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Creemers GJ, van Boven WP, Lowenberg B, van der Heul C "Azathioprine-associated pure red cell aplasia. Use: Adjunctive therapy for prevention of rejection in renal homotransplantation. Bone marrow suppression is dose related and is the most common cause for dosage reductions. Leukopenia any degree has been reported in greater than 50% of renal homograft recipients and 28% of rheumatoid arthritis patients. acka.info abilify

About imuran

Duran S, Apte M, Alarcon GS, et al. "Features associated with, and the impact of, hemolytic anemia in patients with systemic lupus erythematosus: LX, results from a multiethnic cohort. Langer RM, Jaray J, Toth A, Hidvegi M, Vegso G, Perner F "De novo tumors after kidney transplantation: the budapest experience. Azathioprine may also be used for purposes not listed in this medication guide. This medication can affect fertility your ability to have children whether you are a man or a woman. Talk with your doctor if you have concerns about this.

Does imuran interact with other medications

Kerstens PJSM, Stolk JN, Deabreu RA, Lambooy LHJ, Vandeputte LBA, Boerbooms AAMT "Azathioprine-related bone marrow toxicity and low activities of purine enzymes in patients with rheumatoid arthritis. Rheumatoid Arthritis: IMURAN is usually given on a daily basis. RA entered my life forever. MS usually does not hurt your intelligence or long-term memory. It won't change your ability to read or carry on a conversation. Stopped all dairy products, started eating home cook meals, chicken breast, shopp down in little bite size, with veggies, stir fry on a woke, with olive oil, you can do turkey - things that will be easy on your system, and the best thing that help me I started drinking One bottle of water with a teaspoon of BAKING SODA before bed time and One bottle of water with a teaspoon of BAKING SODA when I got up, started excerising my Body, look up the spartan 300 workout on youtube, I been doing this for the past year, and now I been perfect, no more stiffness, nothing I been bless by God now I can walk - Run - workout, I thank the most High for this, I hope it helps you.

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You should not take this medicine if you are allergic to azathioprine, or if you are pregnant unless the benefits of treating you outweigh any risks posed by taking azathioprine. Alopecia has been reported in patients on azathioprine monotherapy or in combination with other immunosuppressants. This side effect may resolve spontaneously despite ongoing therapy. This medicine may increase your risk of getting certain types of cancer, especially of the skin, lymph system lymphoma or blood leukemia. Talk to your doctor if you have concerns about this risk. Being tired is part of the territory. I complained for 30 years before I was properly diagnosed. I had right knee replaced suffered 4 blood clots. Had a stroke 6 months later then I was positive in my ANA blood work. I have been on plaquenil for 7 years. Same dosage as you. Seems to work fine. Keep up with your eye exams. I have had spine fusion, left knee replaced 2times, went deaf in left ear and experience Lupus Fog. I say this it is tiresome it attacks folk different but any day that is good be thankful. Do anything that makes you happy and be glad for being in your right mind. I encourage you to keep up with your vitamins especially D for your bones that's my downfall. Lupus attacks my joints and I have an enlarged heart as well all Lupus related. It is a very sneaky disease that causes many problems in the system. Tell your Dr. anything you feel is wrong no matter how small. Go to therapy if you need to talk!



What is azathioprine Imuran?

Use with caution. May make these conditions worse. Bir K, Herzenberg AM, Carette S "Azathioprine induced acute interstitial nephritis as the cause of rapidly progressive renal failure in a patient with Wegener's granulomatosis. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Eland IA, van Puijenbroek EP, Sturkenboom MJ, Wilson JH, Stricker BH "Drug-associated acute pancreatitis: twenty-one years of spontaneous reporting in The Netherlands. Azathioprine can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being near people who are sick or have infections. Avoid activities that may increase your risk of bleeding injury. Tell your doctor at once if you develop signs of infection. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Take azathioprine with a full glass of water. Using these medicines together could cause serious unwanted effects. The increased risk of cancer may be more pronounced when azathioprine is used concomitantly with other immunosuppressive agents. Renal transplant patients may have a higher risk of developing lymphoproliferative disorders, lymphomas, and leukemia, as well as some solid tumors while receiving azathioprine. Welcome to the community. Please feel free to join our discussions. I am sorry about your infection and hope that you feel better soon. The other issue you address are the respiratory complications of methotrexate. There is one very serious respiratory issue that can occur in patients taking methotrexate and this is called methotrexate pneumonitis. I warn my patients that if they develop cough, shortness of breath or fever-to stop methotrexate and be seen. Even thought many of my patients have a primary care doctor, I want to know when they are sick so they can be treated appropriately. I typically recommend that my patients who develop a cough on methotrexate be seen and get a chest xray. While methotrexate pneumonitis can be a very serious medical problem, it is fortunately not common and most patients who present with cough on this drug end up having a viral bronchitis and less commonly pneumonia. How should I take Imuran azathioprine?



