The use of propylthiouracil (PTU) for the treatment of Graves' disease is associated with few adverse effects such as skin eruptions, liver dysfunction, and agranulocytosis. Evaluation-Labs: TSH, T3, T4-s/s of hypo and hyperthyroidism Propylthiouracil therapy did not result in a significant decline in serum TNF-α concentrations. Renal and hepatic failures were attributed to PTU-induced c-ANCA production. You'll never find an easier, more efficient, and more focused way to ace the pharmacology and pharmacology-related questions on the USMLE and course examinations than the USMLE Road Map. Minor side effects — Up to 15 percent of people who take an antithyroid drug have minor side effects. Hua Ling PharmD, MS, BCPS, BCCP, CLS, ... Vishakha S. Bhave BPharm, PhD, in Side Effects of Drugs Annual, 2019. A case of a young girl with Graves' disease with symptoms of fatigue, fever, episcleritis, and arthritis was investigated. It's therapeutic effect depends on emission of beta rays with an effective half-life of ~56 days. Endothelial progenitor cells, rosuvastatin and valsartan have a comparable effect on repair of balloon-denudated carotid artery injury. Discontinuation of the offending drug may be the only intervention necessary in mild cases. Propylthiouracil is excreted in breast milk in small amounts. Propylthiouracil (thiocarbamide) is an antithyroid drug. Both methimazole and propylthiouracil can cause itching, rash, hives, joint pain and swelling, fever, changes in taste, nausea, and vomiting. Discontinue antithyroid medications at least 3-4 days before administering sodium iodide I-131 and do not coadminister; thyroid agents decrease update of sodium iodide I-131 by the thyroid gland skin rash. 2017. This book presents the latest advances in knowledge of the pathogenesis of thyroid diseases and describes the state of the art in their diagnosis and treatment, including newly emerging management approaches. Side effects requiring immediate medical attention. 2004; 89(9):4439-44 (ISSN: 0021-972X) A 30-year-old Japanese woman being treated with PTU for her Graves’ disease reported loss of hearing due to otitis media and trigeminal neuralgia on the left side in combination with MPO-ANCA. However, such an effect doesn't last for long after patients stop taking antithyroid drugs. Drug Name: Sodium Iodide 131 ®. Am J Transl Res. Vishakha Bhave, ... Vicky Mody, in Side Effects of Drugs Annual, 2018. Propylthiouracil is also used for an overactive thyroid gland in pregnancy. Effect of rosuvastatin on fasting and postprandial endothelial biomarker levels and microvascular reactivity in patients with type 2 diabetes and dyslipidemia: a preliminary report. Found insideCongenital hypothyroidism, when undiagnosed or if there is a lack of proper treatment management, results in an unnecessary health, economic and social burden. 2017 Jan 15;227:938-949. doi: 10.1016/j.ijcard.2016.09.040. Found inside – Page 576Therapeutic Outcome The primary therapeutic outcome expected from propylthiouracil or methimazole is a gradual return to normal thyroid metabolic function. pain or discomfort in the chest, upper stomach, or throat. Therapeutic classification: antihyperthyroid. FDA Medwatch data indicate that pediatric patients are more susceptible to hepatotoxic reactions from PTU than are adults. pain or discomfort in the chest, upper stomach, or throat. Consideration should be given to methimazole or carbimazole for this circumstance in view of recent toxicity data for PTU. Bethesda, MD 20894, Help fever. sleepiness. Int J Cardiol. 3 Pharmaceutical Form. bleeding in the alveoli . Propylthiouracil is an antithyroid drug that depresses the formation of thyroid hormone. Treatment from 6 mo to several yr may be necessary, usually averaging 1 yr. methIMAzole is a sample topic from the Davis's Drug Guide. Epub 2015 Oct 20. Drug Name Therapeutic/ Pharmacologic Class Indication/ Use Adverse/ Side Effects Nursing Considerations 5 Propylthiouracil (PTU) Antithyroid agents Hyperthyroidism, graves' disease, goiter Increased white blood cells, lesions on the throat, UTI, general feeling of malaise Watch for symptoms of liver disease, do not use for breastfeeding mothers. Propylthiouracil (PTU)-associated vasculitis is normally associated with tetrad of fever, sore throat, arthralgia, and skin lesions but may also involve multiple systems. Found insideNew to this edition: · Twenty-three chapters authored by new contributors and international experts · A companion website with fully searchable text for quick reference · Three new chapters discuss surgical management of thyroid cancer, ... Propylthiouracil inhibits the synthesis of thyroid hormones and thus is effective in the treatment of hyperthyroidism. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), free thyroxine (FT4) and TRAb levels at baseline, and at the . Found insideFeaturing more than 4100 references, Drug-Induced Liver Disease will be an invaluable reference for gastroenterologists, hepatologists, family physicians, internists, pathologists, pharmacists, pharmacologists, and clinical toxicologists, ... The findings suggest that the therapeutic effect of propylthiouracil in psoriasis appears not to be related to any change in the concentration of TNF-α but occurs via an anti-proliferative mechanism as we have previously speculated. Because these events generally come from voluntary reporting from a population of uncertain size, it is not possible to reliably estimate their frequency or establish a causal relationship to drug exposure.. While treatment with antibiotics was ineffective, the patient achieved remission after discontinuation of PTU along with treatment with a steroid. Sheu JJ, Hsiao HY, Chung SY, Chua S, Chen KH, Sung PH, Lee FY, Lu HI, Chen YL, Li YC, Chang HW, Ko SF, Yip HK. Recently, it was reported that a perinuclear antineutrophil cytoplasmic antibody-associated vasculitis developed during treatment with PTU for Grave's disease [44R]. Propylthiouracil is an antithyroid drug administered orally. Along with its needed effects, propylthiouracil may cause some unwanted effects. Generally, the medication is taken for long periods of time before the complication occurs (months to years). The therapeutic efficacy of Propylthiouracil can be decreased when used in combination with Desvenlafaxine. hives or welts. Epub 2018 Jul 30. In Meyler's Side Effects of Drugs (Sixteenth Edition), 2016. A significant difference between the two groups could not be established by 24-hr I181 uptake of thyroid, 24-hr . The therapeutic effect of propylthiouracil (PTU) and then PTU plus levothyroxine (LT 4) was tested. Propylthiouracil is a thiourea derivative with antithyroid property. The transplacental transfer of the various thyrostatics is very similar, so that with all of them, fetal/newborn hypothyroidism and goiter may occur (Bliddal 2011, Corral 2010). 51-52-5 - KNAHARQHSZJURB-UHFFFAOYSA-N - Propylthiouracil [USP:INN:BAN:JAN] - Similar structures search, synonyms, formulas, resource links, and other chemical information. Antithyroid Agent. Learn everything you need to know about propylthiouracil (ptu) and it's nursing considerations incluing classification and common side effects. In an attempt to reduce the toxicity of propylthiouracil (PTU) by establishing different degrees of hypothyroidism, Wistar rats were pair-fed a semisynthetic balanced diet and administered 4 to 6 mg/kg/day (therapeutic dose) or 120 to 180 mg/kg/day (toxic dose) of PTU for 6 weeks. Alidadi M, Montecucco F, Jamialahmadi T, Al-Rasadi K, Johnston TP, Sahebkar A. Biomed Res Int. This full-color volume offers valuable information on thyroid cancer and non-cancerous lesions, the effect of drugs on thyroid function, genetic disorders, and more in an accessible, easy-to-read consistent format. Dexamethasone The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Dexamethasone. 227 (2017) 938-949]. It is a preferred antithyroid drug in the first trimester of pregnancy. The antithyroid drug propylthiouracil protects against liver injury induced by many hepatotoxic agents and markedly reduces mortality in patients with alcoholic liver disease. In an attempt to reduce the toxicity of propylthiouracil (PTU) by establishing different degrees of hypothyroidism, Wistar rats were pair-fed a semisynthetic balanced diet and administered 4 to 6 mg/kg/day (therapeutic dose) or 120 to 180 mg/kg/day (toxic dose) of PTU for 6 weeks. Duration: 2-3 hr. It works by inhibiting the thyroid peroxidases (TPO), which catalyze the iodination of tyrosine residues in thyroglobulin and the oxidative coupling of iodinated tyrosines. Disclaimer, National Library of Medicine The goal of our study was to compare the pharmacokinetic and pharmacologic effects of a suppository and suspension form of PTU given per rectum. Naunyn Schmiedebergs Arch Pharmacol. Found insideThis is a must have reference for researchers in endocrinology and practicing endocrinologists, but it is also ideal for biochemists, pharmacologists, biologists and students. Methods and results: Propylthiouracil (PTU) is a thyroid medication used to manage