natgillin/translations-raw huggingface dataset:
Apparent clearance of zonisamide at steady-state after oral administration is about 0.70 l/h and the terminal elimination half-life is about 60 hours in the absence of CYP3A4 inducers.
Navidezni očistek zonisamida v stanju dinamičnega ravnovesja po peroralnem dajanju je 0,70 l/h, končni razpolovni čas izločanja v odsotnosti induktorjev CYP3A4 pa približno 60 ur.
There is inadequate information to assess the relationship, if any, between dose and duration of treatment and these events.
Za oceno morebitne povezave med odmerkom in trajanjem zdravljenja ter temi dogodki podatkov ni dovolj.
What you need to know before you take Zonegran
Kaj morate vedeti, preden boste vzeli zdravilo Zonegran
In clinical studies of paediatric patients, down-titration was completed by dose reductions at weekly intervals in increments of about 2 mg/kg (i.e. in accordance with the schedule in Table 3).
V kliničnih študijah pri pediatričnih bolnikih so odmerek v tedenskih intervalih zmanjševali za približno 2 mg/kg (tj. v skladu z načrtom v preglednici 3).
Specific safety issues that were encountered in the paediatric studies were: decreased appetite and weight loss, decreased bicarbonate levels, increased risk of kidney stones and dehydration.
Specifične težave glede varnosti, ki so jih opazili v študijah pri pediatrični populaciji, so bile: zmanjšanje apetita in izguba telesne mase, znižanje ravni bikarbonata, povečano tveganje za ledvične kamne in dehidracija.
Zonegran has been administered to over 1,200 patients in clinical studies, more than 400 of whom received Zonegran for at least 1 year.
V kliničnih študijah je zdravilo Zonegran jemalo več kot 1.200 bolnikov, več kot 400 jih je zdravilo Zonegran jemalo najmanj eno leto.
Zonegran hard capsules are for oral use.
Zonegran trde kapsule se uporabljajo peroralno.
• ecchymosis (a small bruise caused by blood leaking from broken blood vessels in the skin).
• ekhimoza (manjša podplutba zaradi uhajanja krvi iz poškodovanih žil v koži);
• The recommended daily dose is between 300 mg and 500 mg.
• Priporočeni dnevni odmerek je med 300 mg in 500 mg.
• have difficulty breathing, a swollen face, lips or tongue, or a severe skin rash as these symptoms may indicate that you are having a severe allergic reaction.
• če se pojavijo težave pri dihanju, vam otečejo obraz, ustnice ali jezik ali se pojavi hud kožni izpuščaj, ker ti simptomi lahko kažejo na to, da imate hudo alergijsko reakcijo;
• get a sudden pain in your back or stomach, have pain on urinating (passing water) or notice blood in your urine, as this may be a sign of kidney stones.
• če se pojavijo nenadne bolečine v hrbtu ali trebuhu, imate bolečine pri uriniranju (odvajanju vode) ali opazite kri v urinu, ker so to lahko znaki ledvičnih kamnov;
All generalized Tonic-Clonic Secondary Tonic-Clonic Generalized Tonic-Clonic
Sekundarni tonično-klonični Generalizirani tonično-klonični
Such electrolyte imbalance has been observed with the use of Zonegran in placebo-controlled clinical trials and in the post-marketing period.
Takšno elektrolitsko neravnovesje so opazovali po uporabi zdravila Zonegran v kliničnih preskušanjih, kontroliranih s placebom, in v obdobju trženja.
• difficulty sleeping, strange or unusual thoughts, feeling anxious or emotional.
• motnje spanja, čudne ali neobičajne misli, tesnoba ali pretirano čustveno počutje;
• glaucoma, which is a blockage of fluid in the eye causing increased pressure in the eye.
• glavkom, ki je zapora tekočine v očesu, kar povzroči zvišanje znotrajočesnega tlaka.
Additional information on special populations:
Dodatne informacije za posebne skupine bolnikov:
In clinical studies of adult patients, dose reductions of 100 mg at weekly intervals have been used with concurrent adjustment of other antiepileptic medicine doses (where necessary).
V kliničnih študijah pri odraslih so odmerek zdravila Zonegran zmanjševali po 100 mg na teden s sočasno prilagoditvijo odmerkov drugih antiepileptičnih zdravil (po potrebi).
