natgillin/translations-raw huggingface dataset:
If you forget to take Incresync 
Ako ste zaboravili uzeti Incresync
Incresync is indicated as a second or third line treatment in adult patients aged 18 years and older with type 2 diabetes mellitus: 
Incresync je indiciran kao druga ili treća linija liječenja odraslih bolesnika u dobi od 18 godina i starijih sa šećernom bolešću tipa 2:
Therapy with Incresync 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. 
Terapija Incresyncom se ne smije započeti u bolesnika s povišenim početnim razinama jetrenih enzima (ALT > 2,5 puta iznad gornje granice normale) ili bilo kojim drugim dokazom bolesti jetre.
Not known (frequency cannot be estimated from the available data): - An allergic reaction. 
Nepoznato (učestalost se ne može procijeniti na temelju dostupnih podataka):
In a pre- and postnatal development study in rats, exposures far above the human exposure at the recommended dose did not harm the developing embryo or affect offspring growth and development. 
U ispitivanju prenatalnog i postnatalnog razvoja u štakora, izloženostima daleko iznad izloženosti kod ljudi pri preporučenoj dozi nisu naštetile razvoju embrija niti utjecale na rast i razvoj mladunčadi.
Close monitoring of glycaemic control should be considered (see section 4.4). 
Potrebno je razmotriti pomno praćenje kontrole glikemije (vidjeti dio 4.4).
Patients (≥ 65 years old) with type 2 diabetes mellitus are considered more susceptible to episodes of hypoglycaemia than patients < 65 years old. 
Bolesnici (≥ 65 godina starosti) sa šećernom bolešću tipa 2 smatraju se podložnijima epizodama hipoglikemije nego bolesnici < 65 godina starosti.
The inter-subject coefficient of variation for alogliptin AUC was small (17%). 
Koeficijent varijacije za AUC alogliptina u pojedinačnih ispitanika bio je mali (17%).
Minimal to mild simple transitional cell hyperplasia was seen in the urinary bladder of male rats at the lowest dose used (27 times the human exposure) without establishment of a clear NOEL (no observed effect level). 
Minimalna do blaga jednostavna hiperplazija tranzicijskih stanica viđena je u mokraćnom mjehuru muških štakora, kod najmanje primijenjene doze (27 puta veća od izloženosti kod ljudi) bez jasno određene razine bez opaženog učinka (RBON).
However, the incidences of oedema, weight gain and heart failure were increased. 
Međutim, incidencije edema, povećanja težine i zatajenja srca bile su povišene.
Total serum concentration of pioglitazone is unchanged, but with an increased volume of distribution. 
Ukupna koncentracija pioglitazona u plazmi nije izmijenjena, ali je volumen distribucije povećan.
Pharmacotherapeutic group: Drugs used in diabetes; combinations of oral blood glucose lowering drugs. 
Farmakoterapijska skupina: lijekovi za liječenje šećerne bolesti; kombinacije peroralnih lijekova za snižavanje glukoze u krvi.
MARKETING AUTHORISATION NUMBER(S) EU/1/13/842/001-036 
BROJ(EVI) ODOBRENJA ZA STAVLJANJE LIJEKA U PROMET EU/1/13/842/001-036
Alogliptin is 20-30% bound to plasma proteins. 
Vezanje alogliptina za proteine plazme je 20-30%.
The MAH shall provide an educational pack targeting all physicians who are expected to prescribe/use alogliptin/pioglitazone. 
Nositelj odobrenja osigurat će edukacijski paket namijenjen svim liječnicima koji očekuju da će propisivati/primjenjivati alogliptin/pioglitazon.
What Incresync is Incresync contains two different medicines called alogliptin and pioglitazone in one tablet: 
Što je Incresync Incresync sadrži dva različita lijeka koji se zovu alogliptin i piogliazon u jednoj tableti:
However, as the distribution of AUC values for alogliptin in these patients was within the same range as control subjects, no dose adjustment of alogliptin for patients with mild renal impairment is necessary (see section 4.2). 
Međutim, kako je distribucija AUC vrijednosti za alogliptin u tih bolesnika bila unutar istog raspona kao i u kontrolnih ispitanika, prilagodba doze u bolesnika s blagim oštećenjem bubrega nije potrebna (vidjeti dio 4.2).
