FrancophonIA/ELRC3.0 huggingface dataset:
English: Taking into account the risk of medication errors and the clarification as regards indications and contraindications, the CHMP agreed the following key messages to be used in a direct healthcare professional communication (DHPC) to general practitioners, orthopaedics, internists, cardiologists, haematologists, surgeons, pharmacists, nurses (or other as per national health care system):
Croatian: Uzimajući u obzir rizik od pogrešaka pri davanju lijeka i obrazloženjima o indikacijama i kontraindikacijama, CHMP donio je sljedeće ključne poruke koje se trebaju koristiti u izravnom pismu liječnicima (DHPC) opće prakse, ortopedima, internistima, kardiolozima, hematolozima, kirurzima, farmaceutima, medicinskim sestrama (ili drugima, ovisno o sustavu zdravstvene skrbi):
English: Enoxaparin sodium is a low molecular weight heparin marketed under the trade names Lovenox and associated names.
Croatian: Enoksaparin-natrij je heparin male molekularne težine koji se na tržište stavlja pod trgovačkim nazivom Lovenox i povezanim nazivima.
English: For example, for pre-filled syringes of 0.4 ml, the strength will appear as: <Local tradename> 4,000 IU (40 mg)/0.4 ml solution for injection.
Croatian: Na primjer, za napunjene štrcaljke od 0,4 ml, jačina se prikazuje na sljedeći način: <Lokalni trgovački naziv> 4,000 IU (40 mg)/0,4 ml otopina za injektiranje.
English: • discontinue treatment in case of skin necrosis and cutaneous vasculitis.
Croatian: • liječenje treba prekinuti u slučaju kožne nekroze i kožnog vaskulitisa.
English: In terms of posology for this indication most of the countries stated a dose of enoxaparin 1mg/kg and a few countries stated a lower dose for this indication.
Croatian: U pogledu doziranja za tu indikaciju većina zemalja navela je dozu enoksaparina od 1 mg/kg, a nekoliko zemalja navelo je nižu dozu za tu indikaciju.
English: Patients in whom PCIs could be performed at any time for failed fibrinolysis or urgently in case of recurrent myocardial ischemia/infarction, but had to be deferred in other situations at least for 48 hours.
Croatian: Bolesnici u kojih se perkutani koronarni zahvat mogao provesti u svakom trenutku zbog neuspjele fibrinolize ili hitno u slučaju ponavljajućeg infarkta miokarda, ali je zahvat u drugim situacijama trebao biti odgođen barem 48 sati.
English: Vials of 100 mg/10 mL and a pen of 10 x 40 mg (equivalent to 10 x 4 000 IU anti Xa) are also authorised.
Croatian: Bočice od 100 mg/10 mL i olovka od 10 x 40 mg (jednako 10 x 4 000 IU anti-Xa) također su odobrene.
English: • Enoxaparin strength will now be expressed both in international units (IU) of anti-Xa activity and in milligram (mg): One mg of enoxaparin sodium is equivalent to 100 IU anti-Xa activity.
Croatian: • Jačina enoksaparina odsad se izražava i u međunarodnim jedinicama (IU) aktivnosti anti-Xa i u miligramima (mg): Jedan miligram enoksaparin-natrija jednak je 100 UI anti-Xa aktivnosti.
English: • increase in the risk of hepatic impairment;
Croatian: • povećanje rizika od oštećenja jetre;
English: • History of immune mediated heparin-induced thrombocytopenia (HIT) within the past 100 days or in the presence of circulating antibodies (see also section 4.4 );
Croatian: • Povijest imunološki posredovane trombocitopenije izazvane heparinom (HIT) u posljednjih 100 dana ili u prisutnosti cirkulirajućih antitijela (vidjeti i odjeljak 4.4);
English: • gastrointestinal ulcer, presence of malignant neoplasm at high risk of bleeding, recent brain, spinal or ophthalmic surgery, known or suspected oesophageal varices, arteriovenous malformations, vascular aneurysms or major intraspinal or intracerebral vascular abnormalities;
Croatian: • gastrointestinalni ulkus, prisutnost zloćudne neoplazme s visokim rizikom od krvarenja, nedavne operacije na mozgu, kralježnicu ili oka, poznati ili mogući varikoziteti jednjaka, arteriovenske malformacije, vaskularni aneurizmi ili značajne intraspinalne ili intracerebralne vaskularne abnormalnosti;
English: No difference exists between countries in terms of enoxaparin dosage regimen (1 mg/kg every 12 hours by subcutaneous injection) in these indications.
