FrancophonIA/ELRC3.0 huggingface dataset:
English: In such patients it is advisable to introduce entacapone treatment as a separate treatment (entacapone tablets) and adjust the levodopa dose if necessary, before switching to Levodopa/Carbidopa/Entacapone Orion.
Danish: Hos disse patienter kan det anbefales at introducere entacaponbehandling separat (entacapontabletter) og om nødvendigt justere levodopadoseringen, før der igangsættes behandling med Levodopa/Carbidopa/Entacapone Orion.
English: You may experience the following side effects: - Inability to resist the impulse to perform an action that could be harmful, which may include: - strong impulse to gamble excessively despite serious personal or family consequences - altered or increased sexual interest and behaviour of significant concern to you or to others, for example, an increased sexual drive - uncontrollable excessive shopping or spending - binge eating (eating large amounts of food in a short time period) or compulsive eating (eating more food than normal and more than is needed to satisfy your hunger).
Danish: Du kan få følgende bivirkninger: - Ikke være i stand til at modstå lysten til at udføre aktiviteter, der kan være skadelige Det kan omfatte: - voldsom trang til at spille umådeholdent på trods af alvorlige personlige eller familiære konsekvenser - forandret eller øget seksuel lyst og adfærd, der giver betydelig bekymring for dig eller andre, for eksempel en øget sextrang - ukontrolleret og udtalt købelyst eller pengeforbrug - udtalt overspisning (at spise store mængder af mad i løbet af kort tid) eller tvangsspisning (at spise mere mad end normalt og mere end nødvendigt for at stille sulten).
English: Levodopa/Carbidopa/Entacapone Orion may be taken with or without food.
Danish: Levodopa/Carbidopa/Entacapone Orion kan tages med eller uden mad.
English: Patients taking these medicinal products with Levodopa/Carbidopa/Entacapone Orion should be carefully observed for loss of therapeutic response.
Danish: Patienter, der anvender disse lægemidler samtidig med Levodopa/Carbidopa/Entacapone Orion, bør nøje overvåges med henblik på reduceret terapeutisk respons.
English: Hepatitis with mainly cholestatic features (see section 4.4)*
Danish: Hepatitis hovedsagelig med galdeophobning (se pkt.
English: Because the effects of Levodopa/Carbidopa/Entacapone Orion tablets are equivalent with entacapone 200 mg tablet administered concomitantly with the commercially available standard release carbidopa/levodopa preparations in corresponding doses these results are applicable to describe the effects of Levodopa/Carbidopa/Entacapone Orion as well.
Danish: Virkningen af Levodopa/Carbidopa/Entacapone Orion-tabletter svarer til entacapon 200 mg tabletter administreret samtidig med markedsførte præparater af standard-formuleringer med carbidopa/levodopa i tilsvarende doser, og disse resultater kan derfor også anvendes til at beskrive virkningen af Levodopa/Carbidopa/Entacapone Orion.
English: The evidence of the therapeutic effects of Levodopa/Carbidopa/Entacapone Orion is based on two phase III double-blind studies, in which 376 Parkinson's disease patients with end-of-dose motor fluctuations received either entacapone or placebo with each levodopa/DDC inhibitor dose.
Danish: De terapeutiske virkninger af Levodopa/Carbidopa/Entacapone Orion er vist i to fase III dobbeltblinde studier, hvor 376 patienter med Parkinsons sygdom med motoriske end-of-dose-fluktuationer blev behandlet med enten entacapon eller placebo ved hver levodopa/DDC-hæmmer dosis.
English: even if their symptoms signs of illness are the same as yours.
Danish: Det kan være skadeligt for andre, selvom de har de samme symptomer, som du har.
English: If required, appropriate anti-arrhythmic therapy should be given.
Danish: Behandling med antiarytmika bør indgives ved behov.
English: Discolourations other than urine (e.g. skin, nail, hair, sweat)*
Danish: Ikke almindelig: Andre misfarvninger end urin (f.eks. hud, negle, hår, sved)* Sjælden:
English: - A previous history of Neuroleptic Malignant Syndrome (NMS) and/or non-traumatic rhabdomyolysis.
Danish: - Malignt neuroleptikasyndrom (MNS) og/eller ikke-traumatisk rabdomyolyse i anamnesen.
