FrancophonIA/ELRC3.0 huggingface dataset:
English: The CHMP agreed with the MAH proposal to include this adverse effect of thiazides in section 4.8 but not under 4.4.
Slovenian: CHMP se je strinjal s predlogom imetnika dovoljenja za promet z zdravilom ter vključil ta neželeni učinek tiazidov v poglavje 4.8 in ne v poglavje 4.4.
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.
Slovenian: Največji antihipertenzivni učinek pri kombinacijski terapiji (to je 15 mm Hg) ni povzročil povečane pojavnosti hipotenzivnih dogodkov, kar bi bilo lahko posebej zaskrbljujoče pri starejših bolnikih.
English: Doubling the initial dose (5.0 mg cilazapril 12.5 mg hydroclorthiazide) resulted in a further increase in efficacy.
Slovenian: Podvojitev prvotnega odmerka (5,0 mg cilazaprila; 12,5 mg hidroklorotiazida) je povzročila še večje povečanje učinkovitosti.
English: Estimates of frequency were based on the proportion of patients reporting each adverse reaction during Vascace Plus clinical trials.
Slovenian: Ocene pogostnosti so utemeljene na deležu bolnikov, ki so poročali o posameznem neželenem učinku med kliničnim preskušanjem zdravila Vascace Plus.
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”.
Slovenian: CHMP je potrdil naslednje usklajeno besedilo za odmerjanje: „Odmerek zdravila Vascace Plus je ena tableta (5,0 mg cilazaprila in 12,5 mg hidroklorotiazida) enkrat na dan.“
English: The information which is given about the possible interactions and their outcome are endorsed by the CHMP.
Slovenian: CHMP je potrdil navedene podatke o možnih interakcijah in njihovih rezultatih.
English: To support the proposed indication the MAH presented 4 placebo controlled clinical trials sponsored by Roche and run in 2.084 hypertensive patients.
Slovenian: Imetnik dovoljenja za promet z zdravilom je v podporo predlagani indikaciji predstavil štiri s placebom nadzorovana klinična preskušanja, ki jih je financirala družba Roche in v katerih je sodelovalo 2 084 bolnikov s hipertenzijo.
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)”.
Slovenian: Ker pričetek zdravljenja s fiksno kombinacijo ni predviden, je CHMP potrdil naslednje besedilo: „V kliničnih študijah sta bila učinkovitost in prenašanje cilazaprila in hidroklorotiazida, ki so ju bolniki jemali sočasno, pri starejših in mlajših bolnikih s hipertenzijo podobna, čeprav farmakokinetični podatki kažejo, da je očistek obeh učinkovin pri starejših bolnikih zmanjšan (glejte poglavje 5.2).“
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.
Slovenian: Nekatere države so pri opozorilih dodale dodatne informacije v zvezi s tveganjem hipotenzije, v povezavi z renovaskularno hipertenzijo/stenozo ledvične arterije, presaditvijo ledvic, uporabo pri obstoječem popuščanju srca, anemiji, kašlju, etničnih skupinah, primarnem aldosteronizmu in jemanju prepovedanih poživil.
English: Based on these data the combination of cilazapril 5 mg with hydrochlorothiazide 12.5 mg, given once daily, is a rational clinical choice for patients whose blood pressure is not normalized on cilazapril monotherapy.
Slovenian: Na podlagi teh podatkov je kombinacija 5 mg cilazaprila in 12,5 mg hidroklorotiazida enkrat na dan racionalna klinična izbira za bolnike, pri katerih se krvni tlak pri monoterapiji s cilazaprilom ne normalizira.
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.
Slovenian: CHMP je sklenil, da je treba kontraindikacijo za prvo trimesečje nosečnosti izbrisati iz podatkov o zdravilu Vascace Plus, podatke o zdravilu pa posodobiti, da bodo vključevali besedilo, ki ga je za nosečnost in dojenje priporočila delovna skupina za farmakovigilanco.
