natgillin/translations-raw huggingface dataset:
diltiazem and verapamil) - anti-arrhythmic medicines (amiodarone) used to control arrhythmia (uneven beating of the heart) - medicines known as “statins” used to treat elevated cholesterol and triglycerides - phenytoin or phenobarbital, used to treat epilepsy - the corticosteroids prednisolone and methylprednisolone, belonging to the class of corticosteroids used to treat inflammations or suppress the immune system (e.g. in transplant rejection) - nefazodone, used to treat depression - Herbal preparations containing St. John's Wort (Hypericum perforatum) or extracts of
- fenitoin ili fenobarbital, koji se primjenjuju za liječenje epilepsije - kortikosteroidi prednizolon i metilprednizolon, koji pripadaju klasi kortikosteroida koja se primjenjuje za liječenje upala ili potiskivanje imunološkog sustava (npr. kod odbacivanja presatka) - nefazodon, koji se primjenjuje za liječenje depresije - biljni pripravci koji sadrže gospinu travu (Hypericum perforatum) ili ekstrakte biljke Schisandra sphenanthera.
inflammation of the throat, cough, flu-like symptoms - Stomach problems such as inflammation or ulcer causing abdominal pain or diarrhoea, bleeding in the stomach, inflammation or ulcer in the mouth, collection of fluid in the belly, vomiting,
- želučane tegobe poput upale ili vrijeda koji uzrokuju bol u trbuhu ili proljev, krvarenje u želudac, upala ili vrijed u ustima, nakupljanje tekućine u trbuhu, povraćanje, bol u trbuhu,
CYP3A4 inhibitors potentially leading to increased tacrolimus blood levels Clinically the following substances have been shown to increase tacrolimus blood levels: Strong interactions have been observed with antifungal agents such as ketoconazole, fluconazole, itraconazole, voriconazole, and isavuconazole, the macrolide antibiotic erythromycin, HIV protease inhibitors (e.g. ritonavir, nelfinavir, saquinavir), HCV protease inhibitors (e.g. telaprevir, boceprevir, and the combination of ombitasvir and paritaprevir with ritonavir, when used with and without dasabuvir), or the CMV antiviral letermovir, the pharmacokinetic enhancer cobicistat, and the tyrosine kinase inhibitors nilotinib and imatinib.
Jake interakcije opažene su s antimikoticima kao što su ketokonazol, flukonazol, itrakonazol, vorikonazol i izavukonazol, makrolidnim antibiotikom eritromicinom, inhibitorima proteaze HIV-a (npr. ritonavir, nelfinavir, sakvinavir), inhibitorima proteaze HCV-a (npr. telaprevir, boceprevir i kombinacija ombitasvira i paritaprevira s ritonavirom, primijenjena s dasabuvirom ili bez njega) ili antivirotikom za liječenje CMV infekcija letermovirom, zatim farmakokinetičkim pojačivačem kobicistatom te inhibitorima tirozin kinaze nilotinibom i imatinibom.
Tacrolimus
Killorglin
It is an immunosuppressant.
Modigraf je imunosupresiv.
thromboembolic and ischaemic events, vascular hypotensive disorders, haemorrhage, peripheral vascular disorders uncommon:
tromboembolijski i ishemijski događaji, krvožilni hipotenzivni poremećaji,
arthralgia, back pain, muscle spasms, pain in extremity uncommon:
artralgija, bol u leđima, spazam mišića, bol u ekstremitetu
Modigraf 1 mg granules for oral suspension Each sachet contains 1 mg tacrolimus (as monohydrate).
Modigraf 1 mg granule za oralnu suspenziju Jedna vrećica sadrži 1 mg takrolimusa (u obliku hidrata).
Croscarmellose sodium (E468)
6.1 Popis pomoćnih tvari laktoza hidrat hipromeloza (E464) karmelozanatrij, umrežena (E468)
This can lead to graft rejection or increased incidence of undesirable effects, including under- or overimmunosuppression, due to clinically relevant differences in systemic exposure to tacrolimus.
nenamjerni ili nenadzirani prelazak na formulacije takrolimusa s trenutnim ili produljenim oslobađanjem općenito nije siguran jer može dovesti do odbacivanja presatka ili povećanja incidencije nuspojava, uključujući i preslabu ili prejaku imunosupresiju zbog klinički važnih razlika u sistemskoj izloženosti takrolimusu.
