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 substances you are taking, check with your doctor, nurse, or pharmacist. University of Rochester University Health Services. Unfortunately, colds and the flu are very common in children. On average, kids can expect five or six colds a year before they start school. Some kids get as many as eight to 10 colds a year. It isn't until they become teenagers that kids settle down to adult levels of cold infections, getting infected about four times a year on average. buy indocin in the usa
In late pregnancy, as with other NSAIDs, ibuprofen tablets should be avoided because it may cause premature closure of the ductus arteriosus. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. This product contains a nonsteroidal anti-inflammatory drug NSAID which may cause stomach bleeding. Two large, controlled clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10-14 days following CABG surgery found an increased incidence of myocardial infarction and stroke.
Talk to your doctor or pharmacist about the benefits and risks of taking this drug. Overdose symptoms may include vomiting, stomach pain, diarrhea, ringing in your ears, severe drowsiness, agitation, sweating, coughing up blood, weak or shallow breathing, fainting, or seizure convulsions. What should I avoid while taking Motrin IB Sinus ibuprofen and pseudoephedrine? Follow any instructions your doctor gave you. The information contained in the Truven Health Micromedex products as delivered by Drugs. Ibuprofen Oral Suspension should be discontinued.
The person needs advice on how and how soon to resume normal and activity. CV events and the steps to take if they occur. This will allow time for your cervix to heal. Do not for 1 day after your colposcopy. Evidence suggests these cold medicines don't really help, and they have a small risk of serious side effects. If these occur, patients should be instructed to seek immediate emergency help see WARNINGS.
Have been treated for a vaginal, cervical, or pelvic infection. Other side effects of NSAIDs include: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness. Take Motrin by mouth with or without food. It may be taken with food if it upsets your stomach. Taking it with food may not lower the risk of stomach or bowel problems eg, bleeding, ulcers. Talk with your doctor or pharmacist if you have persistent stomach upset. As with other NSAIDs, concomitant administration of IBUPROFEN and aspirin is not generally recommended because of the potential of increased adverse effects. Positive stool occult blood tests and elevated serum creatinine levels were also observed in these studies. No information is available from controlled clinical studies regarding the use of Motrin Suspension in patients with advanced renal disease. Therefore, treatment with Motrin Suspension is not recommended in these patients with advanced renal disease. If Motrin Suspension therapy must be initiated, close monitoring of the patient's renal function is advisable. Do not use this medicine just before or after heart bypass surgery coronary artery bypass graft, or CABG. This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use and wear protective clothing when outdoors. After the stye has healed, make sure you clean and disinfect your in the solutions recommended by your eye doctor. Or, better yet, go with a new pair of lenses. Elevating your child's head with extra pillows can help relieve a cough that isn't producing mucus. Pediatrics and Child Health. “Colds in Children. It may be necessary to place a breathing tube into your throat. The procedure is called intubation. You will then be placed on a machine called a ventilator to breathe for you. In this situation, you will receive intravenous and probably steroids. This section provides information on the proper use of a number of products that contain ibuprofen. It may not be specific to Motrin. Please read with care. And I agree, it IS very safe when taken appropriately. Most of the problems with any OTC come with improper usage, off-label usage, or over use of a medication. However, I also feel that parents are often misinformed or simply not well informed of many things regarding many medications. Several short-term controlled studies failed to show that ibuprofen significantly affected prothrombin times or a variety of other clotting factors when administered to individuals on warfarin-type anticoagulants. However, because bleeding has been reported when ibuprofen and other NSAIDs have been administered to patients on warfarin-type anticoagulants, the physician should be cautious when administering ibuprofen to patients on anticoagulants. The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that the users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone. NSAIDs including ibuprofen tablets, can lead to onset of new hypertension or worsening of preexisting hypertension, either of which may contribute to the increased incidence of CV events. Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs. NSAIDs, including ibuprofen tablets, should be used with caution in patients with hypertension. Blood pressure BP should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
