Medication simvastatin. Medical search. Frequent questions

Statins such as simvastatin, atorvastatin and pravastatin are used to lower cholesterol. (oprah.com)
Cholesterol-lowering medications, such as atorvastatin (Lipitor) and simvastatin (Zocor), block the action of HMG-CoA reductase, an enzyme involved in making cholesterol. (livescience.com)
Some commonly used statins include: atorvastatin (Lipitor), simvastatin (Zocor), or lovastatin (Mevacor). (rxfacts.org)

Simvastatin is available generic forms and under the commercial name of Zocor in tablets of 5, 10, 20, 40 and 80 mg. the recommended dose is 5 to 80 mg daily based upon tolerability and lipid levels. (nih.gov)
[3-19-2010] Based on review of data from a large clinical trial and data from other sources, the U.S. Food and Drug Administration (FDA) is informing the public about an increased risk of muscle injury in patients taking the highest approved dose of the cholesterol-lowering medication, Zocor* (simvastatin) 80 mg, compared to patients taking lower doses of simvastatin and possibly other drugs in the "statin" class. (fda.gov)
Simvastatin is sold as a single-ingredient generic medication and as the brand-name, Zocor. (fda.gov)
Simvastatin, sold under the brand name Zocor among others, is a statin, a type of lipid-lowering medication. (wikipedia.org)
ZOCOR (simvastatin) is a lipid-lowering agent that is derived synthetically from a fermentation product of Aspergillus terreus. (globalrph.com)
Were you looking for FDA Recommends Changes to Zocor (Simvastatin) lawsuits? (lawyersandsettlements.com)
A recent Zocor SEARCH study shows that higher doses of the Zocor drug (simvastatin) can cause an increased risk of muscle damage and Zocor toxicity . (lawyersandsettlements.com)
The FDA has warned that the risk of Zocor side effects is also increased when Zocor simvastatin is combined with certain other drugs. (lawyersandsettlements.com)
Simvastatin is an ingredient in Merck & Co's Zocor and Abbott Laboratories Inc's Simcor, and is now sold generically. (lawyersandsettlements.com)
If you are starting therapy with simvastatin, or had your dose of Zocor increased, you should contact a health professional immediately if you have experienced symptoms of fever, dark urine, and any unexplained muscle injury, such as muscle cramps, pain, tenderness, stiffness or spasm. (lawyersandsettlements.com)
This condition is reportedly linked to the dose size, meaning the higher the Zocor (simvastatin) dose, the higher the likelihood of experiencing muscle pain. (lawyersandsettlements.com)
Zocor and the generic Simvastatin is available in the strength of 10 mg, 20 mg, 40 mg and 80 mg tablets. (canadapharmacyonline.com)
Zocor (Simvastatin) is a prescription medication that is used along with a proper diet to lower bad cholesterol and triglycerides in the blood and raise good cholesterol. (canadapharmacyonline.com)
You should not take Zocor if you are allergic to Simvastatin or if you have any other allergies. (canadapharmacyonline.com)
In general, all drug prices, not only Zocor, are more affordable to order from Canada because the price of both the brand and generic medication is regulated by the government. (canadapharmacyonline.com)
Mevacor ( lovastatin ) and Zocor ( simvastatin ) are both used to reduce cholesterol levels. (rxlist.com)
Zocor (simvastatin) is a statin that lowers lipids and cholesterol levels used in conjunction with lifestyle changes such as a low-fat, low cholesterol diet, and exercise to reduce the chances of cardiovascular disease and ischemic strokes in patients with elevated lipids and cholesterol. (rxlist.com)

Lipostat, Pravastatin and Simvastatin are just a few of the medications that are available at euroClinix to treat high cholesterol. (euroclinix.net)
Synthetically prepared HMG-CoA reductase inhibitor with some similarities to lovastatin, simvastatin, and pravastatin. (medscape.com)

Mevacor (lovastatin) is a cholesterol-lowering medication called a statin prescribed to treat elevated blood cholesterol levels. (rxlist.com)

