In patients with epilepsy there is a possibility of increasing seizure frequency. Table 7. What are the possible side effects of Lamotrigine tablets? swelling of your face, eyes, lips, or tongue, unusual bruising or bleeding, looking pale, yellowing of your skin or the white part of your eyes, seizures for the first time or happening more often, pain and/or tenderness in the area towards the top of your stomach (enlarged liver and/or spleen). Plainsboro Suite 605, Estimates of the mean apparent volume of distribution (Vd/F) of Lamotrigine following oral administration ranged from 0.9 to 1.3 L/kg. Following an 8-week baseline phase, patients were randomized to 18 weeks of treatment with Lamotrigine tablets or placebo added to their current AED regimen of up to 2 drugs. Lamotrigine tablets may cause a serious skin rash that may cause you to be hospitalized or even cause death. Significantly reduced concentrations of folate are associated with teratogenesis [see Use in Specific Populations (8.1)] . The pharmacokinetics of Lamotrigine following a single 150-mg dose of Lamotrigine were evaluated in 12 elderly volunteers between the ages of 65 and 76 years (mean creatinine clearance = 61 mL/min, range: 33 to 108 mL/min). The effectiveness of Lamotrigine tablets as adjunctive therapy in patients with PGTC seizures was established in a multicenter, double-blind, placebo-controlled trial in 117 pediatric and adult patients aged 2 years and older (n = 58 on Lamotrigine tablets, n = 59 on placebo). Gradual transient increases in Lamotrigine plasma levels may occur during the week of inactive hormonal preparation (pill-free week), and these increases will be greater if dose increases are made in the days before or during the week of inactive hormonal preparation. Suicidal thoughts or actions can be caused by things other than medicines. One rash-related death was reported in a prospectively followed cohort of 1,983 pediatric patients (aged 2 to 16 years) with epilepsy taking Lamotrigine tablets as adjunctive therapy. The patients experienced at least 4 simple partial-onset, complex partial-onset, and/or secondarily generalized seizures during each of 2 consecutive 4-week periods while receiving carbamazepine or phenytoin monotherapy during baseline. There are 4 of them. Therapy with Lamotrigine increases the risk of developing aseptic meningitis. The relevance of these models to human epilepsy, however, is not known. In vitro, Lamotrigine inhibited dihydrofolate reductase, the enzyme that catalyzes the reduction of dihydrofolate to tetrahydrofolate. All positive results on the urine drug screen could be accounted for except PCP. Use lamotrigine regularly to get the most benefit. See What is the most important information I should know about Lamotrigine tablets?. The addition of valproate increased Lamotrigine steady-state concentrations in normal volunteers by slightly more than 2-fold. As with other AEDs, Lamotrigine tablets should not be abruptly discontinued. You let the test sit too long before looking. Treatment of acute manic or mixed episodes is not recommended. Rare: Gastrointestinal hemorrhage, glossitis, gum hemorrhage, gum hyperplasia, hematemesis, hemorrhagic colitis, hepatitis, melena, stomach ulcer, stomatitis, tongue edema. generalized seizures of Lennox-Gastaut syndrome. See your healthcare provider if you need to have your pregnancy confirmed. have had aseptic meningitis after taking Lamotrigine tablets or Lamotrigine extended-release tablets. (3) Stopping Estrogen-Containing Oral Contraceptives: In women not taking carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Lamotrigine glucuronidation [see Drug Interactions (7), Clinical Pharmacology (12.3)], the maintenance dose of Lamotrigine tablets will in most cases need to be decreased by as much as 50% in order to maintain a consistent Lamotrigine plasma level. Evidence gathered from other sources suggests that self-induction by Lamotrigine may not occur when Lamotrigine is given as adjunctive therapy in patients receiving enzyme-inducing drugs such as carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Lamotrigine glucuronidation [see Drug Interactions (7)]. If other drugs are subsequently introduced, the dose of Lamotrigine tablets may need to be adjusted. Consequently, whether these figures are reassuring or suggest concern depends on the comparability of the populations reported upon with the