Levofloxacin

Levofloxacin antibiotic – Uses, Side effects, dosage

Uses, Dosage, Side effects, Interaction, warning, pregnancy and breast feeding effects and more for Levofloxacin

Levofloxacin is a broad-spectrum antibiotic used to treat a variety of conditions like Bronchitis, Pneumonia, infections of the bladder, etc.

Levofloxacin is used to treat bacterial infections.

It should be avoided if you are known to be allergic to Levofloxacin or any other fluoroquinolones.

This medicine should be used with caution in the elderly population as it increases the risk of Tendinitis and Tendon rupture.

Levofloxacin oral tablet is available as both a generic and brand-name drug.

This drug also comes as an oral solution, eye drops, and an intravenous (IV) drug that is only given by a healthcare provider.


Levofloxacin Classification and General Details.

  • Category : Quinolones
  • Schedule : Schedule “H”
  • Prescription : Required
  • Legal Status : Approved
  • Available as : Tablets (250 mg, 500 mg, 750 mg) , oral solution, eye drops, and an intravenous (IV) drug
  • Brand Name : Levaquin

Description of Levofloxacin

Levofloxacin was approved for medical use in the United States in 1996.

It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system.

Levofloxacin oral tablet is a prescription drug that’s available as the brand-name drug called Levaquin.

It’s also available as a generic drug. Generic drugs usually cost less.

In some cases, they may not be available in every strength or form as the brand-name version.


Uses of Levofloxacin

Why Levofloxacin is prescribed for?

Levofloxacin is used to treat a variety of bacterial infections. This medication belongs to a class of drugs known as quinolone antibiotics. It works by stopping the growth of bacteria.

This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

Levofloxacin is used to treat bacterial infections in adults. These include:

Cystitis

Levofloxacin is used in the treatment of Cystitis which is a bladder infection caused by E.coli, Pseudomonas aeruginosa, Enterococci, and Klebsiella pneumoniae.

Pyelonephriits

Levofloxacin is used in the treatment of Pyelonephritis which is a type of kidney infection caused by E.coli, Pseudomonas aeruginosa, Enterococci, and Klebsiella pneumoniae.

Nongonococcal Urethritis

Levofloxacin is used in the treatment of Nongonococcal Urethritis which is an inflammation of urethra caused by E.coli, Pseudomonas aeruginosa, and Klebsiella.

Skin and structure Infection

Levofloxacin is used in the treatment of Skin and Structure infection like cellulitis, wound infection, and cutaneous abscess caused by Streptococcus pyogenes and Staphylococcus aureus.

Pneumonia

Levofloxacin is used in the treatment of community-acquired pneumonia which is a most common type of lung infection caused by Streptococcus pneumoniae and Haemophilus influenzae.

Bronchitis

Levofloxacin is used in the treatment of bronchitis which is an inflammation of the lungs caused by Streptococcus pneumoniae, Haemophilus influenzae, and some Mycoplasma pneumoniae.

Inhalation Anthrax

Levofloxacin is used in the treatment of anthrax which is a rare but serious bacterial illness caused by Bacillus anthracis.

Plague

Levofloxacin is used in the treatment of Plague which is a serious bacterial illness caused by Yersinia pestis.

Levofloxacin may be used as part of a combination therapy. This means you may need to take it with other medications.


How to use Levofloxacin?

Read the Medication Guide provided by your pharmacist before you start taking levofloxacin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily with or without food. Drink plenty of fluids while taking this medication unless otherwise directed by your doctor.

Take this medication at least 2 hours before or 2 hours after taking other products that may make it work less well. Examples include quinapril, sucralfate, vitamins/minerals (including iron, zinc), and products that contain magnesium, aluminum, or calcium (such as antacids, didanosine solution, calcium-enriched juice), among others. Ask your pharmacist about all the products you take.

The dosage and length of treatment are based on your medical condition and response to treatment. In children, the dosage is also based on weight.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time every day.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.


Side effects / Adverse Effects

what are the Major & minor side effects for Levofloxacin?

More common side effects

Some of the more common side effects of levofloxacin include:

  • nausea
  • headache
  • diarrhea
  • insomnia (trouble sleeping)
  • constipation
  • dizziness

Serious side effects

Allergic reaction. Symptoms can include:

  • hives
  • trouble breathing or swallowing
  • swelling of your lips, tongue, face
  • throat tightness or hoarseness
  • fast heart rate
  • fainting
  • skin rash

Central nervous system effects. Symptoms can include:

  • seizures
  • hallucinations (hearing voices, seeing things, or sensing things that aren’t there)
  • restlessness
  • anxiety
  • tremors (uncontrollable rhythmic movement in one part of your body
  • feeling anxious or nervous
  • confusion
  • depression
  • trouble sleeping
  • nightmares
  • lightheadedness
  • paranoia (feeling suspicious)
  • suicidal thoughts or acts (thoughts or behaviors of harming yourself)
  • a headache that won’t go away, with or without blurred vision

