.
Slovenian: pri mačkah.
English: It is efficacious against ticks (Ixodes spp.)
Slovenian: Učinkovit je proti klopom (Ixodes spp.)
English: It is efficacious against ticks (Ixodes spp., Dermacentor spp.
Slovenian: Učinkovit je proti klopom (Ixodes spp., Dermacentor spp.
English: Soya-bean oil
Slovenian: Sojino olje
English: Manufacturer responsible for batch release: Intervet GesmbH
Slovenian: Proizvajalec, odgovoren za sproščanje serij: Intervet GesmbH
English: The sachets should only be opened immediateley prior to use.
Slovenian: Vrečke odprite le neposredno pred uporabo.
English: Date of first authorisation: 11/02/2014
Slovenian: DATUM PRIDOBITVE/PODALJŠANJA DOVOLJENJA ZA PROMET Datum pridobitve dovoljenja za promet: 11/02/2014
English: Step 3: Squeeze the pipette gently and apply the entire contents directly to the cat's skin.
Slovenian: Tretji korak: Narahlo stiskajte merilno kapalko in nanesite njeno celotno vsebino neposredno na kožo.
English: Parasites need to start feeding on the host to become exposed to fluralaner; therefore the risk of the transmission of parasite borne diseases cannot be excluded.
Slovenian: Paraziti se morajo začeti hraniti na gostitelju, da so izpostavljeni fluralanerju, zato tveganja prenašanja bolezni, ki jih prenašajo paraziti, ni mogoče izključiti.
English: Administer Bravecto chewable tablets at or around the time of feeding.
Slovenian: Bravecto tableto dajte ob času hranjenja ali približno takrat.
English: For optimal control of tick infestation, the timing of retreatment depends on the tick species.
Slovenian: Za optimalni nadzor infestacije s klopi je čas ponovnega zdravljenja odvisen od vrste klopov.
English: Hypersensitivity reactions in humans have been reported.
Slovenian: Pri ljudeh so poročali o preobčutljivostnih reakcijah.
English: Bodyweight of dog (kg)
Slovenian: Telesna teža psa (kg)
English: The product should not be used by persons with a hypersensitivity to the active substance or to any of the excipients (see contraindications, section 4.3).
Slovenian: Zdravila ne smejo uporabljati osebe s preobčutljivostjo za učinkovino ali katerokoli pomožno snov (glejte Kontraindikacije, poglavje 4.3).
English: 1 chewable tablet 2 chewable tablets 4 chewable tablets
Slovenian: VELIKOST PAKIRANJA 1 žvečljiva tableta 2 žvečljivi tableti 4 žvečljive tablete
English: Strength and number of tablets to be administered
Slovenian: Jakost in število tablet, ki jih je treba dati
English: Step 1: Immediately before use, open the sachet and remove the pipette.
Slovenian: Prvi korak: Neposredno pred uporabo odprite vrečko in izvlecite merilno kapalko.
English: Incubation of fluralaner in the presence of carprofen or warfarin in dog plasma at maximum expected plasma concentrations did not reduce the protein binding of fluralaner, carprofen or warfarin.
Slovenian: Inkubacija fluralanerja v prisotnosti karprofena ali varfarina v plazmi psa pri največjih pričakovanih plazemskih koncentracijah ni zmanjšala vezave fluralanerja, karprofena ali varfarina na beljakovine.
English: Avoid the application of more than 1 ml of solution at any one spot as it could cause some of the solution to run or drip off the dog.
Slovenian: Ne nanašajte več kot 1 ml raztopine na posamezno mesto, ker bi je lahko nekaj steklo ali odkapljalo s psa.
English: PARTICULARS TO APPEAR ON THE OUTER PACKAGE Carton Box
Slovenian: PODATKI NA ZUNANJI OVOJNINI KARTONSKA ŠKATLA
English: Fluralaner is a potent inhibitor of parts of the arthropod nervous system by acting antagonistically on ligand-gated chloride channels (GABA-receptor and glutamate-receptor).
Slovenian: Fluralener je močan inhibitor delov živčnega sistema artropodov s svojim antagonističnim delovanjem na ligand odvisne kloridne kanal (GABA receptor in receptor glutamata).
English: Cardboard box with 1 aluminium foil blister sealed with PET aluminium foil lid stock containing 1, 2 or 4 chewable tablets.
Slovenian: Kartonska škatla z 1 aluminijastim pretisnim omotom, zavarjenim s prevleko PET aluminijasta folija, ki vsebuje 1, 2 ali 4 žvečljive tablete.
English: Keep the pipette in the sachet until use.
Slovenian: Merilno kapalko hranite v vrečki do uporabe.
English: The following other signs shortly after administration were uncommonly observed: apathy/tremors/anorexia (0.9% of treated cats) or vomiting/hypersalivation (0.4% of treated cats).
Slovenian: Drugi znaki, ki so bili občasno opaženi kratek čas po dajanju zdravila, so: apatija/tresenje/neješčnost (0,9% zdravljenih mačk) ali bruhanje/povečano slinjenje (0,4 % zdravljenih mačk).
