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EVOREL SEQUI

Active substance(s): ESTRADIOL HEMIHYDRATE / ESTRADIOL HEMIHYDRATE MICRONISED / NORETHISTERONE ACETATE / NORETHISTERONE ACETATE MICRONISED / ESTRADIOL HEMIHYDRATE / ESTRADIOL HEMIHYDRATE MICRONISED / NORETHISTERONE ACETATE / NORETHISTERONE ACETATE MICRONISED

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PACKAGE LEAFLET: INFORMATION FOR THE USER

Evorel® Sequi
(estradiol hemihydrate, norethisterone acetate)
Evorel is a registered trademark
Read all of this leaflet carefully before you start using this medicine.

In this leaflet

Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if
their symptoms are the same as yours.
If you get side effects and they become serious or if you notice any side effects not listed in this
leaflet, please tell your doctor or pharmacist.

1. What Evorel Sequi is and what it is used for
2. Before you use Evorel Sequi
3. Safety of HRT
4. How to use Evorel Sequi
5. Possible side effects
6. How to store Evorel Sequi
7. Further information

1. What Evorel Sequi is and what it is used for
The name of your medicine is Evorel Sequi. It belongs to a group of
medicines called hormone replacement therapy (HRT).
Evorel Sequi contains two medicines:
An oestrogen (estradiol)
A progestogen (norethisterone)
They are both female hormones.
Evorel Sequi comes in a ‘memory pack’. This can be used to help
you remember when to change your patches. Each pack contains
eight patches:
Four ‘Evorel 50’ patches marked ‘CE50’ (containing estradiol
only)
Four ‘Evorel Conti’ patches marked ‘CEN1’ (containing
estradiol and norethisterone)
The hormones are spread evenly in each patch. They pass slowly
into your body through the skin.

What Evorel Sequi is used for
Evorel Sequi is used:
For the symptoms of the menopause (see ‘What is the
menopause?’). It is only used in women who still have a womb.
It is suitable for women who have had the menopause

(postmenopausal) or who are around the time of the
menopause (perimenopausal)
To prevent osteoporosis (fragile bones) in women who have
had the menopause and are most likely to have bone
problems. Evorel Sequi is only used if other medicines for
osteoporosis have been tried first and they have not worked

What is the menopause?
Women produce oestrogen hormones from their ovaries
throughout their adult life. These hormones are important in sexual
development and control of the menstrual cycle.
The menopause happens when the level of hormones produced by
the ovaries goes down. This is a gradual process. During this time,
the levels of oestrogen can go up and down. This can cause:
Hot flushes, night sweats or mood swings
Vaginal problems such as dryness or itching
Uncomfortable or painful sexual intercourse
You may get the same symptoms if you have had your ovaries
taken out in an operation.

How Evorel Sequi works
Evorel Sequi is known as ‘continuous sequential’ HRT. This is
because two hormones are used one after another:
Estradiol is used by itself for two weeks
Then estradiol and norethisterone are used together for the
next two weeks
Evorel Sequi replaces the oestrogen that is normally released by
the ovaries. However, taking an oestrogen hormone regularly may
cause the lining of your womb to build-up and get thicker.
This means it is necessary to add a progestogen hormone to
the oestrogen
This helps shed the lining of the womb and stop any problems
happening. Evorel Conti patches used during weeks 3 and 4
contain this progestogen
The shedding of the lining of the womb will probably give a
‘withdrawal bleed’. This will be like having a period each month.
The withdrawal bleed will start during week 4, before you finish an
Evorel Sequi pack.
Evorel Sequi is not a contraceptive.

2. Before you use Evorel Sequi
Do not use Evorel Sequi if:
You are allergic to anything in the patches (listed in section 7)
You have (or have ever had) or think you may have breast
cancer
You have ( or are suspected of having) or ever had a cancer
that is made worse by oestrogens (such as endometrial
cancer)
You have a thickening of the lining of the womb which has not
been treated
You have vaginal bleeding you cannot explain
You have ever had blood clots in a vein (thrombosis) or a
blood clot that has travelled to your lung (pulmonary embolism)
You have problems with your blood which increases the
likelihood of developing a blood clot (thrombosis) (such as
protein C, protein S or antithrombin deficiency)
You have ever had blocked arteries (arterial thrombo-embolic
disease) that gave you angina or a heart attack or a stroke
You have (or have ever had) a liver disease and your liver
function tests have not returned to normal
You have a blood problem called ‘porphyria’
Do not use this medicine if any of the above applies to you. If you
are not sure, talk to your doctor or pharmacist before using Evorel
Sequi. Stop using Evorel Sequi at once if any of the above appears
for the first time and talk to your doctor immediately.
Evorel Sequi should not be used by children.

