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Lexapro (escitalopram) Disease Interactions

There are 9 disease interactions with Lexapro (escitalopram):

Major

Ssri Antidepressants (Includes Lexapro) ↔ Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Depression, Psychosis

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate

Citalopram (Includes Lexapro) ↔ Renal Dysfunction

Moderate Potential Hazard, Low plausibility

Applies to: Renal Dysfunction

Citalopram (racemic) and escitalopram (the more pharmacologically active S-enantiomer) are extensively metabolized and only small amounts are excreted unchanged in the urine. No dosage adjustments are necessary in patients with mild to moderate renal impairment, as the oral clearance of citalopram has been shown to decrease only modestly (17%) in these patients compared to those with normal renal function. There is no information on the pharmacokinetics of citalopram or escitalopram in patients with severe renal impairment (CrCl < 20 mL/min). Therapy with these agents should be administered cautiously in such patients.

References

  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
Moderate

Ssri (Includes Lexapro) ↔ Hyponatremia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyponatremia

Treatment with SSRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

Moderate

Ssris (Includes Lexapro) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Selective serotonin reuptake inhibitors (SSRIs) are primarily metabolized by the liver. The plasma concentrations of SSRIs and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Dosage adjustments may be necessary in accordance with the individual product package labeling.

References

  1. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  2. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  3. Finley PR "Selective serotonin reuptake inhibitors: pharmacologic profiles and potential therapeutic distinctions." Ann Pharmacother 28 (1994): 1359-69
  4. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  5. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  6. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  7. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  8. Lund J, Thayssen P, Mengel H, Pedersen OL, Kristensen CB, Gram LF "Paroxetine: pharmacokinetics and cardiovascular effects after oral and intravenous single doses in man." Acta Pharmacol Toxicol (Copenh) 51 (1982): 351-7
  9. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  10. Krastev Z, Terziivanov D, Vlahov V, Maleev A, Greb WH, Eckl KM, Dierdorf HD, Wolf D "The pharmacokinetics of paroxetine in patients with liver cirrhosis." Acta Psychiatr Scand Suppl 350 (1989): 91-2
  11. Murdoch D, McTavish D "Sertraline. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depression and obsessive- compulsive disorder." Drugs 44 (1992): 604-24
  12. van Harten J "Clinical pharmacokinetics of selective serotonin reuptake inhibitors." Clin Pharmacokinet 24 (1993): 203-20
  13. Benfield P, Ward A "Fluvoxamine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness." Drugs 32 (1986): 313-34
  14. Kaye CM, Haddock RE, Langley PF, Mellows G, Tasker TC, Zussman BD, Greb WH "A review of the metabolism and pharmacokinetics of paroxetine in man." Acta Psychiatr Scand Suppl 350 (1989): 60-75
  15. Schenker S, Bergstrom RF, Wolen RL, Lemberger L "Fluoxetine disposition and elimination in cirrhosis." Clin Pharmacol Ther 44 (1988): 353-9
  16. Wilde MI, Plosker GL, Benfield P "Fluvoxamine. An updated review of its pharmacology, and therapeutic use in depressive illness." Drugs 46 (1993): 895-924
  17. Doogan DP, Caillard V "Sertraline: a new antidepressant." J Clin Psychiatry 49 (1988): 46-51
View all 17 references
Moderate

Ssris (Includes Lexapro) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Mania, Depression

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.

