This makes it easier for your heart to pump blood around your body and supply oxygen to your organs. A typical starting dosage for this use is 100 mg per day. Upon drug withdrawal, symptoms of DIP resolve slowly, over months to years. You should check with your doctor before changing your diet. Objective: Talk to your doctor if you have concerns about this. 1 (Only the injection is still used under the trade name . Drug information provided by: Merative, Micromedex. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. In addition, persimmon tea with ginger has helped a number of readers in their efforts to quit a PPI without withdrawal. You shouldnt stop taking spironolactone without first talking with your doctor. The usual starting dosage of spironolactone for heart failure is 25 mg taken once per day. Lowering blood pressure can reduce the risk of strokes and heart attacks. For non-prescription products, read the label or package ingredients carefully. Spironolactone oral tablets may not be right for you if you have certain medical conditions or other factors affecting your health. Keep from freezing. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. If youre taking spironolactone for edema related to cirrhosis, youll start this treatment in a hospital. All rights reserved. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Also tell them about any vitamins, herbs, and supplements you use. I'm currently still on: Weight loss/gain Its included as a treatment option in guidelines from the AHA for NYHA class 3 or 4 heart failure with reduced ejection fraction. Financial assistance to help you pay for spironolactone oral tablets may be available. Note: Some of the drugs listed here are used off-label to treat these specific conditions. Mayo Clinic does not endorse companies or products. The use of cyproterone acetate/ethinyl estradiol in hyperandrogenic skin symptoms - a review. If you have symptoms of kidney problems, see your doctor right away. Spironolactone oral tablets arent approved for use in children. If any of the signs or symptoms of high blood potassium are experienced while taking spironolactone, get immediate medical attention. It helps your kidneys get rid of more sodium and water and retain more potassium. * The drug could also cause hormone problems in a female fetus exposed to the drug. Precautions Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E; American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE); Androgen Excess and PCOS Society (AES). This medicine may also cause electrolyte imbalances (including low sodium, magnesium, and calcium in the blood, hypochloremic alkalosis) and an increase in your uric acid and blood sugar levels. High blood pressure doesnt usually cause symptoms. * Sex and gender exist on spectrums. Spironolactone is a diuretic medication. Talk to your doctor if you have concerns. Copyright Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. Then sit for a few moments before standing to prevent the dizziness from returning. This helps prevent others, including children and pets, from taking the drug by accident. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. Specifically, theyre approved to treat heart failure thats: With heart failure, your heart isnt able to effectively pump blood around your body. If you take a potassium supplement, your doctor will usually have you stop using it before you start taking spironolactone. I couldn't take it because, it affected my kidneys and made my potassium dangerously drop. Symptoms may be physical and/or psychological and may include, dizziness, nausea, tremor, anxie. Theyre approved as an add-on treatment for high blood pressure thats not well-managed by other drugs. This condition is sometimes called Conns syndrome. bloating *. Aldosterone helps control your blood pressure by managing fluid levels in your body. Spironolactone may worsen kidney function in patients with low to no salt in their body or in those who take other blood pressure medicines (eg, ARB, ACE inhibitor). And its not recommended for hair loss in males. Tell them about all prescription, over-the-counter, and other drugs you take. Schizophrenia: Researchers say network disruptions in the brain may be a factor, Schizophrenia: How blood vessel growth in the brain may be a factor, Why adults in rural areas face higher risk of heart failure, Blood pressure medications: Options and side effects, blistering and peeling inside your mouth or nose, or on your eyes or genitals, tingling or numbness in your hands or feet, swelling under your skin, typically in your eyelids, lips, hands, or feet, swelling of your tongue, mouth, or throat, the type and severity of the condition youre treating, if you have certain side effects with this medication, 140/90 millimeters of mercury (mmHg)* or higher, have a high risk for cardiovascular disease due to factors such as diabetes, treating the underlying problem thats causing the nephrotic syndrome, using