In clinical studies, patients have taken pioglitazone at higher than the recommended highest dose of 45 mg daily. 
U kliničkim ispitivanjima bolesnici su uzimali pioglitazon u dozama koje su bile više od najviše preporučene doze od 45 mg na dan.
Patients should be informed of the characteristic symptom of acute pancreatitis: persistent, severe abdominal pain, which may radiate to the back. 
Bolesnike treba upozoriti na karakteristični simptom akutnog pankreatitisa: ustrajnu, jaku bol u abdomenu koja se širi prema leđima.
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. 
Ako bilo koji bolesnik razvije simptome koji ukazuju na poremećaj funkcije jetre, koji mogu uključivati neobjašnjenu mučninu, povraćanje, bol u abdomenu, umor, anoreksiju i/ili tamnu mokraću, potrebno je provjeriti jetrene enzime.
HOMA analysis shows that pioglitazone improves beta-cell function as well as increasing insulin sensitivity. 
Analiza HOMA pokazuje da pioglitazon poboljšava funkciju beta stanica, kao i da povećava osjetljivost na inzulin.
- if you have or have had a disease of the pancreas. 
• ako imate ili ste imali bolest gušterače.
In addition, Incresync can be used to replace separate tablets of alogliptin and pioglitazone in those adult patients aged 18 years and older with type 2 diabetes mellitus already being treated with this combination. 
Dodatno, Incresync može zamijeniti zasebne tablete alogliptina i pioglitazona u onih odraslih bolesnika u dobi od 18 godina i starijih sa šećernom bolešću tipa 2 koji se već liječe tom kombinacijom.
Visual disturbance has been reported mainly early in treatment and is related to changes in blood glucose due to temporary alteration in the turgidity and refractive index of the lens as seen with other hypoglycaemic treatments. 
Poremećaj vida prijavljen je uglavnom na početku liječenja i bio je povezan s promjenama glukoze u krvi zbog privremene promjene u napetosti i indeksu refrakcije leće kakav se vidi i kod drugih hipoglikemijskih liječenja.
The efficacy and safety of the recommended doses of alogliptin and pioglitazone in a subgroup of patients with type 2 diabetes mellitus and ≥ 65 years old were reviewed and found to be consistent with the profile obtained in patients < 65 years old. 
Djelotvornost i sigurnost preporučenih doza alogliptina i metformina u podskupini bolesnika sa šećernom bolešću tipa 2 i dobi ≥ 65 godina starosti su procijenjene i nađeno je da odgovaraju profilu dobivenom u bolesnika < 65 godina starosti.
The European Medicines Agency has waived the obligation to submit the results of studies with Incresync in all subsets of the paediatric population in the treatment of type 2 diabetes mellitus (see section 4.2 for information on paediatric use). 
Europska agencija za lijekove je izuzela obvezu podnošenja rezultata ispitivanja lijeka Incresync u jednoj ili više podskupina pedijatrijske populacije za liječenje šećerne bolesti tipa 2 (vidjeti dio 4.2 za informacije o pedijatrijskoj primjeni).
After excluding patients in whom exposure to the medicinal product was less than one year at the time of diagnosis of bladder cancer, there were 7 cases (0.06%) on pioglitazone and 2 cases (0.02%) in control groups. 
Nakon isključenja bolesnika koji su u vrijeme dijagnoze karcinoma mokraćnog mjehura bili izloženi ispitivanom lijeku kraće od jedne godine, u skupinama na pioglitazonu bilo je 7 slučajeva (0,06%), a u kontrolnim skupinama 2 slučaja (0,02%).
DPP-4 is the principal enzyme involved in the rapid degradation of the incretin hormones, glucagon-like peptide-1 (GLP-1) and GIP (glucosedependent insulinotropic polypeptide), which are released by the intestine and levels are increased in response to a meal. 
DPP-4 je glavni enzim uključen u brzu degradaciju inkretinskih hormona, glukagonu sličnog peptida 1 (GLP-1) i GIP (inzulinotropnog polipeptida ovisnog o glukozi), koji se izlučuju u crijevu i razine su im povišene kao odgovor na obrok.
