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Generic Name: Meloxicam
Class: Other Nonsteroidal Anti-inflammatory Agents
Chemical Name: 1,1-Dioxide-4-Hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide
CAS Number: 71125-38-7

Medically reviewed by Last updated on Nov 11, 2019.


    Cardiovascular Risk
  • Increased risk of serious (sometimes fatal) cardiovascular thrombotic events (e.g., MI, stroke).1 500 502 508 Risk may occur early in treatment and may increase with duration of use.500 502 505 506 508 (See Cardiovascular Thrombotic Effects under Cautions.)

  • Contraindicated in the setting of CABG surgery.508

    GI Risk
  • Increased risk of serious (sometimes fatal) GI events (e.g., bleeding, ulceration, perforation of the stomach or intestine).1 Serious GI events can occur at any time and may not be preceded by warning signs and symptoms.1 Geriatric individuals are at greater risk for serious GI events.1 (See GI Effects under Cautions.)


NSAIA referred to as a “preferential” rather than “selective” cyclooxygenase-2 (COX-2) inhibitor; oxicam derivative; structurally related to piroxicam.1 2 3 4 5 6 7 8 9 10

Uses for Mobic

Consider potential benefits and risks of meloxicam therapy as well as alternative therapies before initiating therapy with the drug.1 Use lowest effective dosage and shortest duration of therapy consistent with the patient’s treatment goals.1


Symptomatic treatment of osteoarthritis.1 Effect comparable to that of other NSAIAs (piroxicam, diclofenac).1 11 12 13 14 15

Rheumatoid Arthritis in Adults

Symptomatic treatment of rheumatoid arthritis in adults.1 18 19

Juvenile Arthritis

Symptomatic management of pauciarticular or polyarticular course juvenile rheumatoid arthritis in children ≥2 years of age.1 23 Effect comparable to that of naproxen.1 23

Cardiovascular Risk Reduction

Not a substitute for aspirin in the prevention of adverse cardiovascular events (MI).1

Mobic Dosage and Administration


  • Consider potential benefits and risks of meloxicam therapy as well as alternative therapies before initiating therapy with the drug.1


Oral Administration

Administer orally once daily without regard to meals.1

Agitate the suspension well prior to administration of each dose.1

Formulation Considerations

Meloxicam oral suspension is the preferred dosage form for children weighing <60 kg because of suitability for providing the calculated dosage.1


To minimize the potential risk of adverse cardiovascular and/or GI events, use lowest effective dosage and shortest duration of therapy consistent with the patient’s treatment goals.1 Adjust dosage based on individual requirements and response; attempt to titrate to the lowest effective dosage.1

Pediatric Patients

Juvenile Arthritis

Children ≥2 years of age: 0.125 mg/kg (maximum 7.5 mg) once daily.1 Higher dosages not associated with additional benefit.1 23



7.5 mg once daily; may increase to 15 mg once daily.1

Rheumatoid Arthritis

7.5 mg once daily; may increase to 15 mg once daily.1

Prescribing Limits

Pediatric Patients


Maximum 7.5 mg daily.1



Maximum 15 mg daily.1

Special Populations

Hepatic Impairment

Dosage adjustment not necessary in patients with mild to moderate hepatic impairment; not studied in those with severe impairment.1

Renal Impairment

Dosage adjustment not necessary in patients with mild to moderate renal impairment (Clcr >15 mL/minute); not recommended in those with severe impairment.1

Cautions for Mobic


  • Known hypersensitivity to meloxicam or any ingredient in the formulation.1

  • History of asthma, urticaria, or other sensitivity reaction precipitated by aspirin or other NSAIAs.1

  • In the setting of CABG surgery.508



Cardiovascular Thrombotic Effects

NSAIAs (selective COX-2 inhibitors, prototypical NSAIAs) increase the risk of serious adverse cardiovascular thrombotic events (e.g., MI, stroke) in patients with or without cardiovascular disease or risk factors for cardiovascular disease.500 502 508

Findings of FDA review of observational studies, meta-analysis of randomized controlled trials, and other published information500 501 502 indicate that NSAIAs may increase the risk of such events by 10–50% or more, depending on the drugs and dosages studied.500

Relative increase in risk appears to be similar in patients with or without known underlying cardiovascular disease or risk factors for cardiovascular disease, but the absolute incidence of serious NSAIA-associated cardiovascular thrombotic events is higher in those with cardiovascular disease or risk factors for cardiovascular disease because of their elevated baseline risk.500 502 506 508

