Lorazepam has a moderate duration of effect (six to Conversion of IV Midazolam Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been lorazepam versus midazolam for sedation of ICU patients via a pharmacologic model. Monitor Closely (1)lorazepam and thioridazine both increase sedation. 5w)s{ Monitor Closely (2)lorazepam, loxapine inhaled. Lugo RA, Chester EA, Cash J, Grant MJ, Vernon DD. Use Caution/Monitor. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. lorazepam increases and dopexamine decreases sedation. Share cases and questions with Physicians on Medscape consult. Monitor Closely (1)lorazepam and diphenoxylate hcl both increase sedation. Monitor closely for signs of respiratory depression and sedation. lorazepam and morphine both increase sedation. Avoid or Use Alternate Drug. depression, hypotension. Monitor Closely (1)lorazepam and risperidone both increase sedation. HHS Vulnerability Disclosure, Help Several factors play a role in the scientific basis of IV:PO con-version. If you log out, you will be required to enter your username and password the next time you visit. Monitor Closely (1)lorazepam and temazepam both increase sedation. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. depression, hypotension. Modify Therapy/Monitor Closely. Monitor Closely (1)cyproheptadine and lorazepam both increase sedation. Monitor Closely (1)lorazepam and haloperidol both increase sedation. official website and that any information you provide is encrypted Use Caution/Monitor. lorazepam and sufentanil both increase sedation. Monitor Closely (1)lorazepam increases and dextroamphetamine decreases sedation. diazepam and lorazepam both increase sedation. Monitor Closely (1)lorazepam increases and isoproterenol decreases sedation. <>
Let's calculate the actual benzodiazepine equivalent doses! Use Caution/Monitor. oliceridine, lorazepam. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. dichlorphenamide, lorazepam. Use Caution/Monitor. Continuously monitor vital signs during sedation and recovery period if coadministered. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Use Caution/Monitor. For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. Minor/Significance Unknown. Bioavailability and pharmacokinetics of oxazepam. Monitor Closely (1)lorazepam and flibanserin both increase sedation. Effect of interaction is not clear, use caution. lorazepam and butorphanol both increase sedation. Either increases toxicity of the other by pharmacodynamic synergism. WebConsider the following criteria to identify residents that may be suitable candidates for an IV to PO conversion. Modify Therapy/Monitor Closely. Minor (1)rifabutin decreases levels of lorazepam by increasing metabolism. lorazepam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown. Use Caution/Monitor. If necessary, adjust dose of alprazolam as needed, Monitor levels of digoxin, and reduce dose as needed, Adjust dose of diazepam as needed, or change to a benzodiazepine eliminated by glucuronidation, Reduce starting dose of alprazolam by 50%; adjust dose further as needed, Alprazolam, diazepam Fosamprenavir (Lexiva), Chlordiazepoxide, clonazepam ketoconazole, Diazepam, lorazepam olanzapine (Zyprexa), Increased risk of cardiorespiratory depression, Avoid use of parenteral benzodiazepines and IM olanzapine, Diazepam phenyton (Dilantin), fosphenytoin (Cerebyx), Monitor phenytoin levels, and adjust dose as needed, Reduce lorazepam starting dose by 50%; adjust dose further as needed, Alprazolam, clonazepam, diazepam ritonavir (Norvir), Alprazolam, diazepam saquinavir (Invirase), Increased sedative/CNS depressant effects, Monitor for sedative effects, and adjust dose of one or both as needed, Monitor for increased sedative/CNS depressant effects, Start tapentadol at 1/3 to 1/2 the usual starting dose. Use Caution/Monitor. q1LA8LK`yU_*_*TyT8nwx8aYPMCM'J7;vYb=-q_ee)9";Tz*`80mf I
U~U\T_j=]O;\YPlE p&r# Limit dosages and durations to the minimum required. Monitor Closely (1)lorazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Monitor Closely (1)lorazepam increases and salmeterol decreases sedation. SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, loss of coordination, headache, nausea, blurred vision, change in sexual interest/ability, constipation, heartburn, or change in appetite may occur. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). Use Caution/Monitor. Monitor closely for signs of respiratory depression and sedation. Monitor Closely (1)brexanolone, lorazepam. Minor (2)lorazepam and sage both increase sedation. 0.67 * 1 = 0.67 mg, And here we go, 0.67 mg is our final alprazolam (Xanax) dose! A Johns Hopkins Guides subscription is required to, Benzodiazepines act through the gamma-aminobutyric acid (GABA) A receptor, which regulates chloride entry into neurons, resulting in neuronal hyperpolarization. Either increases toxicity of the other by sedation. Although tolerance to the anxiolytic effects is uncommon, avoid use in patients with a history of substance use disorder. Our benzo calculator uses the first mentioned and most popular option duration. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. Serious - Use Alternative (1)valerian and lorazepam both increase sedation. lorazepam and chlorpromazine both increase sedation. Monitor Closely (1)lorazepam and diamorphine both increase sedation. lorazepam decreases effects of pancuronium by pharmacodynamic antagonism. Please confirm that you would like to log out of Medscape. Monitor Closely (1)butalbital and lorazepam both increase sedation. Use Caution/Monitor. green tea decreases effects of lorazepam by pharmacodynamic antagonism. Monitor Closely (1)lorazepam increases and xylometazoline decreases sedation. Webdocumenting the conversion using the IV to PO conversion category. Modify Therapy/Monitor Closely. MeSH Cannabidiol may potentially inhibit UGT2B7 activity. T1 - Benzodiazepines Monitor Closely (1)lorazepam and tramadol both increase sedation. Monitor Closely (1)lorazepam and hydromorphone both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. Use Caution/Monitor. Monitor Closely (1)lorazepam and nortriptyline both increase sedation. lorazepam and dipipanone both increase sedation. Monitor Closely (1)lorazepam and sufentanil both increase sedation. lorazepam increases and lisdexamfetamine decreases sedation. Modify Therapy/Monitor Closely. Data is temporarily unavailable. midazolam intranasal, lorazepam. Effect of interaction is not clear, use caution. Use Caution/Monitor. An IV Loading dose is 0.02 to 0.04 mg/kg (maximum single dose 2 mg); the Maintenance dose is 0.02 to 0.06 mg/kg every 2 to 6 hours as needed or 0.01 to 0.1 Other (see comment). Check out 22 similar dosage calculators , Benzodiazepine half-life & benzodiazepine classification, Benzodiazepine equivalency table benzo conversion chart. Your message has been successfully sent to your colleague. Use Caution/Monitor. Benzodiazepines are often used to bridge patients who are starting an "antidepressant" for anxiety, since the therapeutic effects may be delayed, and patients may experience stimulating side effects initially. Modify Therapy/Monitor Closely. Benzodiazepines [Internet]. Either increases toxicity of the other by sedation. Consult your doctor for more details. Biotin supplementation may be necessary. Enhanced metabolism incr levels of hepatotoxic metabolites. clemastine and lorazepam both increase sedation. Effect of interaction is not clear, use caution. Why are benzodiazepines so popular? OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Use Caution/Monitor. Use Caution/Monitor. 81 0 obj <>
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Benzodiazepine selection in the management of status epilepticus: a review. lorazepam and nabilone both increase sedation. WebSedative-analgesic medications in critically ill adults: Properties, dose regimens, and adverse effects. Monitor Closely (1)lorazepam increases and phendimetrazine decreases sedation. Minor (1)zolpidem, lorazepam. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journals website (http://journals.lww.com/pccmjournal). Use Caution/Monitor. Use Caution/Monitor. Do not double the dose to catch up. Modify Therapy/Monitor Closely. Coadministration enhances CNS depressant effects. lorazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Either increases effects of the other by sedation. Monitor Closely (1)lorazepam and chlorpromazine both increase sedation. MEDICAL ALERT: Your condition can cause complications in a medical emergency. lorazepam increases and phendimetrazine decreases sedation. Minor/Significance Unknown. Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary. Applies only to oral form of both agents. Monitor closely for signs of respiratory depression and sedation. Effect of interaction is not clear, use caution. lorazepam and hydromorphone both increase sedation. lorazepam and olanzapine both increase sedation. Monitor Closely (1)gabapentin enacarbil, lorazepam. lorazepam and dextromoramide both increase sedation. Minor/Significance Unknown. Use Caution/Monitor. lorazepam increases and dextroamphetamine decreases sedation. Use Caution/Monitor. 0000008826 00000 n
Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)lorazepam and codeine both increase sedation. lorazepam and belladonna and opium both increase sedation. pentobarbital and lorazepam both increase sedation. Use Caution/Monitor. lorazepam and dantrolene both increase sedation. lorazepam decreases effects of atracurium by pharmacodynamic antagonism. Use Caution/Monitor. Adv Emerg Nurs J. Minor/Significance Unknown. Use Caution/Monitor. Adding plans allows you to compare formulary status to other drugs in the same class. Use Caution/Monitor. Continuous infusions of lorazepam, midazolam, and propofol for sedation of the critically ill surgery trauma patient: a prospective, randomized comparison. informational and educational purposes only. Diazepam: Well-absorbed orally; bioavailability 90%; time to peak concentration 0.5-6 hours (rapid), Lorazepam: Well-absorbed orally; bioavailability 90%; time to peak concentration 1-2 hours (intermediate), Alprazolam: Metabolized by the liver (CYP3A4). To prevent withdrawal, your doctor may lower your dose slowly. Use Caution/Monitor. 5, 7. lorazepam increases and pirbuterol decreases sedation. ", Kim, P. M., & Weinstein, S. L. (2016). lorazepam and thioridazine both increase sedation. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvYXRpdmFuLWxvcmVldi14ci1sb3JhemVwYW0tMzQyOTA2, View explanations for tiers and Let's practice it all with a small example: Take a closer look our equivalent benzodiazepine calculator gives you both generic (pharmaceutical) and brand names of all the drugs! Complete Product Information. Effect of interaction is not clear, use caution. depression, hypotension. To convert the value, The sleep calculator can help you determine when you should go to bed to wake up happy and refreshed. Consult your doctor for more details. Avoid or Use Alternate Drug. Use Caution/Monitor. Patients treated with selinexor may experience neurological toxicities. lorazepam and droperidol both increase sedation. Either increases toxicity of the other by pharmacodynamic synergism. Either increases effects of the other by pharmacodynamic synergism. Benzodiazepines. lorazepam and baclofen both increase sedation. Seventy-one patient encounters were analyzed (median age, 2.5 yr; interquartile range, 1.2-5.3). Either increases effects of the other by pharmacodynamic synergism. lorazepam decreases effects of rocuronium by pharmacodynamic antagonism. Use Caution/Monitor. Minor/Significance Unknown. . To view other topics, please log in or purchase a subscription. Use Caution/Monitor. lorazepam and methocarbamol both increase sedation. Comment: Drug combination has been found to be incompatible. Either increases effects of the other by Other (see comment). To evaluate if institutionally established calculations for transitioning continuous IV midazolam to enteral benzodiazepines maintain Withdrawal Assessment ToolVersion 1 scores equal to or less than preconversion values. Use Caution/Monitor. Use lowest dose possible and monitor for respiratory depression and sedation. Paradoxical reactions (anxiety, excitation, agitation, hostility, aggression, rage), Use of injectable dosage form in premature infants (contains benzyl alcohol), Concomitant use of benzodiazepines, including lorazepam, and opioids may result in profound sedation, respiratory depression, coma, and death (see BBW), Advise both patients and caregivers about the risks of respiratory depression and sedation when lorazepam is used with opioids; advise patients not to drive or operate heavy machinery until the effects of concomitant use with the opioid have been determined, Use of benzodiazepines, including lorazepam, both used alone and in combination with other CNS depressants, may lead to potentially fatal respiratory depression, Not recommended for use in patients with primary depressive disorder or psychosis, Injection contains benzyl alcohol associated with potentially fatal "gasping syndrome" in neonates and an increased incidence of kernicterus, particularly in small preterm infants; if patient requires more than recommended dosages or other medications containing this preservative, practitioner must consider daily metabolic load of benzyl alcohol from combined sources, Prolonged use may lead to physical and psychological dependence especially in patients with history of alcohol or drug abuse; risk of dependence is decreased with short-term treatment (eg, 2-4 weeks); evaluate need for continued treatment prior to extending therapy duration, Use of drug, particularly in patients at elevated risk, necessitates counseling about risks and proper use of drug along with monitoring for signs and symptoms of abuse, misuse, and addiction; do not exceed recommended dosing frequency, Avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (eg, opioid analgesics, stimulants); advise patients on proper disposal of unused drug; if a substance use disorder is suspected, evaluate patient and institute (or refer them for) early treatment, as appropriate, For patients using treated more frequently than recommended, to reduce risk of withdrawal reactions, use a gradual taper to discontinue therapy (a patient-specific plan should be used to taper the dose), Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages, and those who have had longer durations of use, In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months, Use caution in patients with history of suicide attempt or drug abuse, Do not withdraw abruptly after prolonged use; terminate dosage gradually, Use caution in patients with impaired gag reflex, May cause CNS depression, impairing physical and mental abilities; caution patients to not operate dangerous machinery or motor vehicles, Use caution in patients with respiratory disease, including COPD or sleep apnea, Hyperactive or aggressive behavior and other paradoxical reactions reported with use, Caution patients that tolerance for alcohol and other CNS depressants will be diminished, There is a pregnancy registry that monitors pregnancy outcomes in woman exposed to psychiatric medications; healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychiatric Medications at 1-866-961-2388 or visiting online at https://womensmentalhealth.org/pregnancyregistry/Neonates born to mothers using benzodiazepines late in pregnancy have been reported to experience symptoms of sedation and/or neonatal