Like other members of its class (the "statins"), simvastatin lowers total serum cholesterol and particularly low density lipoprotein (LDL) cholesterol concentrations, thereby reducing the risk of atherosclerosis and its complications - myocardial infarction and stroke. (nih.gov)
The medications most commonly used to treat high cholesterol are statins. (euroclinix.net)
For those who have a bad reaction to statins or when statins do not lower cholesterol enough, other medications, such as ezetimibe, niacin, fibrates, or bile acid sequestrants, may be combined with statins. (rxfacts.org)

Amlodipine may be taken in combination with other heart or blood pressure medications. (medicalnewstoday.com)
As with all medications, the cost of amlodipine can vary. (medicalnewstoday.com)
High doses of simvastatin are also contraindicated with the widely used antihypertensive amlodipine. (wikipedia.org)

ALT elevations are clearly more frequent in patients taking higher doses of simvastatin (40 and 80 mg daily). (nih.gov)
Your doctor may need to change the doses of your medications or monitor you carefully for side effects. (medlineplus.gov)
The risk of myopathy is also increased when simvastatin, especially at the higher doses, is used with certain drugs (see Simvastatin Dose Limitations below). (fda.gov)
Be aware of the potential increased risk of muscle injury with the 80 mg dose of simvastatin compared to lower doses of simvastatin and possibly other statin drugs. (fda.gov)
There is evidence to suggest that rare side effects such as joint pain, memory loss, and muscle cramps are more likely to occur in patients who take higher doses of simvastatin. (wikipedia.org)
A side effect is an unwanted response to a medication when it is taken in normal doses. (medbroadcast.com)
In June 2011, the US FDA announced a simvastatin warning update, alerting patients to the risk of muscle injury (myopathy) when simvastatin was used at the highest doses (80 mg) and especially within the first 12 months of taking the medication. (lawyersandsettlements.com)
So that they can help you with appropriate medications with the right doses, to bring desirable changes for you. (chestercountycheese.org)

Use of simvastatin is contraindicated in medications that are strong inhibitors of cytochrome P450 activity (such as cyclosporine, ketoconazole, diltiazem, ciprofloxacin or amiodarone), and dose adjustments are appropriate for its use with other agents that inhibit CYP 3A4. (nih.gov)
In 2002, the FDA issued its first warning about the risk of rhabdomyolysis to healthcare professionals not to administer more than 20 mg/day of simvastatin to patients receiving heart drugs containing amiodarone such as Cordarone and Pacerone. (lawyersandsettlements.com)
But in August 2008, the FDA issued another warning because it continued to receive reports of the muscle disease in patients taking both simvastatin and amiodarone. (lawyersandsettlements.com)
Amiodarone may also be used for purposes not listed in this medication guide. (cigna.com)
Be sure to read all medication guides or instruction sheets for oral amiodarone. (cigna.com)
Current medications included amiodarone, amlodipin and simvastatin. (biomedcentral.com)

The muscle injury, also called myopathy, is a known side effect with all statin medications. (fda.gov)
Myopathy and rhabdomyolysis are listed as possible side effects in the simvastatin and other statin drug labels. (fda.gov)
Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher simvastatin dosage. (nih.gov)
Discontinue simvastatin if markedly elevated CK levels occur or myopathy is diagnosed or suspected. (nih.gov)
Inform patients of the risk of myopathy and rhabdomyolysis when starting or increasing simvastatin dosage. (nih.gov)

On the adult questionnaire, aspirin was moved to the non-prescription medications sections unless the strength or brand name reported was only available by prescription (e.g. (cdc.gov)
Mr A had been living alone in his own home and was non-compliant with his prescribed medication regimen (which included aspirin, simvastatin and atenolol). (hdc.org.nz)
His current medications were noted as aspirin, simvastatin, and atenolol. (hdc.org.nz)
However, Mr A was administered atenolol and aspirin at 9am on Days 2, 3 and 4 and simvastatin at 6.30pm on Days 2 and 3. (hdc.org.nz)
The polypill regimen was a fixed-dose pill containing 5 mg ramipril, 50 mg atenolol, 12·5 mg hydrochlorothiazide, 20 mg simvastatin, and 100 mg aspirin administered as two capsules once per day for 12 months. (bvsalud.org)

