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SALMETEROL 50MICROGRAMS INHALATION POWDER

Active substance(s): SALMETEROL

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Package Leaflet: Information for the User
®

Serevent 50micrograms
Accuhaler®
(salmeterol xinafoate)
Outer case

Counter
Full Empty
60
0
Thumbgrip

Mouthpiece
Lever

Read all of this leaflet carefully before
you start taking this medicine because it
contains important information for you.
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
only. Do not pass it on to others. It may harm
them, even if their signs of illness are the
same as yours.
If you get any side effects, talk to your doctor
or pharmacist. This includes any possible side
effects not listed in this leaflet. See section 4.
The name of your medicine is Serevent
50micrograms Accuhaler but will be referred to as
Serevent Accuhaler or Serevent throughout this
leaflet.

In this leaflet:
1
2
3
4
5
6

What Serevent Accuhaler is and what it is
used for
What you need to know before you use
Serevent Accuhaler
How to use Serevent Accuhaler
Possible side effects
How to store Serevent Accuhaler
Contents of the pack and other information

1

What Serevent Accuhaler is and what
it is used for

Serevent Accuhaler contains the medicine
salmetrol. It is a ‘long-acting bronchodilator’. It
helps the airways in the lungs to stay open.
This makes it easier for air to get in and out.
The effects are usually felt within 10 to 20
minutes and last for 12 hours or more.
The doctor has prescribed it to help prevent
breathing problems. These could be caused
by asthma. Taking Serevent Accuhaler
regularly will help prevent asthma attacks.
This also includes asthma brought on by
exercise or at night.
Taking Serevent Accuhaler regularly will also
help prevent breathing problems caused by
other chest illnesses such as Chronic
Obstructive Pulmonary Disease (COPD).
Serevent Accuhaler helps to stop
breathlessness and wheezing coming on. It
does not work once you are breathless or
wheezy. If that happens, you need to use a
fast acting ‘reliever’ medicine, such as
salbutamol.
Serevent is supplied to you in an inhaler called
the Accuhaler. You breathe the medicine
directly into your lungs.
If you are being treated for asthma, you should
always be given both a Serevent and a steroid
inhaler to use together.

2

What you need to know before you
use Serevent Accuhaler

Do not take Serevent Accuhaler if:
you are allergic (hypersensitive) to salmeterol
xinafoate, or to the other ingredient lactose.

Take special care with Serevent Accuhaler
If you are using Serevent for asthma your
doctor will want to regularly check your
symptoms.
If your asthma or breathing gets worse tell
your doctor straight away. You may find that
you feel more wheezy, your chest feels tight
more often or you may need to use more of
your fast acting ‘reliever’ medicine. If any of
these happen, do not increase your number of
puffs of Serevent. Your chest condition may
be getting worse and you could become
seriously ill. See your doctor as you may need
a change in asthma treatment.
Once your asthma is well controlled your
doctor may consider it appropriate to gradually
reduce the dose of Serevent.
If you have been prescribed Serevent for your
asthma, continue to use any other asthma
medication you are already taking. These
could include a steroid inhaler or steroid
tablets. Continue taking the same doses as
before, unless your doctor tells you otherwise.
Do this even if you feel much better. Do not
stop taking your steroid inhaler (or any
steroid tablets) when you start using
Serevent.
Your doctor may want to check your health
regularly if you have an overactive thyroid
gland, diabetes mellitus (Serevent may
increase your blood sugar) or heart disease,
including an irregular or fast heartbeat.

Other medicines and Serevent
Tell your doctor if you are taking or have
recently taken any other medicines. This
includes those for asthma or any other
medicines obtained without a prescription.
This is because Serevent may not be suitable
to be taken with other medicines.