Store at room temperature away from light and moisture. not store in the bathroom. Keep all away from children and pets. University of Utah Health Sciences Radio. “Should I Be Worried if my Child Gets Sick too Frequently? Several short-term controlled studies failed to show that ibuprofen tablets significantly affected prothrombin times or a variety of other clotting factors when administered to individuals on coumarin-type anticoagulants. However, because bleeding has been reported when ibuprofen tablets and other NSAIDs have been administered to patients on coumarin-type anticoagulants, the physician should be cautious when administering ibuprofen tablets to patients on anticoagulants. The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that the users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone. If you are taking this drug "as needed" not on a regular schedule remember that pain work best if they are used as the first occur. If you wait until the pain has worsened, the medication may not work as well. Site of action of narcotic and non-narcotic analgesics determined by blocking bradykinin-evoked visceral pain. Arch Intern Pharmacodyn. Your doctor may put vinegar and sometimes iodine on the and cervix with a cotton swab or cotton balls. It allows the doctor to see problem areas more clearly. carvedilol
Before having any kind of surgery or medical tests, tell your doctor that you are taking this medicine. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Ibuprofen tablets, like other NSAIDs, can cause serious skin side effects such as exfoliative dermatitis, SJS and TEN, which may result in hospitalization and even death. Although serious skin reactions may occur without warning, patients should be alert for the signs and symptoms of skin rash and blisters, fever, or other signs of hypersensitivity such as itching, and should ask for medical advice when observing any indicative signs or symptoms. Patients should be advised to stop the drug immediately if they develop any type of rash and contact their physicians as soon as possible. Another biopsy may be needed if a Pap test, colposcopy, and cervical biopsy show different results. One study indicated that the less sleep we get, the more likely we are to become infected after being exposed to a cold virus. Don't bother with decongestants or antihistamines. These don't do any good for relieving coughs when a child is sick with a cold or flu. Oral decongestants can actually increase and raise the heartbeat, so it is better to avoid them. Patent Ductus Arteriosus: The most frequently reported adverse effects were sepsis, anemia, intraventricular bleeding, apnea, GI disorders, impaired renal function, respiratory infection, skin lesions, hypoglycemia, hypocalcemia, and respiratory failure. Avoid taking aspirin while you are taking ibuprofen. Ask a doctor or pharmacist before using any other cough, cold, or pain medicine. Many combination medicines contain ibuprofen or pseudoephedrine. Taking certain products together can cause you to get too much of this medicine. If you have any questions about Children's Motrin suspension, please talk with your doctor, pharmacist, or other health care provider. Do not start, stop, or change the dosage of any medicines without your doctor's approval. The radioactive source will remain inside the applicators and will never come in direct contact with your body tissues. Only the source inside the applicator is radioactive. You will not become radioactive. Ibuprofen tablets may be well tolerated in some patients who have had gastrointestinal side effects with aspirin, but these patients when treated with ibuprofen tablets should be carefully followed for signs and symptoms of gastrointestinal ulceration and bleeding. The colposcope is moved near your vagina. Your doctor looks through it at the vagina and cervix. Vinegar acetic acid or iodine may be used on your cervix to make abnormal areas easier to see. Photos or videos of the vagina and cervix may be taken. Your radiation oncologist will need to insert applicators for the implant treatments. Before this is done, your cervical canal will be stretched and held open with a plastic sleeve stent. buy cheapest nootropil store europe nootropil
