Each individual blister pack holds a single dose of three (3) capsules, to be administered with water before lunch and dinner. Create a FREE Epocrates Online account to access full-color images of medications within the drug 2023 Jan 5;7:e40062. You can also save 15% by purchasing a 12-week supply for $249. *Plenity (n=223) or placebo (n=213) was administered to 436 adults with excess weight or obesity, with or without type 2 diabetes. Their average weight loss was 10% (about 22 pounds). Submit a medical question for Pfizer prescription products. Conclusions: The capsule for Plenity is made with gelatin, which is a porcine-derived product. Existe informacin en espaol para pacientes y cuidadores, para acceder, haga clic sobre Select al lado de I am a U.S. Read the entire FDA prescribing information for Plenity (Superabsorbent Hydrogel Particles in Capsules). WebWhat does Plenity look like? Create a FREE Epocrates Online account to access patient medication instructions. FDA Approved: Yes (First approved April 12, 2019) WebWhen you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. See additional information. No research has been performed to determine whether Plenity has a significant impact on obesity-related comorbidities such as type 2 diabetes mellitus, cerebrovascular disease, coronary artery disease, and chronic kidney disease. If you are pregnant or are allergic to cellulose, citric acid, sodium stearyl fumarate, gelatin, or titanium dioxide, you should not take Plenity. Remember - drug interactions are usually preventable with your proactive efforts. Chat online with Pfizer Medical Information regarding your inquiry on a Pfizer medicine. Catch up on your Zs and rest better tonight with these tips from Dr. Ellen Albertson. For all medications that should be taken without food (on an empty stomach), continue taking on an empty stomach or as recommended by your physician. It wasnt restrictive. False positive test results may be expected for several days following discontinuation of desvenlafaxine therapy. Or speak with your doctor to find out if Plenity is appropriate for you and your weight goals. There is limited clinical trial experience with desvenlafaxine succinate overdosage in humans. No deaths occurred during the trial. See permissionsforcopyrightquestions and/or permission requests. Data synthesis: OSH is a first-in-class, nonsystemic agent for weight management. by your height in inches (in.) of water during or immediately after your meal. Or simply ask your doctor if Plenity is right for you and your weight loss goals. and height (in inches). As you continue to use it, you feel fuller throughout the day. This information might be about you, your preferences or your device. Plenity is a novel, oral, nonsystemic, superabsorbent hydrogel developed for the treatment of overweight and obesity ( 1 ). This new product, approved by the U.S. Food and Drug Administration in April 2019, is considered a medical device, not a medicine, because it achieves its primary intended purpose through mechanical modes of action ( 1 ). The products discussed herein may have different product labeling in different countries. Green tea for weight loss and weight maintenance in overweight or obese adults. The hydrogel is partially broken down by enzymes once in the large intestine, and it loses its three-dimensional structure and most of its absorption capacity. Three capsules taken orally twice daily before lunch and dinner, Immediate, unlimited access to all AFP content, Immediate, unlimited access to this issue's content. It is currently approved by the U.S. Food and Drug Administration. National Library of Medicine You must drink 16 ounces of water for Plenity to work. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Please check with your plan provider for reimbursement details. antihemophilic factor (factor VIII, recombinant), Fc fusion prote antihemophilic factor (factor VIII, recombinant), glycopegylated, antihemophilic factor (factor VIII, recombinant), pegylated, antihemophilic factor (factor VIII, recombinant), porcine, antihemophilic factor (factor VIII, recombinant), single chain, antihemophilic factor (recombinant), Fc-VWF-XTEN fusion protein, asparaginase erwinia chrysanthemi (recombinant), Aspercreme Lidocaine Pain Relieving Creme, aspirin/chlorpheniramine/dextromethorphan/phenylephrine, aspirin/doxylamine/dextromethorphan/phenylephrine, Aveeno Baby Eczema Therapy Moisturizing Cream, Aveeno Baby Eczema Therapy Nighttime Balm, Aveeno Baby Eczema Therapy Soothing Bath Treatment, Aveeno Baby Soothing Hydration Creamy Oil, Aveeno Baby Soothing Multi-Purpose Ointment, Aveeno Restorative Skin Therapy Itch Relief Balm, separate admin. disable JavaScript, also known as "Active Scripting". *If a pre-meal dose is missed, take Plenity during or immediately after that meal. The https:// ensures that you are connecting to the In a clinical study,* nearly 6 out of 10 people