Modigraf 0.2 mg granules for oral suspension Each sachet contains 0.2 mg tacrolimus (as monohydrate).
Modigraf 0,2 mg granule za oralnu suspenziju Jedna vrećica sadrži 0,2 mg takrolimusa (u obliku hidrata).
febrile neutropenia
povećanje masnog tkiva febrilna neutropenija
It is necessary to consider the clinical condition of the patient when interpreting whole blood levels.
Kad se tumače razine u punoj krvi potrebno je uzeti u obzir kliničko stanje bolesnika.
Cases of BK virus associated nephropathy, as well as cases of JC virus associated progressive multifocal leukoencephalopathy (PML), have been reported in patients treated with immunosuppressants, including Modigraf.
U bolesnika liječenih imunosupresivima, uključujući i Modigraf, zabilježeni su slučajevi nefropatije povezane s BK virusom, kao i slučajevi progresivne multifokalne leukoecefalopatije (PML) povezane s JC virusom.
Each sachet of Modigraf 1 mg granules contains 1 mg of tacrolimus (as monohydrate).
Jedna vrećica Modigraf 1 mg granula sadrži 1 mg takrolimusa (u obliku hidrata).
liver function tests abnormal common:
poremećeni nalazi testova jetrene funkcije često:
Eye disorders common:
Poremećaji oka Često:
Lansoprazole and ciclosporin may potentially inhibit CYP3A4-mediated metabolism of tacrolimus and thereby increase tacrolimus whole blood concentrations.
Lansoprazol i ciklosporin mogu potencijalno inhibirati metabolizam takrolimusa posredovan CYP3A4
Prophylaxis of liver transplant rejection
Profilaksa odbacivanja presatka jetre
Each sachet of Modigraf 0.2 mg granules contains 0.2 mg of tacrolimus (as monohydrate).
Jedna vrećica Modigraf 0,2 mg granula sadrži 0,2 mg takrolimusa (u obliku hidrata).
diabetes mellitus, hyperglycaemic conditions, hyperkalaemia common:
šećerna bolest, hiperglikemijska stanja, hiperkalijemija
Each sachet contains 1 mg tacrolimus (as monohydrate).
Jedna vrećica sadrži 1 mg takrolimusa (u obliku hidrata).
Read the package leaflet before use.
NAČIN PRIMJENE LIJEKA Prije uporabe pročitati uputu o lijeku.
Each sachet contains 0.2 mg tacrolimus (as monohydrate).
Jedna vrećica sadrži 0,2 mg takrolimusa (u obliku hidrata).
acute respiratory distress syndrome Gastrointestinal disorders very common:
akutni respiratorni distres sindrom
- Obstruction of the gut, increased blood level of the enzyme amylase, reflux of stomach content in your throat, delayed emptying of the stomach - Inflammation of the skin, burning sensation in the sunlight - Joint disorders - Painful menstruation and abnormal menstrual bleeding - Multiple organ failure, flu-like illness, increased sensitivity to heat and cold, feeling of pressure on your chest, jittery or abnormal feeling, weight loss
- upala kože, osjećaj žarenja na suncu - poremećaji zglobova - bolne menstruacije i poremećeno menstrualno krvarenje - zatajenje brojnih organa, bolest slična gripi, pojačana osjetljivost na toplinu i hladnoću, osjećaj pritiska u prsima, nemir ili nenormalno osjećanje, gubitak na tjelesnoj težini
coagulopathies, pancytopenia, neutropenia, coagulation and bleeding analyses abnormal rare:
koagulopatije, pancitopenija, neutropenija, poremećeni nalazi koagulacije i krvarenja
Myasthenia
hipoakuzija
In patients without antibody induction, if tacrolimus therapy is initiated intravenously, the recommended starting dose is 0.03 - 0.05 mg/kg/day (with Prograf 5 mg/ml concentrate for solution for infusion) as a continuous 24-hour infusion targeted to achieve tacrolimus whole blood concentrations of 15 - 25 nanogram/ml.
Ako se u bolesnika bez indukcije protutijela terapija takrolimusom započne intravenski, preporučena početna doza je 0,03 - 0,05 mg/kg na dan (s Prograf 5 mg/ml koncentratom za otopinu za infuziju) u obliku kontinuirane 24-satne infuzije s ciljem da se postignu koncentracije takrolimusa u punoj krvi od
An initial oral dose of 0.30 mg/kg/day should be administered in 2 divided doses (e.g. morning and evening).