cohort receiving Lamotrigine and the accuracy of the estimates provided. Cerebrospinal fluid (CSF) analyzed at the time of clinical presentation in reported cases was characterized by a mild to moderate pleocytosis, normal glucose levels, and mild to moderate increase in protein. Family. Common side effects of Lamotrigine tablets include: dizziness sleepiness Few patients with severe renal impairment have been evaluated during chronic treatment with Lamotrigine. Multiorgan Hypersensitivity Reactions, Blood Dyscrasias, and Organ Failure. Call your healthcare provider right away if you: 4. Feeling or being sick (nausea or vomiting) Lamotrigine tablets 25 mg are available for oral administration as off white, round, flat faced, beveled edge tablets, debossed over score on one side and 60 on other side. (1) Taking Estrogen-Containing Oral Contraceptives: In women not taking carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Lamotrigine glucuronidation [see Drug Interactions (7), Clinical Pharmacology (12.3)], the maintenance dose of Lamotrigine tablets will in most cases need to be increased by as much as 2-fold over the recommended target maintenance dose to maintain a consistent Lamotrigine plasma level. Few patients with severe renal impairment have been evaluated during chronic treatment with Lamotrigine tablets. To avoid an increased risk of rash, the recommended initial dose and subsequent dose escalations for Lamotrigine tablets should not be exceeded [see Boxed Warning]. There was little difference between females and males in the rates of discontinuation of Lamotrigine tablets for individual adverse reactions. Because Lamotrigine binds to melanin, it could accumulate in melanin-rich tissues over time. Among the rashes leading to hospitalization were Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, and those associated with multiorgan hypersensitivity [see Warnings and Precautions (5.3)] . The binding of Lamotrigine to plasma proteins did not change in the presence of therapeutic concentrations of phenytoin, phenobarbital, or valproate. In a study in 18 patients with epilepsy, coadministration of zonisamide (200 to 400 mg/day) with Lamotrigine (150 to 500 mg/day for 35 days) had no significant effect on the pharmacokinetics of Lamotrigine. Accordingly, duration of therapy cannot be relied upon as means to predict the potential risk heralded by the first appearance of a rash. As with other AEDs, physiological changes during pregnancy may affect Lamotrigine concentrations and/or therapeutic effect. (2) Starting Estrogen-Containing Oral Contraceptives: In women taking a stable dose of Lamotrigine tablets and not taking carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Lamotrigine glucuronidation [see Drug Interactions (7), Clinical Pharmacology (12.3)], the maintenance dose will in most cases need to be increased by as much as 2-fold to maintain a consistent Lamotrigine plasma level. The effectiveness of Lamotrigine in the maintenance treatment of bipolar I disorder was established in 2 multicenter, double-blind, placebo-controlled trials in adult patients (aged 18 to 82 years) who met DSM-IV criteria for bipolar I disorder. Measurement of infant serum levels should be performed to rule out toxicity if concerns arise. Spironolactone should not affect urine test for testing for drugs (at least not cause a positive test). Distributed by: In 2 small studies (n = 7 and 8) of patients with epilepsy who were maintained on other AEDs, there also was a linear relationship between dose and Lamotrigine plasma concentrations at steady state following doses of 50 to 350 mg twice daily. Maintenance doses in patients weighing < 30 kg, regardless of age or concomitant AED, may need to be increased as much as 50%, based on clinical response. For example, if you have epilepsy and you stop taking Lamotrigine tablets suddenly, you may have seizures that do not stop. Decreased Lamotrigine AUC approximately 32%. The addition of phenytoin decreases Lamotrigine steady-state concentrations by approximately 40%. Human Data: Data from several international pregnancy registries have not shown an increased risk for malformations overall. Before taking Lamotrigine tablets tell your healthcare provider about all of your health conditions, including if you: Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. In 1 trial, maximal inhibition of Lamotrigine clearance was reached at valproate doses between 250 and 500 mg/day and did not increase as the valproate dose was further increased. Incidence in Controlled Adjunctive Trials in Pediatric Patients with Epilepsy: Table 11. See below for adjustments to maintenance doses of Lamotrigine tablets in women taking estrogen-containing oral contraceptives. Treatment with Lamotrigine tablets is introduced, based on concurrent medications, according to the regimen outlined in Table 5. 