Inform your doctor before using Serevent if
you are currently being treated
for any fungal infections with medicines
containing ketoconazole or itraconazole, or
if you are being treated for HIV with ritonavir.
These medicines may increase the risk of you
experiencing side effects with Serevent,
including irregular heart beats, or may make
side effects worse.
Beta-blockers should be avoided when taking
Serevent, unless your doctor tells you to take
them. Beta-blockers, including atenolol,
propranolol and sotalol, are mostly used for
high blood pressure or other heart conditions.
Tell your doctor if you are taking beta-blockers
or have recently been prescribed betablockers as they may reduce or abolish the
effects of salmeterol.
Serevent can reduce the amount of potassium
in your blood. If this happens you may notice
an uneven heartbeat, muscle weakness or
cramp. This is more likely to happen if you
take Serevent with some medicines used to
treat high blood pressure (diuretics – water
tablets) and other medicines used to treat
breathing problems such as theophylline or
steroids. Your doctor may ask for you to have
blood tests to check the amount of potassium
in your blood. If you have any concerns
discuss them with your doctor.

Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you
may be pregnant or are planning to have a baby,
ask your doctor or pharmacist for advice before
taking this medicine.

Driving and using machines
The possible side effects associated with Serevent
are unlikely to affect your ability to drive or use
machines.

3

The Serevent Accuhaler device holds blisters
containing Serevent as a powder.
There is a counter on top of the Serevent
Accuhaler which tells you how many doses
are left. It counts down to 0. The numbers 5 to
0 will appear in red to warn you when there
are only a few doses left. Once the counter
shows 0, your inhaler is empty.

How to use Serevent Accuhaler

Always use this medicine exactly as your doctor or
pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.
If you are being treated for asthma, you
should always be given both a Serevent
and a steroid inhaler to use together.
Use Serevent every day, until your doctor
advises you to stop.
You will start to feel your medicine working
within the first day of use.
Serevent is for inhalation by mouth only.

Adults and adolescents aged 12 years
and older with Asthma
The usual starting dose is 1 puff twice a day.
For people with more severe asthma, your
doctor may increase your dose to 2 puffs twice
a day.

Children with Asthma
In children aged 4 to 12 the usual dose is 1
puff twice a day.
Serevent is not recommended for use in
children below 4 years of age.

Adults with Chronic Obstructive
Pulmonary Disease (COPD) including
bronchitis and emphysema
The usual starting dose is 1 puff twice a day.
Not applicable for children and adolescents.

Instructions for use
Your doctor, nurse or pharmacist should show
you how to use your inhaler. They should
check how you use it from time to time. Not
using the Serevent Accuhaler properly or as
prescribed may mean that it will not help your
asthma or COPD as it should.

Using your inhaler
To open your Serevent

1 Accuhaler, hold the

outer case in one hand and
put the thumb of your other
hand on the thumbgrip.
Push your thumb away
from you as far as it will go.
You will hear a click. This
will open a small hole in the
mouthpiece.
Hold your Serevent
Accuhaler with the
mouthpiece towards you.
You can hold it in either your
right or left hand. Slide the
lever away from you as far as
it will go. You will hear a click.
This places a dose of your
medicine in the mouthpiece.

2

Every time the lever is pushed back a blister is
opened inside and the powder made ready for you
to inhale. Do not play with the lever as this opens
the blisters and wastes medicine.
Hold the Serevent Accuhaler away from your
3 mouth,
breathe out as far as is comfortable.
Do not breathe into your Serevent Accuhaler.

If you forget to use Serevent
Put the mouthpiece to your lips; breathe in
steadily and deeply
through the Serevent
Accuhaler, not through your
nose. Remove the Serevent
Accuhaler from your mouth.
Hold your breath for about 10
seconds or for as long as is
comfortable.
Breathe out slowly.

4

Afterwards rinse your mouth with water and
s
spit it out. This may help to stop you getting
thrush and being hoarse.

5

To close the Serevent Accuhaler, slide
the thumbgrip back towards
you, as far as it will go. You
will hear a click. The lever
will return to its original
position and is reset.

6

Your Serevent Accuhaler is now ready for you to
use again.

Cleaning your inhaler
Wipe the mouthpiece of the Serevent Accuhaler
with a dry tissue to clean it.

If you use more Serevent than you should
It is important to use the inhaler as instructed. If
you accidentally take a larger dose than
recommended, talk to your doctor or pharmacist.
You may notice your heart beating faster than
usual and that you feel shaky and/or dizzy. You
may also have a headache, muscle weakness and
aching joints.