Croatian: U pogledu doziranja enoksaparina ne postoje razlike u zemljama (1 mg/kg svakih 12 sati supkutanom injekcijom) u tim indikacijama.
English: • careful biological monitoring by anti-Xa activity measurement in renally impaired patients;
Croatian: • pažljivi biološki nadzor mjerenjem aktivnosti anti-Xa u bolesnika s oštećenjem jetre;
English: • The presentation 10,000 IU (100 mg)/10 mL solution for injection is used only for extracorporeal dialysis, and hence only this indication is covered in section 4.1,
Croatian: • Primjena otopine od 10,000 IU (100 mg)/10 mL za injektiranje koristi se samo za vantjelesnu dijalizu i stoga je samo ta indikacija pokrivena u odjeljku 4.1,
English: Due to divergent information across Member States, updates were also made in further subsections including paediatric population, elderly, hepatic and renal impairment in line with the agreed indications and based on available data in these populations.
Croatian: Zbog različitih informacija u državama članicama unesene su izmjene i u daljnje pododjeljke koji uključuju pedijatrijsku populaciju, starije osobe, oštećenja jetre i bubrega u skladu s dogovorenim indikacijama i na temelju dostupnih podataka za te skupine.
English: The principal pharmacological properties of enoxaparin include antifactor Xa and antifactor IIa (antithrombin) activity, which are dependent on its binding affinity for antithrombin.
Croatian: Glavna farmakološka svojstva enoksaparina uključuju djelovanje antifaktora Xa i IIa (antitrombin) koji su ovisni o sposobnostima vezanja za antitrombin.
English: The CHMP considered keeping the indication in line with the most common wording accepted in the countries.
Croatian: CHMP uskladio je indikaciju s najuobičajenijim tekstom koji je prihvaćen u tim državama.
English: As harmonisation of expression of strength to one of the options would have led to changes to the established practice in several countries, and as this may increase the risk of medication errors leading to higher risk of thrombosis or major bleeding, the wording has been amended to express the strength in both units (in IU anti-Xa/mL and its equivalence in mg/ml) on the outer-carton and immediate packaging (syringe) and in sections 1, 2 and 4.2.
Croatian: Budući da bi usklađivanje izražavanja jakosti jedne od mogućnosti dovelo do promjena prihvaćene prakse u nekoliko zemalja, povećanja rizika od pogrešaka pri davanju lijekova i većeg rizika od tromboze ili ozbiljnog krvarenja, tekst je izmijenjen kako bi izrazio jačinu u obje jedinice (u IU anti-Xa/mL i istoznačnoj vrijednosti u mg/ml) na vanjskoj ambalaži i pakiranju (štrcaljka) te u odjeljcima 1, 2 i
English: • use of multiple dose vials containing benzyl alcohol in newborns or premature neonates due to risk of gasping syndrome in this population.
Croatian: • upotreba bočica s više doza koje sadrže benzil alkohol u novorođenčadi ili prijevremeno rođene djece zbog rizika od sindroma teškog disanja u toj skupini.
English: The section was harmonised to address variations in the exact wording in prophylaxis and treatment indications.
Croatian: Ovaj je odjeljak usklađen kako bi se u obzir uzele varijacije u točnom tekstu u pogledu profilakse i indikacija za liječenje.
English: Other populations
Croatian: Druge grupe bolesnika
English: • to be used with extreme caution in patients with a history (>100 days) of heparin-induced thrombocytopenia without circulating antibodies;
Croatian: • oprezno koristiti u bolesnika s poviješću (>100 dana) trombocitopenije izazvane heparinom bez cirkulirajućih antitijela;
English: Further sub-sections were added to provide information on switch between enoxaparin sodium and oral anticoagulants as well as recommendations for administration in spinal/epidural anaesthesia or lumbar puncture.