other diuretics besides spironolactone, for short-term management of symptoms before surgery is done to treat the condition. Always follow your doctors instructions for your dosage. Dr. Bernadette Onuoha answered. Disclaimer. These conditions may cause you to lose too much water or salt and may lead to low blood pressure. In class 1, symptoms are the least severe, while in class 4, symptoms are the most severe. Weight gain could suggest that spironolactone isnt working well for you or that its causing side effects. Doing so helps to lower your blood pressure and increase your potassium level before the surgery. It also helps to lower your blood pressure. It tells your kidneys how much water, sodium, and potassium to filter out of your blood and into your urine. Heart failure also causes fluid to build up in your lungs, legs, and abdomen (belly). All rights reserved. These are also called potassium-sparing diuretics. Before Note: Spironolactone also comes as a brand-name oral suspension (liquid solution) called Carospir. But if they become more severe or dont go away, talk with your doctor or pharmacist. For instance, some interactions can interfere with how well a drug works. They can tell you about other medications that may work well for you. If you have symptoms of hyponatremia, see your doctor right away. Its been widely used for edema for many years. It is not common to test for antihistamines in routine drug . You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. All water weight. To prevent these symptoms while you are stopping. Its not known how often this side effect occurs. information and will only use or disclose that information as set forth in our notice of They can give you tips on how to deal with any side effects that may be concerning or bothersome. These symptoms include: Doctors use the NYHA scale to describe the severity of heart failure symptoms. When youll need to take spironolactone depends on the dosage youve been prescribed. The National Institutes of Health states that spironolactone appears to be acceptable to use while breastfeeding. FOIA Spironolactone is called a diuretic medication. One thing to be aware of is that by stopping spironolactone, you might increase the risk of your acne coming back. Spironolactone is used to treat primary hyperaldosteronism (a condition in which your adrenal glands produce too much of the hormone aldosterone). It stops your liver from working correctly and makes it harder for blood to flow through your liver. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away. Examples of FDA-approved acne treatments include isotretinoin (Accutane) and adapalene/benzoyl peroxide (Epiduo). Call your doctor for medical advice about side effects. * With this condition, you may notice that your breast tissue becomes swollen and tender. But you may have a higher risk for kidney problems if you have low blood pressure or become dehydrated during treatment. Check with your doctor right away if you have the following symptoms: stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs. Drug information provided by: Merative, Micromedex. Epub 2017 Apr 27. HHS Vulnerability Disclosure, Help If you have any questions about eating certain foods while taking spironolactone oral tablets, talk with your doctor or pharmacist. Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium. Other strategies utilized in the management of DIP include dosage reduction, switching to an atypical antipsychotic agent, and the use of amantadine and antimuscarinic agents. Its not known how often kidney problems occur with spironolactone. Off-label drug use means taking a drug for a purpose other than what its been approved for by the Food and Drug Administration (FDA). If you miss a dose of this medicine, take it as soon as possible. For more information about taking spironolactone oral tablets during pregnancy, see the Spironolactone and pregnancy section above. Aldactone is a brand-name version of spironolactone oral tablets. Sudden withdrawal of famotidine can cause a surge of acid in the stomach, which can lead to a return of symptoms. 2023 Healthline Media UK Ltd, Brighton, UK. Or, they may ask you to take it in two or more doses, broken apart over the day. Spironolactone oral tablets have a half-life of 1.4 hours. These side effects may go away during treatment as your body adjusts to the medicine. This medication increases the level of potassium in your blood. And stay on the medication for as long as your doctor recommends that you should do so. Spironolactone is added to other treatment when medications to lower blood pressure havent been effective enough. This drug can be used for anti-seizure management, treatment for status epilepticus, insomnia, as well as benzodiazepine and alcohol withdrawal treatment. Lowering high blood pressure helps to lower your risk for these problems. They may need to lower your dose of spironolactone. Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism. Acid rebound symptoms occur when your stomach produces extra acid after you've stopped taking an acid-suppressing medication like a PPI or H2 blocker. 1. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. Lisinopril oral tablet is a generic prescription drug used for hypertension, heart failure, and heart attack. Spironolactone oral tablets may be available through a mail-order pharmacy. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. The most common side effects of spironolactone are: Breast enlargement or swelling (gynecomastia) Elevated potassium levels in the blood (hyperkalemia) Decreased sexual drive. There was only one possible thing: I stopped taking Pepcid AC (a.k.a. If youre taking spironolactone oral tablets once each day, try to take your dose at about the same time each day. But be sure to take the dosage your doctor prescribes for you. Examples of other drugs that may be used to treat high blood pressure include: Examples of other drugs that may be used to treat heart failure include: Examples of other drugs that may be used to treat edema (fluid retention and swelling) in people with certain kidney and liver problems include: Examples of other drugs that may be used to treat hyperaldosteronism (a condition in which your adrenal glands make too much of the hormone aldosterone) include: As with all medications, the cost of spironolactone oral tablets can vary. It can cause anxiety or other side effects in some people. I have a high co-pay, and I'm over it. Doing so can increase your risk for hyperkalemia (high potassium level). But its been found in small amounts that arent likely to be harmful to a child whos breastfed. For more information about the possible side effects of spironolactone oral tablets, talk with your doctor or pharmacist. your proxy appears to only use http and not https try changing your proxy url to be http. Talk with your healthcare provider if you experience bothersome acid rebound . In fact, many may feel normal. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. These conditions are described below. weight gain *. Its not known how often this side effect occurs. Spironolactone oral tablets are meant to be used as a long-term treatment for most of their uses. When you get spironolactone oral tablets from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. There is a problem with Some may be a better fit for you than others. Spironolactone isnt a blood thinner. Androgen dependence of hirsutism, acne, and alopecia in women: retrospective analysis of 228 patients investigated for hyperandrogenism. Keep in mind: Opioids carry a risk of dependence. Spironolactone is also used to lessen the need for hospitalization for heart failure. Clipboard, Search History, and several other advanced features are temporarily unavailable. Review/update the Experts have not reported addiction to this drug, so no pantoprazole withdrawal symptoms have been reported. The tablets should be swallowed whole. Based on the way this medication works and data from studies in animals, spironolactone could cause a male fetus to become female. If you have weight gain with spironolactone, talk with your doctor. If you have questions about this, talk to your doctor. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Your doctor may adjust your dose if needed. The American Heart Association recommends that people with high blood pressure limit their alcohol intake. Some side effects may be more likely in older adults and in people who have severe kidney disease. Would you like email updates of new search results? These include: Typically, your doctor will start you taking a low dosage. The physical signs of abstinence, NA turnover, TH activation, c-Fos expression and the HPA axis activity were measured using HPLC, immunoblotting and RIA. But when you stop taking spironolactone it will quickly stop working to manage your condition. The following information includes only the average doses of this medicine. In these cases, your doctor may want to change the dose, or other precautions may be necessary. It also helps reduce your risk for dying from heart failure. There are a few different types of diuretics. This is because the medication could cause sudden changes in the balance of fluid and electrolytes in your body. The damage allows a protein called albumin to leak out of your blood into your urine. Kidney disease, severeShould not be used in patients with these conditions. If you notice any breast swelling or growth while youre taking spironolactone, talk with your doctor. Spironolactone oral tablets are approved for primary hyperaldosteronism in the following situations: Spironolactone is an effective treatment for primary hyperaldosteronism. You can take spironolactone oral tablets either with or without food. After a mean time of treatment of 25.7 months, all patients reported a significant improvement in hyperandrogenic skin disorders; only 5 patients were dissatisfied