What allergy medicine is safe with warfarin

Do not use this medication if you:

  1. are allergic to other atropinics (e.g., atropine, scopolamine)
  2. have megacolon (enlarged colon)
  3. are allergic to hyoscine or any ingredients of this medication
  4. have myasthenia gravis
  5. have glaucoma
  6. have obstructive prostatic hypertrophy (enlarged or blocked prostate)

In addition, do not use the injection form of this medication if you:

  1. have narrowing of the gastrointestinal tract
  2. have a quick heartbeat
  3. are receiving this medication as an intramuscular injection and are taking a blood thinner medication (e.g., warfarin, heparin)
  4. have angina
  5. have heart failure


What form(s) does this medication come in?

Tablets
Each circular, white, sugar-coated tablet contains hyoscine butylbromide 10mg.

Nonmedicinal ingredients: acacia, carnauba wax, castor oil, lactose, magnesium stearate, maize starch, polyethylene glycol, shellac, sucrose, talc, tartaric acid, titanium dioxide, and white wax.

Injection
EachmL contains hyoscine butylbromide 20mg. Nonmedicinal ingredients: sodium chloride and water for injection.


What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses.

Side effects can be mild or severe, temporary or permanent.

The side effects listed under are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects own been reported by at least 1% of people using this medication. Numerous of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be capable to advise you on managing side effects.

  1. diarrhea
  2. dizziness
  3. blurred vision that is temporary
  4. decreased ability to sweat
  5. constipation
  6. flushing
  7. fast heartbeat
  8. dry mouth
  9. nausea

Although most of the side effects listed under don’t happen extremely often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  1. shortness of breath
  2. skin rash and itching
  3. difficulty urinating
  4. vision changes

Stop using the medication and seek immediate medical attention if any of the following occur:

  1. painful red eye with loss of vision
  2. symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, mouth, tongue, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are using this medication.


How should I use this medication?

The usual dose of hyoscine tablets is 1 or 2 10mg tablets per day. If you need to take this medication regularly, the usual dose is 1 tablet 3 to 5 times a day.

The maximum dose is 6 tablets per day.

For the injection, the usual dose is 10mg to 20mg given by intramuscular (into a muscle), intravenous (into a vein), or subcutaneous (under the skin) injection.

What allergy medicine is safe with warfarin

The maximum daily dose is mg.

Numerous things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose diverse from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Swallow the tablets whole with a glass of water. Do not crush or chew the tablets.

It is significant to use this medication exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not certain what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and hold it out of the reach of children.

Do not dispose of medications in wastewater (e.g. below the sink or in the toilet) or in household trash. Enquire your pharmacist how to dispose of medications that are no longer needed or own expired.



Why do I own blood tests?

The purpose of treatment with warfarin is to thin your blood but not stop it clotting completely.

Getting this balance correct means your dose of warfarin must be carefully monitored.

You’ll own a regular blood test called the international normalised ratio (INR). It measures how endless it takes your blood to clot. The longer your blood takes to clot, the higher the INR.

Most people taking anticoagulants own a ratio of between 2 and This means their blood takes 2 to times longer to clot than usual.

The dose of warfarin you need depends on your blood test result. If the blood test result has gone up or below, your warfarin dose will be increased or decreased.

You’ll own the blood tests at your GP surgery or local hospital’s anticoagulant clinic.

If your blood test results are stable, you might only need a blood test once every 8 to 12 weeks.

If it’s unstable or you own just started on warfarin, you might need to own a blood test every week.

How much will I take?

The usual warfarin dose is 10mg a day for the first 2 days, then between 3mg and 9mg a day after that.

Warfarin tablets come in 4 diverse strengths. The tablets and the boxes they come in are diverse colours to make it easier for you to take the correct dose.

The strengths and colours are:

  1. 1mg — brown tablet
  2. 3mg — blue tablet
  3. mg — white tablet
  4. 5mg — pink tablet

Your dose may be made up of a combination of diverse coloured tablets.

Warfarin also comes as a liquid, where 1ml is equal to a 1mg (brown) tablet.

Warfarin liquid comes with a plastic syringe to assist you measure the correct quantity.

The yellow book and alert card

When you start taking warfarin, you may be given a yellow book about anticoagulants.

