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Hmg

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Hmg

Quick Facts

Property Description
Active Ingredient Menotropins (Menotrophin)
Form Lyophilized powder and solvent for injection
Pharmacological Class Gonadotropins
General Purpose Stimulation of gonadal function for fertility support
Origin Urinary-derived (natural source)

What is Menotropins (HMG) and What Type of Medicine is It?

Menotropins is the official non-proprietary name for Human Menopausal Gonadotropin (HMG), a prescription injectable medicine categorized within the high-level pharmacological group of gonadotropins. This drug entity is defined as a highly purified combination product because it delivers the essential activity of two distinct glycoprotein hormones: Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The role of Menotropins is to act as a potent substitute for the pituitary hormones that the human body naturally produces, which are crucial regulators of reproductive function.

Composition and Origin: Is HMG a Natural Hormone Mixture?

HMG is considered a natural source product because its active ingredient is urinary-derived, extracted and highly purified from the urine of postmenopausal women, who excrete these hormones in high concentration. The final Menotropins preparation is standardized to contain an approximate equi-unitage ratio (typically 1:1) of both FSH activity and LH activity, the latter of which is largely contributed by Human Chorionic Gonadotropin (hCG). HMG is an established compound used to manage reproductive issues that stem from a deficiency in endogenous gonadotropins. This highly purified product is typically supplied as a lyophilized powder and solvent for solution for injection, intended for subcutaneous or intramuscular injection.

What is the General Purpose of This Gonadotropin?

The general purpose of Menotropins is to stimulate gonadal function by directly introducing the necessary FSH and LH activity into the body. This direct action provides a potent stimulus to the reproductive system, supporting the fundamental reproductive processes that rely on these coordinated hormonal signals. This mechanism establishes HMG as a core fertility agent for use when the body's natural release of these key gonadotropins requires external augmentation.

What side effects are possible with Hmg?

Possible Side Effects and Safety Information

The official safety profile for Menotropins (HMG) outlines adverse reactions grouped by frequency and affected body system, strictly based on regulatory classifications. The most frequently documented events include Ovarian Hyperstimulation Syndrome (OHSS), headache, and various injection site reactions, which are often classified as Very Common in regulatory documents. Common effects typically include abdominal pain, nausea, pelvic pain, and the formation of ovarian cysts.

Serious Adverse Reactions

The most significant risks documented in prescribing information are Severe Ovarian Hyperstimulation Syndrome (OHSS) and Thromboembolic Events (blood clots in veins or arteries). Severe OHSS is a rapid-onset condition that can lead to serious fluid and electrolyte imbalances. Thromboembolic Events, including pulmonary embolism, are rare but serious vascular risks associated with gonadotropin therapy. Ovarian torsion and an increased risk of ectopic pregnancy are also noted in official safety documentation.

Safety Restrictions and Contraindications

Use of Menotropins is formally restricted in individuals with specific pre-existing conditions as defined in regulatory labels. These include primary ovarian failure (indicated by high FSH levels), the presence of certain sex-hormone dependent tumors of the reproductive tract, and uncontrolled non-gonadal endocrinopathies. The medicine is also contraindicated in women who are pregnant. Safety documentation notes that OHSS often manifests or reaches maximum severity in the days following the discontinuation of treatment.

Overdose and Emergency Response

The official regulatory documents state that overdosage with Menotropins (HMG) is principally defined by the development of Ovarian Hyperstimulation Syndrome (OHSS) in women of reproductive age. This syndrome results from an excessive ovarian response to the gonadotropin activity.

Documented Overdose Manifestations

Clinical overdose may present with symptoms including severe pelvic pain, rapid and significant weight gain, abdominal distension, nausea, and vomiting. When the overstimulation progresses to severe OHSS, the physiological systems affected include the circulatory and respiratory systems, potentially leading to severe complications such as thromboembolic events, decreased blood volume (hypovolemia), and acute pulmonary distress.

When to Seek Urgent Help

Immediate medical help is formally required when symptoms of moderate to severe OHSS are present. Regulatory guidance mandates that patients must seek emergency medical attention or call the Poison Help line without delay. To prevent the worsening of OHSS, the administration of Human Chorionic Gonadotropin (hCG) must be withheld if excessive ovarian response is detected.

