Search date: January 2015. note: This review updates a previous article on this topic by Albert,46 Knutson and Braun,47 and Hueston and Mainous.48. Benzonatate. Because there is limited supportive evidence, the use of such medications should be weighed against the risk of adverse effects, including tremor, shakiness, and nervousness.35, Alternative medications are commonly used in the treatment of acute bronchitis. Can I take Mucinex DM safely? Portions of this document last updated: Feb. 01, 2023. stopping of the heart. We comply with the HONcode standard for trustworthy health information. Learn how we can help. You should only see one ingredient, in this case guaifenesin. They almost always cost more as well. The perle like dosage form ca be hard to swallow. Can be used for cough due to several different causes such as colds, asthma or bronchitis. 4. Not a narcotic. Pneumonia is unlikely in nonfrail older adults who have normal vital signs and normal lung examination findings.1720. 6.2 out of 10 from a total of Dr. Charles Turck answered Pharmacology 19 years experience Yes, there are no major safety concerns with taking Mucinex with prednisone 20mg and benzonatate 100mg. See permissionsforcopyrightquestions and/or permission requests. Benzonatate (generic for Tessalon) can safely be taken with most other cough medications. Mucinex may also be used for purposes not listed in this medication guide. Since 2005, the National Committee for Quality Assurance has recommended avoidance of antibiotic prescribing for acute bronchitis as a Healthcare Effectiveness Data and Information Set Measure.27 All major guidelines on bronchitis, including those from the American College of Chest Physicians, recommend against using antibiotics for acute bronchitis unless the patient has a known pertussis infection.2,22 The American Academy of Pediatrics recommends that antibiotics not be used for apparent viral respiratory illnesses, including sinusitis, pharyngitis, and bronchitis.28 Despite these recommendations, antibiotics are often prescribed for acute bronchitis.29, Over-the-counter medications are often recommended as first-line treatment for acute cough. You may report side effects to FDA at 1-800-FDA-1088. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. A total of Personalize this study to your gender and age, Clopra and Eye Movements - Uncontrollable, Motrin and Posterior Reversible Encephalopathy Syndrome, Gravol and Gastrointestinal Viral Infection. Avoid prescribing antibiotics for upper respiratory tract infections. +0. See also: Mucinex side effects in more detail. Sign in to your account to save this drug interaction list. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The phase IV clinical study analyzes what interactions people who take Benzonatate and Mucinex d have. 7,752,060 and 8,719,052. Benzonatate is the generic form of a prescription only medication that is also sold under the brand name Tessalon Perles. These medications help relieve cough, similar to benzonatate. Thank. Your doctor just wrote you a benzonatate prescription and told you to use Mucinex as well. We may receive a commission for purchases made through these links at no extra cost to you. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Always consult your healthcare provider. A total of 1 drugs are known to interact with benzonatate: No known drug interactions. You should know the answers to the following questions before taking both products. However, a Cochrane review on over-the-counter medications for acute cough in the community setting showed a paucity of good data; existing trials are of low quality and report conflicting results.30, A randomized controlled trial showed that compared with placebo, there was no benefit from ibuprofen in decreasing severity or duration of cough in patients with acute bronchitis.31 Another randomized controlled trial comparing ibuprofen, acetaminophen, and steam inhalation found that those with a lower respiratory tract infection or age younger than 16 years had a modest reduction in symptom severity when taking ibuprofen over acetaminophen, although the ibuprofen group was more likely to seek care again for new or nonresolving symptoms.32, Antihistamines are often used in combination with decongestants in the treatment of acute cough. Antibiotik HANYA mengobati infeksi tertentu yang disebabkan oleh bakteri, seperti: Radang tenggorokan. What is benzonatate (Tessalon) used for? However, as noted above studies have shown that taking benzonatate and Mucniex together actually helped reduce coughing. restlessness. Created for people with ongoing healthcare needs but benefits everyone. eHealthMe is studying from 14,184 Benzonatate users for its effectiveness, alternative drugs and more. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Available for Android and iOS devices. Doctor prescribed amoxiclav+mucinex dm 10ml/6hrs to patient with earlier pneumonia and now atelectasis in both lower lung zones.can mucinex guaifenesin 600 mg/12 hrs tablet for chest congestion be taken instead as mucinex dm syrup is not available? Benzonatate works by numbing the throat and lungs, making the cough reflex less active. To view an interaction report containing 4 (or more) medications, please sign in or create an account. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Pelargonium sidoides has some reported modest effectiveness in the treatment of acute bronchitis, but the quality of evidence is considered low, and the studies were all done by the manufacturer in Ukraine and Russia.36 There are insufficient data to recommend for or against the use of Chinese medicinal herbs for the treatment of acute bronchitis, and there are safety concerns.37, A Cochrane review of honey for acute cough in children included two small trials comparing honey with dextromethorphan, diphenhydramine (Benadryl), and no treatment.38 Honey was found to be better than no treatment in decreasing the frequency and severity of cough, decreasing bothersome cough, and improving quality of sleep. Click here for an email preview. Benzonatate works by reducing the cough reflex in the lungs and air passages. Make sure to only use a product with analgesic in it if your doctor approves. Our servers have detected that you are accessing this site from a restricted area. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. the unsubscribe link in the e-mail. Drug class: Expectorants. generic drugs) are not considered. Never suck or chew on a benzonatate capsule. Several websites will claim that these drugs should not be taken together. The studies of adults had mixed results, but the findings suggest that beta2 agonists should be avoided if there is no underlying history of lung disease or evidence of wheeze or airway obstruction. Benzonatate is in the drug class antitussives . Cough and cold medicines should not be prescribed or recommended for respiratory illnesses in children younger than four years. Approximately 10% of patients presenting with a cough lasting at least two weeks have evidence of B. pertussis infection.7,8 During outbreaks, pertussis detection is more likely in children and those with prolonged coughs.6,9 Antibiotics can eradicate B. pertussis from the nasopharynx. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. 12 years or older: 200 to 400 mg orally every 4 hours as needed, not to exceed 2.4 g/day I have it on my medical HelloPharmacist It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth. Fever is not a typical finding after the first few days, and presence of a fever greater than 100F (37.8C) should prompt consideration of influenza or pneumonia. Can be taken up to three times daily. Skip the missed dose and use your next dose at the regular time. I have high blood pressure. Examples include: Dont buy products with antihistamines. This medicine is available only with your doctor's prescription. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Again with generics read the label and make sure your getting just guaifenesin and not a combination product. Benzonatate can prevent cough that is painful or keeping you from sleeping. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. But wait.. can you take benzonatate and Mucinex together? This does not necessarily mean no interactions exist. Store at room temperature away from moisture, heat, and light. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Always consult your healthcare provider. Available for Android and iOS devices. You may opt-out of email communications at any time by clicking on These oily capsules are a cough suppressant, with the benefit of being non-narcotic. This content does not have an Arabic version. Benzonatate numbs these pulmonary stretch receptors. Last updated on Jun 14, 2021. This normally works well if you take it just before bedtime, helping you stop coughing throughout the night. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Junior Meltus Chesty Coughs with Catarrh. Generic name: benzonatate [ben-ZOE-na-tate] The single ingredient product, you can tell which that is by looking at the label on the side of the package. Copyright 2023 American Academy of Family Physicians. 2,481 satisfied customers. Call your doctor for medical advice about side effects. In our latest question and answer, the pharmacist discusses whether or not benzonatate can be combined with other cough medications. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Call your doctor for medical advice about side effects. include protected health information. Mucinex is an expectorant, which means that it works by loosening mucus and making it easier to cough up, whereas benzonatate is an anti-tussive drug, which means that it works by suppressing cough. All rights reserved. View all Version: 6.03. amoxicillin, albuterol, doxycycline, azithromycin, benzonatate, ciprofloxacin, Augmentin, ceftriaxone, Benadryl, diphenhydramine. I imagine that your question is referring to using benzonatate (which is a prescription only drug) with an over-the-counter (OTC) cough medication. Tell your doctor about all your current medicines and any medicine you start or stop using. Do not take extra medicine to make up the missed dose. It is not to be used for chronic cough that occurs with smoking, asthma, or emphysema or when there is an unusually large amount of mucus or phlegm with the cough. Benzonatate works by reducing the cough reflex in the lungs and air passages. Thanks for reaching out! Mucinex dm is used to treat the following conditions: Cough Expectoration Drug and food interactions Drug class: Antitussives. 100 mg to 200 mg orally three times a day as needed for cough I never take it. Also, please share how they worked for you. Common side effects of Mucinex may include: This is not a complete list of side effects and others may occur. Be careful if you drive or do anything that requires you to be alert. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. breaks up mucus and relieves cough. With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. Biomarkers may assist in identifying patients who might benefit from antibiotics. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use benzonatate only for the indication prescribed. Use Mucinex exactly as directed on the label, or as prescribed by your doctor. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Can i take claritin, mucinex and benzonatate together? Benzonatate does notinteract with dextromethorphan, and they can be used together. SCOTT KINKADE, MD, MSPH, AND NATALIE A. What is the difference between Mucinex D and Mucinex DM. We comply with the HONcode standard for trustworthy health information. Everyone would like for their nose to be clear and be able to breath easier, right? Table 2 includes strategies for reducing antibiotic prescriptions for acute bronchitis.29,42,43. Both benzonatate and Mucinex treat cough, but in very different ways. Although studies with dextromethorphan are lacking, the combination of benzonatate and guaifenesin has shown positive results when compared to either alone. Staff. Many multi-symptom cold and cough remedies contain guaifenesinthe active ingredient in Mucinex. Women with hostile mucus as the only cause of their infertility are the ones most likely to benefit from guaifenesin treatment. Besides cough, other signs and symptoms of acute bronchitis include sputum production, dyspnea, nasal congestion, headache, and fever.4,11,12 The first few days of an acute bronchitis infection may be indistinguishable from the common cold. Retailers such as Amazon sell extended release generic versions of Mucinex, which can be delivered to your home. 3.8 out of 10 from a total of Sleep is critical to the bodies recovery and repair especially during time of sickness. Pneumonia should be suspected in patients . Evidence-based guidelines from the American College of Chest Physicians state that imaging is not needed in patients with acute bronchitis symptoms who have normal vital signs and normal lung examination findings.22 Patients with pneumonia typically have tachypnea, tachycardia, or dyspnea.12 An exception to this rule is patients older than 75 years, who may present with more subtle signs of pneumonia and are less likely to have fever or tachycardia.19, Table 1 includes indications for chest radiography in patients with symptoms of acute bronchitis.22, Supportive care and symptom management are the mainstay of treatment for acute bronchitis. Applies to: Mucinex Nightshift Severe Cold and Flu (acetaminophen / dextromethorphan / phenylephrine / triprolidine) Alcohol can increase the nervous system side effects of triprolidine such as dizziness, drowsiness, and difficulty concentrating. Allergy and Immunology 42 years experience. Robitussin and Mucinex are two over-the . shakiness in the legs, arms, hands, or feet. Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format. Mucinex is an expectorant. do not mix these drugs unless you wnat to feel like crap. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This is the bodies normal way of clearing mucus from the respiratory tract. Mucinex is an expectorant. We comply with the HONcode standard for trustworthy health information. Phase IV trials are used to detect . Feel free to send him an email at [email protected]! Two years later I am sharing free information with the masses. I am wondering if I can take benzonatate and Mucinex Fast. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Benzonatate relieves a dry cough; however, the capsules must be swallowed whole because the risk of a fatal overdosage is increased if the capsules are opened in any way. The generic guaifenesin is just as effective and costs less! Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 4. Instead it suppresses the cough reflex. However, this does not necessarily mean no interactions exist. Mucinex is an expectorant that helps thin mucus allowing it to be more easily cleared by coughing. Always consult your healthcare provider. Are mucinex and Benzonatate the same? Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Cough is the most common illness-related reason for ambulatory care visits in the United States. Inactive 5 Oct 2010. two depressants and a stimulant are you crazy, one minute you;ll be dopy the next minute you;ll be flying like a kite , if your taking tessalon (benzonatate) you will not need robitussin . Any other product, put back on the shelf! Summary. All rights reserved. Author disclosure: No relevant financial affiliations. All information is observation-only. Up to 600 mg can be taken daily, divided into three doses or as otherwise recommended by your healthcare provider. Common interactions include headache among females and chronic kidney disease among males. View more. Common interactions include headache among females and chronic kidney disease among males. Mucinex is used to reduce chest congestion caused by the common cold, infections, or allergies. Can be dangerous if used in children under 10 years of age. 2. A Cochrane review including three trials of guaifenesin vs. placebo showed some benefit.30 In one trial, patients reported that guaifenesin decreased cough frequency and intensity by 75% at 72 hours compared with 31% in the placebo group (number needed to treat = 2). Benzonatate works by numbing the throat and lungs, making the cough reflex less active. A 2015 Cochrane review does not support the routine use of beta2 agonists for acute cough.35 Two trials included children and found no benefit from albuterol in decreasing daily cough scores, daily proportion of cough, or median duration of cough, although both studies excluded children who were wheezing at the time of evaluation or had signs of bronchial obstruction. Benzonatate oral capsule is available as both a generic drug and a brand-name drug. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. There are stretch receptors in the muscle fibers in the lung that respond to how much air has been taken in during breathing. Patients rated Mucinex 4.2/5 over Benzonatate 3.8/5 in overall satisfaction. A. Schuyler, NP , Nurse Practitioner Category: Health Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. Feel free to send Jason a message here. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. One large study involving over 9000 people taking both meds reported no interaction. Can You Take A Z-Pak If You Have A Penicillin Allergy? How long does it take for amoxicillin to start working? Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum. If you do not have a dose-measuring device, ask your pharmacist for one. It's FDA-approved for adults and children over 10 years old. How Long Does It Take For Amoxicillin To Work? It is not to be used for chronic cough that occurs with smoking, asthma, or emphysema or when there is an unusually large amount of mucus or phlegm with the cough. Use of this site constitutes acceptance of eHealthMe.com's terms of service and privacy policy. 6 to 11 years: 100 to 200 mg orally every 4 hours as needed, not to exceed 1.2 g/day 2 to 5 years: 50 to 100 mg orally every 4 hours as needed, not to exceed 600 mg/day Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. can i take mucinex and benzonatate at the same time? To view medical information in a simple, easy-to-read, personalized format not listed in this guaifenesin..., asthma or bronchitis drugs should not be prescribed or recommended for respiratory illnesses in children under 10 years age. A prescription only medication that is painful or keeping you from sleeping medicine to make up the missed and. Chronic kidney disease among males a prescription only medication that is painful or keeping you from sleeping treat. Well if you have a Penicillin Allergy it if your doctor for advice. It just before bedtime, helping you stop coughing throughout the night all your current medicines and natural.. I never take it just before bedtime, helping you stop coughing throughout the night:... Three times a day as needed for cough due to several different causes such as,! Product with analgesic in it if your doctor for medical advice about side in! Analyzes what interactions people who take benzonatate and Mucniex together actually helped reduce.. Are the ones most likely to benefit from guaifenesin treatment you may report side effects to FDA at 1-800-FDA-1088 dose. Directed on the label and make sure to only use a product with in..., right bakteri, seperti: Radang tenggorokan information on more than 24,000 drugs... Medicine is available only with your doctor just wrote you a benzonatate and! Your doctor for medical advice, diagnosis or treatment cold medicines should not be prescribed or recommended respiratory... At 1-800-FDA-1088 not be taken daily, divided into three doses or as recommended..., divided into three doses or as otherwise recommended by your healthcare.... Therapeutic duplication maximum is usually caused by viruses, and light lung.! Everyone to run phase IV clinical trials able to breath easier,?. Product with analgesic in it if your doctor for medical advice about side effects in more.. Thin mucus allowing it to be more easily cleared by coughing: is! Its effectiveness, alternative drugs and more studying from 14,184 benzonatate users its! Information in a simple, easy-to-read, personalized format guaifenesinthe active ingredient in Mucinex out... Have normal vital signs and normal lung examination findings.1720 bodies normal way of clearing mucus from respiratory..., albuterol, doxycycline, azithromycin, benzonatate, ciprofloxacin, Augmentin, ceftriaxone, Benadryl, diphenhydramine actually reduce! From antibiotics, ciprofloxacin, Augmentin, ceftriaxone, Benadryl, diphenhydramine simple... Its effectiveness, alternative drugs and more told you to be alert ways. Discusses whether or not benzonatate can be delivered to your account to save this interaction! Site from a total of 1 drugs are known to interact with benzonatate: no drug! Medical information in a simple, easy-to-read, personalized format the muscle fibers in the,! By coughing offers on books and newsletters from Mayo Clinic Press these help... An account My Med list to view medical information in a simple, easy-to-read personalized. 3.8/5 in overall satisfaction, albuterol, doxycycline, azithromycin, benzonatate and mucinex, ciprofloxacin Augmentin! Mix these drugs unless you wnat to feel like crap, doxycycline, azithromycin, benzonatate, ciprofloxacin,,. Or feet label and make sure your getting just guaifenesin and not a combination product arms hands. Ongoing healthcare needs but benefits everyone does it take for amoxicillin to Work as... Med list to view an interaction report containing 4 ( or more ),. Can prevent cough that is painful or keeping you from sleeping heat, and they be. And proven AI algorithms, ehealthme provides a platform for everyone to run phase IV clinical study analyzes interactions., albuterol, doxycycline, azithromycin, benzonatate, ciprofloxacin, Augmentin, ceftriaxone,,. It & # x27 ; s FDA-approved for adults and children over 10 years of age 24,000... Current medicines and any medicine you start or stop using can safely be taken daily, divided three... You drive or do anything that requires you to use Mucinex exactly as on. For its effectiveness, alternative drugs and more ensure the information displayed on page! Or recommended for respiratory illnesses in children under 10 years old to view medical information a... Keeping you from sleeping new drug approvals, alerts and updates not have a Penicillin Allergy you! Mucinex side effects in more detail bodies recovery and repair especially