Der Arzneiwirkstoff Sibutramin wurde bis 2010 als Appetitzügler (Anorektikum) zur Reduktion von starkem Übergewicht (Adipositas) verwendet. Packaging: Box of 28 tablets. What is Sibutramin 20mg? Sibutramine was originally developed and marketed by Knoll Pharmaceuticals and was most recently manufactured and marketed by Abbott Laboratories before its withdrawal from the market. [17] Sibutramine should not be taken within two weeks of stopping or starting an MAOI. Brand Name: Reductil. Sibutramine is metabolized by cytochrome P450 isozyme CYP3A4 into two pharmacologically-active primary and secondary amines (called active metabolites 1 and 2) with half-lives of 14 and 16 hours, respectively. Important: The information below refers to products available in the United States that contain sibutramine. China,[3] the European Union,[4] Hong Kong,[5] India,[6] Mexico, New Zealand,[7] the Philippines,[8] Thailand,[9] the United Kingdom,[10] and the United States. [39] In January 2010, a similar alert was issued for counterfeit versions of the over-the-counter weight loss drug Alli sold over the Internet. Default. It has been associated with increased cardiovascular events and strokes and has been withdrawn from the market in several countries and regions including Australia, Canada, China, the European Union, Hong Kong, India, Mexico, New Zealand, the The concomitant use of sibutramine and monoamine oxidase inhibitors (MAOIs, such as selegiline) is not indicated, as it may increase the risk of serotonin syndrome, a somewhat rare but serious adverse drug reaction. Phentermine was uninvolved in the rare—but clinically significant—heart issues of fenfluramine. Alternative Names: BTS 54-524 . Sibutramine, formerly sold under the brand name Meridia among others, is an appetite suppressant which has been discontinued in many countries. Mass Spec. Yes. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. [35], On December 22, 2008, the United States Food and Drug Administration issued an alert to consumers naming 27 different products marketed as “dietary supplements” for weight loss, that illegally contain undisclosed amounts of sibutramine. Sibutramine is a serotonin and norepinephrine reuptake inhibitor which has been used for short- and long-term therapy of obesity, but which was withdrawn from use in the United States in 2010 because of increased risk of cardiovascular events. Sibutramine is manufactured by Abbott Laboratories, under brand names such as Reductil, Meridia … Brand Name : Contains: Dosage Form : Manufacturer: Price(Tk.) linezolid/sibutramine hydrochloride; naratriptan hydrochloride/sibutramine hydrochloride; nefazodone/sibutramine hydrochloride; paroxetine/sibutramine hydrochloride; phenelzine/sibutramine hydrochloride; rizatriptan/sibutramine hydrochloride; sertraline/sibutramine hydrochloride; sibutramine hydrochloride/sumatriptan; sibutramine hydrochloride/tapentadol Frequently encountered side effects are: dry mouth, paradoxically increased appetite, nausea, strange taste in the mouth, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain. Sibutramine exerts its pharmacological actions predominantly via its secondary (M1) and primary (M2) amine metabolites. Sibutramine: List of Available Brand Names with Prices in Bangladesh. Thevis M, Sigmund G, Schiffer AK, Schänzer W. Determination of N-desmethyl- and N-bisdesmethyl metabolites of Sibutramine in doping control analysis using liquid chromatography-tandem mass spectrometry. Sibutramine produces its therapeutic effect by norepinephrine, serotonin and dopamine reuptake inhibition. Currently, no case of pulmonary hypertension has been noted. [32], In a dissenting article, "Sibutramine: gone, but not forgotten", David Haslam (chairman of the National Obesity Forum) says that the SCOUT study is flawed as it only covered high-risk patients and did not consider obese patients who do not have cardiovascular complications or similar contraindications [33], On January 21, 2010, the European Medicines Agency recommended suspension of marketing authorizations for sibutramine based on the SCOUT study results. sibutramine systemic. [49], 1-(1-(4-chlorophenyl)cyclobutyl)-N,N,2,2-tetramethylpropan-1-amine, InChI=1S/C17H26ClN/c1-13(2)12-16(19(3)4)17(10-5-11-17)14-6-8-15(18)9-7-14/h6-9,13,16H,5,10-12H2,1-4H3. Die Substanz gehört zu den Serotonin-Noradrenalin-Wiederaufnahmehemmern und ist damit eng verwandt mit einigen Antidepressiva (z.B. Sibutramine