English: Levodopa, carbidopa and entacapone together may cause dizziness and symptomatic orthostatism.
Danish: Levodopa, carbidopa og entacapon kan sammen forårsage svimmelhed og symptomatisk ortostatisme.
English: Dopamine Dysregulation Syndrome (DDS) is an addictive disorder seen in some patients treated with carbidopa/levodopa.
Danish: Dopaminergt dysreguleringssyndrom (DDS) er en addiktiv forstyrrelse, der er set hos visse patienter, der er blevet behandlet med carbidopa/levodopa.
English: Discontinuation of Levodopa/Carbidopa/Entacapone Orion therapy: If Levodopa/Carbidopa/Entacapone Orion treatment (levodopa/carbidopa/entacapone) is discontinued and the patient is transferred to levodopa/DDC inhibitor therapy without entacapone, it is necessary to adjust the dosing of other antiparkinsonian treatments, especially levodopa, to achieve a sufficient level of control of the parkinsonian symptoms.
Danish: Seponering af Levodopa/Carbidopa/Entacapone Orionbehandling: Hvis behandling med Levodopa/Carbidopa/Entacapone Orion (levodopa/carbidopa/entacapon) afbrydes, og patienten overføres til behandling med levodopa/DDC-hæmmer uden entacapon, er det nødvendigt at justere doseringen af anden antiparkinson-behandling, specielt levodopa, for at opnå tilstrækkelig kontrol over parkinsonsymptomerne.
English: Therefore, do not take Levodopa/Carbidopa/Entacapone Orion and iron supplements at the same time.
Danish: Tag derfor ikke Levodopa/Carbidopa/Entacapone Orion og jerntilskud samtidig.
English: Levodopa/Carbidopa/Entacapone Orion is used for the treatment of Parkinson's disease.
Danish: Levodopa/Carbidopa/Entacapone Orion bruges til behandling af Parkinsons sygdom.
English: Levodopa/Carbidopa/Entacapone Orion may lower your blood pressure, which may make you feel light-headed or dizzy.
Danish: Levodopa/Carbidopa/Entacapone Orion kan sænke blodtrykket, og du kan føle dig ør og svimmel.
English: Adverse reactions that are mainly attributable to entacapone or are more frequent with entacapone than levodopa/DDC inhibitor alone are indicated with an asterisk in Table 1, section 4.8b.
Danish: Bivirkninger, som fortrinsvis kan tilskrives entacapon, eller som er hyppigere med entacapon end med levodopa/DDC-hæmmer alene, er mærket med en stjerne i Tabel 1, pkt.
English: Depression, hallucination, confusional state*, abnormal dreams*, anxiety, insomnia
Danish: Depression, hallucination, konfusion*, abnorme drømme*, angst, insomni Ikke almindelig: Psykoser, agitation* Ikke kendt:
English: If this happens, a general medical evaluation including liver function should be considered - feel the need to stop using Levodopa/Carbidopa/Entacapone Orion, see section 'If you stop taking Levodopa/Carbidopa/Entacapone Orion'.
Danish: I så fald bør der overvejes at foretage en generel medicinsk undersøgelse, som bør omfatte leverfunktionen - føler behov for at holde op med at bruge Levodopa/Carbidopa/Entacapone Orion, se afsnittet ”Hvis du holder op med at tage Levodopa/Carbidopa/Entacapone Orion”.
English: Serious events of gastrointestinal haemorrhage (uncommon) and angioedema (rare) have been identified from the clinical trials with Levodopa/Carbidopa/Entacapone Orion or entacapone combined with levodopa/DDC inhibitor.
Danish: Alvorlige tilfælde af gastrointestinal blødning (ikke almindelig) og angioødem (sjælden) er påvist i kliniske studier med Levodopa/Carbidopa/Entacapone Orion eller entacapon kombineret med levodopa/DDC-hæmmer.
English: Very common (may affect more than 1 in 10 people) - uncontrolled movements (dyskinesias) - feeling sick (nausea) - harmless reddish-brown discolouration of urine - muscle pain - diarrhoea
Danish: Meget almindelig (kan påvirke flere end 1 ud af 10 personer) - ukontrollerbare bevægelser (dyskinesier) - kvalme - harmløs rødbrun misfarvning af urinen - muskelsmerter - diarré
English: - Periodic evaluation of hepatic, haematopoietic, cardiovascular and renal function is recommended during extended therapy with Levodopa/Carbidopa/Entacapone Orion.
