natgillin/translations-raw huggingface dataset:
Depending on the condition of your liver, your doctor may reduce the dose to avoid potential side effects.
Odvisno od stanja vaših jeter vam bo zdravnik mogoče zmanjšal odmerek, da bo preprečil morebitne neželene učinke;
What Tygacil is and what it is used for
Kaj je zdravilo Tygacil in za kaj ga uporabljamo
Streptococcus anginosus group* (includes S. anginosus, S. intermedius and S. constellatus) Streptococcus pyogenes*
Skupina Streptococcus anginosus* (vključuje S. anginosus, S. intermedius in S. constellatus) Streptococcus pyogenes*
• If you are allergic to tigecycline, or any of the other ingredients of this medicine (listed in section 6).
• če ste alergični na tigeciklin ali katerokoli sestavino tega zdravila (navedeno v poglavju 6).
Read all of this leaflet carefully before you are given this medicine because it contains important information for you or your child. - Keep this leaflet.
Pred začetkom uporabe zdravila natančno preberite navodilo, ker vsebuje pomembne podatke za vas ali vašega otroka!
Renal clearance is approximately 13 % of total clearance.
Ledvični očistek predstavlja približno 13 % celotnega očistka.
Gram-negative Aerobes Citrobacter freundii* Citrobacter koseri Escherichia coli* Klebsiella oxytoca*
Gramnegativni aerobi Citrobacter freundii* Citrobacter koseri Escherichia coli* Klebsiella oxytoca*
Tigecycline is administered intravenously and therefore has 100 % bioavailability.
Tigeciklin se daje intravensko in ima zato 100-odstotno biološko uporabnost.
Therefore, patients presenting with cholestasis should be closely monitored.
Zato je treba bolnike s holestazo skrbno spremljati.
Lifetime studies in animals to evaluate the carcinogenic potential of tigecycline have not been performed, but short-term genotoxicity studies of tigecycline were negative.
Dolgoročnih študij na živalih za vrednotenje kancerogenega potenciala tigeciklina niso opravili, kratkoročne študije genotoksičnosti tigeciklina pa so bile negativne.
On average, it is estimated that less than 20 % of tigecycline is metabolised before excretion.
Ocenjujejo, da se povprečno manj kot 20 % tigeciklina presnovi, preden se izloči.
These alterations were shown to be reversible after two weeks of dosing.
Dokazali so, da so te spremembe po dveh tednih dajanja zdravila reverzibilne.
The powder should be mixed in the vial with a small amount of solution.
Prašek je treba raztopiti v viali z majhno količino raztopine.
• In certain serious infections, your doctor may consider to use Tygacil in combination with other antibiotics.
• pri nekaterih resnih okužbah lahko zdravnik uporabi zdravilo Tygacil v kombinaciji z drugimi antibiotiki;
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before receiving Tygacil.
Če ste noseči ali dojite, menite, da bi lahko bili noseči ali načrtujete zanositev, se posvetujte z zdravnikom, preden boste prejeli zdravilo Tygacil.
are generally less susceptible to tigecycline than other members of the Enterobacteriaceae.
so na splošno manj občutljivi za tigeciklin kot druge Enterobacteriaceae.
Tigecycline pharmacokinetics was investigated in two studies.
Farmakokinetiko tigeciklina so preučevali v dveh študijah.
Tigecycline shows a polyexponential elimination from serum with a mean terminal elimination half-life after multiple doses of 42 hours although high interindividual variability exists.
Tigeciklin kaže polieksponencialno eliminacijo iz seruma s srednjim končnim razpolovnim časom odstranjevanja iz telesa po več odmerkih, ki je 42 ur, čeprav obstaja velika variabilnost med posamezniki.
The results in a large study in patients with diabetic foot infection, showed that tigecycline was less effective than comparator, therefore, tigecycline is not recommended for use in these patients (see section 4.1).
Rezultati v veliki študiji bolnikov z okužbo diabetičnega stopala so pokazali, da je bil tigeciklin manj učinkovit kot primerjalno zdravilo, zato tigeciklina ne priporočajo za uporabo pri teh bolnikih (glejte poglavje 4.1).
Tygacil is only used when your doctor thinks other antibiotics are not suitable.
Zdravilo Tygacil se uporablja le v primerih, ko zdravnik presodi, da drugi antibiotiki niso primerni.
