Generic Name: insulin-glargine, Injectable Solution

Generic Name:

insulin-glargine, Injectable Solution

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SECTION 1 of 5

Highlights for insulin-glargine

Injectable Solution
1

Insulin glargine is an injectable drug that’s used to control high blood sugar (hyperglycemia) in people with type 1 and type 2 diabetes.

2

This drug is a long-acting insulin. If you have type 1 diabetes, it must be used in combination with short- or rapid-acting insulin. If you have type 2 diabetes, you may or may not need to take another diabetes drug with it.

3

Insulin glargine is available as an injectable solution. It’s injected once per day to lower your blood sugar.

4

The main side effect is low blood sugar (hypoglycemia). Signs of low blood sugar include hunger, nervousness, shakiness, sweating, chills, clamminess, dizziness, fast heart rate, lightheadedness, sleepiness, confusion, blurred vision, headache, feeling confused or not like yourself, and irritability.

5

Testing your blood sugar as often as your doctor tells you to will let you know if you have high blood sugar. If your readings are often high, tell your healthcare provider. Your dose of Insulin glargine may need to be changed.

IMPORTANT INFORMATION

Low blood sugar

You may have mild or severe low blood sugar (hypoglycemia) while you’re taking insulin glargine. Severe low blood sugar can be dangerous. It can harm your heart or brain, and cause unconsciousness, seizures, or even be fatal. Low blood sugar can happen very quickly and come on without symptoms. It’s important to check your blood sugar as often as your doctor says to. Symptoms may include:

  • anxiety, irritability, restlessness, trouble concentrating, feeling confused or not like yourself
  • tingling in your hands, feet, lips, or tongue
  • dizziness, lightheadedness, or drowsiness
  • nightmares or trouble sleeping
  • headache
  • blurred vision
  • slurred speech
  • fast heart rate
  • sweating
  • shaking
  • unsteady walking

Heart failure

Taking diabetes pills called thiazolidinediones (TZDs) with insulin glargine may cause heart failure. Tell your healthcare provider if you have any new or worse symptoms of heart failure, including:

  • shortness of breath
  • swelling of your ankles or feet
  • sudden weight gain

Your doctor may adjust your TZD dose if you have these symptoms.

Drug Features

Insulin glargine is a prescription drug. It is available as an injectable solution. This drug is self-injectable.

If you have type 1 diabetes, insulin glargine must be used in combination with short- or rapid-acting insulin. If you have type 2 diabetes, this drug may be used alone or with other medicines.

Why It's Used

Insulin glargine is used to reduce blood sugar levels in adults and children with type 1 diabetes. It’s also used to reduce blood sugar levels in adults with type 2 diabetes.

How It Works

Insulin glargine belongs to a drug class called long-acting insulin. A class of drugs refers to medications that work similarly.

More Details

How It Works

Insulin glargine belongs to a drug class called long-acting insulin. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Insulin glargine works by controlling how sugar is used and stored in your body. It increases the amount of sugar your muscles use, helps to store sugar in fat, and stops your liver from making sugar. It also stops fat and protein from being broken down, and helps your body make protein.

If you have type 1 diabetes, your pancreas cannot make insulin. If you have type 2 diabetes, your pancreas may not make enough insulin, or your body can’t use the insulin that your body makes. Insulin glargine replaces part of the insulin your body needs.

SECTION 2 of 5

insulin-glargine Side Effects

Injectable Solution

Most Common Side Effects

The most common side effects that occur with insulin glargine include:

  • low blood sugar. Symptoms may include:

    • hunger
    • nervousness
    • shakiness
    • sweating
    • chills
    • clamminess
    • dizziness
    • fast heart rate
    • lightheadedness
    • sleepiness
    • confusion
    • blurred vision
    • headache
    • feeling confused or not like yourself, and irritability
  • unexplained weight gain

  • swelling in your arms, legs, feet, or ankles (edema)

  • reactions at injection site. Symptoms may include:

    • a small indent in your skin (lipoatrophy)
    • increase or decrease in fatty tissue under the skin from using the injection site too much
    • red, swollen, burning, or itchy skin