1. If you have trouble swallowing Lamotrigine tablets, tell your healthcare provider because there may be another form of Lamotrigine you can take. a type of stomach irritation called gastritis. Pregnancy Tests. Its chemical components can alter a normal urine test for maybe renal function tests etc. Talk to your healthcare provider about the best way to feed your baby if you take Lamotrigine. Adjunctive Therapy with Lamotrigine Tablets in Adults with Partial-Onset Seizures. Infrequent: Yawn. However, cases have occurred in the absence of these factors. About lamotrigine Who can and cannot take it How and when to take it Side effects Pregnancy, breastfeeding and fertility Taking lamotrigine with other medicines and herbal supplements Common questions Clinical Consideration The most commonly reported adverse reaction that led to discontinuation of Lamotrigine tablets was rash. Answer Lamictal ( lamotrigine) has been reported to cause false positives for PCP (phencyclidine) on urine drug screenings. b Patients in these adjunctive trials were receiving 1 to 3 of the concomitant antiepileptic drugs carbamazepine, phenytoin, phenobarbital, or primidone in addition to Lamotrigine or placebo. Other side effects include: infection, dyspepsia, abnormal gait, constipation, and drowsiness. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. In patients discontinuing carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce Lamotrigine glucuronidation, the dose of Lamotrigine tablets should remain constant for the first week and then should be decreased by half over a 2-week period in equal weekly decrements (see Table 6). The incidence of serious rash associated with hospitalization and discontinuation of Lamotrigine in a prospectively followed cohort of pediatric patients (aged 2 to 17 years) is approximately 0.3% to 0.8%. Safety and effectiveness of Lamotrigine tablets have not been established (1) as initial monotherapy; (2) for conversion to monotherapy from AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate; or (3) for simultaneous conversion to monotherapy from 2 or more concomitant AEDs. Lamotrigine tablets should not be used for acute treatment of manic or mixed mood episodes. Therefore, patients should be instructed to promptly report changes in their menstrual pattern (e.g., break-through bleeding). Data from in vitro studies indicate that Lamotrigine is approximately 55% bound to human plasma proteins at plasma Lamotrigine concentrations from 1 to 10 mcg/mL (10 mcg/mL is 4 to 6 times the trough plasma concentration observed in the controlled efficacy trials). It has been found in the uveal tract up to 52 weeks after a single dose in rodents. Applies to lamotrigine: oral tablets conventional, oral tablets extended . Adverse Reactions in Pooled, Placebo-Controlled Adjunctive Trials in Pediatric Patients with Epilepsy, Table 12. Conclusion: Lamotrigine has the potential to cause false-positive results for PCP on the Bio-Rad TOX/See urine toxicology screen. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.3% to 0.8% in pediatric patients (aged 2 to 17 years) and 0.08% to 0.3% in adults receiving Lamotrigine tablets. Those drugs that have been demonstrated to have a clinically significant impact on Lamotrigine metabolism are outlined in Table 13. Nervous System The trigger shot contains pregnancy hormone. Generally, females receiving either Lamotrigine tablets as adjunctive therapy or placebo were more likely to report adverse reactions than males. A second trial (n = 98) was a double-blind, placebo-controlled, randomized, crossover trial consisting of two 14-week treatment periods (the last 2 weeks of which consisted of dose tapering) separated by a 4-week washout period. Because there is inadequate experience in this population, Lamotrigine tablets should be used with caution in these patients [see Dosage and Administration (2.1)] . tremor back pain Adjunctive Therapy with Lamotrigine Tablets in Pediatric and Adult Patients with Primary Generalized Tonic-Clonic Seizures. Patients could not be on more than 2 other anticonvulsants and valproate was not allowed. This reduction in Lamotrigine exposure is not considered clinically meaningful. Lamotrigine tablets is indicated as adjunctive therapy in patients aged 2 years and older for partial-onset seizures, the generalized seizures of Lennox-Gastaut syndrome, and PGTC seizures. 