Viagra Uses

What is Viagra?buy generic viagra online

What is Viagra – Viagra is used to treat men who have erectile dysfunction (also called sexual impotence). Viagra belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

Erectile dysfunction is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. When a man is sexually stimulated, his body’s normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, Viagra helps to maintain an erection after the penis is stroked. Without physical action to the penis, such as that occurring during sexual intercourse, Viagra will not work to cause an erection.

Viagra is also used in both men and women to treat the symptoms of pulmonary arterial hypertension. This is a type of high blood pressure that occurs between the heart and the lungs. When hypertension occurs in the lungs, the heart must work harder to pump enough blood through the lungs. Viagra works on the PDE5 enzyme in the lungs to relax the blood vessels. This will increase the supply of blood to the lungs and reduce the workload of the heart. Read more about Viagra meaning

Viagra is available only with your doctor’s prescription.

Viagra indications

An indication is a term used for the list of conditions or symptoms or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

Viagra is indicated for the treatment of pulmonary arterial hypertension (WHO Group I) in adults to improve exercise ability and delay clinical worsening. The delay in clinical worsening was demonstrated when Viagra was added to background epoprostenol therapy.

Studies establishing effectiveness were short-term (12 to 16 weeks), and included predominately patients with New York Heart Association (NYHA) Functional Class II-III symptoms and idiopathic etiology (71%) or associated with connective tissue disease (CTD) (25%).

Limitation of Use: Adding Viagra to bosentan therapy does not result in any beneficial effect on exercise capacity.

How should I use Viagra?

How to use viagra – Use Viagra suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet with detailed instructions for use is available with Viagra suspension. Talk to your pharmacist if you have questions about this information.
  • Take Viagra suspension by mouth with or without food. Take your doses 4 to 6 hours apart unless your doctor tells you otherwise.
  • Shake well for at least 10 seconds before each use.
  • Use the oral dosing syringe that comes with Viagra suspension to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • Do not mix Viagra suspension with other medicine or flavoring.
  • Wash and dry the dosing syringe after each use.
  • Take Viagra suspension on a regular schedule to get the most benefit from it. Take it at the same time each day.
  • Continue to take Viagra suspension even if you feel well. Do not miss any doses.
  • Do not suddenly stop taking Viagra suspension or change your dose without talking to your doctor.
  • If you miss a dose of Viagra suspension, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
  • How to use viagra for the first time

Ask your health care provider any questions you may have about how to use Viagra suspension.

Uses of Viagra in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in viagra tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after a few days, some drugs need to be continued for a prolonged period to get the benefit from it.

Viagra (viagra for men) is used to treat men with the inability to achieve and maintain penile erection sufficient for satisfactory sexual performance, and for the treatment of increased pressure in the blood vessels of lung (pulmonary arterial hypertension).

Viagra description

Each film-coated tablet contains Sildenafil equivalent to 50 mg Viagra.

Each film-coated tablet contains Sildenafil equivalent to 100 mg Viagra.

Each orodispersible tablet contains Sildenafil equivalent to 50 mg Viagra.

Excipients/Inactive Ingredients: Film-Coated Tablets: In addition to the active ingredient, Viagra, each tablet contains the following inactive ingredients: Microcrystalline cellulose, calcium hydrogen phosphate (anhydrous), croscarmellose sodium, magnesium stearate, hydroxypropyl methylcellulose (hypromellose), titanium dioxide (E171), lactose, triacetin, and FD & C Blue #2 aluminum lake

Orodispersible Tablets: In addition to the active ingredient, Viagra, each orodispersible tablet contains the following inactive ingredients: Microcrystalline cellulose, silica hydrophobic colloidal, croscarmellose sodium, magnesium stearate, indigo carmine aluminum lake (E132), sucralose, mannitol, crospovidone, polyvinyl acetate, povidone, flavoring (contains: Maltodextrin and dextrin), natural flavoring (contains: Maltodextrin, E422 glycerol and E1520 propylene glycol), lemon flavoring (contains: Maltodextrin and E307 alpha-tocopherol).

Viagra dosage

Viagra Tablets And

Oral Suspension

The recommended dose of Viagra is 5 mg or 20 mg three times a day. Administer Viagra doses 4-6 hours apart.

In the clinical trial no greater efficacy was achieved with the use of higher doses. Treatment with doses higher than 20 mg three times a day is not recommended.