This educational pack is aimed at strengthening awareness of important identified risks of bladder cancer and heart failure and the overall recommendations intended to optimise the benefit-risk margin at the patient level. 
Svrha ovog edukacijskog paketa jest povisiti svijest o važnosti utvrđenih rizika od karcinoma mokraćnog mjehura i zatajenja srca te opće preporuke namijenjene optimizaciji raspona koristi-rizika na razini bolesnika.
Alogliptin has not been studied in patients with severe hepatic impairment (Child-Pugh score > 9). 
Alogliptin nije ispitan u bolesnika sa teškim oštećenjem jetre (Child-Pugh indeks >9).
- if you have liver disease. 
• ako imate bolest jetre.
- if you have a problem with your liver or kidneys. 
• ako imate probleme s jetrom ili bubrezima.
• Caution in use in the elderly in light of age related risks (in particular bladder cancer, fractures and heart failure). 
• Oprez kod primjene u starijih s obzirom na rizike povezane s dobi (osobito karcinom mokraćnog mjehura, prijelome i zatajenje srca).
In an animal model of familial adenomatous polyposis, treatment with two other thiazolidinediones increased tumour multiplicity in the colon. 
Na životinjskom modelu obiteljske adenomatozne polipoze, liječenje s dva druga tiazolidindiona povećala je brojnost tumora u debelom crijevu.
M-I is an active metabolite and is a highly selective inhibitor of DPP-4 similar to alogliptin; M-II does not display any inhibitory activity towards DPP-4 or other DPP-related enzymes. 
M-I je aktivni metabolit i visoko je selektivni inhibitor DPP-4 slično alogliptinu; M-II ne pokazuje nikakvu inhibicijsku aktivnost na DPP-4 ili bilo koji drugi DPP enzim.
• The risk of heart failure and relevant risk minimisation advice. 
• Rizik od zatajenja srca i odgovarajuće savjete o minimizaciji rizika.
Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. 
Ovaj lijek se ne smije upotrijebiti nakon isteka roka valjanosti navedenog na kutiji i na blisteru iza „Rok valjanosti“/ EXP.
- Severe and persistent pain in the abdomen (stomach area) which might reach through to your back, as well as nausea and vomiting, as it could be a sign of an inflamed pancreas (pancreatitis). 
• Jaka i ustrajna bol u trbuhu (u području želuca) koja može sezati do leđa, kao i mučnina i povraćanje, što može biti znak upale gušterače (pankreatitis).
Weight gain 
Povećanje težine
Incresync has no or negligible influence on the ability to drive and use machines. 
Alogliptin ne utječe ili zanemarivo utječe na sposobnost upravljanja vozilima i rada sa strojevima.
Alogliptin works to increase the levels of insulin in the body after a meal and decrease the amount of sugar in the body. 
Alogliptin djeluje tako da podiže razine inzulina u tijelu nakon obroka i smanjuje razinu šećera u krvi.
Following oral administration of radiolabelled pioglitazone to man, recovered label was mainly in faeces (55%) and a lesser amount in urine (45%). 
Nakon peroralne primjene radioaktivno označenog pioglitazona u čovjeka, označeni lijek većim se dijelom otkrio u stolici (55%) i u manjem dijelu u mokraći (45%).
Almost all subjects (95%) were receiving cardiovascular medicinal products (beta blockers, angiotensin-converting-enzyme (ACE) inhibitors, angiotensin II antagonists, calcium channel blockers, nitrates, diuretics, aspirin, statins, fibrates). 
Gotovo su svi ispitanici (95%) primali kardiovaskularne lijekove (beta blokatore, ACE inhibitore, antagoniste angiotenzina II, blokatore kalcijevih kanala, nitrate, diuretike, aspirin, statine, fibrate).
Although the study failed regarding its primary endpoint, which was a composite of all-cause mortality, non-fatal myocardial infarction, stroke, acute coronary syndrome, major leg amputation, coronary revascularisation and leg revascularisation, the results suggest that there are no long-term cardiovascular concerns regarding use of pioglitazone. 
Iako ispitivanje nije uspjelo u pogledu primarnog ishoda, koji je bio kompozitna smrtnost od svih uzroka, infarkt miokarda bez smrtnog ishoda, moždani udar, akutni koronarni sindrom, velika amputacija noge, koronarna revaskularizacija i revaskularizacija noge, rezultati pokazuju da primjena pioglitazona nije nosila dugoročne kardiovaskularne rizike.
