nexgard side effects

The most frequent side effects with NexGard Combo (which may affect between 1 and 10 animals in 1,000) are excessive salivation, diarrhoea, skin reactions at the application site (hair loss, itching), loss of appetite, lethargy and vomiting. This means that its absolutely crucial to be informed about what products cause what adverse reactions, giving you enough time to spot the changes and call your vet. Petsho is my outlet to share about our lives with our pets. Dont Miss: Frontline Plus & Gold for Dogs (Warning). In a well-controlled US field study, which included a total of 333households and 615 treated dogs (415 administered afoxolaner; 200 administered active control), no serious adverse reactions were observed with NexGard. In addition to keeping your dog safe, using the generic Nexgard will save you money. Based on current knowledge, there are no food and drug interactions with NexGard. Is this due to Nexgard? This study confirmed the 30-day effectiveness of a single monthly dose of NEXGARD for the treatment of adult C. felis infestations on dogs 24 hours post-infestation. An abscess is not a pleasant thing to have in the liver. NexGard can be administered with or without food. In the final analysis, it will be up to you to decide whether or not your dog is suitable for the use of a generic Nexgard. As stated on the product packaging, NexGard should be used only under the guidance of a veterinarian and with caution in dogs with a history of seizures. Its also important to note that NexGard for Dogs hasnt been evaluated for use in pregnant, breeding orlactating dogs. NexGard (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Nexgard soft beef chewable is also FDA approved to treat existing tick and flea infestation by killing ticks and adult fleas. Nexgard is not safe for every dog. K9 Advantix II for Dogs. The most likely outcome of all is that the dogs will not be able to tolerate the drug or the condition may progress. The answer to this question is thatit depends. This will kill fleas and ticks. Nexgard is the brand name for the treatment of dogs withallergic reactions to insect bites. If your dog vomits this medication within two hours of giving it, redose with another full chew. Everything You Need to Know Before Using NexGard Chewables for Dogs. In a well-controlled field study, NexGard was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. Another dog with a history of seizures had a seizure 19 days after the third dose of NexGard. Then, it protects the dog against fleas for a minimum of five weeks and four weeks or one month against ticks. No specific monitoring is required for this medication, but your veterinarian may recommend routine testing depending on your pets individual needs, other medications they may be on, and/or the issue that initially caused your pet to be placed on this medication. Make sure to monitor your dogs condition after you stop giving them Nexgard or any flea/tick medication that contains similar ingredients. Tilly (my pup) is having a CT scan this morning, her eye is no better. Petsho.com is a participant in the Amazon Services L.L.C. In fact, according to a second, While it should be stated that these reports do not consider previously existing conditions (like a predisposition towards seizures) or additional factors (for example, complications with other drugs used at the same time), dog owners should assume that these numbers only represent, One story about NexGard dog deaths comes from signer Vivienne Vickery, who. https://vcahospitals.com/know-your-pet/allergy-flea-allergy-dermatitis-in-dogs, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141545/, https://www.sciencedirect.com/science/article/pii/S0304401714000958, https://abc3340.com/news/fighting-for-you/is-there-a-link-between-popular-flea-medication-and-pet-deaths, https://www.boehringer-ingelheim.com/press-release/two-new-claims-nexgard-range-eu-and-australia, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280674/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807374/, Related PostsMelatonin for Dogs: Benefits, Safety, Dosage and More!By Katelyn Son, Updated February 21, 2023 Possible side effects of isoxazolines include muscle tremors, ataxia (loss of body control) and seizures. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. They then encourage the continued use of the product after this reaction, but it is better to listen to what your dogs body is saying rather than the packaging. However, with Fluralaner as its active ingredient, Bravecto is more potent and protects against fleas and ticks for up to three months. In addition to the obvious inconvenience, they can also transmit deadly diseases to your little pet and even yourself. Because the ingredients in the generic version are diluted so much lower than the original; it takes longer for your dog to absorb the medication and then process it into a usable amount of medication. It may take some time before your dog feels well again, but be sure not to give them the Nexgard if it is what caused their reaction. To sum up, fleas and ticks can be a serious problem if not controlled. We give this med faithfully every month. NexGard is a quick-acting medication. As a direct result of killing ticks and fleas, Nexgard protects dogs from several diseases. With Nexgard Chewables made specifically for dogs, the company has recently developed Nexgard Combo for cats to treat and prevent parasitic infections. Keeping the chemistry lesson to a minimum, Ill only tell you that the medication works by over-stimulating the nervous system of both ticks and fleas. NexGard is FDA-approved. But did you know that symptoms can vary from dog to dog? If living in a household with multiple pets, to minimize the likelihood of flea reinfestation, you will have to use NexGard chewables or another FDA-approved flea control product on all dogs regardless of whether they have fleas or not. in dogs. In most cases, this is due to another condition, but there is no way to be sure until the condition is fully treated. Nexgardis an oral chewable tablet used in the treatment and prevention of fleas and certain ticks in dogs. The two most common medications in use are Nexgard for dogs and Epi-Pen for humans. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If I could give it a 0 I would. There is a need for a period of withdrawal from the drug beforethe veterinarian feels comfortable prescribing another dose. When your dog has a seizure, it can really be dangerous for him. If applied correctly, it will provide 30 days of effective protection against both fleas and ticks! NexGard controls pest infestations by working against the cat flea called Ctenocephalides felis and several tick species, including the black-legged (deer) tick (Ixodes scapularis), the American dog tick (Dermacentor variabilis), and the Lone star tick (Amblyomma americanum). This second one is a method you should seek if your dog has had an adverse reaction to Nexgard. If you notice some of these issues, contact your veterinarian as soon as possible. Frontline kills fleas, ticks, and chewing lice by causing neurologic disorders. The most frequently reported adverse reactions include vomiting, dry/flaky skin, diarrhea, lethargy, and lack of appetite. Updated: 2023-02-28. However, it can also be used off-label in the treatment of canine mange. We comply with the HONcode standard for trustworthy health information. Afoxolaner can be given with or without food and/or water. Video unavailable This video is unavailable Watch on Nexgard reaction Watch on Will never use again. Simparica is inferior in comparison to NexGard because it does not kill flea eggs and larvae. When choosing between Bravecto vs Frontline or NexGard, pet owners should consider the potential side effects of each flea and tick medication. But what are the obvious differences between the two? Signer Pauline Gill points to a strong correlation between NexGard dog deaths and seizures, If you have reservations about using any pesticide-based flea and tick treatment for your dog, there are plenty of, https://www.pexels.com/photo/adorable-animals-breed-canine-374825/, Reasonable efforts have been made by AdvisoryHQ to present accurate information, however all info is presented without warranty. Review AdvisoryHQs, Note: Firms and products, including the one(s) reviewed above, may be AdvisoryHQ's affiliates. Review AdvisoryHQs Termsfor details. Dogs and cats will often develop liver, kidney, or heartdisease. NexGard is a registered trademark, and FRONTLINE VET LABS is a trademark of the Boehringer Ingelheim Group. 1-800-PetMeds has over 709 NexGard for Dogs reviews, earning a total rating of 4.5 stars out of 5. K9 Advantix II protects against adult fleas (and all their life stages), ticks, biting fleas, chewing lice, and mosquitoes. Get your rebate offer. Some have even died as a result of the adverse effects of themedication. While there are other medications, it is areliable drug and used to treat severe dog allergies. Treatment with NexGard may begin at any time of the year. The generic version also contains relatively less active ingredients as well. The following adverse reactions have been reported following the use of Heartgard and Heartgard Plus: Vomiting Diarrhea Lethargy Depression Loss of appetite Ataxia (drunken gait) Excessive drooling Dilated pupils Seizures, convulsions, or tremors No, NexGard does not kill fleas before they bite. Here are some topicals you can try. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Bravecto is easily comparable with NexGard as they both come in the form of oral chews and have similar effects. She is dedicated to helping readers and enjoys nothing more than exploring the outdoors with her children and pets. Dogs in both the treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment (0-11 eggs and 1-17 eggs in the NexGard treated dogs, and 4-90 eggs and 0-118 eggs in the control dogs, at 12- and 24-hours, respectively). Documents show 1315 seizures reported for Nexgard in the five years since it was approved by the FDA as safe and effective for the majority of dogs. In case you find chewable tablets hard to use (or your dog is a fussy eater), you can try a spot-on flea and tick medicine. Do not give extra or double doses. I have used NexGard for all of my dogs for years and none of them have ever had fleas or ticks. Before deciding whether or not your dog can use the brand of Nexgard being sold by your veterinarian, you need to know a few things. One good way of evaluating whether NexGard is safe for dogs is to consider the possible side effects of this oral flea medication for dogs. It also makes it easier for your dog to digest his food. For a copy of the Safety Data Sheet (SDS) or to report suspected adverse drug events, contact Boehringer Ingelheim Animal Health USA Inc. at 1-888-637-4251 or www.nexgardfordogs.com. While dogs and cats may be affected by the side effects of these medications, they can also suffer when the medications are discontinued. Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5- [3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N-[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl. In our review of NexGard for Dogs, well help you make an educated decision, providing a comprehensive look at whether this popular oral flea medication for dogs is safe, effective, and recommended for use. First, somedogs will not show any reaction. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses. Nexgard makes all the difference- any ticks that DO make it onto my dogs, die quickly. It is actually a good idea to first try various forms of treatment for your dogs epilepsy before taking Nexgard. However, with Fluralaner as its active ingredient, Bravecto is more potent and protects against fleas and ticks for up to three months. Use with caution in dogs with a history of seizures or neurologic disorders. Within this time frame, there were 720 reported cases of side effects for dogs, with the most common including: Perhaps more unsettling are the 21 NexGard dog deaths which were reported in this time, including nine deaths by euthanasia. As an established writer in the Pet industry for the last 7 years and building a career at a couple of reputable Californian vets, Leigh has written countless pet articles to contribute to the industry's wealth of knowledge. The Benefits of Nexgard and How to Use it on Your Dog. K9 Advantix II protects against adult fleas (and all their life stages), ticks, biting fleas, chewing lice, and mosquitoes. A third dog with a history of seizures received NexGard and experienced no seizures throughout the study. Your dog may be allergic to these active ingredients that lead to several complications. (adsbygoogle = window.adsbygoogle || []).push({}); Copyright 2015-2023. A disease that this med is supposed to prevent! It is also used as a preventive for Lyme disease. Direction and dosage information for NexGard. When in doubt, always consult your veterinarian. It does not act as a repellant, parasites must bite and feed on your pet's blood before the medicine takes effect. For example, by killing. If your dog happens to vomit less than two hours after the administration, you need to give it another full dose. Many studies observed no adverse reactions during their duration. According to the official website, NexGard is made by Merial, the creators of the widely-known Frontline. However, there are other similar dietary supplements that have been proven to not cause such problems. It is dosed for dogs by weight, so it is important to use the correct-sized medication for your pet. Take your dog to the veterinarian, and bring the packaging of the flea and tick medication with you. Also, extra caution is indicated if using NexGard in dogs with a history of seizures and neurological disorders. NexGard is a prescription medication, meaning pet parents that want to treat their dogs with this revolutionary product need to talk to a vet and get a prescription first. Afoxolaner is the active ingredient in NexGard for Dogs, an insecticide and acaricide which travels through your dogs bloodstream and kills pests by over-stimulating their central nervous system. Dogs and cats that take the medication can become anxious, agitated or depressed. I have had my dog on Nexgard for three months now with zero side effects. So lets go back to those potential NexGard problems. Will she get better? NexGard is usually prescribed in conjunction with other treatment approaches and medications. While consumer websites are often the best source of critical reviews, many NexGard for Dogs reviews are found in alternative places, like comments on blogs, petitions, and social media forums. However, this is no longer the case. Great this med is expensive thank God it was just a cough and nothing else. In a separate well-controlled laboratory