Danish: - Det anbefales jævnligt at vurdere den hepatiske-, hæmatopoietiske-, kardiovaskulære- og renale funktion ved forlænget behandling med Levodopa/Carbidopa/Entacapone Orion.
English: - Dopamine Dysregulation Syndrome (DDS) is an addictive disorder resulting in excessive use of the product seen in some patients treated with carbidopa/levodopa.
Danish: - Dopaminergt dysreguleringssyndrom (DDS), som er en addiktiv forstyrrelse, der medfører overdreven brug af lægemidlet, som er set hos visse patienter, der er blevet behandlet med carbidopa/levodopa.
English: maprotiline, venlafaxine and paroxetine, - rimiterole and isoprenaline, used to treat respiratory diseases - adrenaline, used for severe allergic reactions - noradrenaline, dopamine and dobutamine, used to treat heart diseases and low blood pressure - alpha-methyldopa, used to treat high blood pressure - apomorphine, which is used to treat Parkinson's disease.
Danish: maprotilin, venlafaxin og paroxetin - rimiterol og isoprenalin, som bruges til behandling af sygdomme i luftvejene - adrenalin, som bruges mod alvorlige allergiske reaktioner - noradrenalin, dopamin og dobutamin, som bruges til behandling af hjertesygdomme og lavt blodtryk - alfamethyldopa, som bruges til behandling af forhøjet blodtryk - apomorphin, som bruges til behandling af Parkinsons sygdom.
English: Method of administration
Danish: ANVENDELSESMÅDE OG ADMINISTRATIONSVEJ
English: - Coadministration of Levodopa/Carbidopa/Entacapone Orion with non-selective monoamine oxidase (MAO-A and MAO-B) inhibitors (e.g. phenelzine, tranylcypromine).
Danish: - Samtidig administration af Levodopa/Carbidopa/Entacapone Orion og non-selektive monoaminooxidase (MAO-A og MAO-B)-hæmmere (f.eks. phenelzin, tranylcypromin).
English: Paediatric population: The safety and efficacy of Levodopa/Carbidopa/Entacapone Orion in children aged below 18 years have not been established.
Danish: Pædiatrisk population: Levodopa/Carbidopa/Entacapone Orions sikkerhed og virkning hos børn under 18 år er ikke klarlagt.
English: 4.8 Undesirable effects a.
Danish: 4.8 Bivirkninger a. Resumé af sikkerhedsprofilen
English: Levodopa/Carbidopa/Entacapone Orion is not recommended to be used for treatment of extrapyramidal symptoms (e.g. involuntary movements, shaking, muscle rigidity and muscle contractions) caused by other medicines.
Danish: Levodopa/Carbidopa/Entacapone Orion er ikke egnet til behandling af symptomer i nervebanerne (f.eks. ufrivillige bevægelser, rysten, muskelstivhed og muskeltrækninger), der er forårsaget af andre typer medicin.
English: There is evidence that breast-feeding is suppressed during treatment with levodopa.
Danish: Der er set laktationshæmning under behandling med levodopa.
English: Other adverse reactions with an asterisk in Table 1, section 4.8b are marked based on either their more frequent occurring (by the frequency difference of at least 1%) in the clinical trial data with entacapone than levodopa/DDCI alone or the individual case safety reports received after the introduction of entacapone into the market.
Danish: 4.8 b er mærket på grund af enten deres hyppigere forekomst (med hyppighedsforskel på mindst 1%) i kliniske studiedata med entacapon end med levodopa/DDC-hæmmer alene eller i de individuelle sikkerhedsrapporter, der er modtaget efter entacapons introduktion på markedet.
English: However, a direct switch from levodopa/DDC inhibitor to Levodopa/Carbidopa/Entacapone Orion is not recommended for patients who have dyskinesias or whose daily levodopa dose is above 800 mg.
Danish: Dog kan det ikke anbefales at overføre patienter direkte fra levodopa/DDChæmmer til Levodopa/Carbidopa/Entacapone Orion hos patienter med dyskinesier, eller hvor den daglige levodopadosering er højere end 800 mg.
