FrancophonIA/ELRC3.0 huggingface dataset:
English: Severe infections and neutropaenia were reported in clinical trials with concurrent use of anakinra (an interleukin-1 antagonist) or abatacept (a CD28 modulator) and another TNF-antagonist, etanercept, with no added benefit compared to TNF-antagonist therapy alone.
Croatian: Zabilježene su teške infekcije i neutropenija u kliničkim istraživanjima s istodobnom primjenom anakinre (antagonist interleukina-1) ili abatacepta (CD28 modulator) i drugog TNF-antagonista, etanercepta, bez dodatne koristi u odnosu na liječenje samo TNF-antagonistom.
English: Table 9: ASDAS-MI and ASAS 40 responses in AS0006 (percent of patients)
Croatian: Tablica 9: Odgovori ASDAS-MI i ASAS 40 u ispitivanju AS0006 (postotak bolesnika)
English: MTX should be continued during treatment with Cimzia where appropriate.
Croatian: MTX treba nastaviti uzimati tijekom liječenja Cimzijom, kada je to moguće.
English: • blood and lymphatic system cancers like lymphoma and leukaemia
Croatian: • zloćudni tumori krvnog i limfnog sustava kao što su limfom i leukemija
English: The data above reflect the percentage of patients whose test results were considered positive for antibodies to Cimzia in an ELISA, and are highly dependent on the sensitivity and specificity of the assay.
Croatian: Prethodno navedeni podaci odražavaju postotak bolesnika u kojih su rezultati ELISA testa na protutijela na Cimziju smatrani pozitivnima i značajno ovise o osjetljivosti i specifičnosti testa.
English: Overall, 16% of patients had prior TNF-antagonist exposure.
Croatian: Ukupno 16% bolesnika je bilo ranije izloženo TNF-antagonistima.
English: If new skin lesions appear during or after therapy with Cimzia or existing skin lesions change appearance, tell your doctor.
Croatian: Ako se pojave nove promjene na koži za vrijeme ili nakon liječenja Cimzijom ili se postojećima promijeni izgled, obavijestite o tome svog liječnika.
English: Do NOT touch the needle guard activation clips (labelled as 3 in Figure 1) during removal in order to prevent prematurely covering the needle with the needle guard.
Croatian: NEMOJTE dirati aktivacijske spojnice za štitnik igle (označene brojem 3 na Slici 1) tijekom uklanjanja zatvarača kako biste spriječili preuranjeno pokrivanje igle sa štitnikom za iglu.
English: Some of these reactions occurred after the first administration of Cimzia.
Croatian: Neke od tih reakcija su se pojavile nakon prve primjene Cimzije.
English: The other ingredients are: sodium acetate, sodium chloride and water for injection (see “Cimzia contains sodium acetate and sodium chloride” in section 2).
Croatian: - Drugi sastojci su: natrijev acetat, natrijev klorid i voda za injekcije (vidjeti „Cimzia sadrži natrijev acetat i natrijev klorid“ u dijelu 2).
English: The potential role of TNF-antagonist therapy in the development of malignancies is not known.
Croatian: Potencijalna uloga terapije TNF-antagonistima u razvoju malignih bolesti nije poznata.
English: • sexual dysfunction
Croatian: • poremećaj spolne funkcije
English: In study-to-study comparison, the pharmacokinetics of certolizumab pegol appeared similar to those observed previously in healthy subjects.
Croatian: Usporedba studija pokazala je da farmakokinetika certolizumabpegola odgovara onoj koja je prethodno opažena u zdravih ispitanika.
English: The symptoms described above can be due to some of the side effects listed below, which have been observed with Cimzia:
Croatian: Prethodno navedeni simptomi mogu biti i posljedica nekih u nastavku navedenih nuspojava koje su zabilježene tijekom liječenja Cimzijom:
English: The pivotal non-clinical safety studies were conducted in the cynomolgus monkey.
Croatian: Ključna neklinička ispitivanja sigurnosti provedena su u makaki majmuna.
English: Axial spondyloarthritis Overall Population
Croatian: Aksijalni spondiloartritis Ukupna populacija
English: Carriers of HBV who require treatment with Cimzia should be closely monitored for signs and symptoms of active HBV infection throughout therapy and for several months following termination of therapy.
