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Why it's used

Candesartan is used to treat high blood pressure. This medicine works by preventing the activity of certain natural substances that tighten the blood vessels which results in decreased blood pressure. This medicine helps by making blood flowing smoothly and the heart to pump more effectively. Candesartan is also used to treat heart failure in patients with reduced heart muscle function (left ventricular systolic dysfunction).
Candesartan may also be used together with other medicines to treat certain conditions as recommended by the doctor. It is used in combination with Diuretic, Hydrochlorothiazide, other anti-hypertensive, Amlodipine, or Felodipine to treat high blood pressure. It is also used with angiotensin-converting-enzyme-inhibitor, beta-adrenergic-blocker, Diuretic, or Digitalis Glycosides to treat heart failure.
Angiotensin 2 Receptor Blocker
Candesartan is a prescription medicine that belongs to a class of medicines called Angiotensin 2 Receptor Blocker. Angiotensin II receptor blockers are used for the treatment of high blood pressure and heart failure. These medicines act by relaxing the blood vessels and makes it easier for your heart to pump blood.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Candesartan, ask your doctor or pharmacist. Use Candesartan as per the instructions provided by your doctor.
Candesartan is eaten with or without food. Candesartan is usually taken one or two times a day with or without food. Patients with high blood pressure should maintain a healthy weight, take low fat and salt diet, avoid smoke and exercise for at least 30 minutes. These help to control the blood pressure.
The typical dose of Candesartan for adults is 8 mg/day (for high blood pressure). The usual dose for children is not more than 8 mg in one day. The maximum dose for adult patients of Candesartan is 32 mg/day per day. This medicine is generally used for a period of 4-6 weeks for high blood pressure. It takes 2 hours for this medicine to start its action.
This medicine is to be used for longer periods of time. Candesartan should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
If you have any kidney disease, The starting dose of 4 mg once daily is recommended in patients with abnormal functioning of the kidney including patients on hemodialysis. If you have issues with the health of your liver, The lower starting dose of 4 mg once daily is recommended in patients with mild to moderate abnormal liver function. Consult with your doctor before stopping the use of Candesartan.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
If you are giving Candesartan to a child, be sure to use a product that is for use in children. Use the child's weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
Limit drinking alcohol with Candesartan.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Candesartan for conditions or symptoms for which it was not prescribed. Do not give Candesartan to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Candesartan at 25°C (77°F), excursions permitted to 15-30°C (59-86°F), and away from moisture. Store this medicine away from children and pets.

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How to take Candesartan

The dose and frequency of using Candesartan will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Candesartan Dosage

Dosage for High blood pressure

Adult
  • Recommended: 8 mg once daily which can be increased to 16 mg once a day and further up to 32 mg once daily depending upon the patient's blood pressure response
  • Initial: 16 mg once daily and 4 mg once daily for patients with volume depletion
  • Maximum: 32 mg once daily
Children (6 to less than 18 years)
  • Initial: 4 mg once daily
  • Maximum: 8 mg once daily (for patients weighing less than 50 kg or 110.2 lb) and 8-16 mg once daily (for patients weighing more than or equal to 50 kg or 110.2 lb)

Dosage for Heart failure

Adult
  • Initial: 4 mg once daily
  • Maximum: 32 mg once daily

Minimum Age

1 year

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 4 mg, 8 mg, 16 mg, 32 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Candesartan?
In case of overdose, patients should be monitored for vital signs. If symptoms of low blood pressure occur while using this drug, then supportive care and treatment according to the symptoms should be provided. If this method is not sufficient, blood volume should be increased by use of the isotonic saline solution. Also, sympathomimetic products should be considered if the above measures are not enough.
Symptoms of an overdose of Candesartan
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Candesartan, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Candesartan