Do not take a double dose to make up for a
missed dose. Just take your next dose at the usual
time.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

4

Possible side effects

Like all medicines, this medicine can cause side
effects, although not everybody gets them. To
reduce the chances of side effects, your doctor will
prescribe the lowest dose of Serevent to control
your asthma or COPD. These are the side effects
reported by people taking Serevent.
Allergic reactions: you may notice your
breathing suddenly gets worse after using
Serevent. You may be very wheezy and cough.
You may also notice itching and swelling (usually
of the face, lips, tongue or throat). If you get these
effects or they happen suddenly after using
Serevent, tell your doctor straight away.
Allergic reactions to Serevent are very rare (they
affect less than 1 person in 10,000).
Other side effects are listed below:

Common (affects less than
1 person in 10):
Muscle cramps
Feeling shaky; fast or uneven heartbeat
(palpitations), headache, shaking hands
(tremor). Tremors are more likely if you are
taking more than one puff twice daily. These
side effects do not last long and happen less
as treatment with Serevent continues.

Uncommon (affects less than
1 person in 100):
Rash
Very fast heart rate (tachycardia). This is more
likely to happen if you are taking more than
one puff twice daily
Feeling nervous.

Rare (affects less than 1 person in 1,000):
Feeling dizzy
Being unable to sleep or finding sleep difficult
A reduction in the amount of potassium in your
blood (you may get an uneven heartbeat,
muscle weakness, cramp)

Very rare (affects less than 1 person in
10,000):
Breathing difficulties or wheezing that gets
worse straight after taking Serevent. If this
happens stop using your Serevent
Accuhaler. Use your fast-acting ‘reliever’
inhaler to help your breathing and tell your
doctor straight away
Uneven heartbeat or your heart gives an extra
beat (arrhythmias). If this happens do not stop
using Serevent but tell your doctor
Increases in the amount of sugar (glucose) in
your blood (hyperglycaemia). If you have
diabetes, more frequent blood sugar
monitoring and possibly adjustment of your
usual diabetic treatment may be required
Sore mouth or throat
Feeling sick (nausea)
Aching, swollen joints, or chest pain.
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.

5

How to store Serevent Accuhaler

KEEP OUT OF THE SIGHT AND REACH OF
CHILDREN.
Do not store above 30 C.
Store in the original package. Store in a dry
place .
Do not take serevent after the expiry date
which is stated on the carton or label after
‘Exp’. The expiry date refers to the last day of
that month.
If your medicine shows any signs of
deterioration or discolouration, seek the advice
of your pharmacist.
Medicines should not be disposed of via
wastewater or household waste. Ask your
pharmacist how to dispose of medicines no longer
required. These measures will help to protect the
environment.

6

Contents of the pack and other
information

What Serevent Accuhaler contains
Each actuation contains powder for inhalation,
providing 50micrograms of salmeterol (as the
xinafoate).
The other ingredient is lactose monohydrate
(which contains milk proteins).
Warning: If you have been told by your doctor that
you have an intolerance to some sugars, contact
your doctor before taking this medicinal product.

What Serevent Accuhaler looks like and
contents of the pack
Two tone green and turquoise plastic circular
device containing white inhalation powder with
a dose counter indicating number of doses
remaining.
Each dose is pre-dispensed.
The devices are packed in cartons which hold
one Accuhaler containing 60 actuations
Manufactured by: Glaxo Wellcome Production,
Evreux, France.
Procured from within the EU and repackaged
by the Product Licence holder: B&S Healthcare,
Unit 4, Bradfield Road, Ruislip, Middlesex,
HA4 0NU, UK.
Serevent® 50micrograms Accuhaler ®
PL: 18799/1981

POM

Leaflet date: 28.04.2015
Accuhaler and Serevent are trademarks of the
GlaxoSmithKline group of companies

Package Leaflet: Information for the User

Salmeterol 50micrograms
Inhalation Powder

1

Salmeterol Accuhaler contains the medicine
salmeterol. It is a ‘long-acting bronchodilator’.
It helps the airways in the lungs to stay open.
This makes it easier for air to get in and out.
The effects are usually felt within 10 to 20
minutes and last for 12 hours or more.