Tygacil will be given to you by a doctor or a nurse.
Zdravilo Tygacil vam bo dajal zdravnik ali medicinska sestra.
In severe renal impairment, AUC was 30 % higher than in subjects with normal renal function (see section 4.2).
Pri hudi okvari ledvic je bila AUC za 30 % večja kot pri osebah z normalnim delovanjem ledvic (glejte poglavje 4.2).
The potential contribution of P-gp-mediated transport to the in vivo disposition of tigecycline is not known.
Potencialni prispevek P-gp-posredovanega transporta na in vivo razporeditev tigeciklina ni znan.
The total number of cSSTI and cIAI patients treated with tigecycline in Phase 3 and 4 clinical studies was 2,393.
Celotno število bolnikov s cSSTI ter cIAI, zdravljenih s tigeciklinom v kliničnih študijah faze 3 in 4, je bilo 2.393.
The duration of therapy should be guided by the severity, site of the infection, and the patient's clinical response.
Trajanje zdravljenja je odvisno od resnosti okužbe, mesta okužbe in bolnikovega kliničnega odziva.
This medicinal product is for single use only; any unused medicinal product or waste material should be disposed of in accordance with local requirements.
To zdravilo je namenjeno samo za enkratno uporabo; morebitno neuporabljeno zdravilo ali odpadni material zavrzite v skladu z lokalnimi predpisi.
If you develop another bacterial infection, your doctor may prescribe a different antibiotic specific for the type of infection present.
če se bo pojavila še kakšna druga bakterijska okužba, bo vaš zdravnik morda predpisal drugačen antibiotik, specifičen za vrsto prisotne okužbe;
Patients should be closely monitored for the development of superinfection.
Bolnike je treba skrbno spremljati glede pojava superinfekcije.
Your doctor will monitor you closely for any potential infections and treat you if necessary.
Vaš zdravnik bo skrbno spremljal, če bi se pri vas pojavila kakšna okužba, in jo bo po potrebi tudi zdravil.
The adverse reaction profile of tigecycline in these 25 subjects was generally consistent with that in adults.
Profil neželenih učinkov tigeciklina pri teh 25 preiskovancih je bil na splošno skladen s profilom pri odraslih.
Abdominal pain may be indicative of pancreatitis.
Bolečina v trebuhu je lahko pokazatelj pankreatitisa.
For single use only, any unused solution should be discarded.
Samo za enkratno uporabo, morebitno neuporabljeno raztopino je treba zavreči.
What you need to know before you receive Tygacil
Kaj morate vedeti, preden boste prejeli zdravilo Tygacil
Bacteroides fragilis group†
Skupina Bacteroides fragilis†
For instructions on reconstitution & dilution of the medicinal product before administration, see section 6.6.
Za navodila glede rekonstitucije in raztapljanja zdravila pred dajanjem, glejte poglavje 6.6.
This dose is given intravenously (directly into your blood stream) over a period of 30 to 60 minutes.
Ta odmerek se daje intravensko (neposredno v žilo) v časovnem intervalu 30 do 60 minut.
This may impair your ability to drive or operate machinery.
To lahko zmanjša vašo sposobnost za upravljanje motornih vozil ali strojev.
Attention should be paid to possible dehydration.
Zaradi možnosti dehidracije je potrebna previdnost.
Your doctor has prescribed Tygacil because you or your child at least 8 years old has one of the following types of serious infections:
Zdravnik je vam ali vašemu otroku, staremu 8 let ali več, predpisal zdravilo Tygacil, ker ima/-te eno od naslednjih vrst resnih okužb:
• If you have or previously had any side effects due to antibiotics belonging to the tetracycline class (e.g., skin sensitization to sun light, staining on developing teeth, pancreas inflammation, and alteration of certain laboratory values aimed at measuring how well your blood clots).
• če imate ali ste kdaj prej imeli kakšne neželene učinke zaradi antibiotikov tetraciklinske skupine (na primer preobčutljivost kože za sončno svetlobo, obarvanje razvijajočih se zob, vnetje trebušne slinavke in spremembe nekaterih laboratorijskih vrednosti, s katerimi se meri, kako dobro se vam strjuje kri);
• Complicated intra-abdominal infections (cIAI).