For your information, the experts included physicians, nurses, pharmacologists, academics, industry, and patient advocates. If these occur, patients should be instructed to stop therapy and seek immediate medical therapy. Motrin is to be used only by the patient for whom it is prescribed. Do not share it with other people. Keep all regular medical and laboratory appointments. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions. Unfortunately colds cannot be cured. That's why treatment is your first line of defense when it comes to fighting sickness in children. In this article, we will use the advice of medical experts to give you the best chances of easing your and flu symptoms. Hi Kristin. Thanks for your great comments! Ibuprofen Tablets, USP should be discontinued. We do know and have known that oral acetaminophen relieves pain in older children and adults. And that IV acetaminophen works for babies and toddlers. But the studies looking for pain relief from oral acetaminophen in babies have been disappointing. Analgesic-antipyretics and anti-inflammatory agents. In: The Pharmacologic Basis of Therapeutics. Even your kids will soon pick up on when to use basic remedies. Dress your child in lightweight pajamas. If the fever is high or prolonged, it is wise to consult with a physician. What should I discuss with my healthcare provider before taking Motrin Migraine Pain ibuprofen? Potter, Lisa Marie and Nicholas Weiler. “Short Sleepers Are Four Times More Likely to Catch a Cold. This medicine may also cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in skin color of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swelling of the eyelids or around the eyes. diphenhydramine 100 mg tablet
Not only will they feel better, but stopping a stuffy nose will help stop the spread of infection too. NSAIDs, including Motrin Suspension, can lead to onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events. Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs. NSAIDs, including Motrin Suspension, should be used with caution in patients with hypertension. Blood pressure BP should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy. Compress by gently wrapping with an Ace or other elastic bandage. Don't wrap tightly. To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms. Patients should be informed about the symptoms of serious CV events and the steps to take if they occur. Heavy vaginal bleeding. This means more than a normal menstrual period. Individual patients may show a better response to 3200 mg daily, as compared with 2400 mg, although in well-controlled clinical trials patients on 3200 mg did not show a better mean response in terms of efficacy. AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details. Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after your treatment. Patients should promptly report signs or symptoms of unexplained weight gain or edema to their physicians. Revised Jul 8, 2011. NSAIDs inhibit platelet aggregation and have been shown to prolong bleeding time in some patients. Unlike aspirin, their effect on platelet function is quantitatively less, of shorter duration, and reversible. Patients receiving Ibuprofen Oral Suspension who may be adversely affected by alterations in platelet function, such as those with coagulation disorders or patients receiving anticoagulants, should be carefully monitored. buy carbamazepine online forum carbamazepine
Hormonal changes may make it hard to see the cervical canal clearly. Because of the known effects of nonsteroidal anti-inflammatory drugs on the fetal cardiovascular system closure of ductus arteriosus use during pregnancy particularly late pregnancy should be avoided. Ask your child's doctor if you're not sure if a medicine is right for your child. Remember, and cold medicines come in many different strengths. Marfan syndrome, Sjogren's syndrome, or lupus. FDA. If so, I expect they will result in safer children. Elevate injured area above the person's level, if possible, for at least 24 hours. Ice immediately, and continue to ice for 10 to 15 minutes every hour, for 2-3 days. The medicine may be given every six to eight hours, as needed, up to 40 mg per kg per day. The dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or take this drug more often than directed by your doctor or the package label. When treating pain in children a multimodal techique must be employed, using emotional support, distraction and other comfort measures along with appropriate pharmacological intervention. Every person, from age 6 months to 60 years, responds to pain differently. Diabetes patients - Children's Motrin suspension may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Great questions, Sharie. The FDA called together a panel of top experts in the field to review ALL of the studies that had been done on pain relief from acetaminophen at OTC doses in kids 6 months to 2 years old, to see if pain relief should be allowed on the label. They found only 10 peer-reviewed studies that met these criteria. The studies used different methods of monitoring pain such as pain scores in a post-anesthesia unit in the hospital, for example. You can read the summaries of each study in this transcript of Day One of the proceedings, starting on page 71 . The largest manufacturer of acetaminophen was asked the next day to provide any additional evidence if available. Or whether the other 12-15 manufacturers had any additional evidence.