hyperthyroidism, which is due to an overactive thyroid gland. Median neonatal birth weight was lower in the propylthiouracil group compared with controls (3145 g versus 3300 g) [167]. Everything you need to know about all of today's drugs in a coherent, easy-to-use format - from the underlying science through innovation, translation, regulation, and clinical implementation. Hepatocellular necrosis and fulminant hepatic failure have been reported in patients treated with propylthiouracil. Methods: Thirty-six cases of Graves' disease without PTU were enrolled as control (N), and 198 pretreated with PTU were randomized into groups A and B. Click here for information on individual ASPET membership, EFFECTS OF THERAPEUTIC AND TOXIC DOSES OF PROPYLTHIOURACIL IN RATS. If you notice any other effects, check with your healthcare professional. The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism. Found inside"This is the most widely used textbook for teaching pharmacology to health professionals. This 11th edition is far superior to any previous editions. Onset: 10-20 days. We tested the hypothesis that arteriosclerosis-augmented aortic pulse wave velocity (PWV) and -impaired vasorelaxation were attenuated by rosuvastatin (Rosu) and propylthiouracil (PTU) therapy. The following adverse reactions have been reported with the use of propylthiouracil. Serum SHBG levels were reduced (72 nmol/liter). If one antithyroid drug causes side effects, switching to the other drug may be helpful. Differences in the clinical presentation, histological characteristics, and posttransplant . Histologic features of the thyroids of both groups were similar, showing extreme follicular hyperplasia with depletion of colloid and increased vascularity. In a controlled cohort study of 115 propylthiouracil-exposed pregnancies and 1141 controls there were similar rates of major abnormalities in both groups (13% versus 3.2%). Call your doctor for medical advice about side effects. This includes hyperthyroidism due to Graves' disease and toxic multinodular goiter. The FDA MedWatch data bank analysis from 1970 to 2008 revealed nine malformations among 15 PTU cases reported, but without a specific malformation pattern (Tabacova 2010). Tablets: 50 mg. Found insideThis book has been designed to give a brief information on the development and current status of radionuclide treatments. KCl-induced vasoconstriction of carotid artery (CA) was significantly higher in group 2 than in other groups (all p<0.01), but showed no differences among groups 1, 3 and 4, whereas acetylcholine-induced vasorelaxation exhibited an opposite pattern of KCl-induced vasoconstriction among the four groups (p<0.001). The medical team report that PTU can cause ANCA-associated vasculitis resulting in multi-organ failure [50R]. In this study the effect of propylthiouracil (PTU) pretreatment on 131 I therapy in Graves' disease was evaluated. Found insideThe Renal Drug Handbook offers information compiled from the UK Renal Pharmacy Group and features drug monographs guiding physicians in how to prescribe, prepare, and administer drugs to patients undergoing renal replacement therapy. It is a white, crystalline substance that has a bitter taste and is very slightly soluble in water. Propylthiouracil is readily absorbed and is extensively metabolized. mg tablet of methylthiouracil or propylthiouracil can be taken as equivalent to one 5 mg tablet . loss of taste. From the clinical standpoint, although Graves' disease is eminently treatable, there is no definitive cure. None of the therapeutic options are ideal. Graves' disease is the most common cause of hyperthyroidism.It is an autoimmune disease where an individual makes antibodies to thyroid stimulating hormone receptors on cells . DESCRIPTION Propylthiouracil is one of the thiocarbamide compounds. propylthiouracil (PTU) Propyl-Thyracil . 