Side Effects of mexiletine: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major Research Findings

Mexiletine is a Class IB antiarrhythmic drug used for the treatment of arrhythmias, such as ventricular tachycardia and atrial fibrillation. 13 . It is also used to treat neuropathic pain, especially diabetic neuropathy. 22 、 5 、 10 . Some studies have shown that mexiletine can effectively reduce tinnitus. 9 . However, mexiletine can also cause side effects. 19 . When administered orally, mexiletine has a rapid absorption rate and high bioavailability. 13 . The drug is metabolized in the liver, and its metabolites may have similar pharmacological effects as mexiletine itself. 19 . Mexiletine can increase theophylline blood levels, so caution is needed when used in combination. 20 . While mexiletine is generally considered to have fewer side effects than quinidine, common side effects include gastrointestinal disturbances and neurological side effects. 4 、 1 . Combining mexiletine with other antiarrhythmic drugs may increase the risk of side effects. 6 、 11 . Mexiletine may be more likely to cause side effects in children and older adults. 16 、 8 . Mexiletine should be avoided during pregnancy and breastfeeding. 24 .

Reasons for Side Effects

Mexiletine is a sodium channel blocker, which means it blocks the sodium channels in the body. This can lead to a variety of side effects, including those related to the nervous system, gastrointestinal system, and other parts of the body. 5 . Sodium channels play a vital role in nerve and muscle excitation transmission. When mexiletine blocks these channels, it can affect the function of nerves and muscles, leading to various side effects. 7 .

Common Side Effects

Gastrointestinal

Mexiletine can cause gastrointestinal side effects, such as nausea, vomiting, loss of appetite, constipation, and diarrhea. 13 、 15 、 4 、 2 、 8 、 11 .

Nervous System

Mexiletine can also affect the nervous system, causing side effects such as dizziness, lightheadedness, headache, tremors, drowsiness, and memory impairment. 13 、 15 、 2 、 12 .

Other

Mexiletine may also cause other side effects, such as rash, itching, breathing difficulties, chest pain, a rapid heartbeat, and low blood pressure. 12 、 14 .

Side Effect Management

Gastrointestinal

If you experience gastrointestinal side effects, your doctor may recommend dietary and medication adjustments. Dietary changes might include eating easily digestible foods, taking small meals, and chewing your food thoroughly. 15 Medication options include antiemetics, gastric acid secretion inhibitors, and antidiarrheal agents. 13 、 11 .

Nervous System

If you experience nervous system side effects, your doctor will recommend appropriate treatment based on your symptoms. For example, if you experience severe dizziness or lightheadedness, resting and drinking fluids is recommended. 15 For headaches, your doctor may suggest taking an over-the-counter pain reliever. 2 If you have severe tremors, your doctor may prescribe anticonvulsant medication. 14 .

Other

If you experience other side effects while taking mexiletine, consult your doctor immediately. 12 .

Comparison Between Studies

Commonalities of Studies

Multiple studies have indicated that mexiletine can lead to gastrointestinal and neurological side effects. 4 、 1 、 15 、 2 . Additionally, studies have shown that mexiletine can increase theophylline blood levels. 20 . Several studies also indicate that using mexiletine alongside other antiarrhythmic medications may increase the likelihood of side effects. 6 、 11 .

Differences Between Studies

The frequency and severity of mexiletine side effects can vary depending on the study. 4 、 1 . The types of side effects may also differ between studies. 12 . These variations can be attributed to factors such as age, sex, underlying medical conditions, mexiletine dosage, and concomitant medications. 16 、 8 .

Points to Note Regarding Application in Real Life

While mexiletine is an effective medication, it's crucial to remember that it comes with side effect risks. 24 . Always follow your doctor's instructions for taking mexiletine. Do not stop or change the dosage without consulting your doctor. 17 . If you experience any side effects from mexiletine, consult your doctor immediately. 12 .

Limitations of Current Research

Research on mexiletine is still ongoing, and more studies are needed to fully understand its effects. 24 . In particular, more data is needed on the long-term safety of mexiletine and its interactions with other medications. 17 .

