FrancophonIA/ELRC3.0 huggingface dataset:
English: During this period no new patients should be initiated on treatment with meprobamate.
Slovenian: V tem obdobju se ne sme začeti zdravljenja novih bolnikov z meprobamatom.
English: Particularly, the use in the elderly remained considerable.
Slovenian: Še posebej znatna je ostala uporaba pri starejših.
English: As a result, a procedure under article 107 of Directive 2011/83/EC was automatically initiated at European level for meprobamate-containing medicinal products for oral use.
Slovenian: Posledično je bil v skladu s členom 107 Direktive 2011/83/ES na evropskem nivoju samodejno sprožen postopek za zdravila, ki vsebujejo meprobamat, za peroralno uporabo.
English: By comparison, 308 serious and non-serious reports were recorded during the 2001 to 2006 period.
Slovenian: Za primerjavo: v obdobju od leta 2001 do leta 2006 je bilo zabeleženih 308 resnih in neresnih primerov.
English: Overall summary of the scientific evaluation of meprobamate-containing medicinal products for oral use (see Annex I)
Slovenian: Splošni povzetek znanstvenega vrednotenja zdravil, ki vsebujejo meprobamat, za peroralno uporabo (glejte Dodatek I)
English: This is comparable to the 15 fatalities (including 7 due to overdoses) recorded during the May 2006 to July 2009 period.
Slovenian: To je primerljivo s 15 smrtnimi izidi (vključno s 7 zaradi prevelikega odmerka), ki so jih zabeležili v obdobju od maja 2006 do julija 2009.
English: In particular, restriction to hospital-use only was not considered practical, given the nature of the indications and the duration of treatment.
Slovenian: Še posebej omejitev na izključno bolnišnično uporabo ni bila upoštevana kot praktična zaradi narave indikacij in trajanja zdravljenja.
English: As a consequence, they considered additional risk minimisation measures to be unnecessary.
Slovenian: Zato so menili, da dodatni ukrepi za zmanjšanje tveganja niso potrebni.
English: Seven comas had a fatal outcome.
Slovenian: Pri sedmih komah je bil izid smrten.
English: The study period was defined as covering the period July 2009 to March 2011 and the resulting data was compared to data from the May 2006 to July 2009 period.
Slovenian: Obdobje trajanja študije je bilo opredeljeno kot obdobje, ki je trajalo od julija 2009 do marca 2011, pridobljene podatke pa so primerjali s podatki iz obdobja od maja 2006 do julija 2009.
English: It is available as a single product or as fixed combinations with other substances.
Slovenian: Na voljo so samostojno ali z določenimi kombinacijami z drugimi snovmi.
English: 6 cases of inhalation pneumopathy and 3 cases of addiction/withdrawal were reported.
Slovenian: Poročali so o 6 primerih inhalacijske pnevmopatije in o 3 primerih odvisnosti/odtegnitve.
English: Cases of accidental overdose (higher doses than recommended during several days) occurred in 9% of patients.
Slovenian: Do primerov naključnega prevelikega odmerjanja (večji odmerki od priporočenih v času več dni) je prišlo pri 9 % bolnikov.
English: This was confirmed by the analysis, which identified 9 cases of addiction/withdrawal during the study period (3 serious cases and 6 non-serious cases).
Slovenian: To je potrdila analiza, v kateri je bilo ugotovljenih 9 primerov odvisnosti/odtegnitve v času trajanja študije (3 resni primeri in 6 primerov, ki niso bili resni).
English: Grounds for the suspension of the Marketing Authorisations
Slovenian: Razlogi za začasni umik dovoljenj za promet z zdravili
English: A number of indications are approved across Europe, including aid for alcohol withdrawal, treatment of anxiety states, treatment of muscle tension, cramps or spastic state of voluntary muscles, symptomatic treatment of digestive functional disorders, treatment of migraine attacks and treatment of occasional insomnia.
Slovenian: Številne indikacije so odobrene po vsej Evropi, vključno s pomočjo pri odtegnitvi alkohola, zdravljenjem anksioznih stanj, zdravljenjem mišične napetosti, krčev ali spastičnega stanja prečno progastih mišic, simptomatskim zdravljenjem motenj delovanja prebavil, zdravljenjem migrenskih napadov in zdravljenjem občasne nespečnosti.
