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| __NOTOC__
| | #REDIRECT [[Clopidogrel#Drug Interactions]] |
| {{Clopidogrel}}
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| {{CMG}}; {{AE}} {{JH}}
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| ==Drug Interactions==
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| ====7.1 CYP2C19 Inhibitors====
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| Clopidogrel is metabolized to its active metabolite in part by CYP2C19. Concomitant use of certain drugs that inhibit the activity of this enzyme results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Warnings and Precautions (5.1) and Dosage and Administration (2.4)].
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| ======Proton Pump Inhibitors (PPI)======
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| Avoid concomitant use of Plavix with omeprazole or esomeprazole. In clinical studies, omeprazole was shown to reduce the antiplatelet activity of Plavix when given concomitantly or 12 hours apart. A higher dose regimen of clopidogrel concomitantly administered with omeprazole increases antiplatelet response; an appropriate dose regimen has not been established. A similar reduction in antiplatelet activity was observed with esomeprazole when given concomitantly with Plavix. Consider using another acid-reducing agent with minimal or no CYP2C19 inhibitory effect on the formation of clopidogrel active metabolite. Dexlansoprazole, lansoprazole and pantoprazole had less effect on the antiplatelet activity of Plavix than did omeprazole or esomeprazole [see Dosage and Administration (2.4), Warnings and Precautions (5.1) and Clinical Pharmacology (12.3)].
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| ====7.2 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)====
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| Coadministration of Plavix and NSAIDs increases the risk of gastrointestinal bleeding.
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| ====7.3 Warfarin (CYP2C9 Substrates)====
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| Although the administration of clopidogrel 75 mg per day did not modify the pharmacokinetics of S-warfarin (a CYP2C9 substrate) or INR in patients receiving long-term warfarin therapy, coadministration of Plavix with warfarin increases the risk of bleeding because of independent effects on hemostasis.
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| However, at high concentrations in vitro, clopidogrel inhibits CYP2C9.
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| ====7.4 SSRIs and SNRIs====
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| Since selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) affect platelet activation, the concomitant administration of SSRIs and SNRIs with clopidogrel may increase the risk of bleeding.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = PLAVIX (CLOPIDOGREL BISULFATE) TABLET, FILM COATED [BRISTOL-MYERS SQUIBB/SANOFI PHARMACEUTICALS PARTNERSHIP] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=01b14603-8f29-4fa3-8d7e-9d523f802e0b | publisher = | date = | accessdate = }}</ref>
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| ==Major Interactions==
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| {{refbegin|3}}
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| * [[abciximab]]
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| * [[Aggrastat]]
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| * [[Aptivus]]
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| * [[ardeparin]]
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| * [[Arixtra]]
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| * [[Arixtra 10 mg/dose]]
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| * [[Arixtra 5 mg/dose]]
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| * [[Arixtra 7.5 mg/dose]]
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| * [[Bexxar Dosimetric]]
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| * [[Bexxar I 131 Dosimetric]]
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| * [[Bexxar I 131 Therapeutic]]
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| * [[BexxarTherapeutic]]
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| * [[Clexane]]
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| * [[Clexane Forte]]
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| * [[dalteparin]]
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| * [[danaparoid]]
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| * [[dasatinib]]
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| * [[desirudin]]
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| * [[drotrecogin]]
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| * [[drotrecogin alfa]]
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| * [[enoxaparin]]
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| * [[eptifibatide]]
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| * [[fondaparinux]]
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| * [[Fragmin]]
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| * [[ibritumomab]]
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| * [[In-111 Zevalin]]
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| * [[Innohep]]
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| * [[Integrilin]]
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| * [[iodine I 131 tositumomab]]
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| * [[Iprivask]]
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| * [[Lovenox]]
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| * [[Lovenox HP]]
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| * [[Normiflo]]
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| * [[Orgaran]]
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| * [[Reopro]]
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| * [[Sprycel]]
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| * [[tinzaparin]]
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| * [[tipranavir]]
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| * [[tirofiban]]
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| * [[tositumomab]]
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| * [[Xigris]]
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| * [[Y-90 Zevalin]]
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| {{refend}}
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| ==Moderate Interactions==
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| {{refbegin|3}}
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| * [[Abbokinase]]
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| * [[Abbokinase Open-Cath]]
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| * [[Acetylsalicylic Acid]]
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| * [[Acova]]
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| * [[Activase]]
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| * [[Actron]]