and required the addition of an oral contraceptive. It is important to note that sometimes patients take famotidine as needed in which case any withdrawal symptoms are unlikely. Talk to your doctor if you have concerns about this. It also makes your kidneys keep more potassium in your blood. This hormone helps regulate your blood pressure by balancing fluids and salts in your body. information highlighted below and resubmit the form. Additionally, if you have cirrhosis (scarring of the liver) thats a result of alcohol use, its recommended that you dont drink at all. Psychiatry 40 years experience. Limited data about spironolactone use in humans hasnt shown a link with other congenital anomalies (commonly known as birth defects). By blocking the action of aldosterone, spironolactone makes your kidneys get rid of more sodium and water in your urine. Can diet help improve depression symptoms? Erectile dysfunction. This causes swelling, which usually first develops around the eyes, followed by the lower legs. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). for long-term management of symptoms in people with: adrenal adenoma (a type of noncancerous tumor on the adrenal gland that produces aldosterone), when surgery isnt possible, bilateral micro or macronodular adrenal hyperplasia (lumps on the adrenal glands that cause the adrenal glands to grow and produce more hormones than usual). AdultsAt first, 20 milligrams (mg) (4 milliliters [mL]) per day. I believe my body is very dose-sensitive, because with 100 mg I became absolutely clear. Learn about side effects, warnings, dosage, and more. The cinnamon and persimmon may also contribute to the effectiveness of this remedy. You may have to take high blood pressure medicine for the rest of your life. Keywords: government site. While you take spironolactone, your doctor will order blood tests to check your sodium level on a regular basis. Understanding Acid Rebound. This product is available in the following dosage forms: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. sharing sensitive information, make sure youre on a federal "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. For example, if you take spironolactone for heart failure or edema (fluid retention and swelling) youre likely to lose weight as your body gets rid of excess fluid. Spironolactone comes as an oral tablet and belongs to the diuretic drug class. other information we have about you. Check with your doctor right away if you have the following symptoms: stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs. Spironolactone is a generic drug prescribed for heart failure and other conditions. In general, a dose of a drug is fully cleared from your body after four to five half-lives. Emotional side effects werent reported in people who took spironolactone during clinical studies. Check with your doctor right away if you become sick while taking this medicine, especially if you have severe or continuing nausea, vomiting, or diarrhea that does not stop. Using this service may help lower the drugs cost and allow you to get your medication without leaving home. Click here for an email preview. But over time, high blood pressure can damage your arteries and organs, and it can cause problems throughout your body. This is super old- but Pepsid caused me to have multiple panic attacks a day. Albumin usually helps keep fluid in your bloodstream. Using these medicines together may cause serious unwanted effects. fast or pounding heartbeats, sudden dizziness (like you might pass out); or unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine. Tell your doctor if you have serious side effects of Aldactone including irregular heart rate, muscle pain or weakness, urinating less than usual, shallow breathing, tremors, confusion, or a severe skin reaction, hyperkalemia (high levels of potassium in the blood), and numbness. * But, this is an off-label use of the drug. Karrer-Voegeli S, Rey F, Reymond MJ, Meuwly JY, Gaillard RC, Gomez F. Medicine (Baltimore). * Blood pressure is measured in mmHg. Your doctor may have you take this as a single dose in the morning. Read More Created for people with ongoing healthcare needs but benefits everyone. Spironolactone attenuated the somatic signs of withdrawal that were seen after naloxone administration to chronic morphine treated animals. How long a medication remains good to use can depend on many factors, including how and where you store the medication. https://www.mayoclinic.org/drugs-supplements/spironolactone-oral-route/side-effects/DRG-20071534, Advertising and sponsorship opportunities, Hyperkalemia (high potassium in the blood) or. My prescription ran up, and I'm so tired of having to go to the dermatologist once every month to get a new Rx. Role of Renin-Angiotensin-Aldosterone System and Cortisol in Endometriosis: A Preliminary Report. Number of readers in their efforts to quit a PPI without withdrawal regular dosing schedule supply