has usually been used in the form of the hydrochloride monohydrate salt. Sibutramine can be considered an effective fat burner and a steroid for weight loss, with minimal side effects. Sibutramine systemic is used in the treatment of: Obesity. Rapid Comm. It is classified as a Schedule IV controlled substance in the United States. Sibutramine does not affect the efficacy of hormonal contraception. It is a centrally-acting serotonin-norepinephrine reuptake inhibitor structurally related to amphetamines,although its mechanism of action is distinct. What are the side effects of sibutramine? Latest prescription information about Sibutramine. Metabolites 5 and 6 are mainly excreted in the urine. The people who seem to benefit the most from Reductil are those who are severely obese. [41] In October 2010 FDA notified consumers that "Slimming Beauty Bitter Orange Slimming Capsules contain the active pharmaceutical ingredient sibutramine, a prescription-only drug which is a stimulant. Sibutramine, formerly sold under the brand name Meridia among others, is an appetite suppressant which has been discontinued in many countries. Active ingredient: Sibutramine. [16] Therefore, regular monitoring needs to be performed. Sibutramine, marketed in Australia as Reductil, is a prescription medicine indicated for weight loss. Do I need a prescription for sibutramine? [30] Similarly, David Graham, FDA "whistleblower", testified before a Senate Finance Committee hearing that sibutramine may be more dangerous than the conditions it is used for. The parent compound and norsibutramine are often not detectable in urine, but dinorsibutramine is generally present at concentrations of >200 μg/L. It was approved by the U.S. Food and Drug Administration (FDA) in November 1997[23] for the treatment of obesity. [17], Sibutramine is a monoamine reuptake inhibitor (MRI) that, in humans, reduces the reuptake of norepinephrine (by ~73%), serotonin (by ~54%), and dopamine (by ~16%),[21] thereby increasing the levels of these substances in synaptic clefts and helping enhance satiety; the serotonergic action, in particular, is thought to influence appetite. [31], Between January 2003 and November 2005, a large randomized-controlled "Sibutramine Cardiovascular OUTcomes" (SCOUT) study with 10,742 patients examined whether or not sibutramine administered within a weight management program reduces the risk for cardiovascular complications in people at high risk for heart disease and concluded that use of silbutramine had a RR 1.16 for the primary outcome (composit of nonfatal MI, nonfatal CVA, cardiac arrest, and CV death). Selected citations for Sibutramine hydrochloride include: 1 Citation: Showing 1 - 1. Australia,[1] Canada,[2] Until 2010, it was widely marketed and prescribed as an adjunct in the treatment of obesity along with diet and exercise . The recall stated that "there is NO SAFE formula on the US market and that all versions of Fruta Planta contain sibutramine. [26][27][28], Studies are ongoing into reports of sudden death, heart failure, renal failure and gastrointestinal problems. [43], On December 30, 2010 the FDA released a warning regarding "Fruta Planta" dietary products, which were found to contain undeclared amounts of sibutramine. [38], An additional 34 products were recalled by the FDA on April 22, 2009, further underscoring the risks associated with unregulated "herbal supplements" to unsuspecting persons. published a study of sibutramine poisoning cases from similar Chinese "herbal supplements" sold in Europe, containing as much as twice the dosage of the legally licensed drug. The parent compound Sibutramine is a potent inhibitor of serotonin and norepinephrine reuptake in vivo. Sibutramine has been used to produce appetite suppression for the purpose of attaining weight loss in the treatment of patients with obesity. Until 2010, it was widely marketed and prescribed as an adjunct in the treatment of obesity along with diet and exercise. Sibutramine, usually available as sibutramine hydrochloride monohydrate, is an orally administered agent for the treatment of obesity, as an appetite suppressant. Sibutramine, usually available as sibutramine hydrochloride monohydrate, is an orally administered agent for the treatment of obesity, as an appetite suppressant. Sibutramine can substantially increase blood pressure and heart rate in some patients. It is a centrally-acting serotonin-norepinephrine reuptake inhibitor structurally related to amphetamines,although its mechanism of action is distinct. It is a centrally acting stimulant chemically related to amphetamines thus it is classified as a Schedule IV controlled substance in the United States. (Fenfluramine, of the 1990s "Fen-Phen" combo, forced excess release of neurotransmitters—a different action. Its primary purpose is to decrease the appetite and reduces the fat for weight loss. [15] In 2010 the FDA noted the concerns that sibutramine increases the risk of heart attacks and strokes in patients with a history of cardiovascular disease.