natgillin/translations-raw huggingface dataset:
(44- 20) 74 18 84 00 Fax (44- 20) 74 18 86 68 E- mail: mail@ emea. eu. int http: // www. emea. eu. int ©EMEA 2006 Reproduction and/ or distribution of this document is authorised for non commercial purposes only provided the EMEA is acknowledged omfattede 1305 patienter, som tog denne kombination.
(44-20) 74 18 84 00 Fax (44-20) 74 18 86 68 E-mail: mail@emea. eu. int http: / /www. emea. eu. int ©EMEA 2006 Reproduction and/ or distribution of this document is authorised for non commercial purposes only provided the EMEA is acknowledged What benefit has Competact shown during the studies?
HbA1c- niveauerne faldt yderligere med 0, 64 til 0, 89% i forhold til niveauerne, når der kun anvendes metformin.
In all studies, adding pioglitazone 30 mg to metformin gave an improvement in the control of blood sugar, with levels of HbA1c which were further decreased by 0.64 to 0.89% compared to the levels on metformin alone.
De hyppigste bivirkninger af Competact (hos mellem 1 og 10 patienter ud af 100) er anæmi (lavt antal røde blodlegemer), synsforstyrrelser, vægtforøgelse, arthralgia (ledsmerter), hovedpine, haematuria (blod i urinen), erektil dysfunktion (problemer med at få erektion).
The most common side effects of Competact (seen in between 1 and 10 patients in 100) are anaemia (low red blood cells), visual disturbance, weight increase, arthralgia (joint pain), headache, haematuria (blood in the urine), erectile dysfunction (problems getting an erection).
Den fuldstændige liste over bivirkningerne ved Competact fremgår af indlægssedlen.
For the full list of side effects reported with Competact, see the Package Leaflet.
Competact må ikke anvendes til personer, som kan være overfølsomme (allergiske) over for pioglitazon, metformin eller et eller flere af de øvrige indholdsstoffer, og til patienter med hjerteinsufficiens eller lever - eller nyreproblemer.
Competact should not be used in people who may be hypersensitive (allergic) to pioglitazone, metformin or any of the other ingredients, and in patients who have heart failure, or problems with their liver or their kidneys.
Competact må ikke anvendes til patienter, der har en sygdom, som forårsager iltmangel i vævene, som for eksempel et nyligt indtruffet hjerteanfald eller chok.
Competact should not be used in patients who have a disease that causes lack of oxygen to the tissues such as a recent heart attack or shock.
Competact må ikke anvendes ved alkoholforgiftning, diabetisk ketoacidose (høje niveauer af ketoner), tilstande, som kan påvirke nyrene eller ved amning.
Competact should not be used where there is alcohol intoxication, diabetic ketoacidosis (high levels of ketones), conditions that may effects the kidneys, and during breast-feeding.
Hvorfor er Competact blevet godkendt?
Why has Competact been approved?
Udvalget for Humanmedicinske Lægemidler (CHMP) konkluderede, at der var påvist tilstrækkelig effekt af pioglitazon og metformin hos type 2- diabetes, og at Competact forenkler behandlingen og forbedrer overholdelsen af anvendelsesbestemmelserne, når der kræves en kombination af de aktive indholdsstoffer Udvalget besluttede, at fordelene ved Competact er større end risiciene ved behandling af type 2- diabetes Udvalget anbefalede udstedelse af markedsføringstilladelse for Competact.
They recommended that Competact be given marketing authorisation.
Andre oplysninger om Competact:
Other information about Competact:
Europa- Kommissionen udstedte en markedsføringstilladelse for Competact med gyldighed i hele Den Europæiske Union til Takeda Europe R & D Centre Limited den 28. juli 2006.
The European Commission granted a marketing authorisation valid throughout the European Union, for Competact to Takeda Global Research and Development Centre (Europe) Ltd on 28 July 2006.
Den europæiske offentlige vurderingsrapport (EPAR) for Competact kan ses i sin helhed her.
The full EPAR for Competact is available here.
Dette sammendrag blev sidst ajourført i 06- 2006.
This summary was last updated in 06-2006.
