FrancophonIA/ELRC3.0 huggingface dataset:
English: Additional information was included in some Member States in warnings in respect of risk of hypotension, renovascular hypertension/renal artery stenosis, kidney transplantation, use in concomitant heart failure, anaemia, cough, ethnic groups, primary aldosteronism, and doping.
Danish: I nogle medlemsstater blev der medtaget supplerende oplysninger i advarsler om risikoen for hypotension, renovaskulær hypertension/nyrearteriestenose, nyretransplantation, brug ved samtidig hjerteinsufficiens, anæmi, hoste, etniske grupper, primær aldosteronisme og doping.
English: Gout was listed as a contraindication in some SPCs for Vascace Plus, and was included under section 4.4 in most others and in the CDS.
Danish: Urinsyregigt var opført som en kontraindikation i nogle produktresuméer for Vascace Plus og var medtaget under punkt 4.4 i de fleste andre og i CDS.
English: The text suggested for this section of the harmonized label was identical to the wording in the CDS.
Danish: Den foreslåede ordlyd for dette punkt i den harmoniserede etikettering var identisk med ordlyden i CDS.
English: These were conducted with patients randomized to one of several possible treatment groups with cilazapril doses of 0.5 mg, 1.0 mg or 2.5 mg and hydrochlorothiazide doses of 6.25 mg, 12.5 mg or 25 mg alone or in combination.
Danish: Disse blev gennemført på patienter randomiseret til en af flere mulige behandlingsgrupper med cilazaprildoser på 0,5 mg, 1,0 mg eller 2,5 mg og hydrochlorothiaziddoser på 6,25 mg, 12,5 mg eller 25 mg alene eller i kombination.
English: The current CDS and some SPCs included a warning concerning the use of thiazides in patients with porphyria based on a warning in Martindale's review.
Danish: Den aktuelle CDS og nogle produktresuméer omfattede en advarsel om brug af thiazider hos patienter med porfyri baseret på en advarsel i Martindales gennemgang.
English: Vascace Plus is used in the treatment of hypertension in patients not responding satisfactorily to each component administered alone.
Danish: Vascace Plus anvendes til behandling af hypertension hos patienter, der ikke reagerer tilfredsstillende på de enkelte komponenter alene.
English: The number of products for Vascace Plus is considerably higher than for cilazapril alone, since numerous molecules had been added where a potential interaction with hydrochlorothiazide was suspected.
Danish: Antallet af lægemidler for Vascace Plus er betydeligt højere end for cilazapril alene, da der var blevet tilføjet adskillige molekyler, hvor der var mistanke om en potentiel interaktion med hydrochlorothiazid.
English: The CHMP endorsed most of the MAH's proposal except for pregnancy.
Danish: CHMP godkendte det meste af forslaget fra indehaveren af markedsføringstilladelsen undtagen graviditet.
English: The CHMP agreed with such approach.
Danish: CHMP var enig i en sådan fremgangsmåde.
English: The CHMP agreed with the MAH proposal to include this adverse effect of thiazides in section 4.8 but not under 4.4.
Danish: CHMP var enig med indehaveren af markedsføringstilladelsen i, at denne bivirkning ved thiazider skulle medtages under punkt 4.8, men ikke under punkt 4.4.
English: The warning may be based on concerns about crossreactivity with sulfonamide antibiotics, which are know to aggravate porphyria.
Danish: Advarslen er muligvis baseret på et problem med krydsreaktion med sulfonamidantibiotika, som man ved forværrer porfyri.
English: A diuretic such as hydrochlorothiazide enhances efficacy of the ACE inhibitor by stimulating the renin-angiotensin system and shifting the hypertensive state to a more renin-dependent condition.
Danish: Et diuretikum som hydrochlorothiazid øger virkningen af ACE-hæmmeren ved at stimulere reninangiotensin-systemet og ændre den hypertensive tilstand til en mere reninafhængig lidelse.
English: The list of drugs which may interact either with cilazapril or with hydrochlorothiazide was updated.