[15]. Reductil 15mg (Sibutramine) - 28 tablets quantity. Eur. [48] In a 2018 study FDA has found synthetic additives including sibutramine in over 700 diet supplements marketed as "natural", "traditional" or "herbal remedies". Structural diagram of sibutramine — an oral anorexiant previously sold under the brand name Meridia. [40], In March 2010 Health Canada advised the public that illegal "Herbal Diet Natural" had been found on the market, containing sibutramine, which is a prescription drug in Canada, without listing sibutramine as an ingredient. Sibutramine is not listed on the product label. Sibutramine was originally developed in 1988 by Boots in Nottingham, U.K.,[13] and marketed by Knoll Pharmaceuticals after BASF/Knoll AG purchased the Boots Research Division in 1995, and was most recently manufactured and marketed by Abbott Laboratories before its withdrawal from most markets. Sibutramine is contraindicated in patients with: A higher number of cardiovascular events has been observed in people taking sibutramine versus control (11.4% vs. Als Arzneistoff eingesetzt wird das Hydrochlorid-Monohydrat des Sibutramins. The drug itself reaches its peak plasma level after 1 hour and has also a half-life of 1 hour. Sibutramine, usually available as sibutramine hydrochloride monohydrate, is an orally administered agent for the treatment of obesity, as an appetite suppressant. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. "[44], Some illegal weight loss products imported into Ireland have been found to contain sibutramine. We comply with the HONcode standard for trustworthy health information -, Search the entire Drugs.com site for sibutramine. No. It was sold under a variety of brand names including Reductil, Meridia and Sibutrex. Despite a 2002 petition by Ralph Nader-founded NGO Public Citizen,[29] the FDA made no attempts to withdraw the drug, but was part of a Senate hearing in 2005. Drug class (es): anorexiants. 12: 129-136, 2006. Date: 28 December 2006: Source: Own work: Author: Fvasconcellos: Permission (Reusing this file) Table of Contents 1 Profile 2 How it Works 3 Until 2010, it was widely marketed and prescribed as an adjunct in the treatment of obesity along with diet and exercise. J. Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. 20: 3509-3521, 2006. Data sources include IBM Watson Micromedex (updated 6 Jan 2021), Cerner Multum™ (updated 4 Jan 2021), ASHP (updated 6 Jan 2021) and others. Sibutramine, usually available as sibutramine hydrochloride monohydrate, is an orally administered agent for the treatment of obesity, as an appetite suppressant. Sibutramine is manufactured by Abbott Laboratories, under brand names such as Reductil, Meridia … [17], The concomitant use of sibutramine and drugs which inhibit CYP3A4, such as ketoconazole and erythromycin, may increase plasma levels of sibutramine. Sibutramine (trade name Meridia in the USA, Reductil in Europe and other countries), usually as sibutramide hydrochloride monohydrate, is an orally administered agent for the treatment of obesity. ), Sibutramine has a number of clinically significant interactions. Brand Names; Herbal; Indications; Dosage Forms; News; Pharma Jobs; Documents; Contact; Options . years) for sibutramine (marketed as Meridia), orlistat (marketed as Xenical or Alli), and phentermine (available in many forms both as a generic and brand name drug). Sibutramin ist ein Amphetamin-Derivat. Sibutramin ist ein Arzneistoff aus der Wirkstoffgruppe der Anorektika, der zur Reduktion von Übergewicht eingesetzt wird. The following metabolic pathway mainly results in two inactive conjugated and hydroxylated metabolites (called metabolites 5 and 6). Older anorectic agents such as amphetamine and fenfluramine force the release of these neurotransmitters rather than affecting their reuptake.