EMEA’ s procedurenr.
Pharmaceutical Form
EMEA/ H/ C/ 000655/ 001 EMEA/ H/ C/ 000655/ 002 EMEA/ H/ C/ 000655/ 003 EMEA/ H/ C/ 000655/ 004 EMEA/ H/ C/ 000655/ 005 EMEA/ H/ C/ 000655/ 006 EMEA/ H/ C/ 000655/ 007 EMEA/ H/ C/ 000655/ 008 EMEA/ H/ C/ 000655/ 009
EMEA/ H/ C/ 000655/ 001 EMEA/ H/ C/ 000655/ 002 EMEA/ H/ C/ 000655/ 003 EMEA/ H/ C/ 000655/ 004 EMEA/ H/ C/ 000655/ 005 EMEA/ H/ C/ 000655/ 006 EMEA/ H/ C/ 000655/ 007 EMEA/ H/ C/ 000655/ 008 EMEA/ H/ C/ 000655/ 009
Særnavn Competact Competact Competact Competact Competact Competact Competact Competact Competact
Competact Competact Competact Competact Competact Competact Competact Competact Competact
Styrke 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg
15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg 15 mg/ 850 mg
Lægemiddelform Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet Filmovertrukket tablet
Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet Film-coated tablet
Indgivelsesvej Oral brug Oral brug Oral brug Oral brug Oral brug Oral brug Oral brug Oral brug Oral brug
Oral use Oral use Oral use Oral use Oral use Oral use Oral use Oral use Oral use
Emballage Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu)
Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu) Blister (alu/ alu)
Pakningsstørrelse 14 28 30 50 56 60 90 98 180
14 28 30 50 56 60 90 98 180
Competact 15 mg/ 850 mg filmovertrukket tablet.
Competact 15 mg/ 850 mg film-coated tablets.
Hver tablet indeholder 15 mg pioglitazon (som hydroklorid) og 850 mg metforminhydrochlorid.
Each tablet contains 15 mg of pioglitazone (as hydrochloride) and 850 mg of metformin hydrochloride.
Tabletten er hvid til gråligt hvid, aflang, filmovertrukket og mærket med ‘ 15/ 850 ’ på den ene side og på den anden side.
The tablets are white to off-white, oblong, film-coated, embossed ‘ 15 / 850’ on one face and ‘ 4833M’ on the other.
Competact er indiceret til behandling af type 2 diabetes mellitus- patienter, særligt hos overvægtige patienter, som ikke kan opnå tilstrækkelig glykæmisk kontrol ved deres maksimalt tolererede dosis af oral metformin alene.
Competact is indicated in the treatment of type 2 diabetes mellitus patients, particularly overweight patients, who are unable to achieve sufficient glycaemic control at their maximally tolerated dose of oral metformin alone.
4. 2 Dosering og indgivelsesmåde
Dosage in adults:
Dosering, voksne Den normale dosis af Competact er 30 mg pioglitazon dagligt plus 1700 mg metforminhydrochlorid dagligt (givet som en Competact- tablet med 15 mg/ 850 mg 2 gange dagligt).
The usual dose of Competact is 30 mg/ day pioglitazone plus 1700 mg/ day of metformin hydrochloride (this dosage is achievable with one tablet of Competact 15 mg/ 850 mg, taken twice a day).
Et direkte skift fra metformin monoterapi til Competact kan overvejes, hvis det vurderes klinisk passende.
When clinically appropriate, direct change from metformin monotherapy to Competact may be considered.
De gastrointestinale symptomer forbundet med metformin kan reduceres, hvis Competact tages med, eller umiddelbart efter, et måltid.
Taking Competact with, or just after food, may reduce gastrointestinal symptoms associated with metformin.
Ældre Da metformin udskilles via nyrerne, og ældre har en tendens til forringet nyrefunktion, bør ældre patienter, som behandles med Competact, have deres nyrefunktion monitoreret regelmæssigt (se pkt.
As metformin is excreted via the kidney, and elderly patients have a tendency to decreased renal function, elderly patients taking Competact should have their renal function monitored regularly (see sections 4.3 and 4.4).
4. 3 og 4. 4).