Medical check-ups
Before taking HRT, your doctor should ask about you and your
family’s medical history. Your doctor may decide to examine your
breasts or your tummy and may do an internal examination. They
will only do this if it is necessary for you or if you have any special
concerns.
Once you have started on HRT, see your doctor for regular checkups (at least once a year). At these check-ups, your doctor may
discuss the benefits and risks of continuing to take HRT.

Make sure that you:
Go for regular breast screening and cervical smear tests
Regularly check your breasts for any changes such as
dimpling of the skin, changes in the nipple or any lumps you
can see or feel

Take special care with Evorel Sequi

Taking other medicines

Tell your doctor if you have ever had any of the following. You may
need to have checks more often.

Please tell your doctor or pharmacist if you are taking or have
recently taken any other medicines. This includes medicines that
you buy without a prescription or herbal medicines.

Vaginal bleeding which you could not explain
A problem caused by growth of the womb lining:
Inside the womb (fibroids)
Outside the womb (endometriosis)
Thickening of the lining of the womb (endometrial
hyperplasia)
Increased risk of blood clots (see ‘Blood clots’ in section 3
below)
A family history of increased risk of cancers related to
oestrogens (see ‘Breast cancer’ in section 3 below)
High blood pressure (hypertension). Your doctor may tell you
to stop using Evorel Sequi if your blood pressure goes up
Diabetes
Gallstones
Migraine or severe headaches
Systemic lupus erythematosus (SLE). This is an allergic
condition that causes joint pain, skin rashes and fever
Epilepsy
Asthma
A disease affecting the eardrum and hearing (otosclerosis)
Liver, heart or kidney problems
High levels of triglycerides (a type of fat) in your blood as you
may have a higher risk of pancreatitis (inflammation of the
pancreas, which causes severe pain in the abdomen and back)
Any breast problems
History of sudden swelling of the face or throat, which may
cause difficulty in swallowing or breathing, rapid swelling of the
hands and feet and stomach cramps
You may still be able to use Evorel Sequi, but you should discuss
this with your doctor first. Also tell your doctor if these illnesses
return or get worse while you are using Evorel Sequi.
If you have had a premature menopause the risk of using HRT
may be different. Talk to your doctor about the risks.

Other conditions:
If you have brown patches on your face or body (chloasma) or
have a history of them, you may need to keep out of the sun or
away from sunbeds (these patches may not completely disappear
again)

In particular, tell your doctor or pharmacist if you are taking
any of the following:
Medicines for epilepsy such as phenobarbital, phenytoin or
carbamazepine
Certain medicines for infections such as rifampicin, rifabutin,
nevirapine, efavirenz, ritonavir or nelfinavir
Bosentan - for high blood pressure in the blood vessels of the
lungs
St. John’s Wort - for depression
Taking these medicines with Evorel Sequi can stop it from working
as well. Because of this you may get some bleeding like a period,
when you are not expecting it.
A medicine for epilepsy called lamotrigine. Using Evorel Sequi
with lamotrigine could affect control of your epilepsy

Operations or tests
Tell your doctor if you are going to have surgery. You may need to
stop taking HRT about 4 to 6 weeks before the operation to reduce
the risk of a blood clot. Your doctor will tell you when you can start
taking HRT again.
If you visit a hospital or your family doctor for a blood or urine test,
tell them that you are taking Evorel Sequi. This is because this
medicine may affect the results of the tests.

Pregnancy and breast-feeding
Do not use this medicine if you are pregnant, think you may be
pregnant or might become pregnant. This is because it may affect
the baby. If you become pregnant, contact your doctor straight
away and remove the patch.
Do not use this medicine if you are breast-feeding.
Ask your doctor or pharmacist for advice before taking any
medicine if you are pregnant or breast-feeding.