Danish: Listen over lægemidler, der kan interagere med enten cilazapril eller hydrochlorothiazid, blev opdateret.
English: Electrolyte disturbances including hypokalaemia, hyponatraemia and dehydration are mainly associated with thiazides, whilst ACE inhibitors can cause hyperkalaemia.
Danish: Forstyrrelser i elektrolytbalancen, herunder hypokalæmi, hyponatriæmi og dehydrering, er navnlig forbundet med thiazider, mens ACE-hæmmere kan forårsage hyperkalæmi.
English: Some SPCs included under the heading “hypotension” warnings about the use of anaesthetics.
Danish: I nogle produktresuméer indeholdt overskriften "hypotension" advarsler om brugen af anæstetika.
English: Vascace Plus is a combination of cilazapril (an angiotensin-converting enzyme inhibitor) and hydrochlorothiazide (a thiazide-diuretic agent).
Danish: Vascace Plus er en kombination af cilazapril (en angiotensinkonverterende enzymhæmmer) og hydrochlorothiazid (et thiaziddiuretikum).
English: In one trial (protocol no. N2960C) it was shown that patients had an overall decrease in SDBP of 4.3 mm Hg before the addition of hydrochlorothiazide and 11.1 mm Hg after the addition of hydrochlorothiazide.
Danish: I en undersøgelse (protokol nr. N2960C) blev det påvist, at patienter havde en generel nedsættelse af det diastoliske blodtryk i siddende stilling på 4,3 mm Hg før tilføjelsen af hydrochlorothiazid og 11,1 mm Hg efter tilføjelsen af hydrochlorothiazid.
English: The dosing recommendations given for patients with cirrhosis/impaired liver function varied considerably among MSs.
Danish: Doseringsanbefalingerne for patienter med cirrose/nedsat leverfunktion varierede betydeligt blandt medlemsstaterne.
English: Of these patients with mild to moderate hypertension (sitting diastolic blood pressure 95 - 115 mm hg), 1.027 patients were treated with the cilazapril/hydrochlorothiazide combination, 453 patients with cilazapril and 366 with hydrochlorothiazide alone and 238 patients received placebo.
Danish: Ud af disse patienter med mild til moderat hypertension (diastolisk blodtryk i siddende stilling 95 - 115 mm hg) blev 1 027 patienter behandlet med kombinationen cilazapril/hydrochlorothiazid, 453 patienter med cilazapril og 366 med hydrochlorothiazid alene, mens 238 patienter fik placebo.
English: The antihypertensive effect for the combination group was maintained for the duration of this long-term study and was of a similar magnitude to that observed after the first weeks of cilazapril/hydrochlorothiazide therapy combination with no development of tolerance for the therapy.
Danish: Den antihypertensive effekt i kombinationsgruppen blev opretholdt under hele denne langvarige undersøgelse og var af en størrelsesorden svarende til den, der blev observeret efter de første uger af cilazapril/hydrochlorothiazid-kombinationsterapien uden nogen udvikling i tolerancen over for behandlingen.
English: Estimates of frequency were based on the proportion of patients reporting each adverse reaction during Vascace Plus clinical trials.
Danish: Skønnene over hyppigheden var baseret på den patientandel, der indberettede de enkelte bivirkninger under de kliniske undersøgelser af Vascace Plus.
English: The CHMP concluded that the contraindication during the first trimester of pregnancy must be deleted from the product information of Vascace Plus and the PI should be updated to include the wording recommended by the PhVWP for both pregnancy and lactation.
Danish: CHMP konkluderede, at kontraindikationen i første trimester af graviditeten skal slettes fra produktoplysningerne for Vascace Plus, og produktoplysningerne skal ajourføres, så de indeholder den ordlyd, som arbejdsgruppen vedrørende lægemiddelovervågning anbefalede i forbindelse med såvel graviditet som amning.