English: The measures were also inadequate to address the risk of pharmacodependence and of serious withdrawal symptoms.
Slovenian: Ukrepi so bili tudi nezadostni za reševanje tveganja farmakološke odvisnosti in resnih odtegnitvenih simptomov.
English: Regarding the meprobamate/aceprometazine combination products, the second Lille CPRV analysis identified 365 medically confirmed cases during the study period, of which 277 (76%) were recorded as serious (corresponding to 894 adverse events) while 88 were recorded as non-serious (corresponding to 153 adverse events).
Slovenian: V zvezi s kombiniranimi zdravili meprobamata in aceprometazina je bilo v drugi analizi agencije Lille CPRV v času trajanja študije ugotovljenih 365 medicinsko potrjenih primerov, od katerih je bilo 277 (76 %) zabeleženih kot resnih (kar ustreza 894 neželenim učinkom), 88 primerov pa kot neresnih (kar ustreza 153 neželenim učinkom).
English: The overall reports involved patients over the age of 65 in 22% of cases and patients aged 75 and over in 13% of cases.
Slovenian: Skupna poročila so v 22 % primerov vključevala bolnike nad 65 letom starosti, v 13 % primerov pa bolnike nad 75 letom starosti.
English: In addition, Afssaps was particularly concerned by adverse events in elderly patients.
Slovenian: Poleg tega je Afssaps izrazil skrb zaradi neželenih učinkov pri starejših bolnikih.
English: 30 fatal cases were recorded during the study period, of which 27 were associated with the use of psychotropic drugs and 20 were recorded as overdoses.
Slovenian: V času trajanja študije je bilo zabeleženih 30 primerov s smrtnim izidom, od katerih je bilo 27 povezanih z uporabo psihotropnih zdravil, 20 pa jih je bilo zabeleženih kot prekomerni odmerki.
English: The CHMP noted that despite the 10% decrease in the proportion of elderly patient during the current study period, elderly patients remained the main affected age group (40% of patients over 65 years of age and 32% of patients over 75 years of age).
Slovenian: CHMP je zabeležil, da so kljub 10 % upadu deleža starejših bolnikov v času trajanja študije starejši bolniki ostali poglavitna prizadeta starostna skupina (40% bolnikov nad 65 letom starosti in 32 % bolnikov nad 75 letom starosti).
English: There were also reports of consciousness disorders (36 cases), falls (30 cases), hypotension (26 cases) and confusion and disorientation (20 cases).
Slovenian: Poročali so tudi o motnjah zavesti (36 primerov), padcih (30 primerov), hipotenziji (26 primerov) in zmedenosti ter dezorientiranosti (20 primerov).
English: The most frequently encountered serious adverse events were comas (75 cases).
Slovenian: Najpogosteje navedeni resni neželeni učinki so bili kome (75 primerov).
English: For the suspension to be lifted, the Marketing Authorisation Holders should provide convincing data to identify a patient population in which the benefits of meprobamate clearly outweigh its identified risks (see Annex III of the Opinion).
Slovenian: Za odpravo začasnega umika dovoljenja za promet morajo imetniki dovoljenja za promet z zdravilom predložiti prepričljive podatke z opredelitvijo populacije bolnikov, v kateri koristi zdravljenja z meprobamatom jasno odtehtajo opredeljena tveganja (glejte Dodatek III tega mnenja).
English: Overall benefit-risk assessment
Slovenian: Splošna ocena razmerja med tveganji in koristmi
English: Afssaps therefore considered the benefit-risk of meprobamate-containing products to be unfavourable and notified the European Medicines Agency (EMA) and the Committee for Medicinal Products for Human Use (CHMP) on 25 July 2011 of its intention to suspend the French marketing authorisations of oral medicines containing meprobamate, effective as of January 2012.
