natgillin/translations-raw huggingface dataset:
The development of a potentially life-threatening serotonin syndrome may occur with the concomitant use of serotonergic medicinal products such as Selective Serotonin Re-uptake Inhibitors (SSRIs) and Serotonin Norepinephrine Re-uptake Inhibitors (SNRIs), and with medicinal products which impair metabolism of serotonin (including Monoamine Oxidase Inhibitors [MAOIs]).
Do razvoja serotoninskog sindroma potencijalno opasnog po život može doći pri istovremenoj primjeni serotoninergičkih lijekova kao što su selektivni inhibitori ponovne pohrane serotonina (SSRI) ili selektivni inhibitori ponovne pohrane serotonina i noradrenalina (SNRI) te lijekova koji narušavaju metabolizam serotonina (uključujući inhibitore monoaminooksidaze [MAOI]).
- Press side tabs inwards using your thumb and middle finger - At the same time, place your other thumb on the front pressure pad and also press inwards - Continue to apply pressure on all three points
- Pritisnite na mjestu bočnih jezičaka palcem i srednjakom - Istovremeno postavite palac na prednju pritisnu površinu i pritisnite je - Istovremeno pritiščite sve tri točke
If a child is accidentally exposed to Instanyl it may cause death, please seek immediate medical assistance.
Slučajno izlaganje djece Instanylu može izazvati smrt, te u takvom slučaju uvijek treba potražiti medicinsku pomoć.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
Ukoliko imate dodatnih pitanja o primjeni ovog lijeka, obratite se liječniku ili ljekarniku.
Limited data on pharmacokinetics are available for the use of fentanyl in cachectic (debilitated) patients.
Podaci o farmakokinetici fentanila u kahektičnih bolesnika (bolesnici narušenog zdravstvenog stanja) su ograničeni.
Instanyl is not recommended for use in patients who have received Monoamine Oxidase Inhibitors (MAOIs) within 14 days because severe and unpredictable potentiation by MAOIs inhibitors has been reported with opioid analgesics.
Ne preporučuje se primjena Instanyla kod bolesnika koji su u prethodnih 14 dana primali inhibitore monoaminooksidaze (MAO), jer je zabilježeno jako i nepredvidivo pojačanje djelovanja opioidnih analgetika MAO inhibitorima.
This effect could either be due to altered maternal care or a direct effect of fentanyl on the pups.
Taj učinak može biti posljedica smanjene roditeljske skrbi ili izravnog djelovanja fentanila na mladunce.
- if you have ever developed adrenal insufficiency or lack of sex hormones (androgen deficiency) with opioid use.
- ako ste uz primjenu opioida ikada razvili adrenalnu insuficijenciju ili manjak spolnih hormona (nedostatak androgena); - ako uzimate antidepresive ili antipsihotike, molimo pogledajte dio
Sleepiness, dizziness even with difficulties keeping balance, headache, irritation of the throat, nausea, vomiting, flushing, feeling very warm, excessive sweating.
Pospanost, omaglica čak s teškoćama u održavanju ravnoteže, glavobolja, nadražaj grla, mučnina, povraćanje, navale crvenila, osjećaj jake vrućine, prekomjerno znojenje.
Clinically significant respiratory depression may occur with fentanyl, and patients must be observed for these effects.
Fentanil može izazvati klinički značajnu depresiju disanja, te se kod bolesnika mora obratiti pažnju na takvo djelovanje.
Fall, diarrhoea, convulsions (fits), loss of consciousness, swelling of arms or legs, seeing or hearing things that are not really there (hallucinations), drug dependence (addiction), drug abuse, fatigue, malaise, withdrawal syndrome (may manifest by the occurrence of the following side effects nausea, vomiting, diarrhoea, anxiety, chills, tremor, and sweating), shortness of breath.
Pad, proljev, konvulzije (napadaji), gubitak svijesti, oticanje ruku ili nogu, viđanje ili slušanje nečeg što zapravo ne postoji (halucinacije), ovisnost o lijeku, zlouporaba lijeka, umor, malaksalost, sindrom ustezanja (može se očitovati nastankom sljedećih nuspojava: mučnina, povraćanje, proljev, tjeskoba, zimice, nevoljno drhtanje i znojenje), nedostatak zraka.