English: These include: - dopamine antagonists used to treat mental disorders, nausea and vomiting - phenytoin, used to prevent convulsions - papaverine used to relax the muscles.
Danish: Disse er: - dopamin-antagonister, som bruges til behandling af mentale lidelser, kvalme og opkastning - phenytoin, som bruges til at forebygge kramper - papaverin, som bruges til at afslappe musklerne.
English: Patients should be instructed to take only one Levodopa/Carbidopa/Entacapone Orion tablet per dose administration.
Danish: Patienten skal instrueres i kun at tage én enkelt Levodopa/Carbidopa/Entacapone Orion-tablet ved hver dosering.
English: Chest pain, peripheral oedema, fall, gait disturbance, asthenia, fatigue
Danish: Brystsmerter, perifert ødem, fald, gangforstyrrelser, asteni, træthed Ikke almindelig: Utilpashed
English: Levodopa/Carbidopa/Entacapone Orion may have a major influence on the ability to drive and use machines.
Danish: Levodopa/Carbidopa/Entacapone Orion kan i væsentlig grad påvirke evnen til at føre motorkøretøj og betjene maskiner.
English: - Coadministration with a selective MAO-A inhibitor and a selective MAO-B inhibitor (see section 4.5).
Danish: - Samtidig administration med en selektiv MAO-A-hæmmer plus en selektiv MAO-B-hæmmer (se pkt.
English: Carbidopa and entacapone improve the antiparkinson effects of levodopa.
Danish: Carbidopa og entacapon forbedrer levodopas antiparkinson-virkning.
English: - Levodopa/Carbidopa/Entacapone Orion may induce orthostatic hypotension.
Danish: - Levodopa/Carbidopa/Entacapone Orion kan inducere ortostatisk hypotension.
English: You should be aware that Levodopa/Carbidopa/Entacapone Orion may make these reactions worse.
Danish: Du skal være opmærksom på, at Levodopa/Carbidopa/Entacapone Orion kan forværre denne virkning.
English: Hepatic impairment: It is advised that Levodopa/Carbidopa/Entacapone Orion should be administered cautiously to patients with mild to moderate hepatic impairment.
Danish: Nedsat leverfunktion: Det anbefales at Levodopa/Carbidopa/Entacapone Orion administreres med forsigtighed til patienter med mild til moderat leversvigt.
English: Description of selected adverse reactions
Danish: c. Beskrivelse af udvalgte bivirkninger
English: Levodopa/Carbidopa/Entacapone Orion may increase the effects and side effects of certain medicines.
Danish: Levodopa/Carbidopa/Entacapone Orion kan øge virkningen og bivirkningerne af visse lægemidler.
English: No particular studies on the pharmacokinetics of carbidopa and levodopa in patients with hepatic impairment are reported, however, it is advised that Levodopa/Carbidopa/Entacapone Orion should be administered cautiously to patients with mild or moderate hepatic impairment.
Danish: Der er ikke rapporteret om specifikke farmakokinetiske studier med carbidopa og levodopa hos patienter med nedsat leverfunktion, men det anbefales imidlertid, at Levodopa/Carbidopa/Entacapone Orion gives med forsigtighed til patienter med mild til moderat nedsat leverfunktion.
English: Patients and carers should be made aware that behavioural symptoms of impulse control disorders including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists and/or other dopaminergic treatments containing levodopa including Levodopa/Carbidopa/Entacapone Orion.
Danish: Patienter og omsorgspersoner skal informeres om, at der kan forekomme adfærdssymptomer på impulskontrolforstyrrelser, herunder patologisk spilletrang, øget libido, hyperseksualitet, tvangsforbrug eller sygelig købelyst, udtalt overspisning og spiseforstyrrelser hos patienter, der behandles med dopaminagonister og/eller andre dopaminerge lægemidler, der indeholder levodopa, herunder Levodopa/Carbidopa/Entacapone Orion.
English: If you during the treatment with Levodopa/Carbidopa/Entacapone Orion experience the following symptoms, contact your doctor immediately: - Your muscles get very rigid or jerk violently, you get tremors, agitation, confusion, fever, rapid pulse, or wide fluctuations in your blood pressure.