0,20 do 0,30 mg/kg na dan treba primijeniti u 2 podijeljene doze (npr. ujutro i navečer).
Modigraf 1 mg granules for oral suspension tacrolimus
Modigraf 1 mg granule za oralnu suspenziju takrolimus
anaemia, thrombocytopenia, leukopenia, red blood cell analyses abnormal, leukocytosis uncommon:
anemija, trombocitopenija, leukopenija, poremećeni nalazi crvenih krvnih stanica, leukocitoza
Talk to your doctor or pharmacist before taking Modigraf
Obavijestite svog liječnika ili ljekarnika prije primjene Modigrafa: - ako imate ili ste imali tegobe s jetrom.
Very rare side effects (may affect up to 1 in 10,000 people): - Muscular weakness - Abnormal heart scan - Liver failure - Painful urination with blood in the urine - Increase of fat tissue
Rijetke nuspojave (mogu se javiti u do 1 na 1000 osoba): - sitna krvarenja u kožu zbog krvnih ugrušaka
Thereafter the cup is rinsed once with the same quantity of water and the rinsings consumed by the patient.
Nakon toga treba jedanput isprati čašu istom količinom vode koju bolesnik treba popiti.
hearing impaired
Poremećaji oka
Modigraf 0.2 mg granules for oral suspension tacrolimus
Modigraf 0,2 mg granule za oralnu suspenziju takrolimus
When tacrolimus is administered intravenously as rapid infusion/bolus injection at a dose of 0.1 to 1.0 mg/kg, QTc prolongation has been observed in some animal species.
Kada se takrolimus primjenjuje intravenski kao brza infuzija/bolus injekcija pri dozi od 0,1 do 1,0
Highly variable age dependent total body clearance and half life were observed in limited paediatric clinical investigations, especially in early childhood.
U ograničenim pedijatrijskim kliničkim ispitivanjima, osobito u vrlo male djece, primijećeno je da su ukupni tjelesni klirens i poluvijek vrlo varijabilni i ovise o dobi.
As tacrolimus treatment may be associated with hyperkalaemia, or may increase pre-existing hyperkalaemia, high potassium intake, or potassium-sparing diuretics (e.g. amiloride, triamterene, or spironolactone) should be avoided (see section 4.4).
Budući da liječenje takrolimusom može biti povezano s hiperkalijemijom ili pojačati već postojeću hiperkalijemiju, potrebno je izbjegavati uzimanje velikih količina kalija ili diuretika koji štede kalij
Mechanism of action and pharmacodynamic effects At the molecular level, the effects of tacrolimus appear to be mediated by binding to a cytosolic protein (FKBP12) which is responsible for the intracellular accumulation of the compound.
Čini se da su na molekularnoj razini učinci takrolimusa posredovani vezivanjem za protein citosola
Excipients
sljepoća
Common side effects (may affect up to 1 in 10 people): - Reduction in blood cell counts (platelets, red or white blood cells), increase in white blood cell counts, changes in red blood cell counts (seen in blood tests) - Reduced magnesium, phosphate, potassium, calcium or sodium in the blood, fluid overload,
- sniženje broja krvnih stanica (krvnih pločica, crvenih ili bijelih krvnih stanica), povećanje broja bijelih krvnih stanica, promjene broja crvenih krvnih stanica (vide se na krvnim pretragama)
abdominal pain, indigestion, constipation, passing wind, bloating, loose stools - Bile duct disorders, yellowing of the skin due to liver problems, liver tissue damage and inflammation of the liver - Itching, rash, hair loss, acne, increased sweating - Pain in joints, limbs, back and feet, muscle spasms - Insufficient function of the kidneys, reduced production of urine, impaired or painful urination - General weakness, fever, collection of fluid in your body, pain and discomfort, increase of the enzyme alkaline phosphatase in your blood, weight gain, feeling of temperature disturbed - Insufficient function of your transplanted organ
- svrbež, osip, gubitak kose, akne, pojačano znojenje - bol u zglobovima, udovima, leđima i stopalima, mišićni grčevi - nedostatna funkcija bubrega, smanjeno stvaranje mokraće, narušeno ili bolno mokrenje
Blood trough levels of tacrolimus should also be closely monitored when clinical signs of toxicity or acute rejection are observed, following conversion between Modigraf granules to Prograf capsules, dose adjustments, changes in the immunosuppressive regimen, or co-administration of substances which may alter tacrolimus whole blood concentrations (see section 4.5).