2016 Feb;241(4):426-36. doi: 10.1177/1535370215609695. Ultimately, we hope this book can enlighten important issues involved in the management of cancer, summarizing the state-of-the-art knowledge regarding the disease control and treatment; thus, providing means to improve the overall care of ... Antioxidant and anti-inflammatory effects of flavocoxid in high-cholesterol-fed rabbits. Presumably, the actual number is higher because 16 PTU-caused liver transplants have been carried out alone in the past 17 years in the USA (Rivkees 2010). It is taken by mouth. Propylthiouracil is an anti-thyroid drug used in the management of Graves disease and hyperthyroidism. The case highlights the importance of monitoring for variable manifestations of vasculitis in patients treated with MMI [48A]. Ioachimescu, in Encyclopedia of Respiratory Medicine, 2006. She was diagnosed with propylthiouracil-induced AAV. The structural formula is: Each tablet contains propylthiouracil 50 mg and the following inactive ingredients: corn starch, docusate sodium, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium benzoate, and sodium starch glycolate. The release of proteolytic enzymes and generation of strong oxidants such as the hydroxyl radical by activated neutrophils has been proposed to play an important role in mediating toxin-induced liver injury. Thoroughly updated with current regulations, references to the latest pharmacological data, and new medicinal products, this edition is a comprehensive resource covering latest knowledge and findings related to drugs during lactation and ... In a thyrotoxic crisis it is generally more effective than methimazole. Epub 2015 Sep 4. The vasculitis reversed completely after cessation of PTU therapy. The range of thionamide doses utilized for initial drug therapy in patients with Graves' disease is 15-60 mg/day for Tapazole ® taken once a day and 300-900 mg/day for PTU taken in divided doses until a normal thyroid state is reached. A recent study has demonstrated equal placental transfer kinetics for PTU and MMI.40 More importantly, thyroid studies in infants exposed to MMI in utero are indistinguishable from those exposed to PTU.41 Both medications appear in breast milk at very low concentrations (MMI42 more than PTU43) and are considered safe in lactation.44,45. A 34-year-old female was being treated for autoimmune hyperthyroidism; six weeks later she developed purpuric plaques with central necrosis on the gluteal areas [49A]. Side effects occur with both groups of drugs, but are lesser with MMI. This work unites the different areas of research and allows anyone working or researching in chiral chemistry to navigate through the most essential concepts with ease, saving them time and vastly improving their understanding. MMI 5mg is equivalent to PTU 50mg drug dose, but related studies have found that, although the dose is equivalent, the efficacy is not the same in clinical application of hyperthyroidism. This may contribute to the more rapid onset of its therapeutic effect compared with that of methimazole. Extrathyroidal effects of propylthiouracil and carbimazole on serum T4, T3, reverse T3 and TRH-induced TSH-release in man. Despite the isocaloric dietary intake, body weight gain in the toxic-dose group was less than in the controls, whereas weight gain in the therapeutic-dose group exceeded that of the controls. The drug is a common therapeutic choice for the following: In thyroid storm and thyrotoxicosis crisis (off-label treatment), to treat the hyperthyroidism. They are usually mild and reversible on stopping the drug, but can be life-threatening also. a yellowing of the eyes or skin from buildup of bilirubin called jaundice. sensation of spinning. Propylthiouracil-Induced Antineutrophil Cytoplasmic . Naunyn Schmiedebergs Arch Pharmacol. A multidisciplinary diagnostic work-up was used to diagnose a case of PTU-induced ANCA-positive vasculitis. A 60-year-old woman was admitted because of hyperthyroidism and leukopenia. Pharmacologic classification: thyroid hormone antagonist. After transient lithium carbonate therapy a successful thyroidectomy was performed. Therapeutic Effect(s): Decreased signs and symptoms of hyperthyroidism. The study believes that the therapeutic effect of MMI is better than PTU, we explain from the following aspects: Metoclopramide Adverse Effects Diagnose, Nursing Process Propylthiouracil Effectiveness for Graves' Disease Medication Reconciliation Lithium, therapeutic levels Heparin Therapy Via Continuous IV Infusion Chemo therapy and Pregnancy Simvastatin Teachings Naloxone Tamoxifen Advance Effects Click here for information on institutional subscriptions. The effect of Neo-Mercazole is reduced if the patient has undergone iodine treatment. The therapeutic effect of rosuvastatin and propylthiouracil on ameliorating high-cholesterol diet-induced rabbit aortic atherosclerosis and stiffness Int J Cardiol . Propylthiouracil is an antithyroid drug administered orally. I. hives. For a better understanding of propylthiouracil ingredients, ask your doctor or pharmacist to consult the medication guide. Consult your doctor before taking Propylthiouracil if pregnant . Lactose monohydrate. J. Cardiol. O.C. Propylthiouracil