Patients with renal impairment:
Patienter med nedsat nyrefunktion Competact må ikke anvendes hos patienter med nyresvigt eller nedsat nyrefunktion, (kreatininclearance < 60 ml/ min.) (se pkt.
Competact should not be used in patients with renal failure or renal dysfunction (creatinine clearance < 60 ml/ min)(see sections 4.3 and 4.4).
4. 3 og 4. 4).
2 Patients with hepatic impairment:
Patienter med nedsat leverfunktion Competact bør ikke anvendes hos patienter med nedsat leverfunktion (se pkt.
Competact should not be used in patients with hepatic impairment (see sections 4.3 and 4.4).
4. 3 og 4. 4).
Children and adolescents:
2 Børn og unge Der er ingen tilgængelige data om brugen af pioglitazon hos personer under 18 år, og brugen af Competact anbefales derfor ikke til denne aldersgruppe.
There are no data available on the use of pioglitazone in patients under 18 years of age and therefore the use of Competact in this age group is not recommended.
- overfølsomhed over for de aktive stoffer eller andre af indholdsstofferne
- Hypersensitivity to the active substances or to any of the excipients
- svigtende hjertefunktion eller en anamnese med hjertesvigt (NYHA grad I til IV)
- Cardiac failure or history of cardiac failure (NYHA stages I to IV)
- akut eller kronisk sygdom, som kan medføre vævshypoxi såsom hjerte - eller
- Acute or chronic disease which may cause tissue hypoxia such as cardiac or respiratory failure,
respirationsinsufficiens, nyligt myokardieinfarkt, shock
recent myocardial infarction, shock
- nedsat leverfunktion
- Hepatic impairment
- akut alkoholforgiftning, alkoholisme
- Acute alcohol intoxication, alcoholism
- diabetisk ketoacidose eller diabetisk prækoma
- Diabetic ketoacidosis or diabetic pre-coma
4. 4).
- Renal failure or renal dysfunction (creatinine clearance < 60 ml/ min) (see section 4.4).
- akutte tilstande, der muligvis kan forværre nyrefunktionen, såsom:
- Acute conditions with the potential to alter renal function such as:
- dehydrering
- Dehydration
- svær infektion
- Severe infection
- shock
- Shock
4. 4)
- Intravascular administration of iodinated contrast agents (see section 4.4)
- amning.
- Lactation
Der er ingen klinisk erfaring med pioglitazon i kombination med to andre perorale antidiabetika.
There is no clinical experience of pioglitazone in triple combination with other oral antidiabetic agents.
Lactacidose Lactacidose er en meget sjælden, men alvorlig, metabolisk komplikation, der kan forekomme på grund af metforminophobning.
Lactic acidosis is a very rare, but serious, metabolic complication that can occur due to metformin accumulation.
Forekomsten af lactacidose kan og bør reduceres ved også at bedømme andre relaterede risikofaktorer såsom dårligt reguleret diabetes, ketose, længerevarende faste, overdrevet alkoholindtag, leverinsufficiens samt enhver tilstand, der er forbundet med hypoxi.
The incidence of lactic acidosis can and should be reduced by assessing also other associated risk factors such as poorly controlled diabetes, ketosis, prolonged fasting, excessive alcohol intake, hepatic insufficiency and any condition associated with hypoxia.
Diagnose Lactacidose er karakteriseret ved acidotisk dyspnø, mavesmerter og hypotermi efterfulgt af koma.
Lactic acidosis is characterised by acidotic dyspnoea, abdominal pain and hypothermia followed by coma.
Diagnostiske laboratoriefund omfatter nedsat pH i blodet, plasmalaktatniveau over 5 mmol/ l og et forhøjet aniongap og laktat/ pyruvat- forhold.
Diagnostic laboratory findings are decreased blood pH, plasma lactate levels above 5mmol/ l, and an increased anion gap and lactate/ pyruvate ratio.
4. 9).