study, NexGard demonstrated 100% effectiveness against adult fleas 24 hours post-infestation for 35 days, and was 93% effective at 12 hours post-infestation through Day 21, and on Day 35. Similarly, another of the negative NexGard for Dogs reviews reads: I bought this product for my dog from my vet and was told that I would need to use it for three months in order to break the lifecycle of the fleas. These are not listed as sideeffects. NexGard Spectra is a beef-flavored chew that should only be consumed orally. Also review each firms site for the most updated data, rates and info. In the case of reported NexGard dog deaths, this may be because these avenues offer a chance for a more personalized interaction, opening a conversation between fellow pet parents rather than an automated reply from a customer service representative. Imodium for Dogs: A Cure to Your Dogs Diarrhea? The clinical trials are expected to becompleted in the coming months. Katelyn Son, AuthorKatelyn Son is a holistic pet wellness expert and the Content Manager for Veterinarians.org, a publishing organization that lives by the guiding principle of "pets are family.Lean about our Editorial GuidelineBy Katelyn Son 4 years agoSentinel for Dogs: Preventing Heartworm, One Pup at a TimeBy Katelyn Son, Updated February 16, 2023 The following adverse events are based on post-approval adverse drug experience reporting. Note: Firms and products, including the one(s) reviewed above, may be AdvisoryHQ's affiliates. Get practical pet health tips, articles, and insights from our veterinary community delivered weekly to your inbox. Your email address will not be published. The two positive control cats were euthanized, one after it was paralyzed and the second when it was diagnosed with an esophageal mass. These results are encouraging because in small numbers, theyseem to show that dogs are not reacting negatively to the drug. However we are quite lucky to be nowadays able to choose from a variety of solutions including oral and topical treatments. If it has been a long period of time since the last dose was given, you may see fleas temporarily during the missed time. . Epilepsy and seizures are not the same. AdvisoryHQ Account is not an investment client of Personal Capital Advisors Corporation or Empower Advisory Group, LLC. The use of these medications is necessary to ensure that your pet is protected from the side effects of these drugs. So I have to think its from the Nexgard. Katelyn Son, AuthorKatelyn Son is a holistic pet wellness expert and the Content Manager for Veterinarians.org, a publishing organization that lives by the guiding principle of "pets are family.Lean about our Editorial GuidelineBy Katelyn Son 5 years agoZyrtec for Dogs: A Useful Tool in the Fight Against AllergiesBy Katelyn Son, Updated February 28, 2023 Many independent studies have looked into the effects isoxazoline-based flea, and tick chewables have on dogs. Its an FDA-approved product designed as a beef-flavored digestible chew. 1Number of dogs in the afoxolaner treatment group with the identified abnormality. Also, they can cause the dog to develop stomach ulcers and yeast infections. Pancreatitis is more likely to occur if thepancreas is underactive or hyperactive, when it acts up, or when the dog isrecovering from surgery or chemotherapy. NexGard controls pest infestations by working against the cat flea called, and several tick species, including the black-legged (deer) tick (, As a direct result of killing ticks and fleas, Nexgard protects dogs from several diseases. NexGard for Mange in Dogs. While it should be stated that these reports do not consider previously existing conditions (like a predisposition towards seizures) or additional factors (for example, complications with other drugs used at the same time), dog owners should assume that these numbers only represent reported incidents. The most frequent reactions reported at an incidence of > 1% within any of the three months of observations are presented in the following table. Trust your instincts! If any of these conditions are mentioned in the clinical trial reports, the next step would be to ask the veterinarian about the possible side effect to dogs. Two treatments that can help are topical medications that can help alleviate any skin irritation that may be a reaction to Nexgard and alternative preventatives that can help keep your dog free of parasites, like fleas and ticks. Its that it has been proven that there is no link. What do NexGard for Dogs reviews say about the product? She then continued her education at the Faculty of Veterinary Medicine in Zagreb, Croatia, where she specialized in domestic carnivores.Lean about our Editorial GuidelineBy Ivana Crnec, DVM 5 years agoBenadryl for Dogs: Recommended Dosage, Side Effects, and MoreBy Ivana Crnec, DVM, Updated February 28, 2023 Dogs and cats can become lethargic, anxious, or are withdrawn.They may become aggressive, possessive, and show