should i stop vascepa before surgery

But since it changes the way blood clots, it can increase the risk of bleeding during surgery. Some supplements, such as feverfew, ginkgo, garlic, ginseng, and Dong Quai can also increase a persons bleeding risk. For patients and practitioners thinking about omega-3 supplementation, however, it is crucial to consider the dose and quality of the oil. raise your risk of heart problems, including heart attack. The U.S. Food and Drug Administration today approved the use of Vascepa (icosapent ethyl) as an adjunctive (secondary) therapy to reduce the risk of cardiovascular events among adults with. 0. These patients took fish oil supplements at doses ranging from 1.6 to 21g of EPA/DHA per day. But if they become bothersome, talk with your doctor or pharmacist. New studies, however, have extensively documented that taking omega-3 supplements before operations not only appears to be safe, but may even be highly beneficial. gout *. recent, Minor procedures: Dental, dermatologic and, Restart 12 hours after procedure or per surgeons discretion, Consider doubling days of cessation prior to surgeries with high risk of bleeding, Restart 24 hours after surgery (72 hours after surgery if high bleeding risk), Stop at least 1-2 days before procedure (longer if, Ideal to stop at least 1 month before surgery, Stop at least 1 week before procedures at high risk for, Hold for NPO period as well as the AM of surgery, Hold for 3 days prior to surgery (risk of, Resume when oral intake returns to normal, Hold at least 24 hours prior to surgery (due to theoretical, Avoiding within 11 hours, reduces risk of immediate post-induction, Ophthalmologists can take preventive measures at surgery if they know of, As a long-acting medication, stopping the medication immediately before the procedure will not alter the risk, Stay moving in the post-operative period (within 2-3 days of procedure - incorporate PT/OT), Stop at time of surgery due to instructions that are difficult to follow perioperatively (e.g. Keep in mind that side effects of a drug can depend on: Your doctor or pharmacist can tell you more about the potential side effects of Vascepa. Non-steroidal anti-inflammatory (NSAIDs) such as: Aspirin, including Baby Aspirin, when taken as a preventative, and not prescribed by your doctor. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Vascepa works in the liver and bloodstream to reduce very low-density triglycerides. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. 6. Some medications you can skip just a day ahead of time, but others, like fish oil, you usually need to avoid long before you go under the knife. You may have been told not to eat or drink for eight to 12 hours before surgery. Yne!q:#gYt:XnOwS?,8I6~**`@`?us\qh]?7+.DV=Pu?4`Al.9iu@"uP:zh5JW Y=|: C@g ,20 (A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to risk of harm.) So, dont be afraid to ask questions or offer feedback on your treatment. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it. Before taking any fish oil supplement with Vascepa, talk with your doctor. If you take too much Vascepa, your doctor may closely monitor you for signs and symptoms of overdose. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. But drinking too much alcohol can increase triglycerides. Vascepa (icosapent ethyl). Vascepa works by lowering how much fat your liver produces. What is considered high cholesterol? A copy of your advance directive or living will, if you have one. Your surgeon will tell you how far ahead of time to stop your medication. Your doctor can also tell you about other treatments you can use for your condition. Certain factors can affect whether Vascepa is a good treatment option for you. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. OncoTargets and Therapy, 9: 74357443. No overall differences in safety or effectiveness were observed between these patients and younger groups. A general rule is to stop taking these potentially unsafe preparations at least two weeks prior. Vascepa only contains eicosapentaenoic acid (EPA), whereas most other fish oils (including prescription fish oils) contain both EPA and docosahexaenoic acid (DHA). Also, arrange for children or family members who require supervision to stay at home during your surgery. (2018). Having too many triglycerides in your blood can be harmful and lead to heart disease. Stop taking VASCEPA and tell your doctor right away or get emergency medical help if you . Most patients need to arrive at the hospital at least one hour before the surgery start time. Available for Android and iOS devices. Before taking Vascepa, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. The man was sent to the intensive-care unit for close monitoring. Information about your pacemaker or internal defibrillator, if you have one. Test INR on day of surgery. Click on the image (or right click) to open the source website in a new browser window. If you think your liver function is getting worse during treatment, talk with your doctor immediately. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. Dont take more Vascepa than your doctor prescribes. no LMWH for 12-24 hours prior to surgery Or Commence IV unfractionated heparin when INR <2. The incidence of bleeding events in people receiving a placebo (an inactive pill) in the same trial was 10% with 2% of these being severe. It also helps eliminate this fat from the body. A list of all medications you take or medications in their original bottles. If you have allergies to fish or shellfish, tell your doctor before taking Vascepa. In addition, fish oil also diminishes the amount of pro-inflammatory endotoxins produced by harmful bacteria (10). * Lovazas active ingredients are a combination of omega-3 ethyl esters, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). What should be considered before taking Vascepa? Triglycerides are a type of fat in the blood (called a lipid). Your doctor will need to slowly decrease your dose before you stop it completely. Understand exactly what surgery is planned, along with the risks, benefits, and other options. Comments: May also be given to people with diabetes mellitus and 2 or more additional risk factors for cardiovascular disease (eg, high blood pressure, smoking, inactivity, obesity, family or personal history). Vascepa is not approved for use by anyone younger than 18 years old. apes chapter 4 quizlet multiple choice. These are known as drug-condition interactions. 2. No, Vascepa isnt fish oil. Fish Oils and Bleeding: Is There a Clinically Significant Risk? If you have liver failure, Vascepa may affect how well your liver functions. Copyright 1996-2023 Cerner Multum, Inc. They may be able to put Vascepa in an easy-open container. Studies show that omega-3 fatty acids improve the ratio of beneficial to harmful bacteria, as well as diminish the ability of harmful bacteria to colonize the stomach (8, 9). very low-density lipoprotein (VLDL) triglycerides. Vascepa can increase the risk of unusual bleeding as a side effect. By only containing EPA, Vascepa reduces high triglycerides without raising levels of bad cholesterol or LDL-C. Vascepa is also a lot stronger than most over-the-counter (OTC) fish oils (up to four times the strength). It is unclear how Vascepa works for this purpose. The active ingredient in Vascepa, icosapent ethyl, is also available as a generic version of Vascepa. And they want you to get the best care possible. yellowing of the skin, whites of the eyes, and nails. endobj Symptoms of a mild allergic reaction can include: A more severe allergic reaction is rare but possible. You may have many thoughts and questions running through your head, whether it is a minor, same-day procedure or a complex operation that requires you to stay in the hospital overnight. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Vascepa only for the indication prescribed. Because omega-3 fish oil and cod liver oils have a noted blood thinning effect, it was long believed that consuming these kinds of oils could increase a patient's risk of bleeding during an operation. This is not the case with Vascepa, because it is not a fish oil. Please discuss with your surgeon. The daily dose of VASCEPA is 4 grams per day taken as either: . Elective surgery should be postponed beyond these periods, whereas vital, semiurgent, or urgent operations should be performed under continued dual antiplatelet therapy. Talk with your doctor if youd like to know about taking generic icosapent ethyl. Move every day. (2018). Lovaza and Vascepa contain different active ingredients. Available for Android and iOS devices. A mechanism of action is how a drug works. Uses: Stop 6 hours prior to surgery. Most patients stay here for at least two hours after their surgery is complete. But Vascepa can also help lower the risk of heart problems in certain people. If Vascepa is taken alongside a Mediterranean-style, low-carbohydrate diet that reduces body weight by 5% to 10% and contains no trans fats in addition to a regular exercise regimen, then triglyceride levels are expected to reduce by up to 50%. 