(salmeterol xinafoate)
Outer case

Counter
Full Empty
60
60
0
Thumbgrip

The doctor has prescribed it to help prevent
breathing problems. These could be caused
by asthma. Taking Salmeterol Accuhaler
regularly will help prevent asthma attacks.
This also includes asthma brought on by
exercise or at night.

Mouth piece
Mouthpiece
Lever

Read all of this leaflet carefully before
you start taking this medicine because it
contains important information for you.
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
only. Do not pass it on to others. It may harm
them, even if their signs of illness are the
same as yours.
If you get any side effects, talk to your doctor
or pharmacist. This includes any possible side
effects not listed in this leaflet. See section 4.
The name of your medicine is Salmeterol
50micrograms Inhalation Powder but will be
referred to as Salmeterol Accuhaler or Salmeterol
throughout this leaflet.

What Salmeterol Accuhaler is and
what it is used for

Taking Salmeterol Accuhaler regularly will also
help prevent breathing problems caused by
other chest illnesses such as Chronic
Obstructive Pulmonary Disease (COPD).
Salmeterol Accuhaler helps to stop
breathlessness and wheezing coming on. It
does not work once you are breathless or
wheezy. If that happens, you need to use a
fast-acting ‘reliever’ medicine, such as
salbutamol.
Salmeterol is supplied to you in an inhaler
called the Accuhaler. You breathe the
medicine directly into your lungs.

In this leaflet:

If you are being treated for asthma, you should
always be given both a Salmeterol and a
steroid inhaler to use together.

1

2

2
3
4
5
6

What Salmeterol Accuhaler is and what it is
used for
What you need to know before you use
Salmeterol Accuhaler
How to use Salmeterol Accuhaler
Possible side effects
How to store Salmeterol Accuhaler
Contents of the pack and other information

What you need to know before you
use Salmeterol Accuhaler

Do not take Salmeterol Accuhaler if:
you are allergic (hypersensitive) to salmeterol
xinafoate, or to the other ingredient lactose.

Take special care with Salmeterol Accuhaler
If you are using Salmeterol for asthma your
doctor will want to regularly check your
symptoms.
If your asthma or breathing gets worse tell
your doctor straight away. You may find that
you feel more wheezy, your chest feels tight
more often or you may need to use more of
your fast-acting ‘reliever’ medicine. If any of
these happen, do not increase your number of
puffs of Salmeterol. Your chest condition may
be getting worse and you could become
seriously ill. See your doctor as you may need
a change in asthma treatment.
Once your asthma is well controlled your
doctor may consider it appropriate to gradually
reduce the dose of Salmeterol.
If you have been prescribed Salmeterol for
your asthma, continue to use any other
asthma medication you are already taking.
These could include a steroid inhaler or
steroid tablets. Continue taking the same
doses as before, unless your doctor tells you
otherwise. Do this even if you feel much
better. Do not stop taking your steroid
inhaler (or any steroid tablets) when you
start using Salmeterol.
Your doctor may want to check your health
regularly if you have an overactive thyroid
gland, diabetes mellitus (Salmeterol may
increase your blood sugar) or heart disease,
including an irregular or fast heartbeat.