Croatian: U nositelja HBV-a koji trebaju liječenje Cimzijom treba strogo pratiti pojavu znakova i simptoma aktivne HBV infekcije tijekom terapije i nekoliko mjeseci nakon završetka terapije.
English: No effect of age was observed in a population pharmacokinetic analysis in adult patients with plaque psoriasis.
Croatian: Nije zabilježen učinak dobi u populacijskoj farmakokinetičkoj analizi u odraslih bolesnika s plak psorijazom.
English: • anxiety and mood disorders such as depression, appetite disorders, weight change
Croatian: • tjeskoba i poremećaji raspoloženja kao što su depresija, poremećaji apetita, promjene tjelesne težine
English: CIMPASI-1 and CIMPASI-2 evaluated 234 patients and 227 patients respectively.
Croatian: U ispitivanjima CIMPASI-1 i CIMPASI-2 procijenjeno je 234 bolesnika odnosno 227 bolesnika.
English: • the treatment of moderate to severe, active rheumatoid arthritis (RA) in adult patients when the response to disease-modifying antirheumatic drugs (DMARDs) including MTX, has been inadequate.
Croatian: • liječenje umjerenog do teškog, aktivnog reumatoidnog artritisa (RA) u odraslih bolesnika, u kojih odgovor na liječenje antireumatskim lijekovima koji mijenjaju tijek bolesti (DMARD, eng. disease-modifyng antirheumatic drugs), uključujući MTX, nije bio zadovoljavajući.
English: After proper training, the injection can be self-administered or given by another person, for example a family member or friend.
Croatian: Nakon odgovarajuće obuke, bolesnici si mogu sami injicirati lijek ili to može učiniti neka druga osoba, na primjer član obitelji ili prijatelj.
English: Subject who escaped or withdrew (based on not achieving PASI 50 response) were treated as non-responders at Week 48.
Croatian: Ispitanici koji su napustili liječenje (escaped) ili koji su se povukli iz ispitivanja (na osnovi nepostizanja rezultata odgovora PASI 50) vodili su se kao bolesnici bez odgovora u 48. tjednu.
English: Multiple doses of up to 800 mg subcutaneously and 20 mg/kg intravenously have been administered.
Croatian: Višestruke doze primjenjivane su supkutano do najviše 800 mg, odnosno intravenski do najviše 20 mg/kg.
English: The mean PASI score at baseline was 20 and ranged from 12 to 69.
Croatian: Srednja vrijednost početnog PASI rezultata bila je 20 i kretala se u rasponu od 12 do 69.
English: Sustained inhibition of progression of structural damage was demonstrated in a subset of 449 of these patients who completed at least 2 years of treatment with Cimzia (RA-I and open-label extension study) and had evaluable data at the 2-year timepoint.
Croatian: Održana inhibicija progresije strukturalnih oštećenja pokazana je u podskupini 449 bolesnika koji su liječeni najmanje 2 godine Cimzijom (RA-I i otvoreni produžetak istraživanja) s dostupnim podacima za evaluaciju nakon 2 godine.
English: If you are a woman of childbearing potential, discuss with your doctor regarding use of adequate contraception while using Cimzia.
Croatian: Ako ste žena u reproduktivnoj dobi, raspravite sa svojim liječnikom primjenu odgovarajuće kontracepcije dok primjenjujete Cimziju.
English: If symptoms of tuberculosis (persistent cough, weight loss, listlessness, mild fever), or any other infection appear during or after therapy with Cimzia tell your doctor immediately.
Croatian: Ako se simptomi tuberkuloze (dugotrajni kašalj, gubitak tjelesne težine, bezvoljnost, blago povišena tjelesna temperatura) ili neka druga infekcija pojave tijekom ili nakon liječenja Cimzijom, odmah o tome obavijestite svog liječnika.
English: Non-clinical studies suggest low or negligible level of placental transfer of a homologue Fab-fragment of certolizumab pegol (no Fc region) (see section 5.3).
Croatian: Neklinička ispitivanja pokazala su nisku ili zanemarivu razinu prijenosa homolognog Fab fragmenta certolizumabpegola (ne Fc regije) kroz placentu (vidjeti dio 5.3).