Simvastatin is also available as a fixed combination with ezetimibe under the brand name Vytorin. (nih.gov)
Vytorin has been shown to provide no medical benefits over cheaper generic alternatives and its marketing of the medication was investigated by the US Department of Justice. (lawyersandsettlements.com)

The usual starting dose of simvastatin to reduce the risk of heart attack or stroke is 40 mg taken by mouth once a day, in the evening. (pharmasave.com)

The Heart Protection Study evaluated the effects of simvastatin in people with risk factors including existing cardiovascular disease, diabetes, or stroke, but having relatively low LDL cholesterol. (wikipedia.org)
We aimed to investigate the antidepressant effects of simvastatin as an adjuvant therapy in patients with moderate to severe depression. (druglib.com)
Cardiovascular and inflammatory effects of simvastatin therapy in patients with COPD: a randomized controlled trial. (druglib.com)

These prescriptions include medication for high cholesterol, high blood pressure, low thyroid function, and diabetes. (huffpost.com)
The table below provides information about the costs of similarly effective medications to treat high cholesterol. (rxfacts.org)

Simvastatin lowers the level of total cholesterol and low-density lipoprotein (LDL, or 'bad' cholesterol) and raises high-density lipoprotein (HDL, or 'good' cholesterol) levels. (pharmasave.com)

Bempedoic acid is in a class of medications called adenosine triphosphate-citrate lyase (ACL) inhibitors. (medlineplus.gov)
Erdafitinib belongs to the class of medications called protein kinase inhibitors . (medbroadcast.com)

Up to 5% of patients taking simvastatin chronically may experience minor elevations in serum ALT levels during therapy, but confirmed elevations to above three times the upper limit of normal (ULN) occur in only 1% to 2% of patients. (nih.gov)
Simvastatin 80 mg daily dosage is restricted to patients who have been taking simvastatin 80 mg daily chronically (e.g., for 12 months or more) without evidence of muscle toxicity. (nih.gov)

For example, taking warfarin (a blood thinner) and simvastatin (a cholesterol drug) can increase the risks of bleeding problems. (huffpost.com)

Our Canadian Pharmacy also carries other cholesterol medications such as Lipitor , Crestor and Zetia . (canadapharmacyonline.com)

tell your doctor and pharmacist if you are allergic to bempedoic acid, any other medications, or any of the ingredients in bempedoic acid tablets. (medlineplus.gov)
We also carry the generic Simvastatin in the strength of 5 mg tablets. (canadapharmacyonline.com)
These highlights do not include all the information needed to use SIMVASTATIN TABLETS safely and effectively. (nih.gov)
See full prescribing information for SIMVASTATIN TABLETS. (nih.gov)
SIMVASTATIN tablets, for oral use. (nih.gov)

Simvastatin (sim" va stat' in) is an orally available inhibitor of hepatic 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the major rate-limiting enzyme in cholesterol synthesis. (nih.gov)
Patients in the simvastatin group took simvastatin 20 mg orally daily during two perioperative periods: from the 7th to the 5th preoperative day and from the 2nd day after decannulation until the 7th postoperative day. (hindawi.com)
Take simvastatin orally once daily in the evening. (nih.gov)

Know that rhabdomyolysis is a rare side effect reported with all statin medications. (fda.gov)
Temporarily discontinue simvastatin in patients experiencing an acute or serious condition at high risk of developing renal failure secondary to rhabdomyolysis. (nih.gov)

Serious allergic reactions to simvastatin are rare. (wikipedia.org)
tell your doctor and pharmacist if you are allergic to phenytoin, other hydantoin medications such as ethotoin (Peganone) or fosphenytoin (Cerebyx), any other medications, or any of the ingredients in phenytoin injection. (medlineplus.gov)

