farmakovigilanca
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Agencija za lekove i medicinska sredstva Srbije(ALIMS)
Postmarketinško praćenjebezbednosti lekovaFarmakovigilanca
www.alims.gov.rs
Marko rić
Nacionalni centar za farmakovigilancu
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NationalControl
Laboratory
NationalPharmacovigilance
Centre
NationalCentre for
Information
Centre forSupport
HumanMedicines
Centre
VeterinaryMedicines
Department
MedicalDevices
Department
ManagingDirectorOffice
QC Manager
ManagingDirector
!ysico"C!emical
Laboratory
#iological
Laboratory
Quality Controland Support
!armaceutical
Department
$ssessmentDepartment
LicensingDepartment
MedicalDepartment
%inancialDepartment
$ccountancy
Commercial$ffairs
$dministrativeDepartment
&eceipt ' Issuing$ffairs
Legal ' (eneral$ffairs
I) (roup
ALIMS
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Ograničena informacija o bezbednostiOgraničena informacija o bezbednosti
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Promene u Sa žetku i Uputstvu: uvođenje novihkontraindikacija, mera opreza i upozorenja,neželjenih dejstava, interakcija, ograničenje
indikacijskog područ ja...
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• Acomplia (rimonabant)®
• Blokator kanabinoidnih (CB1) receptora,
• Registracija, jun 2006, u prometu u 1
!" #emalja,
• $ndikacije % redukcija telesne mase kod&• 'rlo goja#nih (B$ 0 kg*m2)
• goja#nih (B$ 2+) u# pridruene -aktore ri#ika (dijabetes,
dislipidemije)
Be#bednosni problemi&
.sihijatrijski poreme/aji (depresija)%naglaeno u .C*.$3u4
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5uli 200+&
Kontraindikacije&
14 ajor7 depresija,
24 .rimena antidepresi'a,
Upozorenja i mere opreza&
8busta'a primene kod pr'ih simptoma
depresije4
aj 200&.ra/enje pacijenata, od trenutka inicijacije terapije4
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8ktobar 200&
8dluka o po'la9enju leka i# prometa,
Ra#log % odnos koristi i ri#ika negati'an:::;orist& umerena e-ikasnost, be# doka#a o pre'enti'nom
delo'anju na ;< bolesti,
Ri#ik& = suicida (6000 ispitanika) u periodu od 2
meseca (samo 1 u placebo grupi)444
>?A& lek nikada nije registro'an
Agencija #a leko'e rbije (A$)& lek nikada nije registro'an
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NationalControl
Laboratory
NationalPharmacovigilance
Centre
NationalCentre for
Information
Centre forSupport
HumanMedicines
Centre
VeterinaryMedicines
Department
MedicalDevices
Department
ManagingDirectorOffice
QC Manager
ManagingDirector
!ysico"C!emical
Laboratory
#iological
Laboratory
Quality Controland Support
!armaceuticalDepartment
$ssessmentDepartment
LicensingDepartment
MedicalDepartment
%inancialDepartment
$ccountancy
Commercial$ffairs
$dministrativeDepartment
&eceipt ' Issuing$ffairs
Legal ' (eneral$ffairs
I) (roup
*or+ing(roups
on &is+"#enefit$ssessment for
Mar+eted Medicinalroducts
ALIMS
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• ADRs spontaneous reporting – collecting and assessing ADRs case reports,
signal detection, alerts, communication (HCs, !AHs"• ADRs national data#ase – $H%&'!C igi)low Data#ase• *'Rs assessment• R!s assessment• Risk minimization activities, risk communication (Dear HC +etter,
Newsletter"• 'rgent safet restrictions• Regulator measures – variations, drug
restrictions-recalls-suspension-witdrawals• Continuous maintenance and improvement of te National sstem
• /ducational programme for HCs and !AHs (seminars, worksops,pu#lications on drug safet and spontaneous reporting, professional #rocures,lea0ets, #ooklets, etc"
Nacionalni centar za farmakovigilancu - N
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1ainteresovane strane2• Regulatorni autoriteti2 !inistarstvo zdravl3a –
Mo! – 4nspekci3a5 ALIMS – Nacionalnicentar za farmakovigilancu ("#F"
• Nosilac dozvole za lek & !arketing Autorization
Holder – MA!• 1dravstveni radnici & Healt Care rofessionals &
!#P
Nacionalni sistem farmakovigilance
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Prijavljivanje neželjenih reakcija
MAHQPPV for Seria HCPFee!ack ADRs Case
Assessmen
t
ADRs Case
Report
ALIMS - NPC
ADRs Case
Report
CIOMS I
form
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Centralizovani sistem
NPC
HCP HCP HCP HCP HCP HCP HCP
HCP
Coor!inatorsfor P"V
HCP
Coor!inatorsfor P"V
HCP HCP
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)ormiran3e regionalni centara za
NPC
#PC #PC #PC
HCP HCP HCP HCP HCP
HCP HCP
#PC
HCP HCPHCP
Coor!inatorsfor P"V
HCPCoor!inators
for P"VHCP
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$ta se %ri&avl&u&e?
ovi lek ! sve neželjene reakcije
"ek # #potre$i %#že o% & 'o%ina ! o($iljne ineo)ekivane *)ak i ako nis# o($iljno'karaktera+
Informacije o pove,anj# inci%ence ispoljavanjao)ekivanih reakcija- klini)ki (na)ajniminterakcijama- (lo#potre$i leka-pre%o(iranj#- primeni # perio%# tr#%no,e i%ojenja- i(ostank# efikasnosti- kao iinformacije o me%icinskoj 're.ci/
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'ako %ri&aviti?Minim#m po%ataka ! pacijent- reakcija *%at#m
ispoljavanja+- s#spektni lek- i(ve.ta)/O$ra(ac na sajt# A"IMS0a1 e0mail- po.ta- fa2-
prijavljivanje p#tem telefona/
Me%icinski potvr3eni sl#)ajevi/
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NC%
rocena
*HO databaseentering " Vigi%lo,
Odgovor
rocenaslu-a.a
ri3avl3ivan3e NR+ NC)&u
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www.alims.gov.rs
Procena bezbednosni$ podataka poreklom iz pre% ili
postmarketinški$ klini&ki$ st'dija epidemiološki$ st'dijaspontanog prijavljivanja i literat're
I"*IFI+A#I,A -I.I+A
+A-A+*-I.A#I,A -I.I+A
P-/#"A -I.I+A
MI"IMI.A#I,A 0 +/M1"I+A#I,A -I.I+A
lan 'pravl3an3a Rizikom & R!
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www.alims.gov.rs
!inimizaci3a rizika – 6omunikaci3a
& +etopro2en& "imes'lid& *alidomid
& Rutinske aktivnosti6omunikaci3a putem *mC-4+&a, davan3e
o#3ektivni informaci3a o riziku& Dodatne aktivnosti
isma zdravstvenim radnicima, speci78niprogrami2 edukaci3a, prevenci3a, kartice zapaci3enta
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*talno %DR9AAN:/ i'NAR/;4AN:/"acionalnogsistema P3 u cil3u
identi7kovan3a iupravl3an3a rizicima io#ez#e<ivan3aracionalne terapi3skeprimene
www.alims.gov.rs
/dgovornost2