natgillin/translations-raw huggingface dataset:
The SHIFT study was a large multicentre, international, randomised double-blind placebo controlled outcome trial conducted in 6,505 adult patients with stable chronic CHF (for ≥4 weeks), NYHA class II to IV, with a reduced left ventricular ejection fraction (LVEF ≤35%) and a resting heart rate ≥70 bpm.
Ispitivanje SHIFT, veliko multicentrično, međunarodno, randomizirano, dvostruko slijepo, placebo kontrolirano ispitivanje ishoda, provedeno je na 6505 odraslih bolesnika sa stabilnim kroničnim zatajenjem srca (s trajanjem ≥ 4 tjedana), NYHA stupanj II-IV, sa smanjenom ejekcijskom frakcijom lijeve klijetke (LVEF ≤ 35%) i srčanom frekvencijom u mirovanju ≥ 70/min.
HDPE bottle with opaque polypropylene screw cap with aluminium induction sealing liner with wad and desiccant in sizes of 56, 98, and 100 film-coated tablets.
Boca od polietilena visoke gustoće (HDPE) s neprozirnim propilenskim navojnim čepom s indukcijski zavarenom aluminijskom folijom, vatom i desikantom u veličinama s 56, 98 i 100 filmom obloženih tableta.
A small statistically significant increase in the PCE was observed in a pre-specified subgroup of patients with angina patients in CCS class II or higher at baseline (n = 12,049) (annual rates 3.4% versus 2.9%, relative risk ivabradine/placebo 1.18, p = 0.018), but not in the subgroup of the overall angina population in CCS class ≥ I (n=14,286) (relative risk ivabradine/placebo 1.11, p = 0.110).
Mali, ali statistički značajan porast u PCE zabilježen je u prethodno definiranoj podskupini bolesnika s početno utvrđenom anginom pektoris CCS (Canadian Cardiovascular Society) klase II ili više (n = 12 049) (godišnje stope 3,4% naspram 2,9%, relativni rizik ivabradin/placebo 1,18, p= 0,018), ali ne u podskupini sveukupne populacije bolesnika s anginom pektoris CCS klase ≥I (n = 14 286) (relativni rizik ivabradin/placebo 1,11, p=0,110).
Furthermore as elevated heart rate adversely affects the heart functioning and vital prognosis in patients with chronic heart failure, the specific heart rate lowering action of ivabradine helps to improve the heart functioning and vital prognosis in these patients.
Nadalje, kako povećana brzina srčanih otkucaja negativno utječe na funkciju srca i životnu prognozu bolesnika sa kroničnim zatajenjem srca, specifičan učinak ivabradina na smanjivanje brzine srčanih otkucaja pomaže u poboljšanju rada srca kao i životne prognoze kod ovih bolesnika.
Palpitations and cardiac extra beats, feeling sick (nausea), constipation, diarrhoea, abdominal pain, spinning sensation (vertigo), difficulty breathing (dyspnoea), muscle cramps, changes in laboratory parameters: high blood levels of uric acid, an excess of eosinophils (a type of white blood cell) and elevated creatinine in blood (a breakdown product of muscle), skin rash, angioedema (such as swollen face, tongue or throat, difficulty in breathing or swallowing), low blood pressure, fainting, feeling of tiredness, feeling of weakness, abnormal ECG heart tracing, double vision, impaired vision.
Osjećaj lupanja srca i neuobičajeni otkucaji srca, osjećaj slabosti (mučnina), zatvor, proljev, bol u trbuhu, osjećaj vrtnje (vrtoglavica), poteškoće u disanju (dispneja), grčevi u mišićima i promjene u laboratorijskim pretragama: visoka razina mokraćne kiseline u krvi, prekomjeran broj eozinofila (vrsta bijelih krvnih stanica) i povišena razina kreatinina u krvi (nastaje zbog raspada mišića), kožni osip, angioedem (kao npr. oticanje lica, jezika ili grla, poteškoće u disanju ili gutanju), niski krvni tlak, nesvjestica, osjećaj umora, osjećaj slabosti, abnormalni nalaz EKG-a, dvoslike, oštećen vid.
The most common symptom of angina is chest pain or discomfort.
Najčešći simptom angine pektoris je pojava boli ili nelagode u prsnom košu.
CARTON/BOTTLE LABEL
NALJEPNICA NA KUTIJI/BOCI
Mean LVEF increased from 31.8% to 45.3% at M012 in ivabradine group versus 35.4% to 42.3% in the placebo group.