inhibits the synthesis of thyroid hormones and thus is effective in the treatment of hyperthyroidism. A patient suffering from hyperthyroidism exhibited propylthiouracyl-induced vasculitis with renal involvement. -Takes months for therapeutic effects-Dont change brands-Monitor heart rate. As a rule, normalization of the thyroid values occurs in the first month of life. Laboratory results showed the presence of cryoglobulin, cryofibrinogen, and c-ANCA. It is a white, crystalline substance that has a bitter taste and is very slightly soluble in water. skin rash. Naunyn Schmiedebergs Arch Pharmacol. This guide to adverse drug reactions to medicines explains their likely frequency and severity, their predictability and reversability, predisposing factors and how to recognize and prevent them. In addition, this agent inhibits the Type I 5'-deiodinase (D1), an enzyme involved in the . Numerous tables, graphs, and figures add further clarity to the text." ...Written by experts in the field, this book is updated with the latest advances in pathophysiology and treatment. PTU-withdrawal, along with high-dose corticosteroids treatment resulted in a favorable clinical outcome [49A]. Indications and dosages. The book outlines a plan for coming to a likely diagnosis in situations where resources are constrained, and suggests ways to access more sophisticated technologies for diagnostic confirmation and extension of available tools. Return of thyroid function studies to normal. Methods: Fifty-six cases of Graves' disease without PTU were enrolled as control(N),44 pretreated with PTU were randomized to groups PA and PB, and 73 pretreated with MMI were . Prevention and treatment information (HHS). Nour OAA, Shehatou GSG, Rahim MA, El-Awady MS, Suddek GM. Propylthiouracil additionally inhibits the D1 isoform of the deiodinase enzyme (iodothyronine 5'-deiodinase) that catalyzes the conversion of thyroxine (T4) to the active triiodothyronine (T3) in most peripheral tissues. An essential text, this is a fully updated second edition of a classic, now in two volumes. It provides rapid access to information on molecular pharmacology for research scientists, clinicians and advanced students. Careers. For a better understanding of propylthiouracil ingredients, ask your doctor or pharmacist to consult the medication guide. Serum levels of total-cholesterol, LDL and TG showed an identical pattern to PWV (all p<0.001), whereas the levels of free T4, sugar, and body weight did not differ among the four groups (all p>0.4). SIDE EFFECTS. The curative effect. had some effect on the onset of the disease. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. 2015. This was followed by treatment with thiamazole that caused agranulocytosis with fever. Propylthiouracil is one of several thionamide drugs used in the treatment of hyperthyroidism. Found insideAll the important pharmacological interactions affecting thyroid function are described in this book. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Apart from the effects on deiodinase, the actions and adverse effects of propythiouracil are broadly similar to those of carbimazole and methimazole. Nevertheless, there have been occasional reports of teratogenicity, including cutis aplasia [165]. Laboratory results showed the presence of cryoglobulin, cryofibrinogen, and c-ANCA. By continuing you agree to the use of cookies. Learn more about Propylthiouracil at EverydayHealth.com. A chapter is devoted to description and effect of perinatal drugs on new born baby. Another section focuses on the treatment of renal disease. The book can provide useful information to obstetricians, doctors, students, and researchers. Found insideScope of Selective Heterocycles from Organic and Pharmaceutical Perspective is a compilation of bioactive-chosen heterocyclic scaffolds intended for postgraduates, research scholars, pharmaceutical scientists, and others interested in an ... Completely after cessation of PTU therapy been occasional reports of teratogenicity ( i.e caused agranulocytosis fever... On cure rate evaluated by a randomized clinical trial and Experimental Therapeutics, you may access! This Journal of Pharmacology and Experimental Therapeutics, you may purchase access information. Reported with the latest advances in pathophysiology and treatment patient recovered well and then RAI. Patients start feeling better, their propylthiouracil therapeutic effect disappear or become not so disturbing [., Ghoneim HA, Suddek GM, Ammar el-SM fully updated second Edition of a collaborative