Increased risk may occur early (within the first weeks) following initiation of therapy and may increase with higher dosages and longer durations of use.500 502 505 506 508

In controlled studies, increased risk of MI and stroke observed in patients receiving a selective COX-2 inhibitor for analgesia in first 10–14 days following CABG surgery.508

In patients receiving NSAIAs following MI, increased risk of reinfarction and death observed beginning in the first week of treatment.505 508

Increased 1-year mortality rate observed in patients receiving NSAIAs following MI;500 508 511 absolute mortality rate declined somewhat after the first post-MI year, but the increased relative risk of death persisted over at least the next 4 years.508 511

Some systematic reviews of controlled observational studies and meta-analyses of randomized studies suggest naproxen may be associated with lower risk of cardiovascular thrombotic events compared with other NSAIAs.26 27 28 30 500 501 502 503 506 FDA states that limitations of these studies and indirect comparisons preclude definitive conclusions regarding relative risks of NSAIAs.500

Use NSAIAs with caution and careful monitoring (e.g., monitor for development of cardiovascular events throughout therapy, even in those without prior cardiovascular symptoms) and at the lowest effective dosage for the shortest duration necessary.1 500 508

Some clinicians suggest that it may be prudent to avoid NSAIA use, whenever possible, in patients with cardiovascular disease.505 511 512 516 Avoid use in patients with recent MI unless benefits of therapy are expected to outweigh risk of recurrent cardiovascular thrombotic events; if used, monitor for cardiac ischemia.508 Contraindicated in the setting of CABG surgery.508

No consistent evidence that concomitant use of low-dose aspirin mitigates the increased risk of serious adverse cardiovascular events associated with NSAIAs.1 502 508 (See Specific Drugs under Interactions.)

GI Effects

Serious GI toxicity (e.g., bleeding, ulceration, perforation) can occur with or without warning symptoms; increased risk in those with a history of GI bleeding or ulceration, geriatric patients, smokers, those with alcohol dependence, and those in poor general health.1

Lower incidence of adverse GI effects compared with other prototypical NSAIAs (e.g., diclofenac, naproxen, piroxicam) in some studies.16 17


Hypertension and worsening of preexisting hypertension reported; either event may contribute to the increased incidence of cardiovascular events.1 Use with caution in patients with hypertension; monitor BP.1

Impaired response to ACE inhibitors, angiotensin II receptor antagonists, β-blockers, and certain diuretics may occur.1 508 (See Specific Drugs under Interactions.)

Heart Failure and Edema

Fluid retention and edema reported.1 508

NSAIAs (selective COX-2 inhibitors, prototypical NSAIAs) may increase morbidity and mortality in patients with heart failure.500 501 504 507 508

NSAIAs may diminish cardiovascular effects of diuretics, ACE inhibitors, or angiotensin II receptor antagonists used to treat heart failure or edema.508 (See Specific Drugs under Interactions.)

Manufacturer recommends avoiding use in patients with severe heart failure unless benefits of therapy are expected to outweigh risk of worsening heart failure; if used, monitor for worsening heart failure.508

Some experts recommend avoiding use, whenever possible, in patients with reduced left ventricular ejection fraction and current or prior symptoms of heart failure.507

Renal Effects

Direct renal injury, including renal papillary necrosis, reported in patients receiving long-term NSAIA therapy.1

Potential for overt renal decompensation.1 Increased risk of renal toxicity in patients with renal or hepatic impairment or heart failure, in patients with volume depletion, in geriatric patients, and in those receiving a diuretic, ACE inhibitor, or angiotensin II receptor antagonist.1 20 29 (See Renal Impairment under Cautions.)

Correct dehydration before initiating meloxicam therapy.1

Sensitivity Reactions

Hypersensitivity Reactions

Anaphylactoid reactions reported.1

Immediate medical intervention and discontinuance for anaphylaxis.1

Avoid in patients with aspirin triad (aspirin sensitivity, asthma, nasal polyps); caution in patients with asthma.1

Dermatologic Reactions

Serious skin reactions (e.g., exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) reported; can occur without warning.1 Discontinue at first appearance of rash or any other sign of hypersensitivity (e.g., blisters, fever, pruritus).1

General Precautions

Hepatic Effects

Severe reactions including jaundice, fatal fulminant hepatitis, liver necrosis, and hepatic failure (sometimes fatal) reported rarely with NSAIAs.1

Elevations of serum ALT or AST reported.1

Monitor for symptoms and/or signs suggesting liver dysfunction; monitor abnormal liver function test results.1 Discontinue if signs or symptoms of liver disease or systemic manifestations (e.g., eosinophilia, rash) occur or if liver function test abnormalities persist or worsen.1