The concomitant use of Instanyl with strong CYP3A4 inhibitors (e.g. ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, and nelfinavir) or moderate CYP3A4 inhibitors (e.g., amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, and verapamil) may result in increased fentanyl plasma concentrations, potentially causing serious adverse drug reactions including fatal respiratory depression.
Istovremena primjena Instanyla s jakim CYP3A4 inhibitorima (npr. ritonavir, ketokonazol, itrakonazol, troleandomicin, klaritromicin i nelfinavir) ili umjerenim CYP3A4 inhibitorima (npr. amprenavir, aprepitant, diltiazem, eritromicin, flukonazol, fosamprenavir i verapamil) može za posljedicu imati porast plazmatske koncentracije fentanila, te moguće izazivanje ozbiljnih nuspojava uključujući i fatalnu respiratornu depresiju.
• Gently hold the single-dose container with your thumb supporting it at the plunger at the bottom and your index and middle finger on either side of the spray tip (see drawing).
• Nježno držite jednodozni spremnik tako da palac pridržava klip s donje strane, a kažiprst i srednjak se oslanjaju na suprotnim stranama gornjeg nastavka spreja (vidjeti crtež).
• Not to use Instanyl nasal spray for treatment of more than four breakthrough cancer pain episodes a day.
• Neka ne koriste Instanyl sprej za nos za liječenje više od četiri epizode probojne karcinomske boli dnevno.
Fentanyl is an opioid analgesic interacting primarily with the opioid μ-receptor as a pure agonist with low affinity for the - and κ-opioid receptors.
Fentanil je opioidni analgetik koji se prvenstveno veže na opioidni μ-receptor kao čisti agonist s niskim afinitetom za δ- i κ-opioidne receptore.
Instanyl may affect or be affected by other medicines.
Instanyl može utjecati na druge lijekove i drugi lijekovi mogu utjecati na Instanyl.
Nasal septum perforation, dyspnoea
Perforacija nosnog septuma, dispneja
It is recommended that alternative administration forms should be considered for concomitant treatment of concurrent diseases that can be treated via nasal administration.
Preporučuje se izbor alternativnih farmaceutskih oblika terapije za prateće bolesti koje se mogu liječiti primjenom lijeka u nos.
If after 10 minutes you need a second dose of Instanyl to relieve your pain, repeat steps 1 to 8 in the other nostril.
Ako Vam nakon 10 minuta treba druga doza Instanyla za ublažavanje bolova, ponovite korake od 1 do 8 u drugoj nosnici.
Before using the nasal spray for the first time, it must be pumped 5 times (primed) to give a full dose of Instanyl.
Prije prve primjene spreja za nos mora se napraviti 5 potisaka u zrak (priprema spreja) kako bi se postiglo istiskivanje pune doze Instanyla.
B. CONDITIONS OR RESTRICTIONS REGARDING SUPPLY AND USE Medicinal product subject to special and restricted medical prescription (See Annex I: Summary of Product Characteristics, section 4.2).
Lijek se izdaje na poseban i ograničeni recept (vidjeti Prilog I.: Sažetak opisa svojstava lijeka, dio 4.2).
You should tell your doctor if you experience recurrent episodes of nose bleeding or nasal discomfort.
Obratite se liječniku ako ponavljano krvarite iz nosa ili osjećate nelagodu u nosu.
Breakthrough pain is an additional sudden pain that occurs despite you having taken your usual opioid pain relieving medicines.
Probojna bol je dodatna iznenadna bol koja se pojavljuje usprkos redovitoj terapiji opioidima za ublažavanje boli.
• The Instanyl nasal spray dose strengths cannot be compared with other Fentanyl products.
• Jačina doze Instanyl spreja za nos ne može se usporediti s drugim lijekovima s fentanilom.
Impaired renal or hepatic function
Oštećenje funkcije bubrega ili jetre
Sleeplessness, drowsiness, convulsive muscle contractions, abnormal sensation of the skin even unpleasant, change of taste, motion sickness, low blood pressure, severe breathing problems, nose bleeds, nasal ulcer, runny nose, constipation, inflammation of the mouth, dry mouth, skin pain, itching of the skin, fever.