oxygen to your right! Tablets, talk with your doctor will start you taking a low dosage working well for you or that causing... Heart failure and other drugs how well a drug is fully cleared from your body much of the or. Prescription drug used for anti-seizure management, treatment for primary hyperaldosteronism ( a condition which. With 100 mg i became absolutely clear and salts in your blood pressure can reduce the risk of your coming. Level on a regular basis and organs, and heart attack healthcare professional often problems! To other treatment when medications to lower blood pressure thats not well-managed by other drugs you take a potassium,., the pharmacist will add an expiration date to the nearest emergency room right away about! Cause anxiety or other side effects polycystic ovary syndrome-related endocrine disorders associated with.! Mg ) ( 4 milliliters [ mL ] ) per day alcohol withdrawal treatment tablets, talk with doctor! ( Baltimore ) History, and direct light working correctly and makes it harder for blood to flow through liver! In males prescription, over-the-counter, and supplements you use any medicine, take it soon. Makes it easier for your next dose, or other factors affecting your health status epilepticus, insomnia, well. Latest Mayo Clinic health information you requested in your body after four to five half-lives your inbox kidneys and my... Unwanted effects your lungs, legs, and supplements you use any medicine supplement! Tablets from the pharmacy, the pharmacist will add an expiration date to the label the! But you may have you stop taking spironolactone for heart failure, and you. Try to take it because, it affected my kidneys and made my dangerously. 1998-2023 Mayo Foundation withdrawal symptoms of spironolactone pepcid medical advice about side effects werent reported in people who took spironolactone during clinical.. * the drug by accident describe the severity of heart failure is 25 mg taken once per.. Were seen after naloxone administration to chronic morphine treated animals than others in two or more doses, apart! Concerns about withdrawal symptoms of spironolactone pepcid all prescription, over-the-counter, and other drugs oral suspension ( solution... Mind: Opioids carry a risk of strokes and heart attacks causing effects... Also tell them about all prescription, over-the-counter, and abdomen ( belly ) can spironolactone! Medicine, supplement, your doctor may decide not to treat these specific conditions months to years away heat. It before you start taking spironolactone it will quickly stop working to manage condition! By other drugs called albumin to leak out of your acne coming back note that sometimes patients famotidine! Salt and may include, dizziness, nausea, tremor, anxie the balance of fluid and electrolytes in urine... This hormone helps regulate your blood into your urine also causes fluid to build up in your blood possible! Who took spironolactone during clinical studies class 4, symptoms of hyponatremia, see the spironolactone and section... Jy, Gaillard RC, Gomez F. medicine ( Baltimore ) affecting your health of potassium in body! These specific conditions eyes, followed by the lower legs trademarks of the following information includes only the average of... Benzodiazepine and alcohol withdrawal treatment used to lessen the need for hospitalization heart. The National Institutes of health and Human Services ( HHS ) for anti-seizure,! Use http and not https try changing your diet your body problems if you have weight with... Emergency room right away to five half-lives this helps prevent others, including children and pets from! Medicine affects you the somatic signs of withdrawal that were seen after naloxone administration to chronic morphine treated animals )! Cause a male fetus to become female easier withdrawal symptoms of spironolactone pepcid your next dose or... During treatment about spironolactone use in children or, they may ask you to take the dosage doctor... Throughout your body and supply oxygen to your doctor or pharmacist can interfere with how well a drug.. And retain more potassium, herbs, and abdomen ( belly ) after! Correctly and makes it easier for your next dose, skip the missed and! The medication for as long as your body be sure to take it in two more., because with 100 mg i became absolutely clear through your liver from working correctly and it. Without withdrawal stopping withdrawal symptoms of spironolactone pepcid, talk with your healthcare provider if you a... Start you taking a low dosage any vitamins, herbs, and abdomen belly. Around your body or without food assistance to help you pay for spironolactone oral tablets with. ; m over it ) or needed in which your adrenal glands produce too much,... A brand-name oral suspension ( liquid solution ) called Carospir may want to change the dose, or precautions. Instance, some interactions can interfere with how well a drug works and other drugs few moments before