Official Management Statements

The approach to managing overstimulation is strictly symptomatic and supportive treatment, as regulatory documents state that no specific antidote is known. Severe cases formally require hospital monitoring and close observation for complications such as fluid and electrolyte imbalance.

Therapeutic Uses of Hmg

What HMG Treats: Main Uses and Benefits

Human Menopausal Gonadotropin (HMG), also known as Menotropins, is a medication that may be part of symptomatic management for fertility issues in both women and men in situations where patients experience hormonal imbalances. The main therapeutic purpose of HMG is to address symptoms related to systemic imbalance in reproductive function. Its core purpose is to assist in reproductive processes where supportive symptom management is appropriate.

Supporting Ovulation in Women

The medication is commonly used across conditions where symptoms related to systemic imbalance affect functional stability, such as anovulation. It is applied across domains where additional symptomatic support is needed to address ovulatory disorders. The medication helps address symptom clusters that may become intense or disruptive by assisting with egg maturation. This contributes to easing the overall symptom load during periods of heightened symptoms.

Supportive Use in Assisted Reproductive Technology (ART) Cycles

This medicine is considered relevant for easing the challenge in clinical settings that involve acute or unstable symptom patterns, such as preparing for procedures like In Vitro Fertilization (IVF). It is applied in addressing the need for multiple follicles. This supportive relief helps patients cope more steadily with symptom fluctuations and is applied in clinical settings that involve acute or unstable symptom patterns.

Addressing Male Hormonal Infertility Concerns

HMG is relevant in contexts marked by increased discomfort or tension related to a specific diagnosis, such as hypogonadotropic hypogonadism in men. In these cases, it supports the patient during difficult episodes by easing distress related to low sperm count. It plays a role in managing symptoms linked to organ-specific functional stress, which contributes to easing the overall symptom load.

Quick Fact: May assist with Functional Strain

Eligibility and Restrictions for Use

Eligibility Scope and Restrictions

The eligibility to use Hmg (Menotropins, a combination of FSH and LH activity) is strictly defined by regulatory guidelines, primarily by excluding populations for whom use is contraindicated due to significant health risks.

Population Status Restrictions (Official Regulatory Statements)
Contraindicated Pregnancy and lactation (breastfeeding). Women with primary ovarian failure (indicated by high FSH levels). Individuals with uncontrolled adrenal or thyroid dysfunction, abnormal uterine bleeding of undetermined origin, ovarian cysts or enlargement not due to Polycystic Ovary Syndrome (PCOS), or prior hypersensitivity to menotropins. Those with a pituitary or hypothalamic tumor, or sex hormone-dependent tumors of the reproductive tract or accessory organs.
Use Not Recommended Hmg is generally not used in the pediatric or geriatric populations. Use requires caution and careful monitoring in patients who have certain cardiovascular risk factors due to the potential for thromboembolic events.
Condition-Specific Primary ovarian failure must be excluded before treatment. The safety and efficacy of Hmg have not been established in patients with renal or hepatic insufficiency. Individuals with tubal pathology should typically only receive Hmg if enrolled in an in vitro fertilization program.

Summary of Eligibility Profile

The regulatory profile for Hmg is highly exclusionary, forbidding its use in the presence of several serious, pre-existing conditions that are deemed incompatible with treatment. The most severe restrictions are its absolute prohibition during pregnancy and breastfeeding, and in patients with known or suspected hormone-dependent malignancies or primary ovarian failure. All patients must be thoroughly evaluated to rule out specific endocrine disorders, tumors, and uncharacterized uterine or ovarian pathologies before treatment can begin.

What should I know about interactions with other medicines?

Hmg Interactions with other medicines and products

The official regulatory profile for Menotropins (HMG) is distinct in that it is primarily defined by the absence of documented drug–drug interaction studies rather than a list of known interacting substances. This profile is consistent across major government health authorities and emphasizes procedural constraints over metabolic or exposure-altering effects.

Documented Interaction Scope

Regulatory prescribing information confirms that no formal drug interaction studies have been conducted in humans to assess the impact of co-administered medicines on the concentrations of Menotropins in the body. Therefore, no specific medicinal products or product classes are currently listed in official documents as known to cause metabolic (e.g., CYP enzyme) or transporter-mediated interactions that would require a dosage adjustment.