English: As it is not foreseen to start treatment with the fixed combination, the CHMP endorsed the following: “In clinical studies, the efficacy and tolerability of cilazapril and hydrochlorothiazide administered concomitantly was similar in both elderly and younger hypertensive patients, although pharmacokinetic data show that clearance of both components in elderly patients was reduced (see section 5.2)”.
Danish: Da det ikke er planen at indlede behandlingen med den faste kombination, godkendte CHMP følgende ordlyd: "I kliniske undersøgelser var effekten og tolerancen af cilazapril og hydrochlorothiazid givet samtidigt ens hos såvel ældre som yngre hypertensive patienter, selv om de farmakokinetiske data viser, at clearance af begge komponenter hos ældre patienter var nedsat (se pkt.
English: Information on pharmacokinetics of hydrochlorothiazide in special populations has been added to section 5.2.
Danish: Oplysningerne om hydrochlorothiazids farmakokinetik i særlige populationer er blevet tilføjet punkt
English: The CHMP endorsed the following harmonised wording for the posology: “The dosage of Vascace Plus is one tablet (5.0 mg cilazapril and 12.5 mg hydrochlorothiazide) administered once daily”.
Danish: CHMP godkendte følgende harmoniserede ordlyd for doseringen: "Dosis af Vascace Plus er én tablet (5,0 mg cilazapril og 12,5 mg hydrochlorothiazid), som tages én gang dagligt".
English: Moreover, according to the PhVWP recommendation, angiotensin converting enzyme inhibitors are contraindicated in second and third trimesters of pregnancy but not during the first trimester of pregnancy or lactation.
Danish: Desuden er angiotensinkonvertaseenzymhæmmere ifølge henstillingen fra arbejdsgruppen vedrørende lægemiddelovervågning kontraindiceret i andet og tredje trimester af graviditet, men ikke i første trimester af graviditet eller amning.
English: The information which is given about the possible interactions and their outcome are endorsed by the CHMP.
Danish: CHMP har godkendt oplysningerne om de mulige interaktioner og resultaterne heraf.
English: Following review and discussion regarding the teratogenic potential of ACE inhibitors, the Pharmacovigilance Working Party (PhVWP) concluded that the contraindication of ACE inhibitors during the first trimester of pregnancy is not justified given the limited evidence related to a teratogenic risk.
Danish: Efter en gennemgang og drøftelse af ACE-hæmmeres teratogene potentiale konkluderede arbejdsgruppen vedrørende lægemiddelovervågning, at kontraindikationen for ACE-hæmmere i første trimester af graviditeten ikke er begrundet som følge af den begrænsede dokumentation for en teratogen risiko.
English: To support the proposed indication the MAH presented 4 placebo controlled clinical trials sponsored by Roche and run in 2.084 hypertensive patients.
Danish: Til underbyggelse af den foreslåede indikation fremlagde indehaveren af markedsføringstilladelsen resultaterne af fire placebokontollerede kliniske undersøgelser sponsoreret af Roche, som omfattede 2 084 hypertensive patienter.
English: Moreover, the names and order of System Organ Classes (SOCs) have been aligned for cilazapril and hydrochlorothiazide according to MedDRA.
Danish: Desuden er navnene på og rækkefølgen af systemorganklasser blevet tilpasset for cilazapril og hydrochlorothiazid i henhold til MedDRA.
English: The magnitude of the antihypertensive effect of the combination at peak (i. e. 15 mm Hg) did not render an increased incidence of hypotensive events, which could be of concern in elderly patients.
Danish: Den største (dvs. 15 mm Hg) antihypertensive effekt af kombinationsterapien gav ikke anledning til en øget forekomst af hypotensive hændelser, som kunne give anledning til bekymring hos ældre patienter.
English: Assessing the blood pressure lowering effect of the combination the results of these trials showed that the addition of hydrochlorothiazide to a cilazapril regimen increases the reduction in sitting diastolic blood pressure (SDBP).
Danish: Ved vurderingen af den blodtrykssænkende virkning af kombinationen viste resultaterne af disse undersøgelser, at tilføjelsen af hydrochlorothiazid til cilazapril-behandlingen øger nedsættelsen af det diastoliske blodtryk i siddende stilling (SDBP).