Driving or using machines
There is no information about whether Evorel Sequi affects your
ability to drive or use machines. See how this medicine affects you
before you drive or use any tools or machines.

3. Safety of HRT
As well as benefits, HRT has some risks. Consider the following
when deciding to take or continue HRT.

Heart disease
HRT is not recommended for women who have had heart disease
recently. If you have ever had heart disease, talk to your doctor to
see if you should be taking HRT.

HRT will not help to prevent heart disease.
Studies of HRT (containing oestrogen and progestogen) have
shown that women may be slightly more likely to get heart disease.
If you get a pain in your chest that spreads to your arm and neck:
See a doctor as soon as possible
Do not use any more HRT until your doctor says you can.
This pain may be a sign of heart disease.

Stroke
Research suggests that HRT slightly increases the risk of having a
stroke. Other things that can increase the risk of stroke include:
Getting older
High blood pressure

Smoking
Drinking too much alcohol
An irregular heart beat
If you are worried about any of these things or if you have had a
stroke in the past, talk to your doctor to see if you should take
HRT.

How likely is a stroke?
Looking at women in their 50s, on average, over 5 years:
In women not taking HRT - 3 in 1000 would be expected to
have a stroke
In women taking HRT - 4 in 1000 would be expected to have
a stroke
Looking at women in their 60s, on average, over 5 years:
In women not taking HRT - 11 in 1000 would be expected to
have a stroke
In women taking HRT - 15 in 1000 would be expected to
have a stroke
If you get migraine-type headaches which you cannot explain:
See a doctor as soon as possible

Do not use any more HRT until your doctor says you can
These headaches may be an early warning sign of a stroke.

Blood clots
HRT is not recommended for women who have ever had a blood
clot.
HRT may increase the risk of blood clots in the veins (also called
deep vein thrombosis or DVT), especially during the first year of
taking it.
These blood clots are not always serious. However, if a clot travels
to the lungs, it can cause chest pain, breathlessness, collapse or
even death. This is called pulmonary embolism or PE.
You are more likely to get a blood clot if:
You are very overweight (BMI > 30 kg/m2)
You have had a blood clot before
Any of your close family have had blood clots
You have had one or more miscarriages
You have any blood clotting problem that needs treatment with
a medicine such as warfarin

You are off your feet for a long time because of major surgery,
injury or illness
You are going on a long journey and will not be moving about
for some time
You have a rare illness called SLE (Systemic lupus
erythematosus)
You have cancer
If any of these things apply to you, talk to your doctor to see if you
should take HRT.

For all kinds of HRT, the extra risk of breast cancer goes up the
longer you take it. However, it returns to normal within about 5
years after stopping HRT.

How likely is a blood clot?

Looking at women aged 50, on average, over the next 15 years:
In women not taking HRT - 32 in 1000 will get breast cancer
In women taking oestrogen-only HRT at age 50 and take it
for 5 years, between 33 and 34 in 1000 will get breast cancer
In women taking oestrogen-only HRT for 10 years - 37 in
1000 will get breast cancer
In women taking oestrogen plus progestogen HRT at age
50 and take it for 5 years - 38 in 1000 will get breast cancer
In women taking oestrogen plus progestogen HRT for 10
years - 51 in 1000 will get breast cancer

Looking at women in their 50s, on average, over 5 years:
In women not taking HRT - 3 in 1000 would be expected to
get a blood clot
In women taking HRT - 7 in 1000 would be expected to get a
blood clot
Looking at women in their 60s, on average, over 5 years:
In women not taking HRT - 8 in 1000 would be expected to
get a blood clot
In women taking HRT - 17 in 1000 would be expected to get a
blood clot

Your risk of breast cancer is also higher if:
You have a close relative (mother, sister or grandmother) who
has had breast cancer
You are very overweight

If you have had your womb removed because of
endometriosis, any endometrium left in your body may be at risk
of cancer. This means your doctor may prescribe HRT that
includes a progestogen as well as an oestrogen.
Your product, Evorel Sequi, contains a progestogen. Evorel Sequi
is only used in women who still have a womb (see Section 1 ‘What
Evorel Sequi is used for’).