Hematologic Effects

Anemia reported rarely.1 Determine hemoglobin concentration or hematocrit in patients receiving long-term therapy if signs or symptoms of anemia occur.1

Notable effects on platelets or bleeding times not observed.3 8 9

Other Precautions

Not a substitute for corticosteroid therapy; not effective in the management of adrenal insufficiency.1

May mask certain signs of infection.1

Obtain CBC and chemistry profile periodically during long-term use.1

Specific Populations


Category C.1 Avoid use in third trimester because of possible premature closure of the ductus arteriosus.1


Distributed into milk in rats; not known whether distributed into milk in humans.1 Discontinue nursing or the drug.1

Pediatric Use

Safety and efficacy not established in children <2 years of age.1

Safety and efficacy in pediatric patients 2–17 years of age with juvenile rheumatoid arthritis supported by evidence from controlled studies.1 23

Abdominal pain, vomiting, diarrhea, headache, and pyrexia reported more frequently in children than adults.1

Geriatric Use

Caution advised.1 Fatal adverse GI effects reported more frequently in geriatric patients than younger adults.1

Hepatic Impairment

Not studied in patients with severe hepatic impairment (Child-Pugh class III).1

Renal Impairment

Use with caution in renal disease.1 Use not recommended in patients with advanced renal disease; close monitoring of renal function advised if used.1

Common Adverse Effects

Abdominal pain, diarrhea, dizziness, dyspepsia, edema, flatulence, headache, nausea, rash, upper respiratory tract infection, influenza-like illness, musculoskeletal and connective tissue signs and symptoms (back pain, muscle spasms, musculoskeletal pain).1

Interactions for Mobic

Metabolized by CYP isoenzymes, mainly by CYP2C9 and to a lesser extent by CYP3A4.1

Specific Drugs




ACE inhibitors

Reduced BP response to ACE inhibitor1

Possible deterioration of renal function in individuals with renal impairment29

Monitor BP1

Angiotensin II receptor antagonists

Reduced BP response to angiotensin II receptor antagonist29

Possible deterioration of renal function in individuals with renal impairment29

Monitor BP29


Pharmacokinetic interaction unlikely1

Administer meloxicam without regard to antacids1


Increased plasma meloxicam concentrations1

Increased risk of GI ulceration and other complications1

No consistent evidence that low-dose aspirin mitigates the increased risk of serious cardiovascular events associated with NSAIAs1 502 508

Clinical importance of pharmacokinetic interaction unknown1

Manufacturer states that concomitant use not recommended1


Increased meloxicam clearance1

Clinical importance not established1


Pharmacokinetics of meloxicam not altered1


No protein-binding interaction; pharmacokinetics of digoxin not altered1

Diuretics (furosemide, thiazides)

Reduced natriuretic effects possible1

Monitor for diuretic efficacy and renal failure1


Increased plasma lithium concentrations1

Monitor for lithium toxicity1


Possible toxicity associated with increased plasma methotrexate concentrations1

Caution advised1


Possibility of bleeding complications and increases in PT1

Monitor anticoagulant activity; caution advised1

Mobic Pharmacokinetics



Well absorbed following oral administration; bioavailability is about 89%.1 Peak plasma concentration usually attained within about 4–5 hours.1

Commercially available tablets and oral suspension are bioequivalent.1


No clinically important effect.1

Special Populations

In patients with mild or moderate hepatic impairment (Child-Pugh class I or II), no important differences in plasma concentrations compared with healthy individuals; not studied in patients with severe hepatic impairment (Child-Pugh class III).1

In patients with mild or moderate renal impairment, some pharmacokinetic values altered (total plasma concentrations decreased, free concentrations unchanged); not studied in patients with severe renal impairment.1

Systemic exposure in children 2–6 years of age lower than that in children 7–16 years of age.1 Systemic exposure in children 7–16 years of age similar to or slightly lower than that in adults.1



Total meloxicam concentrations in synovial fluid are 40–50% of plasma concentrations; free fraction in synovial fluid exceeds that in plasma.1

Plasma Protein Binding

99.4% (principally albumin).1



Extensively metabolized to inactive metabolites by CYP isoenzymes, mainly by CYP2C9 and to a lesser extent by CYP3A4.1

Elimination Route

Undergoes biliary secretion and enterohepatic recirculation.1 2 3 4 8 10 Excreted to an equal extent in urine and feces as metabolites.1