Slovenian: Afssaps je zato menil, da je razmerje med tveganji in koristmi zdravil, ki vsebujejo meprobamat, neugodno, ter dne 25. julija 2011 Evropsko agencijo za zdravila (EMA) in Odbor za zdravila za uporabo v humani medicini (CHMP) obvestil o svoji nameri za začasni umik francoskih dovoljenj za promet z zdravili, ki vsebujejo meprobamat, za peroralno uporabo, ki začne veljati januarja 2012.
English: The CHMP also noted that the available medical practice guidelines for anxiety disorder, alcohol withdrawal and migraine do not recommend meprobamate.
Slovenian: CHMP je prav tako opozoril, da razpoložljive smernice medicinske prakse za anksiozno motnjo, odtegnitev alkohola in migreno ne priporočajo meprobamata.
English: Some MAHs nonetheless proposed minor amendments to the product information, in particular with regard to treatment duration.
Slovenian: Nekateri imetniki dovoljenja za promet z zdravilom pa so predlagali manjše spremembe podatkov o zdravilu, predvsem v zvezi s trajanjem zdravljenja.
English: While the CHMP noted the minor decrease in the number of elderly patients, it raised concerns over the high proportion of elderly patients using the product.
Slovenian: Čeprav je CHMP opazil manjši upad števila starejših bolnikov, je izrazil zadržke zaradi velikega deleža starejših bolnikov, ki uporabljajo zdravilo.
English: The most frequently encountered serious adverse events were comas (11 cases), consciousness disorders (16 cases), confusion states (15 cases) and intoxications (33 cases, including deliberate, accidental or nonspecified).
Slovenian: Najpogostejši resni neželeni učinki so bili kome (11 primerov), motnje zavesti (16 primerov), stanja zmedenosti (15 primerov) in zastrupitve (33 primerov, vključno z namernimi, naključnimi in nedoločenimi).
English: Meprobamate is a carbamate derivative, acting as a central nervous system depressant with anxietyrelieving, sedative and muscle relaxant activity.
Slovenian: Meprobamat je derivat karbamata, ki deluje kot zaviralec osrednjega živčnega sistema ter blaži anksioznost, deluje kot pomirjevalo in mišični relaksant.
English: Oral formulations of meprobamate have been authorised in the EU as prescription-only products.
Slovenian: Peroralne farmacevtske oblike meprobamata so bile v EU odobrene kot zdravila, ki se izdajajo le na recept.
English: Based on the same Eudravigilance dataset, the CHMP also noted 11 cases of withdrawal symptoms, of which one was fatal.
Slovenian: Na podlagi istega nabora podatkov iz baze Eudravigilance je CHMP ugotovil tudi 11 primerov odtegnitvenih simptomov, od katerih je bil en primer s smrtnim izidom.
English: Giving due consideration to the serious risk of withdrawal symptoms, the CHMP recommended that the withdrawal of meprobamate from the market should be implemented over a 15 month period, in order to ensure the safe termination of treatment or switching of patients already being treated with meprobamate.
Slovenian: Ob ustreznem upoštevanju resnega tveganja za odtegnitvene simptome je CHMP priporočil umik meprobamata s trga v obdobju 15 mesecev, da se zagotovitvi varna prekinitev zdravljenja oziroma sprememba zdravljenja za bolnike, ki so že zdravljeni z meprobamatom.
English: In summary, the CHMP assessed the totality of the available data, including responses submitted by the MAHs in writing and during an oral explanation, as well as the nationally-conducted French pharmacovigilance assessments.
Slovenian: CHMP je ocenil vse razpoložljive podatke, vključno z odzivi, ki so jih posredovali imetniki dovoljenja za promet z zdravilom v pisni obliki in ustni obrazložitvi, kakor tudi nacionalno izvedene francoske farmakovigilančne ocene.
English: The CHMP was concerned by the identified risk of pharmacodependence, including in cases under normal conditions of use, as suggested by the 17 reported cases of pharmacodependence and withdrawal symptoms (13 serious and 4 non-serious).
Slovenian: CHMP je izrazil zaskrbljenost zaradi ugotovljenega tveganja za farmakološko odvisnost, vključno s primeri pri običajnih pogojih uporabe, kot je pokazalo 17 primerov farmakološke odvisnosti in odtegnitvenih simptomov (13 resnih in 4 neresni).
