Примери за използване на To afatinib на Английски и техните преводи на Български
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Monitor for ADRs related to afatinib.
Do not take GIOTRIF- if you are allergic to afatinib or any of the other ingredients of this medicine(listed in section 6).
Monitor for ADRs related to afatinib.
Exposure to afatinib was found to be increased in patients with moderate or severe renal impairment(see section 5.2).
Lung cancer cells with mutated EGFR proteins are particularly sensitive to afatinib.
Exposure to afatinib in subjects with renal impairment was compared to healthy volunteers following a single dose of 40 mg GIOTRIF.
P-glycoprotein(P-gp) interactions Concomitant treatment with strong inducers of P-gp may decrease exposure to afatinib(see section 4.5).
Other potential mechanisms of resistance to afatinib have been suggested preclinically and MET gene amplification has been observed clinically.
Strong P-gp inducers(including but not limited to rifampicin, carbamazepine, phenytoin, phenobarbital or St. John's wort(Hypericum perforatum))may decrease exposure to afatinib(see section 4.4).
Systemic exposure to afatinib is decreased by 50%(Cmax) and 39%(AUC0-∞), when administered with a high-fat meal compared to administration in the fasted state.
The acquisition of a secondary T790M mutation is a major mechanism of acquired resistance to afatinib and gene dosage of the T790M-containing allele correlates with the degree of resistance in vitro.
Exposure to afatinib moderately increased with lowering of the creatinine clearance(CrCL, calculated according to Cockcroft Gault), i.e. for a patient with a CrCL of 60 mL/min or 30 mL/min exposure(AUCτ, ss) to afatinib increased by 13% and 42%, respectively, and decreased by 6% and 20% for a patient with CrCL of 90 mL/min or 120 mL/min, respectively, compared to a patient with the CrCL of 79 mL/min(median CrCL of patients in the overall patient population analysed).
Female gender, lower body weight, and underlying renal impairment Higher exposure to afatinib has been observed in female patients, patients with lower body weight and those with underlying renal impairment(see section 5.2).
NSCLC tumours with common activating EGFR mutations(Del 19, L858R) and several less common EGFR mutations in exon 18(G719X) and exon 21(L861Q)are particularly sensitive to afatinib treatment in non-clinical and clinical settings.
Co-administration of a high-fat meal with GIOTRIF resulted in a significant decrease of exposure to afatinib by about 50% in regard to Cmax and 39% in regard to AUC0-∞.
Pre-treatment with rifampicin(600 mg once daily for 7 days), a potent inducer of P-gp,decreased the plasma exposure to afatinib by 34%(AUC0-∞) and 22%(Cmax) after administration of a single dose of 40 mg GIOTRIF.
When the strong P-gp and BCRP inhibitor ritonavir(200 mg twice a day for 3 days) was administered 1 hour before a single dose of 20 mg GIOTRIF,exposure to afatinib increased by 48%(area under the curve(AUC0-∞)) and 39%(maximum plasma concentration(Cmax)).
In vitro binding of afatinib to human plasma proteins is approximately 95%.
Afatinib binds to proteins both non-covalently(traditional protein binding) and covalently.
Covalent adducts to proteins were the major circulating metabolites of afatinib.
Caution should be exercised in administering afatinib with ritonavir(refer to the afatinib SmPC).
Animal studies with afatinib did not indicate direct or indirect harmful effects with respect to reproductive toxicity(see section 5.3).
By blocking these proteins, afatinib helps to control cell division and thereby slows down the growth and spread of the non-small cell lung cancer.
Approximately 2% of the afatinib dose was metabolized by FMO3 and the CYP3A4-dependent N-demethylation was too low to be quantitatively detected.
In vitro data indicated that drug-drug interactions with afatinib due to inhibition of OATB1B1, OATP1B3, OATP2B1, OAT1, OAT3, OCT1, OCT2, and OCT3 transporters are considered unlikely.
Afatinib covalently binds to and irreversibly blocks signalling from all homo- and heterodimers formed by the ErbB family members EGFR(ErbB1), HER2(ErbB2), ErbB3 and ErbB4.
Boehringer Ingelheim has announced the submission of a Marketing Authorisation Application to the European Medicines Agency(EMA) for approval of afatinib*, the first irreversible ErbB Family Blocker, as a treatment for patients with EGFR(ErbB1) mutation positive non-small cell lung cancer(NSCLC).
At the time of the analysis, 14 Nov 2013,176 patients(76.5%) in the afatinib arm and 70 patients(60.9%) in the chemotherapy arm experienced an event contributing to the PFS analysis, i.e. disease progression as determined by central independent review or death.