U ivabradinskoj skupini, srednja vrijednosti LVEF se povećalo sa 31,8% na 45,3% nakon 12 mjeseci ispitivanja u usporedbi s 35,4% na 42,3% u placebo skupini.
Each film-coated tablet contains 55.09 mg lactose (as anhydrous).
Svaka filmom obložena tableta sadrži 55,09 mg laktoze (bezvodne).
In addition there was no clinically significant effect of ivabradine on the pharmacokinetics of simvastatin, amlodipine, lacidipine, on the pharmacokinetics and pharmacodynamics of digoxin, warfarin and on the pharmacodynamics of aspirin.
Ivabradin nije imao klinički značajan učinak na farmakokinetiku simvastatina, amlodipina, lacidipina, na farmakokinetiku i farmakodinamiku digoksina, varfarina te na farmakodinamiku acetilsalicilatne kiseline..
The major active metabolite is the N-desmethylated derivative (S 18982) with an exposure about 40% of that of the parent compound.
N-desmetilirani derivat (S 18982), a izloženost ovom derivatu iznosi približno 40% izloženosti ishodišnom spoju.
Do not take Ivabradine JensonR - if you are allergic to ivabradine or any of the other ingredients of this medicine (listed in section 6); - if your resting heart rate before treatment is too slow (below 70 beats per minute); - if you are suffering from cardiogenic shock (a heart condition treated in hospital); - if you suffer from a heart rhythm disorder; - if you are having a heart attack; - if you suffer from very low blood pressure; - if you suffer from unstable angina (a severe form in which chest pain occurs very frequently and with or without exertion); - if you have heart failure which has recently become worse; - if your heart beat is exclusively imposed by your pacemaker; - if you suffer from severe liver problems; - if you are already taking medicines for the treatment of fungal infections (such as ketoconazole,
Nemojte uzimati Ivabradine JensonR - ako ste alergični na ivabradin ili neki drugi sastojak ovog lijeka (naveden u dijelu 6.); - ako Vam je srčana frekvencija u mirovanju prije liječenja prespora (manje od 70 otkucaja u minuti); - ako bolujete od kardiogenog šoka (medicinsko stanje koje se liječi u bolnici); - ako bolujete od poremećaja srčanog ritma; - ako imate srčani udar; - ako imate niski krvni tlak; - ako imate nestabilnu anginu pektoris (težak oblik angine pektoris u kojoj se bolovi u prsnom košu javljaju vrlo često uz napor, ali i bez napora); - ako imate zatajenje srca koje se nedavno pogoršalo; - ako imate elektrostimulator (pacemaker); - ako imate teške bolesti jetre; - ako uzimate lijekove za liječenje gljivičnih infekcija (kao što su ketokonazol, itrakonazol),
- Renal impairment: the impact of renal impairment (creatinine clearance from 15 to 60 ml/min) on ivabradine pharmacokinetic is minimal, in relation with the low contribution of renal clearance (about 20%) to total elimination for both ivabradine and its main metabolite S 18982 (see section 4.2).
- Oštećenje bubrega: utjecaj oštećenja bubrega (klirens kreatinina od 15 do 60 ml/min) na farmakokinetiku ivabradina je minimalan, srazmjeran niskom doprinosu renalnog klirensa (oko 20%) ukupnoj eliminaciji i ivabridina i njegovog glavnog metabolita
No dose adjustment is required in patients with renal insufficiency and creatinine clearance above 15 ml/min (see section 5.2).
U bolesnika s insuficijencijom funkcije bubrega i klirensom kreatinina iznad 15 ml/min nije potrebno prilagođavati dozu (vidjeti dio 5.2).
The concomitant use of ivabradine with these medicinal products is contraindicated (see section 4.3).
Kontraindicirana je istovremena primjena ivabradina s tim lijekovima (vidjeti dio 4.3).
Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the symptomatic treatment of chronic stable angina pectoris in coronary artery disease adults with normal sinus rhythm and heart rate ≥70 bpm.
Simptomatsko liječenje kronične stabilne angine pektoris Ivabradin je indiciran za simptomatsko liječenje kronične stabilne angine pektoris u odraslih bolesnika s koronarnom arterijskom bolesti s normalnim sinusnim ritmom i sa srčanom frekvencijom ≥ 70 otkucaja u minuti.