This explains your treatment. There’s also a section for you to record below and hold a record of your warfarin dose.

It’s a excellent thought to take your yellow book with you to every your warfarin appointments.

You’ll also be given an anticoagulant alert card. Carry this with you every the time.

It tells healthcare professionals that you’re taking an anticoagulant. This can be useful for them to know in case of a medical emergency.

If you need any medical or dental treatment, show your anticoagulant alert card to the nurse, doctor or dentist beforehand.

This includes before you own vaccinations and routine sessions with the dental hygienist.

Your doctor may advise you to stop taking warfarin or reduce your dose for a short time before your treatment.

If you own lost your alert card or were not given one, enquire your doctor or anticoagulant clinic.

How to take it

It’s extremely significant to take warfarin as your doctor advises. Take it once a day at about the same time.

It’s usual to take warfarin in the evening. This is so that if you need to change the dose after a routine blood test, you can do this the same day rather than waiting until the following morning.

Warfarin does not generally upset your stomach, so you can take it whether you own eaten recently or not.

Will my dose go up and down?

Your warfarin dose may change often, especially in the first few weeks of treatment, until your doctor finds the dose that’s correct for you.

What if I take too much?

If you take an additional dose of warfarin by accident, call your anticoagulant clinic straight away.

You may need to change your next dose of warfarin or own a blood test.

If you take more than 1 additional dose of warfarin, you’re at risk of serious bleeding.

What if I forget to take it?

It’s significant to attempt to remember to take your warfarin on time.

It’s not a problem if you occasionally forget to take a dose at the correct time.

But if you forget often, your blood could be affected — it might become thicker and put you at risk of having a blood clot.

If you miss a dose of warfarin, record it below in your yellow book.

Take the missed dose as soon as you remember.

If you do not remember until the next day, skip the missed dose and take your normal dose at the usual time.

Never take more than 1 dose a day.

If you often forget doses, it may assist to set an alarm to remind you.

You could also enquire your pharmacist for advice on other ways to assist you remember to take your medicine.

If you’re worried, contact your anticoagulant clinic or doctor.

How endless to take it for

If you own had a blood clot in your leg or lungs, you’ll probably take a short course of warfarin for 6 weeks to 6 months.

If you take warfarin to reduce your risk of having a blood clot in future or because you hold getting blood clots, it’s likely your treatment will be for longer than 6 months, maybe even for the relax of your life.

Urgent advice: Call your doctor or anticoagulant clinic, or go to A&E, if you take more than 1 additional dose

If you need to go to hospital, take the warfarin packet or leaflet inside it, plus any remaining medicine, with you.

If you own a yellow book, take that too.

Find your nearest A&E

Patients own poor knowledge of warfarin which may increase their risk of serious side effects, according to research presented today at EuroHeartCare by Dr Kjersti Oterhals, a nurse researcher at Haukeland University Hospital in Bergen, Norway.

«The stroke and bleeding complications from warfarin can be fatal,» said Dr Oterhals. «Worldwide warfarin causes the most deaths from drug-related side effects.

Patients need to know what foods and drugs own an impact on how warfarin works, and what to do if they own symptoms of an overdose or underdose.»

Warfarin is given to patients at increased risk of blood clots from conditions such as atrial fibrillation or a mechanical heart valve.

What allergy medicine is safe with warfarin

Blood clots can travel through the blood to the brain and cause a stroke. Warfarin ‘thins the blood’ by slowing below the anticoagulation effect of vitamin K, thereby increasing the time it takes blood to clot and reducing the risk of stroke. Taking too much warfain raises the risk of bleeding.

Patients on warfarin take an individually tailored dose that depends on their genes, usual diet, drugs and physical activity.

What allergy medicine is safe with warfarin

Initially patients own a daily blood test to check their international normalised ratio (INR) which indicates how endless it takes the blood to clot. People not taking warfarin own an INR of around 1 but patients with a mechanical heart valve should own an INR in the range of to to prevent their body creating a blood clot which could travel to the brain and cause a stroke.

«The goal is to thin the blood enough to prevent a stroke but not too much and cause bleeding,» said Dr Oterhals.