Croatian: Daljnji pododjeljci dodani su radi pružanja informacija o prelasku s enoksaparin-natrija na oralne antikoagulanse, kao i davanja preporuka za primjenu tijekom spinalne/epiduralne anestezije ili lumbalne punkcije.
English: • Hypersensitivity to enoxaparin sodium, heparin or its derivatives, including other low molecular weight heparins (LMWH) or to any of the excipients;
Croatian: • Preosjetljivost na enoksaparin-natrij, heparin ili njegove derivate, uključujući druge heparine niske molekularne težine ili druge pomoćne tvari;
English: In general, the sub-sections on posology and method of administration were aligned with the harmonised indications for enoxaparin.
Croatian: Općenito, pododjeljci o doziranju i načinu primjene usklađeni su s usklađenim indikacijama za enoksaparin.
English: In view of prevention of extracorporeal thrombus during haemodialysis, all Member States had this indication in the PI, except the Netherlands who did not find the data using the dosing scheme proposed at the time of initial Marketing authorisation sufficient.
Croatian: U pogledu prevencije stvaranja tromba u vantjelesnoj cirkulaciji tijekom hemodijalize, sve su države članice imale tu indikaciju u informacijama o lijeku osim Nizozemske koja predložene podatke o doziranju nije smatrala dostatnim u vrijeme početnog odobrenja za stavljanje lijeka u promet.
English: The wording for the indication in this population therefore includes now disease in medical patients with an acute illness (such as acute heart failure, respiratory insufficiency, severe infections or rheumatic diseases) and reduced mobility at increased risk of venous thromboembolism.
Croatian: Tekst indikacije za tu skupinu stoga obuhvaća bolesnike s akutnom bolesti (na primjer akutno zatajenje srca, respiratorno zatajenje, teške infekcije kao i reumatske bolesti) i smanjenom mobilnosti kao bolesnike s visokim rizikom o venske tromboembolije.
English: • the Committee considered the referral under Article 30 of Directive 2001/83/EC,
Croatian: Direktive 2001/83/EZ
English: The CHMP referred also for this indication to the existing ACCP guidelines, and further preferred a wording more in line with the current recommendations for thromboprophylaxis in acutely ill medical patients in the literature.
Croatian: CHMP je i tu indikaciju uključio u postojeće smjernice ACCP-a te je predložio tekst koji je usklađeniji s trenutačnim preporukama za tromboprofilaksu u bolesnika s akutnim bolestima u literaturi.
English: • spinal or epidural anaesthesia or loco-regional anaesthesia when enoxaparin sodium is used for treatment in the previous 24 hours (with a reference to section 4.4);
Croatian: • spinalna ili epiduralna anestezija ili lokoregionalna anestezija kada se koristi enoksaparinnatrij za liječenje u posljednja 24 sata (upućivanje na odjeljak 4.4);
English: Some Member States had a contra-indication for severe renal impairment (clearance < 30 mL/min) in the therapeutic indications, which has been removed as part of the referral based on available data supporting use in this population.
Croatian: Neke države članice imale su kontraindikaciju ozbiljnog oštećenja jetre (klirens < 30 mL/min) u terapijskim indikacijama koja je uklonjena u upućivanju na temelju dostupnih podataka koji podržavaju upotrebu u toj skupini.
English: • The pen presentation (10 x 4,000 IU (10x 40 mg)) contains all approved indications except use in extracorporeal dialysis.
Croatian: • Primjena olovke (10 x 4,000 IU (10x 40 mg)) sadrži sve odobrene indikacije osim uporabe u vantjelesnoj dijalizi.
English: • the scope of the referral was the harmonisation of the product information,
Croatian: • predmet upućivanja bilo je usklađivanje informacija o lijeku,
English: However, the CHMP considered that acetylsalicylic acid (ASA) should be recommended at dose from 75 mg to 325 mg in the SmPC to be in line with clinical data and clinical practice.
Croatian: Međutim, CHMP smatra da bi se u sažecima opisa svojstava lijeka trebala preporučiti primjena acetilsalicilatne kiseline u dozi od 75 mg do 325 mg kako bi bila u skladu s kliničkim podacima i praksom.