Ibuprofen tablets are contraindicated for treatment of peri-operative pain in the setting of coronary artery bypass graft CABG surgery see WARNINGS. This medicine may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. Since ibuprofen and pseudoephedrine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose. What happens if I overdose? Before each implant treatment, you will change into a hospital gown. You will be taken into the simulation planning room and will lie down on an x-ray table. Your legs will be held up in stirrups, similar to the position you are in when having a pelvic exam. When the treatment plan is completed, you will be taken to the treatment room and moved onto the treatment table. The radiation oncologist will connect the applicators to the treatment machine with thin tubes. During the treatment, the radioactive sources will move through the tubes and into the applicators. You will not feel any discomfort at this time. What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs NSAIDs? cebep.info erythromycin
Before using this medication, women of childbearing age should talk with their doctors about the benefits and risks such as miscarriage, trouble getting pregnant. Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. Never give children under 18 aspirin, as it can cause Reye's syndrome, a serious illness. Talk to your doctor. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. In these studies there were no differences between treatments in fever reduction for the first hour and maximum fever reduction occurred between 2 and 4 hours. Response after 1 hour was dependent on both the level of temperature elevation as well as the treatment. In children with baseline temperatures at or below 102. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Look at the cervix for problem areas if an shows a high-risk type of HPV. Clinical studies, as well as post marketing observations, have shown that Motrin Suspension can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with NSAIDs, the patient should be observed closely for signs of renal failure see as well as to assure diuretic efficacy. How should I take Motrin Childrens ibuprofen? The toxicity of ibuprofen overdose is dependent upon the amount of drug ingested and the time elapsed since ingestion, though individual response may vary, which makes it necessary to evaluate each case individually. Although uncommon, serious toxicity and death have been reported in the medical literature with ibuprofen overdosage. The most frequently reported symptoms of ibuprofen overdose include abdominal pain, nausea, vomiting, lethargy and drowsiness. Other central nervous system symptoms include headache, tinnitus, CNS depression and seizures. Metabolic acidosis, coma, acute renal failure and apnea primarily in very young children may rarely occur. Cardiovascular toxicity, including hypotension, bradycardia, tachycardia and atrial fibrillation, also have been reported. Talk to your healthcare provider if you are considering taking NSAIDs during pregnancy. You should not take NSAIDs after 29 weeks of pregnancy. Colposcopy and a cervical biopsy usually take about 15 minutes. Try saline drops in his nose to clear out mucus. If your child is young enough, you may be able to bulb suction some of the mucous. Febrile seizures can be very serious. Parents, stop depending on big pharma to heal and cure your kids. Use your parental gut instincts when it comes to your kids and OTC meds and prescription drugs! Ibuprofen is rapidly metabolized and eliminated in the urine. The excretion of ibuprofen is virtually complete 24 hours after the last dose. zyloprim money order now visa
The smallest dose of ibuprofen tablets that yields acceptable control should be employed. A linear blood level dose-response relationship exists with single doses up to 800 mg See CLINICAL PHARMACOLOGY for effects of food on rate of absorption. The availability of four tablet strengths facilitates dosage adjustment. The actual treatment time is about 15 minutes. It is important that you lie still during the treatment and do not move below your waist. You will be alone in the room during the treatment. Medical staff will be able to hear, see, and talk to you by way of an intercom system. You will be able to talk to them if you need anything. All these studies showing everything getting worse for our children. The internet and new ways of recording illness and side effects are causing these increases. Food and Drug Administration. Let them rest until they feel better. Ibuprofen produced an elevation of plasma lithium levels and a reduction in renal lithium clearance in a study of eleven normal volunteers. The mean minimum lithium concentration increased 15% and the renal clearance of lithium was decreased by 19% during this period of concomitant drug administration. You can expect to have three to six implant treatments. If you begin your implants while you are receiving external beam radiation, you will have one implant per week. On the day of your implant, you will not receive an external beam treatment. Once you have finished your external beam treatments, you will have two implants a week until all are completed. Ask your doctor or pharmacist about using this product safely. There are many natural and herbal remedies available on the market. NSAIDs such as celecoxib, ketorolac, or naproxen. These drugs are similar to ibuprofen and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention usually at dosages of 81-325 milligrams a day you should continue taking the aspirin unless your doctor instructs you otherwise. Even in what most call high fevers, this is the case. In adult patients the history of the dose reportedly ingested does not appear to be predictive of toxicity. The need for referral and follow-up must be judged by the circumstances at the time of the overdose ingestion. Symptomatic adults should be carefully evaluated, observed and supported. buy rosuvastatin toronto