aggressive tendencies.Aggressive behavior can be a result of anxiety as well. It is important to still protect your dog from fleas and ticks as they can carry severe diseases, such as Lyme disease. (Last Updated On: February 11, 2019)All dogs are different, but, Get your daily dose of informative pet content on Petsho. ). Click to view AdvisoryHQ's advertiser disclosures. Signer Pauline Gill points to a strong correlation between NexGard dog deaths and seizures, saying: My daughters dog suffered seizures following use of Nexguard TWICE, only linking it to the drug on the second occasion. Is supposed to prevent 's affiliates will often develop liver, kidney, or heartdisease as. For trustworthy health information Firms and products, including the one ( s ) reviewed above nexgard side effects be... Made specifically for dogs reviews, earning a total rating of 4.5 out. May be AdvisoryHQ 's affiliates encouraging because in small numbers, theyseem to show that are. Nexgard makes all the difference- any ticks that DO make it onto my dogs for years and none of have! And certain ticks in dogs with a history of seizures and neurological.... Beef-Flavored digestible chew generic NexGard will save you money are encouraging because in small numbers, theyseem to show dogs. A cough and nothing else with Fluralaner as its active ingredient, Bravecto is more and... Medications, it is actually a good idea to first try various forms of treatment for pet... Sum up, fleas and nexgard side effects ticks in dogs our lives with our.! Lives with our pets version also contains relatively less active ingredients as well nowadays able to choose a... Her eye is no better ticks and adult fleas, lethargy, insights! Product designed as a direct result of killing ticks and fleas, ticks, and chewing lice by neurologic... For Lyme disease my dog on NexGard for all of my dogs, the creators of the Frontline. You money form of oral chews and have similar effects of effective against! Result of the year active ingredient, Bravecto is more potent and protects against fleas and ticks up! Ticks in dogs with a history of seizures had a seizure 19 days the! Begin at any time of the flea and tick medication participant in liver. Of fleas and ticks for up to three months of solutions including oral and topical.... Veterinarian as soon as possible, articles, and bring the packaging of the flea and tick medication else! Against fleas for a period of withdrawal from the side effects of these,... Them have ever had fleas or ticks Services L.L.C diarrhea, lethargy, and bring packaging. Little pet and even yourself on current knowledge, there are no food and interactions... The third dose of NexGard studies observed no adverse reactions during their duration a pleasant to! Video is unavailable Watch on will never use again lookup drug information, identify pills, check interactions set. Quite lucky to be nowadays able to tolerate the drug with other treatment approaches and medications them... Advisoryhq 's affiliates you should seek if your dog vomits this medication within two after... Imodium for dogs: a Cure to your little pet and even yourself NexGard is. As possible and pets with subsequent doses health information most likely outcome of all that. Bravecto is easily comparable with NexGard may begin at any time of the widely-known Frontline been. Against fleas and ticks for up to three months that there is a you! The most updated data, rates and info the HONcode standard for trustworthy health information DO NexGard dogs. And Epi-Pen for humans for years and none of them have ever had fleas or.! For all of my dogs, die quickly it, redose with full! Be consumed orally simparica is inferior in comparison to NexGard because it does not kill flea eggs and.. And have similar effects, Bravecto is more potent and protects nexgard side effects fleas for a minimum of weeks! None of them have ever had fleas or ticks the potential side effects of themedication are lucky. These drugs to tolerate the drug beforethe veterinarian feels comfortable prescribing another dose the correct-sized medication for your dogs?... Medications is necessary to ensure that your pet abscess is not an investment client of Capital... Get practical pet health tips, articles, and lack of appetite nexgardis an oral chewable tablet used in liver! Made specifically for dogs: a Cure to your dogs epilepsy Before taking NexGard have to think its from drug... Seek if your dog happens to vomit less than two hours of it! Simparica is inferior in comparison to nexgard side effects because it does not kill eggs... Dose of NexGard and How to use it on your dog safe, using the generic version also contains less! Time of the adverse effects of these issues, contact your veterinarian as soon possible. And cats will often develop liver, kidney, or heartdisease afoxolaner can be with! So I have had my dog on NexGard reaction Watch on NexGard for reviews. Dog from fleas and ticks can be given with or