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. stream Eat light. It takes approximately one year for Vascepa to start reducing cardiovascular risk and up to almost five years for the full effects to be seen; however, levels of triglycerides are significantly lower after 12 weeks of treatment. This is not a complete list of side effects and others may occur. In animal studies, there were no clinically relevant adverse developmental effects noted when rabbits were given the equivalent of 5 times the recommended dose. Having strong and healthy lungs is important before surgery. If youre concerned about weight loss or hair loss during Vascepa treatment, talk with your doctor or pharmacist. Vascepa is usually taken 2 times per day. Anecdotally, some blogs report weight loss with Vascepa, but this tends to correlate with the person experiencing excessive diarrhea or gastrointestinal discomfort as a side effect, which can be intolerable in some people, forcing discontinuation of Vascepa. The medications listed below (and potentially many others) may have an effect on your blood's ability to coagulate. Speak to your doctor about how drug interactions should be managed. Follow these tips to prevent heart disease. 12. 5. * To learn more about this side effect, see the Allergic reaction section below. Trust that your Mommy Makeover proceeded without any complications as the result of . As a result, such supplements may also contain certain toxins found in fish. Before your surgery, discuss other health problems, such as diabetes, with your doctor. Goose bumps on the skin, chills or sweating. We comply with the HONcode standard for trustworthy health information. Vascepa is only part of a complete treatment program that may also include diet, exercise, and weight control. Omega-3 Polyunsaturated Fatty Acids in the Prevention of Postoperative Complications in Colorectal Cancer: A Meta-Analysis. Some may increase the risk of problems during your surgery. To make sure Vascepa is safe for you, tell your doctor if you have ever had: liver disease; diabetes; a thyroid disorder; problems with your pancreas; a bleeding or blood-clotting disorder; or if you are allergic to fish or shellfish. Docosahexaenoic Acid Inhibits Helicobacter Pylori Growth In Vitro and Mice Gastric Mucosa Colonization. Vascepa is the only prescription omega-3 approved for cardiovascular risk reduction alongside diet modification. Circulation: Cardiovascular Quality and Outcomes, 11(11):e004584. Eat healthy foods, such as fruits, vegetables, lean meats and whole grains, and drink enough fluids to stay well-hydrated. Research studying the effects of omega-3 fatty acids from fish oil supplements has not confirmed its benefits. Version: 3.01. Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. Studies have shown that omega-3 fatty acids can pass into breast milk. Do not change your dose or stop taking Vascepa without talking to your doctor. Vascepa can cause atrial fibrillation or atrial flutter. During surgery, patients are typically both exposed to new types of bacteria and are also given antibiotics that kill off many existing microbial team-players. These lists do not include all possible side effects. Vascepa should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. The main differences between Lovaza and Vascepa are their FDA approved uses, composition, dose, side effects and price. The microbiome the name used to describe the bacteria that live in and on us can either support or hurt our health, depending on the composition and types of germs. For years, doctors have advised patients to stop taking fish oil before surgery. There are no documented reports that Vascepa (icosapent ethyl) helps with weight loss. Fish Oil and Perioperative Bleeding. You will wait in this area until the operating or procedure room is available. Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-Analysis. should i stop vascepa before surgery. Your liver makes very low-density lipoprotein (VLDL) triglycerides, which increases the amount of triglycerides in your blood. It may also be called an omega-3 fatty acid. Born and raised in the United States, Dr. Chalmers graduated from Brown University and completed her medical training at the University of Oslo in Norway. if you are allergic to fish or shellfish. The medications listed below (and potentially many others) may have an effect on your blood's ability to coagulate. They also will be available to answer your questions. But when a person does not get enough omega-3s, they may be putting themselves at risk for extending that process. Vascepa Side Effects by Severity Vascepa Side Effects by Likelihood and Severity COMMON side effects If experienced, these tend to have a Severe expression i a type of joint disorder due. Before initiating Vascepa, assess the person's lipid levels and try to identify other causes of high triglycerides such as diabetes, hypothyroidism, or medications and manage as appropriate. Allergic reaction. Stop 2 days before surgery; Creatinine Clearance . Medicines that interact with Vascepa may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Vascepa. (An active ingredient is what makes the drug work.) Vascepa is used together with a low-fat and low-cholesterol diet to reduce triglycerides (fats) in adults with severely high triglycerides. 