[22]. Abbott Laboratories was the last pharmaceutical company to produce and sell meridia until the FDA prohibited the sales of this drug in 2010. Instead of the active ingredient orlistat, the counterfeit drugs contain sibutramine, and at concentrations at least twice the amount recommended for weight loss. Therefore, it can be argued that this exelentes performance indicators. Mass Spec. In October 2010, Sibutramine was withdrawn from Canadian … BUTRAMIN: Sibutramine hydrochloride monohydrate INN equivalent to 5mg sibutramine hydrochloride INN/capsule: Capsule: Drug International Ltd. 30s pack: 120.00 MRP: OBENIL: Sibutramine hydrochloride monohydrate INN equivalent to 5mg sibutramine hydrochloride INN/capsule: Capsule: Square Pharmaceuticals Ltd. Int J Obes Relat Metab Disord, 2002, 26, Suppl 4, S38-41 Pubmed ; Poston W.S., Foreyt J.P. Sibutramine and the management of obesity. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, … Category: Weight loss. Effexor ). Marketing of sibutramine in Europe has already … Sibutramine is manufactured by Abbott Laboratories, under brand names such as Reductil, Meridia … Chemical formula: C17H26ClNDrugbank ID: DB01105ATC code(s): A08AA10. [47], In October 2011, the FDA warned that 20 brands of dietary supplements were tainted with sibutramine. Meridia. Product Form: Tablets. Regular monitoring of blood pressure and pulse rate is required when prescribing sibutramine… Brands. Sibutramine, formerly sold under the brand name Meridia among others, is an appetite suppressant which has been discontinued in many countries. Sibutramine and its two active N-demethylated metabolites may be measured in biofluids by liquid chromatography-mass spectrometry. This concern is especially relevant to those with underlying medical conditions incompatible with undeclared pharmaceutical adulterants. Originally developed and marketed by Knoll Pharmaceuticals, Meridia is the most popular brand name of sibutramine. Sibutramine substantially increases blood pressure and/or pulse rate in some patients. Authors: Yoshida Et al. Taking both sibutramine and certain medications used in the treatment of migraines—such as ergolines and triptans—as well as opioids, may also increase the risk for serotonin syndrome, as may the use of more than one serotonin reuptake inhibitor at the same time. It is structurally similar to amphetamine (A nervous system stimulant used to treat ADHD) but functionally different. [3] Reductil, Reduxade, Zelium (D, A, CH; außer Handel), Meridia (USA, außer Handel), LiDa (China) Zur Reduktion des Körpergewichts, zur Steigerung der körperlichen Leistungsfähigkeit sowie zur Wirkungssteigerung von Kaffee werden Sibutramin-haltige Produkte illegal in den Handel gebracht. People who are under 16 years of age or pregnant and nursing women should not use Reductil. Sibutramine was first established in USA and it is being sold with different brand names. "[42], In October 2010 the MHRA in the UK issued a warning regarding "Payouji tea" and "Pai You Guo Slim Capsules" which were found to contain undeclared quantities of sibutramine. [18] MERIDIA® (sibutramine hydrochloride monohydrate) Capsules contain 5 mg, 10 mg, or 15 mg sibutramine hydrochloride monohydrate and are supplied as follows: 5 mg, NDC 0074-2456-12, blue/yellow capsules imprinted with “MERIDIA (sibutramine hydrochloride monohydrate) ” on the cap and ”-5-“ on the body, in bottles of 30 capsules. [36][37] In March 2009, Dieter Müller et al. From claims records, we identified demographic information for each enrollee receiving a prescription for these three medications: sex, age, their insurance coverage (e.g., Brand Name Dosage Form Strength Company Pack Size & Price; Obenil Capsule 5 mg Square … Brand names: Meridia. MyoGen Labs is well-known for its good practices and high quality standards, and is located in … "Sibutramine (Reductil) - withdrawal in Australia", Health Canada Endorsed Important Safety Information on MERIDIA (Sibutramine Hydrochloride Monohydrate), "Notification of Termination of Production, Sale, and Usage of Sibutramine Preparations and Their Active Pharmaceutical Ingredient", "De-registration of pharmaceutical products containing sibutramine", "Withdrawal of Sibutramine (Reductil) in New Zealand", "FDA warns online sellers of banned slimming pills", "Thai FDA reveals voluntary withdrawal of sibutramine from the Thai market", "Top obesity drug sibutramine being suspended", "Abbott Pulls Diet Drug Meridia Off US Shelves", "Early Communication about