Current indications for simvastatin are hypercholesterolemia and reduction in risk for death from coronary, cerebrovascular and peripheral artery disease in patients with these diseases. (nih.gov)
In several studies, ALT elevations were no more frequent in patients taking 10 and 20 mg of simvastatin daily than in placebo recipients. (nih.gov)
Patients cannot breastfeed while on simvastatin due to potentially disrupting the infant's lipid metabolism. (wikipedia.org)
Patients provided written informed consent and were randomly divided into 2 groups (65 in the simvastatin group and 65 in the control group) by assigning random numbers from a random number table. (hindawi.com)
According to the FDA, no new patients should be put on the 80 mg dose and patients currently on that dose should only continue if they have used simvastatin for more than a year without muscle pain. (lawyersandsettlements.com)
For patients that require a high-intensity statin or are unable to achieve their LDL-C goal receiving simvastatin 40 mg daily, prescribe alternative LDL-C lowering treatment. (nih.gov)
Use another simvastatin product to initiate dosing in such patients. (nih.gov)
Many patients go on to have many years of high quality active life after recovery from a heart attack and it is important to realise how good the future can be with proper rehabilitation, lifestyle changes, and medication. (familydoctor.co.nz)
Simvastatin as an adjuvant therapy to fluoxetine in patients with moderate to severe major depression: A double-blind placebo-controlled trial. (druglib.com)
The MeDS seems to be a valid and reliable tool that can be used to assess medication self-management skills among diverse patients, including those with limited literacy skills. (dovepress.com)
1 - 5 While estimates of non-adherence vary depending upon how adherence is measured and the characteristics of the drug in question, evidence suggests that approximately half of US patients do not take medication as prescribed. (dovepress.com)
6 Ensuring that patients take medications safely, appropriately, and consistently has therefore become a public health issue, particularly for the growing number of patients managing chronic diseases that require multi-drug regimens. (dovepress.com)
While devices like medication event monitoring system (MEMS) caps have advanced the measurement of medication adherence, they are often too costly to use in practice, especially when patients take multiple drugs. (dovepress.com)
While a small number of preferred drugs may be feasible for specialist prescribers, this may prove challenging for general practitioners (GPs) as generalists prescribing a wide range of treatments,[ 3 ] and who often manage all medications for patients, including those initiated by specialists in secondary care. (medrxiv.org)
Schmidt-Mende K, Andersen M, Wettermark B, Hasselström J. Educational intervention on medication reviews aiming to reduce acute healthcare consumption in elderly patients with potentially inappropriate medicines -A pragmatic open-label cluster randomized controlled trial in primary care. (janusinfo.se)

Sometimes, your doctor will recommend reducing your dosage or even weaning off the medication completely. (webmd.com)
The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. (bidrx.com)
Many interactions, however, may be dealt with by a dosage adjustment or a change in medication schedule. (groupeproxim.ca)
Maximum recommended dosage is simvastatin 40 mg once daily. (nih.gov)
See full prescribing information for simvastatin dosage modifications due to drug interactions. (nih.gov)
These include a medication's indication, dosage, frequency, duration of use, adverse effects, contraindications and interactions with other medications or conditions an individual may have. (medrxiv.org)
In addition to having a substantial adverse event profile quinidine can react with many concomitant medications, requiring dosage adjustments and careful monitoring, typically in an Intensive Care Unit (ICU) setting (15-17). (cdc.gov)

Cyproterone belongs to a group of medications known as steroidal antiandrogens . (medbroadcast.com)

Simvastatin is a commonly used cholesterol lowering agent (statin) that is associated with mild, asymptomatic and self-limited serum aminotransferase elevations during therapy, and rarely with clinically apparent acute liver injury. (nih.gov)
Rare cases of acute liver failure and death have been attributed to simvastatin. (nih.gov)
Simvastatin in the acute respiratory distress syndrome. (druglib.com)

Simvastatin is available as a generic medication, and is on the World Health Organization's List of Essential Medicines. (wikipedia.org)

In 2020, it was the thirteenth most commonly prescribed medication in the United States, with more than 36 million prescriptions. (wikipedia.org)

The cause of hepatic injury from simvastatin is unknown. (nih.gov)
Coadministration with these agents may cause increases in simvastatin levels and potentiate its hepatic or muscle toxicity. (nih.gov)

To investigate the effect and mechanism of simvastatin on myocardial injury in cardiac valve surgery with CPB. (hindawi.com)

Simvastatin is contraindicated with pregnancy, breastfeeding, and liver disease. (wikipedia.org)

Current medications are lisinopril and simvastatin. (acponline.org)