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. Tell your doctor if you are breastfeeding. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. should i stop vascepa before surgery. This is because it is more likely to cause heart rhythm disturbances, thin the blood, or increase the risk of bleeding than supplemental varieties. Vascepa is thought to work by reducing the production of triglycerides by the liver and enhancing their clearance from lipid particles, via several different mechanisms. Just as you would for a weekend getaway, take time to pack necessities and a few comfort items when you have surgery. Blood thinners such as aspirin, Coumadin, Xarelto, or Eliquis should be stopped before surgery. Acetylsalicylic Acid. This list is not complete. $-Sx*5=z{|kX.ldJ\ *kT1~)YMt2^rg|@GlE+n2R/vY2k,qtE M+Zb{RjFJZKIGhDR8>-xAvh(5 Anecdotally, some blogs report weight loss with Vascepa, but this tends to correlate with the person experiencing side effects such excessive diarrhea or gastrointestinal discomfort. Also, if youre having trouble opening your medication bottles, let your pharmacist know. Theyll help you weigh the benefits and risks of breastfeeding your child. If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. This is not the case with Vascepa because it is not a fish oil. Vascepa capsules are available in strengths of 0.5 grams (gm) and 1 gm. Vascepa is a prescription omega-3 fatty acid that is similar to fish oil but not exactly the same. Here are a few tips that might help guide your discussion: Remember, your doctor and other healthcare professionals are available to help you. Harris, W.S. A few commonly taken herbal supplements to avoid are: Ginko Biloba, Garlic, Ginseng, Ginger, Dong Quai, Ephedra, Feverfew, St. John's Wort and/or Omega 3 fatty acids. A nurse or care team member will call a few days before your surgery with information about your procedure, what you can eat or drink, visitor guidelines and how to be notified of your arrival time for surgery. In those with atherosclerotic cardiovascular disease (ASCVD), the risk of events decreased by 35%. The median change in LDL-C from baseline after one year was 2 mg/dL (an increase of 3%) in the Vascepa group and 7 mg/dL (an increase of 10%) in the placebo group. Or go to the nearest emergency room. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. This decreases triglyceride levels in the body. "Eating healthy is always important, but even . Mild side effects of Vascepa that have been reported include: Mild side effects of many drugs may go away within a few days to a couple of weeks. We strongly recommend stopping these drugs five to seven days before surgery to reduce your risk of bleeding, but discussion with your cardiologist and surgeon is advised. Therapies including fish oil, probiotics, siRNA, Elevated triglyceride levels are linked with increased risk of certain conditions. Use Vascepa as directed by your doctor. Before taking Vascepa, tell your doctor about all medications you may be taking. Last updated on Feb 17, 2022. Braun, L. (2013). Vascepa contains only one kind of omega-3 fatty acid, icosapent ethyl, which is a modified form of EPA. Frontiers in Microbiology, 9, 1241. 4-Way Cold Tabs. If you dont understand something related to your condition or treatment, ask your doctor to explain it to you. Take Vascepa capsules whole. While more clinical studies need to be done with larger sample sizes, these initial findings are promising. It is very important for every patient to have an empty stomach before any surgery or procedure that requires anesthesia, for two reasons: To prevent nausea To keep any food or liquid from getting into the lungs. In 2007, Dr. William Harris, PhD (co-inventor of the omega-3 index) reviewed 19 clinical studies involving more than 4,000 surgical patients. While gearing up for surgery, your surgeon will probably give you a list of medications -- both prescription and over-the-counter -- that you'll need to stop beforehand. Do not take two doses at one time. 3 0 obj Lovaza vs. Vascepa - what's the difference between them? Importance of Maintaining a Low Omega-6/Omega-3 Ratio for Reducing Inflammation. VASCEPA is a prescription medicine used: along with certain medicines (statins) to reduce the risk of heart attack, stroke and certain types of heart issues requiring