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| * [[Acular]]
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| * [[Acular LS]]
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| * [[Acular PF]]
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| * [[Acuprin 81]]
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| * [[Advil]]
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| * [[Advil Childrens]]
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| * [[Advil Junior Strength]]
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| * [[Advil Liquigel]]
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| * [[Advil Migraine]]
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| * [[Advil Pediatric]]
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| * [[Aflaxen]]
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| * [[Aleve]]
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| * [[Aleve Caplet]]
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| * [[Aleve Easy Open Arthritis]]
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| * [[Aleve Gelcap]]
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| * [[alteplase]]
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| * [[Amigesic]]
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| * [[Anaflex]]
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| * [[Anafranil]]
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| * [[Anaprox]]
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| * [[Anaprox-DS]]
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| * [[Angiomax]]
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| * [[anisindione]]
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| * [[anistreplase]]
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| * [[Ansaid]]
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| * [[argatroban]]
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| * [[Argesic-SA]]
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| * [[Arthritis Pain]]
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| * [[Arthropan]]
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| * [[ASA]]
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| * [[Ascriptin Enteric]]
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| * [[Aspergum Cherry]]
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| * [[Aspergum Orginal]]
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| * [[Aspir-Low]]
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| * [[aspirin]]
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| * [[aspirin extended release]]
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| * [[Aspirin Lite Coat]]
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| * [[Aspirin Litecoat]]
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| * [[Aspirin Low Strength]]
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| * [[Aspirtab]]
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| * [[atorvastatin]]
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| * [[Bayer Aspirin]]
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| * [[Bayer Aspirin Regimen]]
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| * [[Bayer Aspirin Sugar Free]]
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| * [[Bayer Aspirin with Calcium]]
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| * [[Bayer Childrens Aspirin]]
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| * [[Bayer Low Strength]]
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| * [[Bayer Plus]]
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| * [[Bayer Select Backache Pain Formula]]
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| * [[Bextra]]
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| * [[Biaxin]]
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| * [[Biaxin XL]]
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| * [[Biaxin XL-Pak]]
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| * [[Bismarex]]
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| * [[Bismatrol]]
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| * [[Bismatrol Maximum Strength]]
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| * [[bismuth subsalicylate]]
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| * [[bivalirudin]]
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| * [[bosentan]]
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| * [[bromfenac]]
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| * [[bromfenac ophthalmic]]
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| * [[Budeprion SR]]
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| * [[Budeprion XL]]
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| * [[Buffered Aspirin]]
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| * [[Bufferin]]
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| * [[Bufferin Arthritis Strength]]
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| * [[Bufferin Extra Strength]]
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| * [[Buffex]]
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| * [[buPROPion]]
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| * [[buPROPion 24 hour extended release]]
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| * [[buPROPion extended release]]
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| * [[Cataflam]]
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| * [[Cathflo Activase]]
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| * [[Celexa]]
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| * [[Childrens Ibuprofen Berry]]
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| * [[Childrens Kaopectate]]
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| * [[choline salicylate]]
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| * [[cilostazol]]
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| * [[citalopram]]
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| * [[clarithromycin]]
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| * [[clarithromycin extended release]]
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| * [[Clinoril]]
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| * [[clomiPRAMINE]]
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| * [[Coumadin]]
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| * [[Cymbalta]]
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| * [[Daypro]]
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| * [[desvenlafaxine]]
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| * [[dexfenfluramine]]
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| * [[diclofenac]]
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| * [[diclofenac ophthalmic]]
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| * [[diclofenac potassium]]
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| * [[diclofenac sodium]]
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| * [[diclofenac sodium extended release]]