English: The SmPC was aligned to state the recommended dose as accepted in most countries of 1mg/kg, which is in line with the clinical data and with the recommendations from treatment guidelines.
Croatian: Sažeci opisa svojstava lijeka usklađeni su tako da navode preporučenu dozu koja je prihvaćena u većini zemalja, 1 mg/kg, a to je u skladu s kliničkim podacima i preporukama u smjernicama za liječenje.
English: The product is currently registered in the EU under concentrations of 100 mg/mL (equivalent to 10 000 IU anti Xa/mL) in prefilled syringes, multi-dose vials, ampoules, and 150 mg/mL (equivalent to 15 000 IU anti Xa/mL) in prefilled syringes.
Croatian: Ovaj je proizvod trenutačno registriran u EU-u u koncentraciji od 100 mg/mL (jednako 10 000 IU anti-Xa/mL) u unaprijed napunjenim štrcaljkama, bočicama s više doza, ampulama i u koncentraciji od 150 mg/mL (jednako 15 000 IU anti-Xa/mL) u unaprijed napunjenim štrcaljkama.
English: For treatment of acute ST-segment elevation myocardial infarction, the CHMP noted that the pivotal study (ExTRACT-TIMI 25) was carried out in STEMI patients fulfilling the following criteria:
Croatian: U pogledu liječenja akutnog infarkta miokarda sa ST elevacijom CHMP je ukazao na to da je glavno ispitivanje (ExTRACT-TIMI 25) provedeno na bolesnicima s infarktom miokarda sa ST elevacijom koji ispunjavaju sljedeće kriterije:
English: • use of enoxaparin is not recommended for patients with end stage renal disease due to lack of data in this population outside the prevention of thrombus formation in dialysis patients;
Croatian: • upotreba enoksaparina ne preporučuje se u bolesnika s bolesti jetre u zadnjoj fazi zbog nedostatka podataka za tu skupinu, osim podataka o sprječavanju stvaranja tromba u bolesnika na dijalizi;
English: The terminology used for the indication prophylaxis of venous thromboembolism in medical patients varied across Member States.
Croatian: Terminologija koja se koristi za indikaciju venske tromboembolije u bolesnika razlikuje se u državama članicama.
English: • the Committee considered the divergences identified in the notification for Lovenox and associated names, as well as the remaining sections of the product information,
Croatian: • Odbor je razmotrio utvrđene različitosti u prijavi za lijek Lovenox i povezane nazive te preostale odjeljke informacija o lijeku.
English: The CHMP as a consequence, concluded that the benefit-risk balance of Lovenox and associated names remains favourable, subject to the agreed changes to the product information and the condition to the marketing authorisation.
Croatian: Posljedično, CHMP je zaključio da omjer koristi i rizika za Lovenox i povezane nazive ostaje povoljan pod uvjetom da se u informacije o lijeku i odobrenje za stavljanje u promet unesu dogovorene izmjene.
English: • reduction of dosage in patients above 75 years old treated by enoxaparin for ST-segment elevation myocardial infarction (STEMI);
Croatian: • smanjenje doze u bolesnika starijih od 75 godina koji akutni infarkt miokarda sa ST elevacijom (STEMI) liječe enoksaparinom;
English: The harmonised indication therefore states prophylaxis of venous thromboembolic disease in moderate and high risk surgical patients, in particular those undergoing orthopaedic or general surgery including cancer surgery.
Croatian: Usklađena indikacija stoga navodi profilaksu venske tromboembolijske bolesti u bolesnika s umjerenim i visokim rizikom, posebno u onih koji se podvrgavaju ortopedskom ili općekirurškom zahvatu, uključujući onkolške zahvate.
English: A previously existing contraindication for use in patients with end stage renal disease (creatinine clearance <15 mL/min) was also removed due to lack of safety data in this population justifying a contraindication, however use in this population is not recommended, as outlined below.