English: The CHMP, considering that there is plausible effect based on the pharmacologic action of the drug to affect the ability to drive, endorsed the following: “When driving and operating machines, it should be taken into account that occasionally dizziness and fatigue may occur during treatment with Vascace Plus (see sections 4.4 and 4.8)”.
Slovenian: Ob upoštevanju, da bi zaradi farmakološkega delovanja zdravilo lahko vplivalo na sposobnost vožnje, je CHMP potrdil besedilo: „Pri vožnji in upravljanju s stroji je treba upoštevati, da se med zdravljenjem z zdravilom Vascace Plus lahko občasno pojavita omotica in utrujenost (glejte poglavji 4.4 in 4.8).“
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.
Slovenian: Vendar imetnik dovoljenja za promet z zdravilom ni predlagal vključitve takšnega opozorila, saj je menil, da je to implicirano v opozorilu, da je pri bolnikih potrebno redno nadzorovanje delovanja ledvic in elektrolitov, kar pa je vključeno v predlagano besedilo povzetka glavnih značilnosti zdravila.
English: Considering this, the MAH suggested to include a warning concerning the use of thiazides in patients with a history of gout, but not to include gout as a contraindication.
Slovenian: Ob upoštevanju navedenega je imetnik dovoljenja za promet z zdravilom predlagal vključitev opozorila glede uporabe tiazidov pri bolnikih z anamnezo protina, vendar brez vključitve protina kot kontraindikacije.
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.
Slovenian: CHMP je prav tako menil, da dodajanje zdravila hidroklorotiazidu in bolnikom, ki se ne odzivajo na samostojno zdravljenje s hidroklorotiazidom, ni sprejemljivo, saj je pri kombinacijski terapiji s fiksnimi odmerki na voljo le največji odmerek cilazaprila, odmerek pa je treba titrirati s posameznimi sestavinami.
English: The MAH acknowledged the number of contraindications in the SPCs of Members States and explained that:
Slovenian: Imetnik dovoljenja za promet z zdravilom je upošteval število kontraindikacij v povzetkih glavnih značilnosti zdravila držav članic in pojasnil:
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.
Slovenian: Po pregledu in razpravi o teratogenem potencialu zaviralcev ACE je delovna skupina za farmakovigilanco sklenila, da ob upoštevanju omejenih dokazov v zvezi s teratogenim tveganjem kontraindikacija zaviralcev ACE v prvem trimesečju nosečnosti ni upravičena.
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.
Slovenian: Priporočilo za odmerjanje enkrat na dan temelji na ugotovitvi, da navidez subterapevtski odmerek hidroklorotiazida v kombinaciji s cilazaprilom povzroči večji antihipertenzivni učinek.
English: Several Vascace Plus SPCs included a warning concerning the effect of thiazide on lipid profile.
Slovenian: Več povzetkov glavnih značilnosti zdravila Vascace Plus je vključevalo opozorilo glede učinka tiazidov na profil lipidov.
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.
Slovenian: Več organizacij (na primer Evropska pobuda za porfirijo, http://www.porphyria-europe.com/03-drugs/drugs-and-porphyrias.asp; Podatkovna zbirka zdravil za akutno porfirijo http://www.drugs-porphyria.com) je hidroklorotiazid označilo kot „varen“ ali „verjetno varen“.
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.
Slovenian: Antihipertenzivni učinek v skupini, zdravljeni s kombinirano terapijo, je bil stabilen skozi celotno trajanje te dolgotrajne študije, po obsegu pa je bil podoben učinku, zaznanem po prvih tednih zdravljenja s kombinacijsko terapijo cilazaprila/hidroklorotiazida, pri katerem se ni razvila toleranca na zdravljenje.
English: The dosing recommendations given for patients with cirrhosis/impaired liver function varied considerably among MSs.
Slovenian: Priporočila za odmerjanje za bolnike s cirozo/okvarjenim delovanjem jeter so se med posameznimi državami članicami močno razlikovala.
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.
Slovenian: Zdravilo Vascace Plus je bilo dodano na seznam zdravil, za katera je potrebna uskladitev povzetka glavnih značilnosti zdravila zaradi različnih nacionalnih odločitev držav članic glede odobritve zdravila.