After three to four weeks of treatment, if the patient is still symptomatic, if the initial dose is well tolerated and if resting heart rate remains above 60 bpm, the dose may be increased to the next higher dose in patients receiving 2.5 mg twice daily or 5 mg twice daily.
Nakon tri do četiri tjedna liječenja, ukoliko su u bolesnika još uvijek prisutni simptomi, ukoliko se početna doza dobro podnosi i ako srčana frekvencija u mirovanju ostaje iznad 60 otkucaja u minuti, doza se može povećati na sljedeću višu dozu u bolesnika koji uzimaju 2,5 mg dva puta na dan ili 5 mg dva puta na dan.
Cold form perforated unit dose blisters (OPA/Alu/PVC) in pack sizes of 14 x 1 and 56 x 1 film-coated tablets.
Hladno oblikovani perforirani blisteri djeljivi na jedinične doze (OPA/Al/PVC) u pakiranjima od 14 x 1 i 56 x 1 filmom obloženom tabletom.
In the subgroup of patients with HR ≥75 bpm (n = 4,150), a greater reduction was observed in the primary composite endpoint of 24% (hazard ratio: 0.76, 95% CI [0.68;0.85] - p <0.0001) and for other secondary endpoints, including all cause death (hazard ratio: 0.83, 95% CI [0.72;0.96] - p = 0.0109) and CV death (hazard ratio: 0.83, 95% CI [0.71;0.97] - p = 0.0166).
U podskupini bolesnika sa srčanom frekvencijom ≥ 75/min (n=4 150), zabilježeno je izraženije smanjenje primarne kompozitne mjere ishoda od 24% (omjer hazarda (HR): 0,76, 95%CI [0,68;0,85]p< 0,0001) kao i za ostale sekundarne mjere ishoda, uključujući smrt zbog svih uzroka (omjer hazarda (HR): 0,83, 95%CI [0.72;0.96] - p=0,0109) i smrt zbog kardiovaskularnih uzroka (omjer hazarda (HR): 0,83, 95%CI [0.71;0.97] - p=0,0166).
In some cases (e.g. if you are elderly), your doctor may prescribe half the dose i.e., one half 5 mg tablet of Ivabradine JensonR 5 mg (corresponding to 2.5 mg ivabradine) in the morning and one half 5 mg tablet in the evening.
U nekim slučajevima (npr. kod starijih osoba) postoji mogućnost da Vam liječnik propiše pola doze, t.j. jednu polovicu tablete od 5mg lijeka Ivabradine JensonR 5 mg (što odgovara količini od 2,5 mg ivabradina) ujutro i jednu polovicu tablete od 5 mg uvečer.
If you stop taking Ivabradine JensonR:
Ako prestanete uzimati Ivabradine JensonR:
Ivabradine JensonR is available in blister packs of 14, 14 x 1, 28, 56, 56 x 1, 98 and 112 film-coated tablets.
Ivabradine JensonR dostupan je u blister pakiranjima s 14, 14 x 1, 28, 56, 56 x 1, 98 i 112 filmom obloženih tableta.
Make sure to tell your doctor if you are taking any of the following medicines, as a dose adjustment of Ivabradine JensonR or monitoring should be required: - fluconazole (an antifungal medicine) - rifampicin (an antibiotic) - barbiturates (for difficult sleeping or epilepsy) - phenytoin (for epilepsy) - Hypericum perforatum or St John's wort (herbal treatment for depression) - QT prolonging medicines to treat either heart rhythm disorders or other conditions: - quinidine, disopyramide, ibutilide, sotalol, amiodarone (to treat heart rhythm disorders) - bepridil (to treat angina pectoris) - certain types of medicines to treat anxiety, schizophrenia or other psychoses (such as pimozide, ziprasidone, sertindole) - anti-malarial medicines (such as mefloquine or halofantrine) - intravenous erythromycin (an antibiotic) - pentamidine (an antiparasitic medicine) - cisapride (against the gastro-oesophageal reflux) - Some types of diuretics which may cause decrease in blood potassium level, such as furosemide, hydrochlorothiazide, indapamide (used to treat oedema, high blood pressure).