Serious rashes occur in association with Zonegran therapy, including cases of Stevens-Johnson syndrome.
V povezavi z zdravljenjem z zdravilom Zonegran se pojavljajo resni izpuščaji, vključno s primeri Stevens-Johnsonovega sindroma.
In other cases, the overdose was followed by symptoms such as somnolence, nausea, gastritis, nystagmus, myoclonus, coma, bradycardia, reduced renal function, hypotension and respiratory depression.
Pri drugih pa so se po prevelikem odmerjanju pojavili simptomi, kot na primer somnolenca, navzea, gastritis, nistagmus, mioklonus, koma, bradikardija, zmanjšana ledvična funkcija, hipotenzija in depresija dihanja.
300 to 500 mg for a child with a body weight more than 55 kg (which ever dose is lower) taken once a day.
500 mg za otroka s telesno maso več kot 55 kg (tisti odmerek, ki je manjši) enkrat na dan.
Zonegran contains the active substance zonisamide, and is used as an antiepileptic medicine.
Zdravilo Zonegran vsebuje učinkovino zonisamid in se uporablja kot antiepileptično zdravilo.
Adjunctive therapy - with CYP3A4inducing agents (see section 4.5)
Adjuvantno zdravljenje - z induktorji CYP3A4 (glejte poglavje 4.5)
An in vitro study shows that zonisamide is a weak inhibitor of P-gp (MDR1) with an IC50 of 267 µmol/l and there is the theoretical potential for zonisamide to affect the pharmacokinetics of substances which are P-gp substrates.
Študija in vitro je pokazala, da je zonisamid šibek inhibitor P-gp (MDR1) z IC50 267 µmol/l in da obstaja teoretična možnost, da bi zonisamid vplival na farmakokinetiko substanc, ki so substrati P-gp.
When comparing the same dose level, subjects of higher total body weight appear to have lower steady-state serum concentrations, but this effect appears to be relatively modest.
Ko primerjamo enako raven odmerka, imajo preiskovanci z večjo telesno maso nižje serumske koncentracije v stanju dinamičnega ravnovesja, vendar pa je ta učinek relativno skromen.
• Other medicines like phenytoin, carbamazepine, phenobarbitone and rifampicin can decrease your blood levels of Zonegran, which may require an adjustment of your dose of Zonegran.
• Druga zdravila, na primer fenitoin, karbamazepin, fenobarbiton in rifampicin, lahko zmanjšajo koncentracijo zdravila Zonegran v vaši krvi, zato bo mogoče treba prilagoditi odmerek zdravila Zonegran, ki ga jemljete.
• The recommended daily dose is 6 to 8 mg per kg for a child with a body weight of up to 55 kg or
• Priporočeni dnevni odmerek je 6 do 8 mg na kg za otroka s telesno maso do 55 kg ali 300 do
Patients with an impaired liver function: The pharmacokinetics of zonisamide in patients with impaired liver function have not been adequately studied.
Bolniki z jetrno okvaro: Farmakokinetike zonisamida pri bolnikih z jetrno okvaro niso ustrezno raziskali.
Physicians treating patients with Zonegran should ensure that patients are fully informed about the need to use appropriate effective contraception, and should use clinical judgement when assessing whether oral contraceptives (OCs), or the doses of the OC components, are adequate based on the individual patient's clinical situation.
Zdravniki, ki za zdravljenje uporabljajo zdravilo Zonegran, morajo zagotoviti, da so bolniki v celoti obveščeni o potrebi uporabe ustrezne učinkovite kontracepcije in s klinično presojo oceniti, ali so peroralni kontraceptivi ali odmerki učinkovin v peroralnih kontraceptivih ustrezni glede na klinično stanje posameznega bolnika.
Efficacy of zonisamide as monotherapy was established in a double-blind, parallel group, noninferiority comparison to carbamazepine prolonged release (PR) in 583 adult subjects with newly diagnosed partial seizures with or without secondary generalised tonic-clonic seizures.
Učinkovitost zonisamida kot monoterapije so dokazali v dvojno slepi primerjavi neinferiornosti z vzporednimi skupinami s karbamazepinom s podaljšanim sproščanjem pri 583 odraslih osebah z na novo diagnosticiranimi parcialnimi epileptičnimi napadi s sekundarno generaliziranimi toničnoklonični napadi ali brez njih.