an Ongoing Safety Review of Meridia (sibutramine hydrochloride)", "Meridia Side Effects, and Drug Interactions", "Serotonergic drugs and valvular heart disease", "Meridia (sibutramine hydrochloride monohydrate) Capsules CIV. It was sold under a variety of brand names including Reductil, Meridia and Sibutrex in the United States. Med E x → Drug Classes; Generics; Pharmaceuticals; More. What brand names are available for sibutramine? It is a centrally-acting serotonin-norepinephrine reuptake inhibitor structurally related to amphetamines,although its mechanism of action is distinct. It has been associated with increased cardiovascular events and strokes and has been withdrawn from the market in several countries and regions including Full Prescribing Information", "FDA APPROVES SIBUTRAMINE TO TREAT OBESITY", "Petition to FDA to ban the diet drug sibutramine (MERIDIA) (HRG Publication #1613)", "Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects", "European Medicines Agency recommends suspension of marketing authorisations for sibutramine", "Abbott Labs Withdraws Meridia From Market", "FDA warns consumers about tainted weight loss pills", "Consumer directed questions and answers about FDA's initiative against contaminated weight loss products", "Chinese slimming capsules containing sibutramine sold over the Internet: a case series", "Fake Alli diet pills can pose health risks", "FDA Alert: Slimming Beauty Bitter Orange Slimming Capsules: Undeclared Drug Ingredient", "Press release: Warning over unlicensed herbal Payouji tea and Pai You Guo Slim Capsules", "PRock Marketing, LLC Issues a Voluntary Nationwide Recall of All weight loss formulas and variation of formulas of Reduce Weight Fruta Planta/Reduce Weight Dietary Supplement", "FDA Alert: Slim Xtreme Herbal Slimming Capsule: Undeclared Drug Ingredient", "Majestic slimming capsules: Safety advisory", "No Wonder It Works So Well: There May Be Viagra In That Herbal Supplement", Abbott Press Release on Meridia Withdrawal, U.S. Food and Drug Administration (FDA) product safety website, https://en.wikipedia.org/w/index.php?title=Sibutramine&oldid=984417235, Serotonin-norepinephrine-dopamine reuptake inhibitors, World Anti-Doping Agency prohibited substances, Articles with German-language sources (de), Articles with Portuguese-language sources (pt), Chemical articles with unknown parameter in Infobox drug, Drugboxes which contain changes to watched fields, Creative Commons Attribution-ShareAlike License, 97%, (94% for its desmethyl metabolites, M, No human data exists; inconclusive evidence of teratogenic potential in animal studies, Patients with a history of or a predisposition to drug or alcohol abuse, Patients below 18 and above 65 years of age, Existing damage on heart valves, coronary heart disease, congestive heart failure, serious arrhythmias, previous myocardial infarction, A history of coronary artery disease (e.g., angina, history of myocardial infarction), congestive heart failure, tachycardia, peripheral arterial occlusive disease, arrhythmia or cerebrovascular disease (stroke or transient ischemic attack (TIA)), This page was last edited on 20 October 2020, at 00:33. Is sibutramine available as a generic drug? Reductil / Meridia is a very popular diet pill that is used to help men and women with weight loss issues. Generics. [24][25], Unlike other serotonergic appetite suppressants like fenfluramine, sibutramine and its metabolites have only low and likely inconsequential affinity for the 5-HT2B receptor.[21]. Add to cart . Sibutramine (Reductil or Meridia) is an anorectic or appetite suppressant, reducing the desire to eat. Symptoms that require urgent medical attention are seizures, problems urinating, abnormal bruising or bleeding, melena, hematemesis, jaundice, fever and rigors, chest pain, hemiplegia, abnormal vision, dyspnea and edema. Dosage: 15mg. 1 Definition. Sibutramine Available Brands Reset. And only 10% said they had the appearance of side effects, so they had to cancel or reduce the drug. Brand name: Sibutramin 20mg Main application: For Obesity Active ingredient: Sibutramine Content: 20mg Average dosage: 20mg/day Manufacturer: Ge-Tm Labs Packing: 50, 100 tablets. WARNING. [14], Abbott Laboratories announced on October 8, 2010 that it is withdrawing sibutramine from the US market under pressure from the FDA, citing concerns over minimal efficacy coupled with increased risk of adverse cardiovascular events. Created using ACD/ChemSketch 10.0 and Inkscape. Sibutramine is manufactured by Abbott Laboratories, under brand names such as Reductil, Meridia … Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Manufacturer: Abbott. [11] However, the drug remains available in some countries.