Ako uzimate neke od slijedećih lijekova, svakako o tome obavijestite svog liječnika koji bi trebao prilagoditi dozu Ivabradine JensonR ili pratiti liječenje: - flukonazol (antifungik) - rifampicin (antibiotik) - barbiturati (za otežano spavanje ili epilepsiju) - fenitoin (za epilepsiju) - Hypericum perforatum ili gospina trava (biljna terapija za depresiju) - lijekovi koji produljuju QT-interval i primjenjuju se za liječenje poremećaja srčanog ritma ili drugih bolesti: - kinidin, dizopiramid, ibutilid, sotalol, amiodaron (za liječenje poremećaja srčanog ritma) - bepridil (za liječenje angine pektoris) - lijekovi za liječenje anksioznosti, shizofrenije ili drugih psihoza (kao što su pimozid, ziprasidon, sertindol) - antimalarici (kao npr. meflokin ili halofantrin) - intravenski eritromicin (antibiotik) - pentamidin (antiparazitik) - cisaprid (za liječenje gastro-ezofagealnog refluksa) - Neke vrste diuretika koji mogu uzrokovati sniženje razine kalija u krvi, poput furosemida, hidroklorotiazida, indapamida (koriste se za liječenje edema, povišenog krvnog tlaka).
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Ivabradine JensonR is also available in bottles with a screw cap and a desiccant of 56, 98 and 100 film-coated tablets.
Ivabradine JensonR dostupan je u bocama s navojnim čepom i sredstvom za sušenje s 56, 98 i 100 filmom obloženih tableta.
Mylan Hungary Kft. Mylan utca.
Mylan Hungary Kft.
In pivotal phase III clinical trials the following medicinal products were routinely combined with ivabradine with no evidence of safety concerns: angiotensin converting enzyme inhibitors, angiotensin II antagonists, beta-blockers, diuretics, anti-aldosterone agents, short and long acting nitrates, HMG CoA reductase inhibitors, fibrates, proton pump inhibitors, oral antidiabetics, aspirin and other anti-platelet medicinal products.
U pivotalnim kliničkim ispitivanjima faze III, sljedeći lijekovi su rutinski primjenjivani s ivabradinom bez štetnih utjecaja: inhibitori konvertaze angiotenzina, antagonisti angiotenzina II, beta- blokatori, diuretici, antagonisti aldosterona, nitrati brzog i dugog djelovanja, inhibitori HMG CoA reduktaze, fibrati, blokatori protonske pumpe, oralni antidijabetici, acetilsalicilatna kiselina. i drugi antitrombocitni lijekovi.
Mon → Tue → Wed → Thu → Fri → Sat → Sun
DRUGO pon → uto → sri → čet → pet → sub → ned
N-desmethylated derivative of ivabradine has been identified as the main active metabolite in humans.
Kao glavni aktivni metabolit u ljudi identificiran je N-desmetilirani derivat ivabradina.
Ivabradine did not show additional efficacy on secondary endpoints of ETT parameters at the trough of drug activity while an additional efficacy was shown at peak (3-4 hours after oral ivabradine intake).
Ivabradin nije pokazao dodatnu djelotvornost u sekundarnim mjerama ishoda - parametrima testa opterećenja, pri najnižoj koncentraciji lijeka dok je pri vršnoj koncentraciji lijeka uočena dodatna djelotvornost (3-4 sata nakon peroralnog uzimanja ivabradina).
If you forget to take Ivabradine JensonR:
Ako ste zaboravili uzeti Ivabradine JensonR:
Do not take Ivabradine JensonR if you are able to become pregnant unless you use reliable contraceptive measures (see “Do not take Ivabradine JensonR”).
Nemojte uzimati Ivabradine JensonR ako ste žena koja može zatrudnijeti, osim u slučaju da koristite pouzdanu kontracepciju (pogledajte dio „Nemojte uzimati Ivabradine JensonR”).
The pack sizes 14 x 1 and 56 x 1 film-coated tablets are presented in unit dose blisters.
Pakiranja s 14 x 1 i 56 x 1 filmom obloženom tabletom u obliku su blistera djeljivih na jedinične doze.
PVC/Aclar-Alu perforated unit dose pack in pack sizes of 14 x 1 and 56 x 1 film-coated tablets.
PVC/Aclar-Al perforirani blisteri djeljivi na jedinične doze u pakiranjima od 14 x 1 i 56 x 1 filmom obloženom tabletom.
- The other ingredients in the tablet core are: lactose anhydrous, magnesium stearate, maltodextrin, microcrystalline cellulose, colloidal anhydrous silica, hydroxypropyl cellulose, and in the tablet coating are : hypromellose, titanium dioxide, macrogol, polysorbate 80, yellow iron oxide (E172), red iron oxide (E172).