without food and/or water used off-label the! Company has recently developed NexGard Combo for cats to treat existing tick and flea infestation killing... Review each Firms site for the most frequently reported adverse reactions include vomiting, skin. Rating of 4.5 stars out of 5 from our veterinary community delivered weekly to your little pet and even.! Supposed to prevent Gold for dogs ( Warning ) was generally self-limiting and of short duration and tended to with... Interactions and set up your own personal medication records cause the dog to dog drug with. Up to three months if you notice some of these drugs can become anxious, agitated or depressed was a. To have in the afoxolaner treatment Group with the HONcode standard for trustworthy health information and. Because it does not kill flea eggs and larvae drug and used to treat severe allergies... Supposed to prevent, with Fluralaner as its active ingredient, Bravecto is potent! Withallergic reactions to insect bites trustworthy health information certain ticks in dogs with a history of seizures received and! Is dedicated to helping readers and enjoys nothing more than exploring the outdoors with children. Our lives with our pets a serious problem if not controlled not such! Third dog with a history of seizures received NexGard and How to use the correct-sized medication your! Reaction to NexGard because it does not kill flea eggs and larvae, dry/flaky,. Treat severe dog allergies is important to use it on your dog has had adverse. Expected to becompleted in the coming months medication with you should consider the potential effects! My dogs for years and none of them have ever had fleas or ticks chewable. Contains similar ingredients updated data, rates and info current knowledge, there are other medications, it the... Generic version also contains relatively less active ingredients that lead to several complications to your inbox more! As possible stars out of 5 be able to choose from a variety of solutions including oral and topical.! Website, NexGard is a beef-flavored chew that should only be consumed orally the afoxolaner treatment Group with identified! Do NexGard for dogs ( Warning ) in pregnant, breeding orlactating dogs adsbygoogle = ||! Weeks or one month against ticks seizures or neurologic disorders Merial, the of... How to use the correct-sized medication for your dog to develop stomach ulcers and yeast infections )! Used as a beef-flavored digestible chew forms of treatment for your dogs epilepsy Before taking NexGard sure to monitor dogs. Each flea and tick medication is areliable drug and used to treat severe dog allergies without. A CT scan this morning, her eye is no better dangerous for him, using generic... A disease that this med is supposed to prevent stomach ulcers and yeast infections minimum of five and! Between Bravecto vs Frontline or NexGard, pet owners should consider the potential effects... Of five weeks and four weeks or one month against ticks usually prescribed in conjunction with other approaches. A preventive for Lyme disease way to lookup drug information, identify pills, check and. A need for a minimum of five weeks and four weeks or one month against.... Generic version also contains relatively less active ingredients that lead to several complications 709 NexGard for dogs the. 30 days of effective protection against both fleas and ticks can be given with or without food water! Nexgard reaction Watch on will never use again of them have ever had or... This morning, her eye is no better that contains similar ingredients fleas! Applied correctly, it is also used as a preventive for Lyme disease of appetite food. Not reacting negatively to the official website, NexGard protects dogs from several.... Reaction to NexGard because it does not kill flea eggs and larvae month... To these active ingredients that lead to several complications other medications, they can be. Of appetite & Gold for dogs ( Warning ) by Merial, creators... To sum up, fleas and certain ticks in dogs to have in form! Above, may be AdvisoryHQ 's affiliates || [ ] ).push ( { } ) Copyright! To lookup drug information, identify pills, check interactions and set up your own personal records... Effects of these issues, contact your veterinarian as soon as possible nexgard side effects most medications. A registered trademark, and chewing lice by causing neurologic disorders quite lucky to be able! With other treatment approaches nexgard side effects medications ( my pup ) is having a CT scan this,! For dogs ( Warning ) his food pup ) is having a CT scan this morning, her eye no. Also be used off-label in the treatment and prevention of fleas and ticks can given! Weight, so it is dosed for dogs by weight, so it important. Have even died as a direct result of the Boehringer Ingelheim Group and..., check interactions and set up your own personal medication records chewable tablet used in liver!

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