References

  1. Piredda SG, Rubinstein SL "Hypomania induced by fluoxetine?" Biol Psychiatry 32 (1992): 107
  2. Peet M "Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants." Br J Psychiatry 164 (1994): 549-50
  3. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  4. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  5. Lensgraf SJ, Favazza AR "Antidepressant-induced mania." Am J Psychiatry 147 (1990): 1569
  6. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
  7. Burrai C, Bocchetta A, del Zompo M "Mania and fluvoxamine." Am J Psychiatry 148 (1991): 1263-4
  8. Vieta E, Bernardo M "Antidepressant-induced mania in obsessive-compulsive disorder." Am J Psychiatry 149 (1992): 1282-3
  9. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  10. Achamallah NS, Decker DH "Mania induced by fluoxetine in an adolescent patient." Am J Psychiatry 148 (1991): 1404
  11. Beal DM, Harris D, Bartos M, Korsak C, Splane G, Quant R, Starke J "Safety and efficacy of fluoxetine." Am J Psychiatry 148 (1991): 1751
  12. Howland RH "Induction of mania with serotonin reuptake inhibitors." J Clin Psychopharmacol 16 (1996): 425-7
  13. Murdoch D, McTavish D "Sertraline. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depression and obsessive- compulsive disorder." Drugs 44 (1992): 604-24
  14. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  15. Laporta M, Chouinard G, Goldbloom D, Beauclair L "Hypomania induced by sertraline, a new serotonin reuptake inhibitor." Am J Psychiatry 144 (1987): 1513-4
  16. Boyer WF, Blumhardt CL "The safety profile of paroxetine." J Clin Psychiatry 53 Suppl (1992): 61-6
  17. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  18. Edwards JG, Inman WH, Wilton L, Pearce GL "Prescription-event monitoring of 10,401 patients treated with fluvoxamine." Br J Psychiatry 164 (1994): 387-95
  19. Mundo E, Ronchi P, Bellodi L "Drug-induced mania." Hosp Community Psychiatry 44 (1993): 689-90
  20. Marshall RD, Printz D, Cardenas D, Abbate L, Liebowitz MR "Adverse events in PTSD patients taking fluoxetine." Am J Psychiatry 152 (1995): 1238-9
  21. Berthier ML, Kulisevsky J "Fluoxetine - induced mania in a patient with poststroke depression." Br J Psychiatry 163 (1993): 698-9
  22. Dorevitch A, Frankel Y, Bar-Halperin A, Aronzon R, Zilberman L "Fluvoxamine-associated manic behavior: a case series." Ann Pharmacother 27 (1993): 1455-7
  23. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  24. Jefferson JW, Greist JH, Perse TL, Rosenfeld R "Fluvoxamine-associated mania/hypomania in patients with obsessive- compulsive disorder." J Clin Psychopharmacol 11 (1991): 391-2
  25. Diaferia G, Mundo E, Bianchi Y, Ronchi P "Behavioral side effects in obsessive-compulsive patients treated with fluvoxamine: a clinical description." J Clin Psychopharmacol 14 (1994): 78-9
  26. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  27. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
View all 27 references
Moderate

Ssris (Includes Lexapro) ↔ Platelet Function

Moderate Potential Hazard, High plausibility

Applies to: Bleeding, Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

References

  1. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  2. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
  3. Hergovich N, Aigner M, Eichler HG, Entlicher J, Drucker C, Jilma B "Paroxetine decreases platelet serotonin storage and platelet function in human beings." Clin Pharmacol Ther 68 (2000): 435-42
  4. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  5. Alderman CP, Moritz CK, Ben-Tovim DI "Abnormal platelet aggregation associated with fluoxetine therapy." Ann Pharmacother 26 (1992): 1517-9
  6. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  7. Settle EC "Antidepressant drugs: disturbing and potentially dangerous adverse effects." J Clin Psychiatry 59 Suppl 16 (1998): 25-30
  8. Skop BP, Brown TM "Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors." Psychosomatics 37 (1996): 12-6
  9. Leung M, Shore R "Fluvoxamine-associated bleeding." Can J Psychiatry 41 (1996): 604-5
  10. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  11. Pai VB, Kelly MW "Bruising associated with the use of fluoxetine." Ann Pharmacother 30 (1996): 786-8
  12. Ottervanger JP, Stricker BH, Huls J, Weeda JN "Bleeding attributed to the intake of paroxetine." Am J Psychiatry 151 (1994): 781-2
  13. Krivy J, Wiener J "Sertraline and platelet counts in idiopathic thrombocytopenia purpura." Lancet 345 (1995): 132
  14. Aranth J, Lindberg C "Bleeding, a side effect of fluoxetine." Am J Psychiatry 149 (1992): 412
  15. Yaryura-Tobias JA, Kirschen H, Ninan P, Mosberg HJ "Fluoxetine and bleeding in obsessive-compulsive disorder." Am J Psychiatry 148 (1991): 949
  16. Alderman CP, Seshadri P, Ben-Tovim DI "Effects of serotonin reuptake inhibitors on hemostasis." Ann Pharmacother 30 (1996): 1232-4
  17. Humphries JE, Wheby MS, VandenBerg SR "Fluoxetine and the bleeding time." Arch Pathol Lab Med 114 (1990): 727-8
  18. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
View all 18 references
Moderate