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| * [[diclofenac topical]]
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| * [[dicumarol]]
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| * [[diflunisal]]
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| * [[Disalcid]]
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| * [[Doans Pills]]
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| * [[Doans Pills Extra Strength]]
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| * [[Dolobid]]
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| * [[dong quai]]
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| * [[duloxetine]]
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| * [[DurAct]]
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| * [[E-Mycin]]
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| * [[E.E.S. Granules]]
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| * [[E.E.S.-200]]
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| * [[E.E.S.-400]]
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| * [[E.E.S.-400 Filmtab]]
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| * [[Easprin]]
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| * [[EC-Naprosyn]]
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| * [[Ecotrin]]
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| * [[Ecotrin Adult Low Strength]]
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| * [[Ecotrin Maximum Strength]]
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| * [[Effexor]]
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| * [[Effexor XR]]
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| * [[Elmiron]]
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| * [[Empirin]]
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| * [[Entaprin]]
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| * [[Entercote]]
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| * [[Ery-Tab]]
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| * [[Eryc]]
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| * [[EryPed]]
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| * [[EryPed 200]]
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| * [[EryPed 400]]
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| * [[Erythrocin Lactobionate]]
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| * [[Erythrocin Stearate Filmtab]]
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| * [[Erythrocot]]
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| * [[erythromycin]]
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| * [[erythromycin base]]
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| * [[erythromycin estolate]]
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| * [[erythromycin ethylsuccinate]]
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| * [[erythromycin lactobionate]]
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| * [[erythromycin stearate]]
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| * [[escitalopram]]
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| * [[etodolac]]
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| * [[etodolac extended release]]
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| * [[Extra Strength Bayer]]
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| * [[Fasprin]]
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| * [[Feldene]]
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| * [[fenfluramine]]
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| * [[fenoprofen]]
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| * [[Flector Patch]]
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| * [[fluoxetine]]
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| * [[fluoxetine extended release]]
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| * [[flurbiprofen]]
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| * [[flurbiprofen ophthalmic]]
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| * [[fluvoxamine]]
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| * [[fluvoxamine extended release]]
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| * [[garlic]]
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| * [[Garlic Oil]]
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| * [[Genacote]]
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| * [[Gennin-FC]]
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| * [[Genpril]]
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| * [[Genprin]]
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| * [[ginger]]
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| * [[Ginger Root]]
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| * [[Ginger(obs)]]
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| * [[gingko]]
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| * [[gingko biloba]]
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| * [[ginkgo]]
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| * [[ginkgo biloba]]
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| * [[ginseng]]
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| * [[Halfprin]]
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| * [[Haltran]]
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| * [[hemin]]
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| * [[Hofels Ginger One A Day]]
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| * [[Ibu]]
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| * [[IBU-200]]
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| * [[Ibu-4]]
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| * [[Ibu-6]]
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| * [[Ibu-8]]
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| * [[Ibu-Tab]]
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| * [[ibuprofen]]
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| * [[Ibuprofen PMR]]
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| * [[iloprost]]
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| * [[Ilosone]]
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| * [[Ilotycin Gluceptate]]
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| * [[Indocin]]
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| * [[Indocin SR]]
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| * [[indomethacin]]
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| * [[indomethacin extended release]]
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| * [[Jantoven]]
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| * [[K-Pek]]
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| * [[Kabikinase]]
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| * [[Kao-Tin Bismuth Subsalicylate Formula]]
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| * [[Kaopectate]]
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| * [[Kaopectate Anti-Diarrheal Upset Stomach Reliever]]