Nesanica, omamljenost, konvulzivni grčevi mišića, neobičan osjet na koži čak i neugodan, promjene okusa, bolest kretanja, niski krvni tlak, jake teškoće s disanjem, krvarenje iz nosa, čir u nosu, curenje iz nosa, zatvor, upala usta, suha usta, bolnost kože, svrbež kože, vrućica.
You can use Instanyl to treat up to 4 episodes of breakthrough pain per day.
Možete koristiti Instanyl za liječenje do 4 epizode probojne boli dnevno.
1.8 ml - 10 doses 2.9 ml - 20 doses 5.0 ml - 40 doses
1,8 ml - 10 doza 2,9 ml - 20 doza 5,0 ml - 40 doza
It is contained in a nasal spray with a metering pump, an electronic display, a dose counter, an in-built lock-out mechanism and a child-resistant cap.
Nalazi u spreju za nos s odmjernom pumpom, elektroničkim zaslonom, brojačem doza te ugrađenim mehanizmom za zaključavanje i zatvaračem sigurnim za djecu.
If adequate analgesia is not achieved, redosing of the same strength may be administered at the earliest after 10 minutes.
Ako adekvatna analgezija nije postignuta, ista se doza može ponovno primijeniti nakon najmanje 10 minuta.
Do not use Instanyl if you are breast-feeding.
Nemojte uzimati Instanyl ako dojite.
• Press the plunger upwards firmly to release the dose with your thumb while inhaling gently through the nose and then remove the spray container from the nose.
• Čvrsto pritisnite klip palcem kako biste istisnuli dozu dok udišete lagano kroz nos, a zatim izvucite vršak spreja iz nosnice.
If after 10 minutes you need a second dose of Instanyl to relieve your pain, repeat step 1 to 7 in the other nostril.
Ako nakon 10 minuta trebate drugu dozu lijeka Instanyl kako biste ublažili bol, ponovite korake od 1 od 7 u drugoj nosnici.
The results of summary of PID at 60 minutes (SPID0-60) showed that all strengths of Instanyl had significantly higher mean SPID0-60 scores compared with placebo (p < 0.001) demonstrating better pain relief of Instanyl compared to placebo during 60 minutes.
Instanyla imaju značajno višu srednju SRIB0-60 u usporedbi s placebom (p< 0,001), ukazujući na bolju kontrolu boli Instanylom u usporedbi s placebom tijekom 60 minuta.
Blow your nose if it feels blocked or you have a cold. 2.
Ispušite nos ako osjećate da je začepljen ili ako ste prehlađeni.
Remember to clean the nasal spray tip after use with a clean tissue, and then discard afterwards.
11. Ne zaboravite očistiti vrh spreja za nos nakon uporabe čistom maramicom i potom ju bacite.
Please read the instruction for use at the end of this leaflet to learn how to use the nasal spray.
Pročitajte uputu za uporabu na kraju ove upute kako biste naučili kako primjenjivati sprej za nos.
If you experience recurrent nose bleeding or nasal discomfort whilst being treated with Instanyl, you must contact your doctor, who will consider alternative treatment for your breakthrough pain.
Ako za vrijeme liječenja Instanylom ponavljano krvarite iz nosa ili osjećate nelagodu u nosu, morate se javiti liječniku koji će razmisliti od alternativnim načinima primjene lijeka za probojnu bol.
During this priming process medicine will be expelled.
Tijekom ovog postupka pripreme spreja istiskuje se lijek.
• Always to put the child-resistant cap back on to the multi-dose nasal spray DoseGuard, and close after use.
• Da uvijek stave zatvarač siguran za djecu natrag na višedozni sprej za nos DoseGuard i zatvore ga nakon uporabe.
If you have to take a second dose after 10 minutes to get sufficient pain relief, this dose should be taken in the other nostril.
Ako nakon 10 minuta trebate primijeniti još jednu dozu za dostatno ublažavanje boli, tu drugu dozu treba primijeniti u drugu nosnicu.
Nausea, vomiting Constipation, stomatitis, dry mouth
Poremećaji probavnog sustava Mučnina, povraćanje Konstipacija, stomatitis, suha usta
The overall extent of fentanyl exposure in subjects with common cold without prior treatment with nasal vasoconstrictor is comparable to that in healthy subjects.
Ukupna izloženost fentanilu kod ispitanika s prehladom bez prethodne primjene intranazalnog vazokonstriktora je usporediva s onom kod zdravih ispitanika.