Before you use Candesartan, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Candesartan, tell your doctor of your medical history including allergic to Candesartan, liver disorders, kidney disorders, heart failure, patients with volume or salt depletion, low blood sugar, kidney damage due to low blood sugar, increased levels of aldosterone in the blood (hyperaldosteronism), weak heart muscles or blood related brain disorder (ischaemic cardiopathy or cerebrovascular disease), patients with reduced or absent activity of lactase (galactose intolerance, Lapp lactase deficiency) and abnormal absorption of glucose and galactose in the body (glucose-galactose, patients on dialysis, kidney transplant, severe vomiting or diarrhea, taking diazoxide, beta-blockers, and angiotensin-converting enzyme inhibitors, aliskiren, non-steroidal anti-inflammatory drugs, potassium supplements, lithium, heparin, diuretics, stroke, or taking combination of angiotensin-converting enzyme inhibitors with mineralocorticoid receptors antagonists. Patients with a history of kidney failure may experience a decreased level of urine output, high levels of nitrogen-containing compounds in the blood (azotemia) and other fatal conditions. Patients with heart defects may suffer from low blood pressure, heart attack or stroke. Before having any surgery when using Candesartan, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.
The use of this medicine may change creatinine and blood urea nitrogen. The use of Candesartan in patients with heart failure may increase the levels of creatinine and urea nitrogen in the blood.
The use of Candesartan may change sugar, triglycerides, and uric acid. Increased levels of sugar, triglycerides, and uric acid in the blood has been observed in patients using Candesartan.
The use of this medicine may change potassium and sodium. Patients using Candesartan may see increased levels of potassium and decreased levels of sodium in the blood.
The use of this medicine may change hemoglobin and hematocrit. The use of Candesartan may decrease the level and percentage volume of red blood cells (hemoglobin and hematocrit respectively).
The use of Candesartan may change liver function test (liver enzymes and bilirubin). When Candesartan is used, it may increase the level of liver enzymes such as bilirubin and transaminases in the blood.
Limit the consumption of alcohol with Candesartan. Drinking alcohol may cause dizziness, and fainting.
Candesartan is not safe for use in pregnant women. If you are pregnant or planning to become pregnant, you should discuss with your doctor the impact this medicine may have on the baby before you start to use this medicine. The use of Candesartan during the second and third trimesters of pregnancy may lead to fetal and neonatal injury, including low blood pressure, abnormalities of the skull, insufficiency to produce urine, kidney failure, limb abnormalities in the fetus, abnormal growth development in head and facial bones, delayed growth, abnormal heart development, high levels of potassium in the blood, delayed growth of uterus, heart problems (ductus arteriosus) and other fatal conditions. Candesartan should be used while breastfeeding only when required. A decision to discontinue Candesartan or nursing should be made after considering the importance of this medicine to the mother due to the potential for the occurrence of severe side effects in infants. Consult with your doctor on the use of Candesartan, if you are trying to conceive.
Candesartan can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Candesartan can make you feel more sleepy.
Candesartan may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of headache, dizziness, upper respiratory tract infection, cough, irregular heartbeat, cold (nasopharyngitis), pain in the mouth (oropharyngeal pain), rash, sore throat, runny nose, fever, increased heart rate, and low levels of sodium in the blood.
Candesartan may increase side-effects in older patients. Elderly patients may see an increased risk of abnormal functioning of the kidney, low blood pressure, and increased levels of potassium in the blood.

What precautions should be taken during Pregnancy and Nursing, and administering Candesartan to Children or the Older Adults?

Pregnant Women

Contraindicated or Not Recommended
Warning: The use of Candesartan during the second and third trimesters of pregnancy may lead to fetal and neonatal injury.

Breastfeeding

Only When Necessary
Warning: A decision on whether to discontinue Candesartan or nursing should be made, taking into account the benefit of breastfeeding and the potential risk to the adverse effect on the child.

Younger Adults Population

Only When Necessary
Warning: The safety and effectiveness of Candesartan in children aged 1 to less than 18 years have not been established.

Older Adults Population

Only When Necessary
Warning: Elderly patients should be monitored for blood pressure, potassium and creatinine levels when using Candesartan.