English: Pharmacotherapeutic group: immunosuppressants, tumour necrosis factor alpha (TNFα) inhibitors, ATC code: L04AB05
Croatian: Farmakoterapijska skupina: imunosupresivi, inhibitori faktora nekroze tumora - alfa (TNFα), ATK oznaka: L04AB05
English: • Once ava is placed firmly against your skin “When ready press > once” is shown.
Croatian: • Nakon što postavite uređaj „ava” čvrsto na kožu, prikazat će se poruka „Kada ste spremni, jednom pritisnite >”.
English: Other disorders - Patients with chronic obstructive pulmonary disease (COPD), or who are heavy smokers, may be at increased risk for cancer with Cimzia treatment.
Croatian: Ostali poremećaji - bolesnici s kroničnom opstruktivnom plućnom bolešću (KOPB) ili teški pušači mogu imati povećan rizik pojave zloćudnog tumora tijekom liječenja Cimzijom.
English: Table 1 Adverse reactions in clinical trials and postmarketing System Organ Class
Croatian: Tablica 1 Nuspojave u kliničkim istraživanjima i u postmarketinškom praćenju Klasifikacija organskih sustava
English: N/A
Croatian: N/D
English: In both studies, the safety profile for these patients was consistent with the safety profile in rheumatoid arthritis and previous experience with Cimzia.
Croatian: U oba ispitivanja, sigurnosni profil za ove bolesnike bio je u skladu sa sigurnosnim profilom za reumatoidni artritis i prethodnim iskustvom s Cimzijom.
English: • When the syringe is empty, carefully remove the needle from the skin at the same angle at which it was inserted.
Croatian: • Kada je štrcaljka ispražnjena, oprezno izvucite iglu iz kože pod istim kutem pod kojim ste je uboli u kožu.
English: The physician should discuss with the patient which injection presentation option is the most appropriate.
Croatian: Liječnik treba razgovarati s bolesnikom o tome koji oblik injekcija lijeka Cimzia je najprikladniji.
English: • When the injection is complete, a message is shown on ava's screen saying "Injection complete.
Croatian: • Kada injekcija završi, na zaslonu uređaja „ava” prikazuje se poruka „Injekcija završena.
English: No serious infections were reported in the placebo-treated patients.
Croatian: U bolesnika liječenih placebom nisu opisane ozbiljne infekcije.
English: Effects on sperm motility measures and a trend of reduced sperm count in male rodents have been observed with no apparent effect on fertility (see section 5.3).
Croatian: U mužjaka glodavaca uočeni su učinci na pokretljivost spermija i trend smanjivanja broja spermija, no bez očiglednog utjecaja na plodnost (vidjeti dio 5.3).
English: • Remove the Cimzia pack from the refrigerator.
Croatian: • Izvadite pakiranje Cimzije iz hladnjaka.
English: For these reasons, comparison of the incidence of antibodies to Cimzia with the incidence of antibodies to other TNF-antagonists is not appropriate.
Croatian: Zbog tih razloga usporedba incidencije protutijela na Cimziju s incidencijom protutijela na druge TNFantagoniste nije primjerena.
English: There are limited data on the use of Cimzia in patients who have experienced a severe hypersensitivity reaction towards another TNF-antagonist; in these patients caution is needed.
Croatian: Nema dovoljno podataka o primjeni Cimzije u bolesnika u kojih se prethodno javila teška reakcija preosjetljivosti na primjenu nekog drugog TNF-antagonista; u tih bolesnika potreban je oprez.
English: In clinical trials with Cimzia and other TNF-antagonists, more cases of lymphoma and other malignancies have been reported among patients receiving TNF-antagonists than in control patients receiving placebo (see section 4.8).
Croatian: U kliničkim istraživanjima s Cimzijom i drugim TNF-antagonistima zabilježeno je više slučajeva limfoma i drugih malignih bolesti među bolesnicima koji su primali TNF-antagoniste nego u bolesnika koji su primali placebo (vidjeti dio 4.8).
English: After patients receive Cimzia, careful attention should be given to interpretation of abnormal coagulation results.
Croatian: Nakon što bolesnici prime Cimziju, treba s oprezom tumačiti abnormalne rezultate koagulacije.
English: MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS TRAY BACKING TEXT
Croatian: PODACI KOJE MORA NAJMANJE SADRŽAVATI BLISTER ILI STRIP TEKST NA POLEĐINI
English: You will be given Cimzia as either one (200 mg dose) or two injections (400 mg dose) under the skin (subcutaneous use, abbreviation: SC).