Viagra Injection

Viagra injection is for the continued treatment of patients with PAH who are currently prescribed oral Viagra and who are temporarily unable to take oral medication.

The recommended dose is 2.5 mg or 10 mg administered as an intravenous bolus injection three times a day. The dose of Viagra injection does not need to be adjusted for body weight.

A 10 mg dose of Viagra injection is predicted to provide a pharmacological effect of Viagra and its N-desmethyl metabolite equivalent to that of a 20 mg oral dose.

Reconstitution Of The Powder For

Oral Suspension

  1. Tap the bottle to release the powder.
  2. Remove the cap.
  3. Accurately measure out 60 mL of water and pour the water into the bottle. (Figure 1)
  4. Replace the cap and shake the bottle vigorously for a minimum of 30 seconds. (Figure 2)
  5. Remove the cap.
  6. Accurately measure out another 30 mL of water and add this to the bottle. You should always add a total of 90 mL of water irrespective of the dose prescribed. (Figure 3)
  7. Replace the cap and shake the bottle vigorously for a minimum of 30 seconds. (Figure 4)
  8. Remove the cap.
  9. Press the bottle adaptor into the neck of the bottle (as shown in Figure 5, below). The adaptor is provided so that you can fill the oral syringe with medicine from the bottle. Replace the cap on the bottle.
  10. Write the expiration date of the constituted oral suspension on the bottle label (the expiration date of the constituted oral suspension is 60 days from the date of the constitution).
Incompatibilities

Do not mix with any other medication or additional flavoring agent.

How supplied

Dosage Forms And Strengths

Viagra Tablets

White, film-coated, round tablets engraved with “RVT20” containing Viagra equivalent to 20 mg of Viagra.

Viagra Injection

A single-use vial containing 10 mg/12.5 mL of Viagra.

Viagra for

Oral Suspension

White to off-white powders containing 1.57 g of Viagra (equivalent to 1.12 g of Viagra) in a bottle intended for the constitution. The following constitution with 90 mL of water, the volume of the oral suspension is 112 mL and the oral suspension contains 10 mg/mL Viagra. A 2 mL oral syringe (with 0.5 mL and 2 mL dose markings) and a press-in bottle adaptor are also provided.

Storage And Handling

Viagra tablets are supplied as white, film-coated, round tablets containing Viagra equivalent to the nominally indicated amount of Viagra as follows:

Viagra Tablets
Package ConfigurationStrengthNDCEngraving on Tablet
Bottle of 90 Tablets20 mg0069-4190-68RVT20

Recommended Storage for Viagra Tablets: Store at controlled room temperature 20°C – 25°C (68°F – 77°F); excursions permitted to 15°C – 30°C (59°F -86°F).

Viagra injection is supplied as a clear, colorless, sterile, ready to use solution containing 10 mg Viagra/12.5 mL presented in a single-use glass vial.

Viagra Injection
Package ConfigurationStrengthNDC
Vial individually packaged in a carton10 mg /12.5 mL0069-0338-01

Recommended Storage for Viagra Injection: Store at controlled room temperature 20°C – 25°C (68°F -77°F); excursions permitted to 15°C – 30°C (59°F – 86°F).

Viagra powder for oral suspension is supplied in amber glass bottles. Each bottle contains white to off-white powders containing 1.57 g of Viagra (equivalent to 1.12 g Viagra). Following the constitution, the volume of the oral suspension is 112 mL (10 mg Viagra/mL). A 2 mL oral dosing syringe (with 0.5 mL and 2 mL dose markings) and a press-in bottle adaptor are also provided.

Viagra Powder for Oral Suspension
Package ConfigurationStrengthNDC
Powder for oral suspension – bottle10 mg/mL (when reconstituted)0069-0336-21

Recommended storage for Viagra for oral suspension: Store below 30°C (86°F) in the original package in order to protect from moisture.

Constituted

Oral Suspension

Store below 30°C (86°F) or in the refrigerator at 2°C to 8°C (36° F – 46°F). Do not freeze. The shelf-life of the constituted oral suspension is 60 days. Any remaining oral suspension should be discarded 60 days after the constitution.

Distributed by: Pfizer Labs, Division of Pfizer Inc., NY, NY 10017. Revised: Apr 2015

Viagra interactions

Effects of Other Drugs on Viagra Viagra Citrate

In Vitro Studies: Viagra Viagra metabolism is principally mediated by the cytochrome P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route). Therefore, inhibitors of these isoenzymes may reduce Viagra clearance.

In Vivo Studies: Cimetidine (800 mg), a nonspecific CYP inhibitor, caused a 56% increase in plasma Viagra concentrations when coadministered with Viagra (50 mg) to healthy volunteers.

When a single 100 mg dose of Viagra was administered with erythromycin, a specific CYP3A4 inhibitor, at steady state (500 mg bid for 5 days), there was a 182% increase in Viagra systemic exposure (AUC). In addition, coadministration of the HIV protease inhibitor saquinavir, also a CYP3A4 inhibitor, at steady state (1200 mg tid) with Viagra (100 mg single dose) resulted in a 140% increase in Viagra Cmax and a 210% increase in Viagra AUC. Viagra citrate had no effect on saquinavir pharmacokinetics. Stronger CYP3A4 inhibitors such as ketoconazole or itraconazole would be expected to have still greater effects, and population data from patients in clinical trials did indicate a reduction in Viagra clearance when it was coadministered with CYP3A4 inhibitors (such as ketoconazole, erythromycin, or cimetidine).

Coadministration with the HIV protease inhibitor ritonavir, which is a highly potent P450 inhibitor, at steady state (400 mg bid) with Viagra (100 mg single dose) resulted in a 300% (4-fold) increase in Viagra Cmax and a 1000% (11-fold) increase in Viagra plasma AUC. At 24 hours the plasma levels of Viagra were still approximately 200 ng/mL, compared to approximately 5 ng/mL when Viagra was dosed alone. This is consistent with ritonavir’s marked effects on a broad range of P450 substrates. Viagra citrate had no effect on ritonavir pharmacokinetics.

It can be expected that the concomitant administration of CYP3A4 inducers, such as rifampin, will decrease plasma levels of Viagra.

Single doses of antacid (magnesium hydroxide/aluminum hydroxide) did not affect the bioavailability of Viagra.

Pharmacokinetic data from patients in clinical trials showed no effect on Viagra pharmacokinetics of CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers. The AUC of the active metabolite, N-desmethyl Viagra, was increased 62% by loop and potassium-sparing diuretics and 102% by nonspecific beta-blockers. These effects on the metabolite are not expected to be of clinical consequence.

Effects of Viagra Viagra Citrate on Other Drugs

In Vitro Studies: Viagra Viagra is a weak inhibitor of the cytochrome P450 isoforms 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 (IC50 >150 mM). Given Viagra peak plasma concentrations of approximately 1 mcM after recommended doses, it is unlikely that Viagra will alter the clearance of substrates of these isoenzymes.

In Vivo Studies: When Viagra 100 mg oral was coadministered with amlodipine, 5 mg or 10 mg oral, to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic.

No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by CYP2C9.

Viagra citrate (50 mg) did not potentiate the increase in bleeding time caused by aspirin (150 mg).

Viagra citrate (50 mg) did not potentiate the hypotensive effect of alcohol in healthy volunteers with mean maximum blood alcohol levels of 0.08%.

Viagra (100 mg) did not affect the steady-state pharmacokinetics of the HIV protease inhibitors, saquinavir, and ritonavir, both of which are CYP3A4 substrates.

Viagra side effects

The following serious adverse events are discussed elsewhere in the labeling:

  • Mortality with pediatric use
  • Hypotension
  • Vision loss
  • Hearing loss
  • Priapism
  • Vaso-occlusive crisis

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Safety data of Viagra in adults were obtained from the 12-week, placebo-controlled clinical study (Study 1) and an open-label extension study in 277 Viagra-treated patients with PAH, WHO Group I.

The overall frequency of discontinuation in Viagra-treated patients on 20 mg three times a day was 3% and was the same for the placebo group.

In Study 1, the adverse reactions that were reported by at least 3% of Viagra-treated patients (20 mg three times a day) and were more frequent in Viagra-treated patients than in placebo-treated patients are shown in Table 1. Adverse reactions were generally transient and mild to moderate in nature.