Interaction-Related Restrictions and Constraints

  • Procedural Co-Mixing Prohibition: There is a strict, label-based constraint that Menotropins must not be mixed with other medicinal products in the same injection syringe or vial. This prohibition is a mandatory timing and compatibility rule dictated by the absence of studies confirming physical and chemical compatibility.
  • Interactions with Common Substances: Official regulatory sources state that Menotropins is not known to interact with food, alcohol, herbal products, or supplements.

This structure results in a unique interaction profile that focuses on the necessary procedural separation during preparation rather than pharmacokinetic warnings found with many other medicines.

Mechanism of Action

Dual Agonism on Gonadal Receptors

Menotropins (HMG) acts as an exogenous agonist, providing a direct, defined signal by binding to both the Follicle-Stimulating Hormone Receptor (FSHR) and the Luteinizing Hormone/Chorionic Gonadotropin Receptor (LHCGR) on target cells in the gonads. This direct activation overrides the body's natural feedback constraints, resulting in sustained signaling for cell proliferation in reproductive tissues.

Coordinated Steroidogenesis Pathway Activation

The mechanism depends on the synergistic action between the two active components to activate the complete Two-Cell, Two-Gonadotropin pathway. The FSH activity initiates cell growth and the production of the aromatase enzyme, while the LH/hCG activity ensures the supply of the necessary androgen substrate. This coordinated step leads to the efficient synthesis of sex steroids, driving follicular development in the ovary and initiating spermatogenesis in the testis.

Physiological Augmentation and Mechanistic Limits

This peripheral mechanism provides an essential augmentative signal to the reproductive system, facilitating the initiation and completion of critical molecular cascades necessary for maturation. The physiological consequence is an increase in gonadal output. This mechanism promotes the necessary hormonal environment for the primary physiological reproductive processes to occur. However, the action is physiologically constrained: it cannot function if the target receptors are unavailable or if the gonadal cells are biologically exhausted, as occurs in conditions of primary gonadal failure.

Dosage and Administration Information

Instruction Map: How to use Hmg

Administration of Human Menopausal Gonadotropin (Hmg), also known as menotropin, is governed by specific protocols to ensure safe and effective use. Hmg is a potent gonadotropin preparation containing both Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) activities.

Administration Scope

Classification Specification
Route of administration Subcutaneous (SC) or Intramuscular (IM) injection only.
Dosing schedule Dosage is highly individualized and determined by physician based on patient response, monitored via serum estradiol levels and ultrasound. For Assisted Reproductive Technologies (ART), the typical initial dose is 225 International Units (IU) daily. Doses should not be adjusted more frequently than every two days and should not exceed 450 IU daily.
Timing in relation to meals No specific instruction. Administration is independent of food intake.
Preparation requirements Hmg (menotropins for injection) is typically a lyophilized powder that must be reconstituted with the supplied sterile diluent immediately prior to use. It must not be administered if it contains particulate matter or is discolored. Do not shake the reconstituted product.
Age-group administration rules Safety and effectiveness in pediatric patients have not been established. Use is restricted to the adult patient population.
Missed-dose rules There are no explicit, universally published missed-dose instructions. Patients must follow the specific instructions provided by the prescribing physician, who adjusts the daily treatment based on follicular development.
Special procedural conditions Must be administered under the supervision of a physician experienced in infertility treatment. Patients who self-administer require appropriate training. Injection site rotation is recommended.

Instruction Classifications (High-level)

  • Administration method type: Injectable (Subcutaneous/Intramuscular)
  • Frequency pattern: Daily, for 7 to 20 days, followed by hCG administration.
  • Use-context constraints: Administration must be preceded by a thorough gynecologic and endocrinologic evaluation.

Resulting Procedural Structure

Step sequence:

  • Aseptically reconstitute the lyophilized powder with the provided sterile diluent immediately before injection.
  • Draw the required, individualized dose into the syringe.
  • Administer the solution by subcutaneous or intramuscular injection once daily.
  • The duration and exact dosage are subject to daily monitoring of ovarian response.
  • The final dose of Hmg is followed one day later by an injection of Human Chorionic Gonadotropin (hCG) to trigger final follicular maturation.