• zapletene intraabdominalne okužbe (complicated intra-abdominal infections - cIAI).
A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from tigecycline therapy taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.
Odločiti se je treba med prenehanjem dojenja in prenehanjem/prekinitvijo zdravljenja s tigeciklinom, pri čemer je treba upoštevati prednosti dojenja za otroka in prednosti zdravljenja za mater.
• If you have blockage of the bile ducts (cholestasis).
• če imate zaporo žolčevodov (holestazo).
During treatment with Tygacil:
Med zdravljenjem z zdravilom Tygacil:
* single dose AUC0-∞, multiple dose AUC0-12h
* AUC0-∞ pri enkratnem odmerku, AUC0-12h pri večkratnih odmerkih
The diagnosis of acute pancreatitis should be considered in patients taking tigecycline who develop clinical symptoms, signs, or laboratory abnormalities suggestive of acute pancreatitis.
Na diagnozo akutnega pankreatitisa moramo pomisliti pri bolnikih, ki prejemajo tigeciklin, pri katerih se razvijejo klinični simptomi, znaki ali laboratorijske nenormalnosti, ki kažejo na akutni pankreatitis.
For anaerobic bacteria there is clinical evidence of efficacy in polymicrobial intra-abdominal infections, but no correlation between MIC values, PK/PD data and clinical outcome.
Za anaerobne bakterije obstajajo klinični dokazi o učinkovitosti pri polimikrobnih intraabdominalnih okužbah, vendar ni nikakršne korelacije med vrednostmi MIC, podatki o farmakokinetiki in farmakodinamiki in kliničnim izidom.
Abdominal pain is commonly reported in children as it is in adults.
Pri otrocih so bolečino v trebuhu pogosteje poročali kot pri odraslih.
In vitro, tigecycline is neither a competitive inhibitor nor an irreversible inhibitor of CYP450 enzymes (see section 5.2).
In vitro tigeciklin ni niti kompetitiven inhibitor niti ireverzibilen inhibitor encimov CYP450 (glejte poglavje 5.2).
Decreased susceptibility in Acinetobacter baumannii has been attributed to the overexpression of the AdeABC efflux pump.
Zmanjšano občutljivost pri Acinetobacter baumannii so pripisali čezmerni ekspresiji AdeABC iztočne črpalke.
Pharmacotherapeutic group: Antibacterials for systemic use, tetracyclines, ATC code: J01AA12.
Farmakoterapevtska skupina: zdravila za sistemsko zdravljenje bakterijskih infekcij, tetraciklini, oznaka ATC: J01AA12.
Experience in the use of tigecycline for treatment of infections in patients with severe underlying diseases is limited.
Izkušenj z uporabo tigeciklina za zdravljenje okužb pri bolnikih s hudimi osnovnimi boleznimi je malo.
No loading dose was administered in these studies.
V teh študijah ni bilo polnilnega odmerka.
Infections and infestations sepsis/septic shock, pneumonia, abscess, infections
Infekcijske in parazitske bolezni sepsa/septični šok, pljučnica, absces, okužbe
Tygacil should be used only in situations where other alternative antibiotics are not suitable (see sections 4.4, 4.8 and 5.1).
Zdravilo Tygacil se sme uporabiti le v primerih, ko drugi antibiotiki niso primerni (glejte poglavja 4.4, 4.8 in 5.1).
Talk to your doctor about the need for an additional method of contraception while receiving Tygacil.
Pogovorite se z zdravnikom o tem, ali potrebujete med zdravljenjem z zdravilom Tygacil še dodatno kontracepcijsko metodo.
The in vitro plasma protein binding of tigecycline ranges from approximately 71 % to 89 % at concentrations observed in clinical studies (0.1 to 1.0 mcg/ml).
Vezava tigeciklina na plazemske beljakovine in vitro sega od približno 71 % do 89 % pri koncentracijah, ki so jih opazovali v kliničnih študijah (0,1 do 1,0 g/ml).