English: The risks of serious withdrawal symptoms were also acknowledged by the MAH during the oral explanation.
Slovenian: Tveganja za resne odtegnitvene simptome je v ustni obrazložitvi potrdil tudi imetnik dovoljenja za promet z zdravilom.
English: Finally, the CHMP also noted a clinical epidemiological study by Kovacs et al, 2002, which reported 25 cases of accidental overdoses with meprobamate.
Slovenian: CHMP je opozoril tudi na klinično epidemiološko študijo avtorjev Kovacs et al, 2002, v kateri je bilo zabeleženih 25 primerov naključnega prevelikega odmerjanja meprobamata.
English: Regarding meprobamate-only products, the first Lille CPRV analysis identified 119 medically confirmed cases following the implementation of the risk minimisation measures, which was similar to the data for the period prior to the implementation, despite an assumed reduction in patient exposure, based on sales data.
Slovenian: V zvezi z zdravili, ki vsebujejo le meprobamat, je bilo v prvi analizi agencije Lille CPRV po uvedbi ukrepov za zmanjšanje tveganja ugotovljenih 119 medicinsko potrjenih primerov, kar je bilo podobno podatkom za obdobje pred uvedbo, kljub predvidenemu zmanjšanju izpostavljenosti bolnikov, ki je temeljilo na podatkih o prodaji.
English: The first analysis reviewed meprobamate-only products, indicated as withdrawal aid for alcoholdependent subjects, with a treatment duration of 1 to 3 weeks, with a maximum of 12 weeks.
Slovenian: V prvo analizo so bila vključena zdravila, ki so vsebovala le meprobamat, indiciran za pomoč pri odtegnitvi za odvisnike od alkohola, s trajanjem zdravljenja od 1 do 3 tednov, največ pa 12 tednov.
English: The CHMP also reviewed spontaneous case reports submitted to the Eudravigilance database and identified 18 cases of accidental overdoses, of which 17 were fatal.
Slovenian: CHMP je pregledal tudi spontana poročila o primerih, ki so bila posredovana v podatkovno bazo Eudravigilance, ter ugotovil 18 primerov naključnega prevelikega odmerjanja, od katerih je bilo 17 primerov s smrtnim izidom.
English: Annex II Scientific conclusions and grounds for the suspension of the marketing authorisations presented by the EMA
Slovenian: Dodatek II Znanstveni zaključki in podlaga za začasni umik dovoljenj za promet z zdravilom, ki jih je predstavila Evropska agencija za zdravila
English: Elderly patients constitute a considerable proportion of patients and use in this population is of concern, especially considering the increased risk of adverse events due to interactions with concomitant medication.
Slovenian: Starejši bolniki predstavljajo znaten delež bolnikov, uporaba v tej populaciji pa je zaskrbljujoča, še posebej ob upoštevanju povečanega tveganja za neželene učinke zaradi medsebojnega delovanja s sočasno uporabljanimi zdravili.
English: An association with the use of meprobamate/aceprometazine was considered as possible in all cases.
Slovenian: Povezava z uporabo kombiniranih zdravil meprobamata in aceprometazina je bila v vseh primerih upoštevana kot možna.
English: Two recent pharmacovigilance analyses of data from spontaneous reports, conducted by the Lille CRPV (Centre régional de pharmacovigilance) and finalised in 2011, did not identify any significant impact of the implemented risk minimisation measures and noted the lack of clinical data on the benefit of these products.
Slovenian: Dve nedavni farmakovigilančni analizi podatkov iz spontanih poročil, ki ju je izvedla regionalna agencija za farmakovigilanco Lille CRPV (Centre régional de pharmacovigilance) in sta bili zaključeni leta 2011, nista pokazali nikakršnega bistvenega vpliva na izvedene ukrepe za zmanjšanje tveganja, sta pa opozorili na pomanjkanje kliničnih podatkov v korist teh zdravil.
English: Following a number of French national safety and efficacy reviews and pharmacovigilance analyses of meprobamate, the French National Competent Authority (Afssaps) implemented risk minimisation measures to reduce the identified risks of meprobamate and initiated national pharmacovigilance analyses to assess the impact of these measures.