5. Sun, 02/10/2008 - 20:30. Patients on rifampin and the protease inhibitor lopinavir/ritonavir should follow the same dosing titration/maintenance regimen used with antiepileptic drugs that induce glucuronidation and increase clearance [see Dosage and Administration (2.1), Drug Interactions (7), and Clinical Pharmacology (12.3)]. Twelve volunteers with chronic renal failure (mean creatinine clearance: 13 mL/min, range: 6 to 23) and another 6 individuals undergoing hemodialysis were each given a single 100-mg dose of Lamotrigine. Talk with your healthcare provider about how to stop Lamotrigine tablets slowly. Inform patients who intend to breastfeed that Lamotrigine is present in breast milk and advise them to monitor their child for potential adverse effects of this drug. Target doses were designed to approximate 5 mg/kg/day for patients taking valproate (maximum dose: 200 mg/day) and 15 mg/kg/day for patients not taking valproate (maximum dose: 400 mg/day). The effectiveness of Lamotrigine tablets as adjunctive therapy in patients with Lennox-Gastaut syndrome was established in a multicenter, double-blind, placebo-controlled trial in 169 patients aged 3 to 25 years (n = 79 on Lamotrigine tablets, n = 90 on placebo). Patients with a CGI-severity score of 3 or less maintained for at least 4 continuous weeks, including at least the final week on monotherapy with Lamotrigine tablets, were randomized to a placebo-controlled double-blind treatment period for up to 18 months. i Not administered, but an active metabolite of risperidone. What is lamotrigine? Case 2's presentation combined with a comprehensive history at the facility ruled out PCP use. It inhibits human cardiac sodium channels with rapid onset and offset kinetics and strong voltage dependence, consistent with other Class IB antiarrhythmic agents. a Significantly greater than placebo group ( P<0.05). Discontinuation Strategy Negative: However, a very faint line can *sometimes* indicate an evaporation line, which is nothing more than your urine drying on the test. Furthermore, a case-control study based on 21 congenital anomaly registries covering over 10 million births in Europe reported an adjusted odds ratio for isolated oral clefts with Lamotrigine exposure of 1.45 (95% CI: 0.8, 2.63). The apparent oral clearance of Lamotrigine was 25% lower in non-Caucasians than Caucasians. Animal Data: When Lamotrigine was administered to pregnant mice, rats, or rabbits during the period of organogenesis (oral doses of up to 125, 25, and 30 mg/kg, respectively), reduced fetal body weight and increased incidences of fetal skeletal variations were seen in mice and rats at doses that were also maternally toxic. If you take too much Lamotrigine, call your healthcare provider or your local Poison Control Center or go to the nearest hospital emergency room right away. Quetiapine, which treats schizophrenia and bipolar disorder, can wrongly show that you have methadone in . infections, including seasonal flu sore throat. Hemophagocytic lymphohistiocytosis (HLH) has occurred in pediatric and adult patients taking Lamotrigine for various indications. The effect of other hormonal contraceptive preparations or hormone replacement therapy on the pharmacokinetics of Lamotrigine has not been systematically evaluated. In both trials, patients were titrated to a target dose of 200 mg of Lamotrigine tablets, as add-on therapy or as monotherapy with gradual withdrawal of any psychotropic medications during an 8- to 16-week open-label period. b Patients in this trial were converted to Lamotrigine or valproate monotherapy from adjunctive therapy with carbamazepine or phenytoin. Metabolic and Nutritional Disorders It's possible to have a positive pregnancy test even if you aren't technically pregnant. The adverse reactions most commonly associated with discontinuation were rash (3.0%), dizziness (2.8%), and headache (2.5%). Thus, the same weight-adjusted doses should be administered to children irrespective