• abnormal muscle breakdown (you may feel pain or weakness in your muscles) which can lead to kidney problems.
• nenormalna razgradnja mišic (lahko čutite bolečine ali oslabelost mišic), ki lahko povzroči težave z ledvicami;
In the event of signs or symptoms of dehydration, oligohydrosis, or elevated body temperature, discontinuation of Zonegran should be considered.
Če se pojavijo znaki ali simptomi dehidracije, oligohidroze ali zvišane telesne temperature, je treba razmisliti o prekinitvi zdravljenja z zdravilom Zonegran.
Zonegran may be used:
Zdravilo Zonegran se lahko uporablja:
In adults, efficacy has been demonstrated with Zonegran in 4 double-blind, placebo-controlled studies of periods of up to 24 weeks with either once or twice daily dosing.
Pri odraslih je bila učinkovitost zdravila Zonegran prikazana v štirih dvojno slepih, s placebom kontroliranih študijah, ki so trajale do 24 tednov z odmerjanjem enkrat ali dvakrat na dan.
Important information about some of the ingredients of Zonegran
Pomembne informacije o nekaterih sestavinah zdravila Zonegran
There are limited data from the use of Zonegran in pregnant women.
Podatkov o uporabi zdravila Zonegran pri nosečnicah je malo.
In vitro studies using human liver microsomes show no or little (<25%) inhibition of cytochrome P450 isozymes 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1 or 3A4 at zonisamide levels approximately twofold or greater than clinically relevant unbound serum concentrations.
In vitro študije, v katerih so uporabili humane jetrne mikrosome, niso pokazale ali pa so pokazale nizko (<25 %) inhibicijo izoencimov 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1 ali 3A4 citokroma P450 pri koncentracijah zonisamida, ki so bile dvakrat ali večkrat višje od klinično pomembnih serumskih koncentracij nevezane učinkovine.
Most adverse effects observed in the juvenile rats were similar to those seen in the repeated-dose toxicity studies of zonisamide in adult rats, but renal tubular hyaline droplets and transitional hyperplasia were observed in the juvenile study only.
Večina neželenih učinkov, ki so jih opazili pri podganjih mladičih, je bila podobna tistim, ki so jih opazili v študijah toksičnosti pri ponavljajočih se odmerkih zonisamida pri odraslih podganah, vendar so renalne tubulne hialinske kapljice in tranzicijsko hiperplazijo opazili le v študiji pri mladičih.
This metabolic acidosis is caused by renal bicarbonate loss due to the inhibitory effect of zonisamide on carbonic anhydrase.
Metabolna acidoza je posledica izgube bikarbonata preko ledvic zaradi inhibicijskega učinka zonisamida na karboanhidrazo.
There are limited data from clinical studies in patients with a body weight of less than 20 kg.
Podatkov iz kliničnih študij pri bolnikih s telesno maso, manjšo od 20 kg, je malo.
Prescribers should also take account of the safety profile of Zonegran (see section 4.8).
Zdravnik, ki predpisuje Zonegran, mora upoštevati tudi varnostni profil zdravila (glejte poglavje 4.8).
• Zonegran could possibly increase your blood levels of medicines like digoxin and quinidine, and so a reduction in their dose may be required.
• Zdravilo Zonegran bi pri vas lahko zvišalo koncentracijo nekaterih zdravil v krvi, na primer digoksina in kinidina, zato bo mogoče treba zmanjšati njihov odmerek.
• loss of appetite, decreased blood levels of bicarbonate (a substance that prevents your blood from becoming acidic)
• izguba apetita, znižana koncentracija bikarbonata (snov, ki preprečuje, da bi vaša kri postala kisla) v krvi.
Among 465 subjects in the paediatric safety database (including a further 67 subjects from the extension phase of the controlled clinical trial) there were 7 deaths (1.5%; 14.6/1000 person-years): 2 cases of status epilepticus, of which one was related to severe weight loss (10% within 3 months) in an underweight subject and subsequent failure to take medication; 1 case of head injury/haematoma, and 4 deaths in subjects with pre-existing functional neurological deficits for various causes (2 cases of pneumonia-induced sepsis/organ failure, 1 SUDEP and 1 head injury).