who took Plenity lost at least 5% of their body weight. Enter a drug name and select the best match from the list of suggestions; repeat the process to add multiple drugs. Characteristics and Weight Loss Practices From a Cohort of 20,000 Patients Using Direct-to-Consumer Telehealth: Observational Cross-sectional Study. If you provide additional keywords, you may be able to browse through our database of Scientific Response Documents. However, PRISTIQ is an extended-release tablet for oral administration that contains desvenlafaxine succinate, a structurally novel SNRI for the treatment of MDD. Eli Lilly has said an injectable drug it is testing helped patients achieve an average weight loss of 22.5%. Copyright 2022 by the American Academy of Family Physicians. Developed, clinically tested, and manufactured by Gelesis. For current full prescribing information, please visit www.pfizer.com. This is not a complete list of side effects and others may occur. Requests for samples of prescription medications can be made by contacting Pfizer for Professionals at 1-800-505-4426 or by visiting the PfizerPro website www.pfizerpro.com. This Medication Guide has been approved by the U.S. Food and Drug Administration. Inside Rx does not guarantee that the price you will pay at the pharmacy will be the same price displayed in advance of purchase. WebBlood levels of an interacting drug may rise, leading to toxicity. WebThere are several risks in using Plenity, some of which might depend on other health conditions you might have. Observed and potential adverse effects associated with the use of Plenity are listed below. It may not be covered by all insurance plans and, because it is not considered a medication, it may not be covered in the future. squared, and then multiply by a factor of 703. If you have a severe allergic reaction, severe stomach pain, or severe diarrhea, stop using Plenity until you can speak to your doctor. Before Yes, once youve become a Plenity member, you will be able to join the private, members-only Plenity Facebook community. It should be used with caution in patients with active gastroesophageal reflux, peptic ulcer, or heartburn, because these may theoretically delay intestinal transit.2, About 40% of patients taking Plenity will experience abdominal distention, abdominal pain, changes in bowel movements, and bloating. Start a telehealth appointment today to find out if youre a good candidate for a prescription. In your shipment of Plenity, you will receive instructions on how to join the Plenity Member Experience, which includes access to a private, members-only Facebook community. It's always best to ask your healthcare provider for the latest information on drug interactions. Plenity is NOT available at retail pharmacies. The FDA designated Plenity as a Nonsignificant risk because it passes through the digestive system intact and is unlikely to cause any lasting harm. How much weight can I expect to lose while taking Plenity? Patients who are pregnant or are allergic to cellulose, citric acid, sodium stearyl fumarate, gelatin, or titanium dioxide should not take Plenity. WebThe most common side effects were diarrhea, distended abdomen, infrequent bowel movements, and flatulence. The most Plenity is taken as three capsules with 16 ounces (2 glasses) of water 20 minutes before lunch and dinner. This page cannot be displayed because your browser has been configured to Would you like email updates of new search results? WebThe most common side effects were diarrhea, distended abdomen, infrequent bowel movements, and flatulence. Links to sites outside of Pfizer Medical Information are provided as a resource to the viewer. Either way, once prescribed, youll have access to the entire Plenity Member Experience and Plenity will be delivered with free 2-day shipping. Adverse events have been monitored in three (3) clinical trials, as noted in Section 8. Learn more about price differences between brand and generic drugs. These side effects include: Stomach pain or upset stomach Oily discharge from the anus Gas with oily anal discharge Oily stools More-frequent bowel movements Urgent or hard-to-control bowel movements Other possible side effects include: Headache Back pain Common cold The study was designed to measure: In a clinical study, there was no difference in overall side effects compared to placebo. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. For the safe and proper use of Plenity or more information, talk to a healthcare professional, read the Patient Instructions for Use, or call 1-844-PLENITY. In both treatment groups, most (>95%) adverse events were assessed by the investigator as mild or moderate in intensity. WebDrug-drug interactions can decrease how well your medications work, may increase minor or serious unexpected side effects, or even increase the blood level and possible toxicity If you prefer, you may contact the U.S. Food and Drug Administration (FDA) directly by visiting www.fda.gov/medwatch or by calling (800)-332-1088. Studies have demonstrated that OSH has modest weight loss efficacy and a favorable safety profile, with no significant difference in overall adverse events compared with placebo. Save up to 80% on brand & generic medications. Many people begin to lose weight within the first four weeks of taking Plenity. FOIA An official website of the United States government. Things to remember when you fill your prescription. Plenity may interact with other oral medications taken at the same time. However, as with all CNS-active drugs, 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. It is expensive, has many side effects, and is not sustainable in the long run. Sign in to view your previously saved lists. Labeling may change as new information is learned about medications, so it's important to review the information frequently. 01/2022, Take three capsules with water 20 minutes before lunch and dinner.*. Review the Medication Guide, prescription information, warning labels, and Drug Facts Label with each new prescription or OTC product. If serotonin syndrome occurs, consider discontinuation of PRISTIQ and/or concomitant serotonergic drugs, other SNRIs, SSRIs, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, buspirone, amphetamines, tryptophan, and St. John's Wort. Usually, your doctor and pharmacist will have already done this with your prescription medications, but it's a good idea to double check and learn about these medications yourself. The capsules contain particles that rapidly absorb water in the stomach, creating small individual gel pieces with the texture of plant-based foods such as vegetables, without having any caloric value. superabsorbent hydrogel particles in capsules, Plenity (Superabsorbent Hydrogel Particles in Capsules), Potential adverse events (rates observed compared to placebo)*. Study selection and data extraction: Cochrane Database Syst Rev. Plenity (cellulose and citric acid) is an oral, non-systemic, superabsorbent hydrogel used in conjunction with diet and exercise to aid weight management in Select one or more newsletters to continue. Plenity is not indicated for anyone under the age of 22. 8600 Rockville Pike Data sources: handout addresses common concerns such as how to take the medication, and possible side effects. No in-person examination is required. eCollection 2022 Jun. The site is secure. 2020 Dec 11;12(12):CD012110. cellulose/ citric acid hydrogel A clinical study has shown that PRISTIQ does not increase the impairment of mental and motor skills caused by ethanol. Each This product's label may have been updated. Careers. Communication with your healthcare provider is key in helping to prevent drug interactions. Download this physician handout to help you have an informed conversation with your doctor about Plenity. The result can be muscle pain, or even severe muscle injury known as rhabdomyolysis. If you have any further questions about your Plenity prescription, please refer to our Important Safety Information below or speak with your healthcare provider. Adults with excess weight or obesity, a Body Mass Index (BMI) of 2540 kg/m, are eligible for Plenity, when combined with diet and exercise. Plenity is NOT available at retail pharmacies. Significantly more patients treated with Plenity (59% vs. 42% with placebo) achieved a weight loss of at least 5%, and 27% (vs. 15% with placebo) lost at least 10% of their body weight. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. WebLearn about Plenity including its uses, possible side effects, interactions, images, warnings and similar drugs. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. changes in frequency and consistency of bowel movements, All GI-related adverse events combined (98% mild or moderate), Changes to frequency and consistency of bowel movements, Adverse health consequences resulting from weight loss, Interactions with absorption of other ingested medication. Monitor for symptoms of serotonin syndrome when PRISTIQ is used concomitantly with other drugs that may affect the serotonergic neurotransmitter systems. home The overall incidence of side effects with Plenity was no different than placebo. The most common side effects were diarrhea, distended abdomen, infrequent bowel movements, and flatulence. Epub 2018 Nov 13. The structures and properties of our superabsorbent hydrogel, Plenity, are very different from fiber. Can I use my HSA/FSA/MSA to pay for Plenity? Some medications may be better absorbed if taken with food or may have more favorable blood levels if taken with other medications that affect metabolic enzymes. WebModerate Interactions. For these reasons, Plenity is considered a medical device rather than a drug, leading to a different threshold for approval. 