Please keep us updated

Anyway, what this book says is basically stay away from refined sugars except fruits and white refined flour in any form. This includes bread. I buy Ezekiel bread found in the freezer section of the grocery store, and in any health food store. I think Trader Joe's and Whole Foods always have it. It's a flourless bread made from sprouted grains. Drugs. Many different and drugs can cause temporary muscle damage. Because inflammation in the muscles is often not identified, the muscle problem may be called myopathy rather than myositis. Just turn my back on everyone and pretend my 'cure' didn't happen? What other drugs will affect azathioprine Imuran? May decrease your body's ability to fight infection. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. It also lists % of ANA cells in the lung washing fluid they did; but they give no reference range as to what is normal. Farge D, Parfrey PS, Forbes RD, Dandavino R, Guttmann RD "Reduction of azathioprine in renal transplant patients with chronic hepatitis. If you take this medicine once daily and you miss a dose, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Azathioprine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. Azathioprine sometimes causes nausea or vomiting. Taking this medicine after meals or at bedtime may lessen stomach upset. Talk to your doctor if you have questions or continue to have problems with nausea or vomiting. We also drink raw milk and have cut out most refined foods very hard to do however. Soaked grains can be eaten, I can eat soaked flour with no problems. It took about 3 months, but my joint pain disappeared completely! Anstey A, Lennard L, Mayou SC, Kirby JD "Pancytopenia related to azathioprine-an enzyme deficiency caused by a common genetic polymorphism: a review. While taking azathioprine, you may have a higher risk of developing skin cancer. Talk to your doctor about this risk and what skin symptoms to watch for. CMV retinitis coincident with azathioprine therapy. It is theorized that immunosuppressive therapy may have a role in the development of CMV retinitis in this population. The patient responded to discontinuation of azathioprine, lowering of the corticosteroid dose, and systemic administration of ganciclovir. Wash your hands before using the eye drops. albenza



Prescribing information for imuran

The information contained in the Truven Health Micromedex products as delivered by Drugs. Durezol may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. The majority of reported cases of hepatosplenic T-cell lymphoma have bee in patients with Crohn's disease or ulcerative colitis, and were adolescent and young adult males. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Benari Z, Mehta A, Lennard L, Burroughs AK "Azathioprine-induced myelosuppression due to thiopurine methyltransferase deficiency in a patient with autoimmune hepatitis. Shahnaz S, Choksi MT, Tan IJ "Bilateral cytomegalovirus retinitis in a patient with systemic lupus erythematosus and end-stage renal disease. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. Here is a link to a page which explains this: rawarrior. Ask your doctor to give you updates on any promising results. RA now. I applaud your finding the diet info. Thank you so much for your post, and how great is it that you have gotten your RA under control. I'm right behind you, and it all started when I started to see an acupuncturist and a healer here in my town. She started me on a new way of eating, much like you have just described, and each month that goes by I keep feeling better and better. I am following "The Genotype Diet" by Dr. Peter D'Adamo, and since you are already into it, you should read this book. I keep it as a sort of diet "bible", and I have pretty much adjusted to what he recommends. I did quit drinking coffee, but I have worked it back in on the weekends, and green tea during the week at work. It's the only thing I have had trouble adapting to with my new way of eating. I am losing weight without even trying, so now that I am feeling better, I'm going to turn up the "workout" effort and see how the joints respond. Thank you for posting and giving everyone some new possibilities. I for one am very grateful for this change, and even though I did not want to give up all of those things, I have not felt this good in four years, so it has been worth it to me. Take care and God Bless you, thank you again for posting your successes! Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Join a Crohn's disease support group, where you can share experiences with people who've gone through the same challenges. To learn about support groups in your area, contact the Crohn's and Foundation of America.