Tendon damage, including tendinitis (inflammation of the tendon) and tendon rupture (tear in the tendon). Symptoms can occur in joints such as the knee or elbow and include:

  • pain
  • reduced ability to move

Peripheral neuropathy (nerve damage in your hands, feet, arms, or legs). Symptoms typically occur in the hands and feet and can include:

  • pain
  • numbness
  • weakness

Joint and muscle pain

Liver damage, which can be fatal. Symptoms can include:

  • loss of appetite
  • nausea
  • vomiting
  • fever
  • weakness
  • tiredness
  • itching
  • yellowing of your skin and whites of your eyes
  • light-colored bowel movements
  • pain in your abdomen
  • dark-colored urine

Severe diarrhea caused by the bacteria Clostridium difficile. Symptoms can include:

  • watery and bloody stools
  • stomach cramps
  • fever

Heart rhythm problems, such as prolongation of the QT interval. Symptoms can include:

  • irregular heart rhythm
  • loss of consciousness

Increased sensitivity to the sun. Symptoms can include sunburn of the skin


When not to use?

Contraindications of Levofloxacin

Allergy

This medicine is not recommended for use if you have a known allergy to Levofloxacin or any other fluoroquinolones.

Tendinitis or tendon rupture

This medicine is not recommended for use if you have a past history of tendinitis or tendon rupture after using Levofloxacin or any other fluoroquinolones.

Myasthenia gravis

This medicine is not recommended for use if you have a past history of myasthenia gravis or family history of myasthenia gravis (weakness and rapid tiring of muscles which are under voluntary control).


What special precautions should I follow?

Before taking Levofloxacin :

Tell your doctor or pharmacist if you are allergic to it; or to other quinolone antibiotics (such as ciprofloxacin, moxifloxacin, ofloxacin); or if you have any other allergies.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, joint/tendon problems, kidney problems, mental/mood disorders, a certain muscle condition, nerve problems, seizure disorder.

This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This drug may make you dizzy or lightheaded. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely.

This medication may make you more sensitive to the sun. Limit your time in the sun.

Children may be at greater risk for joint/tendon problems while using this drug. Discuss the risks and benefits with the doctor.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk in small amounts but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.


Dosage and Administration of Levofloxacin

Dosage for pneumonia

Adult dosage (ages 18–64 years)

  • Nosocomial pneumonia: 750 mg taken every 24 hours for 7–14 days.
  • Community acquired pneumonia: 500 mg or 750 mg taken every 24 hours for 5–14 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute bacterial sinusitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 10–14 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute bacterial exacerbation of chronic bronchitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 7 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for skin and skin structure infections

Adult dosage (ages 18–64 years)

  • Complicated skin and skin structure infections (SSSI): 750 mg taken every 24 hours for 7–14 days.
  • Uncomplicated SSSI: 500 mg taken every 24 hours for 7–10 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for chronic bacterial prostatitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 28 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for urinary tract infections

Adult dosage (ages 18–64 years)

  • Complicated urinary tract infection or acute pyelonephritis: 250 mg taken every 24 hours for 10 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.
  • Uncomplicated urinary tract infection: 250 mg taken every 24 hours for 3 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute pyelonephritis

Adult dosage (ages 18–64 years)

250 mg taken every 24 hours for 10 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for inhalational anthrax, postexposure

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 60 days

Child dosage (ages 6 months–17 years)

  • Inhalational anthrax (post-exposure) in children who weigh more than 50 kg: 500 mg taken every 24 hours for 60 days
  • Inhalational anthrax (post-exposure) in children who weigh 50 kg or less: 8 mg/kg (not to exceed 250 mg per dose) taken every 12 hours for 60 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for plague

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 10–14 days

Child dosage (ages 6 months–17 years)

  • Plague in children who weigh more than 50 kg: 500 mg taken every 24 hours for 10–14 days
  • Plague in children who weigh 50 kg or less: 8 mg/kg (not to exceed 250 mg per dose) taken every 12 hours for 10–14 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Missed Dose

The missed dose should be taken as soon as possible. It is advisable to skip the missed dose if it is already the time for your next scheduled dose.

Overdose

Seek emergency medical treatment or contact the doctor in case of an overdose.


Interaction of Levofloxacin

Drug/Food interactions may change how your medications work or increase your risk for serious side effects. 

Levofloxacin may interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.

Interaction with Alcohol : MODERATE

Do not advised to consume alcohol when you use Levofloxacin, though there is a no significance proof of interaction with alcohol but it well known that this drug may make you dizzy or lightheaded.

so with alcohol, it will make you more dizzy.