Med 465 bolniki v podatkovni bazi za varnost pri pediatrični populaciji (vključno s še 67 bolniki iz faze podaljšanega kontroliranega kliničnega preskušanja) je umrlo 7 bolnikov (1,5 %; 14,6/1.000 oseb-let): 2 primera epileptičnega statusa, od katerih je bil eden povezan s hudo izgubo telesne mase (10 % v 3 mesecih) pri bolniku s premajhno telesno maso, ki nato ni jemal zdravil; 1 primer poškodbe glave/hematoma, 4 umrli bolniki pa so imeli že od prej funkcijske nevrološke izpade zaradi različnih vzrokov (2 primera sepse zaradi pljučnice/odpovedi organov, 1 primer SUDEP in 1 poškodba glave).
Zonegran is used to treat seizures that affect one part of the brain (partial seizure), which may or may not be followed by a seizure affecting all of the brain (secondary generalisation).
Zdravilo Zonegran se uporablja za zdravljenje epileptičnih napadov, ki prizadenejo del možganov (parcialni napadi), tem pa lahko sledi napad, ki prizadene vse možgane (sekundarna generalizacija), lahko pa tudi ne.
The most common side effects of Zonegran are mild.
Najpogostejši neželeni učinki zdravila Zonegran so blagi.
Although not formally studied for the treatment of overdose, haemodialysis reduced plasma concentrations of zonisamide in a patient with reduced renal function, and may be considered as treatment of overdose if clinically indicated.
Čeprav hemodializa ni bila formalno preizkušena kot zdravljenje za preveliko odmerjanje, zmanjša plazemsko koncentracijo zonisamida pri bolnikih z zmanjšanjo ledvično funkcijo, zato jo lahko uporabimo kot zdravljenje prevelikega odmerjanja, če je to klinično indicirano.
The plasma AUC of zonisamide was increased by 35% in subjects with creatinine clearance <20 ml/min (see also section 4.2.
Plazemska AUC zonisamida se je pri bolnikih z očistkom kreatinina <20 ml/min povečala za 35 % (glejte tudi poglavje 4.2).
The safety and efficacy of Zonegran in children aged below 6 years or those below 20 kg have not yet been established.
Varnost in učinkovitost zdravila Zonegran pri otrocih, starih manj kot 6 let ali s telesno maso manj kot 20 kg, še nista bili dokazani.
Week 3 to 5
3. do 5. teden
In patients taking Zonegran who develop the clinical signs and symptoms of pancreatitis, it is recommended that pancreatic lipase and amylase levels are monitored.
Pri bolnikih, zdravljenih z zdravilom Zonegran, pri katerih se pojavijo klinični znaki in simptomi pankreatitisa, je priporočljivo spremljanje ravni pankreatične lipaze in amilaze.
In paediatric patients (aged 6 years and above), efficacy has been demonstrated with zonisamide in a double-blind, placebo-controlled study, which included 207 subjects and had a treatment duration of up to 24 weeks.
Pri pediatričnih bolnikih (starih 6 let ali več) so učinkovitost dokazali v dvojno slepi, s placebom kontrolirani študiji z zonisamidom, v katero je bilo vključenih 207 bolnikov, ki se je zdravilo do 24 tednov.
You might also feel sick, have a sore stomach, muscle twitches, eye movement, feel faint, have a slowed heart beat, and reduced breathing and kidney function.
Lahko vam je tudi slabo, imate bolečine v želodcu, trzanje mišic in oči, mogoče se vam zdi, da boste omedleli, imate upočasnjen srčni utrip in zmanjšano delovanje pljuč in ledvic.
A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Zonegran therapy.
Odločiti se je treba med prenehanjem dojenja in prenehanjem/prekinitvijo zdravljenja z zdravilom Zonegran.
Zonisamide also has a modulatory effect on GABA-mediated neuronal inhibition.
Zonisamid ima tudi modulatorni učinek na nevronsko inhibicijo, posredovano z GABA.
Steady-state dosing of either ketoconazole (400 mg/day) or cimetidine (1200 mg/day) had no clinically relevant effects on the single-dose pharmacokinetics of zonisamide given to healthy subjects.
Odmerjanje v stanju dinamičnega ravnovesja tako ketokonazola (400 mg/dan) kot cimetidina (1200 mg/dan) ni imelo klinično pomembnih učinkov na farmakokinetiko enkratnega odmerka zonisamida pri zdravih preiskovancih.
• if you are allergic to other sulphonamide medicines.