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| * [[Kaopectate Extra Strength]]
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| * [[Kapectolin (New Formula)]]
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| * [[ketoprofen]]
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| * [[ketoprofen extended release]]
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| * [[ketorolac]]
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| * [[ketorolac ophthalmic]]
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| * [[Kinlytic]]
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| * [[lapatinib]]
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| * [[Leader Naproxen Sodium]]
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| * [[lepirudin]]
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| * [[Lexapro]]
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| * [[Lipitor]]
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| * [[Litecoat Aspirin]]
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| * [[Lodine]]
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| * [[Lodine XL]]
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| * [[Low Dose ASA]]
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| * [[Luvox]]
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| * [[Luvox CR]]
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| * [[Maalox Total Stomach Relief]]
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| * [[Magan]]
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| * [[magnesium salicylate]]
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| * [[Marthritic]]
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| * [[Maximum Strength Stress]]
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| * [[meclofenamate]]
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| * [[Meclomen]]
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| * [[mefenamic acid]]
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| * [[meloxicam]]
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| * [[Menadol]]
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| * [[Meridia]]
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| * [[Midol Extended Relief]]
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| * [[Midol IB]]
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| * [[Midol Maximum Strength Cramp Formula]]
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| * [[Minitabs]]
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| * [[Miradon]]
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| * [[Mobic]]
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| * [[Mobidin]]
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| * [[Mono-Gesic]]
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| * [[Motrin]]
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| * [[Motrin Childrens]]
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| * [[Motrin IB]]
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| * [[Motrin Infant Drops]]
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| * [[Motrin Junior Strength]]
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| * [[Motrin Migraine Pain]]
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| * [[MST]]
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| * [[MY-E]]
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| * [[nabumetone]]
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| * [[Nalfon]]
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| * [[Naprelan '375']]
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| * [[Naprelan '500']]
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| * [[Naprosyn]]
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| * [[naproxen]]
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| * [[naproxen sodium]]
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| * [[Naproxen Sodium DS]]
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| * [[naproxen sodium extended release]]
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| * [[NeoProfen]]
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| * [[nepafenac ophthalmic]]
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| * [[Nevanac]]
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| * [[Norwich Aspirin]]
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| * [[Nuprin]]
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| * [[Nuprin Backache Caplet]]
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| * [[Ocufen]]
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| * [[Orudis]]
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| * [[Orudis KT]]
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| * [[Oruvail]]
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| * [[oxaprozin]]
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| * [[Panhematin]]
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| * [[paroxetine]]
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| * [[paroxetine extended release]]
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| * [[paroxetine mesylate]]
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| * [[Paxil]]
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| * [[Paxil CR]]
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| * [[PCE Dispertab]]
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| * [[Pediacare Fever]]
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| * [[pentosan polysulfate sodium]]
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| * [[Peptic Relief]]
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| * [[Pepto-Bismol]]
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| * [[Pepto-Bismol Maximum Strength]]
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| * [[Pexeva]]
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| * [[phenyl salicylate]]
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| * [[Pink Bismuth]]
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| * [[piroxicam]]
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| * [[Pletal]]
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| * [[Pondimin]]
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| * [[Ponstel]]
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| * [[Pristiq]]
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| * [[Prozac]]
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| * [[Prozac Weekly]]
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| * [[Q-Profen]]
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| * [[Rapiflux]]
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| * [[Redux]]
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| * [[Refludan]]
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| * [[Relafen]]
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| * [[Remodulin]]
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| * [[Retavase]]
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| * [[reteplase]]