Ssris (Includes Lexapro) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients, and some of them are not recommended in patients with unstable epilepsy. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.

References

  1. Marshall RD, Printz D, Cardenas D, Abbate L, Liebowitz MR "Adverse events in PTSD patients taking fluoxetine." Am J Psychiatry 152 (1995): 1238-9
  2. Hargrave R, Martinez D, Bernstein AJ "Fluoxetine-induced seizures." Psychosomatics 33 (1992): 236-9
  3. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  4. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
  5. Nemeroff CB "The clinical pharmacology and use of paroxetine, a new selective serotonin reuptake inhibitor." Pharmacotherapy 14 (1994): 127-38
  6. Edwards JG, Inman WH, Wilton L, Pearce GL "Prescription-event monitoring of 10,401 patients treated with fluvoxamine." Br J Psychiatry 164 (1994): 387-95
  7. Kim KY, Craig JM, Hawley JM "Seizure possibly associated with fluvoxamine." Ann Pharmacother 34 (2000): 1276-8
  8. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  9. Boyer WF, Blumhardt CL "The safety profile of paroxetine." J Clin Psychiatry 53 Suppl (1992): 61-6
  10. Levine R, Kenin M, Hoffman JS, Dayknepple E "Grand mal seizures associated with the use of fluoxetine." J Clin Psychopharmacol 14 (1994): 145-6
  11. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  12. Madi L, Obrien AAJ, Fennell J "Status epilepticus secondary to fluoxetine." Postgrad Med J 70 (1994): 383-4
  13. Murdoch D, McTavish D "Sertraline. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depression and obsessive- compulsive disorder." Drugs 44 (1992): 604-24
  14. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  15. Doogan DP, Caillard V "Sertraline: a new antidepressant." J Clin Psychiatry 49 (1988): 46-51
  16. Spivey KM, Wait CM "Perioperative seizures and fluvoxamine." Br J Anaesth 71 (1993): 321
  17. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  18. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  19. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  20. Deahl M, Trimble M "Serotonin reuptake inhibitors, epilepsy and myoclonus." Br J Psychiatry 159 (1991): 433-5
  21. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
View all 21 references
Moderate

Ssris (Includes Lexapro) ↔ Siadh

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Hyponatremia, SIADH

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.