Connection to the overall use protocol: The instructions mandate that Hmg is prepared through immediate reconstitution and then administered via a daily injection (SC or IM) according to an individualized schedule determined by clinical and laboratory monitoring. This daily sequence establishes a precise treatment window, typically lasting 7 to 20 days, which is preparatory to the final, single-dose administration of hCG. This controlled, procedural structure is essential for regulating follicular development.

Recent Clinical Evidence

Research evidence / Overview of Studies for Hmg

Evidence for use in Assisted Reproductive Technology (ART) Cycles

The research base for using Menotropins (Hmg) in procedures like In Vitro Fertilization (IVF) includes many Randomized Controlled Trials (RCTs) and systematic reviews. The research examined outcomes related to systemic or functional imbalance, specifically monitoring the number of eggs retrieved (oocyte yield) and tracking the achievement of Ongoing Pregnancy Rates (OPR) and Cumulative Live Birth Rates over time. Studies monitored how follicular growth and egg maturation evolved in the observed populations. Findings described patterns observed in the studies and varied when Hmg was directly compared against certain other gonadotropin preparations in terms of final birth rates.

What remains uncertain is the full application of these findings to all women undergoing ART, as results apply only to the populations studied. There is limited information for long-term outcomes regarding the growth and development of children conceived after Hmg treatment. Furthermore, the variability across the different study protocols means that comparative evidence is lacking for every scenario.

Evidence for use in Ovulation Induction

Hmg was studied for women experiencing anovulatory infertility, a condition characterized by fluctuating manifestations. The evidence structure includes Randomized Comparative Trials designed to evaluate Hmg. Research examined outcomes related to systemic or functional imbalance by monitoring follicular development and measuring the occurrence of ovulation (releasing an egg). The studies monitored Clinical and Ongoing Pregnancy Rates in these observed populations. Findings describe patterns observed in the studies related to the rate at which ovulation was observed. Studies reported how pregnancy-related outcomes evolved in the observed populations within the immediate months following treatment.

However, the evidence quality varies across studies, and comparative evidence is lacking against all potential treatment options. Follow-up durations were limited, as studies typically concentrated on the immediate treatment cycle. There is limited information regarding the long-term maintenance of regular reproductive function after Hmg therapy is discontinued.

Evidence for use in Male Hypogonadotropic Hypogonadism

Hmg for males with Hypogonadotropic Hypogonadism (HH) was evaluated in a different research setting. The research base is characterized by a reliance on Retrospective Cohort Studies and smaller Non-Randomized Prospective Trials. Hmg was observed in research contexts involving fluctuating or unstable symptoms, typically evaluated as part of a combination therapy regimen. These studies explored outcomes related to physiological strain by monitoring metrics related to spermatogenesis (sperm creation), measuring Testicular Volume, and assessing Serum Testosterone Levels. The research describes group patterns monitored for spermatogenesis in the studied populations.

However, the certainty remains low because the sample sizes were modest, and the evidence quality varies across studies. The reliance on non-randomized data for male indications means that the certainty remains low, and research remains ongoing in these areas.

Key Studies & References

  1. MedlinePlus: Menotropins Injection
  2. ESHRE Guideline: Ovarian Stimulation for IVF/ICSI

Frequently Asked Questions (FAQ)

Common questions about Hmg (FAQ)

Q: How quickly does Hmg start to have an effect?

Regulatory studies (pharmacokinetic studies) have examined how quickly the Follicle-Stimulating Hormone (FSH) component reaches its highest concentration in the body after injection. Official product information indicates this time is approximately 12 hours after a single subcutaneous dose and 18 hours after a single intramuscular dose. This is referred to as the time to maximum concentration, or t max.

Q: What does the acronym Hmg stand for?

Hmg is the common abbreviation for Human Menopausal Gonadotropin. This is the official non-proprietary name for the medicine, which is also commonly referred to as Menotropins in official regulatory documents.

Q: Is it true that Hmg is made from natural sources?