Ask your pharmacist how to dispose of medications that are no longer needed or have expired. (pharmasave.com)
If you are using this medication, speak with your doctor or pharmacist for information about your treatment options. (pharmasave.com)
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. (medlineplus.gov)
If you think this medication may be causing side effects (including those described here, or others), talk to your doctor or pharmacist. (groupeproxim.ca)
Check with your pharmacist before using this medication in combination with any other medications (including non-prescription products), vitamins or natural products. (groupeproxim.ca)
Mr B advised the hospital pharmacist that Mr A was non-compliant with his medication. (hdc.org.nz)
The hospital pharmacist therefore crossed out the medications in Mr A's Admission-Discharge planner and wrote in the progress notes that the medication had been stopped. (hdc.org.nz)
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with quinine and each time you refill your prescription. (prescriptiongiant.com)

All survey participants aged 2 months and older are eligible for the Sample prescription medication questions. (cdc.gov)
However, for both the household youth and adult questionnaires if a particular medication reported in the prescription medication section of the questionnaire was available in both prescription and non-prescription strengths (e.g., ibuprofen), the staff assumed it was a prescription medication and left it in this section. (cdc.gov)
See the notes associated with this variable in the data file layout for a detailed discussion of the prescription medication product code. (cdc.gov)
Symtuza is a prescription medication used to treat HIV-1 infection in adults who meet certain requirements. (rxwiki.com)
Symtuza is a prescription medication used to treat HIV-1 infection in adults who have never used antiretroviral treatment or have been on stable antiretroviral treatment for 6 months or more with very low blood virus levels. (rxwiki.com)

Isolated cases of an autoimmune hepatitis-like syndrome associated with simvastatin therapy have been reported, some of which did not reverse completely with discontinuation, resulting in a chronic hepatitis requiring long term immunosuppressive therapy. (nih.gov)

The agency is also reviewing data from other clinical trials, observational studies, adverse event reports, and data on prescription use of simvastatin to better understand the relationship between high-dose simvastatin use and muscle injury (see Data Summary below). (fda.gov)
In 2012, the Clinical Pharmacogenetics Implementation Consortium has released guidelines regarding the use of rs4149056 genotype in guiding dosing of simvastatin and updated the guideline in 2014. (wikipedia.org)
The present clinical randomized controlled trial explored the protective effect of perioperative simvastatin on cardiac muscle after CPB and the relationship of such effects to cardiomyocyte autophagy. (hindawi.com)
High-dose simvastatin for aneurysmal subarachnoid hemorrhage: multicenter randomized controlled double-blinded clinical trial. (druglib.com)
To assess construct and predictive validity, MeDS scores were compared with scores from the 8-item Morisky Medication Adherence Scale and relevant clinical measures (HbA 1c , blood pressure, and low-density lipoprotein cholesterol). (dovepress.com)
Third, for drug development and toxicities, GWAS continues to provide valuable information on gene-drug interactions with the potential to develop safer and more effective drugs as well as to reduce toxicities in the clinical use of existing medications. (cdc.gov)

Review their medical history and current medications with their healthcare professional to determine if they should continue using simvastatin. (fda.gov)

The only FDA-approved treatment for severe malaria in the United States is quinidine, a stereoisomer of quinine that once saw routine hospital use as a Author Manuscript cardiac anti-arrhythmic medication (11, 12). (cdc.gov)

Some health concerns are more common with age, and doctors prescribe medications to help treat them. (webmd.com)
Prescribing is the most common healthcare intervention in developed countries, however decisions to prescribe or continue a medication for a patient are complex, with many factors that must be considered. (medrxiv.org)

Clinically apparent liver injury due to simvastatin is rare. (nih.gov)
But in view of the wide use of simvastatin, clinically apparent liver injury is exceeding rare and is estimated to occur in 1 per 100,000 patient years of exposure. (nih.gov)

Given the current available information, simvastatin should not be recommended solely for the treatment of AMD. (wikipedia.org)
See Treatment and Medication for more detail. (medscape.com)
The sustained release (SR) form of this medication is used for the treatment of mild-to-moderate high blood pressure, when beta-blockers or diuretics (water pills) are not recommended or have caused unacceptable side effects. (medbroadcast.com)
Follow-up regularly after starting treatment to make sure the medication is working and that you are reaching your LDL goals. (rxfacts.org)
Effects of SLCO1B1 Genetic Variant on Metabolite Profile in Participants on Simvastatin Treatment. (cdc.gov)