Candesartan Side-effects

The following side-effects may commonly occur when using Candesartan. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Candesartan. Discuss with your doctor if any of these side-effects last for a long time or are severe:
The following side-effects may commonly occur in children when using Candesartan. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Candesartan may cause the following side-effects:
The following severe side-effects may also occur when using Candesartan:
  • respiratory, and thoracic disorders
    Symptoms: inflammation of the pharynx, inflammation of the nasal sinus difficulties in breathing (dyspnea)
  • liver disorders
    Symptoms: inflammation of the liver increased liver enzyme (bilirubin level)
  • skin disorder
    Symptoms: swelling of the lower layer of skin
  • metabolism and nutrition disorders
    Symptoms: low levels of sodium in the blood, increased creatine phosphokinase, high blood sugar, increased triglycerides level in the blood high level of uric acid in the blood
  • Symptoms: decrease in the total amount of red blood cells (anemia), decrease in the number of leukocytes, abnormally low levels of thrombocytes, decrease in the number of granulocytes, abnormally low count of neutrophils nose bleeding (epistaxis)
    If this happens, contact your doctor as soon as possible.
  • musculoskeletal disorder
    Symptoms: muscle injury (rhabdomyolysis)
  • kidney and urinary disorders
    Symptoms: presence of blood in the urine (hematuria) increased kidney enzyme (creatinine)
  • stomach and intestinal disorders
    Symptoms: diarrhea vomiting
  • Symptoms: anxiety, depression drowsiness
  • heart disorders
    Symptoms: increase heartbeat heart attack
Your doctor has prescribed this Candesartan because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Candesartan.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Candesartan by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • difficulties in breathing
  • severe itching of the skin (with raised lumps)
  • swelling of the face, lips, tongue and throat
If this happens, stop taking Candesartan and contact your doctor as soon as possible.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Rare family history of reduced or absent activity of fructose (fructose intolerance)

Patients with rare family history of fructose intolerance are at an increased risk when using this medicine. This medicine should not be used in such patients.

Dual blockade of the renin-angiotensin-aldosterone system

Patients using combination therapy of angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors or aliskiren are at an increased risk. These patients may experience low blood pressure, decreased functioning of the kidney (kidney failure) and increased potassium levels in the blood. Patients should not use angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors or aliskiren in combination. If necessary, the combination should only be used under doctor supervision along with close monitoring of the functioning of the kidney, blood pressure, and electrolytes.

Children with abnormal functioning of the kidney

Candesartan therapy should be started with a lower starting dose under doctor supervision in children with volume depletion and taking diuretics especially those with abnormal functioning of the kidney.

Increased levels of potassium in the blood

Patients with heart failure or high blood pressure are at increased risk when using Candesartan in combination with potassium supplements, potassium-sparing diuretics, medicines increasing potassium levels (heparin) or salt substitutes containing potassium. These patients may experience an increased level of potassium in the blood. Monitoring of the potassium levels is recommended in such patients. Also, the combined use of a potassium-sparing diuretic (spironolactone), angiotensin-converting enzyme inhibitors and Candesartan should not be used. This combination should be taken after carefully evaluating the potential benefit and risks to the patients.

Patients undergoing through hemodialysis (blood purifying technique)

Such patients are at increased risk while using Candesartan. These patients may experience more sensitivity to the blood pressure lowering effect of Candesartan during dialysis. Dose adjustment of 4 mg of Candesartan along with monitoring of the blood pressure should be considered in these patients.

Patients with narrowing of the arteries in the kidney (bilateral kidney artery stenosis)

Such patients are at an increased risk when using Candesartan. These patients may experience increased urea nitrogen and creatinine levels in the blood, low blood pressure, insufficiency to produce urine and kidney failure. Long-term use of Candesartan is not recommended in patients with bilateral kidney artery stenosis or stenosis of the artery to a single functioning of kidneys.