«An INR of 3 means it takes 3 times longer to stop a bleeding than it would take someone not on warfarin. If a patient’s INR is under the target range they are at increased risk of thrombosis and above it they are at risk of bleeding complications. Lack of knowledge on what food and drugs interact with warfarin can lead to INR levels exterior the therapeutic range which can be dangerous.»

The study included patients with aortic stenosis who were taking warfarin.

Almost two-thirds (63%) took warfarin because they had a mechanical heart valve to treat aortic stenosis and 24% took the drug because they had atrial fibrillation. Patients were 68 years ancient on average and 70% were men.

Patients received a postal questionnaire with 28 multiple choice questions about warfarin. They answered 18 questions correctly on average but 22% gave correct answers on less than half of the questions. Questions with the least correct answers concerned food and drug interactions and when to call a doctor.

When asked which of the following foods would interfere with warfarin: celery, carrot, coleslaw or green beans, just 25% correctly said coleslaw and most patients answered green beans.

«Patients often ponder green vegetables own the most vitamin K but that’s not true,» said Dr Oterhals.

«Brassica vegetables such as cabbage, broccoli and cauliflower are wealthy sources. Patients do not own to avoid these foods but they should eat an equal quantity every week because the vitamin K will decrease their INR and put them at increased risk of thrombosis or embolism. Patients who love to eat a lot of vitamin K containing foods can take a higher warfarin dosage but they need to be consistent.»

While 80% knew they should go directly to the emergency room if they had nose bleeding that would not stop, only 45% correctly said diarrhoea for more than one day should trigger a visit to the doctor.

Some 86% knew that the INR test tells the pharmacist how thick or thin the blood is while taking warfarin.

The study found that increased age was associated with decreasing correct answers. Dr Oterhals said: «We can only speculate why. Younger people tend to seek out information about how to manage their disease while the older generation wants the doctor to tell them what to do.»

She continued: «Motivated patients should be offered an INR testing kit so that they can monitor their levels and adjust the warfarin dose themselves, just as patients with diabetes who use insulin do. It enables patients to travel and attempt new foods without having to discover a clinic to get tested.

Patients tell me that boiling weather increases their INR while another found out while in Asia that nori decreased his INR.»

Warfarin checklist

  1. Drugs: antibiotics increase INR; avoid herbal medicines; enquire about over the counter drugs
  2. Exercise: patients who exercise regularly need a higher warfarin dose
  3. Diet: hold vitamin K intake consistent and check content of new foods; even little levels eaten in large amounts affect the INR
  4. Call the doctor: nosebleeds indicate blood is too thin; diarrhoea causes vitamin K loss
  5. Be consistent: check how anything out of the ordinary will affect your warfarin.
  6. K.

    Oterhals, C. Deaton, S. De Geest, T. Jaarsma, M.

    What allergy medicine is safe with warfarin

    Lenzen, P. Moons, J. Martensson, K. Smith, S. Stewart, A. Stromberg, D.

    What allergy medicine is safe with warfarin

    R. Thompson, T. M. Norekval. European cardiac nurses’ current practice and knowledge on anticoagulation therapy. European Journal of Cardiovascular Nursing, ; 13 (3): DOI: /

Dr Oterhals concluded: «Warfarin is a life saving drug but can be deadly if not used carefully. Health professionals own a responsibility to educate patients but unfortunately even cardiac nurses do not know enough.2 There is an urgent need to improve health professionals’ warfarin knowledge so they can educate patients.»


Story Source:

Materials provided by European Society of Cardiology.

Note: Content may be edited for style and length.


Journal Reference:

  • K. Oterhals, C. Deaton, S. De Geest, T. Jaarsma, M. Lenzen, P. Moons, J. Martensson, K. Smith, S. Stewart, A. Stromberg, D. R. Thompson, T.

    What allergy medicine is safe with warfarin

    M. Norekval. European cardiac nurses’ current practice and knowledge on anticoagulation therapy. European Journal of Cardiovascular Nursing, ; 13 (3): DOI: /


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European Society of Cardiology. «Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor.» ScienceDaily. ScienceDaily, 15 April <>.

European Society of Cardiology. (, April 15). Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor.

ScienceDaily. Retrieved January 29, from

European Society of Cardiology. «Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor.» ScienceDaily. (accessed January 29, ).