NAME OF THE MARKETING AUTHORISATION HOLDER Takeda Pharma A/S
NAZIV NOSITELJA ODOBRENJA ZA STAVLJANJE LIJEKA U PROMET Takeda Pharma A/S
Instanyl can cause somnolence, dizziness, visual disturbances or other adverse reactions which may affect their ability to drive or operate machinery.
Instanyl može izazvati somnolenciju, omaglicu, smetnje vida ili druge nuspojave koje mogu utjecati na sposobnost upravljanja vozilima ili rada na strojevima.
Instanyl must be kept out of the sight and reach of children.
Instanyl se mora čuvati izvan pogleda i dohvata djece.
You may experience withdrawal symptoms similar to the possible side effects of Instanyl when discontinuing Instanyl.
Pri prekidu korištenja Instanyla možete osjetiti simptome ustezanja koji su slični mogućim nuspojavama Instanyla.
Recurrent episodes of epistaxis (see section 4.4).
Ponavljajuće epizode krvarenja iz nosa (vidjeti dio 4.4).
Coadministration of fentanyl with a serotoninergic agent, such as a Selective Serotonin Re-uptake Inhibitor (SSRI) or a Serotonin Norepinephrine Re-uptake Inhibitor (SNRI) or a Monoamine Oxidase Inhibitor (MAOI), may increase the risk of serotonin syndrome, a potentially life-threatening condition.
Istovremena primjena fentanila sa serotoninergičkim lijekom kao što je selektivni inhibitor ponovne pohrane serotonina (SSRI) ili selektivni inhibitor ponovne pohrane serotonina i noradrenalina (SNRI) ili inhibitor monoaminooksidaze (MAOI) može povećati rizik od pojave serotoninskog sindroma koji može biti opasan po život.
LOCK symbol
Simbol LOKOTA
Generally you should wait 4 hours before treating another episode of breakthrough pain.
Općenito, trebali biste pričekati 4 sata prije liječenja sljedeće epizode probojne boli.
Concomitant use of nasal vasoconstrictor should be avoided (see section 4.5).
Istovremenu primjenu nazalnog vazokonstriktora treba izbjegavati (vidjeti dio 4.5).
Remember to always put the child-resistant cap back on to the nasal spray and close it after use.
Ne zaboravite uvijek staviti zatvarač siguran za djecu natrag na sprej za nos te ga zatvoriti nakon uporabe.
How to use Instanyl
Kako primjenjivati Instanyl
• Information about dose counting scheme included in the labelling and the educational material for the multi-dose nasal spray.
• Upute o shemi za brojenje doza uključenoj u označavanju lijeka te u edukacijskom materijalu za višedozni sprej za nos.
• Instanyl nasal spray should be used only by physicians experienced, knowledgeable and skilled in the management of opioid therapy in cancer patients.
• Instanyl sprej za nos smiju primjenjivati samo liječnici koji su iskusni te posjeduju znanje i vještine u primjeni opioidne terapije kod bolesnika s karcinomom.
The overall extent of fentanyl exposure in subjects with allergic rhinitis without prior treatment with nasal vasoconstrictor is comparable to that in healthy subjects.
Ukupna izloženost fentanilu kod ispitanika s alergijskim rinitisom bez prethodne primjene nazalnog vazokonstriktora usporediva je s onom kod zdravih ispitanika.
Single-dose container consisting of a vial (clear type I glass) integrated in a polypropylene spray container, packed in child-resistant blister.
Jednodnozni spremnik sastoji se od bočice (prozirno staklo tipa 1) ugrađene u spremnik od polipropilena, pakirane u blister siguran za djecu.
The single-dose container contains 1 dose of Instanyl and and is supplied in a child-resistant blister.
Jednodozni spremnik sadrži 1 dozu Instanyla i pakiran je u blisteru sigurnom za djecu.
Do not use Instanyl after the expiry date which is stated on the bottle after EXP.
Instanyl se ne smije upotrijebiti nakon isteka roka valjanosti navedenog na bočici iza oznake „EXP“.
The nasal spray is supplied in a child-resistant outer box and comes in three different pack sizes: 1.8 ml (equal to 10 doses), 2.9 ml (equal to 20 doses) and 5.0 ml (equal to 40 doses).