Modigraf granula na Prograf kapsule, nakon prilagodbe doze, nakon promjene imunosupresivnog režima ili kod istodobne primjene tvari koje mogu promijeniti koncentracije takrolimusa u punoj krvi
In paediatric patients converted to tacrolimus, an initial oral dose of 0.20 - 0.30 mg/kg/day should be administered in 2 divided doses (e.g. morning and evening).
U odraslih bolesnika koji su prebačeni na Modigraf početnu peroralnu dozu od 0,15 mg/kg na dan treba primijeniti u 2 odvojene doze (npr. ujutro i navečer).
Cardiac disorders common:
Srčani poremećaji Često:
Tacrolimus was started as continuous intravenous infusion at a dose of 0.025 mg/kg/day and oral tacrolimus was administered at a dose of 0.15 mg/kg/day with subsequent dose adjustments to target trough levels of 10 to 20 nanogram/ml.
0,025 mg/kg na dan, a peroralni takrolimus je primijenjen u dozi od 0,15 mg/kg na dan s naknadnim prilagodbama doze do ciljnih najnižih razina od 10 do 20 nanogram/ml.
Excretion
Doziranje
Several cases of accidental overdose have been reported with tacrolimus; symptoms have included tremor, headache, nausea and vomiting, infections, urticaria, lethargy and increases in blood urea nitrogen, serum creatinine concentrations and alanine aminotransferase levels.
Simptomi su uključivali tremor, glavobolju, mučninu i povraćanje, infekcije, urtikariju, letargiju i povećanje dušika iz ureje,
nervous system disorders, seizures, disturbances in consciousness, peripheral neuropathies, dizziness, paraesthesias and dysaesthesias, writing impaired uncommon:
poremećaji živčanog sustava, napadaji, poremećaji svijesti, periferne neuropatije,
Hepatic impairment
- mišićna slabost
renal failure, renal failure acute, nephropathy toxic, renal tubular necrosis, urinary abnormalities, oliguria, bladder and urethral symptoms uncommon:
zatajenje bubrega, akutno zatajenje bubrega, toksična nefropatija, bubrežna tubularna nekroza, mokraćni poremećaji, oligurija, simptomi mokraćnog mjehura i mokraćne cijevi
If the clinical condition of the patient prevents oral dosing, an initial intravenous dose of 0.075 - 0.100 mg/kg/day (with Prograf 5 mg/ml concentrate for solution for infusion) should be administered as a continuous 24-hour infusion.
Ako kliničko stanje bolesnika ne dopušta peroralnu primjenu, treba dati početnu intravensku dozu od 0,075 do 0,100 mg/kg na dan (s Prograf 5 mg/ml koncentratom za otopinu za infuziju) u obliku kontinuirane 24-satne infuzije.
Prophylaxis of kidney transplant rejection
Profilaksa odbacivanja presatka bubrega
parenchymal lung disorders, dyspnoea, pleural effusion, cough, pharyngitis, nasal congestion and inflammations uncommon:
poremećaji plućnog parenhima, dispneja, pleuralni izljev, kašalj, faringitis,
haemolytic uraemic syndrome, anuria very rare:
hemolitičko-uremijski sindrom, anurija
Tacrolimus has been used with or without antibody induction in paediatric heart transplantation.
U pedijatrijskih se bolesnika s presatkom srca takrolimus primjenjuje uz indukciju ili bez indukcije protutijela.
Therapeutic drug monitoring of mycophenolic acid may be appropriate when switching from ciclosporin to tacrolimus or vice versa.
Pri prelasku s ciklosporina na takrolimus i obrnuto možda će biti potrebno terapijsko praćenje mikofenolatne kiseline.
Modigraf 1 mg granules for oral suspension tacrolimus oral use
Modigraf 1 mg granule za oralnu suspenziju takrolimus kroz usta
If the clinical condition of the patient prevents oral dosing, an initial intravenous dose of 0.05 mg/kg/day (with Prograf 5 mg/ml concentrate for solution for infusion) should be administered as a continuous 24-hour infusion.