Species for which acquired resistance may be a problem Gram-negative Aerobes
Vrste, pri katerih je lahko problematična pridobljena odpornost Gramnegativni aerobi
Blood and lymphatic system disorders prolonged activated partial thromboplastin time (aPTT), prolonged prothrombin time (PT)
Bolezni krvi in limfatičnega sistema podaljšan aktivirani parcialni tromboplastinski čas (aPTČ), podaljšan protrombinski čas (PČ)
For intravenous use after reconstitution and dilution.
za intravensko uporabo po rekonstituciji in redčenju
All patients received IV tigecycline for a minimum of 3 consecutive days to a maximum of 14 consecutive days, with the option to be switched to an oral antibiotic on or after day 4.
vsaj 3 zaporedne dni do največ 14 zaporednih dni z možnostjo prehoda na peroralni antibiotik 4. dan ali pozneje.
Patients with severe underlying disease, such as those that were immunocompromised, patients with decubitus ulcer infections, or patients that had infections requiring longer than 14 days of treatment (for example, necrotizing fasciitis), were not enrolled.
Bolniki s hujšo osnovno boleznijo, na primer imunsko oslabljeni bolniki, bolniki z okužbami preležaninskih razjed ali bolniki z okužbami, pri katerih je bilo potrebno zdravljenje, daljše od 14 dni (na primer nekrotizirajoči fasciitis), niso bili vključeni.
Patients with severe hepatic impairment (Child Pugh C) should be treated with caution and monitored for treatment response (see sections 4.4 and 5.2).
Bolnike s hudo okvaro jeter (razred C po Child-Pughovi lestvici) je treba zdraviti previdno in spremljati odziv na zdravljenje (glejte poglavji 4.4 in 5.2).
Skin and subcutaneous tissue disorders pruritus, rash severe skin reactions, including Stevens-Johnson Syndrome
Bolezni kože in podkožja pruritus, izpuščaj hude kožne reakcije, vključno s StevensJohnsonovim sindromom
Tigecycline is able to overcome the two major tetracycline resistance mechanisms, ribosomal protection and efflux.
Tigeciklin je sposoben premagati oba poglavitna mehanizma odpornosti proti tetraciklinom, ribosomsko zaščito in iztok.
The summary of clinical response in the modified intent-to-treat (mITT) population results is shown in the following table.
Povzetek kliničnega odziva v modificirani populaciji, ki so jo nameravali zdraviti (mITT - modified intent-totreat), je prikazan v spodnji preglednici.
If you develop diarrhoea during or after your treatment, tell your doctor at once.
Če se vam razvije driska med zdravljenjem ali po njem, to takoj povejte zdravniku.
At 4 times the minimum inhibitory concentration (MIC), a 2-log reduction in colony counts was observed with tigecycline against Enterococcus spp., Staphylococcus aureus, and Escherichia coli.
Pri koncentraciji, ki je bila štirikrat višja od minimalne inhibicijske koncentracije (MIC), so pri tigeciklinu opazovali zmanjšanje 2-log števila kolonij proti Enterococcus spp., Staphylococcus aureus in Escherichia coli.
Tygacil is not to be used in children less than 8 years of age due to the lack of data on safety and efficacy in this age group and because it may induce permanent dental defects such as staining on the developing teeth.
Zdravilo Tygacil se ne sme uporabljati pri otrocih, mlajših od 8 let, zaradi pomanjkanja podatkov o varnosti in učinkovitosti v tej starostni skupini in ker lahko povzroča trajne okvare zob, na primer obarvanost razvijajočih se zob.
• Your doctor will monitor you closely for the development of any other bacterial infections.
• vaš zdravnik bo skrbno spremljal, če se je pri vas pojavila še kakšna druga bakterijska okužba.
• Low fibrinogen levels in the blood (a protein involved in blood clotting)
• nizke ravni fibrinogena v krvi (beljakovine, vključene v strjevanje krvi)
Tigecycline is administered only by intravenous infusion over 30 to 60 minutes (see sections 4.4 and 6.6).
Tigeciklin se daje samo z intravensko infuzijo, ki teče 30 do 60 minut (glejte poglavji 4.4 in 6.6).
No specific information is available on the treatment of overdosage.
O zdravljenju prevelikega odmerjanja specifičnih podatkov ni na voljo.
• Sepsis (severe infection in the body and blood stream)/septic shock (serious medical condition which can lead to multiple organ failure and death as a result of sepsis)
• sepsa (huda okužba v telesu in krvnem obtoku)/septični šok (težko zdravstveno stanje, ki lahko kot posledica sepse povzroči odpoved več organov in smrt)
hypofibrinogenaemia
hipofibrinogenemija
Do not take any diarrhoea medicine without first checking with your doctor.