As you get older, your doctor is likely to recommend certain medications to improve your health and longevity. (webmd.com)
The maximum daily dose may be lower for people taking certain medications. (pharmasave.com)
Certain medications used concomitantly with metformin may also increase the risk of lactic acidosis. (pdr.net)

Repurposing Antihypertensive and Statin Medications for Spinal Pain: A Mendelian Randomization Study. (cdc.gov)

Pregnancy must be avoided while on simvastatin due to potentially severe birth defects. (wikipedia.org)
Taking this medication during pregnancy may be harmful for the baby. (groupeproxim.ca)
This medication should not be used during pregnancy. (canadapharmacyonline.com)
Make sure any doctor caring for your pregnancy or your baby knows you have received this medication. (cigna.com)

Simvastatin also reduced the numbers of other events like heart attacks, strokes, and revascularizations and MI significantly. (wikipedia.org)
This medication may interact with other medications or supplements, sometimes significantly. (groupeproxim.ca)

Simvastatin is made from the fungus Aspergillus terreus. (wikipedia.org)

USES: Simvastatin is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. (bidrx.com)

What side effects can this medication cause? (medlineplus.gov)
Report any side effects with simvastatin to FDA's MedWatch program using the information at the bottom of the page in the "Contact Us" box. (fda.gov)
SIDE EFFECTS: Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. (bidrx.com)
Many people using this medication do not have serious side effects. (bidrx.com)
Using this medication improperly or without the advice of a doctor can result in serious side effects or death. (cigna.com)
What side effects are possible with this medication? (medbroadcast.com)
Many medications can cause side effects. (medbroadcast.com)
The side effects listed below are not experienced by everyone who takes this medication. (medbroadcast.com)
If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. (medbroadcast.com)
The following side effects have been reported by at least 1% of people taking this medication. (medbroadcast.com)
Those taking this medication have reported side effects. (familywize.org)

Retrospective analyses and genetic studies have suggested that other medications (simvastatin) and HFE polymorphisms may play a role in serum aminotransferase elevations and Gilbert syndrome in hyperbilirubinemia. (nih.gov)

The primary uses of simvastatin are to treat dyslipidemia and to prevent atherosclerosis-related complications such as stroke and heart attacks in those who are at high risk. (wikipedia.org)
Depending on the cause of stroke, carotid endarterectomy or stenting, antiplatelet medications, or anticoagulants may help reduce risk of subsequent strokes. (msdmanuals.com)

You will receive each dose of phenytoin injection in a medical facility, and a doctor or nurse will monitor you carefully while you are receiving the medication and afterwards. (medlineplus.gov)
Phenytoin is in a class of medications called anticonvulsants. (medlineplus.gov)
Your doctor will probably not want you to receive phenytoin injection if you are taking this medication. (medlineplus.gov)

Simvastatin was approved for use in the United States in 1991 and is still widely used with more than 40 million prescriptions being filled yearly. (nih.gov)
When you get older, it's normal to be using more than one medication - usually a combination of prescriptions and over-the-counter remedies. (webmd.com)

The medication usually takes about 2 to 4 weeks to have a significant effect on the cholesterol level in your blood. (pharmasave.com)
This drug can be used alone or in combination with other heart or blood pressure medications. (medicalnewstoday.com)
Blood tests must be done regularly while using this medication. (groupeproxim.ca)
Several other medications including (but not limited to) the blood pressure drug nifedipine, the anti-anxiety drug buspirone and the antihistamine fexofenadine may also be affected by grapefruit. (oprah.com)
After 14 to 21 days, your doctor may increase or decrease your dose, depending on the results of blood tests and how well the medication is tolerated. (medbroadcast.com)
Though it may be lowering blood pressure or cholesterol, for example, these "helpful" changes can be perceived in the body as stress and lead to further health problems down the line, possibly leading to even more medication. (huffpost.com)

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