Ako kliničko stanje bolesnika ne dopušta peroralnu primjenu, potrebno je dati početnu intravensku dozu od 0,05 mg/kg na dan (s Prograf 5 mg/ml koncentratom za otopinu za infuziju) u obliku kontinuirane 24-satne infuzije.
optic neuropathy Ear and labyrinth disorders common:
Poremećaji uha i labirinta Često:
Astellas Pharma Kft. Tel.: + 36 1 577 8200
Tel.: + 36 1 577 8200
CYP3A4 inducers potentially leading to decreased tacrolimus blood levels Clinically the following substances have been shown to decrease tacrolimus blood levels: Strong interactions have been observed with rifampicin, phenytoin or St. John's Wort (Hypericum perforatum) which may require increased tacrolimus doses in almost all patients.
Inhibitori CYP3A4 koji mogu dovesti do povećanja koncentracije takrolimusa u krvi Klinički se pokazalo da sljedeće tvari povećavaju koncentracije takrolimusa u krvi:
Modigraf 0.2 mg granules for oral suspension tacrolimus oral use
Modigraf 0,2 mg granule za oralnu suspenziju takrolimus kroz usta
Very common side effects (may affect more than 1 in 10 people): - Increased blood sugar, diabetes mellitus, increased potassium in the blood - Difficulty in sleeping - Trembling, headache - Increased blood pressure - Liver function tests abnormal - Diarrhoea, nausea - Kidney problems
- povišen šećer u krvi, šećerna bolest, povišen kalij u krvi - poteškoće sa spavanjem
increased uric acid or lipids in the blood, decreased appetite, increased acidity of the blood,
- sniženi magnezij, fosfat, kalij, kalcij ili natrij u krvi, preopterećenje tekućinom, povišena mokraćna kiselina ili lipidi u krvi, smanjen apetit, povećana kiselost krvi, druge promjene elektrolita u krvi (vide se na krvnim pretragama)
hypertension common:
hipertenzija
Following your organ transplant (e.g. liver, kidney, heart), your body's immune system will try to reject the new organ.
Vaš imunološki sustav pokušat će odbaciti novi organ.
other changes in the blood salts (seen in blood tests) - Anxiety symptoms, confusion and disorientation, depression, mood changes, nightmare,
- simptomi tjeskobe, smetenost i dezorijentacija, depresija, promjene raspoloženja, noćne more, halucinacije, mentalni poremećaji
If the dose cannot be administered orally as a result of the clinical condition of the patient, intravenous therapy of 0.01 - 0.05 mg/kg/day (with Prograf 5 mg/ml concentrate for solution for infusion) should be initiated as a continuous 24-hour infusion.
Ako kliničko stanje bolesnika ne dopušta peroralnu primjenu doze, potrebno je započeti intravensku terapiju dozom od 0,01 - 0,05 mg/kg na dan (s Prograf 5 mg/ml koncentratom za otopinu za infuziju) u obliku kontinuirane 24-satne infuzije.
Rare side effects (may affect up to 1 in 1,000 people): - Small bleedings in your skin due to blood clots - Increased muscle stiffness - Blindness, deafness - Collection of fluid around the heart - Acute breathlessness - Cyst formation in your pancreas - Problems with blood flow in the liver - Serious illness with blistering of skin, mouth, eyes and genitals; increased hairiness - Thirst, fall, feeling of tightness in your chest, decreased mobility, ulcer
- ozbiljna bolest s mjehurima na koži, u ustima, na očima i spolnim organima; pojačana dlakavost - žeđ, pad, osjećaj stezanja u prsima, smanjena pokretljivost, čir
If the dose cannot be administered orally as a result of the clinical condition of the patient, intravenous therapy of 0.05 - 0.10 mg/kg/day (with Prograf 5 mg/ml concentrate for solution for infusion) should be initiated as a continuous 24-hour infusion.