Other medicines and Salmeterol
Tell your doctor if you are taking or have
recently taken any other medicines. This
includes those for asthma or any other
medicines obtained without a prescription.
This is because Salmeterol may not be
suitable to be taken with other medicines.
Inform your doctor before using
Salmeterol if you are currently being treated
for any fungal infections with medicines
containing ketoconazole or itraconazole, or
if you are being treated for HIV with ritonavir.
These medicines may increase the risk of you
experiencing side effects with Salmeterol,
including irregular heart beats, or may make
side effects worse.
Beta-blockers should be avoided when taking
Salmeterol, unless your doctor tells you to
take them. Beta-blockers, including atenolol,
propranolol and sotalol, are mostly used for
high blood pressure or other heart conditions.
Tell your doctor if you are taking beta-blockers
or have recently been prescribed betablockers as they may reduce or abolish the
effects of salmeterol.
Salmeterol can reduce the amount of
potassium in your blood. If this happens you
may notice an uneven heartbeat, muscle
weakness or cramp. This is more likely to
happen if you take Salmeterol with some
medicines used to treat high blood pressure
(diuretics – water tablets) and other medicines
used to treat breathing problems such as
theophylline or steroids. Your doctor may ask
for you to have blood tests to check the
amount of potassium in your blood. If you
have any concerns discuss them with your
doctor.

Pregnancy and breast-feeding
If you are pregnant breast-feeding think you may
be pregnant or are planning to have a baby, ask
your doctor or pharmacist for advice before taking
this medicine.

Driving and using machines
The possible side effects associated with
Salmeterol are unlikely to affect your ability to
drive or use machines.

3

Adults with Chronic Obstructive
Pulmonary Disease (COPD) including
bronchitis and emphysema
The usual starting dose is 1 puff twice a day.
Not applicable for children and adolescents.

Instructions for use
Your doctor, nurse or pharmacist should show
you how to use your inhaler. They should
check how you use it from time to time. Not
using the Salmeterol Accuhaler properly or as
prescribed may mean that it will not help your
asthma or COPD as it should.

How to use Salmeterol Accuhaler

Always use this medicine exactly as your doctor or
pharmacist has told you. Check with your doctor or
pharmacist if you are not sure.

The Salmeterol Accuhaler device holds
blisters containing Salmeterol as a powder.
There is a counter on top of the Salmeterol
Accuhaler which tells you how many doses
are left. It counts down to 0. The numbers 5 to
0 will appear in red to warn you when there
are only a few doses left. Once the counter
shows 0, your inhaler is empty.

If you are being treated for asthma, you
should always be given both a Salmeterol
and a steroid inhaler to use together.
Use Salmeterol every day, until your doctor
advises you to stop.
You will start to feel your medicine working
within the first day of use.
Salmeterol is for inhalation by mouth only.

Adults and adolescents aged 12 years
and older with Asthma
The usual starting dose is 1 puff twice a day.
For people with more severe asthma, your
doctor may increase your dose to 2 puffs twice
a day.

Children with Asthma
In children aged 4 to 12 the usual dose is 1
puff twice a day.
Salmeterol is not recommended for use in
children below 4 years of age.

Using your inhaler
open your Salmeterol
1 To
Accuhaler, hold the outer
case in one hand and put the
thumb of your other hand on
the thumbgrip. Push your thumb away
from you as far as it will go.
You will hear a click. This will
open a small hole in the mouthpiece.
Hold your Salmeterol
Accuhaler with the
mouthpiece towards you. You
can hold it in either your right
or left hand. Slide the lever
away from you as far as it will
go. You will hear a click. This places a dose of
your medicine in the mouthpiece.

2

Every time the lever is pushed back a blister is
opened inside and the powder made ready for you
to inhale. Do not play with the lever as this opens
the blisters and wastes medicine.
Hold the Salmeterol Accuhaler away from
your mouth, breathe out as far as is
comfortable.
Do not breathe into your Salmeterol Accuhaler.

3

Put the mouthpiece to your lips; breathe in
4 steadily
and deeply through
the Salmeterol Accuhaler, not
through your nose. Remove
the Salmeterol Accuhaler from
your mouth. Hold your breath
for about 10 seconds or for
as long as is comfortable.
Breathe out slowly.

If you use more Salmeterol than you
should
It is important to use the inhaler as instructed. If
you accidentally take a larger dose than
recommended, talk to your doctor or pharmacist.
You may notice your heart beating faster than
usual and that you feel shaky and/or dizzy. You
may also have a headache, muscle weakness and
aching joints.

If you forget to use Salmeterol
Do not take a double dose to make up for a
missed dose. Just take your next dose at the usual
time.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.