Directions for Future Research

Future research should focus on investigating the side effects of mexiletine in greater detail. 24 . This includes gathering more information on the long-term safety of the drug and its interactions with other medications. 17 . Research into new methods to reduce mexiletine's side effects is also necessary. 7 .

Conclusion

Mexiletine is an effective medication for certain conditions, but it's important to be aware of its potential side effects. 24 . Always follow your doctor's instructions for taking mexiletine and consult your doctor immediately if you experience any side effects. 12 . Further research is needed to better understand the side effects of mexiletine. 24 .

Keywords
Benefit Keywords
Effective antiarrhythmic
1
Suppresses arrhythmias
2
Suppresses arrhythmias
3
Alternative to quinidine
4
Neuropathic pain relief
5
Effective for VPBs
6
Amyotrophic lateral sclerosis treatment
Antiarrhythmic activity
Myotonia treatment
Myotonic dystrophy treatment
7
Cardiovascular disease treatment
8
Reduced tinnitus loudness
9
Improved symptoms
Reduced pain
10
Prevents tachycardia
Treats tachycardia
11
Neuropathic pain relief
12
Arrhythmia suppression
13
Effective for intractable seizures
14
Reduces tachycardia
Reduces ventricular pairs
Suppresses ventricular ectopy
15
Effective arrhythmia treatment
16
Neuropathic pain treatment
17
Cost-effective arrhythmia treatment
21
Pain relief
Safe therapy
22
Effective long-term
Well tolerated
23
Antimyotonic therapy
24
Risk Keywords
Side effects
1
Constipation
Sexual problems
Tremor
2
Constipation
Sexual problems
Tremor
3
Central nervous system side effects
Gastrointestinal side effects
4
Questionable efficacy
Side effects
5
Dose-dependent side effects
Side effects
6
Side effects
7
Taste complaints
8
Auditory function interference
9
Mild side effects
10
Blood dyscrasias
Gastrointestinal problems
Lupus-like syndrome
QT prolongation
11
Gastrointestinal side effects
Neurological side effects
13
Bradycardia
Hallucinations
Muscle hypotonia
14
Gastrointestinal side effects
Neurological side effects
15
Side effects
16
Side effects
17
Increased lidocaine concentrations
18
Significant side effects
19
Side effects
Theophylline concentration increase
20
Congestive heart failure
Proarrhythmia
21
Side effects
22
Side effects
23
Side effects
24
Literature analysis of 24 papers
Positive Content
19
Neutral Content
3
Negative Content
2
Article Type
9
1
0
5
24
1.

Comparative study of mexiletine and quinidine in the treatment of ventricular ectopia.

Author: AsseyM E, HudsonW M, HangerK H, MillerS C

Effective antiarrhythmic
Side effects

Mexiletine is an effective oral antiarrhythmic agent with side effects that are distinct from those of quinidine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Relationship between plasma mexiletine levels at steady-state. Presence of ventricular arrhythmias and side effects.

Author: PeyrieuxJ C, BoisselJ P, LeizoroviczA

Suppresses arrhythmias
Constipation
Sexual problems
Tremor

Higher plasma levels of mexiletine were associated with a lower rate of ventricular arrhythmias, but also with a higher rate of side effects. The therapeutic range of mexiletine is narrow, suggesting the need for individual dose adjustments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Relationship between plasma mexiletine levels at steady-state. Presence of ventricular arrhythmias and side effects.

Author: PeyrieuxJ C, BoisselJ P, LeizoroviczA

Suppresses arrhythmias
Constipation
Sexual problems
Tremor

Higher plasma levels of mexiletine were associated with a lower rate of ventricular arrhythmias, but also with a higher rate of side effects. The therapeutic range of mexiletine is narrow, suggesting the need for individual dose adjustments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Comparative efficacy and safety of oral mexiletine and quinidine in benign or potentially lethal ventricular arrhythmias.

Author: MorganrothJ

Alternative to quinidine
Central nervous system side effects
Gastrointestinal side effects

Mexiletine hydrochloride and quinidine sulfate were found to be equally effective in treating 491 patients with ventricular arrhythmias. Quinidine was associated with a greater risk of proarrhythmic reactions and QT prolongation than mexiletine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Efficacy of oral mexiletine for neuropathic pain with allodynia: a double-blind, placebo-controlled, crossover study.