Renal Function:
Nyrefunktion Da metformin udskilles via nyrerne, bør serum- kreatininkoncentrationen bestemmes regelmæssigt:
As metformin is excreted by the kidney, serum creatinine concentrations should be determined regularly:
- mindst to til fire gange årligt hos patienter med serum- kreatininkoncentrationer ved den øvre
- at least two to four times a year in patients with serum creatinine levels at the upper limits of
normalgrænse og hos ældre personer.
normal and in elderly subjects
Nedsat nyrefunktion hos ældre patienter forekommer ofte og asymptomatisk.
3 Decreased renal function in elderly patients is frequent and asymptomatic.
Væskeretention og hjertesvigt Pioglitazon kan forårsage væskeretention, hvilket kan forværre eller forårsage hjerteinsufficiens.
Fluid retention and cardiac failure:
3 tilgængelige dosis, som derefter øges gradvist.
Pioglitazone can cause fluid retention, which may exacerbate or precipitate heart failure.
Patienterne bør observeres med henblik på tegn og symptomer på hjerteinsufficiens, vægtøgning og ødem.
When treating patients who have at least one risk factor for development of congestive heart failure (e. g. prior myocardial infarction or symptomatic coronary artery disease), physicians should start with the lowest available dose and increase the dose gradually.
Der er spontant rapporterede tilfælde af hjerteinsufficiens, hvor pioglitazon har været anvendt i kombination med insulin, eller hvor pioglitazon har været anvendt hos patienter med hjerteinsufficiens i anamnesen.
There have been cases of cardiac failure reported from the market when pioglitazone was used in combination with insulin. or patients with a history of cardiac failure.
Da insulin og pioglitazon er associeret med væskeretention, kan samtidig indgivelse af insulin og Competact øge risikoen for ødemer.
Since insulin and pioglitazone are associated with fluid retention, concomitant administration of insulin and Competact may increase the risk of oedema.
Competact bør seponeres, hvis der opstår en forværring i hjertestatus.
Competact should be discontinued if any deterioration in cardiac status occurs.
Der er udført forsøg med fokus på kardiovaskulært endepunkt med pioglitazon hos patienter under 75 år og med type 2- diabetes mellitus og betydende makrovaskulær sygdom.
A cardiovascular outcome study of pioglitazone has been performed in patients under 75 years with type 2 diabetes mellitus and pre-existing major macrovascular disease.
Pioglitazon eller placebo blev tilføjet eksisterende antidiabetika og kardiovaskulær behandling i op til 3, 5 år.
Pioglitazone or placebo was added to existing antidiabetic and cardiovascular therapy for up to 3.5 years.
4. 8).
There have been rare reports of hepatocellular dysfunction during post-marketing experience with pioglitazone (see section 4.8).
Behandling med Competact bør ikke igangsættes hos patienter med forhøjede leverenzymer (ALT > 2, 5 X øvre normal grænse) eller hos patienter med tegn på leversygdom.
Therapy with Competact should not be initiated in patients with increased baseline liver enzyme levels (ALT > 2.5 X upper limit of normal) or with any other evidence of liver disease.
Hvis ALT- niveauer øges til 3 X den øvre, normale grænse under Competact- behandling, bør leverenzymniveauerne vurderes igen så hurtigt som muligt.
If ALT levels are increased to 3 X upper limit of normal during Competact therapy, liver enzyme levels should be reassessed as soon as possible.
Hvis ALT- niveauer forbliver > 3 X den øvre, normale grænse, bør behandlingen seponeres.
If ALT levels remain > 3 X the upper limit of normal, therapy should be discontinued.
Hvis en patient udvikler symptomer, der tyder på leverfunktionssvigt (disse kan omfatte uforklarlig kvalme, opkastninger, mavesmerter, træthed, anoreksi og/ eller mørk urin), så bør leverenzymerne kontrolleres.
If any patient develops symptoms suggesting hepatic dysfunction, which may include unexplained nausea, vomiting, abdominal pain, fatigue, anorexia and/ or dark urine, liver enzymes should be checked.
Vægtøgning I kliniske forsøg med pioglitazon var der tegn på dosisrelateret vægtøgning, hvilket kan skyldes fedtophobning og i nogle tilfælde som følge af væskeretention.
In clinical trials with pioglitazone there was evidence of dose related weight gain, which may be due to fat accumulation and in some cases associated with fluid retention.