Adults: 15–20 hours.1

Children 2–6 years of age: 15.2 hours.1

Children 7–16 years of age: 13 hours.1




Suspension or Tablets

25°C (may be exposed to 15–30°C).1


  • Inhibits COX-2 to a greater extent than COX-1;2 3 5 6 8 10 selectivity is dose dependent and is diminished at higher dosages.5 6 7 8 9

  • Pharmacologic actions similar to those of other NSAIAs; exhibits anti-inflammatory, analgesic, and antipyretic activity.1 2 3 4 5 6 7 8 9 10

Advice to Patients

  • Importance of reading the medication guide for NSAIAs that is provided each time the drug is dispensed.1

  • Risk of serious cardiovascular events (e.g., MI, stroke).1 500 508

  • Risk of GI bleeding and ulceration.1

  • Risk of serious skin reactions.1 Risk of anaphylactoid and other sensitivity reactions.1

  • Risk of hepatotoxicity.1

  • Importance of seeking immediate medical attention if signs and symptoms of a cardiovascular event (chest pain, dyspnea, weakness, slurred speech) occur.1 500 508

  • Not a substitute for aspirin in the prevention of adverse cardiovascular events.1

  • Importance of notifying clinician if signs and symptoms of GI ulceration or bleeding, unexplained weight gain, or edema develops.1

  • Importance of discontinuing meloxicam and contacting clinician if rash or other signs of hypersensitivity (blisters, fever, pruritus) develop.1 Importance of seeking immediate medical attention if an anaphylactic reaction occurs.1

  • Importance of discontinuing therapy and contacting clinician immediately if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur.1

  • Risk of heart failure or edema; importance of reporting dyspnea, unexplained weight gain, or edema.508

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1 Importance of avoiding meloxicam in late pregnancy (third trimester).1

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.1

  • Importance of informing patients of other important precautionary information.1 (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name



Dosage Forms


Brand Names




7.5 mg*

Meloxicam Tablets


Boehringer Ingelheim,

15 mg*

Meloxicam Tablets


Boehringer Ingelheim,


7.5 mg/5 mL


Boehringer Ingelheim

AHFS DI Essentials™. © Copyright 2020, Selected Revisions November 21, 2016. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.


1. Boehringer Ingelheim. Mobic (meloxicam) tablets prescribing information. Ridgefield, CT; 2006 Jul 10.

2. Anon. Meloxicam (Mobic) for osteoarthritis. Med Lett Drugs Ther. 2000; 42:47-8.

3. Noble S, Balfour JA. Meloxicam. Drugs. 1996; 51:424-30.

4. Boehringer Ingelheim. Product information form for American hospital formulary service: Mobic (meloxicam). Ridgefield, CT; 2000.

5. Jackson LM, Hawkey CJ. COX-2 selective nonsteroidal anti-inflammatory drugs: do they really offer any advantages? Drugs. 2000; 59:1207-16.

6. Tegeder I, Lotsch J, Krebs S et al. Comparison of inhibitory effects of meloxicam and diclofenac on human thromboxane biosynthesis after single doses and at steady state. Clin Pharmacol Ther. 1999; 65:533-44.

7. Noble SL, King DS, Olutade JI. Cyclooxygenase-2 enzyme inhibitors: place in therapy. Am Fam Physician. 2000; 61:3669-76.

8. Kaplan-Machlis B, Klostermeyer BS. The cyclooxygenase-2 inhibitors: safety and effectiveness. Ann Pharmacother. 1999; 33:979-88.

9. de Meijer A, Vollaard H, de Metz M et al. Meloxicam, 15 mg/day, spares platelet function in healthy volunteers. Clin Pharmacol Ther. 1999; 66:425-30.

10. Davies NM, Skjodt NM. Clinical pharmacokinetics of meloxicam; a cyclo-oxygenase-2 preferential nonsteroidal anti-inflammatory drug. Clin Pharmacokinet. 1999; 36:115-26.

11. Prouse PJ, Bevis PJ, Bluhmki E et al. Evaluation of the safety, tolerability, and efficacy of meloxicam tablets in patients with osteoarthritis. Clin Ther. 1996; 18:429-39.

12. Linden B, Distel M, Bluhmki E. A double-blind study to compare the efficacy and safety of meloxicam 15 mg with piroxicam 20 mg in patients with osteoarthritis of the hip. Br J Rheumatol. 1996; 35:35-8.