Author: WallaceM S, MagnusonS, RidgewayB

Neuropathic pain relief
Questionable efficacy
Side effects

This study examined the effects of oral mexiletine on pain, neurosensation, allodynia, and quality of life.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Voltage-Gated Sodium Channel Blockers: Synthesis of Mexiletine Analogues and Homologues.

Author: CatalanoAlessia, FranchiniCarlo, CarocciAlessia

Amyotrophic lateral sclerosis treatment
Antiarrhythmic activity
Myotonia treatment
Myotonic dystrophy treatment
Side effects

Mexiletine is a drug used to treat heart rhythm problems. It has also been used to treat muscle disorders. However, mexiletine can cause side effects, and it has been withdrawn from the market in some countries. This review discusses the development of new mexiletine-like drugs that may be safer and more effective.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Taste effects of lingual application of cardiovascular medications.

Author: ZervakisJ, GrahamB G, SchiffmanS S

Cardiovascular disease treatment
Taste complaints

Cardiovascular medications are often prescribed in Western countries. However, taste complaints are common side effects of these medications. This study tested 9 cardiovascular medications on human volunteers to determine their effects on taste receptors. All medications had a predominantly bitter taste and affected the taste of other stimuli.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

The effect of intravenously administered mexiletine on tinnitus - a pilot study.

Author: BerningerErik, NordmarkJan, AlvánGunnar, KarlssonKjell K, IdrizbegovicEsma, MeurlingLennart, Al-ShurbajiAyman

Reduced tinnitus loudness
Auditory function interference

Mexiletine was found to reduce tinnitus loudness in some patients who previously responded to lidocaine. While the concentration-effect relationship remains unclear, mexiletine shows potential as a therapeutic agent for tinnitus.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Mexiletine for treatment of chronic painful diabetic neuropathy.

Author: DejgardA, PetersenP, KastrupJ

Improved symptoms
Reduced pain
Mild side effects

Mexiletine was found to be effective in reducing symptoms and signs of chronic painful diabetic neuropathy, suggesting its potential for managing this condition.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

11.

Procainamide: a perspective on its value and danger.

Author: EllenbogenK A, WoodM A, StamblerB S

Prevents tachycardia
Treats tachycardia
Blood dyscrasias
Gastrointestinal problems
Lupus-like syndrome
QT prolongation

Procainamide, a widely used antiarrhythmic agent, is effective in preventing ventricular tachycardia. Long-term therapy can be limited by side effects like lupus-like syndrome and blood dyscrasias. Monitoring QT interval is crucial to prevent drug toxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Effect of oral mexiletine on capsaicin-induced allodynia and hyperalgesia: a double-blind, placebo-controlled, crossover study.

Author: AndoK, WallaceM S, BraunJ, SchulteisG

Neuropathic pain relief

This study investigated the effects of mexiletine on human experimental pain after achieving dose-limiting side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

13.

Mexiletine: pharmacology and therapeutic use.

Author: ManolisA S, DeeringT F, CameronJ, EstesN A

Arrhythmia suppression
Gastrointestinal side effects
Neurological side effects

Mexiletine is a Class IB antiarrhythmic drug that is effective in suppressing ventricular arrhythmias. The drug is well tolerated, but can cause side effects such as tremor, dizziness, and gastrointestinal upset.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

[Efficacy and side effects of lidocaine by intravenous drip infusion in children with intractable seizures].

Author: SataY, AiharaM, HatakeyamaK, HinoharaY, KamiyaY, ShimodaC, KanemuraH, NakazawaS

Effective for intractable seizures
Bradycardia
Hallucinations
Muscle hypotonia

Intravenous lidocaine was effective in treating intractable seizures in children, but careful monitoring is required due to potential side effects.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

15.

[Anti-arrhythmia effectiveness and tolerance of retard in comparison with standard mexiletine].

Author: ZehenderM, GeibelA, HustM, HohnloserS, MeinertzT, JustH

Reduces tachycardia
Reduces ventricular pairs
Suppresses ventricular ectopy
Gastrointestinal side effects
Neurological side effects

Mexiletine was found to be effective in suppressing ventricular arrhythmias in 21 patients with coronary artery disease. Both the standard form and a sustained-release form of mexiletine were effective in suppressing ventricular ectopy in 47% of the patients. The sustained-release form resulted in slightly higher plasma concentrations. Side effects were mainly gastrointestinal or neurological and mild.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

17.