• če ste alergični na druga sulfonamidna zdravila, kot so na primer: sulfonamidni antibiotiki,
In clinical studies co-administration of lamotrigine had no apparent effect on zonisamide pharmacokinetics.
V kliničnih študijah sočasno zdravljenje z lamotriginom ni imelo očitnih učinkov na farmakokinetiko zonisamida.
PVC/PVDC/aluminium blisters, packs of 14, 28, 56 and 84 hard capsules.
PVC/PVDC/aluminijasti pretisni omoti, škatle s 14, 28, 56 in 84 trdimi kapsulami.
Do not take Zonegran: • if you are allergic to zonisamide or any of the other ingredients of this medicine (listed in section
• če ste alergični na zonisamid ali katero koli drugo sestavino tega zdravila (navedeno v poglavju 6);
Zonegran is not recommended for children who are underweight or have a small appetite, and should be used with caution in those below 20 kg.
Zdravilo Zonegran ni priporočljivo za otroke, ki imajo premajhno telesno maso ali imajo slab apetit, pri tistih, ki tehtajo manj kot 20 kg, pa ga je treba uporabljati previdno.
Marketing Authorisation Holder Eisai GmbH, Lyoner Straße 36, 60528 Frankfurt am Main, Germanye-mail: medinfo_de@eisai.net
Imetnik dovoljenja za promet z zdravilom Eisai GmbH, Lyoner Straße 36, 60528 Frankfurt am Main, Nemčija e-mail: medinfo_de@eisai.net
If Zonegran is prescribed during pregnancy, patients should be fully informed of the potential harm to the foetus and use of the minimal effective dose is advised along with careful monitoring.
Če se zdravilo Zonegran predpiše v nosečnosti, je treba bolnico obvestiti o vseh možnih tveganjih za plod; svetujeta se uporaba najmanjšega še učinkovitega odmerka in skrbno spremljanje.
Elderly: No clinically significant differences were observed in the pharmacokinetics between young (aged 21-40 years) and elderly (65-75 years).
Starejši: Med mladimi (starimi 21 - 40 let) in starejšimi (65 - 75 let) ni opaznih klinično pomembnih razlik v farmakokinetiki.
Zonisamide caused developmental abnormalities in mice, rats, and dogs, and was embryolethal in monkeys, when administered during the period of organogenesis at zonisamide dosage and maternal plasma levels similar to or lower than therapeutic levels in humans.
Zonisamid je povzročil razvojne nepravilnosti pri miših, podganah in psih, pri opicah je povzročil smrt zarodka, če je bil dan v času organogeneze v odmerkih in koncentracijah v materini plazmi, podobnimi ali nižjimi, kot so terapevtske koncentracije pri ljudeh.
In clinical studies in healthy subjects, steady-state dosing with Zonegran did not affect serum concentrations of ethinylestradiol or norethisterone in a combined oral contraceptive.
V kliničnih študijah pri zdravih preiskovancih odmerjanje zdravila Zonegran v stanju dinamičnega ravnovesja ni imelo vpliva na serumske koncentracije etinilestradiola ali noretisterona v kombiniranem peroralnem kontraceptivu.
The plasma AUC of zonisamide was increased by 35% in subjects with creatinine clearance < 20 ml/min.
Plazemska AUC zonisamida se pri bolnikih z očistkom kreatinina <20 ml/min poveča za 35 %.
If the decision is made to continue patients on Zonegran in the face of persistent acidosis, alkali treatment should be considered.
Če se odločite za nadaljevanje zdravljenja z zdravilom Zonegran kljub trdovratni acidozi, je treba razmisliti o zdravljenju z alkalnimi zdravili.
In a repeated-dose oral toxicity study in juvenile rats, at exposure levels similar to those observed in paediatric patients at the maximum recommended dose, decreases in body weight and changes in renal histopathology and clinical pathology parameters and behavioural changes were observed.
V študiji peroralne toksičnosti ponavljajočih se odmerkov pri podganjih mladičih pri ravneh izpostavljenosti, podobnih tistim, ki so jih opazili pri pediatričnih bolnikih pri največjem priporočenem odmerku, so opazili zmanjšanje telesne mase in spremembe ledvične histopatologije in kliničnih patoloških parametrov ter spremembe v vedenju.
PVC/PVDC/aluminium blisters, packs of 28, 56, 84, 98 and 196 hard capsules.
