. . . . . . "004.002" . "4.2\tD\u00E1vkov\u00E1n\u00ED a zp\u016Fsob pod\u00E1n\u00ED"@cs . . . . . . . . . "D\u00E1vkov\u00E1n\u00ED\nDosp\u011Bl\u00ED a mladistv\u00ED (od 12 let):\nP\u0159\u00EDpravek Tramylpa by se m\u011Bl pod\u00E1vat pouze pacient\u016Fm se st\u0159edn\u011B siln\u00FDmi a\u017E siln\u00FDmi bolestmi, u nich\u017E se pova\u017Euje za vhodnou kombinace tramadol hydrochloridu a paracetamolu.\nD\u00E1vku je t\u0159eba upravit individu\u00E1ln\u011B podle intenzity bolest\u00ED a pacientovy reakce.\nDoporu\u010Duje se po\u010D\u00E1te\u010Dn\u00ED d\u00E1vka dvou potahovan\u00FDch tablet p\u0159\u00EDpravku Tramylpa. Podle pot\u0159eby je mo\u017Eno tuto d\u00E1vku zv\u00FD\u0161it, nem\u00E1 v\u0161ak b\u00FDt vy\u0161\u0161\u00ED ne\u017E 8\u00A0potahovan\u00FDch tablet (co\u017E p\u0159edstavuje 300 mg tramadolu a 2600 mg paracetamolu) za den. \nInterval mezi jednotliv\u00FDmi d\u00E1vkami nem\u00E1 b\u00FDt krat\u0161\u00ED ne\u017E 6 hodin.\nZe \u017E\u00E1dn\u00E9ho d\u016Fvodu se Tramylpa nem\u00E1 u\u017E\u00EDvat d\u00E9le, ne\u017E je naprosto nezbytn\u00E9 (viz bod 4.4).\nJe-li vzhledem k charakteru a z\u00E1va\u017Enosti onemocn\u011Bn\u00ED nutn\u00E9 opakovan\u00E9 pod\u00E1v\u00E1n\u00ED nebo dlouhodob\u00E1 l\u00E9\u010Dba (a to pokud mo\u017Eno p\u0159eru\u0161ovan\u00E1), je zapot\u0159eb\u00ED pacienta pe\u010Dliv\u011B pravideln\u011B sledovat, aby bylo mo\u017En\u00E9\u00A0posoudit, zda je je\u0161t\u011B nutn\u00E9 v\u00A0l\u00E9\u010Db\u011B pokra\u010Dovat.\nD\u011Bti:\n\u00DA\u010Dinnost a bezpe\u010Dnost p\u0159\u00EDpravku Tramylpa u d\u011Bt\u00ED mlad\u0161\u00EDch 12\u00A0let nebyla stanovena; proto se u t\u00E9to skupiny pacient\u016F u\u017E\u00EDv\u00E1n\u00ED p\u0159\u00EDpravku nedoporu\u010Duje.\nStar\u0161\u00ED pacienti:\nM\u016F\u017Ee se u\u017E\u00EDvat obvykl\u00E1 d\u00E1vka, je v\u0161ak t\u0159eba poznamenat, \u017Ee u dobrovoln\u00EDk\u016F ve v\u011Bku 75 let byl p\u0159i peror\u00E1ln\u00EDm pod\u00E1v\u00E1n\u00ED elimina\u010Dn\u00ED polo\u010Das tramadolu o 17\u00A0% del\u0161\u00ED. U osob star\u0161\u00EDch ne\u017E 75 let se s\u00A0ohledem na p\u0159\u00EDtomnost tramadolu doporu\u010Duje, aby interval mezi d\u00E1vkami nebyl krat\u0161\u00ED ne\u017E 6\u00A0hodin. \nRen\u00E1ln\u00ED insuficience:\nU pacient\u016F se z\u00E1va\u017Enou ren\u00E1ln\u00ED insuficienc\u00ED (clearance kreatininu <\u00A010 ml/min) se u\u017E\u00EDv\u00E1n\u00ED p\u0159\u00EDpravku Tramylpa s\u00A0ohledem na p\u0159\u00EDtomnost tramadolu nedoporu\u010Duje. V p\u0159\u00EDpadech st\u0159edn\u011B t\u011B\u017Ek\u00E9 ren\u00E1ln\u00ED insuficience (clearance kreatininu 10 \u2013 30 ml/min) je t\u0159eba prodlou\u017Eit interval mezi d\u00E1vkami na 12 hodin. Jeliko\u017E hemodial\u00FDzou nebo hemofiltrac\u00ED se tramadol odstra\u0148uje velmi pomalu, nen\u00ED obvykle po dial\u00FDze zapot\u0159eb\u00ED pod\u00E1vat dal\u0161\u00ED d\u00E1vku k\u00A0udr\u017Een\u00ED analgezie.\nHepat\u00E1ln\u00ED insuficience:\nOsoby se z\u00E1va\u017Enou jatern\u00ED insuficienc\u00ED nesm\u011Bj\u00ED p\u0159\u00EDpravek Tramylpa u\u017E\u00EDvat (viz bod 4.3). V p\u0159\u00EDpadech st\u0159edn\u011B t\u011B\u017Ek\u00E9 jatern\u00ED dysfunkce je t\u0159eba pe\u010Dliv\u011B zv\u00E1\u017Eit prodlou\u017Een\u00ED intervalu mezi d\u00E1vkami (viz bod 4.4).\nZp\u016Fsob pod\u00E1n\u00ED\nPeror\u00E1ln\u00ED pod\u00E1n\u00ED.\nPotahovan\u00E9 tablety se polykaj\u00ED vcelku a zap\u00EDjej\u00ED se dostate\u010Dn\u00FDm mno\u017Estv\u00EDm tekutiny. Nesm\u011Bj\u00ED se l\u00E1mat ani kousat.\n"@cs . . .