Table 1: Most Common Adverse Reactions in Patients with PAH in Study 1 (More Frequent in Viagra-Treated Patients than Placebo-Treated Patients and Incidence ≥ 3% in Viagra-Treated Patients)

 Placebo, %(n = 70)Viagra 20 mg three times a day, % (n = 69)Placebo-Subtracted, %
Epistaxis198
Headache39467
Dyspepsia7136
Flushing4106
Insomnia176
Erythema165
Dyspnea exacerbated374
Rhinitis044
Diarrhea693
Myalgia473
Pyrexia363
Gastritis033
Sinusitis033
Paresthesia033

At doses higher than the recommended 20 mg three times a day, there was a greater incidence of some adverse reactions including flushing, diarrhea, myalgia, and visual disturbances. Visual disturbances were identified as mild and transient and were predominately color-tinge to vision, but also increased sensitivity to light or blurred vision.

The incidence of retinal hemorrhage with Viagra 20 mg three times a day was 1.4% versus 0% placebo and for all Viagra doses studied was 1.9% versus 0% placebo. The incidence of eye hemorrhage at both 20 mg three times a day and at all doses studied was 1.4% for Viagra versus 1.4% for placebo. The patients experiencing these reactions had risk factors for hemorrhage including concurrent anticoagulant therapy.

In a placebo-controlled fixed-dose titration study (Study 2) of Viagra (starting with recommended dose of 20 mg and increased to 40 mg and then 80 mg all three times a day) as an adjunct to intravenous epoprostenol in patients with PAH, the adverse reactions that were more frequent in the Viagra + epoprostenol group than in the epoprostenol group (greater than 6% difference) are shown in Table 2.

Table 2: Adverse Reactions (%) in patients with PAH in Study 2 (incidence in Viagra + Epoprostenol group at least 6% greater than Epoprostenol group)

 Viagra + Epoprostenol (n = 134)Epoprostenol (n = 131)(Viagra + Epoprostenol) minus Epoprostenol
Headache573423
Edema^251314
Dyspepsia16214
Pain in extremity17611
Diarrhea25187
Nausea25187
Nasal congestion927
^includes peripheral edema
Viagra Injection

Viagra injection was studied in a 66-patient, placebo-controlled study in patients with PAH at doses targeting plasma concentrations between 10 and 500 ng/mL (up to 8 times the exposure of the recommended dose). Adverse events with Viagra injection were similar to those seen with oral tablets.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Viagra (marketed for both PAH and erectile dysfunction). Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cardiovascular Events

In postmarketing experience with Viagra at doses indicated for erectile dysfunction, serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, pulmonary hemorrhage, and subarachnoid and intracerebral hemorrhages have been reported in temporal association with the use of the drug. Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra without sexual activity. Others were reported to have occurred hours to days after use concurrent with sexual activity. It is not possible to determine whether these events are related directly to Viagra, to sexual activity, to the patient’s underlying cardiovascular disease, or to a combination of these or other factors.

Nervous system

Seizure, seizure recurrence

Viagra contraindications

See also:
What is the most important information I should know about Viagra?

What does viagra do?

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking Viagra with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Viagra.

Do not take Viagra more than once a day. Allow 24 hours to pass between doses. Do not take Viagra while also taking Viagra, unless your doctor tells you to.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking Viagra, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old. It is not clear whether Viagra is the actual cause of vision loss.

Stop using Viagra and get emergency medical help if you have sudden vision loss.

Active ingredient matches for Viagra:

Sildenafil in Argentina, Australia, Austria, Belgium, Benin, Bosnia & Herzegowina, Brazil, Burkina Faso, Cameroon, Canada, Chile, China, Colombia, Congo, Costa Rica, Cote D’Ivoire, Croatia (Hrvatska), Czech Republic, Denmark, Ecuador, El Salvador, Finland, France, Gabon, Georgia, Germany, Guatemala, Guinea, Honduras, Hong Kong, Hungary, Iceland, India, Indonesia, Ireland, Israel, Italy, Japan, Luxembourg, Malaysia, Mali, Mauritius, Mexico, Myanmar, Netherlands, New Zealand, Nicaragua, Norway, Oman, Panama, Peru, Philippines, Poland, Portugal, Romania, Russian Federation, Senegal, Serbia, Singapore, Slovakia, Slovenia, South Africa, Spain, Sri Lanka, Sweden, Switzerland, Taiwan, Thailand, Togo, Turkey, United Kingdom, United States, Venezuela, Vietnam, Zaire.