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • allergic reactions. Symptoms may include:

    • skin rash
    • itching or hives
    • swelling of your face, lips, or tongue
  • breathing problems

  • very low blood sugar (hypoglycemia). Symptoms may  include:

    • anxiety
    • confusion
    • dizziness
    • increased hunger
    • unusual weakness or tiredness
    • sweating
    • shakiness
    • low body temperature
    • irritability
    • headache
    • blurred vision
    • fast heart rate
    • loss of consciousness
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Insulin glargine doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

insulin-glargine May Interact with Other Medications

Injectable Solution

Insulin glargine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food Interactions

The type and amount of food you eat can affect how much insulin glargine you need. Talk to your healthcare provider if you change your diet. They may need to adjust your insulin glargine dose.

Alcohol Interaction

Alcohol may make it more difficult to control your blood sugar while you’re taking insulin glargine. Limit alcohol while taking this drug.

Medications That Might Interact with This Drug

Oral medicines for diabetes
  • pioglitazone
  • rosiglitazone

These medicines should be used with caution with insulin glargine. Using them together may increase your risk of water retention and heart problems, such as heart failure.

Injectable medicine for diabetes
  • exenatide

Taking these drugs together can increase your risk of low blood sugar. Your doctor may reduce your dose of insulin glargine.

Blood pressure and heart drugs (beta blockers)
  • acebutolol (Sectral)
  • atenolol (Tenormin)
  • bisoprolol (Zebeta)
  • esmolol (Brevibloc)
  • metoprolol (Lopressor, Toprol XL)
  • nadolol (Corgard)
  • nebivolol (Bystolic)
  • propranolol (Inderal LA)

These drugs change how your body manages blood sugar. Taking them with insulin glargine can cause high or low blood sugar. They may also mask your symptoms of low blood sugar. Your doctor will watch you closely if you take these drugs with insulin glargine.

Blood pressure drugs (angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists)

Examples are:

  • benazepril (Lotensin)
  • captopril (Capoten)
  • enalapril (Vasotec)
  • fosinopril (Monopril)
  • lisinopril (Prinivil, Zestril)
  • quinapril (Accupril)
  • ramipril (Altace)
  • candesartan (Atacand)
  • eprosartan mesylate (Teveten)
  • irbesartan (Avapro)
  • losartan potassium (Cozaar)
  • telmisartan (Micardis)
  • valsartan (Diovan)

These medicines may make you more sensitive to insulin glargine. This may raise your risk of low blood sugar. If you’re taking these drugs with insulin glargine, you should be monitored closely for blood sugar control.

Irregular heart rate medication
  • disopyramide

This drug may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

Medicine that lowers your cholesterol
  • fibrates

This drug may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

  • niacin

This drug may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Medications to treat depression
  • fluoxetine
  • monoamine oxidase inhibitors (MAOIs)

These drugs may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

Pain medications
  • propoxyphene
  • salicylates

These drugs may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

Sulfonamide antibiotics
  • sulfamethoxazole
  • mafenide

These drugs may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

Blood thinner medication
  • pentoxifylline

This drug may increase the blood sugar lowering effect of insulin glargine. This may raise your risk of low blood sugar. Your doctor may decrease your dose of insulin glargine.

Drug used to treat inflammation
  • corticosteroids 

This drug may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Medicines used to treat asthma
  • epinephrine
  • albuterol
  • terbutaline 

These drugs may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Medication used to treat infections
  • isoniazid

This drug may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Thyroid hormones

These drugs may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Female hormones

Hormones commonly used in birth control, such as:

  • estrogen
  • progestogens

These drugs may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Drugs used to treat human immunodeficiency virus (HIV)
  • protease inhibitors

These drugs may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Medicine to treat psychotic disorders
  • olanzapine
  • clozapine

These drugs may decrease the blood sugar effect of insulin glargine. This may raise your risk of high blood sugar. Your doctor may increase your insulin glargine dose if you take these medicines together.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with liver disease

Your liver may not be able to make glucose and break down insulin glargine as well as it should. Your doctor may lower your dose of this medication.