Anesthesia and surgery

Patients using angiotensin II antagonists are at increased risk during surgery. Such patients may experience low blood pressure. On the occurrence of severe low blood pressure, use of blood pressure increasing agents (vasopressors) and intravenous fluids should be recommended.

Patients with heart defects such as thickening of the heart muscles (aortic and mitral valve stenosis, obstructive hypertrophic cardiomyopathy)

These patients are at an increased risk while using Candesartan. Such patients may experience low blood pressure, which may lead to heart attack and stroke. Precaution should be taken in patients with abnormalities of the heart.

Patients with increased levels of aldosterone hormone (hyperaldosteronism)

These patients do not have any therapeutic benefit of Candesartan. Candesartan should not be used in such patients.

Increased mortality in infants

A fetus is at increased risk when pregnant women use this medicine. The use of Candesartan during the second and third trimesters of pregnancy may lead to fetal and neonatal injury, including low blood pressure, abnormalities of the skull, insufficiency to produce urine, kidney failure, limb abnormalities in the fetus, abnormal growth development in head and facial bones, delayed growth, abnormal heart development, high levels of potassium in the blood, delayed growth of uterus, heart problems (ductus arteriosus) and other fatal conditions. Discontinue the use of Candesartan immediately after diagnosis of pregnancy. When Candesartan is considered necessary, the patients planning to conceive should be changed to another safe alternate therapy.

Low blood pressure condition in salt depleted patients

These patients who are on treatment with diuretics are at an increased risk while using Candesartan. Such patients may experience symptomatic low blood pressure. Such patients should be advised to correct this condition before the beginning of treatment with Candesartan, or the treatment should be stated under the close supervision of the doctor. If low blood pressure transpires, the patient should be made to lie down and, if necessary, should be given an infusion of normal saline into the vein.

Low blood pressure in heart failure patients

Patients with heart failure are at an increased risk when using Candesartan. Such patients may experience symptomatic low blood pressure. Precaution should be taken in these patients when starting Candesartan therapy. Dose reduction of Candesartan should be also be considered. Monitoring of the blood pressure should be considered during dose adjustment and afterward.

Abnormal functioning of the kidney

Patients with low blood pressure and abnormality in the functioning of the kidney are at increased risk when using Candesartan. These patients may experience increased levels of Candesartan. Periodic monitoring of the blood pressure, potassium and creatinine levels along with dose adjustment should be considered in such patients. This should also be considered in patients with heart failure, abnormal functioning of the kidney, and elderly patients of 75 years or older.

Combined therapy of Candesartan with angiotensin-converting enzyme inhibitors in heart failure

Patients using combined therapy of Candesartan with angiotensin-converting enzyme inhibitors are at an increased risk. Such patients may experience low blood pressure, decreased functioning of the kidney and increased levels of the potassium in the blood. The triple combination of the mineralocorticoid receptor antagonist, angiotensin-converting enzyme inhibitors and Candesartan should not be used. Proper supervision along with frequent and close monitoring of the functioning of the kidney, blood pressure, and electrolytes should be considered while using these combinations. Also, the combined use of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors should not be used in patients with kidney damage due to high blood sugar levels.