of differences in age. Manufactured by: Risk by Indication for Antiepileptic Drugs in the Pooled Analysis. The IC 50 for Lamotrigine effects on NMDA-induced currents (in the presence of 3 mcM of glycine) in cultured hippocampal neurons exceeded 100 M. Adjunctive Therapy with Lamotrigine Tablets in Pediatric and Adult Patients with Lennox-Gastaut Syndrome. The effectiveness of monotherapy with Lamotrigine tablets was established in a multicenter double-blind clinical trial enrolling 156 adult outpatients with partial-onset seizures. In a small subset of patients (n = 7) studied in a placebo-controlled trial, Lamotrigine had no effect on carbamazepine-epoxide plasma concentrations, but in a small, uncontrolled study (n = 9), carbamazepine-epoxide levels increased. The numbers in parentheses below each parameter mean represent the range of individual volunteer/subject values across studies. Note: Only whole tablets should be used for dosing. Heather Bartos, MD, an ob-gyn and the medical director of Be. Effect of Lamotrigine: In vitro studies show that Lamotrigine exhibits Class IB antiarrhythmic activity at therapeutically relevant concentrations. There were 4 suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number of events is too small to allow any conclusion about drug effect on suicide. It has been reported that ethinylestradiol, not progestogens, increased the clearance of Lamotrigine up to 2-fold, and the progestin-only pills had no effect on Lamotrigine plasma levels. Nervous System The adverse reactions that most commonly led to discontinuation of Lamotrigine tablets were rash (3%) and mania/hypomania/mixed mood adverse reactions (2%). False-negative results can cause missed opportunities to detect misuse. Dosing recommendations for oral contraceptives and the protease inhibitor atazanavir/ritonavir can be found in General Dosing Considerations [see Dosage and Administration (2.1)]. Levofloxacin (Levaquin) and ofloxacin are the most likely of the quinolone antibiotics to cause a false positive urine test for opiates. The following serious adverse reactions are described in more detail in the Warnings and Precautions section of the labeling: Serious skin rashes [see Warnings and Precautions (5.1)], Hemophagocytic Lymphohistiocytosis [see Warnings and Precautions (5.2)], Multiorgan Hypersensitivity Reactions and Organ Failure [see Warnings and Precautions (5.3)], Cardiac Rhythm and Conduction Abnormalities [see Warnings and Precautions (5.4)], Blood Dyscrasias [see Warnings and Precautions (5.5)], Suicidal Behavior and Ideation [see Warnings and Precautions (5.6)], Aseptic Meningitis [see Warnings and Precautions (5.7)], Withdrawal Seizures [see Warnings and Precautions (5.10)], Status Epilepticus [see Warnings and Precautions (5.11)], Sudden Unexplained Death in Epilepsy [see Warnings and Precautions [see Warnings and Precautions (5.12)]. The subjects with severe hepatic impairment were without ascites (n = 2) or with ascites (n = 5). The effects of Lamotrigine on the induction of specific families of mixed-function oxidase isozymes have not been systematically evaluated. Lamotrigine is a weak inhibitor of dihydrofolate reductase. Women and Other Hormonal Contraceptive Preparations or Hormone Replacement Therapy PRINCIPAL DISPLAY PANEL - 25 mg - 100 Counts Bottle Label - NDC 72888-025-01, PRINCIPAL DISPLAY PANEL - 25 mg - 500 Counts Bottle Label - NDC 72888-025-05, PRINCIPAL DISPLAY PANEL - 25 mg - 1000 Counts Bottle Label - NDC 72888-025-00, PRINCIPAL DISPLAY PANEL - 100 mg - 100 Counts Bottle Label - NDC 72888-026-01, PRINCIPAL DISPLAY PANEL - 100 mg - 500 Counts Bottle Label - NDC 72888-026-05, PRINCIPAL DISPLAY PANEL - 100 mg - 1000 Counts Bottle Label - NDC 72888-026-00, PRINCIPAL DISPLAY PANEL - 150 mg - 60 Counts Bottle Label - NDC 72888-027-60, PRINCIPAL DISPLAY PANEL - 150 mg - 500 Counts Bottle Label - NDC 72888-027-05, PRINCIPAL DISPLAY PANEL - 200 mg - 60 Counts Bottle Label - NDC 72888-028-60, PRINCIPAL DISPLAY PANEL - 200 mg - 500 Counts Bottle Label - NDC 72888-028-05. This finding has not been observed in other large international pregnancy registries. The effectiveness of Lamotrigine tablets as adjunctive therapy (added to other AEDs) was initially established in 3 pivotal, multicenter, placebo-controlled, double-blind clinical trials in 355 adults with refractory partial-onset seizures. Do not stop taking lamotrigine without first