Ne vzemite zdravil proti driski, ne da bi prej vprašali zdravnika;
This consists of severe, persistent or bloody diarrhoea associated with abdominal pain or fever, which can be a sign of serious bowel inflammation, which may occur during or after your treatment.
Prepoznamo ga po hudi, trdovratni ali krvavi driski, povezani z bolečinami v trebuhu ali vročino, ki je lahko znak resnega črevesnega vnetja in se lahko pojavi med vašim zdravljenjem ali po koncu zdravljenja.
Tygacil is an antibiotic of the glycylcycline group that works by stopping the growth of bacteria that cause infections.
Zdravilo Tygacil je antibiotik glicilciklinske skupine, ki deluje tako, da zaustavi rast bakterij, ki povzročajo okužbe.
The use of tigecycline may result in overgrowth of non-susceptible organisms, including fungi.
Uporaba tigeciklina lahko povzroči razraščanje neobčutljivih organizmov, med drugim glivic.
In patients (including paediatrics) with severe hepatic impairment (Child Pugh C), the dose of tigecycline should be reduced by 50%.
Pri bolnikih (vključno z otroci) s hudo okvaro jeter (razred C po Child-Pughovi lestvici) je treba odmerek tigeciklina zmanjšati za 50 %.
In all Phase 3 and 4 (cSSTI and cIAI) studies, death occurred in 2.4 % (54/2216) of patients receiving tigecycline and 1.7% (37/2206) of patients receiving active comparators.
V vseh študijah faze 3 in 4 (študijah cSSTI ter študijah cIAI) je umrlo 2,4 % (54/2.216) bolnikov, ki so prejemali tigeciklin, in 1,7 % (37/2.206) bolnikov, ki so prejemali primerjalne učinkovine.
Animal and human pharmacokinetic studies have demonstrated that tigecycline readily distributes to tissues.
Farmakokinetične študije na živalih in ljudeh so pokazale, da se tigeciklin z lahkoto porazdeljuje v tkiva.
Each vial contains lactose monohydrate.
Ena viala vsebuje laktozo monohidrat.
• Abscess (collection of pus), infections
• abscesi (ognojki), okužbe
Patients should be carefully monitored during therapy (see section 4.8).
Bolnike moramo med zdravljenjem skrbno spremljati (glejte poglavje 4.8).
Dose Normalized to 1 mg/kg Mean ± SD Tigecycline Cmax and AUC in Children Age (yr)
Odmerek normaliziran na povprečno 1 mg/kg ± SD, Cmax in AUC tigeciklina pri otrocih starost (let)
No new or unexpected safety concerns were observed with tigecycline in these studies.
V omenjenih študijah niso opazili novih ali nepričakovanih podatkov o varnosti tigeciklina.
The pH is adjusted with hydrochloric acid, and if necessary sodium hydroxide.
pH je uravnan s klorovodikovo kislino in po potrebi z natrijevim hidroksidom.
In general, tigecycline is considered bacteriostatic.
Na splošno velja, da je tigeciklin bakteriostatik.
If pancreatitis develops, treatment with tigecycline should be discontinued.
Če se pojavi pankreatitis, je treba zdravljenje s tigeciklinom prekiniti.
These vials are distributed to the hospital in a ten tray pack.
Te viale dobavljajo bolnišnicam na podstavkih z desetimi vialami.
Tigecycline has decreased in vitro activity against Proteus, Providencia, and Morganella spp.
^)Tigeciklin ima zmanjšano aktivnost in vitro proti družinam Proteus, Providencia in Morganella spp.
Tigecycline is a substrate of P-gp based on an in vitro study using a cell line overexpressing P-gp.
Tigeciklina je substrat P-gp, kar temelji na študiji in vitro, opravljeni na celični liniji s prekomerno izraženim P gp.
• Laboratory measurements of decreased ability to form blood clots
• laboratorijsko ugotovljena zmanjšana sposobnost strjevanja krvi
In vitro studies using Caco-2 cells indicate that tigecycline does not inhibit digoxin flux, suggesting that tigecycline is not a P-glycoprotein (P-gp) inhibitor.
