FrancophonIA/ELRC3.0 huggingface dataset:
English: • The CMDh considered that the drug utilisation study in condition 3 needs to be performed in more than one Member State in order to achieve its goal of monitoring off-label use.
Croatian: • CMDh je smatrao da je potrebno provesti studiju uporabe lijeka iz uvjeta br. 3 u više od jedne države članice kako bi se postigao cilj praćenja uporabe izvan odobrenih indikacija.
English: Domperidone is a peripheral dopamine D2-receptor antagonist with gastrokinetic and anti-emetic properties.
Croatian: Domperidon je periferni antagonist dopaminskih D2-receptora s gastrokinetičkim i antiemetičkim svojstvima.
English: The CMDh highly recommends that MAHs collaborate in order to avoid unnecessary duplication of studies.
Croatian: CMDh snažno preporučuje da nositelji odobrenja surađuju međusobno kako bi se izbjeglo nepotrebno ponavljanje studija.
English: o Is not favourable for the combination domperidone/cinnarizine.
Croatian: o Nije povoljan za kombinaciju domperidona/cinarizina.
English: Domperidone-containing medicines are available as over-the-counter (OTC) or prescription-only medicines (POM).
Croatian: Lijekovi koji sadrže domperidon dostupni su kao bezreceptni (OTC) ili lijekovi dostupni samo na recept (POM).
English: However, the CMDh considered that changes were necessary to proposed conditions to the Marketing Authorisations (Annex IV).
Croatian: Međutim, CMDh je smatrao da su bile nužne promjene za predložene uvjete odobrenja za stavljanje lijeka u promet (Prilog IV.).
English: Domperidone is marketed in several formulations, for oral or rectal administration under various trade names.
Croatian: Domperidon se trži u nekoliko formulacija za peroralnu ili rektalnu primjenu pod različitim trgovačkim imenima.
English: • The revocation of the marketing authorisations for:
Croatian: • Opoziv odobrenja za stavljanje lijeka u promet za:
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.
Croatian: Iz gore spomenutih razloga ključno je da bolesnici dobiju najnižu moguću djelotvornu dozu i PRAC je smatrao da je preporuka za dozu 0,25 mg/kg do 3 puta na dan odgovarajuća.
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.
Croatian: Stoga je važno da je rizik smanjen ograničavanjem maksimalne doze (10 mg do 3 puta na dan za odrasle i adolescente od 12 godina starosti i starije te koji imaju tjelesnu težinu ≥ 35 kg), ograničavanjem trajanja liječenja na najkraće potrebno kako bi se kontroliralo simptome i kontraindiciralo druge lijekove za koje se također zna da produljuju QT interval.
English: o epigastric sense of fullness, early satiety, feeling of abdominal distension, upper abdominal pain o bloating, eructation, flatulence o nausea and vomiting o heartburn with or without regurgitations of gastric contents in the mouth
Croatian: o epigastrični osjećaj punoće, rana zasićenost, osjećaj abdominalne distenzije, bol u gornjem dijelu abdomena o napuhanost, eruktacija, flatulencija o mučnina i povraćanje o žgaravica sa ili bez regurgitacije želučanog sadržaja u usta
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.
Croatian: Međutim, da bi se osiguralo da ispitivanje daje relevantne podatke, od nositelja odobrenja zahtijeva se da predaju protokole za sporazume nadležnim državnim tijelima.
English: o Is not favourable for high dose rectal formulations (60 mg) or rectal formulations approved for paediatric use (10 mg).
Croatian: o Nije povoljan za rektalne formulacije visokih doza (60 mg) ili rektalne formulacije odobrene za pedijatrijsku uporabu (10 mg).
English: these circumstances patients should not be exposed to the additional risk associated to a combination product.
Croatian: U tim okolnostima bolesnici se ne smiju izlagati dodatnom riziku povezanom s lijekom koji sadrži kombinaciju djelatnih tvari.
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.
Croatian: Kao posljedica novih maksimalnih preporučenih doza, PRAC je smatrao da određene formulacije poput tableta u dozi od 20 mg i supozitorija u dozi od 60 mg imaju negativan omjer koristi i rizika i da ih stoga treba povući.
English: In addition, the CMDh took the opportunity to introduce the following clarification to the description of the products for which revocation is recommended:
Croatian: Pored toga, CMDh je iskoristio priliku da uvede sljedeće objašnjenje u opis lijekova za koje se preporučuje povlačenje:
English: The authorized indications of domperidone, as listed in the Company Core Data Sheet of the originator, are presented below:
Croatian: Odobrene indikacije domperidona, navedene u originatorovim Temeljnim podacima tvrtke o sigurnosti lijeka navedene su u nastavku:
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.