4

5

Afterwards rinse your mouth with water and
s
spit it out. This may help to stop you getting
thrush and being hoarse.
To close the Salmeterol Accuhaler, slide
the thumbgrip back towards
you, as far as it will go. You
will hear a click. The lever will
return to its original position
and is reset.

6

Your Salmeterol Accuhaler is now ready for you to
use again.

Cleaning your inhaler
Wipe the mouthpiece of the Salmeterol Accuhaler
with a dry tissue to clean it.

Possible side effects

Like all medicines, this medicine can cause side
effects, although not everybody gets them. To
reduce the chances of side effects, your doctor will
prescribe the lowest dose of Salmeterol to control
your asthma or COPD. These are the side effects
reported by people taking Salmeterol.
Allergic reactions: you may notice your
breathing suddenly gets worse after using
Salmeterol. You may be very wheezy and cough.
You may also notice itching and swelling (usually
of the face, lips, tongue or throat). If you get these
effects or they happen suddenly after using
Salmeterol, tell your doctor straight away.
Allergic reactions to Salmeterol are very rare (they
affect less than 1 person in 10,000).

Other side effects are listed below:

Increase in the amount of sugar (glucose) in
your blood (hyperglycaemia). If you have
diabetes, more frequent blood sugar
monitoring and possibly adjustment of your
usual diabetic treatment may be required

Common (affects less than
1 person in 10):
Muscle cramps
Feeling shaky; fast or uneven heartbeat
(palpitations), headache, shaking hands
(tremor). Tremors are more likely if you are
taking more than one puff twice daily. These
side effects do not last long and happen less
as treatment with Salmeterol continues

Uncommon (affects less than
1 person in 100):
Rash
Very fast heart rate (tachycardia). This is more
likely to happen if you are taking more than
one puff twice daily
Feeling nervous

Sore mouth or throat
Feeling sick (nausea)
Aching, swollen joints, or chest pain
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. 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.

5

How to store Salmeterol Accuhaler

Rare (affects less than 1 person in 1,000):
Feeling dizzy
Being unable to sleep or finding sleep difficult
A reduction in the amount of potassium in your
blood (you may get an uneven heartbeat,
muscle weakness, cramp)

Very rare (affects less than 1 person in
10, 000):
Breathing difficulties or wheezing that gets
worse straight after taking Salmeterol. If
this happens stop using your Salmeterol
Accuhaler. Use your fast-acting ‘reliever’
inhaler to help your breathing and tell your
doctor straight away
Uneven heartbeat or your heart gives an extra
beat (arrhythmias). If this happens do not stop
using Salmeterol but tell your doctor

Keep out of the sight and reach of children.
Do not store above 30°C.

6

Contents of the pack and other
information

What Salmeterol Accuhaler contains
Each actuation contains powder for inhalation,
providing 50micrograms of salmeterol (as the
xinafoate).
The other ingredient is lactose monohydrate
(which contains milk proteins).
Warning: If you have been told by your doctor that
you have an intolerance to some sugars, contact
your doctor before taking this medicinal product.
What Salmeterol Accuhaler looks like and
contents of the pack
Two tone green and turquoise plastic circular
device containing white inhalation powder with
a dose counter indicating number of doses
remaining.
Each dose is pre-dispensed.
The devices are packed in cartons which hold
one Accuhaler containing 60 actuations

Store in the original package. Store in a dry
place

Manufactured by: Glaxo Wellcome Production,
Evreux, France.

Do not use Salmeterol after the expiry date
which is stated on the label and carton.

Procured from within the EU and repackaged
by the Product Licence holder: B&S Healthcare,
Unit 4, Bradfield Road, Ruislip, Middlesex,
HA4 0NU, UK.

If your Salmeterol Accuhaler shows any signs
of deterioration seek the advice of your
pharmacist.
Medicines should not be disposed of via
wastewater or household waste. Ask your
pharmacist how to dispose of medicines no longer
required. These measures will help to protect the
environment.

Salmeterol 50micrograms Inhalation Powder
PL: 18799/1981
POM
Leaflet date: 28.04.2015

Expand view ⇕

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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