Imuran warnings

Gradual dose reduction is recommended to reduce the risk of toxicities. It is not known whether Durezol will harm an unborn baby. Tell your doctor if you are pregnant. HermannsLe T, Pierard GE "Azathioprine-induced skin peeling syndrome. Jeurissen ME, Boerbooms AM, van de Putte LB, Kruijsen MW "Azathioprine induced fever, chills, rash, and hepatotoxicity in rheumatoid arthritis. Major GA, Moore PG "Profound circulatory collapse due to azathioprine. Wait at least 10 minutes before using any other eye drops your doctor has prescribed. My blood ANA levels have previously been negative. buy generic gefitinib canada



Imuran forms and strengths

McHenry PM, Allan JG, Rodger RS, Lever RS "Nephrotoxicity due to azathioprine. Fonclare AL, Khosrotehrani K, Aractingi S, Duriez P, Cosnes J, Beaugerie L "Erythema Nodosum-like Eruption as a Manifestation of Azathioprine Hypersensitivity in Patients With Inflammatory Bowel Disease. Get emergency medical help if you have signs of an allergic reaction to Durezol: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Use Durezol ophthalmic emulsion exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. Krishnan K, Adams P, Silveira S, Sheldon S, Dabich L "Therapy-related acute myeloid leukaemia following immunosuppression with azathioprine for polymyositis. If you need to have surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. This is the most accurate test for diagnosing myositis. A doctor identifies a weak muscle, makes a small incision, and removes a small sample of muscle tissue for testing. Muscle biopsy leads to a final diagnosis in most people with myositis. She manages to treat herself with herbal medicine, acupuncture, meditation, and much more I'm sure. There are infinite possibilities out there for all of us RA'ers as well as people who suffer from cancer, diabetes, heart disease, and any other prevalent disease in our society today. I am a huge believer that diet has just as much to do with disease as anything else, along with stress, suppressed anger, allergens, pollutants, ozone, and also that RA existed long before there was a name for it, or people knew what it was. I happen to believe that many of us have the propensity to come down with a number of diseases, and certain things "trigger" our bodies to start attacking itself. It's a natural thing for our bodies to do, us auto-immuners just can't stop it from doing it in a bad way. There have been case reports of patients with symptoms that imitate viral gastroenteritis nausea, vomiting, diarrhea, and fever occurring hours after a single dose of azathioprine. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of the following symptoms: fever, night sweats, itching, loss of appetite, weight loss, tiredness, feeling full after eating only a small amount, pain in your upper stomach that may spread to your shoulder, nausea, easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate, dark urine, clay-colored stools, or jaundice yellowing of the skin or eyes.



Side effects of imuran

Urine may also turn a dark brown or red color. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. Inflammatory conditions. Conditions causing inflammation throughout the body may affect the muscles, causing myositis. Many of these causes are autoimmune conditions, in which the body attacks its own tissues. Use sunscreen or sunblock lotions with a sun protection factor SPF of at least 15 on a regular basis when you are outdoors. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Dosage reduction or alternative therapy may be required in patients with reduced thiopurine S-methyltransferase TPMT activity. Depression and RA should be talked about. At least three cases of atrial fibrillation have been reported one case involving a patient with ulcerative colitis although causality is unknown. A 52-year-old male with steroid-dependent ulcerative colitis experienced atrial fibrillation coincident with azathioprine therapy. The drug had been started 3 years earlier, but discontinued after a few months because the patient reported palpitations, lipothymia, nausea, and vomiting. Upon a rechallenge with 50 mg of azathioprine, the patient showed general malaise, nausea, and vomiting. An ECG showed atrial fibrillation, and the patient reported that the symptoms were similar to those experienced previously. So well done Jenny for your posting! This section provides information on the proper use of a number of products that contain azathioprine. It may not be specific to Imuran. Please read with care. Adverse Drug Reactions Advisory Committee ADRAC and the Adverse Drug Reactions Unit of the TGA "Australian Adverse Drug Reactions Bulletin. Escousse A, Mousson C, Santona L, Zanetta G, Mounier J, Tanter Y, Duperray F, Rifle G, Chevet D "Azathioprine-induced pancytopenia in homozygous thiopurine methyltransferase-deficient renal transplant recipients: a family study. Not all side effects for azathioprine may be reported. You should always consult a doctor or healthcare professional for medical advice. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? DePinho RA, Goldberg CS, Lefkowitch JH "Azathioprine and the liver: evidence favoring idiosyncratic, mixed cholestatic-hepatocellular injury in humans. purchase tacrolimus store



How should I take Imuran azathioprine?