How likely is endometrial cancer?

How likely is breast cancer?

If you notice any changes in your breast, such as:
Dimpling of the skin
Changes in the nipple
Any lumps you can see or feel

Looking at women aged 50 who still have a womb, on average,
over the next 15 years:
In women not taking HRT - 5 in 1000 will get endometrial
cancer
In women taking oestrogen-only HRT, the number will be 2
to 12 times higher, depending on the dose and how long you
take it for
The addition of a progestogen to oestrogen-only HRT substantially
reduces the risk of endometrial cancer.
If you get breakthrough bleeding or spotting, it is usually
nothing to worry about, especially during the first few months of
taking HRT.

Make an appointment to see your doctor as soon as possible.

But if the bleeding or spotting:
Carries on for more than the first few months
Starts after you have been on HRT for a while
Carries on even after you’ve stopped taking HRT

Breast cancer

Endometrial cancer (cancer of the lining of the
womb)

Make an appointment to see your doctor as soon as possible.
It could be a sign that your endometrium has become thicker.

Women who have breast cancer or have had breast cancer in
the past should not take HRT.

HRT is not recommended for women who have ever had cancer
of the lining of the womb.

Ovarian cancer

Taking HRT slightly increases the risk of breast cancer. The risk is
also slightly increased if you have a later menopause.
Postmenopausal women taking oestrogen-only HRT for 5
years - the risk is about the same as for a woman of the same
age who is still having periods over that time and not taking
HRT
Women taking oestrogen plus progestogen HRT - the risk is
higher than for oestrogen-only HRT. However, oestrogen plus
progestogen HRT is beneficial for the endometrium (see
‘Endometrial cancer’)

Taking oestrogen-only HRT for a long time can increase the
risk of cancer of the lining of the womb (the endometrium).
Taking a progestogen as well as the oestrogen helps to lower the
extra risk.

If you get painful swelling in your leg, sudden chest pain or have
difficulty breathing:
See a doctor as soon as possible
Do not use any more HRT until your doctor says you can
These may be signs of a blood clot.

If you still have your womb, your doctor will usually prescribe a
progestogen as well as oestrogen. These may be prescribed
separately or as a combined HRT product.
If you have had your womb removed (a hysterectomy), your
doctor will discuss with you whether you can safely take oestrogen
without a progestogen.

Ovarian cancer (cancer of the ovaries) is rare, but it is serious. It
can be difficult to diagnose. This is because there are often no
obvious signs of the disease. Some studies have suggested that
taking HRT for more than 5 years may increase the risk of ovarian
cancer.

Dementia
Evorel Sequi and medicines like it will not stop memory loss
(dementia). Women who start using medicines like Evorel Sequi
after the age of 65 may have a small increase in the risk of
dementia

4. How to use Evorel Sequi
Always use Evorel Sequi exactly as your doctor has told you. You
should check with your doctor or pharmacist if you are not sure.
Your doctor will aim to reduce your symptoms with the lowest
possible dose for the shortest amount of time.

When to start using Evorel Sequi
You may put an Evorel 50 patch on at any time if:
You have not used HRT before your menopause and no longer
have menstrual periods
Your menstrual cycles are not regular and you are not
pregnant
You are changing from HRT that does not give you a
withdrawal bleed
Put an Evorel 50 patch on within 5 days of the start of
bleeding if:
You are not currently using HRT and still having regular
periods
Put an Evorel 50 patch on at the end of a treatment cycle or
one week after you finish using another HRT product if:

To help you remember your two ‘patch change’ days, mark them
here or on the pack. They are written on the pack like this:
MON
THUR
S

TUE
FRI

WED
SAT

THUR
SUN

FRI
MON

SAT
TUE

Where to apply the patch
Stick the patch onto a hairless area of skin below the waist. Most
women prefer to wear the patch on the thigh or bottom.
Do not apply on or near the breasts
Do not put it on top of cuts, spots or anywhere the skin is
irritated
Do not use cream, moisturiser or talc before applying the patch
Do not apply the patch on the same area of skin twice in a row
It can be worn under loose areas of clothing
Do not wear a patch under elasticated areas or a tight
waistband
Apply the patch to clean, dry skin as soon as you open the
protective pouch

NEVER apply
patch in this
area

You are changing from an HRT medicine that gives you a
withdrawal bleed
If you are using another type of HRT:

Talk to your doctor if you are not sure which type of HRT you are
using.