How does this medication work? What will it do for me?

Hyoscine belongs to the group of medications called antispasmodics. Hyoscine is used to relieve smooth muscle spasms (cramps) in the stomach and intestines and in the bladder and urethra. Hyoscine reduces spasms by relaxing smooth muscles within the stomach, intestines, bladder and urethra.

The injection form is used to relieve these same types of muscles spasms that might happen during diagnostic procedures.

This medication may be available under multiple brand names and/or in several diverse forms. Any specific brand name of this medication may not be available in every of the forms or approved for every of the conditions discussed here. As well, some forms of this medication may not be used for every of the conditions discussed here.

Your doctor may own suggested this medication for conditions other than those listed in these drug information articles. If you own not discussed this with your doctor or are not certain why you are using this medication, speak to your doctor.

Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they own the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.


make a difference: sponsored opportunity

Cite This Page:

European Society of Cardiology. «Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor.» ScienceDaily. ScienceDaily, 15 April <>.

European Society of Cardiology.

(, April 15). Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor. ScienceDaily. Retrieved January 29, from

European Society of Cardiology. «Poor patient warfarin knowledge may increase risk of deadly side effects: Awareness was lowest on diet and drug interactions and when to call a doctor.» ScienceDaily. (accessed January 29, ).

How does this medication work? What will it do for me?

Hyoscine belongs to the group of medications called antispasmodics. Hyoscine is used to relieve smooth muscle spasms (cramps) in the stomach and intestines and in the bladder and urethra. Hyoscine reduces spasms by relaxing smooth muscles within the stomach, intestines, bladder and urethra.

The injection form is used to relieve these same types of muscles spasms that might happen during diagnostic procedures.

This medication may be available under multiple brand names and/or in several diverse forms. Any specific brand name of this medication may not be available in every of the forms or approved for every of the conditions discussed here. As well, some forms of this medication may not be used for every of the conditions discussed here.

Your doctor may own suggested this medication for conditions other than those listed in these drug information articles. If you own not discussed this with your doctor or are not certain why you are using this medication, speak to your doctor.

Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they own the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.


Are there any other precautions or warnings for this medication?

Before you start using a medication, be certain to inform your doctor of any medical conditions or allergies you may own, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health.

These factors may affect how you should use this medication.

Difficulty urinating: This medication may make it more hard for you to urinate. If you own an enlarged prostate, urinary retention, or difficulty urinating, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Fructose intolerance: Fructose intolerance is a rare condition in which fructose (a type of sugar) is not broken below by the body.

One sugar-coated tablet of 10mg contains mg sucrose, which can result in mg sucrose per day if the maximum recommended daily dose of hyoscine is needed. You should not use this medication if you own fructose intolerance.

Glaucoma: This medication may cause the symptoms of glaucoma (increased pressure in the eye) to develop or become worse. If you own glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Report any changes in vision to your doctor as soon as possible while you are taking this medication.

Heart problems: This medication can increase your heart rate. If you own tachycardia (a quick heart rate), heart disease, an abnormal heart rhythm, heart failure, or mitral stenosis (a heart valve problem), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stomach and intestinal problems: If you own reflux esophagitis, a medical condition that narrow or blocks the intestines (e.g., achalasia, pyloroduodenal stenosis), or ulcerative colitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vision problems: This medication may affect your vision.

Do not drive or operate machinery until any vision problems own resolved. If you get this medication during a diagnostic procedure, you should arrange for someone to drive you home from the hospital or clinic after your procedure.

Get immediate medical attention if you experience a painful red eye with loss of vision.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if hyoscine passes into breast milk.

If you are a breast-feeding mom and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication own not been established for children.

Seniors: Seniors are more sensitive to the side effects of this medication, especially constipation, dry mouth, and difficulty urinating.

What allergy medicine is safe with warfarin

If you experience any of these side effects and they continue or are severe, contact your doctor.


What other drugs could interact with this medication?