Croatian: Kontraindikacija koja je postojala za upotrebu u bolesnika s bolesti jetre u zadnjoj fazi (klirens kreatinina <15 mL/min) također je uklonjena zbog nedostatka sigurnosnih podataka u pogledu te skupine koji bi opravdali kontraindikaciju, međutim upotreba u toj skupini ne preporučuje se kako je istaknuto u nastavku.
English: • The Summary of Product Characteristics (SmPC) and Package Leaflet (PL) covering vials, ampoules and prefilled syringes covers all approved indications,
Croatian: • Sažetak opisa svojstava lijekova i uputa o lijeku koja se odnosi na bočice, ampule i napunjene štrcaljke pokriva sve odobrene indikacije,
English: The regimen should be selected by the physician based on an individual assessment including evaluation of the thromboembolic risk and the bleeding risk.
Croatian: Liječnik bi trebao odabrati način liječenja na temelju individualne procjene, uključujući procjenu rizika od tromboembolije i krvarenja.
English: • in patients with severe renal impairment (creatinine clearance 15-30 mL/min), since exposure of enoxaparin sodium is significantly increased, a dosage adjustment is recommended for therapeutic and prophylactic dosage ranges;
Croatian: • u bolesnika s ozbiljnim oštećenjem jetre (klirensk kreatinina15-30 mL/min) preporučuje se prilagodba raspona doza za terapijske ili profilaktičke doze jer je izloženost enoksaparinnatriju značajno povećana;
English: Changes introduced in the SmPC were consistently reflected in the labelling where relevant, however some sections were left to be completed nationally.
Croatian: Izmjene sažetka opisa svojstava lijeka dosljedno su se odražavale u označivanju, ako je bilo potrebno, međutim sadržaj nekih odjeljaka određivao se na nacionalnoj razini.
English: The CHMP also considered that the regimen should be selected by the physician based on an individual assessment including evaluation of the thromboembolic risk and of the risk of bleeding.
Croatian: CHMP također smatra da bi liječnik trebao odabrati način liječenja na temelju individualne procjene, uključujući procjenu rizika od tromboembolije i krvarenja.
English: For prophylaxis of venous thromboembolism (VTE) in surgical patients, the CHMP considered that it would be relevant to label the indication on the patient's level of thrombotic risk in line with the American College of Clinical Pharmacy (ACCP) Guidelines.
Croatian: Za profilaksu venske tromboembolije u bolesnika koji se podvrgavaju kirurškom zahvatu, CHMP smatra da bi u bolesnika trebalo označiti indikaciju za razinu rizika od tromboze u skladu sa smjernicama AMeričke udruge za kliničku farmakologiju (ACCP).
English: The CHMP noted that in the current ESC guideline, ASA is recommended for all patients without contraindications at an initial oral loading dosed of 150-300 mg (in aspirin-naive patients) and a maintenance dose of 75-100 mg/day longterm regardless of the treatment strategy.
Croatian: CHMP je utvrdio da se u trenutačnim smjernicama ESC-a preporučuje dugoročna primjena acetilsalicilatne kiseline za sve bolesnike bez kontraindikacija u početnoj oralnoj dozi od 150 - 300 mg (u bolesnika koji nisu primali aspirin) i u dozi održavanja od 75 - 100 mg dnevno, bez obzira na način liječenja.
English: - Medically managed patients (not undergoing primarily invasive procedure such as percutaneous coronary intervention (PCI) or coronary bypass artery surgery (CABG);
Croatian: - bolesnici koji se bolnički liječe (koji se ne podvrgavaju primarnom invazivnom zahvatu kao što je perkutani koronarni zahvat ili operacija premošćivanja koronarne arterije);
English: For STEMI, the higher dose on the first day as used in the study ExTRACT-TIMI 25 should be mentioned.
Croatian: Valja napomenuti primjenu veće doze prvog dana za STEMI, kako se primjenjivala u ispitivanju ExTRACT-TIMI
English: Due to the divergent national decisions taken by Member States (MSs) concerning the authorisation of the above-mentioned product and its associated names, France notified the CHMP/European Medicines Agency of a referral under Article 30 of Directive 2001/83/EC for the above-mentioned product, in order to resolve divergences amongst the nationally authorised product information (PI) and thus to harmonise its divergent PIs across the EU.