Croatian: Dobit ćete Cimziju kao jednu (doza od 200 mg) ili dvije injekcije (doza od 400 mg) ispod kože (potkožna primjena, skraćenica: s.c.).
English: Nevertheless, a potential risk of hypersensitivity reactions cannot be completely excluded in latex-sensitive individuals.
Croatian: Međutim, u osoba osjetljivih na lateks ne može se potpuno isključiti potencijalni rizik od reakcija preosjetljivosti.
English: - As the injection is being given, keep holding ava firmly against your skin.
Croatian: - Dok se injekcija primjenjuje, držite uređaj „ava” čvrsto priljubljenim uz kožu.
English: Live vaccines should not be administered concurrently with Cimzia.
Croatian: Živa cjepiva ne smiju se primjenjivati istodobno s Cimzijom.
English: It does not induce apoptosis in vitro in human peripheral blood-derived monocytes or lymphocytes, or neutrophil degranulation.
Croatian: Ne inducira in vitro apoptozu ljudskih monocita ili limfocita iz periferne krvi, odnosno degranulaciju neutrofila.
English: ASAS 40 was a secondary endpoint.
Croatian: Sekundarna mjera ishoda bila je ASAS 40.
English: As clearance decreases with decreasing body weight, females may generally obtain somewhat higher systemic exposure of certolizumab pegol.
Croatian: Kako se klirens smanjuje sa smanjenjem tjelesne težine, može se očekivati da sustavna izloženost certolizumabpegola u žena može općenito biti nešto veća.
English: Thereby this TNFα is blocked by Cimzia and this decreases inflammation diseases such as in rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis and psoriasis.
Croatian: Na taj način Cimzia blokira TNFα i tako ublažava upalne bolesti poput reumatoidnog artritisa, aksijalnog spondiloartritisa, psorijatičnog artritisa i psorijaze.
English: This was also the case for the other parameters of peripheral activity (e.g. number of swollen joints, number of painful/tender joints, dactylitis and enthesitis).
Croatian: Isto je zabilježeno i za ostale parametre periferne aktivnosti (npr. broj otečenih zglobova, broj bolnih/osjetljivih zglobova, daktilitis i entezitis).
English: Certolizumab pegol plasma concentrations were broadly dose-proportional.
Croatian: Koncentracije certolizumabpegola u plazmi u velikoj su mjeri proporcionalne dozi.
English: Key efficacy outcomes
Croatian: Ključni ishodi djelotvornosti
English: Cimzia can be taken together with:
Croatian: Cimzia se može primjenjivati istodobno:
English: • inflammation of the nerves for hearing, seeing, or of the face, impaired coordination or balance
Croatian: • upala živaca za sluh, vid ili lice, poremećaj koordinacije ili ravnoteže
English: At Week 4 and Week 8, all infant concentrations were BLQ.
Croatian: U 4. tjednu i 8. tjednu koncentracije u plazmi kod sve dojenčadi bile su ispod granice kvantifikacije.
English: Similar to the placebo-controlled studies, antibody positivity was associated with reduced efficacy in some patients.
Croatian: Slično kao i u placebom kontroliranim ispitivanjima pozitivnost na protutijela povezana je sa smanjenom djelotvornošću u nekih bolesnika.
English: Certolizumab pegol plasma concentrations measured in 14 infants at birth were Below the Limit of Quantification (BLQ) in 13 samples; one was 0.042 µg/ml with an infant/mother plasma ratio at birth of 0.09%.
Croatian: Koncentracije certolizumabpegola u plazmi izmjerene u 14 novorođenčadi pri rođenju bile su ispod granice kvantifikacije u 13 uzoraka, jedna je iznosila 0,042 µg/ml uz omjer koncentracije u plazmi dojenčadi/majke pri rođenju od 0,09 %.
English: If you forget to use Cimzia If you forget or miss an appointment to receive Cimzia, make another appointment as soon as possible.
Croatian: Ako zaboravite ili propustite ugovoreno vrijeme za dobivanje Cimzije, dogovorite drugo vrijeme što prije.
English: Therefore, caution should be exercised when using any TNF-antagonist in COPD patients, as well as in patients with increased risk for malignancy due to heavy smoking.