Pioglitazone dose adjustment within the recommended posology or changes in diabetic treatment should be considered (see section 4.5). 
Treba razmotriti prilagodbu doze pioglitazona unutar preporučenog doziranja ili promjena u liječenju šećerne bolesti (vidjeti dio 4.5).
Interactions with substances metabolised by these enzymes, e.g. oral contraceptives, cyclosporin, calcium channel blockers and HMGCoA reductase inhibitors, are not to be expected. 
Ne očekuju se interakcije s lijekovima koje ti enzimi metaboliziraju, npr. oralnim kontraceptivima, ciklosporinom, blokatorima kalcijevih kanala i inhibitorima HMG-CoA reduktaze.
Total and peak exposure to alogliptin increased proportionately across single doses of 6.25 mg up to 100 mg alogliptin (covering the therapeutic dose range). 
Ukupna i vršna izloženost alogliptinu se proporcionalno povećavala povišenjem jednokratnih doza od 6,25 mg do 100 mg alogliptina (što obuhvaća raspon terapijskih doza).
Incresync is taken when your blood sugar cannot be adequately controlled by diet, exercise and other oral anti-diabetic medicines such as pioglitazone; or pioglitazone and metformin taken together. 
Incresync se uzima kad se šećer u krvi ne može odgovarajuće kontrolirati dijetom, tjelovježbom i drugim antidijabetičkim lijekovima poput pioglitazona, ili pioglitazona i metformina uzetih zajedno.
Absorption The absolute bioavailability of alogliptin is approximately 100%. 
Apsolutna bioraspoloživost alogliptina je približno 100%.
Effects of other medicinal products on alogliptin 
Učinci drugih lijekova na alogliptin
In studies in vitro, alogliptin was not an inhibitor of the following renal transporters; OAT1, OAT3 and OCT2. 
U ispitivanjima in vitro, alogliptin nije inhibirao sljedeće bubrežne transportere: OAT1, OAT3 i OCT2.
Higher doses of alogliptin were not teratogenic but resulted in maternal toxicity, and were associated with delayed and/or lack of ossification of bones and decreased foetal body weights. 
Više doze alogliptina nisu bile teratogene, ali su izazvale toksičnost u majke te su bile povezane s odgođenim i/ili nedovoljnim okoštavanjem kostiju i smanjenom fetalnom tjelesnom težinom.
Incresync should not be used during pregnancy. 
Incresync se ne smije primjenjivati tijekom trudnoće.
Following initiation of therapy with Incresync, it is recommended that liver enzymes be monitored periodically based on clinical judgement. 
Nakon početka terapije Incresyncom preporučuje se povremeno pratiti jetrene enzime na temelju kliničke procjene.
If ALT levels are increased to 3 x upper limit of normal during therapy, liver enzyme levels should be reassessed as soon as possible. 
Ako se tijekom terapije razine ALT-a povise do 3 puta iznad gornje granice normale, razine jetrenih enzima treba čim prije ponovno provjeriti.
Nonfatal Stroke *Overall there were 153 subjects (5.7%) in the alogliptin group and 173 subjects (6.5%) in the placebo group who died (all-cause mortality) 
*Ukupno je umrlo (svi uzroci smrti) 153 ispitanika (5,7%) u skupini na alogliptinu i 173 ispitanika (6,5%) u skupini na placebu.
For patients switching from separate tablets of alogliptin and pioglitazone, both alogliptin and pioglitazone should be dosed at the daily dose already being taken. 
Za bolesnike koji se prebacuju sa zasebnih tableta alogliptina i pioglitazona, i alogliptin i pioglitazon trebaju se dozirati prema dnevnoj dozi koju bolesnik već uzima.
Mean levels of liver enzymes decreased with treatment with pioglitazone. 
Srednje vrijednosti razina jetrenih enzima smanjivale su se s liječenjem pioglitazonom.
- if you have cysts on your ovaries (polycystic ovarian syndrome). 
• ako imate ciste na jajnicima (sindrom policističnih jajnika).