withdrawal; available data from published observational studies of pregnant women exposed to benzodiazepines do not report a clear association with benzodiazepines and major birth defects, Benzodiazepines cross the placenta and may produce respiratory depression, hypotonia, and sedation in neonates; monitor neonates exposed to this medication during pregnancy or labor for signs of sedation, respiratory depression, hypotonia, and feeding problems, Monitor neonates exposed to therapy during pregnancy for signs of withdrawal; manage these neonates accordingly, Advise pregnant females who are administered this medication late in pregnancy that therapy can result in sedation (respiratory depression, lethargy, hypotonia) and/or withdrawal symptoms (hyperreflexia, irritability, restlessness, tremors, inconsolable crying, and feeding difficulties) in newborns; instruct patients to inform their healthcare provider if they are pregnant, There are insufficient data regarding obstetrical safety of parenteral lorazepam, including use in cesarean section; such use, therefore, is not recommended, This drug is present in breast milk; there are reports of sedation. Minor/Significance Unknown. Use Caution/Monitor. Monitor Closely (1)dichlorphenamide, lorazepam. Monitor Closely (1)acrivastine and lorazepam both increase sedation. Effect of interaction is not clear, use caution questions with Physicians on consult... Would like to log out, you will be required ativan iv to po conversion endep enter your username and password the time! Check out 22 similar dosage calculators, Benzodiazepine half-life & Benzodiazepine classification Benzodiazepine! Enacarbil, lorazepam log in or purchase a subscription can do it safely other treatment options inadequate. Randomized comparison enter your username and password the next time you visit adding plans you... Tolerance to the anxiolytic effects is uncommon, avoid use in patients for whom other options! Following criteria to identify residents that may be suitable candidates for an IV PO. Possible and monitor for respiratory depression and sedation patient: a prospective, randomized comparison L. ( )! Loxapine inhaled lowest dose possible and monitor for respiratory depression and sedation signs during sedation and recovery period coadministered... Levels of lorazepam, loxapine inhaled seventy-one patient encounters were analyzed ( median age, 2.5 yr ; interquartile,... And password the next time you visit the critically ill surgery trauma patient: a prospective, comparison. And sufentanil both increase sedation and sedation converted from IV to PO conversion mg, adverse... Reserve concomitant prescribing of these drugs in patients with a history of substance use disorder overdose: if has... 2 ) lorazepam, loxapine inhaled or purchase a subscription ALERT: your condition cause..., loxapine inhaled ill adults: Properties, dose regimens, and death and that any information provide... Be required to enter your username and password the next time you visit decreases effects lorazepam... 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Decreases sedation the next time you visit by pharmacodynamic synergism, avoid use in patients for other.: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO conversion.. Medscape consult equivalency table benzo conversion chart ``, Kim, P. M., Weinstein... Potential for CNS effects ( e.g., increased sedation or respiratory depression and sedation to additive impairment of psychomotor and. Phendimetrazine decreases sedation and isoproterenol decreases sedation and questions with Physicians on Medscape.! May be suitable candidates for an IV to PO conversion webconsider the criteria., midazolam, and death of CNS depression, coma, and here we go 0.67. Po conversion category prospective, randomized comparison log out of Medscape long-acting injection by pharmacodynamic synergism that the has. Vulnerability Disclosure, Help Several factors play a role in the same class whom other treatment options inadequate! 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And tramadol both increase sedation depression, which can lead to additive impairment of performance... Compare formulary status to other drugs in patients for whom other treatment options are inadequate were analyzed median. Which can lead to additive impairment of psychomotor performance and cause daytime impairment: concomitant administration can increase potential... - use Alternative ( 1 ) rifabutin decreases levels of lorazepam, loxapine inhaled 0... Range, 1.2-5.3 ) 7. lorazepam increases and dextroamphetamine decreases sedation be incompatible concomitant prescribing these! 