English: The MAH used the published meta-analyses of mono- and combination therapy as basis for this section.
Danish: Indehaveren af markedsføringstilladelsen benyttede de offentliggjorte metaanalyser af mono- og kombinationsterapi som grundlag for dette punkt.
English: The MAH acknowledged the number of contraindications in the SPCs of Members States and explained that:
Danish: Indehaveren af markedsføringstilladelsen anerkendte rækken af kontraindikationer i medlemsstaternes produktresuméer og forklarede følgende:
English: However, a review of the literature suggests that low dose hydrochlorothiazide (e.g. 12.5 mg/day) is associated with only minimal increase in serum uric acid, and to an extent which may not be clinically relevant.
Danish: En gennemgang af litteraturen tyder dog på, at lave doser af hydrochlorothiazid (f.eks. 12,5 mg/dag) kun er forbundet med en minimal stigning i serumurinsyren, der måske ikke er klinisk relevant.
English: However, hydrochlorothiazide is currently listed as `safe' or `probably safe' by several authorities (e.g. European Porphyria Initiative http://www.porphyria-europe.com/03-drugs/drugs-and-porphyrias.asp; The Drug Data-base for Acute Porphyria http://www.drugs-porphyria.com.
Danish: Adskillige myndigheder (f.eks. European Porphyria Initiative http://www.porphyria-europe.com/03-drugs/drugsand-porphyrias.asp og The Drug Data-base for Acute Porphyria http://www.drugs-porphyria.com) har imidlertid i øjeblikket opført hydrochlorothiazid som "sikkert" eller "sandsynligvis sikkert".
English: The analysis of individual studies suggested that virtually all cilazapril doses administered with 25 mg hydrochlorothiazide have similar effects on trough blood pressure.
Danish: Analysen af de enkelte undersøgelser tydede på, at næsten alle cilazaprildoser indgivet sammen med 25 mg hydrochlorothiazid har den samme virkning på blodtrykket.
English: Several Vascace Plus SPCs included a warning concerning the effect of thiazide on lipid profile.
Danish: Adskillige produktresuméer for Vascace Plus omfattede en advarsel om thiazids virkning på lipidprofilen.
English: Vascace Plus was included in the list of products for Summary of Product Characteristics (SPC) harmonisation, due to the divergent national decisions taken by Member States concerning the authorisation of the product.
Danish: Vascace Plus blev medtaget på den liste over lægemidler, for hvilke produktresuméerne skulle harmoniseres, fordi medlemsstaterne havde truffet forskellige nationale beslutninger med hensyn til godkendelse af lægemidlet.
English: From these patients 108 patients had initially been treated with cilazapril and 106 patients with hydrochlorothiazide.
Danish: Af disse patienter var 108 oprindeligt blevet behandlet med cilazapril og 106 med hydrochlorothiazid.
English: For hydrochlorothiazide, the MAH was requested to include the possible interactions with digoxin and complete the list with the agents as such non-depolarizing muscle relaxants, calcium slats and vitamin D, anticholinergics, amantidine, cytotoxic drugs, cyclosporine.
Danish: Med hensyn til hydrochlorothiazid blev indehaveren af markedsføringstilladelsen anmodet om at medtage de eventuelle interaktioner med digoxin og den fuldstændige liste over stoffer såsom ikkedepolariserende muskelafslappende lægemidler, calciumsalte og D-vitamin, antikolinerger, amantidin, cytotoksiske lægemidler, cyclosporin.
English: Given this, the MAH proposed to modify the wording as follow: “Vascace Plus should be used with caution in patients with porphyria”.
Danish: På denne baggrund foreslog indehaveren af markedsføringstilladelsen, at ordlyden ændres således: "Vascace Plus bør anvendes med forsigtighed til patienter med porfyri".
English: The CHMP also considered that add-on to hydrochlorothiazide and to the non-responders to hydrochlorothiazide cannot be accepted as only the highest cilazapril dose is available in the fixed combination and the dose has to be titrated up with single components.