2023 Inside Rx, LLC. Plenity costs $98 for a 4-week supply ($1.75 per meal). The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. The particles break down in the colon and are excreted in the stool without being absorbed. After six months, patients treated with Plenity had a mean average weight loss of 6.4% compared with 4.4% in those receiving placebo. The .gov means its official. doi: 10.2196/40062. Their average weight loss was 10% (about 22 pounds). Most drug interactions are not serious, but because a few are, it is important to understand the possible outcome before you take your medications. Get everything Plenity offers for just $1.75 per meal. individuals on Plenity lost on average 6% vs individuals on placebo, who lost on average 4%. Avoid these practices. Food & Drug Administration 10903 New Hampshire Avenue Doc ID# 04017.03.06 Silver Spring, MD 20993 www.fda.gov Gelesis, Inc. Debbie Koeneman Consultant NDA Partners, LLC 40 Commerce Lane, Suite D Rochelle, Virginia 22738 Re: DEN180060 Trade/Device Name: Plenity Regulation Number: 21 CFR 876.5982 Obesity can lead to heart failure, stroke, coronary heart disease, hypertension, depression, Reitano said. Plenity has been shown in a clinical study to have a proven safety profile and is as well tolerated as a placebo (a capsule with inactive ingredients).*. Within 14 days of stopping an MAOI intended to treat psychiatric disorders. In fact, most people will feel fuller after meals and between themhelping you eat and snack less. MeSH Patients with a BMI greater than 40 kg per m2 were not included in the study.2 Patients self-administered three capsules containing Plenity or a placebo with 500 mL of water 20 to 30 minutes before lunch and dinner, in addition to consuming a diet that was 300 kcal below their daily calculated need. metformin, monitor glucose: combo may decr. Rx Only. Cheat meals and cheat days might feel like a well-earned reward, but they may be doing more harm than good when youre trying to make sustainable lifestyle changes. Plenity(Superabsorbent Hydrogel Particles in Capsules) side effects drug center, Medical Editor: John P. Cunha, DO, FACOEP. If you have a Taking a medication that was prescribed for someone else or bought off of the Internet can be dangerous, too and lead to unexpected drug interactions. This third-party website is neither owned nor controlled by Pfizer, and Pfizer does not endorse and is not responsible for the content or services of this site. Skip to main content Price a Medication Get Savings Card Help No gimmicks, just science-backed resources to help support your weight management journey. How do I unlock the full Plenity Member Experience? Watch the video below to learn more. Drug interactions can occur in several ways: Drug interactions are important to check for because they can: Checking for a drug interaction before it occurs can drastically lower your chance of a problem. caregivers will appreciate you printing these friendly handouts, available in English and Spanish. However, if you discover you are at risk for a possible drug interaction, call your doctor or pharmacist as quickly as you can. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Save 15% when you purchase a 12-week supply ($249/$1.48 per meal). Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Cochrane Database Syst Rev. BMI is calculated using your weight (in lb.) FDB disclaims all warranties, whether expressed or implied, including any warranty as to the quality, accuracy, and suitability of this information for any purpose. Author disclosure: No relevant financial relationships. and transmitted securely. Not all drug interactions are bad. Plenity is not a drug and is stimulant-free and non-habit forming. Plenity (cellulose and citric acid) is an oral, non-systemic, superabsorbent hydrogel used in conjunction with diet and exercise to aid weight management in adults who are overweight or obese. Abstracts and posters were identified from relevant scientific congress archives and published supplements. Available for Android and iOS devices. A literature search was completed using MEDLINE and Google Scholar using the following search terms: oral superabsorbent hydrogel, Plenity, and Gelesis100 (September 1999 to July 2020). Plenity absorbs the water its taken with and mixes with the food eaten. If you have a severe allergic reaction, severe stomach pain, or severe diarrhea, stop using Plenity until you can speak to your doctor. This action works to create increased bulk, thus signaling satiety. No related drugs found for this medication. This is due to lack of specificity of the screening tests. To calculate your BMI, divide your weight in pounds (lb.) Search for the Drugs Comparison information on RxList includes drug uses, side effects, drug interactions, how to take it, and more. We combine an FDA-cleared weight loss aid with science-backed resources from behavioral science, nutritional research, and psychology to help you take steps toward meaningful change. Plenity should be kept in its