Pharmacologic management of neuropathic pain: evidence-based recommendations.

Author: DworkinRobert H, O'ConnorAlec B, BackonjaMiroslav, FarrarJohn T, FinnerupNanna B, JensenTroels S, KalsoEija A, LoeserJohn D, MiaskowskiChristine, NurmikkoTuro J, PortenoyRussell K, RiceAndrew S C, StaceyBrett R, TreedeRolf-Detlef, TurkDennis C, WallaceMark S

Neuropathic pain treatment
Side effects

This study provides evidence-based clinical recommendations for pharmacologic management of neuropathic pain (NP). It recommends first-line treatments including antidepressants, gabapentin, pregabalin, and topical lidocaine. Opioids and tramadol are generally considered second-line treatments, and other medications can be considered for third-line use. The study emphasizes the need for individualized treatment approaches and further research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Possible mechanism for pharmacokinetic interaction between lidocaine and mexiletine.

Author: MaedaYorinobu, FunakoshiSachiyo, NakamuraMamoru, FukuzawaMasataka, KugayaYukimasa, YamasakiMiho, TsukiaiSatsuki, MurakamiTeruo, TakanoMikihisa

Increased lidocaine concentrations

Mexiletine decreased the total plasma clearance of lidocaine, resulting in increased plasma lidocaine concentrations and reduced tissue distribution. This observation had implications for loading doses and acute effects of lidocaine in the concurrent therapy of lidocaine and mexiletine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Mexiletine metabolites: a review.

Author: CatalanoAlessia, CarocciAlessia, SinicropiMaria Stefania

Significant side effects

Mexiletine is extensive metabolized in humans via phase I and phase II reactions. Several hydroxylated metabolites showed pharmacological activity similar to that of Mex, thus contributing to its clinical profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Influence of mexiletine on the pharmacokinetics of theophylline in healthy volunteers.

Author: StoysichA M, MohiuddinS M, DestacheC J, NipperH C, HillemanD E

Side effects
Theophylline concentration increase

Mexiletine significantly increased theophylline plasma concentrations, suggesting the need for dosage adjustments in patients receiving both medications.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Comparative cost-effectiveness analysis of quinidine, procainamide and mexiletine.

Author: PodridP J, KoweyP R, FrishmanW H, ArnoldR J, KanieckiD J, BeckJ R, BeshanskyJ R

Cost-effective arrhythmia treatment
Congestive heart failure
Proarrhythmia

Mexiletine, an antiarrhythmic agent, was a cost-saving alternative therapy for ventricular arrhythmias compared to quinidine and procainamide. Mexiletine was associated with fewer side effects and no increase in all-cause mortality, while procainamide showed a trend toward higher mortality.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

22.

Mexiletine in the treatment of diabetic neuropathy.

Author: StrackeH, MeyerU E, SchumacherH E, FederlinK

Pain relief
Safe therapy
Side effects

Mexiletine may be an effective treatment for painful diabetic neuropathy, particularly for patients with stabbing or burning pain, heat sensations, or formication. A medium dose of 450 mg/day appears to be effective and safe, with minimal side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

23.

Chronic mexiletine therapy for suppression of ventricular arrhythmias.

Author: DukeM

Effective long-term
Well tolerated
Side effects

Mexiletine was found to be effective in suppressing ventricular premature contractions (VPCs) in 85 patients over a 9-month period. Between 69 and 80% of patients maintained the same level of VPC suppression observed at the start of the 9-month treatment period. Side effects warranted discontinuation of therapy in 8% of patients, and dosage adjustments were made in 25% of patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Repurposing of sodium channel antagonists as potential new anti-myotonic drugs.

Author: MatthewsE, HannaM G

Antimyotonic therapy
Side effects

This review discusses the current treatment options for myotonia, a painful and disabling symptom. Mexiletine is currently regarded as the first-choice sodium channel blocker. However, there is a clinical need to develop additional antimyotonic agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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