Dette er foreneligt med blodfortynding.
There was a small reduction in mean haemoglobin (4% relative reduction) and haematocrit (4.1% relative reduction) during therapy with pioglitazone, consistent with haemodilution.
Lignende ændringer blev observeret for metformin (hæmoglobin 3- 4% og hæmatokrit 3, 6- 4, 1% relative reduktioner) og i mindre grad for sulfonylurinstof (hæmoglobin 1- 2% og hæmatokrit 1- 3, 2% relative reduktioner) hos patienter i kontrollerede sammenlignende undersøgelser med pioglitazon.
Similar changes were seen in metformin (haemoglobin 3 - 4% and haematocrit 3.6 – 4.1% relative reductions) treated patients in comparative controlled trials with pioglitazone.
Hypoglykæmi Patienter, der er i behandling med pioglitazon kombineret med sulfonylurinstof, kan have risiko for dosisrelateret hypoglykæmi, og det kan være nødvendigt at reducere dosis af sulfonylurinstof.
Hypoglycaemia Patients receiving pioglitazone in dual oral therapy with a sulphonylurea may be at risk for dose- related hypoglycaemia, and a reduction in the dose of the sulphonylurea may be necessary.
Øjensygdomme Der er efter markedsføringen blevet rapporteret om nyudbrud eller forværring af diabetisk makulært ødem med nedsat synsevne med thiazolidinedioner, herunder pioglitazon.
Post-marketing reports of new-onset or worsening diabetic macular oedema with decreased visual acuity have been reported with thiazolidinediones, including pioglitazone.
Ved receptudskrivning bør man dog være opmærksom på risikoen for makulært ødem, hvis patienten klager over forstyrrelser i synsevnen.
As Competact contains metformin hydrochloride, the treatment should be discontinued 48 hours before elective surgery with general anaesthesia and should not be usually resumed earlier than 48 hours afterwards.
Passende oftalmologisk henvisning bør overvejes.
Administration of iodinated contrast agent:
4 Operation Da Competact indeholder metforminhydrochlorid, bør behandlingen afbrydes 48 timer før elektive operationer i universel anæstesi.
The intravascular administration of iodinated contrast agents in radiological studies can lead to renal failure.
Behandlingen bør sædvanligvis ikke genoptages før efter 48 timer.
Therefore, due to the metformin active substance, Competact should be discontinued prior to, or at the time of the test and not reinstituted until 48 hours afterwards, and only after renal function has been re-evaluated and found to be normal (see section 4.5).
4. 5).
Polycystic ovarian syndrome:
Polycystisk ovariesyndrom Som en konsekvens af forøget insulinvirkning kan behandling med pioglitazon hos patienter med polycystisk ovariesyndrom måske resultere i fornyet ovulation.
As a consequence of enhancing insulin action, pioglitazone treatment in patients with polycystic ovarian syndrome may result in resumption of ovulation.
4. 6).
Others:
Andre I en poolet analyse af bivirkningsrapporter om knoglefrakturer fra randomiserede, kontrollerede, dobbeltblindede kliniske forsøg med over 8100 patienter på pioglitazon og 7400 patienter på komparator, der blev behandlet i op til 3, 5 år, blev der set en forøget incidens af frakturer hos kvinder.
An increased incidence in bone fractures in women was seen in a pooled analysis of adverse event reports of bone fracture from randomised, controlled, double blind clinical trials in over 8100 pioglitazone and 7400 comparator treated patients, on treatment for up to 3.5 years.
100 patientår) af de pioglitazonbehandlede kvindelige patienter frakturer.
In the 3.5 year cardiovascular risk PROactive study, 44/ 870 (5.1%; 1.0 fractures per 100 patient years) of pioglitazone-treated female patients experienced fractures compared to 23/ 905 (2.5%; 0.5 fractures per 100 patient years) of female patients treated with comparator.
Til sammenligning opstod der frakturer hos 23/ 905 (2, 5%; 0, 5 frakturer pr.
No increase in fracture rates was observed in men treated with pioglitazone (1.7%) versus comparator (2.1%).