Acute tubulointerstitial nephritis and no active glomerulonephritis were observed on renal biopsy. Cerner Multum, Inc. "UK Summary of Product Characteristics. The principal and potentially serious toxic effects of azathioprine the active ingredient contained in Imuran are hematologic and gastrointestinal. Risk of secondary infection and malignancy is also significant. Frequency and severity of side effects depend on dose and duration of azathioprine as well as on underlying disease or concomitant therapies. Hematologic toxicities and neoplasia were reported more often in renal homograft recipients than in patients using azathioprine for rheumatoid arthritis. Do not use Durezol ophthalmic emulsion while you are wearing regular contact lenses. Wait at least 10 minutes after using Durezol before putting in the lenses. Do not wear any contact lens that has not been approved by your doctor. Now, the question. My pulmonologist is bouncing me to rheumatology to tell me my lung biopsy results. Methotrexate decreases the activity of your body's immune system, which increases the risk of a serious bacterial infection. Some people who take methotrexate develop an infection that requires oral antibiotics; a smaller number of people will develop an infection that requires intravenous antibiotics and hospitalization. Well, I have kept my thoughts to myself for a while, and I cannot do that anymore. Consult WARNINGS section for additional precautions.



What should i avoid while taking imuran

DeClerck YA, Ettenger RB, Ortega JA, Pennisi AJ "Macrocytosis and pure RBC anemia caused by azathioprine. We are here with you and all sending good thoughts out to each other. I wish you the best, and you can consider this a Cyber Hug if you need one. But the symptoms of viral infection may go away days or weeks before myositis symptoms begin. He also says that alcohol is poison to our system, and coffee is almost as bad! DavidNeto E, daFonseca JA, dePaula FJ, Nahas WC, Sabbaga E, Ianhez LE "The impact of azathioprine on chronic viral hepatitis in renal transplantation: A long-term, single-center, prospective study on azathioprine withdrawal. Use and dose must be determined by your doctor. Hohlfeld R, Michels M, Heininger K, Besinger U, Toyka KV "Azathioprine toxicity during long-term immunosuppression of generalized myasthenia gravis. Bottomley WW, Ford G, Cunliffe WJ, Cotterill JA "Aggressive squamous cell carcinomas developing in patients receiving long-term azathioprine. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. triamterene



Imuran side effects

I'm sure someone of you all had had a bronchoscopy where they did a washing for cell samples, I hope! Rarely, bacteria, fungi, or other organisms can cause myositis as well. Viruses or bacteria may invade muscle tissue directly, or release substances that damage muscle fibers. No information is available on the relationship of age to the effects of azathioprine in geriatric patients. Within a couple of weeks there was noticeable improvement in terms of reduced swelling and pain, within a few months my mobility had improved and joints were only occasionally painful and after about 9 months of sticking with it I woke up one sunny day to find that even the morning stiffness feet like planks of wood had completely vanished. AMAZING! Agarwal SK, Mittal D, Tiwari SC, Dash SC, Saxena S, Saxena R, Mehta SN "Azathioprine-induced pure red blood cell aplasia in a renal transplant recipient.



Maybe if I try raw milk instead?

If you suspect impaired thinking, talk with your neurologist or family doctor. Fuzzy thinking can have many causes. If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by this medicine. Blood tests may be needed to check for unwanted effects. Some of the medications we use, such as immunosuppressants and biologic drugs, require monitoring in person. These and other ordinary muscle pains are called myalgias. Azathioprine is used to prevent your body from rejecting a transplanted kidney. It is also used to treat symptoms of rheumatoid arthritis. Inflammation contributes to these symptoms, technically making this a form of myositis. Myositis symptoms after or injury nearly always resolve completely with rest and recovery. Ask your healthcare professional how you should dispose of any medicine you do not use. Zaltzman M, Kallenbach J, Shapiro T, et al "Life-threatening hypotension associated with azathioprine therapy. Azathioprine may be continued long-term in patients with clinical response. What happens if I miss a dose Imuran? buy ranexa au



So well done Jenny for your posting!

Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else. Brown G, Boldt C, Webb JG, Halperin L "Azathioprine-induced multisystem organ failure and cardiogenic shock. Saway PA, Heck LW, Bonner JR, Kirklin JK "Azathioprine hypersensitivity: case report and review of the literature. Burger DC, Florin TH "Hepatosplenic T-cell lymphoma following infliximab therapy for Crohn's disease. Katska DA, Saul SH, Jorkasky D, Sigal H, Reynolds JC, Soloway RD "Azathioprine and hepatic venocclusive disease in renal transplant patients. MS needs constant care or can't live on his or her own. If this becomes an issue, discuss your options with your doctor and family. A social worker or also can help explore options for care. Can Medicine Help? This medicine may increase your risk of developing infections, including a serious brain infection called progressive multifocal leukoencephalopathy. Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Tell your doctor if you have any kind of infection before you start using this medicine. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back. Complications such as colitis, diverticulitis, and bowel perforation have been primarily reported in transplant patients, and may be related to concomitant high-dose corticosteroid therapy. Pancreatitis occurs most commonly in organ recipients and patients with Crohn's disease. What should I discuss with my healthcare provider before taking Imuran azathioprine? Duvoux C, Kracht M, Lang P, Vernant JP, Zafrani ES, Dhumeaux D "Hyperplasie nodulaire regenerative du foie associee a la prise d'azathioprine. This is something that really gets my attention, because I have to watch carbs anyway! Lower doses may be required; however, no specific guidelines have been suggested. Raymond Cross, MD. He's an associate professor of medicine and director of the Program at the University of Maryland School of Medicine. What is the most important information I should know about azathioprine Imuran? Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection. Mion F, Napoleon B, Berger F, Chevallier M, Bonvoisin S, Descos L "Azathioprine induced liver disease: nodular regenerative hyperplasia of the liver and perivenous fibrosis in a patient treated for multiple sclerosis.



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Imuran dosing information


CD8 ratio are significant

Cytoxan chlorambucil Leukeran melphalan Alkeran. Avoid sunlamps and tanning beds. Kerstens PJ, Stolk JN, Hilbrands LB, Vandeputte LB, Deabreu RA, Boerbooms AM "5-nucleotidase and azathioprine-related bone-marrow toxicity. Transplant patients as well as those with rheumatoid arthritis are often treated with multiple immunosuppressants; therefore, the true risk of neoplasia associated with azathioprine alone has yet to be determined. buy now atopex canada

There is no cure for Rheumatoid Arthritis

Bergman SM, Krane NK, Leonard G, Soto-Aguilar MC, WAllin JD "Azathioprine and hypersensitivity vasculitis. Frick TW, Fryd DS, Goodale RL, Simmons RL, Sutherland DE, Najarian JS "Lack of association between azathioprine and acute pancreatitis in renal transplantation patients. RA which is not curable. I wish it were.

Imuran consumer information

Not okay by me. I cannot convince him to give me the results. It's true that over time, about half of people with MS can have some cognitive problems. That means poor focus, slowed thinking, or a fuzzy memory. PS: A little off topic, but when we started using only raw milk, these have helped prevent cavities. You will not get the same result using mass produced heat treated milk however. Bouhnik Y, Lemann M, Mary JY, Scemama G, Tai R, Matuchansky C, Modigliani R, Rambaud JC "Long-term follow-up of patients with crohn's disease treated with azathioprine or 6-mercaptopurine.

What is imuran

RA for a year, strangely enough it was a year after i moved from Australia to live and work in Bali- Indonesia. As a result my diet changed. Keystone EC, Schabas R "Hypotension with oliguria: a side-effect of azathioprine. Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your doctor before having any dental work done. Inform patients of the risk of malignancy with azathioprine.

Call your doctor at once if you have sudden eye irritation or pain, severe eye redness or itching, pain behind your eyes, sudden vision changes, severe headache, slow healing after your eye surgery, signs of new eye infection swelling, draining, crusting tunnel vision, seeing halos around lights, or changes in the color or appearance of your iris the colored part of your eye. Call your doctor if you have missed more than one dose. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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