Croatian: Stoga je potreban oprez kod primjene bilo kojeg TNF-antagonista u bolesnika s KOPB-om kao i u bolesnika s povećanim rizikom za razvoj maligne bolesti zbog teškog pušenja.
English: With the current knowledge, a possible risk for the development of lymphomas, leukaemia or other malignancies in patients treated with a TNF-antagonist cannot be excluded.
Croatian: Prema dosadašnjim spoznajama ne može se isključiti mogući rizik za razvoj limfoma, leukemije ili drugih malignih bolesti u bolesnika koji su liječeni TNF-antagonistima.
English: Cimzia binds to a specific protein called tumour necrosis factor α (TNFα).
Croatian: Cimzia se veže na specifičnu bjelančevinu koji se zove faktor nekroze tumora α (TNFα).
English: Moderate to severe heart failure (NYHA classes III/IV) (see section 4.4).
Croatian: Umjereno do teško zatajenje srca (NYHA stupnjevi III/IV) (vidjeti dio 4.4).
English: Active dose regimen
Croatian: Aktivni režim doziranja
English: • severe rash, hives or other signs of allergic reaction (urticaria)
Croatian: • jako izražen osip, koprivnjača i drugi znakovi alergijske reakcije (urtikarija)
English: The pharmacokinetics of the PEG fraction of certolizumab pegol are expected to be dependent on renal function but have not been assessed in patients with renal impairment.
Croatian: Očekuje se da farmakokinetika PEG dijelova certolizumabpegola ovisi o funkciji bubrega, ali ona nije ispitivana u bolesnika s oštećenjem funkcije bubrega.
English: Spinal mobility was assessed in the double-blind, placebo-controlled period by using BASMI at several time points including Baseline, Week 12 and Week 24.
Croatian: Spinalna pokretljivost ocjenjivana je u dvostruko slijepom, placebom kontroliranom razdoblju prema BASMI indeksu u više vremenskih točaka, uključujući na početku, u 12. tjednu i 24. tjednu.
English: This evaluation should include a detailed medical history for patients with a personal history of tuberculosis, with possible previous exposure to others with active tuberculosis, and with previous and/or current use of immunosuppressive therapy.
Croatian: To ispitivanje treba uključivati detaljnu anamnezu za bolesnike s tuberkulozom u osobnoj anamnezi, s mogućim prethodnim kontaktima s bolesnicima s aktivnom tuberkulozom te onih koji su prethodno uzimali i/ili trenutno uzimaju imunosupresivnu terapiju.
English: Warnings and precautions Talk to your doctor, pharmacist or nurse before using Cimzia if any of the following applies to you:
Croatian: Obratite se svom liječniku, ljekarniku ili medicinskoj sestri prije nego primijenite Cimziju ako se bilo koje od sljedećih upozorenja odnosi na Vas:
English: Scroll wheel (to adjust the speed of injection)
Croatian: 5. Kotačić (za prilagodbu brzine injiciranja)
English: Almost all of these patients had received treatment with the immunosuppressants azathioprine and/or 6-mercaptopurine concomitantly with a TNF-antagonist at or prior to diagnosis.
Croatian: Gotovo su svi bolesnici istodobno liječeni imunosupresivima azatioprinom i/ili 6-merkaptopurinom i TNF-antagonistom nakon ili prije dijagnoze.
English: Treatment with Cimzia may result in the formation of antinuclear antibodies (ANA) and, uncommonly, in the development of a lupus-like syndrome (see section 4.8).
Croatian: Liječenje Cimzijom može dovesti do stvaranja antinuklearnih protutijela (ANA) te, manje često, do razvoja sindroma nalik lupusu (vidjeti dio 4.8).
English: Excipients: sodium acetate, sodium chloride and water for injections.
Croatian: Pomoćne tvari: natrijev acetat, natrijev klorid i voda za injekcije.
English: swelling or rash, stop using Cimzia and contact your doctor IMMEDIATELY.
Croatian: omaglice, oticanje ili osip, ODMAH prestanite primjenjivati Cimziju i obavijestite svog liječnika.
English: Injection site pain was observed in 1.5% of patients treated with Cimzia with no cases leading to withdrawal.