Croatian: Iskazuje svoj učinak putem inhibicije dopaminskih receptora u ljudskom želudcu te u zoni okidanja kemoreceptora koja leži izvan krvnomoždane barijere, u stražnjem području mozga.
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.
Croatian: Rizici su povećani u bolesnika koji su stariji od 60 godina i koji koriste visoke doze lijeka i/ili koji istovremeno koriste lijekove koji produljuju QT segment ili lijekovi koji mogu povećati plazmatske razine domperidona.
English: 1 - PRAC recommendation
Croatian: - Preporuka PRAC-a
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.
Croatian: U tom smislu PRAC je nadalje uočio da ne samo da su podaci o djelotvornosti ograničeni, ali da u biti ne demonstriraju superiornost kombinacije nad lijekom s jednom djelatnom tvari.
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.
Croatian: CMDh je razmotrio zahtjev od jednog nositelja odobrenja s obzirom na vremenski raspored kako bi se ispunili neki od uvjeta koje je predložio PRAC.
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.
Croatian: Prilikom razmatranja postojećih podataka kao potpora djelotvornosti domperidona, PRAC je zaključio da ukupno gledano postoji dovoljno dokaza1,2,3 koji podržavaju uporabu u općoj indikaciji za olakšavanje simptoma mučnine i povraćanja u odraslih.
English: 2 - Detailed explanation for the differences from the PRAC recommendation
Croatian: - Detaljno objašnjenje odstupanja od preporuke PRAC-a
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.
Croatian: PhVWP se složio s izmjenama informacija o lijeku, a od nositelja odobrenja za stavljanje lijeka u promet originatorova lijeka zahtijevalo se da provede farmakoepidemiološku studiju i temeljitu QTc studiju.
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.
Croatian: Ekstrapolacija postojećih farmakokinetičkih podataka omogućava zaključak da su supozitoriji od 30 mg koji se primjenjuju dva puta na dan ekvivalentni peroralnim formulacijama od 10 mg koje se primjenjuju tri puta na dan.
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.
Croatian: Pored toga, da bi se osiguralo da su nadležna državna tijela obaviještena o napretku studije, od nositelja odobrenja traži se da predaju godišnja ažuriranja o napretku procesa regrutacije ispitanika u studiju.
English: Annex II
Croatian: Prilog II.
English: − combination products containing domperidone/cinnarizine
Croatian: − kombinirane lijekove koje sadrže domperidon/cinarizin
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'.
Croatian: • PRAC je smatrao da postojeći podaci, iako su ograničeni, ukazuju na djelotvornost u indikaciji „olakšavanje simptoma mučnine i povraćanja”.
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.
Croatian: Domperidon je također odobren kao kombinacija fiksnih djelatnih tvari s cinarizinom i indiciran je za prevenciju i liječenje simptoma povezanih s bolešću kretanja.
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.
Croatian: PRAC je ipak smatrao prikladnim provođenje daljnjih ispitivanja kako bi se zabilježila djelotvornost domperidona u djece u ovoj indikaciji te u novom preporučenom režimu doziranja.
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.
Croatian: • PRAC je smatrao da se rizik od ozbiljnih srčanih nuspojava može smanjiti uporabom nižih doza domperidona, ograničavanjem trajanja liječenja kontraindiciranjem terapije za bolesnike s posebno visokim rizikom (bolesnici s umjerenim ili teškim oštećenjem jetre, bolesnici za koje je poznato da imaju produljenje srčanih provodnih intervala, posebice QTc-a, bolesnici sa značajnim poremećajima elektrolita ili osnovnom srčanom bolešću poput kongestivnog zatajenja srca) i bolesnici koji istovremeno uzimaju lijekove za produljenje QT segmenta ili potentne inhibitore CYP3A4.
English: Scientific conclusions and grounds for revocation or variation to the terms of the marketing authorisations, as applicable, and detailed explanation for the differences from the PRAC recommendation
Croatian: Znanstveni zaključci i razlozi za stavljanje izvan snage ili izmjene uvjeta odobrenja za stavljanje lijeka u promet, kako je primjenjivo i detaljno objašnjenje odstupanja od preporuka PRAC-a
English: It should also be contraindicated in patients with moderate to severe hepatic impairment and in co-administration with potent CYP3A4 inhibitors, due to the expected increase in plasma levels of domperidone.