Ako kliničko stanje bolesnika ne dopušta peroralnu primjenu doze, potrebno je započeti intravensku terapiju dozom od 0,05 do 0,10 mg/kg na dan (s Prograf 5 mg/ml koncentratom za otopinu za infuziju) u obliku kontinuirane 24-satne infuzije.
hallucination, mental disorders - Fits, disturbances in consciousness, tingling and numbness (sometimes painful) in the hands and feet, dizziness, impaired writing ability, nervous system disorders - Blurred vision, increased sensitivity to light, eye disorders - Ringing sound in your ears - Reduced blood flow in the heart vessels, faster heartbeat - Bleeding, partial or complete blocking of blood vessels, reduced blood pressure - Shortness in breath, changes in the lung tissue, collection of liquid around the lung,
- nepravilan rad srca, preskakanje srca, smanjena radna učinkovitost srca, poremećaj srčanog mišića, povećanje srčanog mišića, pojačano lupanje srca, poremećaj na EKG-u, poremećaj brzine rada srca i pulsa - krvni ugrušak u venama udova, šok
Tacrolimus trough levels should be measured prior to conversion and within 1 week after conversion.
Prije prebacivanja i u roku od 1 tjedna nakon prebacivanja na drugu formulaciju treba izmjeriti najniže razine takrolimusa.
Consideration should be given to use of a behavioural modification programme.
Treba razmotriti primjenu programa modifikacije ponašanja.
QUALITATIVE AND QUANTITATIVE COMPOSITION One tablet contains:
KVALITATIVNI I KVANTITATIVNI SASTAV Jedna tableta sadrži:
These signs are potentially treatment related.
Ti su znakovi potencijalno povezani s terapijom.
The product may therefore result in an increase or decrease in aggression levels.
Proizvod stoga može uzrokovati povećanje ili smanjenje razina agresije.
In comparison, none of the five enzymes increased with increasing doses of imepitoin.
Za usporedbu, nijedan od tih pet enzima nije se povećao uz povećanje doza imepitoina.
This evaluation may include consideration of inciting factors or situations associated with previous aggressive episodes.
Ta procjena može uključivati razmatranje poticajnih čimbenika ili situacija povezanih s prethodnim agresivnim epizodama.
Because of the nature of epilepsy, the pharmacological response to treatment may vary.
Zbog prirode epilepsije, farmakološki odgovor na liječenje može varirati.
Any remaining half-tablet should be used for the next dose.
Preostalu polovicu tablete treba primijeniti za sljedeću dozu.
No interaction with highly protein bound compounds is therefore expected.
Stoga se ne očekuje interakcija sa spojevima s visokim vezanjem na proteine.
The required dose will vary between dogs and will depend on the severity of the disorder.
Potrebna doza razlikovat će se među psima, a ovisit će o težini poremećaja.
Though efficacy may not be complete, imepitoin is considered to be a suitable treatment option in some dogs because of its safety profile.
Iako djelotvornost možda nije potpuna, imepitoin se smatra prikladnom opcijom liječenja u nekih pasa zbog svog sigurnosnog profila.
Imepitoin is extensively metabolised prior to elimination.
Imepitoin se opsežno metabolizira prije eliminacije.
See also section "Pregnancy and lactation".
Vidjeti također dio "Graviditet i laktacija".
Idiopathic epilepsy
Idiopatska epilepsija
Ask your veterinary surgeon how to dispose of medicines no longer required.
Pitajte svog veterinara kako odlagati veterinarsko-medicinske proizvode koji vam više nisu potrebni.
Imepitoin has a relatively high volume of distribution (579 to 1548 ml/kg).
Imepitoin ima relativno visoki volumen distribucije (od 579 do 1548 ml/kg).
Do not use this veterinary medicinal product after the expiry date which is stated on the carton and the bottle after EXP.
Ne koristite ovaj veterinarsko-medicinski proizvod poslije isteka roka valjanosti koji je naznačen na kutiji i bočici poslije EXP.
Pharmacotherapeutic group: Antiepileptics, Other antiepileptics, imepitoin ATCvet code: QN03AX90
FARMAKOLOŠKA SVOJSTVA Farmakoterapijska grupa: antiepileptici, drugi antiepileptici, imepitoin ATCvet kod: QN03AX90
Most events are transient, resolving during or shortly after the end of the treatment course.
Većina je nuspojava prolazna i rješava se tijekom ili neposredno nakon završetka liječenja.
Metabolite profiles in urine and faeces revealed four major inactive metabolites which are formed by oxidative modification.
Profili metabolita u mokraći i stolici pokazuju četiri glavna neaktivna metabolita koji nastaju oksidativnom modifikacijom.