Interactions with Candesartan

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Candesartan may interact with drugs which increase blood potassium level. The use of Candesartan with potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium, or heparin, may lead to increased levels of potassium in the blood. Candesartan should not be used in combination with angiotensin-converting enzyme inhibitor and a potassium-sparing diuretics (spironolactone). If necessary, the combination should be used only after carefully evaluating the potential risks and benefits. Proper monitoring of potassium levels in the blood is required.
There may be an interaction of Candesartan with lithium, which is used to treat depression. Using Candesartan with lithium reversibly increases the level of lithium in the blood which may lead to an increased risk of harmful effects of lithium. The use of Candesartan with lithium should be avoided. If the combination is necessary, patients should be carefully monitored for lithium levels.
Candesartan interacts with non-steroidal anti-inflammatory drugs, which are used to treat pain, fever and inflammation. The combined use of Candesartan and NSAIDs may lead to an increased risk of worsening of the functioning of the kidney, which includes kidney failure, and an increase in potassium levels in the blood, particularly in patients with poor existing kidney problems. Precaution should be taken in patients using these combinations especially in the elderly. Hydration along with monitoring of the functioning of the kidney should be considered after starting this combination and periodically after.
Special instructions need to be followed while taking this medicine along with angiotensin-converting enzyme inhibitors and aliskiren, which are used to treat high blood pressure. When angiotensin II receptor antagonist is used with angiotensin-converting enzyme inhibitors or aliskiren, it may increase the frequency of adverse events such as low blood pressure, stroke, heart failure, increased levels of potassium in the blood, and decrease in the functioning of the kidney (including acute kidney failure). Patients should not use combination therapy of angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors or aliskiren. If necessary, this combination should be used under doctor supervision. Also, close monitoring of the functioning of the kidney, electrolytes and blood pressure should also be considered. Angiotensin-converting enzyme inhibitors and angiotensin receptors blockers should not be used in combination in patients with kidney damage due to low blood sugar.
Your doctor's guidelines may need to be followed while taking this medicine along with a mineralocorticoid receptor antagonist and angiotensin-converting enzyme inhibitors, which are used to treat heart failure. Patients using the triple combination of Candesartan, a mineralocorticoid receptor antagonist, and angiotensin-converting enzyme inhibitors may experience low blood pressure, increased levels of potassium in the blood and decreased functioning of the kidney (including kidney failure). Patients should not use this combination. If necessary, this combination should be used under medical supervision along with close monitoring of the functioning of the kidney, electrolytes and blood pressure.
This page does not contain all the possible interactions of Candesartan. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Candesartan by Severity

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

When should Candesartan be not used?

Allergy to Candesartan or any of its components

This medicine should not be used in patients who are allergic to this medicine or its components. These patients may have the following symptoms if they use this medicine:
  • difficulties in breathing
  • swelling of the face, lips, tongue, and throat
  • severe itching of the skin (with raised lumps)

Second and third trimester of pregnancy

This medicine should not be used in women during the second and third trimester of pregnancy. The use of Candesartan during the second and third trimesters of pregnancy may lead to fetal and neonatal injury. These patients may have the following symptoms if they use this medicine:
  • low blood pressure
  • abnormal brain growth (neonatal skull hypoplasia)
  • nonpassage of urine (anuria)
  • kidney failure
  • decreased functioning of the kidney
  • high potassium levels
  • prematurity
  • low levels of potassium in the blood
  • fetal growth restriction (intrauterine growth retardation)
  • heart problems (patent ductus arteriosus)
  • deficiency of amniotic fluid (oligohydramnios)
  • insufficiency to produce urine

Severe abnormal functioning of the liver and obstruction of bile flow (cholestasis)

This medicine should not be used in these patients.

Children aged below 1 year

This medicine should not be used in children aged below 1 year.

Use of combination therapy in heart or blood vessel disease, abnormal functioning of the kidney, diabetic nephropathy and long-term kidney disease patients

This medicine should not be used in such patients who are using combination therapy with aliskiren, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. Such patients may see an increased risk of stroke and heart failure. These patients may have the following symptoms if they use this medicine:

Use of combination therapy and triple combination therapy in heart failure patients

This medicine should not be used in heart failure patients who are using combination therapy with an ACE inhibitor, and triple combination therapy with an ACE-inhibitor, a mineralocorticoid receptor antagonist (spironolactone) or Candesartan. Such patients may see an increased risk of harmful effects. These patients may have the following symptoms if they use this medicine:

Patients with increased production of aldosterone (primary hyperaldosteronism)

Candesartan should not be used in such patients.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Candesartan is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Candesartan .
High Blood Pressure
Diabetic Nephropathy
Diabetic Kidney Disease
Heart Failure

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