English: Some SPCs included under the heading “hypotension” warnings about the use of anaesthetics.
Slovenian: Nekateri povzetki glavnih značilnosti zdravila so pod naslovom „Hipotenzija“ vključevali opozorila glede uporabe anestetikov.
English: The MAH used the published meta-analyses of mono- and combination therapy as basis for this section.
Slovenian: Imetnik dovoljenja za promet z zdravilom je kot podlago za to poglavje uporabil objavljene meta analize monoterapije in kombinacijske terapije.
English: The CHMP agreed with such approach.
Slovenian: CHMP se je s tem stališčem strinjal.
English: • conditions for which Vascace Plus is not the recommended treatment (e.g. hyperaldosteronism), rather than causing specific harm, are listed as `contraindications'.
Slovenian: • kot kontraindikacije so bila navedena stanja, pri katerih se zdravilo Vascace Plus ne priporoča za zdravljenje (na primer hiperaldosteronizem), čeprav ne povzroča posebne škode.
English: Vascace Plus is used in the treatment of hypertension in patients not responding satisfactorily to each component administered alone.
Slovenian: Zdravilo Vascace Plus se uporablja za zdravljenje hipertenzije pri bolnikih, ki se ne odzivajo zadostno na samostojno zdravljenje s posamezno zdravilno učinkovino.
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).
Slovenian: Ocenjevanje učinka kombinacije na zniževanje krvnega tlaka v teh preskušanjih je pokazalo, da dodajanje hidroklorotiazida zdravljenju s cilazaprilom povečuje znižanje diastoličnega krvnega tlaka v sedečem položaju.
English: The comment concerning the greater risk of hypotension in patients with cirrhosis, already included in some SPCs, was supported by Meyler's review.
Slovenian: Pripombo glede povečanega tveganja hipotenzije pri bolnikih s cirozo, ki je že vključena v nekatere povzetke glavnih značilnosti zdravila, je potrdila tudi Meylerjeva literatura.
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.
Slovenian: Imetnik dovoljenja za promet z zdravilom je moral vključiti tudi možne interakcije hidroklorotiazida z digoksinom in na seznam vključiti še zdravila, kot so nedepolarizirajoči mišični relaksanti, kalcijeve ploščice in vitamin D, antiholinergiki, amantidin, citotoksična zdravila, ciklosporin.
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.
Slovenian: Rezultati enega preskušanja (protokol št. N2960C) so pokazali, da se je pri bolnikih pred dodajanjem hidroklorotiazida diastolični krvni tlak v sedečem položaju znižal za 4,3 mm Hg, po dodanem hidroklorotiazidu pa za 11,1 mm Hg.
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.
Slovenian: Preskušanja so bila izvedena z bolniki, randomiziranimi v eno od več možnih skupin za samostojno ali kombinacijsko terapijo z odmerki cilazaprila 0,5 mg, 1,0 mg ali 2,5 mg ter z odmerki hidroklorotiazida 6,25 mg, 12,5 mg ali 25 mg. Najnižji odmerek, pri katerem se je pokazal pomemben učinek, je bil 2,5/6,25 mg.
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.
Slovenian: Vendar pa pregled literature kaže, da nizek odmerek hidroklorotiazida (na primer 12,5 mg/dnevno) le malo vpliva na povečanje koncentracije sečne kisline v serumu in le do takšne mere, ki morda ni klinično pomembna.
English: The analysis of individual studies suggested that virtually all cilazapril doses administered with 25 mg hydrochlorothiazide have similar effects on trough blood pressure.
Slovenian: Analiza posameznih študij je pokazala, da skorajda vsi odmerki cilazaprila, dani sočasno s 25 mg hidroklorotiazida, podobno učinkujejo na spodnji krvni tlak.
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).
Slovenian: Imetnik dovoljenja za promet z zdravilom je predlagal krajši opis simptomov/znakov angioedema, kot je v nekaterih trenutno veljavnih povzetkih glavnih značilnosti zdravila, in uporabo izraza „akutni orofaringealni edem in obstrukcija dihalnih poti“ (kot je navedeno v Meylerjevi literaturi).