After administration of single, oral doses of up to 800 mg in healthy subjects, alogliptin was rapidly absorbed with peak plasma concentrations occurring 1 to 2 hours (median Tmax) after dosing. 
Nakon primjene jednokratnih peroralnih doza do 800 mg u zdravih ispitanika, alogliptin se brzo apsorbirao i postizao vršnu koncentraciju u plazmi 1 do 2 sata (medijan Tmax) nakon doziranja.
In clinical studies of alogliptin, anaphylactic reactions were reported with a low incidence. 
U kliničkim ispitivanjima alogliptina, anafilaktičke reakcije su prijavljene s niskom incidencijom.
Studies in lactating rats indicate that alogliptin is excreted in milk. 
Ispitivanja u štakora u laktaciji pokazuju da se alogliptin izlučuje u mlijeko.
The pioglitazone dose may need to be increased when rifampicin is concomitantly administered. 
Dozu pioglitazona možda će trebati povisiti kad se istodobno primjenjuje s rifampicinom.
If you have kidney problems your doctor may prescribe you a reduced dose. 
Ako imate probleme s bubrezima, liječnik će možda propisati nižu dozu.
Patients should be advised to adhere strictly to a calorie-controlled diet. 
Bolesnicima treba savjetovati da se strogo pridržavaju dijete s kontroliranim unosom kalorija.
• The risk of bladder cancer and relevant risk minimisation advice. 
• Rizik od karcinoma mokraćnog mjehura i odgovarajuće savjete o minimizaciji rizika.
Visceral fat was significantly decreased while there was an increase in extra-abdominal fat mass. 
Visceralno masno tkivo bilo je značajno smanjeno, dok se masa izvanabdominalnog masnog tkiva povećala.
To be eligible, patients had to have had one or more of the following: myocardial infarction, stroke, percutaneous cardiac intervention or coronary artery bypass graft, acute coronary syndrome, coronary artery disease, or peripheral arterial obstructive disease. 
Da bi bili pogodni za ispitivanje, bolesnici su morali imati jedno ili više od sljedećeg: infarkt miokarda, moždani udar, perkutanu srčanu intervenciju ili premosnicu koronarne arterije, akutni koronarni sindrom, bolest koronarnih arterija ili opstruktivnu bolest perifernih arterija.
This is similar to that seen in a sulphonylurea active comparator group. 
To je slično onom opaženom u skupini koja je primala sulfonilureju kao aktivni usporedni lijek.
Higher doses of alogliptin decreased offspring body weight and exerted some developmental effects considered secondary to the low body weight. 
Više doze alogliptina smanjile su tjelesnu težinu mladunčadi te pokazale neke razvojne učinke koji se smatraju posljedicom niske tjelesne težine.
Interactions with pioglitazone 
Interakcije s pioglitazonom
Pioglitazone undergoes extensive hepatic metabolism by hydroxylation of aliphatic methylene groups. 
Pioglitazon prolazi opsežni metabolizam u jetri hidroksilacijom alifatskih metilenskih skupina.
For patients inadequately controlled on dual therapy with pioglitazone and a maximally tolerated dose of metformin, the dose of metformin should be maintained, and Incresync administered concomitantly. 
Za bolesnike neodgovarajuće kontrolirane dvojnom terapijom pioglitazonom i maksimalnom podnošljivom dozom metformina, dozu metformina treba održati jednakom, a Incresync primijeniti istodobno.
There are no adequate human data to determine the safety of pioglitazone during pregnancy. 
Nema odgovarajućih podataka da bi se mogla utvrditi sigurnost pioglitazona tijekom trudnoće u ljudi.
Pioglitazone appears to act via activation of specific nuclear receptors (peroxisome proliferator activated receptor gamma) leading to increased insulin sensitivity of liver, fat and skeletal muscle cells in animals. 
Pioglitazon vjerojatno djeluje putem aktivacije posebnih receptora u jezgri (receptor gama aktiviran peroksizomskim proliferatorom - PPAR gama), što u životinja dovodi do povećane osjetljivosti jetre, masnog tkiva i skeletnih mišićnih stanica na inzulin.
There were 703 patients who experienced an event within the secondary MACE composite endpoint (first event of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke and urgent revascularization due to unstable angina). 