Slovenian: Po številnih francoskih nacionalnih pregledih varnosti in učinkovitosti ter farmakovigilančnih analizah meprobamata je francoski pristojni nacionalni organ (Afssaps) uvedel ukrepe za zmanjšanje tveganja, da bi zmanjšali ugotovljena tveganja pri uporabi meprobamata, ter začel z nacionalnimi farmakovigilančnimi analizami, da bi ocenil učinek teh ukrepov.
English: The CHMP noted that the majority of MAHs responded that they considered the benefit-risk of their products to be positive and that routine pharmacovigilance activities were sufficient to address the identified safety concerns.
Slovenian: CHMP je zabeležil, da je večina imetnikov dovoljenja za promet z zdravilom odgovorila, da so bili mnenja, da je razmerje med tveganji in koristmi njihovih zdravil pozitivno in da rutinske farmakovigilančne aktivnosti zadoščajo za reševanje ugotovljenih zadržkov v zvezi z varnostjo.
English: The CHMP was of the opinion that the identified risks persist, despite the implemented risk minimisation measures, particularly in patients over the age of 65, who are at high risk of falls and confusion.
Slovenian: CHMP je bil mnenja, da ugotovljena tveganja kljub uvedenim ukrepom za zmanjšanje tveganja, ostajajo, še posebej pri bolnikih nad 65 letom starosti, pri katerih obstaja velika nevarnost za padce in zmedenost.
English: Consequently, the CHMP recommended to the European Commission the suspension of the Marketing Authorisations of meprobamate-containing medicinal products listed in Annex I of the Opinion in all concerned EU Member States, to be effective within 15 months of the adoption of the European Commission Decision, in order to ensure the safe termination of treatment or switching of patients already being treated with meprobamate.
Slovenian: Odbor CHMP je Evropski komisiji zato priporočil začasni umik dovoljenj za promet z zdravili, ki vsebujejo meprobamat in so našteta v Dodatku I tega mnenja, v vseh zadevnih državah članicah EU, ki začne veljati v roku 15 mesecev po sprejetju sklepa Evropske komisije, da se zagotovi varna prekinitev zdravljenja oziroma sprememba zdravljenja za bolnike, ki so že zdravljeni z meprobamatom.
English: Meprobamate can cause physical and psychological dependence and a potentially life-threatening abstinence syndrome with delirium on abrupt withdrawal, in particular after prolonged use, with pharmacological effects similar to those of alcohol and barbiturates, including within the normal dosage and treatment duration, due to the nature of the product.
Slovenian: Meprobamat lahko povzroči fizično in psihološko odvisnost in potencialno življenjsko nevaren abstinenčni sindrom z delirijem ob nenadni prekinitvi, še posebej po daljši uporabi, s farmakološkimi učinki, ki so podobni učinkom alkohola in barbituratov, tudi v okviru običajnega odmerka in trajanja zdravljenja zaradi narave zdravila.
English: One MAH suggested that further to the treatment duration restriction already implemented in France, the only way to reduce the number of voluntary overdose cases would be to restrict the use of the product to hospital-use only.
Slovenian: Eden izmed imetnikov dovoljenja za promet z zdravilom je predlagal, da je poleg omejitve trajanja zdravljenja, ki je v Franciji že v veljavi, edini način za zmanjšanje števila primerov namernega prevelikega odmerjanja omejitev uporabe zdravila na izključno bolnišnično uporabo.
English: • The Committee raised concerns regarding the considerable proportion of elderly patients and regarding use in this population, especially considering the increased risk of adverse events due to interactions with concomitant medication.
Slovenian: • Odbor je izrazil zadržke v zvezi z znatnim deležem starejših bolnikov in uporabo zdravila v tej populaciji, še posebej ob upoštevanju povečanega tveganja za neželene učinke zaradi medsebojnega delovanja s sočasno uporabljenimi zdravili.
English: The CHMP noted that the available data on the efficacy of meprobamate is limited in some indications and non-existent in others.
Slovenian: CHMP je zabeležil, da so razpoložljivi podatki o učinkovitosti meprobamata za nekatere indikacije omejeni, za druge indikacije pa ne obstajajo.