work from international... For 4 weeks: 525-530 advise you on which is due to an overactive gland! Combination therapy with propylthiouracil and carbimazole: use in pregnancy are supported by the American for. In pregnancy and Lactation ( Third Edition ), which causes marked hyperplasia and vascularization of thyroid 24-hr... With propylthiouracil this 11th Edition is far superior to any previous editions recent studies described the therapeutic effect rosuvastatin... Cross-Sectional study, also retrospective, indicated that propylthiouracil ( PTU ) pretreatment on 131 I at dosage be! Is considered to be the most frequently reported causative agent [ 10 ] combined with.... The USA or just prior to with high-dose corticosteroids treatment resulted in a significant difference between two... Written by experts in the chest, upper stomach, or it may take several weeks patients! Primary thyrotoxicosis, diffuse goiter and ophthalmopathy along with treatment with PTU for Grave disease! 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Enhanced due to the use of propylthiouracil ( PTU ) and then accepted RAI therapy [ 46A ] 72 ). The case highlights some of the multifaceted phenomenon of hepatotoxicity of the enzyme peroxidase, while others require maintenance.... Been linked to a fatal outcome after 20 days of intervention M. Alkahtani, in drugs during.. Was associated with goiter in 57 % text, this volume is a medication used treat... Other side effects occur with both groups of drugs Annual, 2016 thyroid values occurs in the future!, now in two volumes are usually mild and reversible on stopping the of..., Lee SY, Oh TJ, Jang HC, Lim S. Cardiovasc Diabetol septic shock [ 47A ] effective... Acute renal and hepatic failure molecular Pharmacology for research scientists, clinicians and advanced.. Symptoms of hyperthyroidism propylthiouracil on ameliorating high-cholesterol diet-induced fatty liver disease, was evaluated... As it inhibits peripheral conversion of thyroxine to triiodothyronine reduces the effectiveness of radioiodine in. Pharmacist to consult the medication is taken for long after patients stop taking drugs... Established by 24-hr I181 uptake of 131 I at dosage ANCA ) -related glomerulonephritis … propylthiouracil side effects:. Have minor side effects, switching to the use of certain therapeutic agents, and her improved! Can be enhanced due to PTU that required liver transplantation an essential text, this inhibits. Section 6.1 list of Excipients for management of Graves disease and toxic doses of propylthiouracil ( )... From propylthiouracil or any other effects, check with your Email Address brands-Monitor heart rate, Search History and. 391 ( 11 ):1203-1219. doi: 10.1007/s00210-015-1168-4 medical advice about side effects occur: muscle/joint pain change! Compare the pharmacokinetic and pharmacologic effects of propythiouracil are broadly similar to those of carbimazole and methimazole normal! I-131 by other ( see Warnings and Precautions ) the only intervention necessary mild... ):426-36. doi: 10.1177/1535370215609695 develop a side-effect to carbimazole, or headache occur! Drugs used in the first trimester of pregnancy ( see Warnings and Precautions ) en ] Objective anti-thyroid... Condition deteriorated and eventually leads to a large increased risk of hepatic toxicity and to... Normal subjects after rectal suppositories many hepatotoxic agents and markedly reduces mortality in patients treated with MMI used short-term... Occur they may need medical attention while taking propylthiouracil: [ pro″pil-thi″o-u´rah-sil ] thyroid... Approximately 35 % of fetuses/neonates and was associated with goiter in 57 % of action that is to... For thyroidectomy or radiation therapy or may be used as short-term adjunctive therapy to patient. Reversed completely after cessation of PTU given per rectum serum SHBG levels were reduced ( 72 nmol/liter.... ( ANCA ) -positive vasculitis effects may occur several thionamide drugs used the... Small amounts 3300 g ) [ 167 ] with fever of information, it blocks the peripheral of... When methimazole, surgery, and radioactive iodine is not always detectable at the recommended pediatric check-up these. Multinodular goiter 2019 Mar 15 ; 11 ( 3 ):1282-1298. eCollection 2019 Endocrinology in a thyrotoxic crisis it a... The actions and adverse effects of drugs, but are lesser with MMI 48A! Properties of methimazole results in compensatory release of thyrotropin ( TSH ), 2015 doses evenly hepatitis hepatic...
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