Sprej za nos je pakiran u kutiju sigurnu za djecu i dostupan u tri različite veličine pakiranja: 1,8 ml (što odgovara 10 doza), 2,9 ml (što odgovara 20 doza) i 5,0 ml (što odgovara 40 doza).
Bottle (brown Type 1 glass) with metering pump and dust cap packed in a child-resistant outer box.
Bočica (smeđe staklo tipa 1) s odmjernom pumpicom i zaštitnom kapicom u kutiji sigurnoj za djecu.
The display now shows ‘P4' and a lock symbol appears.
Zaslon sada prikazuje „P4“ i javlja se simbol lokota.
- Pull lid to open - After use of Instanyl the nasal spray must be placed in the inner tray again and the box closed
- Podignite poklopac i otvorite - Nakon primjene Instanyl sprej za nos treba vratiti u ležište i zatvoriti kutiju
MINIMUM PARTICULARS TO APPEAR ON BLISTERS OR STRIPS INTERMEDIATE CHILD-RESISTANT BLISTER (Single dose)
PODACI KOJE MORA NAJMANJE SADRŽAVATI BLISTER ILI STRIP BLISTER SIGURAN ZA DJECU (Jedna doza)
The countdown-clock is counting downwards.
Brojač odbrojava prema nuli.
Instanyl can cause dizziness, drowsiness and visual disturbances, which may affect your ability to drive or use machines.
Instanyl može izazvati omaglicu, omamljenost i smetnje vida, što može utjecati na sposobnost upravljanja vozilima i strojevima.
INSTRUCTIONS FOR USE OF INSTANYL
UPUTE ZA PRIMJENU INSTANYL SPREJA ZA NOS
Before patients are titrated with Instanyl, it is expected that their background persistent pain is controlled by use of chronic opioid therapy and that they are experiencing no more than four episodes of breakthrough pain per day.
Očekuje se da je prije titracije Instanyla trajna bol kod bolesnika kontrolirana primjenom kronične opioidne terapije, te da se epizode probojne boli ne javljaju češće od četiri puta dnevno.
Instanyl acts rapidly and is used for relieving breakthrough pain in adult cancer patients already treated with opioids for their usual pain.
Instanyl djeluje brzo i koristi se za ublažavanje probojne boli kod odraslih bolesnika s rakom koji već uzimaju opioidnu terapiju za trajnu bol.
• Each single-dose container is sealed in a child-resistant blister.
• Svaki jednodozni spremnik pakiran je u blisteru sigurnom za djecu.
- if you take medicines called partial agonist/antagonists e.g. buprenorphine, nalbuphine and pentazocine (medicines for treatment of pain) as you may experience symptoms of withdrawal syndrome.
“Drugi lijekovi i Instanyl“; - ako uzimate parcijalne agoniste/antagoniste poput buprenorfina, nalbufina i pentazocina (za liječenje boli) jer možete dobiti simptome sindroma ustezanja.
Withdrawal symptoms may be precipitated through the administration of substances with opioid antagonist activity, e.g. naloxone, or mixed agonist/antagonist analgesic (e.g. pentazocine, butorphanol, buprenorphine, nalbuphine).
Simptomi ustezanja mogu se potaknuti primjenom antagonista opioida, primjerice naloksona, ili miješanih agonista/antagonista opioidnih receptora (npr. pentazocina, butorfanola, buprenorfina, nalbufina).
Instanyl may interact with these medicines and you may experience mental status changes (e.g. agitation, hallucinations, coma), and other effects such as body temperature above 38 °C, increase in heart rate, unstable blood pressure, and exaggeration of reflexes, muscular rigidity, lack of coordination and/or gastrointestinal symptoms (e.g. nausea, vomiting, diarrhoea).
Može doći do interakcije Instanyla s tim lijekovima i mogli biste doživjeti promjene mentalnog statusa (npr. uznemirenost, halucinacije, komu) i druge posljedice kao što su povišenje tjelesne temperature iznad 38 °C, ubrzani otkucaji srca, nestabilan krvni tlak, prenaglašeni refleksi, mišićna ukočenost, nekoordiniranost i/ili probavni simptomi (npr. mučnina, povraćanje, proljev).
Fentanyl should be administered with caution to patients with moderate to severe hepatic or renal impairment.