Danish: Hvis du under behandling med Levodopa/Carbidopa/Entacapone Orion bemærker følgende symptomer, skal du kontakte din læge øjeblikkeligt: - Dine muskler bliver meget stive eller rykker kraftigt, du begynder at ryste, bliver ophidset, forvirret, får feber, høj puls eller store udsving i dit blodtryk.
English: If this happens, you should not drive or use any tools or machines (see also section 'Driving and using machines') - notice that uncontrolled movements begin or get worse after you started to take Levodopa/Carbidopa/Entacapone Orion.
Danish: Hvis det sker, må du ikke køre bil eller betjene maskiner (se under afsnittet ”Trafik- og arbejdssikkerhed”) - bemærker ukontrollerbare bevægelser, eller disse forværres, efter du begyndte at bruge Levodopa/Carbidopa/Entacapone Orion.
English: Parkinsonism aggravated (e.g. bradykinesia)*, tremor, on and off phenomenon, dystonia, mental impairment (e.g. memory impairment, dementia), somnolence, dizziness*, headache
Danish: Forværring af Parkinsons sygdom (f.eks. bradykinesi)*, tremor, on og off fænomen, dystoni, nedsat mental funktion (f.eks. dårlig hukommelse, demens), døsighed, svimmelhed*, hovedpine
English: How to transfer patients taking levodopa/DDC inhibitor (carbidopa or benserazide) preparations and entacapone tablets to Levodopa/Carbidopa/Entacapone Orion a. Patients who are currently treated with entacapone and with standard release levodopa/carbidopa in doses equal to Levodopa/Carbidopa/Entacapone Orion tablet strengths can be directly transferred to corresponding Levodopa/Carbidopa/Entacapone Orion tablets.
Danish: Skift af patienter i behandling med levodopa/DDC-hæmmer (carbidopa eller benserazid)-præparater og entacapon-tabletter til Levodopa/Carbidopa/Entacapone Orion a. Patienter, der allerede er i behandling med entacapon og standardformuleringer med levodopa/carbidopa i styrker tilsvarende Levodopa/Carbidopa/Entacapone Orion, kan overføres direkte til den tilsvarende Levodopa/Carbidopa/Entacapone Orion-tablet.
English: With inhibition of the decarboxylase by a DDC inhibitor, catechol-O-methyltransferase (COMT) becomes the major peripheral metabolic pathway catalyzing the conversion of levodopa to 3-Omethyldopa (3-OMD), a potentially harmful metabolite of levodopa.
Danish: Ved at hæmme decarboxylase med en DDC-hæmmer bliver catechol-O-methyltransferase (COMT) hovedmetaboliseringsvejen for levodopa perifert og katalyserer omdannelsen af levodopa til 3-O
English: If you must undergo surgery, please tell your doctor that you are using Levodopa/Carbidopa/Entacapone Orion.
Danish: Hvis du skal opereres, skal du fortælle lægen, at du bruger Levodopa/Carbidopa/Entacapone Orion.
English: It may therefore be necessary, particularly in patients with dyskinesia, to reduce levodopa dose by 10-30% within the first days to first weeks after initiating Levodopa/Carbidopa/Entacapone Orion treatment.
Danish: Det kan derfor være nødvendigt at reducere levodopadosis med 10-30% i løbet af de første dage eller uger efter behandlingsstart med Levodopa/Carbidopa/Entacapone Orion, specielt hos patienter med dyskinesier.
English: Experience with Levodopa/Carbidopa/Entacapone Orion in patients under 18 years is limited.
Danish: Der er kun begrænset erfaring med Levodopa/Carbidopa/Entacapone Orion til patienter under 18 år.
English: If therapy has to be stopped temporarily, Levodopa/Carbidopa/Entacapone Orion may be restarted as soon as oral medicinal products can be taken at the same daily dose as before.
Danish: Hvis det er nødvendigt at afbryde behandlingen midlertidigt, kan den genoptages, så snart oral medicin kan indtages, med samme daglige dosis som tidligere.
English: Management of acute overdose with Levodopa/Carbidopa/Entacapone Orion therapy is similar to acute overdose with levodopa.
Danish: Behandling af akut overdosering med Levodopa/Carbidopa/Entacapone Orion er den samme som ved akut overdosering med levodopa.
English: Levodopa is bound to plasma protein only to a minor extent of about 10-30% and carbidopa is bound approximately 36%, while entacapone is extensively bound to plasma proteins (about 98%) -mainly to serum albumin.