In vitro študije s celicami Caco-2 kažejo, da tigeciklin ne zavira toka digoksina, kar kaže, da tigeciklin ni inhibitor P-glikoproteina (P-gp).
• If you have poor or slow wound healing.
• če se vam rane slabo ali počasi celijo;
Very limited safety data were available from two PK studies (see section 5.2).
Na voljo je le malo podatkov o varnosti iz dveh farmakokinetičnih študij (glejte poglavje 5.2).
Available pharmacodynamic/toxicological data in animals have shown excretion of tigecycline/metabolites in milk (see section 5.3).
Razpoložljivi farmakodinamični/toksikološki podatki pri živalih kažejo na izločanje tigeciklina/presnovkov v mleko (glejte poglavje 5.3).
In humans, the steady-state volume of distribution of tigecycline averaged 500 to 700 L (7 to 9 L/kg), indicating that tigecycline is extensively distributed beyond the plasma volume and concentrates into tissues.
Pri ljudeh je bil volumen porazdelitve tigeciklina v stanju dinamičnega ravnovesja povprečno 500 do 700 l (7 do 9 l/kg), kar kaže, da se tigeciklin obsežno prerazporedi iz plazemskega prostora in se kopiči v tkivih.
Intravenous administration of tigecycline at a single dose of 300 mg over 60 minutes in healthy volunteers resulted in an increased incidence of nausea and vomiting.
Intravensko dajanje tigeciklina zdravim prostovoljcem v enkratnem 300-miligramskem odmerku v času 60 minut je bilo povezano z večjo pojavnostjo navzee in bruhanja.
In clinical studies in complicated skin and soft tissue infections (cSSTI), complicated intra-abdominal infections (cIAI), diabetic foot infections, nosocomial pneumonia and studies in resistant pathogens, a numerically higher mortality rate among tigecycline treated patients has been observed as compared to the comparator treatment.
V kliničnih študijah pri zapletenih okužbah kože in mehkih tkiv (cSSTI - complicated skin and soft tissue infections), zapletenih intraabdominalnih okužbah (cIAI - complicated intra-abdominal infections), okužbah diabetičnega stopala, bolnišnični pljučnici in študijah pri rezistentnih patogenih so opazili številčno višjo stopnjo umrljivosti pri bolnikih, zdravljenih s tigeciklinom, v primerjavi z bolniki, ki so prejemali primerjalna zdravila.
If you are allergic to tetracycline class antibiotics (e.g., minocycline, doxycycline, etc.), you may be allergic to tigecycline.
Če ste alergični na tetraciklinsko skupino antibiotikov (na primer minociklin, doksiciklin itn.), ste mogoče alergični tudi na tigeciklin.
Decreased susceptibility in both groups has been attributed to the overexpression of the non-specific AcrAB multi-drug efflux pump.
Zmanjšano občutljivost pri obeh skupinah so pripisali čezmerni ekspresiji nespecifične AcrAB multimedikamentozne iztočne črpalke.
Biliary excretion accounts for approximately 50 % of the total tigecycline excretion.
Izločanje z žolčem predstavlja okrog 50 % celotnega izločanja tigeciklina.
thrombocytopenia, increased international normalised ratio (INR)
trombocitopenija, zvečano internacionalno normalizirano razmerje (INR)
In in vitro studies, no antagonism has been observed between tigecycline and other commonly used antibiotic classes.
V raziskavah in vitro niso opazili antagonizma med tigeciklinom in drugimi skupinami antibiotikov, ki se pogosto uporabljajo.
As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of the agent in at least some types of infections is questionable.
Če je na lokalnem območju prevalenca odpornosti tolikšna, da je koristnost zdravila vsaj pri nekaterih vrstah okužb vprašljiva, po potrebi poiščite nasvet strokovnjaka.
In vitro studies in human liver microsomes indicate that tigecycline does not inhibit metabolism mediated by any of the following 6 cytochrome P450 (CYP) isoforms: 1A2, 2C8, 2C9, 2C19, 2D6, and 3A4 by competitive inhibition.
Raziskave v mikrosomih človeških jeter in vitro kažejo, da tigeciklin ne zavira presnove, ki jo posreduje katerakoli od naslednjih šestih izoform citokroma P450 (CYP): 1A2, 2C8, 2C9, 2C19, 2D6, in 3A4, s kompetitivno inhibicijo.