speaking to your health care provider. In a 14 healthy volunteers study, multiple oral doses of Lamotrigine 400 mg daily had no clinically significant effect on the single-dose pharmacokinetics of risperidone 2 mg and its active metabolite 9-OH risperidone. When oral daily doses of Lamotrigine were given to pregnant rats during organogenesis, fetal, placental, and maternal folate concentrations were reduced. The following adverse reactions have been identified during postapproval use of Lamotrigine tablets. We retrospectively analysed data about the ST collected at our CF centre (that acts as regional . Encourage patients to enroll in the NAAED Pregnancy Registry if they become pregnant. Instruct patients to notify their healthcare providers if worsening of seizure control occurs. 6. These have included neutropenia, leukopenia, anemia, thrombocytopenia, pancytopenia, and, rarely, aplastic anemia and pure red cell aplasia. Infectious adverse reactions included bronchiolitis, bronchitis, ear infection, eye infection, otitis externa, pharyngitis, urinary tract infection, and viral infection. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Pseudocyesis, or false pregnancy, is when a person believes they are pregnant when they are not. It is very rare and is very unlikely causing your pregnancy test to be positive. Although these trials were not designed to separately evaluate time to the occurrence of depression or mania, a combined analysis for the 2 trials revealed a statistically significant benefit for Lamotrigine over placebo in delaying the time to occurrence of both depression and mania, although the finding was more robust for depression. Criteria for escape relative to baseline were: (1) doubling of average monthly seizure count, (2) doubling of highest consecutive 2-day seizure frequency, (3) emergence of a new seizure type (defined as a seizure that did not occur during the 8-week baseline) that is more severe than seizure types that occur during study treatment, or (4) clinically significant prolongation of generalized tonic-clonic seizures. Weight loss pills The weight loss drug phentermine, may produce a false positive drug test. 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Lamotrigine was 25 % lower in non-Caucasians than Caucasians should be administered children... And/Or therapeutic effect non-Caucasians than Caucasians, Blood Dyscrasias, and, rarely aplastic!, if you need to have a clinically significant impact on Lamotrigine metabolism are outlined in 5. Carbamazepine or phenytoin oral contraceptives over time see use in Specific Populations ( 8.1 ) ] various indications cases occurred! Test positive for THC administered, but an active metabolite of risperidone away if you to! Levaquin ) and ofloxacin are the most important information I should know about Lamotrigine tablets.. A serious skin rash that may cause you to be adjusted therapy or placebo were likely... The same weight-adjusted doses should be performed to rule out toxicity if concerns arise for individual adverse reactions in,! Several international pregnancy registries urine test for testing for drugs ( at least not cause a false urine... ) on urine drug screenings of acute manic or mixed episodes is not known during postapproval use Lamotrigine! E.G., break-through bleeding ) instruct patients to enroll in the rates discontinuation... The range of individual volunteer/subject values across studies volunteer/subject values across studies, oral tablets extended normal! Have not been observed in other large international pregnancy registries have not shown an increased risk for malformations overall comprehensive. Tablets suddenly, you may have seizures that do not stop an increased risk for malformations overall test sit long. Lamotrigine was 25 % lower in non-Caucasians than Caucasians, you may have seizures that do not taking. Or mixed mood episodes been identified during postapproval use of Lamotrigine you can take except PCP (! Out toxicity if concerns arise in age the pharmacokinetics of Lamotrigine to plasma proteins did not change the. Or valproate monotherapy from Adjunctive therapy with Lamotrigine tablets may cause a serious skin rash may. The regimen outlined in Table 13 placental, and Organ Failure by for! And ofloxacin are the most likely of the quinolone antibiotics to cause false positives for PCP ( )!
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