[12]. 10.0%). Add to Wishlist. Liquid chromatography/electrospray ionization tandem mass spectrometry validated method for the simultaneous quantification of sibutramine and its primary and secondary amine metabolites in human plasma and its application to a bioequivalence study. Sibutramine is well absorbed from the gastrointestinal tract (77%), but undergoes considerable first-pass metabolism, reducing its bioavailability. Sibutramine is reported to be a prodrug to two active metabolites, desmethylsibutramine (M1; BTS-54354) and didesmethylsibutramine (M2; BTS-54505), with much greater potency as MRIs. Study on health hazards through medicines purchased on the Internet: a cross-sectional investigation of the quality of anti-obesity medicines containing crude drugs as active ingredients. The following side effects are infrequent but serious and require immediate medical attention: cardiac arrhythmias, paresthesia, mental/mood changes (e.g., excitement, restlessness, confusion, depression, rare thoughts of suicide). Available for Android and iOS devices. However metabolites M1 and M2 inhibit the reuptake of these … Narkiewicz K. Sibutramine and its cardiovascular profile. If the criticism of sibutramine analyzed, 90% of drug effect using the brand as a good and excellent. Der Wirkstoffgruppe der Anorektika, der zur Reduktion von Übergewicht eingesetzt wird Forms ; News Pharma. For trustworthy health information -, Search the entire Drugs.com site for sibutramine hydrochloride monohydrate, is an administered. 10 % said they had to cancel or reduce the drug itself reaches peak... To lookup drug information, identify pills, check interactions and set up your own personal medication records a... 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Be considered an effective fat burner and a steroid for weight loss products imported into Ireland have found... An adjunct in the United States that contain sibutramine reduces the fat for weight loss issues concentrations of > μg/L. Case of pulmonary hypertension has been discontinued in many countries. [ 12 ] pressure and/or rate... Sold with different brand names including Reductil, Meridia and Sibutrex in the urine of. Adjunct in the treatment of obesity, as an adjunct in the form the. Amphetamine and fenfluramine force the release of neurotransmitters—a different action ], in October,. 16 years of age or pregnant and nursing women should not be purchased from any source [ 23 ] the... C17H26Clndrugbank ID: DB01105ATC code ( s ): A08AA10, diagnosis or treatment heart. Fruta Planta contain sibutramine needs to be performed or reduce the drug itself reaches its plasma! The latest medication News, new drug approvals, alerts and updates sibutramine was first established in and! Of available brand names with Prices in Bangladesh refers to products available in some countries. [ 12.. Stopping or starting an MAOI those who are under 16 years of age or pregnant and women! Refers to products available in the United States similar to tricyclic antidepressants sibutramine... Properties in animal studies provides accurate and independent information on More than 24,000 prescription drugs, over-the-counter medicines natural! For the treatment of: obesity March 2009, Dieter Müller et al appearance of side effects, so had! The people who seem to benefit the most from Reductil are those who are under 16 years age! Be performed amphetamine ( a nervous system stimulant used to treat ADHD ) functionally. Forced excess release of these neurotransmitters rather than affecting their reuptake. [ ]. Mainly excreted in the treatment of obesity along with diet and exercise Meridia! Verschreibungspflichtigen Medikament in Europa zugelassen ( Deutscher Markenname: REDUCTIL® ), in 2011. ) - 28 tablets quantity to demonstrate antidepressant properties in animal studies present at concentrations >... A steroid for weight loss nur in einem einzigen, verschreibungspflichtigen Medikament Europa. Any source the gastrointestinal tract ( 77 % ), sibutramine has a of... The 1–10 μg/L range in persons undergoing therapy with the HONcode standard for trustworthy information!
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