English: • The CHMP considered that the available data showed only very limited clinical efficacy of meprobamate in its approved indications.
Slovenian: • CHMP je menil, da razpoložljivi podatki prikazujejo le zelo omejeno klinično učinkovitost meprobamata za njegove odobrene indikacije.
English: • The CHMP therefore concluded that the risk-benefit balance of meprobamate-containing medicinal products for oral use is not positive under normal conditions of use.
Slovenian: • Zato je odbor CHMP sklenil, da razmerje med tveganji in koristmi zdravil, ki vsebujejo meprobamat, za peroralno uporabo, pri običajnih pogojih uporabe ni pozitivno.
English: The second analysis reviewed a combination product containing meprobamate together with aceprometazine, indicated in the treatment of occasional insomnia, with a treatment duration of 2 to 5 days.
Slovenian: V drugo analizo so bila vključena kombinirana zdravila, ki vsebujejo meprobamat skupaj z aceprometazinom, in so indicirana za zdravljenje občasne nespečnosti s trajanjem zdravljenja od 2 do 5 dni.
English: Other frequent SOCs were psychiatric disorders, skin and subcutaneous tissue disorders, and haematologic and lymphatic disorders (6-9% each).
Slovenian: Drugi pogosti neželeni učinki po organskih sistemih so bili psihiatrične motnje, bolezni kože in podkožja ter bolezni krvi in limfatičnega sistema (6-9 % vsaka).
English: The CHMP also acknowledged the potential confounding effect of co-medication as patients were co-medicated in almost all cases, particularly with psychotropic drugs.
Slovenian: CHMP je tudi potrdil možni dodatni učinek zaradi sočasnega zdravljenja z drugimi zdravili, saj so bolniki skoraj v vseh primerih prejemali tudi druga, predvsem psihotropna zdravila.
English: However, the CHMP was of the opinion that this may have increased the risks of adverse events with meprobamate due to interactions and therefore it cannot be excluded that meprobamate may have had a contributory role.
Slovenian: Vendar pa je bil CHMP mnenja, da je to zaradi medsebojnega delovanja lahko povečalo tveganje za neželene učinke meprobamata in zato ni mogoče izključiti, da je bil meprobamat dodatni dejavnik.
English: Meprobamate is considered to have a relatively narrow therapeutic index, with a steep dose-response curve, resulting in an increased risk of unintentional overdoses with serious and potentially fatal adverse events, including coma, profound hypotension, hypothermia, respiratory arrest and cardiogenic shock.
Slovenian: Za meprobamat velja, da ima relativno ozek terapevtski indeks s strmo krivuljo odmerek/odziv, kar povzroča povečano tveganje za nenamerne prevelike odmerke z resnimi in potencialno usodnimi neželenimi učinki, vključno s komo, hudo hipotenzijo, hipotermijo, zastojem dihanja in kardiogenim šokom.
English: Meprobamate may induce generalized tonic-clonic attacks in the predisposed which may be a drawback during alcohol withdrawal, a condition characterized by an increased susceptibility to convulsions.
Slovenian: Meprobamat lahko povzroči generalizirane tonično-klonične napade pri osebah, ki so nagnjene k temu, kar lahko predstavlja pomanjkljivost v času odtegnitve alkohola, torej stanja, ki ga zaznamuje povečana dovzetnost za krče.
English: This analysis assessed the impact of the implementation of the 2009 risk minimisation measures (restriction of the indications, reduction of pack size and circulation of a DHPC) on their risk profile.
Slovenian: Pri tej analizi je bil ocenjen vpliv uvedbe ukrepov za zmanjšanje tveganja iz leta 2009 (omejitev indikacij, zmanjšanje velikosti pakiranja in kroženje protokola DHPC) v njihovem profilu tveganja.
English: One MAH considered the benefit-risk of meprobamate to be negative in the alcohol withdrawal indication and proposed to remove the indication where authorised.
Slovenian: Za enega izmed imetnikov dovoljenja za promet z zdravilom je bilo razmerje med tveganji in koristmi meprobamata negativno pri indikaciji odtegnitve alkohola in je predlagal umik te indikacije, kjer je to dovoljeno.