Fentanil treba primjenjivati s oprezom u bolesnika s umjerenim do teškim oštećenjem jetre ili bubrega.
Keep the bottle stored upright.
Čuvati bočicu u uspravnom položaju.
PARTICULARS TO APPEAR ON THE OUTER PACKAGING OUTER BOX - CARTON: DoseGuard
PODACI KOJI SE MORAJU NALAZITI NA VANJSKOM PAKIRANJU VANJSKA KARTONSKA KUTIJA: DoseGuard
The nasal spray container has an electronic display, a dose counter, a lock-out mechanism and a child-resistant cap.
Spremnik spreja za nos ima elektronički displej, brojač doza, mehanizam za zaključavanje i zatvarač siguran za djecu.
If you use more Instanyl than you should or if you think someone has accidentally used Instanyl You should contact your doctor, hospital or emergency room for assessment of the risk and for advice if you have taken more Instanyl than you should.
Primijenite li više Instanyla nego je potrebno trebate se odmah javiti liječniku, u bolnicu ili hitnoj službi radi ocjene rizika i savjeta.
Do not use Instanyl: - if you are allergic to fentanyl or any of the other ingredients of this medicine (listed in section 6).
Nemojte primjenjivati Instanyl: - ako ste alergični na fentanil ili bilo koji drugi sastojak ovog lijeka (naveden u dijelu 6); - ako za kontrolu stalne boli ne koristite propisani opioidni lijek (npr. kodein, fentanil,
The use of such other drugs at the same time as Instanyl, may cause deep sedation and affect your ability to breath, which may lead to coma and be life-threatening.
Korištenje takvih lijekova istovremeno s lijekom Instanyl može uzrokovati duboku sedaciju i utjecati na vašu sposobnost disanja, što može odvesti do kome i biti opasno po život; - bilo koji lijek koji utječe na način kako tijelo razgrađuje Instanyl, primjerice:
Note to carers
Napomena za njegovatelje
• Block one nostril by placing your other index finger against the side of your nose and insert the spray tip into the other nostril (approximately 1 cm).
• Zatvorite jednu nosnicu položivši drugi kažiprst sa strane nosa i umetnite vrh spreja u drugu nosnicu (otprilike 1 cm).
Instanyl incorporates an electronic dose counter, and a lock out period between doses to reduce the risk of overdose, and helps you to use it adequately.The dose counter enables you, and your doctor, to monitor and adapt your use.
Instanyl ima ugrađen elektronski brojač doza i razdoblje zaključavanja između doza kako bi se smanjio rizik od predoziranja i olakšala vam se njegova pravilna uporaba.
Discontinue the treatment and contact your doctor, hospital or emergency room immediately, if you: - experience severe breathing difficulties.
Odmah prekinite uzimanje lijeka i javite se svome liječniku, u bolnicu ili u hitnu ambulantu ako: - osjetite znatne teškoće s disanjem; - imate čudan zvuk dok udišete; - imate grčevitu bol; - osjećate izrazitu omaglicu.
Motion sickness
Bolest kretanja
• Only to use Instanyl nasal spray if they have been experiencing breakthrough cancer pain episodes.
• Da Instanyl sprej za nos koriste samo ako pate od epizoda probojne karcinomske boli
Press the pump down completely with two fingers one time while breathing through the nose.
7. S dva prsta jedanput pritisnite pumpu do kraja prema dolje dok dišete kroz nos.
If the patient experiences recurrent episodes of epistaxis or nasal discomfort while taking Instanyl, an alternative administration form for treatment of breakthrough pain should be considered.
Ako se tijekom primjene Instanyla javljaju uzastopne epizode epistakse ili neugode u nosu, treba razmisliti o alternativnom načinu primjene terapije za probojnu bol.
You should wait for 4 hours before treating the next episode of breakthrough pain.
Morate pričekati 4 sata prije primjene spreja u liječenju sljedeće epizode probojne boli.
Fentanyl exhibits three compartment distribution kinetics.
Pokazuje distribucijsku kinetiku tri odjeljka.
Instanyl is indicated for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain.
Instanyl je indiciran za zbrinjavanje probojne boli u odraslih koji već uzimaju opioidnu terapiju održavanja zbog kronične karcinomske boli.
Pain of skin, pruritus
Bolna koža, svrbež