There may be an interaction between hyoscine and any of the following:

  1. benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  2. chloral hydrate
  3. aclidinium
  4. baclofen
  5. azelastine
  6. glucagon
  7. dronabinol
  8. donepezil
  9. disopyramide
  10. droperidol
  11. amantadine
  12. atropine
  13. ketotifen
  14. glycopyrrolate
  15. barbiturates (e.g., butalbital, pentobarbital phenobarbital)
  16. brimonidine
  17. efavirenz
  18. galantamine
  19. antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  20. aripiprazole
  21. benztropine
  22. buprenorphine
  23. darifenacin
  24. magnesium sulfate
  25. antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  26. belladonna
  27. alcohol
  28. flavoxate
  29. buspirone
  30. general anesthetics (medications used to put people to sleep before surgery)
  31. ipratropium
  32. MAO inhibitors (e.g., phenelzine, tranylcypromine)
  1. pramipexole
  2. secretin
  3. metoclopramide
  4. oxybutynin
  5. olopatadine
  6. tramadol
  7. solifenacin
  8. selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  9. tapentadol
  10. thalidomide
  11. mirabegron
  12. nabilone
  13. umeclidinium
  14. tranylcypromine
  15. perampanel
  16. rivastigmine
  17. seizure medications (e.g., clobazam, ethosuximide, felbamate, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
  18. tiotropium
  19. mirtazapine
  20. narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  21. quinidine
  22. potassium chloride
  23. thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide, metolazone)
  24. zolpidem
  25. muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
  26. metyrosine
  27. ropinirole
  28. scopolamine
  29. tolterodine
  30. tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline)
  31. zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may desire you to:

  1. change one of the medications to another,
  2. change how you are taking one or both of the medications, or
  3. stop taking one of the medications,
  4. leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about every prescription, over-the-counter (non-prescription), and herbal medications you are taking.

Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or highway drugs can affect the action of numerous medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. – Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may own regarding a medical condition. Source:

Babies can get their first tooth anytime between three and fifteen months, but commonly between four and nine months — although discomfort may start earlier.

Dribbling at three months is generally a result of your baby learning to put things in his/her mouth, which is part of normal development.

Pain management and what can you do to help31,32?

  1. Give your baby a teething ring – either a soft rubber one, or the plastic type that can be kept in the refrigerator
  2. If you ponder your baby is in pain, consider giving acetaminophen, such as Children’s Panadol®, as directed for the child’s age
  3. Rub your baby’s sore gums gently with your finger
  4. Avoid hard sharp-edged toys that could damage teeth and gums.

Don’ts

  1. Don’t dip dummies or teething rings in honey or sweet foods, as it may lead to dental decay (honey shouldn’t be given to babies under 12 months).
  2. Don’t suck your baby’s dummy and give it back to them, as you will transfer bacteria from your mouth to theirs.

Signs of teething

  1. Chewing on everything
  2. Irritability
  3. Rosy, flushed cheeks
  4. Tugging at ears
  5. Tender swollen gums
  6. Loose, frequent stools
  7. Disturbed sleep
  8. Poor appetite
  9. Increased dribbling
  10. Sore red bottom or rash.

Note: Generally, teething does not cause a fever.

If your baby has a high temperature, consult your doctor.31,32

The importance of first teeth30

What numerous parents don’t realise is that emerging baby teeth need to be looked after as carefully as we glance after our own teeth.

As well as their obvious importance for chewing and speaking, they assist proper jaw development, and reserve the spaces for the permanent teeth to come through later.

If you are currently being treated with any of the following medications, you should not use turmeric or curcumin in medicinal forms without first talking to your health care provider.

Blood-thinning medications: Tumeric may make the effects of these drugs stronger, raising the risk of bleeding.

Blood-thinners include warfarin (Coumadin), clopidogrel (Plavix), and aspirin, among others.

Drugs that reduce stomach acid: Turmeric may interfere with the action of these drugs, increasing the production of stomach acid:

  1. Famotidine (Pepcid)
  2. Esomeprazole (Nexium)
  3. Cimetidine (Tagamet)
  4. Ranitidine (Zantac)
  5. Omeprazole
  6. Lansoprazole (Prevacid)

Drugs for diabetes (that lower blood sugar): Turmeric may make the effects of these drugs stronger, increasing the risk of hypoglycemia (low blood sugar).

Review Date: 1/5/
Reviewed By: Steven D.

Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and every medical conditions. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. © A.D.A.M., a trade unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.


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