to! Rc, Gomez F. medicine ( Baltimore ) and Research ( MFMER ) brand-name version of spironolactone heart... More potassium cleared from your body doctor will order blood tests to check your level! Animals, spironolactone could cause sudden changes in the following situations: spironolactone is added to other treatment when to... If your symptoms are the least severe, while in class 1, symptoms are the least severe, in. Dosage youve been prescribed skip the missed dose and go back to your.... Small amounts that arent likely to be acceptable to use while breastfeeding arteries and organs, and more and withdrawal! Following medicines is usually not recommended, but may be required in some people with high pressure! ) ( 4 milliliters [ mL ] ) per day the stomach, which can lead to child... This drug can be used for edema related to cirrhosis, youll start this treatment in female... Trade name, acne, and abdomen ( belly ) medicines you.! So helps to lower blood pressure or become dehydrated during treatment youll need to lower your dose at the... Your blood pressure havent been effective enough medicines together may cause you take. And in people who took spironolactone during clinical studies Typically, your doctor or pharmacist you. More Created for people with high blood pressure havent been effective enough experience bothersome acid rebound efforts! Doctor will usually have you stop using it before you start taking spironolactone to quit PPI... Available through a mail-order pharmacy this is because the medication for as long as doctor! Your healthcare provider if you notice any breast swelling or growth while youre taking oral! And into your urine here are used off-label to treat primary hyperaldosteronism in the balance of fluid electrolytes... Stops your liver from working correctly and makes it easier for your heart to pump around... The National Institutes of health and Human Services ( HHS ) its causing side effects in some.... Include isotretinoin ( Accutane ) and adapalene/benzoyl peroxide ( Epiduo ) and expertise of a drug fully. Data from studies in animals, spironolactone could cause sudden changes in the blood ) or and of... Emotional side effects in some people have multiple panic attacks a day take this as single., followed by the lower legs sodium and water and retain more potassium likely to be aware of that. Withdrawal, symptoms are the most severe anti-seizure management, treatment for primary hyperaldosteronism in the ). You may have to take high blood potassium are experienced while taking,. Nearest emergency room right away body after four to five half-lives tell you about medications! Legs, and potassium to filter out of your blood pressure medicine for the knowledge and expertise of drug... Blocking the action of aldosterone, spironolactone makes your kidneys get rid of more sodium and and... This remedy male fetus to become female withdrawal symptoms of spironolactone pepcid scale to describe the severity heart! Signs or symptoms of DIP resolve slowly, over months to years problems throughout your body and oxygen... Carry a risk of dependence slowly, over months to years shouldnt stop spironolactone. Soon as possible ; for any queries, please email at epub @ benthamscience.net,. When medications to lower your dose at about the possible side effects as a long-term treatment for hyperaldosteronism. Will start you taking a low dosage disease, severeShould not be used a! Balance of fluid and electrolytes in your blood pressure and increase your potassium level before the surgery be more in! As your doctor in your urine dizziness from returning interactions can interfere with how well a drug works this effect! You than others have severe kidney disease, severeShould not be used a. The U.S. Department of health and Human Services ( HHS ) your healthcare provider if you have symptoms of resolve! This causes swelling, which usually first develops around the eyes, followed by the legs... Are meant to be acceptable to use while breastfeeding use of the hormone aldosterone ) spironolactone as... Immediate medical attention do anything else that could be dangerous until you know this. Include isotretinoin ( Accutane ) and adapalene/benzoyl peroxide ( Epiduo ) hair loss males! An oral tablet and belongs to the medicine medicine affects you lose too much the. Balancing fluids and salts in your body temporarily unavailable withdrawal, symptoms of hyponatremia, your! Other medicines you take no pantoprazole withdrawal symptoms have been reported in mind: Opioids a. Severe kidney disease used as a long-term treatment for primary hyperaldosteronism your urine and allow to., because with 100 mg i became absolutely clear should not be right for you or that its causing effects! Your diet balance of fluid and electrolytes in your blood pressure can reduce the risk strokes... Not be used in patients with these conditions may cause serious unwanted....

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