People with kidney disease

Your kidneys may not be able to break down insulin glargine as well as they should. Your doctor may lower your dose of this medication.

People with low blood sugar (hypoglycemia)

You need to use insulin glargine with caution if you get low blood sugar often. It stays in your body for a long time and it may take longer to treat low blood sugar. Your risk may be higher if you’re 65 years or older or if you don’t eat on schedule.

People with edema

Insulin glargine can cause your body to retain sodium. This can trap fluid in your body tissue, which in turn causes swelling (edema) of your hands, feet, arms, and legs. Insulin glargine can make your edema worse.

People with heart failure

Taking oral diabetes pills called thiazolidinediones (TZDs) with insulin glargine can trap fluid in the tissues of your body and cause or worsen heart failure.

Pregnant women

Insulin glargine is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. You should only use insulin glargine during pregnancy if the potential benefit justifies the potential risk to the fetus.

Women who are nursing

It isn’t known if insulin glargine passes through breast milk.

You and your doctor may need to decide if you’ll take insulin glargine or breastfeed. If you do both, your insulin glargine dose may need to be adjusted, and your blood sugar level may be closely monitored. 

For Seniors

People aged 65 years or older may be more sensitive to insulin glargine. This may raise your risk of a low blood sugar reaction. You doctor may start you on a lower dose, and increase your doses slowly.

For Children

Talk to your pediatrician regarding the use of insulin glargine in children.  Special care may be needed.

Contact with drug

Don’t share insulin glargine with others even if they have the same medical condition. It can harm them.

When to call the doctor

Tell your doctor if you’re sick, throwing up, or have changed your eating or exercise habits. Your doctor may adjust your insulin glargine dose or check you for complications of diabetes.

Tell your doctor before you start any new prescription or over-the-counter medicines, herbal products, or supplements.

Allergies

Sometimes severe, life-threatening allergic reactions can happen with insulin glargine. If you think you’re having a severe allergic reaction, seek medical help right away. Signs of insulin glargine allergy may include:

  • rash all over your body
  • shortness of breath
  • trouble breathing (wheezing)
  • fast pulse
  • sweating
  • low blood pressure
SECTION 4 of 5

How to Take insulin-glargine (Dosage)

Injectable Solution

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Improve glucose control in adults and children with type 1 diabetes
Form: Injectable solution
Strengths: 100 units per mL, in a 10-mL vial
Adult Dosage (ages 18-64 years)

You doctor will calculate your starting dose. Your dose depends on the type of diabetes you have, your weight, and if you’ve received insulin before.

If you’re changing from an intermediate- or long-acting insulin to insulin glargine, the amount and timing of your insulins and doses of anti-diabetic drugs may need to be adjusted by your doctor.

  • If you’re switching from once per day Neutral Protamine Hagedorn (NPH) insulin to once-daily insulin glargine, your starting dose of insulin glargine is the same as the dose of NPH.
  • If you’re switching from twice per day NPH insulin to once per day insulin glargine, your starting dose of insulin glargine is 80% of the total of your NPH dose. The dose is decreased to lower your chance of low blood sugar.
  • Your starting dose should be about one-third of your total daily insulin needs. You should use rapid- or short-acting insulin before meals for the rest of your insulin needs.
  • Your doctor will adjust your doses based on your blood sugar measurements.
  • Inject insulin glargine once per day and at the same time every day.
Child Dosage (ages 0-5 years)

The safety and effectiveness haven’t been established in people younger than 6 years.

Child Dosage (ages 6-17 years)

If you’re changing from an intermediate- or long-acting insulin to insulin glargine, the amount and timing of your insulins and doses of anti-diabetic drugs may need to be adjusted by your doctor.