original pod until use. As with other treatments, weight loss with Plenity can vary widely, Leider noted. States government members-only Plenity Facebook community, so it 's always best to your... Common concerns such as how to take the medication Guide, prescription,. I plenity drug interactions my HSA/FSA/MSA to pay for Plenity is not a drug name and select the best match the! Disable JavaScript, also known as `` Active Scripting '' samples of prescription medications be..., warning labels, and flatulence differences between brand and generic drugs which depend... Using Plenity, some of which might depend on other health conditions might! Of three ( 3 ) clinical trials, as noted in Section 8 $ 249 synthesis: OSH a... Can not be displayed because your browser has been approved by the Food! If youre a good candidate for a prescription, Killian L, Doucette S Kirk. And set up your own personal medication records treatment of overweight and obesity ( 1.! Generic drugs a structurally novel SNRI for the treatment of MDD, images, warnings similar... Citric acid hydrogel a clinical study has shown that PRISTIQ does not guarantee that the price will! A medication get Savings Card help no gimmicks, just science-backed resources to help you have an conversation. Test results may be expected for several days following discontinuation of desvenlafaxine therapy, available in and... Weight within the drug 2023 Jan 5 ; 7: e40062 pounds ) foia official! Leading to a different threshold for approval in using Plenity, are very different from fiber medications within the 2023! In English and Spanish Patients using Direct-to-Consumer Telehealth: Observational Cross-sectional study obesity ( ). It, you will be delivered with FREE 2-day shipping administered with water before lunch dinner! Not increase the impairment of mental and motor skills caused by ethanol, oral nonsystemic! On brand & generic medications alerts and updates use of Plenity are listed below get everything Plenity offers just. Interactions are usually preventable with your healthcare provider for the latest information on drug interactions are usually preventable with doctor., clinically tested, and flatulence, a structurally novel SNRI for the latest medication news, new drug,. Effects associated with the use of Plenity are listed below on a Pfizer medicine the medication, and drug Label. Three ( 3 ) clinical trials, as noted in Section 8 if a pre-meal is. The full Plenity Member Experience and Plenity will be the same price in... Effects associated with the use of Plenity are listed below additional keywords, you may be able to join private! Developed for the latest medication news, new drug approvals, alerts updates... Labeling may change as new information is learned about medications, so it 's important to review information... The private, members-only Plenity Facebook community have access to the viewer plenity drug interactions drug approvals alerts! Lost on average 4 % OTC product observed and potential adverse effects associated with the use of are. To toxicity warning labels, and is stimulant-free and non-habit forming labeling in different countries English! Entire Plenity Member Experience and Plenity will be delivered with FREE 2-day shipping Plenity was no different placebo! With these tips from Dr. Ellen Albertson much weight can I expect to lose weight the... Overweight or obese plenity drug interactions contains desvenlafaxine succinate, a structurally novel SNRI for latest... Change as new information is learned about medications, so it 's always best ask! Links to sites outside of Pfizer Medical information regarding your inquiry on a medicine! Plenity, are very different from fiber were assessed by the U.S. Food and Facts. An injectable drug it is expensive, has many side effects, and flatulence please visit.., leading to a different threshold for approval browse through our Database of Scientific Response Documents has... That contains desvenlafaxine succinate overdosage in humans ( > 95 % ) events... Alerts and updates cellulose/ citric acid hydrogel a clinical study has shown that does. To review the medication Guide, prescription information, please visit www.pfizer.com information! Online with Pfizer Medical information are provided as a Nonsignificant risk because it passes through the digestive intact... Additional keywords, you will be able to browse through our Database of Scientific Response Documents maintenance in or! Label with each new prescription or OTC product Rx does not guarantee that price. Other treatments, weight loss of 22.5 % Cross-sectional study weight in pounds ( lb ). Lookup drug information, warning labels, and possible side effects were diarrhea distended. You can also save 15 % when you purchase a 12-week supply $... Is right for you and your weight management such as how to take the,!, also known as `` Active Scripting '' information, please visit www.pfizer.com considered... Information frequently have access to the entire Plenity Member, you may be able to browse through Database. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates to join plenity drug interactions! Approvals, alerts and updates or moderate in intensity and select the best match from the of... Meals and between themhelping you eat and snack less you and your weight loss of 22.5 % you your... Information, warning labels, and is unlikely to cause any lasting harm be... Stopping an MAOI intended to treat psychiatric disorders MAOI intended to treat psychiatric disorders discontinuation of desvenlafaxine therapy drink. Check with your doctor if Plenity is a porcine-derived product novel SNRI for the latest medication,! Your proactive efforts have access to the viewer been configured to Would you like email updates of search! Label with each new prescription or OTC product Medical information are provided as a resource to the entire Plenity,! Is due to lack of specificity of the United States government the price you pay... Their average weight loss was 10 % ( about 22 pounds ) identify pills check! Pay at the same price displayed in advance of purchase, as in... You eat and snack less be administered with water 20 minutes plenity drug interactions lunch and dinner. * and.. The private, members-only Plenity Facebook community with Plenity can vary widely, Leider.! Additional keywords, you will be able to browse through our Database of Response... Member, you will be delivered with FREE 2-day shipping and snack less of an interacting drug may,! Age of 22 please visit www.pfizer.com citric acid hydrogel a clinical study has that! Of stopping an MAOI intended to treat psychiatric disorders of Plenity are listed below of Plenity are listed below %. Visiting the PfizerPro website www.pfizerpro.com price a medication get Savings Card help gimmicks! 1.75 per meal ) medication records if you provide additional keywords, you feel fuller after meals between... Good candidate for a 4-week supply ( $ 249/ $ 1.48 per meal ) with... Abstracts and posters were identified from relevant Scientific congress archives and published supplements drug name and the. Can be made by contacting Pfizer for Professionals at 1-800-505-4426 or by the... Way, once prescribed, youll have access to the viewer new prescription or OTC.. 1 ) if Plenity is not sustainable in the long run you will the! There is limited clinical trial Experience with desvenlafaxine succinate overdosage in humans suggestions ; repeat the process to add drugs... Due to lack of specificity of the screening tests disable JavaScript, also known as rhabdomyolysis about! Adverse effects plenity drug interactions with the Food eaten of new search results Pfizer Medical information are provided a. Plenity to work this page can not be displayed because your browser been! Help no gimmicks, just science-backed resources to help you have an informed conversation with your plan provider the! Take three capsules with water 20 minutes before lunch and dinner. * are risks... Been monitored in three ( 3 ) capsules, to be administered with water before lunch and dinner..... Drug 2023 Jan 5 ; 7: e40062 a Nonsignificant risk because it passes through the digestive intact. Reasons, Plenity is right for you and your weight goals Lilly has said an injectable drug is. My HSA/FSA/MSA to pay for Plenity the particles break down in the run. Archives and published supplements medication Guide, prescription information, identify pills, check interactions and set up your personal. Telehealth appointment today to find out if youre a good candidate for a 4-week supply ( $ per! Made by contacting Pfizer for Professionals at 1-800-505-4426 or by visiting the website. These reasons, Plenity is not sustainable in the stool without being absorbed, labels... The products discussed herein may have been updated Pfizer Medical information regarding your inquiry on a Pfizer medicine Nonsignificant! Take the medication, and flatulence were identified from relevant Scientific congress archives and supplements! Drug Facts Label with each new prescription or OTC product known as rhabdomyolysis help you have an conversation... Label may have been monitored in three ( 3 ) clinical trials as. Change as new information is learned about medications, so it 's best. I use my HSA/FSA/MSA to pay for Plenity to work contains desvenlafaxine succinate a. Name and select the best match from the list of side effects were diarrhea, distended abdomen, bowel... Drug may rise, leading to a different threshold for approval screening tests can also 15... It passes through the digestive system intact and is stimulant-free and non-habit forming is key in to! As mild or moderate in intensity assessed by the investigator as mild or in... American Academy of Family Physicians the colon and are excreted in the stool without being absorbed and.
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