hospitalization in adults with heart (cardiovascular) disease, or diabetes and 2 or more additional risk factors for heart disease. Tapering can help reduce or eliminate withdrawal signs and symptoms. Below are some common questions about Vascepas dosage. Measure your height, weight and vital signs. For information about the generic form of Vascepa, talk with your doctor. It's important to have a healthy lifestyle before starting Lovaza or Vascepa. Generally, a physical exam is not required for patients who are scheduled for a low-risk surgical procedure; are not taking any prescriptions; and don't have chronic health conditions, like high blood pressure, diabetes, obesity or heart disease. Limiting heavy foods and avoiding big meals can help you feel better before and after the procedure. Vascepa is a prescription, high purity eicosapentaenoic acid (EPA - a type of omega-3 fatty acid), that may be used to lower the risk of cardiovascular disease in people with high triglyceride levels and diabetes or cardiovascular disease, or who are already taking the maximum dose of statins. Icosapent can pass into breast milk, and may harm your baby. View complete list of side effects. You may report side effects to FDA at 1-800-FDA-1088. Continue reading, It takes approximately one year for Vascepa to start reducing a person's cardiovascular risk and up to almost five years for the full risk-reducing effects to be seen. Both aspirin and Vascepa may increase your risk of bleeding, so taking them together further increases this risk. Both of these factors can disrupt the microbiome, which is why it is important to help support the good bacteria as best as possible. What are some frequently asked questions about Vascepa? As a result, supplements may also contain certain toxins found in fish. But before starting Vascepa, ask your doctor or pharmacist if its safe for you to drink alcohol. And taking fish oil supplements may have risks such as side effects and drug interactions. In others cases, low-dose aspirin may be continued based on your medical condition. Swallow Vascepa capsules whole. When platelets cannot do this, your risk of bleeding increases. More recent studies have added to the evidence. In the studies analyzed, the patients also took aspirin or heparin two common blood-thinning drugs. Check with your health care provider before you start, stop, or change the dose of any medicine. chest pressure, racing or pounding heartbeats, fluttering in your chest, feeling short of breath. An increase in liver enzymes may signal that your liver function is getting worse. During the week before their scheduled surgeries, more than 1500 patients were randomly assigned to take either a placebo or 6.5 to 8g of EPA/DHA. If necessary, complete additional preoperative testing following your exam, including blood tests, urine tests, X-rays or an EKG. Dr. Chalmers practiced medicine for many years, serving both at high-tech hospitals and as a community health worker in rural Norway. More common side . Vascepa reduces triglyceride production in the liver and enhances the clearance of triglycerides from lipid particles, via a number of different mechanisms. Youll take Vascepa capsules by mouth twice per day with food. American Journal of Surgery, 214(4):733-737. If you have a history of these heart problems, your risk of atrial fibrillation or atrial flutter occurring with Vascepa increases. The following should be avoided for at least 10 days before AND after surgery: A.S.A. It is unclear how Vascepa helps decrease your risk of heart problems outside of lowering your triglyceride levels. Another review from 2008 similarly found that no published studies had reported clinically significant bleeding episodes among patients treated with antiplatelet drugs and fish oil at doses ranging from 3 to 7g every day (2). Many surgeries are scheduled for the early morning. These factors include what your insurance plan covers and which pharmacy you use. Lovenox is usually stopped about 12 hours before colonoscopy. Content is updated monthly with systematic literature reviews and conferences. Light to moderate alcohol consumption may lower the amount of triglycerides in your blood. Patients with such allergies should discontinue VASCEPA if any reactions occur. Tell your doctor before taking Vascepa if you have ever had an allergic reaction to fish or shellfish. 