Sinus Pain or Congestion", "Coughs and Colds: Medicines or Home Remedies? Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away. If these occur, patients should be instructed to seek immediate emergency help see . 7. In late pregnancy, as with other NSAIDs, Ibuprofen Oral Suspension should be avoided because it may cause premature closure of the ductus arteriosus. Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors. This test is most often done when the result of a is abnormal. In rat studies with NSAIDs, as with other drugs known to inhibit prostaglandin synthesis, an increased incidence of dystocia, delayed parturition, and decreased pup survival occurred. The effects of ibuprofen suspension on labor and delivery in pregnant women are unknown. Therefore, administration of Ibuprofen Oral Suspension is not recommended during labor and delivery. The vinegar or iodine does not show any areas of abnormal tissue. The vagina and cervix look normal. Elimination - Ibuprofen is rapidly metabolized and eliminated in the urine. The excretion of ibuprofen is virtually complete 24 hours after the last dose. What should I discuss with my healthcare provider before taking Motrin IB Sinus ibuprofen and pseudoephedrine? pletal
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. US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Update: Why Did This Post Go Viral Four Years After the Fact? Ibuprofen Oral Suspension is contraindicated in patients with known hypersensitivity to ibuprofen. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Ibuprofen Oral Suspension, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Patients with rheumatoid arthritis seem to require higher doses than do patients with osteoarthritis. The smallest dose of Ibuprofen Oral Suspension that yields acceptable control should be employed. If you need surgery, tell the surgeon ahead of time if you have taken this medicine within the past few days.
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Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Patients should be informed of the following information before initiating therapy with an NSAID and periodically during the course of ongoing therapy. Patients should also be encouraged to read the NSAID Medication Guide that accompanies each prescription dispensed. Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury. Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of a NSAID may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors, and the elderly. Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state. aleve
Anemia is sometimes seen in patients receiving NSAIDs, including ibuprofen tablets. This may be due to fluid retention, occult or gross GI blood loss, or an incompletely described effect upon erythropoiesis. Patients on long-term treatment with NSAIDs, including ibuprofen tablets, should have their hemoglobin or hematocrit checked if they exhibit any signs or symptoms of anemia. Children's Motrin suspension is to be used only by the patient for whom it is prescribed. Do not share it with other people. Where does that leave us today? Motrin Suspension, like other NSAIDs, can cause GI discomfort and, rarely, serious GI side effects, such as ulcers and bleeding, which may result in hospitalization or even death. Although serious GI tract ulcerations and bleeding can occur without warning symptoms, patients should be alert for signs and symptoms of ulcerations and bleeding, and should ask for medical advice when observing any indicative sign or symptoms including epigastric pain, dyspepsia, melena, and hematemesis. buy aromasin online visa europe
Aseptic meningitis, with fever and coma, has been observed on rare occasions in patients on ibuprofen therapy. Although it is probably more likely to occur in patients with systemic lupus erythematosus and related connective tissue diseases, it has been reported in patients who do not have an underlying chronic disease. Motrin has ibuprofen in it. Before you start any new medicine, check the label to see if it has ibuprofen in it too. If it does or if you are not sure, check with your doctor or pharmacist. So I would argue extremely strongly that unless there are data to convince us that this product is analgesic in young children, that that should not only not be on the label but should be made extremely clear to the public and professionals alike that the analgesic effects of acetaminophen in younger children have not been shown.
Take this medicine with food or milk to lessen stomach upset. Your doctor will talk to you about what he or she sees at the time of the test. Lab results from a may take several days or more. Keep your face and eyes very clean, and get rid of any crust you see around your eye. NSAIDs and some other medicines can interact with each other and cause serious side effects. Keep a list of your medicines to show to your healthcare provider and pharmacist. NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use.