Croatian: Zbog različitih odluka na nacionalnoj razini koje su donijele države članice u pogledu odobrenja za prethodno navedeni proizvod (i srodne lijekove) Francuska je obavijestila Odbor za lijekove za humanu uporabu (CHMP) / Europsku agenciju za lijekove o pokretanju postupka upućivanja u skladu s člankom 30.
English: For treatment of deep venous thromboembolism, the exact wording varied across Member States, and the CHMP considered harmonising the indication to include treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) excluding PE likely to require thrombolytic therapy or surgery.
Croatian: Točan tekst koji se odnosi na liječenje duboke venske tromboembolije razlikovao se u državama članicama te je CHMP razmotrio usklađivanje indikacije kako bi obuhvaćala liječenje duboke venske tromboze i plućne embolije, isključujući plućnu emboliju koja vjerojatno zahtijeva trombolitičku terapiju ili operaciju.
English: In view of this indication, the CHMP noted the consensus document of the Joint ESC/American College of Cardiology Committee for the redefinition of myocardial infarction (MI), which led to the revision of the definition of acute coronary syndromes (ACS) to UA and NSTEMI.
Croatian: Uzimajući u obzir tu indikaciju, CHMP je ukazao na konsenzus dokument zajedničkog odbora ESC-a / Američkog kardiološkog društva o promjeni definicije infarkta miokarda.
English: For treatment of DVT and PE the CHMP considered, based on the data provided and available treatment guidelines, that the harmonised wording should include a once daily injection of 150 IU/kg (1.5 mg/kg) or a twice daily injections of 100 IU/kg (1 mg/kg) in DVT and PE patients.
Croatian: Za liječenje duboke venske tromboze i plućne embolije CHMP je na temelju dostupnih podataka i postojećih smjernica za liječenje utvrdio da bi usklađeni tekst trebao obuhvaćati primjenu injekcije od 150 IU/kg (1,5 mg/kg) jednom dnevno ili injekcije od 100 IU/kg (1 mg/kg) dvaput dnevno u bolesnika s dubokom venskom trombozom i plućnom embolijom.
English: Treatment of acute ST-segment elevation myocardial infarction (STEMI)
Croatian: Liječenje akutnog infarkta miokarda sa ST elevacijom (STEMI)
English: • the Committee reviewed the totality of the data submitted by the MAH in support of the proposed harmonisation of the product information,
Croatian: • Odbor je pregledao sve podatke koje je dostavio nositelj odobrenja za stavljanje lijeka u promet u korist predloženog usklađivanja informacija o lijeku.
English: The strength of the product is expressed differently in the different MSs, either in mg or in activity IU anti-factor Xa.
Croatian: Jakost lijeka izražava se različito u različitim državama članicama, ili pomoću miligrama ili pomoću aktivnosti IU antifaktora Xa.
English: Dosing in prophylaxis of venous thromboembolism in medical patients was harmonised to be aligned with ACCP guidelines.
Croatian: Doziranje profilakse venske tromboembolije u bolesnika usklađena s smjernicama ACCP-a.
English: Treatment of unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)
Croatian: Liječenje nestabilne angine (UA) i infarkta miokarda bez ST elevacije (NSTEMI)
English: Prevention of thrombus formation during haemodialysis
Croatian: Prevencija stvaranja tromba tijekom hemodijalize
English: • not to use perform spinal/epidural anaesthesia or lumbar puncture during treatment with enoxaparin;
Croatian: • tijekom liječenja enoksaparinom ne smije se uzimati spinalna/epiduralna anestezija niti provoditi lumbalna punktura;
English: • the Committee agreed on a harmonised product information for Lovenox and associated names, the CHMP recommended the variation to the terms of the marketing authorisations for which the product information is set out in Annex III for Lovenox and associated names (see Annex I).
Croatian: CHMP je za Lovenox i povezane nazive (vidjeti Prilog I.) preporučio izmjene uvjeta odobrenja za stavljanje lijeka u promet, za koje su odobrenje, sažetak opisa svojstava lijeka, označavanje i uputa o lijeku navedeni u Prilogu III.