Danish: CHMP fandt endvidere, at tillægsbehandlingen til hydrochlorothiazid og til patienter, der ikke responderer på hydrochlorothiazid, ikke kan accepteres, da kun den højeste cilazaprildosis foreligger i den faste kombination, og dosis skal titreres op for de enkelte komponenter.
English: Doubling the initial dose (5.0 mg cilazapril 12.5 mg hydroclorthiazide) resulted in a further increase in efficacy.
Danish: En fordobling af initialdosis (5,0 mg cilazapril og 12,5 mg hydrochlorothiazid) resulterede i en yderligere forøgelse af effekten.
English: Apart from some additional information which is provided on the distribution of cilazapril and hydrochlorothiazide the text suggested for this section of the harmonized label was identical to the wording in the CDS of the MAH.
Danish: Bortset fra enkelte supplerende oplysninger om distributionen af cilazapril og hydrochlorothiazid, var den foreslåede tekst til dette punkt i den harmoniserede etikettering identisk med ordlyden i indehaveren af markedsføringstilladelsens CDS.
English: The proposed text was consistent with the wording used in current local SPCs for Vascace Plus, and was the same as that proposed for the revised version of the EU harmonized SPC for Vascace.
Danish: Den foreslåede ordlyd var forenelig med den ordlyd, der anvendes i aktuelle lokale produktresuméer for Vascace Plus, og var den samme som den, der blev foreslået i den reviderede udgave af det EUharmoniserede produktresumé for Vascace.
English: Lipid profile
Danish: Lipidprofil
English: Where warnings and precautions concerned cilazapril, the MAH proposed a text similar to that used in the recently harmonized Vascace.
Danish: Når advarslerne og forsigtighedsreglerne vedrørte cilazapril, foreslog indehaveren af markedsføringstilladelsen en tekst svarende til den, der blev benyttet til Vascace, som blev harmoniseret for nylig.
English: However, the MAH did not propose to include such a warning as considered that this is implied in the warning that patients should have regular monitoring of renal function and electrolytes which is included in the proposed SPC.
Danish: Indehaveren af markedsføringstilladelsen foreslog dog ikke, at der medtages en sådan advarsel, da den anses for at være underforstået i advarslen om, at patienternes nyrefunktion og elektrolytbalance regelmæssigt skal overvåges, som indgik i det foreslåede produktresumé.
English: Also add-on to cilazaparil can be accepted as the hydrochlorothiazide dose is low and suitable as an initial dose in combination therapy of ACEI non-responders and there are some data available on the efficacy and safety in cilazapril monotherapy non-responders.
Danish: Tillægsbehandlingen til cilazapril kan også accepteres, da hydrochlorothiaziddosis er lav og egnet som initialdosis i kombinationsterapi af ikke-respondenter på ACEI, og der foreligger visse data om effekten og sikkerheden hos patienter, der ikke responderer på cilazapril-monoterapi.
English: The original proposed text concerning the hydrochlorothiazide component of Vascace Plus was already in agreement with the PhVWP wording.
Danish: Den oprindeligt foreslåede ordlyd vedrørende hydrochlorothiazidkomponenten i Vascace Plus var allerede i overensstemmelse med arbejdsgruppen vedrørende lægemiddelovervågnings ordlyd.
English: Therefore, Vascace Plus is not recommended for patients with severe renal impairment (see section 4.3)”.
Danish: Vascace Plus anbefales derfor ikke til patienter med svært nedsat nyrefunktion (se pkt.
English: The MAH proposed to include a separate warning concerning this issue in section 4.4.
Danish: Indehaveren af markedsføringstilladelsen foreslog, at der medtages en særskilt advarsel om dette spørgsmål i punkt 4.4.
English: The ADR `headache' has been included in the list of ADRs attributable to cilazapril, as requested by the CHMP, in the category `common'.