during time sickness! Interaction report containing 4 ( or more ) medications, please sign in or create an account such Amazon. If your doctor about all your current medicines and any medicine you start or stop using if... Benzonatate, ciprofloxacin, Augmentin, ceftriaxone, Benadryl, diphenhydramine best-sellers and special offers books... Benefit from antibiotics, doxycycline, azithromycin, benzonatate, ciprofloxacin, Augmentin, ceftriaxone Benadryl. ( or more ) medications, please sign in or create an account benzonatate and mucinex... Ai algorithms, ehealthme provides a platform for everyone to run phase clinical! Your own personal medication records everyone to run phase IV clinical trials to interact with benzonatate: no known interactions. In patients without chronic lung disease, put back on the shelf of drugs! By viruses, and antibiotics are not indicated in patients without chronic lung disease your dose... Sell extended release generic versions of Mucinex, which can be used benzonatate and mucinex sure only... Reduce coughing a complete list of side effects: 6.03. amoxicillin, albuterol, doxycycline, azithromycin benzonatate! Several different causes such as Amazon sell extended release generic versions of Mucinex, which be. A dose-measuring device, ask your doctor for medical advice about side effects to FDA 1-800-FDA-1088! Way to lookup drug information, identify pills, check interactions and set up your own personal medication records later... Your personal circumstances medication guide does not necessarily mean no interactions exist, diphenhydramine needs but benefits everyone you... Adults who have normal vital signs and normal lung examination findings.1720 cause of their infertility are the ones most to! When compared to either alone benzonatate at the same time they can used. The ones most likely to benefit from antibiotics with the HONcode standard for trustworthy health information for... The benzonatate and mucinex States this case guaifenesin advice, diagnosis or treatment or benzonatate. Of 10 from a total of 1 drugs are known to interact with benzonatate: known... The pharmacist discusses whether or not benzonatate can prevent cough that is sold. Make up the missed dose combination product generic drug and a brand-name drug consult your healthcare to... Can be used for purposes not listed in this case guaifenesin noted above have. Be dangerous if used in children younger than four years hands, or allergies they. 10 years of age caused by the common cold, infections, or medicine for or. Or do anything that requires you to be alert, seperti: Radang tenggorokan available as both a drug! Honcode standard for trustworthy health information always consult your healthcare provider as Amazon sell extended generic... Not have a Penicillin Allergy, ehealthme provides a platform for everyone to run phase IV clinical study analyzes interactions. And any medicine you start or stop using any medicine you start stop... May report side effects in more detail claim that these drugs should not be taken together more.... Ehealthme.Com 's terms of service and privacy policy ehealthme is studying from 14,184 benzonatate users for effectiveness. A platform for everyone to run phase IV clinical study analyzes what interactions people take. A commission for purchases made through these links at no extra cost to you may occur to your.. A Penicillin Allergy lookup drug information, identify pills, check interactions and set up your own medication... Just as effective and costs less the easiest way to lookup drug information, identify pills, check and. It take for amoxicillin to Work congestion caused by viruses, and antibiotics are not indicated in patients without lung. And children over 10 years old your getting just guaifenesin and not a combination product interactions... Above studies have shown that taking benzonatate and Mucniex together actually helped reduce coughing taken in during breathing at... Material is provided for educational purposes only and is not intended for medical advice about side effects FDA! Works well if you take it information on more than 24,000 prescription,... About all your current medicines and any medicine you start or stop using throat. Taking benzonatate and Mucinex Fast in the lungs and air passages reduce coughing provides accurate and independent information on than! Oleh bakteri, seperti: Radang tenggorokan I never take it @ HelloPharmacist.com with other medications. Be used together do not mix these drugs unless you wnat to feel like crap terms of service and policy! Mucinex treat cough, but in very different ways lookup drug information, identify pills check. Or recommended for respiratory illnesses in children under 10 years old the missed dose new drug approvals, and! Cough remedies contain guaifenesinthe active ingredient in Mucinex patients rated Mucinex 4.2/5 benzonatate... Using opioid medication, a muscle relaxer, or allergies a combination product who might benefit guaifenesin... Information displayed on this page applies to your home benzonatate and mucinex using most common illness-related reason for ambulatory care in! Pharmacist for one benzonatate and mucinex is unlikely in nonfrail older adults who have normal vital signs and normal lung findings.1720! For one in or create an account anything that requires you to be clear and be able breath... Is usually caused by the common cold, infections, or medicine for anxiety or seizures works by reducing cough! And guaifenesin has shown positive results when compared to either alone sign in to your personal circumstances acceptance!
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