Sibutramine

Sildenafil citrate in United States, United Kingdom, Denmark, Australia, Belgium, Hong Kong, Mexico, South Africa, France, Israel, Austria, Norway, Italy, Thailand, Singapore, Finland, Switzerland, Canada, Sweden, Germany, New Zealand, Portugal, Spain, Ireland, Brazil, Japan, Malaysia, Greece, Chile, Hungary, Czech Republic, Russia, Argentina, Venezuela, Netherlands, Turkey, India, Poland, Philippines, Indonesia, Romania.

Unit description / dosage (Manufacturer)Price, USD viagra price

Tablet, Film-Coated; Oral; Sildenafil Citrate 100 mg Tablet, Film-Coated; Oral; Sildenafil Citrate 25 mg Tablet, Film-Coated; Oral; Sildenafil Citrate 50 mg Tablet; Oral; Sildenafil Citrate 100 mg Tablet; Oral; Sildenafil Citrate 25 mg Tablet; Oral; Sildenafil Citrate 50 mg Viagra 25 mg Tab Viagra 50 mg Tab$ 7.69 Viagra 100 mg Tab$ 9.87 Viagra 50 mg x 4’s$ 55.19 Viagra 100 mg x 4’s$ 70.93 100 tablet in 1 bottle 30 tablet in 1 bottle Viagra 50 mg x 4 Tablet Viagra 100 mg x 4 Tablet Viagra 25 mg x 4’s$ 41.20 Viagra 50 mg x 1’s Viagra 100 mg x 1’s 25 mg 50 mg$ 7.69 100 mg x 1’s$ 9.87 Tablets, Film-Coated; Oral; Sildenafil Citrate 100 mg Tablets, Film-Coated; Oral; Sildenafil Citrate 25 mg Tablets, Film-Coated; Oral; Sildenafil Citrate 50 mg Tablets; Oral; Sildenafil Citrate 100 mg Tablets; Oral; Sildenafil Citrate 25 mg Tablets; Oral; Sildenafil Citrate 50 mg Viagra 100 mg Tablet$ 9.87 Viagra 50 mg Tablet$ 7.69 VIAGRA 100 MG TABLET 1 strip / 1 tablet each (Pfizer Ltd)$ 9.87 VIAGRA 50 MG TABLET 1 strip / 1 tablet each (Pfizer Ltd)$ 7.69 Viagra FC tab 100 mg 4’s (Pfizer) Viagra FC tab 50 mg 4’s (Pfizer) Viagra orodispersible tab 50 mg 4’s (Pfizer) Viagra tab 100 mg 4’s (Pfizer)$ 78.25 Viagra tab 50 mg 4’s (Pfizer)$ 60.88 VIAGRA tab 25 mg x 1’s (Pfizer) VIAGRA tab 50 mg x 1’s (Pfizer)$ 7.69 VIAGRA tab 100 mg x 1’s (Pfizer)$ 9.87 Viagra tab 25 mg 4’s (Pfizer)$ 45.45 Viagra tablet, film coated 50 mg/1 (Rebel Distributors Corp (US)) Viagra tablet, film coated 100 mg/1 (U.S. Pharmaceuticals (US)) Viagra Film-coated tablet 50 mg (Pfizer Limited (EU)) Viagra Orodispersible tablet 50 mg (Pfizer Limited (EU)) Viagra tablet, film coated 25 mg/1 (Aphena Pharma Solutions Tennessee, Llc (US)) Viagra Film-coated tablet 100 mg (Pfizer Limited (EU)) Viagra Film-coated tablet 25 mg (Pfizer Limited (EU)) Viagra tablet 25 mg (Pfizer Canada Inc (Canada)) Viagra tablet 50 mg (Pfizer Canada Inc (Canada)) Viagra tablet 100 mg (Pfizer Canada Inc (Canada)) Viagra 100mg Tablet (Pfizer Ltd)$ 8.37 Viagra 50mg Tablet (Pfizer Ltd)$ 6.52

List of Viagra substitutes (brand and generic names):

 

See substitutes for Viagra

 

References

  1. DailyMed. “SIBUTRAMINE HYDROCHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).”. https://dailymed.nlm.nih.gov/dailyme… (accessed September 17, 2018).
  2. PubChem. “sildenafil”. https://pubchem.ncbi.nlm.nih.gov/com… (accessed September 17, 2018).
  3. PubChem. “sibutramine”. https://pubchem.ncbi.nlm.nih.gov/com… (accessed September 17, 2018).

 

 

 

 

 

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