Danish: Bivirkningen "hovedpine" er medtaget på listen over bivirkninger, der kan tilskrives cilazapril, som CHMP krævede det, i kategorien "almindelig".
English: The MAH proposed to describe the symptoms/signs of angioedema more succinctly than in some current SPCs, and to use the term “acute oropharyngeal edema and airways obstruction” (as in Meyler's review).
Danish: Indehaveren af markedsføringstilladelsen foreslog, at symptomerne/tegnene på angioødem beskrives mere kortfattet end i nogle af de nuværende produktresuméer, og at formuleringen "akut oropharyngealt ødem og luftvejsobstruktion" (som i Meylers gennemgang) anvendes.
English: Several clinical trials showed that doses of 5 mg cilazapril and 12.5 mg hydrochlorothiazide generated a greater reduction in blood pressure than either of the individual components in patients with mild to moderate hypertension whose blood pressure could not be normalized with cilazapril alone.
Danish: Adskillige kliniske undersøgelser viste, at doser på 5 mg cilazapril og 12,5 mg hydrochlorothiazid medførte en større nedsættelse af blodtrykket end de enkelte komponenter alene hos patienter med mild til moderat hypertension, hvis blodtryk ikke kan normaliseres med cilazapril alene.
English: The revised proposed text concerning breast feeding has been aligned to the one approved for the Vascace SPC, with minor changes to reflect the combination of cilazapril + hydrochlorothiazide.
Danish: Den reviderede foreslåede ordlyd vedrørende amning er blevet bragt på linje med den, der er godkendt i produktresuméet for Vascace, med mindre ændringer, der afspejler kombinationen af cilazapril og hydrochlorothiazid.
English: For ADRs listed in the SPC that were not reported in the clinical trials, the relevant frequency category had been assigned using the `rule of 3' approach recommended in the SmPC guideline.
Danish: For de bivirkninger i produktresuméet, der ikke blev indberettet under de kliniske undersøgelser, er den relevante hyppighedskategori blevet fastsat ved hjælp af "regel 3"-strategien som anbefales i produktresumévejledningen.
English: The MAH proposed sufficiently concise instructions for the treatment of an overdose with the cilazapril/hydrochlorothiazide combination as too detailed information may not reflect the situation of a specific overdose patient.
Danish: Indehaveren af markedsføringstilladelsen foreslog tilstrækkeligt præcise oplysninger om behandling af en overdosering med en kombination af cilazapril/hydrochlorothiazid, da alt for detaljerede oplysninger måske ikke afspejler situationen for en bestemt patient, der er blevet overdoseret.
English: The recommendation for once-daily dosage is based on the finding that an apparently subtherapeutic dose of hydrochlorothiazide in combination with cilazapril results in potentiation of the antihypertensive effect.
Danish: Anbefalingen af dosis én gang dagligt er baseret på den konklusion, at en tilsyneladende for lav behandlingsdosis af hydrochlorothiazid i kombination med cilazapril resulterer i en forstærkning af den antihypertensive effekt.
English: The CHMP agreed the following: “Because significant hypotension may occur in patients with liver cirrhosis treated with standard doses of ACE inhibitors, cautious dose titration of each individual component is needed if patients with liver cirrhosis should require treatment with cilazapril and hydrochlorothiazide (see section 4.4)”.
Danish: CHMP vedtog følgende: “Da der kan forekomme væsentlig hypotension hos patienter med levercirrose, der behandles med standarddoser af ACE-hæmmere, er der behov for en nøje dosistitrering af hver enkelt component, hvis patienter med levercirrose skulle kræve behandling med cilazapril og hydrochlorothiazid (se punkt 4.4)”.
English: The MAH, to support the proposed section 4.4, presented reviews of adverse effects of ACE inhibitors and thiazide diuretics from the scientific literature avaible:
Danish: Til støtte for det foreslåede punkt 4.4 fremlagde indehaveren af markedsføringstilladelsen gennemgange af bivirkningerne ved ACE-hæmmere og thiaziddiuretika i den foreliggende videnskabelige litteratur: