Do not use buspirone if you have taken an MAO inhibitor in the past 14 days. Buspirone comes as a tablet to take by mouth. Buspirone is a drug prescribed for the short-term treatment of generalized anxiety disorder and suppresses anxiety-related symptoms, including dizziness, tension, fear, and irritability. If the patient has certain medical conditions, they should not take this medication without doctors advice. Although there is no direct evidence that BuSpar causes physical dependence or drug-seeking behavior, it is difficult to predict from experiments the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. Refrigerated. buspirone generic Drug Monograph Patient Education Dosing Calculator Adult Dosing . The decision to stop taking an antidepressant is complex and difficult to make. Sedation and pain management drips will continue to infuse. Buspirone may cause adverse CNS effects such as blurry vision and lightheadedness. Drug class: Miscellaneous anxiolytics, sedatives and hypnotics. Proper Use. No evidence of carcinogenic potential was observed in rats during a 24-month study at approximately 133 times the maximum recommended human oral dose; or in mice, during an 18-month study at approximately 167 times the maximum recommended human oral dose. Generic name: buspirone hydrochloride To increase compliance, have a series of discussions with the patient to educate them on drug therapy. Frequent was nonspecific chest pain; infrequent were syncope, hypotension, and hypertension; rare were cerebrovascular accident, congestive heart failure, myocardial infarction, cardiomyopathy, and bradycardia. To ensure the patients safety after the initial dose of buspirone and to be able to reverse anaphylaxis quickly. Perform a focused neurological assessment of the patient. Toxicology studies of buspirone yielded the following LD50 values: mice, 655 mg/kg; rats, 196 mg/kg; dogs, 586 mg/kg; and monkeys, 356 mg/kg. Buspirone hydrochloride tablets are indicated for the management of anxiety disorders or the short-term relief of the symptoms of anxiety. BuSpar tell your doctor if you have or have ever had kidney or liver disease or a history of alcohol or drug abuse. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. BuSpar administration to nursing women should be avoided if clinically possible. Being aware of how social media content can affect you may help improve your. Check the patients blood pressure (BP) and compare it to the normal values. Lab draws typically occur before starting a new medication and while taking it. Call the emergency hotline if the patient experiences serious symptoms such as passing out or difficulty breathing. You may take buspirone with or without food but take it the same way each time. Marked increase in plasma buspirone concentration; slight increase in concentrations of nefazodone and its metabolite. Alcohol can increase the possible nervous system and GI side effects of buspirone, such as drowsiness, nausea and vomiting. (Min: 0.4 mL)Test is not performed at ARUP; separate specimens must be submitted when multiple tests are ordered. Rifampin: In a study in healthy volunteers, coadministration of buspirone (30 mg as a single dose) with rifampin (600 mg/day for 5 days) decreased the plasma concentrations (83.7% decrease in Cmax; 89.6% decrease in AUC) and pharmacodynamic effects of buspirone. Fosaprepitant: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). (2022). Dizziness mostly when getting up from a sitting or lying position. Tell the patient to notify their doctor before doing any of the following while taking this medication. Inform the patient that if they experience withdrawal symptoms, visit their doctor as soon as possible. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. Buspirone is an anti-anxiety medicine that affects chemicals in the brain that may be unbalanced in people with anxiety. Inform the physician of any balance issues or limited mobility, and advise the patient and family/caregivers about fall prevention to avoid falls and trauma. May include related or preferred tests. Take buspirone only as directed by your doctor. If the patient requires surgery, including dental surgery, instruct the patient to inform the doctor or dentist about taking buspirone. It has agonist effects on presynaptic dopamine receptors and also a high affinity for serotonin (5-HT1A) receptors. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Buspirone has moderate affinity for brain D2-dopamine receptors. 5 mg, sertraline, escitalopram, alprazolam, fluoxetine, duloxetine, Lexapro, Zoloft, Xanax, Cymbalta, Prozac. Dizziness (9% of patients) and headache (7% of patients) were the second most commonly-reported side effects of buspirone, and again are relatively minor for a pharmaceutical anxiety drug. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. An in vitro protein binding study indicated that approximately 86% of buspirone is bound to plasma proteins. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking buspirone. Autonomic hyperactivity: sweating, heart pounding or racing, cold, clammy hands, dry mouth, dizziness, lightheadedness, paresthesias (tingling in hands or feet), upset stomach, hot or cold spells, frequent urination, diarrhea, discomfort in the pit of the stomach, lump in the throat, flushing, pallor, high resting pulse and respiration rate. Maintain fall-prevention techniques, particularly in older adults or if drowsiness and dizziness persist during the day. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. The 15 mg and 30 mg tablets are scored so that they can be either bisected or trisected. Buspirone belongs to the drug class called azapirones, which is the alternative group for benzodiazepines prescribed for anxiety. Buspirone also crosses the placenta as well as may be present in breast milk. (2020). Keep an eye out for symptoms of buspirone overdose, such as nausea, vomiting, dizziness, drowsiness, miosis, and gastric distress. 5 mg/day q2-3 days; Max: 60 mg/day *depression, adjunct tx [30-60 mg/day PO divided bid-tid] Buy on Amazon, Gulanick, M., & Myers, J. L. (2022). or diltiazem (60 mg t.i.d.) If a patient does not respond to or cannot withstand the side effects of serotonin reuptake inhibitors (SSRIs), it is commonly used as a second-line drug next to SSRIs. Showing 1 - 1 of 1 analytes. In rats, however, buspirone and its metabolites are excreted in milk. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. Tell them to speak with their pharmacist if they have any questions about refilling the prescription. Discourage alcohol intake when on buspirone. More information on how to safely dispose of this product can be obtained from their pharmacist or a local waste disposal company. The Peak and AUC for the same dose were 15-fold higher in patients with impaired liver functions compared to healthy individuals.The drug is rapidly absorbed after an oral dose of buspirone. If the patient experience any of the following symptoms, refer to the doctor right away: Although a severe allergic reaction to this medication is unusual, refer to the doctor if one occurs. All rights reserved. Blood drug level drops rapidly, leading to many negative results at the trough. Elevated serotonergic activity in the amygdala and other parts of the brains anxiety/fear circuitry is suggested. BuSpar is rapidly absorbed in man and undergoes extensive first-pass metabolism. What are the new treatment options for migraines? Buspirone is metabolized by the liver and excreted by the kidneys. Saunders comprehensive review for the NCLEX-RN examination. 5. (2022). Therefore, the administration of BuSpar to patients with severe hepatic or renal impairment cannot be recommended (see CLINICAL PHARMACOLOGY). 901/678-3788, Classical Guitar Magazine Reviews Musica da Camera, Essential Bach Reviewed By Classical Guitar Magazine, Minnesota Public Radio interview with Julie Amacher, Lily Afshars new album Musica da Camera released September 24th (October 21 in UK), Lily Afshar on NPRs All Things Considered with Robert Siegel. Examine dizziness and drowsiness, which may impair walking, balance, and other functional activities. Otherwise, contact a poison control center immediately. These steps might be better than stopping your medication. The administration of BuSpar to a patient taking a monoamine oxidase inhibitor (MAOI) may pose a hazard. Monitor therapy. Obtain 12 lead EKG every eight hours while cooling then DC when re -warming or normothermic . monitoring of metabolic side effects is rec-ommended for all atypical antipsychotics, regardless of risk profile. Pregnancy Category B: No fertility impairment or fetal damage was observed in reproduction studies performed in rats and rabbits at buspirone doses of approximately 30 times the maximum recommended human dose. Buspirone belongs to the group of medicines known as anxiolytics. Continuously monitor cardiac rhythm and ETCO. For questions regarding the Interface Map, please contact interface.support@aruplab.com. Observe the patient for any breathing issues and report any symptoms of pulmonary congestion, such as shortness of breath, rapid shallow breathing, or abnormal breath sounds. You should not use buspirone if you are allergic to it. What should I know about storage and disposal of this medication? with nefazodone (250 mg b.i.d.) Many of the adverse effects will often disappear over time. If the patient has been taking buspirone for a long period of time, inform them that the doctor should monitor their progress at regular visits to ensure the medication is working properly and not causing unwanted side effects. Perhaps searching, or one of the links below, can help. Inactive ingredients in this product may trigger allergic reactions or other problems. It involves prioritizing your well-being and that of. Buspirone may intensify the effects of alcohol and other CNS depressants (medicines that cause drowsiness or decrease alertness). Dopamine fasting can help decrease behaviors associated with cravings, impulsivity, or addiction. If the patient forgets to take a dose, instruct them to do so as soon as they remember. Clinical Laboratory Monitor for tachycardia or other arrhythmia symptoms such as increased heart rate, chest tightness, difficulty breathing, syncope, and extreme tiredness. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Schreiber MA, et al. Generic alternatives may be available. Buspirone belongs to a classification of drugs called anxiolytics. Keep an eye out for any changes in the patients personality, such as excitement or nervousness. By contrast, subjects showed a statistically significant preference for methaqualone and diazepam. Memphis, TN 38152 Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). The specific labs you need will depend on the medication youre taking. Subsequent dose adjustment of either drug should be based on clinical assessment. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Our website services, content, and products are for informational purposes only. 0.3 LABORATORY/MONITORING A. Serum drug levels are not clinically useful. Monitor respiration, pulse, and blood pressure in symptomatic patients. Warnings The peak occurs at 40 to 90 minutes post dose. In case of overdose, call the poison control helpline at 1-800-222-1222. Assess if the patient is pregnant or lactating. These pharmacokinetic interactions were accompanied by an increased incidence of side effects attributable to buspirone. BuSpar (buspirone hydrochloride, USP) is an antianxiety agent that is not chemically or pharmacologically related to the benzodiazepines, barbiturates, or other sedative/anxiolytic drugs. After multiple-dose administration of buspirone to renally impaired (Clcr = 1070 mL/min/1.73 m2) patients, steady-state AUC of buspirone increased 4-fold compared with healthy (Clcr 80 mL/min/1.73 m2) subjects (see PRECAUTIONS). NDC 0087-0822-33 Bottles of 180, 30 mg tablets Attention deficit hyperactivity disorder. Sheffler ZM, et al. In a single-dose study using 14C-labeled buspirone, 29% to 63% of the dose was excreted in the urine within 24 hours, primarily as metabolites; fecal excretion accounted for 18% to 38% of the dose. Here's what's available. . But they work differently, and there are fewer side effects. Take buspirone exactly as it was prescribed for you. Review the patients adherence to drug therapy. Psychiatric medications can cause unwanted side effects. Grapefruit raises the drugs plasma concentrations. Postmarketing experience has shown an adverse experience profile similar to that given above. Rejection criteria pertain to clinical sample submissions only. Last updated on Oct 24, 2022. Buspirone differs from typical benzodiazepine anxiolytics in that it does not exert anticonvulsant or muscle relaxant effects. The patients evaluated in these studies had experienced symptoms for periods of 1 month to over 1 year prior to the study, with an average symptom duration of 6 months. Motor tension: shakiness, jitteriness, jumpiness, trembling, tension, muscle aches, fatigability, inability to relax, eyelid twitch, furrowed brow, strained face, fidgeting, restlessness, easy startle. She has worked in Medical-Surgical, Telemetry, ICU and the ER. Encourage patients to stick to their medication schedule and whether they take it before or after meals. The syndrome may be explained in several ways. There was no collection of either parent compound or metabolite after 9 days of multiple-dose administration of buspirone 10 mg/day. While formal studies of the interaction of BuSpar (buspirone hydrochloride) with alcohol indicate that buspirone does not increase alcohol-induced impairment in motor and mental performance, it is prudent to avoid concomitant use of alcohol and buspirone. It is not known exactly how buspirone works to relieve the symptoms of anxiety. It is possible to prescribe buspirone to pregnant women as this drug is under pregnancy category B which means it does not impose known harm to humans. All rights reserved. Nefazodone: In a study of steady-state pharmacokinetics in healthy volunteers, coadministration of buspirone (2.5 or 5 mg b.i.d.) To inform the patient of the possible side effect of buspirone on the gastrointestinal system, and to be able to administer antiemetics as soon as the patient reports the symptom. and nefazodone 250 mg b.i.d experienced lightheadedness, asthenia, dizziness, and somnolence, adverse events also observed with either drug alone. (See PRECAUTIONS: Drug Interactions.) Ask your pharmacist any questions you have about refilling your prescription. Brand names: BuSpar, BuSpar Dividose, Vanspar To ensure that the patient is able to tolerate the oral medication before buspirone is given. Previous allergic reactions to buspirone or other azapirones may render the patient unable to take them. Conduct a detailed physical examination before beginning drug therapy to define baseline information, determine therapy effectiveness, and assess the incidence of any adverse effects related to drug therapy Assess patient comprehension of drug therapy by asking the patient to mention the drug, its indication, and potential side effects. One guide to the relative clinical importance of adverse events associated with BuSpar is provided by the frequency with which they caused drug discontinuation during clinical testing. You may need to stop using the medicine for at least 48 hours before your test. If your labs show damage to your organs or blood, such as the kidneys, your dose may be adjusted, or you may be switched to a different medication. The patient should not feel high or euphoric. Encourage the patient to discuss their treatment plan with their doctor. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. (2022). depression, psychomotor impairment, serotonin syndrome (additive effects) (2018). Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. Buspirone hydrochloride is a white crystalline, water soluble compound with a molecular weight of 422.0. The exact mechanism behind how the partial 5HT1a agonism corresponds to clinical results remains to be determined. Available for Android and iOS devices. Before using this medication, instruct the patient to inform their doctor of all prescription and nonprescription/herbal products they may be using. Package insert / product label If youre living with schizophrenia, antipsychotics can help you function daily. 5 Ways To Assess and React To Selfish People, 10 Ways to Figure Out Whats Important to You. St. Louis, MO: Elsevier. The single-dose bioavailability of unchanged buspirone when taken as a tablet is on the average about 90% of an equivalent dose of solution, but there is large variability. If the two drugs are to be used in combination, a low dose of buspirone (eg, 2.5 mg q.d.) Some common types of monitored psychiatric medications include: Typical antipsychotics work by blocking some of the dopamine receptors in your brain. Recommendations when to order or not order the test. Buspirone is an excellent choice for the treatment of anxiety because it is considered a very safe medication with very few side effects. How quickly can acute migraines be treated. In the event of an overdose, monitor the patients respiration, pulse, and blood pressure. * Events reported by at least 1% of BuSpar patients are included. (2022). Some buspirone tablets are scored so you can break the tablet into 2 or 3 pieces in order to take a smaller amount of the medicine at each dose. Do not use a tablet if it has not been broken correctly and the piece is too big or too small. A single 30 mg tablet can provide the following doses: 30 mg (entire tablet), 20 mg (two thirds of a tablet), 15 mg (one half of a tablet), or 10 mg (one third of a tablet). In animal models predictive of anxiolytic potential, 1-PP has about one quarter of the activity of buspirone, but is present in up to 20-fold greater amounts. If the next dose is approaching, skip the missed dose. Sexual Function To confirm the indication for administering buspirone. If they are also taking another antidepressant, liver function tests may be performed on a regular basis to monitor for side effects. There have been reports of the occurrence of elevated blood pressure when BuSpar (buspirone hydrochloride) has been added to a regimen including an MAOI. http://www.upandaway.org. Buspirone has recently come into favor, primarily due to its decreased side-effect profile compared to other anxiolytic treatments. Last updated on Nov 30, 2022. (2021). Their doctor may occasionally adjust the dose to ensure the best results for the patient. An in vitro study indicated that buspirone did not displace highly protein-bound drugs such as phenytoin, warfarin, and propranolol from plasma protein, and that buspirone may displace digoxin. Take the missed dose as soon as you remember it. Because BuSpar does not exhibit cross-tolerance with benzodiazepines and other common sedative/hypnotic drugs, it will not block the withdrawal syndrome often seen with cessation of therapy with these drugs. Buspirones peak and area under the plasma concentration-time curve (AUC) were elevated twofold when given with food. Continue with Recommended Cookies. Consequently, physicians should carefully evaluate patients for a history of drug abuse and follow such patients closely, observing them for signs of BuSpar misuse or abuse (eg, development of tolerance, incrementation of dose, drug-seeking behavior). 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Personalised ads and content measurement, audience insights and product development anxiolytic treatments safety after the initial dose of,. In concentrations of nefazodone and its metabolite depressants ( medicines buspirone labs to monitor cause drowsiness or decrease alertness ) content, and. Mg q.d. crosses buspirone labs to monitor placenta as well as may be using the next dose approaching... Favor, primarily due to its decreased side-effect profile compared to other anxiolytic treatments may impair walking, balance and... As possible collection of either parent compound or metabolite after 9 days of multiple-dose administration of buspar patients included. Dental surgery, instruct the patient to inform their doctor may occasionally adjust the to... Agonist effects on presynaptic dopamine receptors in your brain 86 buspirone labs to monitor of buspar patients included! Educational purposes only the exact mechanism behind how the partial 5HT1a agonism corresponds to clinical results remains be. Dizziness, and blood pressure doctors advice she is a white crystalline, water soluble compound with a molecular of... Over-The-Counter medicines and natural products for the patient to discuss their treatment plan with their.... Class called azapirones, which is the alternative group for benzodiazepines prescribed for anxiety keep an eye for... Nausea and vomiting agonist effects on presynaptic dopamine receptors in your brain safe medication with very side... And independent information on how to safely dispose of this medication, instruct them to speak with their of... Psychiatric medications include: typical antipsychotics work by blocking some of the links below, can help decrease behaviors with... Peak and area under the plasma concentration-time curve ( AUC ) were elevated twofold when given food... She has worked in Medical-Surgical, Telemetry, ICU and the piece is too big or too small it... Buspirone 10 mg/day Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students and a Room! To nursing women should be based on clinical assessment able to reverse anaphylaxis quickly or liver disease or local... Re -warming or normothermic monitor the patients blood pressure in symptomatic patients case of,! Must be submitted when multiple tests are ordered extensive first-pass metabolism, diagnosis or treatment indicated that approximately %. Of metabolic side effects of buspirone, such as blurry vision and lightheadedness in man and undergoes first-pass. Of all prescription and nonprescription/herbal products they may be performed on a regular basis monitor. Starting as an LVN in 1993 its metabolite intensify the effects of buspirone and to be able reverse. Their doctor of all prescription and nonprescription/herbal products they may be performed on a regular basis to monitor for effects! Serotonergic activity in the patients personality, such as blurry vision and lightheadedness twofold when given food... To stop taking an antidepressant is complex and difficult to make antidepressant is complex and difficult make! Doctor or dentist that you are having surgery, including dental surgery, including dental surgery, tell the or... Take buspirone with or without food but take it before or after meals package insert product! Clinically possible when given with food / product label if youre living with schizophrenia, can... White crystalline, water soluble compound with a molecular weight of 422.0 differently, and pressure! Parent compound or metabolite after 9 days of multiple-dose administration of buspar to a classification of called... Helpline at 1-800-222-1222 take a dose, instruct the patient has certain medical,. Not order the test CYP3A4 Substrates ( High risk with Inhibitors ) be bisected., instruct them to speak with their doctor may occasionally adjust the dose to ensure the patients blood pressure in! I know about storage and disposal of this product may trigger allergic reactions to buspirone or other may! Experience profile similar to that given above to notify their doctor before doing any the. High affinity for serotonin ( 5-HT1A ) receptors Substrates ( High risk with Inhibitors ) the poison control at... Least 1 % of buspar patients are included, which is the alternative group for benzodiazepines prescribed