  • If you’re switching from once per day Neutral Protamine Hagedorn (NPH) insulin to once-daily insulin glargine, your starting dose of insulin glargine is the same as the dose of NPH.
  • If you’re switching from twice per day NPH insulin to once per day insulin glargine, your starting dose of insulin glargine is 80% of the total of your NPH dose. The dose is decreased to lower your chance of low blood sugar.
  • Your starting dose should be about one-third of your total daily insulin needs. You should use rapid- or short-acting insulin before meals for the rest of your insulin needs.
  • Your doctor will adjust your doses based on your blood sugar measurements. 
  • Inject insulin glargine once per day and at the same time every day.
Senior Dosage (ages 65 years and older)
  • Insulin glargine should be used with caution if you’re over 65 years old, because it may be more difficult to spot the signs of low blood sugar. You may also be more sensitive to the effects of insulin.
  • Your doctor may start you with a lower first dose and increase your dose more slowly.
Special Considerations

Liver disease: Your liver may not be able to make glucose and break down insulin glargine as well as it should. Your doctor may lower your dose of this medication.

Kidney disease: Your kidneys may not be able to break down insulin glargine as well as they should. Your doctor may lower your dose of this medication.

Improve glucose control in adults with type 2 diabetes
Form: Injectable solution
Strengths: 100 units per mL, in a 10-mL vial
Adult Dosage (ages 18-64 years)

You doctor will calculate your starting dose. Your dose depends on the type of diabetes you have, your weight, and if you’ve received insulin before.

If you’re changing from an intermediate- or long-acting insulin to insulin glargine, the amount and timing of your insulins and doses of anti-diabetic drugs may need to be adjusted by your doctor.

  • If you’re switching from once per day Neutral Protamine Hagedorn (NPH) insulin to once-daily insulin glargine, your starting dose of insulin glargine is the same as the dose of NPH.
  • If you’re switching from twice per day NPH insulin to once per day insulin glargine, your starting dose of insulin glargine is 80% of the total of your NPH dose. The dose is decreased to lower your chance of low blood sugar.
  • If you’re not already taking insulin, the recommended starting dose is 10 units (or 0.2 units per kilogram) taken once per day.
  • Your doctor will adjust your doses based on your blood sugar measurements.
  • Inject insulin glargine once per day and at the same time every day.
Child Dosage (ages 0-17 years)

If you’re changing from an intermediate- or long-acting insulin to insulin glargine, the amount and timing of your insulins and doses of anti-diabetic drugs may need to be adjusted by your doctor.

  • If you’re switching from once per day Neutral Protamine Hagedorn (NPH) insulin to once-daily insulin glargine, your starting dose of insulin glargine is the same as the dose of NPH.
  • If you’re switching from twice per day NPH insulin to once per day insulin glargine, your starting dose of insulin glargine is 80% of the total of your NPH dose. The dose is decreased to lower your chance of low blood sugar.

The safety and effectiveness haven’t been established in people younger than 6 years.

Senior Dosage (ages 65 years and older)
  • Insulin glargine should be used with caution if you’re over 65 years old, because it may be more difficult to spot the signs of low blood sugar. You may also be more sensitive to the effects of insulin.
  • Your doctor may start you with a lower first dose and increase your dose more slowly.
Special Considerations

Liver disease: Your liver may not be able to make glucose and break down insulin glargine as well as it should. Your doctor may lower your dose of this medication.

Kidney disease: Your kidneys may not be able to break down insulin glargine as well as they should. Your doctor may lower your dose of this medication.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Insulin glargine comes with serious risks if you don’t take it as prescribed.

If You Don’t Take It at All or Skip or Miss Doses

You may have high blood sugar, which may lead to serious health effects.

If You Take Too Much

If you take too much insulin glargine, you may have mild or life-threatening low blood sugar (hypoglycemia). Carry a quick source of sugar with you in case you have symptoms of mild low blood sugar. Follow your low blood sugar treatment plan as prescribed by your doctor. Symptoms of more serious low blood sugar may include:

  • passing out
  • seizures
  • nerve problems 

Seek medical help right away if you think that you’ve taken too much insulin glargine.

What to Do If You Miss a Dose

It’s important not to miss a dose. Your healthcare provider should discuss a plan for missed doses with you. If you do miss a dose, follow that plan.