Interaction with Medicine

  • Escitalopram : SEVERE
  • Ethinyl Estradiol : MODERATE
  • Corticosteroids : SEVERE
  • Quinidine : SEVERE
  • Aspirin : MODERATE
  • Antidiabetic drugs : MODERATE

Levofloxacin and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of Levofloxacin into the bloodstream and reduce its effectiveness.

Disease interactions

Central nervous system disorders : SEVERE

This medicine should be used with extreme caution in patients with a history of seizure disorder and other central nervous system abnormalities.

Report any incidence of tremors, restlessness, anxiety, confusion, hallucinations, etc., to the doctor on priority.

It is advisable to avoid using caffeine-containing products while on therapy with fluoroquinolones.

Colitis  : SEVERE

This medicine should be used with extreme caution in patients having a history of gastrointestinal diseases, particularly colitis.

Inform your doctor if you have any history of gastrointestinal diseases. Report any incidence of severe diarrhoea, abdominal pain, and blood in stools to the doctor immediately.

QT Prolongation  : SEVERE

This medicine should be used with extreme caution in patients with a history of heart diseases and electrolyte disturbances, especially elderly patients.

Report any incidence of discomfort in the chest, heart palpitations, etc., to the doctor on priority. Regular cardiac function tests are to be performed if you have any heart disease (arrhythmia) or family history of heart disease.

Food interactions

Levofloxacin oral tablets may be taken without regard to food. It is important to tell your doctor about all other medications you use, including vitamins and herbs.


Levofloxacin During Pregnancy

This medicine is generally not recommended for use in pregnant women unless absolutely necessary and only under the supervision of a doctor.


Levofloxacin During Breast Feeding

This medicine is not recommended for use in breastfeeding women unless absolutely necessary since it may affect the development of the infant’s joints.

Use only if clearly needed and only under the supervision of a doctor.

Close monitoring of the infant for any undesired effects like diarrhoea, diaper rash, etc., is necessary for such cases.

Avoid breastfeeding for 4 to 6 hours after a dose to decrease the exposure of the infant to the levofloxacin in breast milk.


General warnings

Tendinitis and Tendon ruputure

Use of Levofloxacin will increase the risk to develop tendinitis or tendon rupture during the treatment or several months after treatment. This may affect your shoulders, hands, ankles, or other parts of your body. You are at a higher risk if you are more than 60 years of age or if you have undergone a transplant of kidney, heart, or lung. You are also at a higher risk if you are on corticosteroids like dexamethasone, methylprednisolone, or prednisone.

Liver damage warning

This drug may cause liver damage. Call your doctor right away if you have any signs of liver problems. Symptoms include nausea or vomiting, stomach pain, fever, weakness and, abdominal pain or tenderness.

Drug-resistance

Usage of Levofloxacin without sufficient proof or suspicion of a bacterial infection should be avoided. Irrational dosing might fail in providing the benefits and even cause toxicity. It may also increase the risk of development of bacteria that are drug resistant.

Suicidal thoughts and behaviors warning

This drug can cause suicidal thoughts or behaviors. Your risk is greater if you have a history of depression.

Alternative treatment

Levofloxacin can be used to treat acute bacterial exacerbation of chronic bronchitis or uncomplicated cystitis, but only as a last resort. This drug should be used only if you have no alternative treatment options for the above-mentioned conditions.

Allergy warning

Levofloxacin can cause a severe allergic reaction, even after only one dose. Symptoms can include:

  • hives
  • trouble breathing or swallowing
  • swelling of your lips, tongue, face
  • throat tightness or hoarseness
  • fast heart rate
  • fainting
  • skin rash

How Levofloxacin works?

Levofloxacin is an antibiotic. It works by preventing the bacterial cells from dividing and repairing, thereby killing the bacteria.


Expert Advice for Levofloxacin

Your doctor has prescribed Levofloxacin to cure your infection and improve symptoms.

Do not skip any doses and finish the full course of treatment even if you feel better.

Discontinue Levofloxacin and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.

Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it doesn’t stop or if you find blood in your stools.

Notify your doctor if you feel pain in your tendons, numbness, or tingling sensations.

Inform your doctor if you are pregnant or planning to conceive or breastfeeding.


Other Important Details

Onset of action

The peak effect of this medicine can be observed within 1 to 2 hours of administration of the dose.

Duration of effect

The effect of this medicine lasts for an average duration of 24 to 32 hours.

Is it habit forming?

No habit forming tendency has been reported.

storage and disposal

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.


Commonly Asked Questions / FAQs

What is Levofloxacin?