PVC/PVDC/aluminijasti pretisni omoti, škatle z 28, 56, 84, 98 in 196 trdimi kapsulami.
• are elderly, as your dose of Zonegran may need adjusting, and you may be more likely to develop an allergic reaction, severe skin rash, swelling of the feet and legs, and itchiness when taking Zonegran (see section 4 Possible side effects).
• če ste starejši, ker bo vaš odmerek zdravila Zonegran morda potrebno prilagoditi in ker se utegnejo med jemanjem zdravila Zonegran pogosteje pojaviti alergijska reakcija, hud kožni izpuščaj, oteklost stopal in nog ter srbenje (glejte poglavje 4, Možni neželeni učinki);
In some cases, the overdoses were asymptomatic, particularly where emesis or lavage was prompt.
V nekaj primerih je bilo preveliko odmerjanje asimptomatsko, zlasti pri tistih, kjer se je takoj pojavilo bruhanje ali pa je bilo takoj izvedeno izpiranje želodca.
• hallucinations, memory loss, coma, neuroleptic malignant syndrome (inability to move, sweating,
• halucinacije, izguba spomina, koma, nevroleptični maligni sindrom (nezmožnost gibanja,
Potential medicinal product interactions affecting Zonegran
Možne interakcije med zdravili, ki vplivajo na zdravilo Zonegran
Changes in renal histopathology and clinical pathology parameters were considered to be related to carbonic anhydrase inhibition by zonisamide.
Spremembe ledvične histopatologije in kliničnih patoloških parametrov so pripisali inhibiciji karboanhidraze, ki jo povzroča zonisamid.
Specialist advice should be given to women who are of childbearing potential regarding the possible effects of Zonegran on the foetus and these risks should be discussed with the patient in relation to the benefits before starting treatment.
Ženske v rodni dobi naj dobijo nasvet zdravnika specialista o možnih učinkih zdravila Zonegran na plod, pred začetkom zdravljenja pa se je treba z bolnico pogovoriti o njegovih nevarnostih v primerjavi s koristnimi učinki.
Some patients, especially those with a predisposition to nephrolithiasis, may be at increased risk for renal stone formation and associated signs and symptoms such as renal colic, renal pain or flank pain.
Pri nekaterih bolnikih, zlasti pri tistih, nagnjenih k nefrolitiazi, je morda večje tveganje za nastanek ledvičnih kamnov in z njimi povezanih znakov in simptomov, kot so na primer renalne kolike, renalne bolečine ali bolečine v ledvenem predelu.
Therefore children aged 6 years and above with a body weight of less than 20 kg should be treated with caution.
Zato je treba otroke, stare 6 let ali več, s telesno maso, manjšo od 20 kg, zdraviti previdno.
• if you are allergic to peanut or soya, do not use this medicinal product.
• če ste alergični na arašide ali sojo, ne jemljite tega zdravila.
Zonisamide AUC and Cmax values increased almost linearly after single dose over the dose range of 100-800 mg and after multiple doses over the dose range of 100-400 mg once daily.
Vrednosti AUC in Cmax za zonisamid se po enkratnem odmerku v intervalu od 100 do 800 mg in po večkratnem odmerku v intervalu od 100 do 400 mg enkrat na dan povečujeta skoraj linearno.
Physicians should draw the attention of paediatric patients and their parents/carers to the Patient Alert Box (in the package leaflet) on preventing heatstroke (see section 4.4: Paediatric population).
Zdravniki morajo pediatrične bolnike in njihove starše/negovalce opozoriti na okvirček z opozorili za bolnika (v navodilu za uporabo) glede preprečevanja vročinske kapi (glejte poglavje 4.4: Pediatrična populacija).
• have pain in your muscles or a feeling of weakness, as this may be a sign of abnormal muscle breakdown which can lead to kidney problems.
• če se pojavi bolečina v mišicah ali občutek oslabelosti, ker je to lahko znak nenormalne razgradnje mišic, ki utegne povzročiti težave z ledvicami;
• swollen glands, blood disorders (reduction in the number of blood cells, which can make infection more likely and can make you look pale, feel tired and feverish, and bruise more easily).
• otekle bezgavke, bolezni krvi (zmanjšanje števila krvničk, zaradi katerega se lažje okužite, ste bledi, utrujeni in vročični in vam brez omembe vrednega vzroka nastajajo modrice);