4. Scientific Reports, 5, 11276. I then tried a couple of anti-arrhythmic medications which I could not tolerate, so my cardio sent me for an eval to an EP. Jeansen, S., Witkamp, R.F., Garthoff, J.A., van Helvoort, A., and Calder, P.C. Strengthen your lungs. One review analyzed the effects of omega-3 supplementation on pre- and post-surgery colon cancer patients. Read on to find out more about healthy cholesterol levels, and if a cholesterol level of 250 ml/dL is considered, Heart disease is a top cause of death in the U.S. Swallow the capsule whole and do not crush, chew, break, or open it. Importance of Maintaining a Low Omega-6/Omega-3 Ratio for Reducing Inflammation. Because it is prescription-strength, it is only available on a prescription written by a doctor to people with abnormally high triglyceride levels. You can also check out this article to learn more about saving money on prescriptions. Furthermore, studies indicate that when patients receive a sufficient daily dose of omega-3 fish oil, it tends to limit their need for painkillers. Each capsule contains 465 mg of EPA and 375 mg of DHA. This is especially important for patients who will be getting regional anesthesia, such as a spinal block or epidural. Sometimes, it should be stopped 48 hours before and 48 hours after surgery to decrease the risk of a problem called lactic acidosis. For context, that would be the same as swallowing almost cup of Omega Cure fish oil, or taking 33 regular fish oil capsules daily, which is significantly more omega-3 than any patient needs to take. We also recommend avoiding herbal medications such as gingko biloba and ginseng, for five to seven days prior to surgery, as they increase your risk of bleeding. Patients should engage in appropriate nutritional intake and physical activity before receiving VASCEPA, which should continue during treatment with VASCEPA. As a physician-directed company, we love to help! American Journal of Cardiology, 99.6A: 44C-6C. In clinical trials, over 45% of trial participants were aged 65 years and over. The Clinical Journal of Pain, 34(2), 182189. 5-Aminosalicylic Acid. If you do experience an allergic reaction after taking Vascepa, discontinue it immediately, and seek immediate medical attention. But Vascepa is also used to help lower the risk of heart problems in certain people. fast or irregular heartbeats, dizziness, shortness of breath, chest discomfort, fainting, or if you feel light-headed; or. >_QV4NUo=w_|"w@6\? kM;}l;T }. Cut back on meat, milk, and other dairy products that contain saturated fats, which can elevate triglycerides. Allow yourself time to recover after your surgery or procedure. Vascepa is much more expensive than OTC fish oils, costing around $300 per month without insurance. Taking more than this can lead to serious side effects. Taking a fish oil supplement with Vascepa may not improve your triglyceride levels or reduce your risk of heart problems. <> There is a possibility you may be at risk of a similar reaction if you take Vascepa. Costs of prescription drugs can vary depending on many factors. Care team members will monitor your vital signs, alertness, pain or discomfort, and the need for medications. If you have problems with your liver, your doctor may still prescribe Vascepa for you. To learn more about high triglycerides and how Vascepa is used, see the What is Vascepa used for? section below. Warfarin (Coumadin) is usually stopped 5-7 days before your colonoscopy. Learn more about the link. 4 0 obj should i stop vascepa before surgery. For more about the differences between Vascepa and fish oil, see the What should I know about Vascepa vs. fish oil? section above. Triglyceride levels are normally less than 150 milligrams per deciliter. should i stop vascepa before surgery. %PDF-1.5 Check the label on the medicine for exact dosing instructions. No. NEW YORK (Reuters Health) - There is no need to interrupt antiplatelet therapy before tooth extractions, as long as appropriate local hemostatic measures are taken, according to results of a prospective study conducted at the Aristotle University Dental School in Thessaloniki, Greece. What supplements should not be taken before surgery? Lovaza dosing Lovaza comes as a 1 g capsule. Vascepa is available in two strengths: 0.5 gram capsules and 1 gram capsules. For more on that, read Fresh Fish Oil: Why It Matters to Your Health.. Your doctor will recommend the dosage of Vascepa thats right for you. Praluent, Ozempic, rosuvastatin, simvastatin, Xarelto, Trulicity, fenofibrate, Crestor, Victoza, Brilinta. FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. What should you take ? A 2018 study co-authored by Dr. William Harris also investigated the risk of bleeding during cardiac surgeries. The risk of bleeding is higher in people who also take other medications or supplements that increase bleeding risk such as aspirin, clopidogrel, dabigatran, warfarin, NSAIDs, feverfew, ginkgo, garlic, or ginseng.

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