Levofloxacin is a quinolone antibiotic. It works by killing the bacteria that cause infections in your body. It can be used to treat infections of the sinuses, lungs, urinary tract, including your kidneys or bladder, prostate gland and skin and soft tissue.

Can I take Levofloxacin with prednisone?

Levofloxacin and prednisone when taken together may increase the risk of tendon rupture (a tendon is a cord that joins your muscle to your bones). If you experience pain and inflammation in your tendons or ligaments, which could lead to rupture, stop taking Levofloxacin immediately and talk to your doctor. Always consult your doctor before taking the two medicines together.

Is Levofloxacin a narcotic substance?

No, Levofloxacin is not a narcotic substance. It is a quinolone antibiotic.

Can I take Levofloxacin with loratadine?

Levofloxacin can be taken with loratadine. No drug-drug interactions have been seen between the two. However, interactions can occur. Please consult your doctor before taking the two medicines together.

Can I take Levofloxacin with esomeprazole?

Levofloxacin can be taken with esomeprazole. No drug-drug interactions have been seen between the two. However, interactions can occur. Please consult your doctor before taking the two medicines together.

Does Levofloxacin affect birth control?

Levofloxacin can be taken with birth control pills (oral contraceptive pills). No drug-drug interactions have been reported between them. However, interactions can occur. Talk to a doctor to confirm whether you need to use extra precaution while taking Levofloxacin with birth control pills.

Can I take Levofloxacin for a tooth infection?

Levofloxacin is not used to treat tooth infection. If you think you have a tooth infection, talk to a doctor and start antibiotics only as advised, do not start antibiotics on your own.

Can I take Levofloxacin for streptococcal throat infection?

Levofloxacin is active against streptococcus bacteria and can be used for the treatment of a streptococcal sore throat. If you think you have a sore throat infection, talk to a doctor and start antibiotics only as advised, do not start antibiotics on your own.

Is Levofloxacin same as ciprofloxacin?

Levofloxacin and ciprofloxacin are two different antibiotics, however, they belong to the same class of quinolone antibiotics. Levofloxacin is as effective as ciprofloxacin for treating complicated urinary tract infections. In men with chronic bacterial prostatitis treated for 28 days, oral Levofloxacin 500mg once daily achieved similar clinical and bacteriological response rates to oral ciprofloxacin 500mg twice daily. Levofloxacin is more active against Gram-positive organisms than ciprofloxacin. Ciprofloxacin is an economical alternative and Levofloxacin is active against many bacteria but can cause damage to your tendons. So, it is advisable that you must talk to a doctor for the right choice of antibiotics for your infections.

Can I take Levofloxacin for tonsillitis?

Levofloxacin is not indicated for the treatment of tonsillitis. If you think you have tonsillitis, talk to a doctor and start antibiotics only as advised, do not start antibiotics on your own.

Can I take Levofloxacin with guaifenesin?

Levofloxacin can be taken with guaifenesin. No drug-drug interactions have been seen between the two. However, interactions can occur. Please consult your doctor before taking the two medicines together.

Can I take Levofloxacin with paracetamol?

Levofloxacin can be taken with paracetamol. No drug-drug interactions have been seen between the two. However, interactions can occur. Please consult your doctor before taking the two medicines together.

Does Levofloxacin contain sulfa?

Levofloxacin does not contain sulfa. It belongs to a group of medicines called quinolone antibiotics.

Does Levofloxacin cover methicillin resistant Staphylococcus aureus (MRSA)?

Levofloxacin does not cover methicillin-resistant staphylococcus aureus (MRSA). Also, MRSA is very likely to have co-resistance to quinolones, including Levofloxacin.

Does Levofloxacin expire?

Yes, like any other medicine, Levofloxacin has an expiry date. Please check the expiry date mentioned on the pack before taking the medicine.

Does Levofloxacin treat bacterial vaginosis?

Levofloxacin is not used to treat bacterial vaginosis. If you think you have bacterial vaginosis, talk to a doctor and start antibiotics only as advised, do not start antibiotics on your own.

Does Levofloxacin cause dry mouth?

Levofloxacin does not cause dry mouth. Talk to your doctor if you experience dry mouth while taking Levofloxacin as it could be due to some other underlying condition.

Is Levofloxacin safe to use?

Levofloxacin is safe if used at prescribed doses for the prescribed duration as advised by the doctor.

Is Levofloxacin penicillin?

Levofloxacin is not a penicillin. It belongs to a group of medicines called quinolone antibiotics.

Is Levofloxacin a steroid?

Levofloxacin is not a steroid. It belongs to a group of medicines called quinolone antibiotics.

Is Levofloxacin a quinolone?

Yes, Levofloxacin belongs to a group of medicines called quinolone antibiotics.
Disclaimer :  This information is to supplement, not substitute to the judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet or commencing or discontinuing any course of treatment.

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