The patches need to be changed twice a week. You must use the
patches in the right order.
Weeks 1 and 2

Correct area
for applying
patch

Use the four Evorel 50 patches one at a time.
Weeks 3 and 4
Use the four Evorel Conti patches one at a time. As soon as you
remove your fourth Evorel 50 patch, replace it with the first Evorel
Conti patch.
Start a new pack of Evorel Sequi as soon as you finish one. Do not
leave a break between packs.

Changing your patches
You must change the patches twice a week to give your body a
steady supply of hormones. There is enough hormone in each
patch to last for several days
Change your patch on the same two days every week. This will
mean that one patch is on for three days and the next patch for
four days
For example, if you apply your first patch on a Monday, change
it on Thursday and again on the following Monday. You can
work out your two days from the following table, starting from
the first day of use:
If you put your
first patch on:

Change on:

Monday



Thursday

Tuesday



Change again on:
&

Monday

Friday

&

Tuesday

Wednesday →

Saturday

&

Wednesday

Thursday



Sunday

&

Thursday

Friday



Monday

&

Friday

Saturday



Tuesday

&

Saturday

Sunday



Wednesday

&

Sunday

Apply a new patch of the same type. If you have just had a bath or
shower, wait until your skin cools before applying the new patch.
It is always useful to keep a spare pack that you can use to replace
patches that have fallen off. Talk to your doctor if you need more
patches.

If you forget to change the patch
Change it as soon as you remember and then keep to your original
‘patch change’ days. You may get some bleeding and spotting like
a period during this time.

If you use more Evorel Sequi than you should
It is unlikely that you will have too much of the hormones in Evorel
Sequi. The most common symptoms of having too much oestrogen
or progestogen in your body are:
Tender breasts
Feeling sick (nausea) or being sick
Unexpected vaginal bleeding
Stomach pain or bloating
Removing the patch can reverse the effects of too much oestrogen
and/or progestogen. Talk to your doctor or pharmacist before using
any more patches.

Contraception while using Evorel Sequi

The day you start will depend on the type of HRT you have
been using

Using the patches

SUN
WED

If a patch falls off

Putting a patch on
Do not use a patch if its protective pouch is
already open.
Step 1: Open and Peel
Using the notches as a guide, tear along
two edges of the pouch. Remove the patch
With the protective backing facing you,
bend and peel off half the backing. Don’t
touch the sticky side - it may not stick
properly if you do
Step 2: Apply and Press
Apply the open half of the patch to your skin
Remove the remaining backing and press
down the rest of the patch
Press the patch with the palm of your hand to
make sure it is firmly stuck

Removing a patch
Peel an edge of the patch smoothly away from
the skin
Fold the patch in half, so that the sticky side
sticks to itself
Put it in with the household rubbish, safely out
of the reach of children and pets
Do not flush used patches down the toilet
When you remove the patch some glue may
remain on your skin. It will disappear with time or
you can use baby oil to remove it.

The levels of hormone from the patches are too low to act as a
contraceptive. Use non-hormonal contraceptive methods (such as
a condom, diaphragm or coil) until your periods have completely
stopped.

Everyday activities
You can have a bath or shower as normal. Do not scrub too
hard as this can loosen the edges of the patch
You can go swimming. The patch will not be affected
You can exercise and play sports. However, do not wear the
patch under tight clothing or waist bands
You can sunbathe. However, keep the patch covered, out of
direct sunlight
If you have any further questions on the use of this product, ask
your doctor or pharmacist.