Danish: 36%, mens entacapon bindes betydeligt til plasmaproteiner (ca. 98%), hovedsageligt til serum albumin.
English: The possibility that the patient has taken other active substances in addition to Levodopa/Carbidopa/Entacapone Orion should be taken into consideration.
Danish: Muligheden for at patienten har taget andre lægemidler samtidig med Levodopa/Carbidopa/Entacapone Orion, skal overvejes.
English: Therefore, the use of Levodopa/Carbidopa/Entacapone Orion in children or adolescents is not recommended.
Danish: Derfor frarådes det at anvende Levodopa/Carbidopa/Entacapone Orion til børn eller unge.
English: The safety of levodopa, carbidopa or entacapone in the infant is not known.
Danish: Levodopas, carbidopas eller entacapons sikkerhed hos nyfødte er ikke kendt.
English: No particular studies are reported on the pharmacokinetics of levodopa and carbidopa in patients with renal impairment.
Danish: Der er ikke rapporteret om specifikke farmakokinetiske studier af levodopa og carbidopa hos patienter med nedsat nyrefunktion.
English: When given separately without the two other active substances, the bioavailability for levodopa is 15-33%, for carbidopa 40-70% and for entacapone 35% after a 200 mg oral dose.
Danish: Biotilgængeligheden for levodopa er 15-33%, for carbidopa 40-70% og for entacapon 35% efter en peroral dosis på 200 mg, når disse gives hver for sig uden de to andre aktive stoffer.
English: Not known (cannot be estimated from the available data) Craving for large doses of Levodopa/Carbidopa/Entacapone Orion in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome.
Danish: Ikke kendt (kan ikke beregnes ud fra tilgængelige data)) Trang til større doser Levodopa/Carbidopa/Entacapone Orion ud over den dosis, der er nødvendig for kontrol af motoriske symptomer, kendt som dopaminergt dysreguleringssyndrom.
English: These behaviours are called impulse control disorders and can include addictive gambling, excessive eating or spending, an abnormally high sex drive or a preoccupation with an increase in sexual thoughts or feelings.
Danish: Disse adfærdssmønstre kaldes impulskontrolforstyrrelser og kan omfatte vanedannende spilletrang, overspisning eller sygelig købelyst, en unormal høj sexlyst eller optagethed med forøget seksuel tankegang eller følelser.
English: - If you are taking Levodopa/Carbidopa/Entacapone Orion 200 mg/50 mg/200 mg, do not take more than 7 tablets of this strength per day.
Danish: - Hvis du tager Levodopa/Carbidopa/Entacapone Orion 200 mg/50 mg/200 mg, må du ikke tage mere end 7 tabletter af denne styrke pr. dag.
English: Usually Levodopa/Carbidopa/Entacapone Orion is to be used in patients who are currently treated with corresponding doses of standard release levodopa/DDC inhibitor and entacapone.
Danish: Sædvanligvis bør Levodopa/Carbidopa/Entacapone Orion anvendes til patienter, der allerede er i behandling med tilsvarende doser af standardformuleringer med levodopa/DDC-hæmmer og entacapon.
English: - Levodopa/Carbidopa/Entacapone Orion is not recommended for the treatment of drug-induced extrapyramidal reactions.
Danish: - Levodopa/Carbidopa/Entacapone Orion er ikke egnet til behandling af lægemiddelinducerede ekstrapyramidale reaktioner.
English: For example, a patient taking one tablet of 50 mg/12.5 mg of levodopa/carbidopa with one tablet of entacapone 200 mg four times daily can take one 50 mg/12.5 mg/200 mg Levodopa/Carbidopa/Entacapone Orion tablet four times daily in place of their usual levodopa/carbidopa and entacapone doses.
Danish: F.eks. kan en patient, der tager en tablet på 50 mg/12,5 mg levodopa/carbidopa samtidig med en tablet entacapon på 200 mg 4 gange dagligt, i stedet tage en 50 mg/12,5 mg/200 mg Levodopa/Carbidopa/Entacapone Orion-tablet 4 gange dagligt.
English: Food does not significantly affect the absorption of entacapone.
Danish: Absorptionen af entacapon påvirkes kun i ubetydelig grad af mad.