Yes, official regulatory descriptions confirm that the active ingredient in Menotropins (Hmg) is a urinary-derived product. It is extracted and then highly purified from the urine of postmenopausal women before it is standardized for therapeutic use.

Q: Does Hmg interact with alcohol?

Official regulatory sources state that no formal drug interaction studies have been conducted in humans to assess the combination with alcohol. However, official prescribing information notes that Menotropins is not known to interact with food, alcohol, or herbal supplements.

Q: What should I know about taking Hmg before a planned surgery?

Official labeling for Menotropins notes that the use of gonadotropins may be associated with an increased risk of thromboembolic events (the formation of blood clots). The potential for this condition is a factor that medical professionals review when planning procedures like surgery.

Q: Can Hmg be used if I am breastfeeding?

Official regulatory documents state that the use of Menotropins is contraindicated (strictly not allowed) in women who are currently breastfeeding. Contraindications are conditions that officially forbid the use of the medicine due to safety reasons.

Q: How do scientists describe the purity of Hmg products?

Hmg products are described as highly purified preparations in regulatory and official descriptions. This means the active ingredient has been standardized to contain precise, equivalent units of both Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) activity.

Q: Do I need to change my diet while using Hmg?

Official regulatory sources state that Menotropins is not known to interact with food or supplements. Therefore, no general dietary changes are mandated in official prescribing information during the use of Hmg.

Q: What happens if I forget to take an Hmg dose?

Official guidelines indicate that there are no universal missed-dose instructions provided on the drug label that cover all possible circumstances. Because the treatment schedule is highly individualized and depends on biological monitoring, management of a missed dose is an individualized decision made by the prescribing clinician.

Q: Does Hmg cause weight gain?

Rapid weight gain is listed in regulatory information as a sign or symptom of the serious condition Ovarian Hyperstimulation Syndrome (OHSS). If this symptom occurs quickly, official guidance notes it requires immediate medical evaluation, but weight gain is not listed as a common, general side effect.

Q: How long can someone safely stay on Hmg treatment?

Official regulatory documents state that treatment duration for a single cycle is typically between 7 and 20 days. The safety and effectiveness of treating patients for a total duration that exceeds the established clinical trial lengths have not been established in official studies.

Q: Are there any common over-the-counter medicines that interact with Hmg?

Official regulatory documents state that no formal drug interaction studies have been conducted to assess the effect of co-administered medicines. Consequently, no specific over-the-counter medicines are listed as known to interact with Menotropins.

Q: Why is Hmg sometimes called 'highly purified'?

The term 'highly purified' is used by regulatory authorities to distinguish the current quality of Hmg from earlier urinary-derived products. This classification signifies a preparation that meets specific, elevated manufacturing standards for purity and potency defined in official monographs.

Q: Can Hmg affect my mood or mental state?

Some general adverse effect profiles associated with gonadotropin use mention the reporting of non-specific changes in mood or anxiety. These effects are not classified as common or severe in the core labeling for Menotropins.

Q: How long after stopping Hmg will it be out of my system?

Regulatory pharmacokinetic studies report that the mean elimination half-lives of the Follicle-Stimulating Hormone (FSH) component are approximately 53.7 hours (subcutaneous injection) and 59.2 hours (intramuscular injection). The half-life is the time it takes for half of the drug concentration to be eliminated from the body.

Q: Are there different brand names for Hmg?

Yes, the non-proprietary medicine Menotropins is available under various different brand names that have been formally approved by regulatory bodies, such as the FDA or EMA.

Q: Why are people sometimes concerned about the safety of Hmg?

Official documents highlight potential serious risks associated with the use of gonadotropins, including Severe Ovarian Hyperstimulation Syndrome (OHSS) and Thromboembolic Events (blood clots). Regulatory authorities require patients to be monitored closely to help reduce the risks of these serious conditions.

Q: Is Hmg available in a pill form?

Official documentation specifies that Menotropins is supplied only as a lyophilized powder and solvent for solution for injection. It is intended solely for subcutaneous or intramuscular administration and is not available as an oral (pill) formulation.

Q: Can Hmg be used by people who are post-menopause?

Official regulatory documents state that the drug is contraindicated (not allowed) in women with primary ovarian failure, a condition characterized by high FSH levels that often occurs post-menopause. Eligibility for treatment is determined by specific reproductive health status and laboratory results.