How to Tell If the Drug Is Working

You may be able to tell if this drug is working if your blood sugar level is lower.

Insulin glargine is a long-term drug treatment.

Important Considerations for Taking Insulin glargine

It is important to store insulin glargine correctly for it to work as it should

Unopened vial:

  • Store new (unopened) insulin glargine vials in the refrigerator at 36–46°F degrees F (2–8°C).
  • It can be stored in the refrigerator until the expiration date on the box or vial.
  • Don’t freeze it.
  • Keep insulin glargine out of direct heat and light.
  • If a vial has been frozen, left out at high temperatures, or is expired, throw it away even though there may be insulin left.

Open (in use) vial:

  • Once a vial is opened, you can keep it in the refrigerator or at room temperature below 86°F (30°C). But keep it away from direct heat and light.
  • An opened vial should be thrown away 28 days after the first use even if it still has insulin left.
  • Don’t leave insulin glargine in a car in hot or cold temperatures.

Travel

When traveling with your medication:

  • Always carry your medication with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you.
  • Unopened vials of this medication need to be refrigerated. Use an insulated bag with a cold pack to maintain the temperature when traveling. Opened vials can be refrigerated or kept at room temperature below 86°F (30°C). But keep them away from direct heat and light. Follow the storage instructions mentioned on the medication.
  • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.
  • Needles and syringes need to be used to take this medicine. Check for special rules about traveling with medicine, needles, and syringes.

Self-Management

Your healthcare provider will teach you how to:

  • adjust doses for activities and illness
  • check your blood sugar
  • spot and treat the symptoms of low and high blood sugar

Taking your medicine:

  • Inject insulin glargine at the same time each day. 
  • Take it exactly as your prescribed by your doctor.
  • It should never be mixed in the same syringe with other insulins before injection. 
  • Your doctor, pharmacist, nurse, or diabetes educator will show you how to withdraw insulin from the vial, attach needles, and give your insulin glargine injection. They’ll also teach you how to use this medicine and how to adjust your dose for activities and illness.
  • Always check the appearance of insulin glargine before using it. It should be clear and colorless like water. Don’t use it if it’s cloudy, thickened, colored, or has particles in it.
  • Syringes and needles are used to inject this medicine. Don’t reuse or share needles. Doing so may spread diseases.

In addition to the medication, you’ll also need:

  • needles
  • syringes
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor

Disposing of used needles:

  • Don’t throw out individual needles in trashcans or recycling bins, and never flush them down the toilet.
  • Ask your pharmacist for a safe container for disposing used needles and syringes.
  • Your community may have a program for disposing used needles and syringes.
  • If disposing the container in the trash, label it “do not recycle”.   

Clinical Monitoring

Your doctor may do blood tests before you begin and during treatment with insulin glargine to make sure it’s still safe for you to take. These include:

  • blood sugar levels
  • glycosylated hemoglobin (A1C) levels. This test measures your blood sugar control over the last 2–3 months.
  • Liver function test
  • Kidney function test
  • Blood potassium levels

Your doctor may need to adjust your dose of insulin glargine based on the following:

  • blood sugar levels
  • kidney function
  • liver function
  • other medications you’re taking
  • your exercise habits
  • your eating habits

Your doctor may also do other tests to check for complications of diabetes:

  • eye exam
  • foot exam
  • dental exam
  • tests for nerve damage
  • cholesterol levels
  • blood pressure and heart rate

Your Diet

During treatment with insulin glargine:

  • don’t skip meals
  • ask your doctor if you should avoid alcohol
  • be careful with over-the-counter (OTC) cough and cold medicines. Many OTC products contain sugar or alcohol that can affect your blood sugar.

Hidden Costs

In addition to the medicine, you’ll need to purchase:

  • needles
  • syringes
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

SECTION 5 of 5

How Much Does insulin-glargine Cost?

Injectable Solution
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Lowest price for insulin-glargine

Membership warehouse $384.59
Publix $386.04
Kroger Pharmacy $386.08
These represent the lowest cash prices for insulin-glargine and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on July 23, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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