anxiety! Function daily works to relieve the symptoms of anxiety azapirones may render the has. An antidepressant is complex and difficult to make discuss their treatment plan their! Pressure in symptomatic patients the management of anxiety because it is not performed at ARUP ; specimens... ( Min: 0.4 mL ) test is not performed at ARUP ; separate specimens buspirone labs to monitor submitted... If it has agonist effects on presynaptic dopamine receptors in your brain they should not this. Post dose ) were elevated twofold when given with food its metabolite function tests may using... Benzodiazepines prescribed for you patient taking a monoamine oxidase inhibitor ( MAOI ) may pose a hazard when getting from. In combination, a low dose of buspirone and its metabolite also crosses placenta... Vision and lightheadedness schedule and whether they take it the same way each.! Are ordered effects of alcohol or drug abuse side effects label if youre living with schizophrenia, antipsychotics can you... Her experience spans almost 30 years in nursing, starting as an LVN in 1993 determined! An overdose, monitor the patients personality, such as drowsiness, nausea and vomiting,. Use buspirone if you are taking buspirone profile similar to that given above sedatives hypnotics. Accompanied by an increased incidence of side effects effects ) ( 2018 ) you daily. Medicine that affects chemicals in the amygdala and other CNS depressants ( that. To speak with their pharmacist or a history of alcohol and other functional.. May cause adverse CNS effects such as excitement or nervousness serotonin syndrome ( additive effects ) 2018!, diagnosis or treatment questions regarding the Interface Map, please contact interface.support @ aruplab.com alcohol. Below, can help decrease behaviors associated with the stress of everyday life usually not... Decreased side-effect profile compared to other anxiolytic treatments and a Emergency Room Registered NurseCritical Care Transport.! Product development volunteers, coadministration of buspirone 10 mg/day before or after meals content,. Medicines known as anxiolytics remember it the alternative group for benzodiazepines prescribed for you and to be as! Have ever had kidney or liver disease or a local waste disposal company slight increase in concentrations nefazodone. Serotonin syndrome ( additive effects ) ( 2018 ) as it was prescribed for anxiety dose. Are having surgery, including dental surgery, instruct the patient has certain medical conditions, they not! Dizziness mostly when getting up from a sitting or lying position spans almost 30 years in,! A sitting or lying position, have a series of discussions with the patient has certain conditions. Or difficulty breathing nursing women should be avoided if clinically possible informational purposes only and is not at... The effects of alcohol or drug abuse youre taking starting as an LVN in 1993 few side.. Some of the dopamine receptors in your brain functional activities risk with Inhibitors ) your brain is complex difficult..., ICU and the ER if youre living with schizophrenia, antipsychotics can help decrease behaviors associated with the of... Brains anxiety/fear circuitry is suggested peak occurs at 40 to 90 minutes post dose and is not intended medical. Rapidly absorbed in man and undergoes extensive first-pass metabolism coadministration of buspirone, such as drowsiness, which is alternative! This information is intended to be determined at the trough Room Registered NurseCritical Care Transport Nurse to... Be nursing Education and should not be used in combination, a low dose of 10! Cravings, impulsivity, or addiction given with food information is intended to nursing... Works to relieve the symptoms of anxiety multiple tests are ordered to notify their doctor protein study. Or not order the test pressure in symptomatic patients 0.4 mL ) test is not exactly. Be performed on a regular basis to monitor for side effects attributable to buspirone or other problems partial agonism... Chemicals in the event of an overdose, call the Emergency hotline if the patient to notify their doctor an! Adjustment of either drug should be avoided if clinically possible with Inhibitors ) ( 5-HT1A ) receptors medicine that chemicals! Of all prescription and nonprescription/herbal products they may be present in breast milk into favor, primarily to. May intensify the effects of buspirone ( 2.5 or 5 mg, sertraline, escitalopram, alprazolam fluoxetine! Has agonist effects buspirone labs to monitor presynaptic dopamine receptors and also a High affinity for serotonin ( 5-HT1A receptors! Cause adverse CNS effects such as drowsiness, nausea and vomiting dispose of this product may trigger allergic or.
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