References

  1. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  2. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
  3. Robinson D, Brooks J, Mahler E, Sheikh JI "SIADH--compulsive drinking or SSRI influence?" Ann Pharmacother 30 (1996): 885
  4. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  5. Chua TP, Vong SK "Hyponatraemia associated with paroxetine." BMJ 306 (1993): 143
  6. Settle EC "Antidepressant drugs: disturbing and potentially dangerous adverse effects." J Clin Psychiatry 59 Suppl 16 (1998): 25-30
  7. Woo MH, Smythe MA "Association of SIADH with selective serotonin reuptake inhibitors." Ann Pharmacother 31 (1997): 108-10
  8. Cohen BJ, Mahelsky M, Adler L "More cases of SIADH with fluoxetine." Am J Psychiatry 147 (1990): 948-9
  9. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  10. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  11. Staab JP, Yerkes SA, Cheney EM, Clayton AH "Transient SIADH associated with fluoxetine." Am J Psychiatry 147 (1990): 1569-70
  12. Doshi D, Borison R "Association of transient SIADH with sertraline." Am J Psychiatry 151 (1994): 779-80
  13. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  14. Ayonrinde OT, Reutens SG, Sanfilippo FM "Paroxetine-induced SIADH." Med J Aust 163 (1995): 390
  15. Bouman WP, Johnson H, TrescoliSerrano C, Jones RG "Recurrent hyponatremia associated with sertraline and lofepramine." Am J Psychiatry 154 (1997): 580
  16. Blacksten JV, Birt JA "Syndrome of inappropriate secretion of antidiuretic hormone secondary to fluoxetine." Ann Pharmacother 27 (1993): 723-4
  17. Llorente MD, Gorelick M, Silverman MA "Sertraline as the cause of inappropriate antidiuretic hormone secretion." J Clin Psychiatry 55 (1994): 543-4
  18. Ayonrinde OT, Sanfilippo FM "SSRI antidepressants and SIADH." Aust N Z J Psychiatry 31 (1997): 306-7
  19. Thornton SL, Resch DS "SIADH associated with sertraline therapy." Am J Psychiatry 152 (1995): 809
  20. Kazal LA, Jr Hall DL, Miller LG, Noel ML "Fluoxetine-induced SIADH: a geriatric occurrence?" J Fam Pract 36 (1993): 341-3
  21. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  22. Girault C, Richard JC, Chevron V, Goulle JP, Droy JM, Bonmarchand G, Leroy J "Syndrome of inappropriate secretion of antidiuretic hormone in two elderly women with elevated serum fluoxetine." J Toxicol Clin Toxicol 35 (1997): 93-5
  23. Bradley ME, Foote EF, Lee EN, Merkle L "Sertraline-associated syndrome of inappropriate antidiuretic hormone: case report and review of the literature." Pharmacotherapy 16 (1996): 680-3
  24. "Selective serotonin reuptake inhibitors and SIADH." Med J Aust 164 (1996): 562
  25. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  26. Crews JR, Potts NL, Schreiber J, Lipper S "Hyponatremia in a patient treated with sertraline." Am J Psychiatry 150 (1993): 1564
  27. Jackson C, Carson W, Markowitz J, Mintzer J "SIADH associated with fluoxetine and sertraline therapy." Am J Psychiatry 152 (1995): 809-10
  28. Vishwanath BM, Navalgund AA, Cusano W, Navalgund KA "Fluoxetine as a cause of SIADH." Am J Psychiatry 148 (1991): 542-3
  29. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  30. Goddard C, Paton C "Hyponatraemia associated with paroxetine." BMJ 305 (1992): 1332
View all 30 references
Moderate

Ssris (Includes Lexapro) ↔ Weight Loss

Minor Potential Hazard, Moderate plausibility

Applies to: Anorexia/Feeding Problems, Malnourished, Weight Loss/Failure to Thrive

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.

References

  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
  3. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  4. Meyerowitz W, Jaramillo JDC "Sertraline treatment and weight loss." Curr Ther Res Clin Exp 55 (1994): 1176-81
  5. Oliveros SC, Iruela LM, Caballero L, Baca E "Fluoxetine-induced anorexia in a bulimic patient." Am J Psychiatry 149 (1992): 1113-4
  6. Fichtner CG, Braum BG "Hyperphagia and weight loss during fluoxetine treatment." Ann Pharmacother 28 (1994): 1350-2
  7. Fernstrom MH, Massoudi M, Kupfer DJ "Fluvoxamine and weight loss." Biol Psychiatry 24 (1988): 948-9
  8. Vaz FJ, Salcedo MS "Fluoxetine-induced anorexia in a bulimic patient with antecedents of anorexia nervosa." J Clin Psychiatry 55 (1994): 118-9
  9. "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  10. "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  11. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
View all 11 references

Lexapro (escitalopram) drug Interactions

There are 1100 drug interactions with Lexapro (escitalopram)

Lexapro (escitalopram) alcohol/food Interactions

There is 1 alcohol/food interaction with Lexapro (escitalopram)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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