English: Marketing authorisation holder: Intervet International B. V.
Slovenian: Imetnik dovoljenja za promet z zdravilom: Intervet International B. V.
English: Treatment schedule:
Slovenian: Shema zdravljenja
English: Newly emerged fleas on a dog are killed before viable eggs are produced.
Slovenian: Bolhe, ki se na novo pojavijo na psih, so ubite, preden proizvedejo za življenje sposobna jajčeca.
English: Pharmacotherapeutic group: Ectoparasiticides for systemic use ATCvet code: QP53B E02
Slovenian: Farmakoterapevtska skupina: Učinkovine proti ektoparazitom za sistemsko zdravljenje Oznaka ATC vet: QP53B E02
English: Unchanged fluralaner is excreted in feces and to a very low extent in urine.
Slovenian: Nespremenjen fluralaner se izloči z fecesom in v zelo majhnem delu z urinom.
English: Oral uptake of the product at the maximum recommended dose of 93 mg fluralaner/kg body weight was well tolerated in cats, apart from some self-limiting salivation and coughing or vomiting immediately after administration.
Slovenian: Peroralni vnos največjega priporočenega odmerka (93 mg fluralanerja/kg telesne teže) so mačke dobro prenašale, z izjemo nekaj samoomejevanega slinjenja in kašljanja ali bruhanja neposredno po dajanju.
English: Each carton box contains 1 or 2 pipettes.
Slovenian: V vsaki kartonski škatli sta 1 ali 2 merlni kapalki.
English: In the absence of available data, this veterinary medicinal product should not be used on kitten less than 11 weeks old and /or cats weighing less than 1.2 kg.
Slovenian: Ker ni ustreznih podatkov, se to zdravilo za uporabo v veterinarski medicini ne sme uporabljati za mladiče mlajše od 11 tednov starosti in/ali za mačke, ki tehtajo manj kot 1,2 kg.
English: Oral uptake of the product at the maximum recommended dose was well tolerated in cats, apart from some self-limiting salivation and coughing or vomiting immediately after administration.
Slovenian: Peroralni vnos največjega priporočenega odmerka so mačke dobro prenašale, z izjemo samo omejevanega slinjenja in kašljanja ali bruhanja neposredno po dajanju.
English: Fluralaner is readily absorbed from the topical administration site into the hair, skin and subjacent tissues, from where it is slowly absorbed into the vascular system.
Slovenian: Po tlokalnem dajanju se fluralaner zlahka absorbira iz mesta nanosa v dlako, kožo in pod njo ležeča tkiva, od koder se počasi absorbira v krvni obtok.
English: Unit dose pipette made of laminated aluminium/polypropylene foil closed with an HDPE cap and packed in a laminated aluminium foil sachet.
Slovenian: Kapalka z enoto odmerka je narejena iz laminirane aluminijasto/polipropilenske folije, zaprta s HDPE zaporko in pakirana v vrečko iz laminirane aluminijaste folije.
English: Each ml contains 280 mg fluralaner.
Slovenian: 1 ml vsebuje fluralaner 280 mg.
English: Wash hands thoroughly with soap and water immediately after use of the product.
Slovenian: Takoj po uporabi zdravila si roke dobro umijte z milom in vodo.
English: The product should not be administered at intervals shorter than 8 weeks as the safety for shorter intervals has not been tested.
Slovenian: Zdravilo se ne sme dajati v razmikih, krajših od 8 tednov, ker varnost za krajše razmike ni bila testirana.
English: and fleas (Ctenocephalides spp.)
Slovenian: (Ctenocephalides spp.)
English: Place the pipette tip on the base of the skull of the cat.
Slovenian: Nastavite vrh merilne kapalke na kožo na spodnji del lobanje mačke.
English: CLINICAL PARTICULARS 4.1 Target species
Slovenian: KLINIČNI PODATKI 4.1 Ciljne živalske vrste Psi.
English: Lot: {number}
Slovenian: Lot{številka}
English: Some marbling, speckles or both may be visible.
Slovenian: Včasih je marmorina ali ima majhne lise ali oboje.
English: The product should not be used by persons with a hypersensitivity to the active substance or to any of the excipients (see section Contraindications).
Slovenian: Zdravila ne smejo uporabljati osebe s preobčutljivostjo za učinkovino ali katerokoli pomožno snov (glejte poglavje Kontraindikacije).
English: Safety was demonstrated in breeding, pregnant and lactating animals treated with overdoses of up to 3 times the maximum recommended dose.
Slovenian: Varnost je bila dokazana pri živalih za vzrejo in pri živalih v času brejosti in laktacije, ki so jim dajali odmerke, ki so bili do 3krat večji od največjega priporočenega odmerka.
English: Fluralaner is highly bound to plasma proteins and might compete with other highly bound active substances such as non-steroidal anti-inflammatory drugs (NSAIDs) and the coumarin derivative warfarin.
Slovenian: Fluralaner se močno veže na plazemske beljakovine in lahko tekmuje z drugimi močno vezanimi učinkovinami, kot so nesteroidna protivnetna zdravila (NSAID), in kumarinski derivat varfarin.