5. Possible side effects
Like all medicines, Evorel Sequi can cause side effects, although
not everybody gets them.
Take off the patch and tell your doctor straight away if you
notice or suspect any of the following. You may need urgent
medical treatment.
Blood clots (thrombosis) or stroke (frequency not known)
Yellowing of the skin or whites of the eyes (jaundice) or other
liver problems
Migraine-type headaches for the first time or more frequent
(affects less than 1 in 10 people)
An increase in blood pressure (affects less than 1 in 10
people)
Breast or ovarian cancer, endometrial cancer or hyperplasia
(long, heavy or irregular vaginal bleeding)
Widespread rash with peeling skin and blistering in the mouth,
eyes and genitals (Stevens-Johnson syndrome) (frequency not
known)
Convulsions or fits (frequency not known)
Tell your doctor if you notice any of the following side effects
while using Evorel Sequi:
Very common (affects more than 1 in 10 people)
Irritated, itchy, red skin where the patch is applied

Common (affects less than 1 in 10 people)
Feeling depressed or nervous
Inappropriate signs of emotion
Being unable to sleep
Headache
Itchy skin or red rash
Feeling sick (nausea), or having stomach pain, wind or other
stomach upsets
Diarrhoea
Pain including pain in the back, muscles, joints
Breast pain
Feeling generally unwell
Weight gain
Heavy vaginal bleeding, painful periods
Water retention or build-up of fluid under the skin (oedema)
Uncommon (affects less than 1 in 100 people)
Concentration problems
Feeling dizzy
More or less interest in sex than usual
Allergic reaction (hypersensitivity)
A fungal infection called thrush
Feeling tired
Being aware of your heart beat (palpitations)

Numb or tingling hands or feet, less skin sensitivity
Breast lumps (non-cancerous)
Fuller breasts
Irregular vaginal bleeding
Thickening of the lining of the womb
Frequency not known
Mood swings
Bloated feeling
Gallstones
Swelling of the hands and feet (peripheral oedema)
Puffy skin where the patch is applied
If any of the side effects gets serious, or if you notice any other
side effects not listed in this leaflet, please tell your doctor or
pharmacist.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse.
This includes any possible side effects not listed in this leaflet. You
can also report side effects directly via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
By reporting side effects, you can help provide more information on
the safety of this medicine.

6. How to store Evorel Sequi
Keep out of the sight and reach of children.
Do not store above 25°C. Store in the original pack.
Do not take your Evorel Sequi after the expiry date which is
stated on the label after ‘Exp’. The expiry date refers to the last
day of that month.

Do not use a patch if its protective pouch is open. If the
patches show any signs of deterioration, do not use them and
seek the advice of your pharmacist or physician.

Medicines should not be disposed off via wastewater or
household waste. Ask your pharmacist how to dispose off
medicines no longer required. These measures will help to
protect the environment.

7. Further information
Each Evorel 50 patch contains 3.2mg of estradiol hemihydrate.
Each Evorel 50 patch delivers 50micrograms of estradiol a day.
Each Evorel Conti patch contains 3.2mg of estradiol hemihydrate
and 11.2mg of norethisterone acetate. Each Evorel Conti patch
delivers 50micrograms of estradiol and 170micrograms of
norethisterone a day.
The other ingredients are: acrylate/ vinyl acetate co-polymer,
guar gum, polyethylene terephthalate foil and siliconised
polyethylene terephthalate foil which is removed before application

What Evorel Sequi looks like and contents of the pack
Evorel Sequi comes in a memory pack containing four Evorel 50
patches (marked ‘CE50’) and four Evorel Conti patches (marked
‘CEN1’).
Evorel 50 is a square-shaped transparent patch with rounded
corners marked 'CE50' and a metallic adhesive backing with an
'S'- shaped split for easy removal. Evorel conti is a square-shaped
transparent patch with rounded corners marked 'CEN1' and has a
transparent adhesive backing with an 'S'-shaped transparent split
for easy removal.
Each patch comes in a protective sealed pouch and has a surface
area of 16sq cm.

Manufactured by: Janssen Pharmaceutica NV, Turnhoutseweg
30, B-2340 Beerse, Belgium.
Procured from within the EU and repackaged by the Product
Licence holder: B&S Healthcare, Unit 4, Bradfield Road, Ruislip,
Middlesex, HA4 0NU, UK.
Evorel® Sequi;
PL No: 18799/2013
Leaflet date: 08.06.2015
Evorel is a registered trademark of Janssen-Cilag.

POM

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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