Croatian: Također treba biti kontraindiciran u bolesnika s umjerenim do teškim oštećenjem jetre te kod istovremene primjene s potentnim inhibitorima CYP3A4 zbog očekivanog porasta u plazmatskim razinama domperidona.
English: Oral liquid formulations shall be supplied with an appropriate measuring device.
Croatian: Peroralne tekuće formulacije treba isporučivati s odgovarajućim uređajima za mjerenje.
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.
Croatian: Za sve indikacije osim „olakšavanja simptoma mučnine i povraćanja” postoji iznimno ograničeni dokaz djelotvornosti domperidona i stoga se smatra da su potencijalne koristi nadmašene identificiranim srčanim rizikom.
English: • Extend the timeframe for the submission of the final study report on condition 1 (generation of paediatric efficacy data).
Croatian: • Produljenje vremenskog okvira za podnošenje konačnog izvješća iz ispitivanja o uvjetu br. 1 (generiranje podataka o djelotvornosti u djece).
English: The PRAC also considered that the combination domperidone/cinnarizine, which contains 15 mg domperidone (higher than the newly recommended individual dose), has a negative benefit-risk balance.
Croatian: PRAC je također smatrao da kombinacija domperidona/cinarizina koja sadrži 15 mg domperidona (viša od nove preporučene pojedinačne doze) ima negativan omjer koristi i rizika.
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.
Croatian: Pored toga, podaci koji podržavaju djelotvornost kombinacije domperidona/cinarizina za bolest kretanja ograničeni su, ne dokazuju superiornost kombinacije nad lijekom s pojedinačnom djelatnom tvari i stoga ne opravdavaju izlaganje bolesnika dodatnom riziku povezanom s kombinacijom djelatnih tvari.
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.
Croatian: Belgija je izvijestila Europsku agenciju za lijekove, a u skladu s člankom 31. Direktive 2001/83/EZ o svojoj odluci da potakne postupak arbitraže u skladu s člankom 31. kako bi se zatražila preporuka PRAC-a o tome je li omjer koristi i rizika za te lijekove još uvijek pozitivan u odobrenim indikacijama i trebaju li se odobrenja za lijekove koji sadrže domperidon održati, promijeniti, suspendirati ili povući.
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).
Croatian: • Potrebno je produljiti vremenski okvir za podnošenje završnog izvješća o ispitivanju o uvjetu br. 2 (farmakokinetička studija kako bi se generirali podaci kojima bi se omogućila usporedba između rektalnih i peroralnih formulacija).
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.
Croatian: • PRAC je smatrao da su podaci koji podržavaju djelotvornost domperidona u pedijatrijskoj populaciji ograničeni i preporučio generiranje daljnjih podataka za potvrdu djelotvornosti u ovoj populaciji bolesnika.
English: The data in support of the paediatric use in relief of symptoms of nausea and vomiting is limited.
Croatian: Podaci koji podupiru pedijatrijsku uporabu u olakšavanju simptoma mučnine i povraćanja ograničeni su.
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.
Croatian: • Izmjena uvjeta odobrenja za stavljanje lijeka u promet za preostale lijekove koji sadrže domperidon, a koji su navedeni u Prilogu I., za koje su relevantna poglavlja sažetka opisa svojstava lijeka i upute o lijeku opisani u Prilogu III. preporuci PRAC-a.
English: Therefore the PRAC concluded that the benefit-risk balance of rectal formulations for paediatric patients is negative due to the potential for overdose.
Croatian: Stoga je PRAC zaključio da je omjer koristi i rizika rektalnih formulacija za pedijatrijske bolesnike negativan zbog mogućnosti predoziranja.
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.
Croatian: CMDh je, razmotrivši preporuke PRAC-a od 6. ožujka 2014. godine u skladu s člankom 107.k stavcima 1. i 2. Direktive 2001/83/EZ, izrazio stajalište o izmjeni ili povlačenju, kako je primjenjivo, odobrenja za stavljanje lijekova u promet koji sadrže domperidon, za koje su relevantna poglavlja sažetka opisa svojstava lijeka i upute o lijeku opisani u Prilogu III. te su podložni uvjetima opisanim u Prilogu IV.
English: Minor amendments were also introduced in the Product Information for clarity.
Croatian: U informacije o lijeku također su uvedene manje nadopune radi jasnoće.
English: It is used in the treatment of symptoms of nausea and vomiting of variable origin.
Croatian: Koristi se za liječenje simptoma mučnine i povraćanja različitog podrijetla.