13. Hosie J, Distel M, Bluhmki E. Meloxicam in osteoarthritis: a 6-month, double-blind comparison with diclofenac sodium. Br J Rheumatol. 1996; 35:39-43.

14. Hosie J, Distel M, Bluhmki E. Efficacy and tolerability of meloxicam versus piroxicam in patients with osteoarthritis of the hip or knee: a six-month double-blind study. Clin Drug Invest. 1997; 13:175-84.

15. Yocum D, Fleischmann R, Dalgin P et al. Safety and efficacy of meloxicam in the treatment of osteoarthritis: a 12-week, double-blind, multiple-dose, placebo-controlled trial. Arch Intern Med. 2000; 160:2947-54.

16. Schoenfeld P. Gastrointestinal safety profile of meloxicam: a meta-analysis and systematic review of randomized controlled trials. Am J Med. 1999; 107:48-54S.

17. Hawkey C, Kahan A, Steinbruck K et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. Br J Rheumatol. 1998; 37:937-45.

18. Anon. Drug for rheumatoid arthritis. Med Lett Drugs Ther. 2000; 42:57-64.

19. Lemmel EM, Bolten W, Burgos-Vargas R et al. Efficacy and safety of meloxicam in patients with rheumatoid arthritis. J Rheumatol. 1997; 24:282-90.

20. Novartis Pharmaceuticals. Diovan (valsartan) capsules prescribing information (dated 1997 Apr). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999:2013-5.

21. Arnett FC, Edworthy SM, Bloch DA et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31:315-24.

22. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum. 2002; 46:328-46.

23. Ruperto N, Nikishina I, Pachanov ED. A randomized, double-blind clinical trial of two doses of meloxicam compared with naproxen in children with juvenile idiopathic arthritis: short- and long-term efficacy and safety results. Arthritis Rheum. 2005; 52:563-72.

24. Food and Drug Administration. Analysis and recommendations for agency action regarding non-steroidal anti-inflammatory drugs and cardiovascular risk. 2005 Apr 6.

25. Cush JJ. The safety of COX-2 inhibitors: deliberations from the February 16-18, 2005, FDA meeting. From the American College of Rheumatology web site ( Accessed 2005 Oct 12.

26. McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA. 2006; 296: 1633-44.

27. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332: 1302-5.

28. Graham DJ. COX-2 inhibitors, other NSAIDs, and cardiovascular risk; the seduction of common sense. JAMA. 2006; 296:1653-6.

29. Merck & Co. Clinoril (sulindac) tablets prescribing information. Whitehouse Station, NJ; 2006 Feb.

30. Chou R, Helfand M, Peterson K et al. Comparative effectiveness and safety of analgesics for osteoarthritis. Comparative effectiveness review no. 4. (Prepared by the Oregon evidence-based practice center under contract no. 290-02-0024.) . Rockville, MD: Agency for Healthcare Research and Quality. 2006 Sep. Available at:

500. Food and Drug Administration. Drug safety communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. Silver Spring, MD; 2015 Jul 9. From the FDA web site. Accessed 2016 Mar 22.

501. Coxib and traditional NSAID Trialists' (CNT) Collaboration, Bhala N, Emberson J et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013; 382:769-79.

502. Food and Drug Administration. FDA briefing document: Joint meeting of the arthritis advisory committee and the drug safety and risk management advisory committee, February 10-11, 2014. From FDA web site

503. Trelle S, Reichenbach S, Wandel S et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011; 342:c7086.

504. Gislason GH, Rasmussen JN, Abildstrom SZ et al. Increased mortality and cardiovascular morbidity associated with use of nonsteroidal anti-inflammatory drugs in chronic heart failure. Arch Intern Med. 2009; 169:141-9.

505. Schjerning Olsen AM, Fosbøl EL, Lindhardsen J et al. Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation. 2011; 123:2226-35.

506. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011; 8:e1001098.

507. Yancy CW, Jessup M, Bozkurt B et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 62:e147-239.

508. Boehringer Ingelheim Pharmaceuticals. Mobic (meloxicam) tablets and oral suspension prescribing information. Ridgefield, CT; 2016 May.

511. Olsen AM, Fosbøl EL, Lindhardsen J et al. Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction: a nationwide cohort study. Circulation. 2012; 126:1955-63.

512. Olsen AM, Fosbøl EL, Lindhardsen J et al. Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study. PLoS One. 2013; 8:e54309.

516. Bavry AA, Khaliq A, Gong Y et al. Harmful effects of NSAIDs among patients with hypertension and coronary artery disease. Am J Med. 2011; 124:614-20.

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