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| * [[Rexolate]]
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| * [[Rifadin]]
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| * [[Rifadin IV]]
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| * [[rifampin]]
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| * [[Rimactane]]
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| * [[Robimycin]]
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| * [[Rufen]]
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| * [[Saleto-200]]
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| * [[Saleto-400]]
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| * [[Saleto-600]]
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| * [[Saleto-800]]
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| * [[Salflex]]
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| * [[salsalate]]
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| * [[Salsitab]]
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| * [[Sarafem]]
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| * [[sertraline]]
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| * [[sibutramine]]
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| * [[Sloprin]]
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| * [[sodium salicylate]]
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| * [[sodium thiosalicylate]]
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| * [[Solaraze]]
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| * [[St. Joseph Aspirin]]
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| * [[St. Joseph Aspirin Adult Chewable]]
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| * [[St. Joseph Aspirin Adult EC]]
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| * [[Stanback Analgesic]]
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| * [[Streptase]]
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| * [[streptokinase]]
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| * [[Stress Maximum Strength]]
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| * [[sulindac]]
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| * [[suprofen ophthalmic]]
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| * [[Tao]]
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| * [[tenecteplase]]
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| * [[Therapy Bayer]]
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| * [[tissue plasminogen activator]]
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| * [[TNKase]]
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| * [[Tolectin]]
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| * [[Tolectin 600]]
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| * [[Tolectin DS]]
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| * [[tolmetin]]
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| * [[Toradol]]
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| * [[Toradol IM]]
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| * [[Toradol IV/IM]]
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| * [[TPA]]
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| * [[Tracleer]]
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| * [[treprostinil]]
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| * [[Tri-Buffered Aspirin]]
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| * [[troleandomycin]]
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| * [[Tusal]]
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| * [[Tykerb]]
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| * [[urokinase]]
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| * [[valdecoxib]]
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| * [[venlafaxine]]
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| * [[venlafaxine extended release]]
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| * [[Ventavis]]
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| * [[verteporfin]]
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| * [[Visudyne]]
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| * [[Voltaren]]
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| * [[Voltaren Ophthalmic]]
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| * [[Voltaren Topical]]
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| * [[Voltaren-XR]]
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| * [[warfarin]]
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| * [[Wellbutrin]]
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| * [[Wellbutrin SR]]
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| * [[Wellbutrin XL]]
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| * [[Xibrom]]
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| * [[YSP Aspirin]]
| |
| * [[Zero-Order Release]]
| |
| * [[zingiber]]
| |
| * [[Zoloft]]
| |
| * [[Zorprin]]
| |
| * [[Zyban]]
| |
| * [[Zyban Advantage Pack]]
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| {{refend}}
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| | |
| ==Minor Interactions==
| |
| {{refbegin|3}}
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| * [[Accolate]]
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| * [[Amaryl]]
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| * [[capsaicin]]
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| * [[capsicum]]
| |
| * [[Celebrex]]
| |
| * [[celecoxib]]
| |
| * [[Cerebyx]]
| |
| * [[chamomile]]
| |
| * [[Chem Mart Tamoxifen]]
| |
| * [[clove]]
| |
| * [[Demadex]]
| |
| * [[Demadex I.V.]]
| |
| * [[Di-Phen]]
| |
| * [[Dilantin]]
| |
| * [[Dilantin Infatabs]]
| |
| * [[Dilantin Kapseals]]
| |
| * [[Dilantin-125]]
| |
| * [[Emblon]]
| |
| * [[fenugreek]]
| |
| * [[feverfew]]
| |
| * [[fluvastatin]]
| |
| * [[fluvastatin extended release]]
| |
| * [[fosphenytoin]]
| |
| * [[Genox]]
| |
| * [[GenRx Tamoxifen]]
| |
| * [[glimepiride]]
| |
| * [[Hep-Lock]]
| |
| * [[Hep-Pak]]
| |
| * [[Hep-Pak CVC]]
| |
| * [[heparin]]
| |
| * [[Heparin Lock Flush]]
| |
| * [[Lescol]]
| |
| * [[Lescol XL]]
| |
| * [[matricaria]]
| |
| * [[montelukast]]
| |
| * [[Nolvadex]]
| |
| * [[Nolvadex D]]
| |
| * [[Orinase]]
| |
| * [[Phenytek]]
| |
| * [[phenytoin]]
| |
| * [[phenytoin extended release]]
| |
| * [[Phenytoin Sodium]]
| |
| * [[Prompt]]
| |
| * [[Singulair]]
| |
| * [[Soltamox]]
| |
| * [[Tamofen]]
| |
| * [[Tamofen(obsolete)]]
| |
| * [[Tamone]]
| |
| * [[Tamosin]]
| |
| * [[Tamoxen]]
| |
| * [[tamoxifen]]
| |
| * [[Tamoxifen Hexal]]
| |
| * [[Terry White Chemists Tamoxifen]]
| |
| * [[Tol-Tab]]
| |
| * [[Tolbutamide]]
| |
| * [[torsemide]]
| |
| * [[turmeric]]
| |
| * [[zafirlukast]]
| |
| {{refend}}
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| | |
| ==References==
| |
| {{Reflist}}
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| | |
| {{FDA}}
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| | |
| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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