Croatian: Bol na mjestu primjene zabilježena je u 1,5% bolesnika liječenih Cimzijom, bez slučajeva koji su doveli do prekida liječenja.
English: Cimzia, in combination with MTX, is indicated for the treatment of active psoriatic arthritis in adults when the response to previous DMARD therapy has been inadequate.
Croatian: Cimzia, u kombinaciji s MTX, indicirana je za liječenje aktivnog psorijatičnog artritisa u odraslih u kojih je odgovor na prethodnu DMARD terapiju bio neprimjeren.
English: Inhibition of radiographic progression was maintained with Cimzia treatment up to Week 48 in the subset of patients at higher risk of radiographic progression (patients with a Baseline mTSS score of > 6).
Croatian: Inhibicija radiografske progresije održavana je liječenjem Cimzijom do 48. tjedna u podskupini bolesnika koji su imali viši rizik radiografske progresije (bolesnici s mTSS zbrojem na početku liječenja >6).
English: • bleeding or bruising
Croatian: • krvarenje ili modrice
English: Appropriate screening tests, e.g. tuberculin skin test and chest X-ray, should be performed in all patients (local recommendations may apply).
Croatian: U svih bolesnika treba napraviti odgovarajuće testove probira kao što je tuberkulinski kožni test ili rendgenska snimka pluća (u skladu s lokalnim preporukama).
English: Efficacy and safety of Cimzia in patients with PsA whose predominant symptoms were sacroiliitis or axial spondyloarthritis have not been separately analysed.
Croatian: Djelotvornost i sigurnost Cimzije u bolesnika s PsA čiji su predominantni simptomi bili sakroiliitis i aksijalni spondiloartritis nisu bili zasebno analizirani.
English: Cimzia does not contain a fragment crystallisable (Fc) region, which is normally present in a complete antibody, and therefore does not fix complement or cause antibody-dependent cell-mediated cytotoxicity in vitro.
Croatian: Cimzia ne sadrži dio, kristalizirajući fragment (Fc) koji je normalno prisutan u cijelom protutijelu te stoga ne može vezati komplement ili uzrokovati staničnu citotoksičnost in vitro ovisnu o protutijelima.
English: Manufacturer UCB Pharma S.A. Chemin du Foriest B-1420 Braine l'Alleud Belgium
Croatian: Proizvođač UCB Pharma S.A. Chemin du Foriest B-1420 Braine l'Alleud Belgija
English: • Release the skin with the first hand.
Croatian: • Pustite kožu iz ruke.
English: - methotrexate, - corticosteroids, or - pain medicines including nonsteroidal anti-inflammatory medicines (also called NSAIDs).
Croatian: - s metotreksatom, - s kortikosteroidima, ili - s lijekovima za liječenje boli, uključujući nesteroidne protuupalne lijekove (koje također zovemo NSAIL).
English: In a clinical study 16 women were treated with certolizumab pegol (200 mg every 2 weeks or 400 mg every 4 weeks) during pregnancy.
Croatian: U kliničkom ispitivanju 16 žena je bilo liječeno certolizumabpegolom (200 mg svaka 2 tjedna ili 400 mg svaka 4 tjedna) tijekom trudnoće.
English: Patients had active disease as defined by the BASDAI ≥4, and spinal pain ≥4 on a 0 to 10 NRS.
Croatian: Bolesnici su imali aktivnu bolest kao što je definirano indeksom BASDAI ≥ 4 i spinalnu bol ≥ 4 na ljestvici NRS od 0 do 10.
English: Rare gastrointestinal tumours, melanoma
Croatian: rijetko gastrointestinalni tumori, melanom
English: Adequate data of treating patients who are carriers of HBV with anti-viral therapy in conjunction with TNF-antagonist therapy to prevent HBV reactivation are not available.
Croatian: Nisu dostupni odgovarajući podaci o liječenju bolesnika koji su nositelji HBV-a, a koji uz terapiju TNF-antagonistima kombiniraju antivirusnu terapiju kako bi se spriječila reaktivacija HBV-a.
English: Some of these reactions could occur after the first administration of Cimzia.
Croatian: Neke od tih reakcija mogu se pojaviti nakon prve primjene Cimzije.
English: If you have questions, please ask your doctor.
Croatian: Ako imate dodatna pitanja, savjetujte se sa svojim liječnikom.