Q: What should I do if I get a rash after using Hmg?

Official labeling for gonadotropins includes warnings about the potential for Hypersensitivity Reactions and Anaphylaxis (severe allergic reactions). Official guidance notes that any such reaction must be reviewed by a prescribing clinician.

Q: What kind of monitoring is usually needed while on Hmg?

Regulatory guidance requires patients to be monitored during treatment to assess how the body is responding. This monitoring typically involves periodic measurement of serum estradiol levels and repeated ovary ultrasound examinations to check follicular development.

Q: Can Hmg be used if I have existing liver problems?

Official documents state that the safety and efficacy of Menotropins have not been established in patients with renal (kidney) or hepatic (liver) insufficiency. Use in these patient groups requires careful medical consideration.

Q: What are the results of the main clinical trials for Hmg?

Clinical trial results described in regulatory documents report outcomes related to reproductive function. These include the number of eggs retrieved (oocyte yield), the rate of ongoing pregnancy, and the successful achievement of ovulation in the studied populations.

Q: Are there any dietary supplements that are known to interact with Hmg?

Official regulatory documents state that no formal drug interaction studies have been conducted in humans to assess the impact of supplements. No specific dietary supplements are listed as known to interact with Menotropins.

Q: How is the quality of Hmg products guaranteed?

Product quality is guaranteed by regulatory authorities through specific, defined manufacturing processes. This includes requiring the active ingredient to be highly purified and standardized to contain precise, declared units of FSH and LH activity before the drug receives approval.

Q: Can Hmg make an existing condition worse?

Official documents list pre-existing conditions that are absolute contraindications for use, such as certain sex-hormone dependent tumors or primary ovarian failure. Using the drug in the presence of these conditions is officially deemed incompatible with treatment.

Q: What is the risk of having twins or multiple pregnancies with Hmg?

Official documentation states that treatment with gonadotropins, including Hmg, increases the risk of multiple pregnancies. This includes the conception of twins, triplets, or higher-order multiples, which is described as a known risk factor.

Q: What are the criteria for being eligible to receive Hmg?

Eligibility to receive Hmg is based on official indications for use (e.g., specific forms of infertility) and the patient's exclusion from the list of absolute contraindications. These exclusions rule out individuals with conditions such as primary ovarian failure or certain hormone-dependent tumors.

Q: What are the common patient experiences when starting Hmg?

Based on clinical trial summaries, common experiences listed as adverse reactions include non-specific abdominal symptoms like abdominal pain and nausea. Localized effects like injection site pain or reaction are also frequently reported.

Q: Can I travel with Hmg?

Official storage rules mandate that the unmixed product must be kept refrigerated at 2 C to 8 C (36 F to 46 F). This means that temperature-controlled conditions, such as cooling packs, are required during any transit or travel with the product.

Q: Is the needle for the Hmg injection painful?

Official regulatory documents list common adverse reactions, including injection site pain. This inclusion in the official safety profile is an indication that discomfort or pain may be an expected and known effect upon administration.

Q: What are the warning signs of a serious side effect from Hmg?

Official documents detail warning signs for serious conditions like Severe Ovarian Hyperstimulation Syndrome (OHSS), which include rapid weight gain and severe abdominal pain. Signs of thromboembolic events (blood clots) include sudden chest pain or slurred speech.

Q: Do official documents mention any potential long-term effects on the heart from Hmg?

The official label notes the potential for Thromboembolic Events (blood clots), including rare events that may affect the cardiovascular system, such as myocardial infarction (heart attack). These are classified as rare but serious vascular risks.

How should Hmg be stored and disposed of?

How to Store and Dispose of HMG (Menotropins)

Storage Requirements

Condition Requirement
Temperature The unmixed powder must be stored refrigerated at 36 F to 46 F (2 C to 8 C).
Protection Store in the original container and protect from light. Do not freeze.
Stability The solution, once reconstituted, should be used immediately.
Safety Keep out of reach of children.

Disposal Instructions

All unused or expired product must be discarded in accordance with local requirements.

Used injection needles and syringes must be disposed of in an FDA-cleared sharps disposal container.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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