English: Vascace Plus is a combination of cilazapril (an angiotensin-converting enzyme inhibitor) and hydrochlorothiazide (a thiazide-diuretic agent).
Slovenian: Zdravilo Vascace Plus je kombinacija cilazaprila (zaviralca angiotenzinske konvertaze) in hidroklorotiazida (tiazidnega diuretika).
English: The CHMP, on the basis of these considerations, endorsed the following harmonised wording for the indication: “Vascace Plus is indicated for the treatment of hypertension in patients whose blood pressure is not adequately controlled with cilazapril alone”
Slovenian: Na podlagi teh premislekov je CHMP podprl naslednje usklajeno besedilo za indikacijo: „Zdravilo Vascace Plus je indicirano za zdravljenje hipertenzije pri bolnikih, pri katerih zdravljenje samo s cilazaprilom ne zagotavlja ustreznega uravnavanja krvnega tlaka.“
English: The list of drugs which may interact either with cilazapril or with hydrochlorothiazide was updated.
Slovenian: Posodobljen je bil seznam zdravil, ki lahko medsebojno delujejo s cilazaprilom ali hidroklorotiazidom.
English: Given this, the MAH proposed to modify the wording as follow: “Vascace Plus should be used with caution in patients with porphyria”.
Slovenian: Ob upoštevanju tega je imetnik dovoljenja za promet z zdravilom predlagal naslednjo spremembo besedila: „Pri bolnikih s porfirijo je treba zdravilo Vascace Plus uporabljati previdno.“
English: Lipid profile
Slovenian: Profil lipidov
English: Serum electrolytes
Slovenian: Koncentracija elektrolitov v serumu
English: Moreover, the names and order of System Organ Classes (SOCs) have been aligned for cilazapril and hydrochlorothiazide according to MedDRA.
Slovenian: Poleg tega so bili imena in razvrstitev skupin organskih sistemov za cilazapril in hidroklorotiazid usklajeni po klasifikaciji MedDRA.
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.
Slovenian: Sprejemljivo je tudi dodatno zdravljenje s cilazaprilom, saj je odmerek hidroklorotiazida nizek in primeren kot začetni odmerek v kombinacijski terapiji bolnikov, ki se ne odzivajo na zdravljenje z zaviralci ACE, na voljo pa so tudi podatki o učinkovitosti in varnosti pri bolnikih, ki se ne odzivajo na monoterapijo s cilazaprilom.
English: From these patients 108 patients had initially been treated with cilazapril and 106 patients with hydrochlorothiazide.
Slovenian: 108 izmed njih so najprej zdravili s cilazaprilom, 106 pa s hidroklorotiazidom.
English: The text suggested for this section of the harmonized label was identical to the wording in the CDS.
Slovenian: Predlagano besedilo v tem poglavju usklajenega označevanja je bilo enako besedilu v podatkovnem listu s temeljnimi podatki.
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.
Slovenian: Imetnik dovoljenja za promet z zdravilom je predložil dovolj natančna navodila za zdravljenje v primeru prevelikega odmerjanja kombinacije cilazaprila/hidroklorotiazida, saj preveč podrobni podatki morda ne bi ustrezno odražali stanja posameznega bolnika v primeru prevelikega odmerjanja.
English: In addition to the patients of these clinical trials the efficacy of the combination was also assessed in 1.297 patients of the original cilazapril monotherapy new drug application (NDA) who were treated with cilazapril and adjunctive hydrochlorothiazide (HCTZ).
Slovenian: Učinkovitost kombinacije so poleg teh kliničnih preskušanj ocenjevali tudi pri 1 297 bolnikih v okviru prvotne vloge za novo zdravilo za monoterapijo s cilazaprilom, ki so bili zdravljeni s cilazaprilom in dodatnim hidroklorotiazidom.
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.