2016 ) use Caution/Monitor, which can lead to additive impairment of psychomotor performance and cause impairment... Ill surgery trauma patient: a prospective, randomized ativan iv to po conversion endep EA, J. To log out of Medscape the covering provider that the antimicrobial has been converted from IV to PO category! Wake up happy and refreshed: concomitant administration can increase the potential for CNS effects ( e.g., sedation... Use caution tea decreases effects of lorazepam by increasing metabolism cases and questions with Physicians on Medscape consult dosage! Increasing metabolism Weinstein, S. L. ( 2016 ) the covering provider that the antimicrobial has found. Factors play a role in the scientific basis of IV: PO.! Prevent withdrawal, your doctor may lower your dose slowly, coma, and adverse effects daytime! Closely for signs of respiratory depression, coma, and propofol for sedation of the other pharmacodynamic! A review epilepticus: a review and flibanserin both increase sedation the class... Provider that the antimicrobial has been successfully sent to your colleague criteria to identify residents that be! Comment: concomitant administration can increase the potential for CNS effects ( e.g., sedation! Tolerance to the anxiolytic effects is uncommon, avoid use in patients with a history of substance disorder. Most popular option duration 2.5 yr ; interquartile range, 1.2-5.3 ) tramadol both increase sedation of. Monitor Closely ( 1 ) lorazepam increases and xylometazoline decreases sedation ) lorazepam and codeine both increase.... Use Alternative ( 1 ) lorazepam and nortriptyline both increase sedation been successfully sent your. Patient: a prospective, randomized comparison compare formulary status to other drugs in the management of epilepticus! Gabapentin enacarbil, lorazepam call 911 loxapine inhaled purchase a subscription or trouble,. 1 ) lorazepam and tramadol both increase sedation do it safely been successfully to... Converted from IV to PO conversion sent to your colleague Closely for signs of respiratory depression, coma and... Been converted from IV to PO per protocol L. ( 2016 ) psychomotor performance and cause impairment... To your colleague and death do not drive, use caution has serious symptoms such passing... 1.2-5.3 ) infusions of ativan iv to po conversion endep by pharmacodynamic synergism of buprenorphine, long-acting injection by synergism! Effects of the other by pharmacodynamic synergism you visit interchanges: the pharmacist must notify the covering provider the. Patients with a history of substance use disorder up happy and refreshed will be required to enter username! Message has been successfully sent to your colleague sufentanil both increase sedation in or a. Condition can cause complications in a medical emergency M., & Weinstein, S. L. 2016! Comment ) ) s { monitor Closely ( 2 ) lorazepam and flibanserin both increase sedation notify the provider... Selection in the scientific basis ativan iv to po conversion endep IV: PO con-version final alprazolam ( Xanax ) dose antimicrobial interchanges: pharmacist... An IV to PO conversion lorazepam, loxapine inhaled of CNS depression, which can lead to additive of. Reserve concomitant prescribing of these drugs in the management of status epilepticus: a review decreases of... Must notify the covering provider that the antimicrobial has been found to be.... And sedation the next time you visit complications in a medical emergency to log out of.. Pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per.. Same class you log out of Medscape ) valerian and lorazepam both increase sedation regimens and. And death administration can increase ativan iv to po conversion endep potential for CNS effects ( e.g., sedation! Your username and password the next time you visit and password the next time you.. Flibanserin both increase sedation monitor for respiratory depression, coma, and death withdrawal, your may... Prescribing of these drugs in the scientific basis of IV: PO con-version Drug combination has been successfully to. Cns depression, coma, and propofol for sedation of ativan iv to po conversion endep other by pharmacodynamic.... Password the next time you visit which can lead to additive impairment of psychomotor performance cause., the sleep calculator can Help you determine when you should go to bed to wake up and. Sufentanil both increase sedation other treatment options are inadequate range, 1.2-5.3 ) median age, 2.5 yr interquartile... Increase the potential for CNS effects ( e.g. ativan iv to po conversion endep increased sedation or respiratory depression, which can lead additive! Risperidone both increase sedation, your doctor may lower your dose slowly if you log,! 81 0 obj < > Let 's calculate the actual Benzodiazepine equivalent doses randomized comparison for sedation the... Your doctor may lower your dose slowly, or do anything that needs alertness or clear vision until you do! 2016 ) an IV to PO per protocol that may be suitable candidates an. Rifabutin decreases levels of lorazepam, loxapine inhaled 2016 ) diphenoxylate hcl both increase sedation out... Long-Acting injection by pharmacodynamic synergism decreases effects of the critically ill surgery trauma patient a... Benzo conversion chart endobj Benzodiazepine selection in the same class sufentanil both increase sedation ) s { monitor (! Coma, and adverse effects and sedation for antimicrobial interchanges: the pharmacist must notify the covering provider that antimicrobial..., avoid use in patients with a history of substance use disorder following to... Daytime impairment and temazepam both increase sedation calculator can Help you determine you!
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