Der sås ingen øget hyppighed af frakturer hos mænd, der blev behandlet med pioglitazon (1, 7%) sammenlignet med komparator (2, 1%).
The observed excess risk of fractures for women on pioglitazone in this study is therefore 0.5 fractures per 100 patient years of use.
Den glykæmiske kontrol bør monitoreres nøje.
Glycaemic control should be monitored
5 Der er rapporter om, at samtidig administration af pioglitazon og gemfibrozil (en hæmmer af cytochrom P450 2C8) har resulteret i en stigning på 3 gange i AUC for pioglitazon.
Co-administration of pioglitazone with gemfibrozil (an inhibitor of cytochrome P450 2C8) is reported to result in a 3-fold increase in AUC of pioglitazone.
Da der er en risiko for en stigning i dosisrelaterede bivirkninger, kan det være nødvendigt at nedsætte pioglitazon dosis, når gemfibrozil gives samtidigt.
Since there is a potential for an increase in dose- related adverse events, a decrease in the dose of pioglitazone may be needed when gemfibrozil is concomitantly administered.
Der er rapporter om, at samtidig administration af pioglitazon og rifampicin (en inducer af cytochrom P450 2C8) har resulteret i en nedsættelse på 54% af AUC for pioglitazon.
Co-administration of pioglitazone with rifampicin (an inducer of cytochrome P450 2C8) is reported to result in a 54% decrease in AUC of pioglitazone.
4. 4)
Close monitoring of glycaemic control should be considered (see section 4.4).
Der er øget risiko for lactacidose ved akut alkoholforgiftning (særligt i tilfælde af faste, fejlernæring eller leverinsufficiens) på grund af indholdet af metformin i Competact (se pkt.
There is increased risk of lactic acidosis in acute alcohol intoxication (particularly in the case of fasting, malnutrition or hepatic insufficiency) due to the metformin active substance of Competact (see section 4.4).
4. 4) Undgå indtagelse af alkohol og lægemidler indeholdende alkohol.
Avoid consumption of alcohol and medicinal products containing alcohol.
Intravaskulær administration af jodholdige kontrastmidler i forbindelse med radiologiske undersøgelser kan føre til nyreinsufficiens, som kan betyde ophobning af metformin og risiko for lactacidose.
Intravascular administration of iodinated contrast agents in radiological studies may lead to renal failure, resulting in metformin accumulation and risk of lactic acidosis.
4. 5).
Metformin should be discontinued prior to, or at the time of the test and not reinstituted until 48 hours afterwards, and only after renal function has been re-evaluated and found to be normal.
Kationiske lægemidler, som elimineres via tubulær sekretion i nyrerne (f. eks. cimetidin) kan interagere med metformin ved at konkurrere om fælles tubulære transportsystemer i nyrerne.
Cationic drugs that are eliminated by renal tubular secretion (e. g. cimetidine) may interact with metformin by competing for common renal tubular transport systems.
En undersøgelse med syv normale, raske frivillige viste, at cimetidin, givet i doser på 400 mg to gange dagligt, forøgede metformins systemiske eksponering (AUC) med 50% og Cmax med 81%.
A study conducted in seven normal healthy volunteers showed that cimetidine, administered as 400 mg twice daily, increased metformin systemic exposure (AUC) by 50% and Cmax by 81%.
Derfor skal en tæt monitorering af glykæmisk kontrol, dosisjustering inden for den anbefalede dosering og ændringer i diabetesbehandlingen overvejes ved samtidig indgivelse af kationiske lægemidler, der elimineres via tubulær sekretion i nyrerne.
Therefore, close monitoring of glycaemic control, dose adjustment within the recommended posology and changes in diabetic treatment should be considered when cationic drugs that are eliminated by renal tubular secretion are co-administered.
Kombinationer, som kræver særlige forsigtighedsregler Glucokortikoider (indgivet systemisk og lokalt), beta- 2- agonister og diuretika har intern hyperglykæmisk aktivitet.
Combinations requiring precautions for use Glucocorticoids (given by systemic and local routes), beta-2-agonists, and diuretics have intrinsic hyperglycaemic activity.