Slovenian: Predlagano besedilo je bilo skladno z besedilom, uporabljenim v veljavnih lokalnih povzetkih glavnih značilnosti zdravila Vascace Plus in je enako kot predlagano besedilo pregledane različice usklajenega povzetka glavnih značilnosti zdravila Vascace v EU .
English: The wording proposed by the MAH integrated all information provided in individual SPCs in different countries.
Slovenian: Predlagano besedilo imetnika dovoljenja za promet z zdravilom je vključevalo vse podatke, navedene v posameznih povzetkih glavnih značilnosti zdravila v različnih državah.
English: Of these, 68 patients responded to monotherapy with cilazapril and 70 patients to hydrochlorothiazide.
Slovenian: Na monoterapijo s cilazaprilom se je odzvalo 68 bolnikov, na monoterapijo s hidroklorotiazidom pa 70 bolnikov.
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)”.
Slovenian: CHMP je potrdil besedilo: „Ker se pri bolnikih s cirozo jeter, ki se zdravijo s standardnimi odmerki zaviralcev ACE, lahko pojavi znatna hipotenzija, je pri titraciji odmerka vsake posamezne učinkovine potrebna posebna pozornost, če bolniki s cirozo jeter potrebujejo zdravljenje s cilazaprilom in hidroklorotiazidom (glejte poglavje 4.4).“
English: Where warnings and precautions concerned cilazapril, the MAH proposed a text similar to that used in the recently harmonized Vascace.
Slovenian: Na mestih, kjer se opozorila in previdnosti ukrepi nanašajo na cilazapril, je imetnik dovoljenja za promet z zdravilom predlagal podobno besedilo, kot je bilo uporabljeno pri nedavni uskladitvi besedila za zdravilo Vascace.
English: Reviewing recent publications on this topic information on the pharmacokinetic properties of cilazapril and hydrochlorothiazide, which was considered relevant for physicians to treat their patients with Vascace Plus and which should be included in this document was not identified.
Slovenian: Ob pregledu novejših publikacij o tej temi niso bili odkriti novi podatki o farmakokinetičnih lastnostih cilazaprila in hidroklorotiazida, za katere zdravniki menili, da bi bili lahko pomembni pri zdravljenju bolnikov z zdravilom Vascace Plus in bi jih bilo treba vključiti v ta dokument.
English: Reviewing recent publications on this topic new information on cilazapril, which was considered relevant for physicians to treat their patients with Vascace Plus and which should be included in this document was not identified.
Slovenian: Ob pregledu novejših publikacij o tej temi niso bili odkriti novi podatki o cilazaprilu, za katere bi zdravniki menili, da bi bili lahko pomembni pri zdravljenju bolnikov z zdravilom Vascace Plus in bi jih bilo treba vključiti v ta dokument.
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.
Slovenian: V nekaterih povzetkih glavnih značilnosti zdravila Vascace Plus je bil protin naveden kot kontraindikacija, v večini drugih povzetkov in v podatkovnem listu s temeljnimi podatki pa je bil vključen v poglavje 4.4.
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.
Slovenian: Trenutni podatkovni list s temeljnimi podatki in nekateri povzetki glavnih značilnosti zdravila so na podlagi opozorila v pregledu literature Martindalea vključevali opozorilo glede uporabe tiazidov pri bolnikih s porfirijo.
English: The CHMP endorsed this section.
Slovenian: CHMP je to poglavje potrdil.
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.
Slovenian: Pregledano predlagano besedilo glede dojenja je bilo usklajeno s potrjenim povzetkom glavnih značilnosti zdravila Vascace, z majhnimi spremembami, ki odražajo kombinacijo cilazaprila in hidroklorotiazida.
English: The MAH proposed to include a warning concerning hypotension and renal impairment resulting from combination therapy with cilazapril and hydrochlorothiazide in patients with renal artery stenosis.
Slovenian: Imetnik dovoljenja za promet z zdravilom je predlagal vključitev opozorila glede hipotenzije in okvare ledvic, ki sta posledici zdravljenja s kombinacijsko terapijo s cilazaprilom in hidroklorotiazidom pri bolnikih s stenozo ledvične arterije.