- Pomoćne tvari u jezgri tablete su: bezvodna laktoza, magnezijev stearat, maltodekstrin, mikrokristalična celuloza, koloidni bezvodni silicijev dioksid, hidroksipropilceluloza, a u ovojnici tablete: hipromeloza, titanijev dioksid, makrogol, polisorbat 80, žuti željezov oksid (E172), crveni željezov oksid (E172).
Other medicines and Ivabradine JensonR Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Obavijestite svog liječnika ili ljekarnika ako uzimate, nedavno ste uzeli ili biste mogli uzeti bilo koje druge lijekove.
Cold form blisters (OPA/Alu/PVC) in pack sizes of 14, 28, 56, 98 and 112 film-coated tablets.
Hladno oblikovani blisteri (OPA/Al/PVC) u pakiranjima od 14, 28, 56, 98 i 112 filmom obloženih tableta.
In the subgroup of patients with HR ≥75 bpm and on the recommended target dose of beta-blocker, no statistically significant benefit was observed on the primary composite endpoint (hazard ratio: 0.97, 95%CI [0.74; 1.28]) and other secondary endpoints, including hospitalisation for worsening heart failure (hazard ratio: 0.79, 95% CI [0.56;1.10]) or death from heart failure (hazard ratio: 0.69, 95% CI [0.31;1.53]).
U podskupini bolesnika sa srčanom frekvencijom ≥ 75/min koji primaju preporučenu ciljnu dozu beta-blokatora nije zabilježena značajna korist za primarni kompozitni ishod (omjer hazarda (HR): 0,97, 95%CI [0,74;1,28]) niti za ostale sekundarne ishode uključujući hospitalizaciju zbog pogoršanja zatajenja srca (omjer hazarda (HR): 0,79, 95% CI [0,56;1,10]) ili smrt zbog zatajenja srca (omjer hazarda (HR): 0,69, 95% CI [0,31;1,53]).
In a 1,277-patients randomised placebo-controlled study, ivabradine demonstrated a statistically significant additional efficacy on response to treatment (defined as a decrease of at least 3 angina attacks per week and/or an increase in the time to 1 mm ST segment depression of at least 60 s during a treadmill ETT) on top of amlodipine 5 mg o.d. or nifedipine GITS 30 mg o.d. at the trough of drug activity (12 hours after oral ivabradine intake) over a 6-week treatment period (OR = 1.3, 95% CI [1.0-1.7]; p = 0.012).
U randomiziranom, placebom kontroliranom ispitivanju na 1277 bolesnika, primjena ivabradina uz postojeću primjenu amlodipina od 5 mg jednom dnevno ili nifedipina GITS (gastrointestinalni terapijski sustav) od 30 mg jednom dnevno pri najnižoj koncentraciji lijeka (12 sati nakon uzimanja ivabradina peroralno) pokazala je statistički značajnu dodatnu djelotvornost u odgovoru na liječenje (definiran kao smanjenje od najmanje 3 napadaja angine na tjedan i/ili povećanje vremena do depresije ST segmenta za 1 mm od najmanje 60 s za vrijeme testa opterećenja) tijekom 6 tjedana liječenja (omjer šansi (OR) = 1,3, 95% CI [1,0-1,7]; p=0,012).
A 20% heart rate reduction, without bradycardia, was achieved by 69.9% of patients in the ivabradine group versus 12.2% in the placebo group during the titration period of 2 to 8 weeks (Odds Ratio: E = 17.24, 95% CI [5.91; 50.30]).
U 69,9% bolesnika koji su primali ivabradin postignuto je 20% sniženje broja otkucaja srca bez bradikardije u usporedbi s 12,2% bolesnika u skupini koja je primala placebo tijekom titracije doza u razdoblju od 2 do 8 tjedana (omjer izgleda E = 17,24, 95% CI [5,91; 50,30]).
- Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 - Resting heart rate below 70 beats per minute prior to treatment - Cardiogenic shock - Acute myocardial infarction - Severe hypotension (<90/50 mmHg) - Severe hepatic insufficiency - Sick sinus syndrome - Sino-atrial block - Unstable or acute heart failure - Pacemaker dependent (heart rate imposed exclusively by the pacemaker) - Unstable angina - AV-block of 3rd degree - Combination with strong cytochrome P450 3A4 inhibitors such as azole antifungals (ketoconazole,
- Preosjetljivost na djelatnu tvar ili na neku od pomoćnih tvari navedenih u dijelu 6.1 - Srčana frekvencija u mirovanju prije liječenja sporija od 70 otkucaja u minuti - Kardiogeni šok - Akutni infarkt miokarda - Teška hipotenzija (< 90/50 mmHg) - Teška insuficijencija jetre - Sindrom bolesnog sinusnog čvora - Sinusatrijski blok - Nestabilno ili akutno zatajenje srca - Bolesnici s ugrađenim elektrostimulatorom (broj otkucaja srca isključivo ovisi o pacemakeru)
PVC/Aclar-Alu blisters in pack sizes of 14, 28, 56, 98 and 112 film-coated tablets.
PVC/Aclar-Al blisteri u pakiranjima od 14, 28, 56, 98 i 112 filmom obloženih tableta.
Do not take Ivabradine JensonR if you are breast-feeding (see “Do not take Ivabradine JensonR”).
Ne uzimajte Ivabradine JensonR ako dojite (vidjeti “Nemojte uzimati Ivabradine JensonR”).
Uncommon*
Manje često*
HIV protease inhibitors (nelfinavir, ritonavir) and nefazodone (see sections 4.5 and 5.2) - Combination with verapamil or diltiazem which are moderate CYP3A4 inhibitors with heart rate reducing properties (see section 4.5) - Pregnancy, lactation and women of child-bearing potential not using appropriate contraceptive measures (see section 4.6)
- Istodobna primjena s verapamilom ili diltiazemom koji su umjereni inhibitori CYP3A4 s učinkom na smanjenje srčane frekvencije (vidjeti dio 4.5) - Trudnoća, dojenje i žene reproduktivne dobi koje ne koriste prikladne mjere kontracepcije (vidjeti dio 4.6)
If heart rate increases persistently above 60 beats per minute at rest, the dose can be up titrated to the next upper dose in patients receiving 2.5 mg twice daily or 5 mg twice daily.
Ukoliko je srčana frekvencija stalno iznad 60 otkucaja u minuti u mirovanju doza se može titrirati na višu dozu u bolesnika koji uzimaju 2,5 mg dva puta dnevno ili 5 mg dva puta dnevno.
The dose was adapted depending on the therapeutic response with maximum doses of 0.2 mg/kg bid, 0.3 mg/kg bid and 15 mg bid respectively.
Doza se prilagodila ovisno o terapijskom odgovoru s maksmimalnim dozama do 0,2 mg/kg/dan dva puta na dan, 0,3 mg/kg/dan dva puta na dan i 15 mg/kg/dan dva puta na dan, ovisno o starosnoj podskupini.
If, during treatment, heart rate decreases below 50 beats per minute (bpm) at rest or the patient experiences symptoms related to bradycardia such as dizziness, fatigue or hypotension, the dose must be titrated downward including the lowest dose of 2.5 mg twice daily (one half 5 mg tablet twice daily).
Ukoliko tijekom liječenja srčana frekvencija padne ispod 50 otkucaja u minuti (50/min) u mirovanju ili u bolesnika nastupe simptomi koji su povezani s bradikardijom, kao što su omaglica, umor ili hipotenzija, doza se mora titrirati na nižu, uključujući najnižu dozu od 2,5 mg dva puta na dan (polovica tablete od 5 mg dva puta dnevno).
This increase in heart rate can cause the chest pain in people who suffer from angina.
U ljudi koji boluju od angine, to povećanje brzine srčanih otkucaja može uzrokovati bol u prsnom košu.
If, during treatment, resting heart rate decreases persistently below 50 bpm or the patient experiences symptoms related to bradycardia such as dizziness, fatigue or hypotension, the dose must be titrated downward or treatment discontinued if heart rate below 50 bpm or symptoms of bradycardia persist (see section 4.2).
Ukoliko se, tijekom liječenja, srčana frekvencija u mirovanju neprestano uspori na manje od 50/min, ili ako bolesnik osjeti simptome koji su povezani s bradikardijom, kao što su omaglica, umor ili hipotenzija, doza se mora titrirati na sljedeću nižu dozu ili se liječenje mora prekinuti ukoliko frekvencija u mirovanju ostane manje od 50/min ili perzistiraju simptomi bradikardije (vidjeti dio 4.2).