English: Off-label use of domperidone is known to exist for conditions such as GERD, gastroparesis and stimulation of lactation.
Croatian: Poznata je uporaba domperidona izvan odobrenih indikacija za stanja poput GERB-a, gastropareze i stimulacije laktacije.
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.
Croatian: • PRAC je smatrao da je domperidon povezan s povećanim rizikom od ozbiljnih srčanih nuspojava, uključujući i produljenje QT segmenta i iznenadnu srčanu smrt.
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.
Croatian: Uzimajući u obzir Odluku komisije o postupku za domperidon prema članku 30., CMDh je potvrdio da omjer koristi i rizika za indikaciju „olakšavanje simptoma mučnine i povraćanja” (uključujući i za pedijatrijsku populaciju) ostaje pozitivan.
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.
Croatian: • PRAC je smatrao da su farmakokinetički podaci koji podržavaju rektalne formulacije ograničeni i stoga je preporučio generiranje daljnjih podataka kako bi se omogućila usporedba između peroralnih i rektalnih formulacija.
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.
Croatian: Dostupni su klinički i neklinički podaci koji dosljedno ukazuju da postoji povećani rizik od ozbiljnih i po život opasnih srčanih nuspojava povezanih s uporabom domperidona.
English: A possible association between domperidone and QT-prolongation and cardiac adverse events was identified in the mid-1980s, when high and rapidly administered intravenous doses were used as an anti-emetic during cytotoxic treatment in cancer patients.
Croatian: Ukupni sažetak znanstvene procjene PRAC-a Moguća povezanost između domperidona i produljenja QT segmenta te srčanih nuspojava identificirana je sredinom 80-ih godina prošlog stoljeća kada su se visoke i brzo primjenjivane intravenske doze korištene kao antiemetički lijekovi tijekom citotoksičnog liječenja u bolesnika s karcinomom.
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.
Croatian: • PRAC je zabilježio da je u kombinaciji domperidon/cinarizin, domperidon doziran pri 15 mg što je više od novo preporučene pojedinačne doze.
English: Grounds for the revocation / variation to the terms of the marketing authorisation
Croatian: Razlozi za opoziv / izmjene uvjeta odobrenja za stavljanje lijeka u promet
English: The CMDh considered the below PRAC recommendation with regards to domperidone-containing medicinal products:
Croatian: CMDh je razmatrao preporuku PRAC-a u nastavku u vezi lijekova koji sadrže domperidon:
English: o Is not favourable for high dose oral formulations (higher than 10 mg).
Croatian: o Nije povoljan za peroralne formulacije visoke doze (više od 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.
Croatian: • PRAC je također smatrao da su postojeći podaci o djelotvornosti domperidona u indikacijama različitim od „olakšavanja simptoma mučnine i povraćanja” vrlo ograničeni i da je stoga potencijalna korist nadmašena srčanim rizikom.
English: Whenever approved, it is noted that the currently recommended posology varies between products, ranging from 0.25-0.5 mg/kg 3 to 4 times a day.
Croatian: da trenutno preporučeno doziranje varira između lijekova u rasponu od 0,25 do 0,5 mg/kg 3 do 4puta na dan.
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.
Croatian: PRAC je također zabilježio da rektalne formulacije u dozi od 10 mg i odobrene za pedijatrijsku uporabu ne omogućavaju prilagodbu preporučene doze u skladu s tjelesnom težinom i da je stoga vjerojatno da će doći do izlaganja pedijatrijskih bolesnika dozi višoj od novo preporučene.
English: Doc ID:LMD21025;EDMS-ERI-47362001 2 Englert W, Schlich D. A double-blind crossover trial of domperidone in chronic postprandial dyspepsia.
Croatian: Doc ID:LMD21025;EDMS-ERI-47362001 2 Englert W, Schlich D.
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.
Croatian: Slijedom navedenog, PRAC je zaključio da omjer koristi i rizika za lijekove koji sadrže domperidon ostaje pozitivan i podložan uvjetima odobrenja za stavljanje lijeka u promet, uzimajući u obzir promjene u informacijama o lijeku i druge preporučene mjere smanjenja rizika.
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.
Croatian: • PRAC je zabilježio da rektalne formulacije odobrene za pedijatrijsku uporabu ne omogućavaju nužnu prilagodbu preporučene doze u skladu s tjelesnom težinom i da je stoga vjerojatno da će doći do izlaganja pedijatrijskih bolesnika dozi višoj od preporučene.