U 703 bolesnika javio se događaj unutar sekundarnog MACE kompozitnog ishoda (prvi događaj kardiovaskularne smrti, infarkta miokarda bez smrtnog ishoda, moždanog udara bez smrtnog ishoda ili hitnog postupka revaskularizacije zbog nestabilne angine).
The average renal clearance of alogliptin (170 mL/min) was greater than the average estimated glomerular filtration rate (approx. 120 mL/min), suggesting some active renal excretion. 
Prosječni bubrežni klirens alogliptina (170 ml/min) bio je veći od prosječne procijenjene brzine glomerularne filtracije (približno 120 ml/min), što ukazuje na izvjesnu aktivnu bubrežnu ekskreciju.
The observed excess risk of fractures for women in this dataset on pioglitazone is, therefore, 0.8 fractures per 100 patient years of use. 
Opažen povećan rizik od prijeloma u žena u ovom setu podataka o pioglitazonu stoga je 0,8 prijeloma na 100 bolesnik-godina primjene.
The pharmacokinetics of alogliptin has been shown to be similar in healthy subjects and in patients with type 2 diabetes mellitus. 
Utvrđeno je da je farmakokinetika alogliptina slična u zdravih ispitanika i u bolesnika sa šećernom bolešću tipa 2.
Combination of alogliptin with other anti-diabetic medicinal products 
Kombinacija alogliptina s drugim antidijabetičkim lijekovima
Co-administration of 25 mg alogliptin once daily and 45 mg pioglitazone once daily for 12 days in healthy subjects had no clinically relevant effects on the pharmacokinetics of alogliptin, pioglitazone or their active metabolites. 
Istodobna primjena 25 mg alogliptina jedanput na dan i 45 mg pioglitazona jedanput na dan tijekom 12 dana u zdravih ispitanika nije imala klinički značajne učinke na farmakokinetiku alogliptina, pioglitazona ili njihovih aktivnih metabolita.
Pioglitazone did not cause statistically significant increases in LDL-cholesterol levels compared to placebo whilst reductions were observed with metformin and gliclazide. 
Pioglitazon nije uzrokovao statistički značajna povišenja razina LDL-kolesterola u usporedbi s placebom, dok su sniženja opažena s metforminom i gliklazidom.
Not known: - Visual disturbances (caused by a condition called macular oedema). 
• smetnje vida (uzrokovane stanjem pod nazivom makularni edem)
Concomitant treatment with alogliptin and pioglitazone did not produce new toxicities, nor did it exacerbate any pioglitazone-related findings. 
Istodobno liječenje alogliptinom i pioglitazonom nije izazvalo nove toksičnosti niti je pogoršalo bilo koji nalaz povezan s pioglitazonom.
- pioglitazone belongs to a group of medicines called thiazolidinediones. 
- pioglitazon pripada skupini lijekova pod nazivom tiazolidindioni.
Overall, treatment with the recommended daily dose of 25 mg alogliptin in combination with pioglitazone improved glycaemic control. 
Sveukupno, liječenje preporučenom dnevnom dozom od 25 mg alogliptina u kombinaciji s pioglitazonom poboljšalo je kontrolu glikemije.
Thus, free (unbound) pioglitazone concentration is unchanged (see section 4.2). 
Stoga je koncentracija slobodnog (nevezanog) pioglitazona neizmijenjena (vidjeti dio 4.2).
What Incresync contains - The active substances are alogliptin and pioglitazone. 
Što Incresync sadrži - Djelatne tvari su alogliptin i pioglitazon.
Specific pharmacokinetic drug interaction studies have not been performed with Incresync. 
Specifična ispitivanja interakcija lijeka Incresync nisu provedena.
The maximum recommended daily dose of 25 mg alogliptin and 45 mg pioglitazone should not be exceeded. 
Maksimalna preporučena dnevna doza od 25 mg alogliptina i 45 mg pioglitazona ne smije se prekoračiti.
In patients with renal impairment, serum concentrations of pioglitazone and its metabolites are lower than those seen in subjects with normal renal function, but oral clearance of parent substance is similar. 
U bolesnika s oštećenjem bubrega, koncentracije pioglitazona i njegovih metabolita u serumu niže su od onih viđenih u ispitanika s normalnom funkcijom bubrega, ali oralni klirens izvornog spoja je sličan.