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If your doctor has prescribed this for you, not share it with others. Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is one primary cause of "antibiotic-associated colitis". Antidepressant medicines can interact with other medicines. Know all of the medicines that you or your family member takes. Keep a list of all medicines to show the healthcare provider. Do not start new medicines without first checking with your healthcare provider. What happens if I miss a dose Tofranil? nitrofurantoin

Imipramine warnings

THERE HAVE BEEN REPORTS OF PATIENTS WITH A HISTORY OF PENICILLIN HYPERSENSITIVITY WHO HAVE EXPERIENCED SEVERE HYPERSENSITIVITY REACTIONS WHEN TREATED WITH ANOTHER BETA-LACTAM. Tofranil and are trademarks of Mallinckrodt Inc. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs SSIRs and others showed that these drugs increase the risk of suicidal thinking and behavior suicidality in children, adolescents, and young adults ages 18-24 with major depressive disorder MDD and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older.

How to take imipramine

If your doctor has prescribed this medication, read the Patient Information Leaflet if provided by your before you start using this product and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Tofranil-PM usually administered once daily, but divided doses may be necessary in some patients. b Tofranil-PM should not be used in children of any age. b See Pediatric Warnings under Cautions. Dosage should be tapered off gradually. Both elevation and lowering of blood sugar levels have been reported with imipramine hydrochloride use.

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Elderly patients and patients with cardiac disease or a prior history of cardiac disease are at special risk of developing the cardiac abnormalities associated with the use of imipramine hydrochloride. The pupillary dilation that occurs following use of many antidepressant drugs including Imipramine Pamoate may trigger an angle-closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Treatment with Imipramine Pamoate and any concomitant serotonergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated.



Nicotine and may harm an unborn baby

Tofranil . a b Increase dosage based on response and tolerance up to a maximum of 100 mg daily. Close supervision and careful adjustment of dosage is required when Imipramine Pamoate is administered concomitantly with anticholinergic drugs. Obtain an ECG and immediately initiate cardiac monitoring. Protect the patient's airway, establish an intravenous line and initiate gastric decontamination. See Pediatric Use under Cautions. Safety and effectiveness in the pediatric population other than pediatric patients with nocturnal enuresis have not been established see and . Anyone considering the use of imipramine hydrochloride in a child or adolescent must balance the potential risks with the clinical need. Dosage is based on your medical condition and response to treatment. Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt.



What is imipramine Tofranil?

Consideration should be given to instituting a drug free period following an adequate therapeutic trial with a favorable response, Dosage should be tapered off gradually rather than abruptly discontinued; this may reduce the tendency to relapse. Children who relapse when the drug is discontinued do not always respond to a subsequent course of treatment. Close supervision and careful adjustment of dosage is required when Imipramine hydrochloride is administered concomitantly with anticholinergic drugs. Imipenem, when administered alone, is metabolized in the kidneys by dehydropeptidase I resulting in relatively low levels in urine. Cilastatin sodium, an inhibitor of this enzyme, effectively prevents renal metabolism of imipenem so that when imipenem and cilastatin sodium are given concomitantly, fully adequate antibacterial levels of imipenem are achieved in the urine. Please refer to the for information on shortages of one or more of these preparations. Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. ECG changes of unknown clinical importance reported in pediatric patients receiving twice the recommended maximum daily dosage for enuresis. Nausea and vomiting, anorexia, epigastric distress, diarrhea; peculiar taste, stomatitis, abdominal cramps, black tongue. An ECG recording should be taken prior to the initiation of larger-than-usual doses of Tofranil and at appropriate intervals thereafter until steady state is achieved. Patients with any evidence of cardiovascular disease require cardiac surveillance at all dosage levels of the drug. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Long-term, chronic use not recommended; gradually discontinue therapy following a period of satisfactory response. a To minimize risk of relapse, avoid abrupt discontinuance of therapy. Cardiac abnormalities may include tachycardia, and signs of congestive failure. Respiratory depression, cyanosis, shock, vomiting, hyperpyrexia, mydriasis, and diaphoresis may also be present. Clinical Worsening and Suicide Risk - Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication. After you have stopped and you have reached the best dose and schedule for you, continue at that dose. Start to lower your dose after 6 weeks or as directed by your doctor until you are no longer and no longer need nicotine replacement. It is important to complete the treatment with this medication 12 weeks. If after the treatment period, you still feel the need to use this medication to prevent you from smoking, talk to your doctor. Tolerance tachyphylaxis to therapeutic effects possible with continuous administration of imipramine; consider instituting a drug-free period following an adequate therapeutic trial with favorable response. ziprasidone



Food and Drug Administration

During therapy of Pseudomonas aeruginosa infections, periodic susceptibility testing should be done when clinically appropriate. Whether any of the symptoms described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that Imipramine hydrochloride is not approved for use in treating bipolar depression. Caution should be exercised when imipramine hydrochloride is used with agents that lower blood pressure. Imipramine hydrochloride may potentiate the effects of CNS depressant drugs. Following drug administration, ataxia was rapidly produced and clonic convulsions were noted in about 45 minutes. Deaths occurred within 4-56 minutes at all doses. Discontinue therapy several days prior to surgery whenever possible. Children have been reported to be more sensitive than adults to an acute overdosage of imipramine hydrochloride. An acute overdose of any amount in infants or young children, especially, must be considered serious and potentially fatal. Food does not affect absorption. Erythema at the injection site--0. For children who are early-night bed-wetters, better results may be obtained by administering 25 mg in midafternoon and again at bedtime. If signs of toxicity occur at anytime during this period, extended monitoring is required. There are case reports of patients succumbing to fatal dysrhythmias late after overdose; these patients had clinical evidence of significant poisoning prior to death and most received inadequate gastrointestinal decontamination. Monitoring of plasma drug levels should not guide management of the patient. The most commonly reported side effects were tremors, increased weight, dry mouth, and constipation. If there is evidence of pathological neutrophil depression, discontinue therapy. Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed. See Tables II and III. Numbness, tingling, paresthesias of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, alterations in EEG patterns; tinnitus. omca.info tricor



Use of imipramine

Grapefruit and grapefruit juice may interact with imipramine. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet. Press firmly for 10 to 20 seconds to make sure the patch stays in place. Be sure the edges are held firmly to the skin. with plain water after applying the patch. Do not use soap. Initial dosage should be low and increases should be gradual and cautiously prescribed. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Urinary tract infections complicated and uncomplicated. Keep all follow-up visits with the healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms. Do not stop using imipramine without first talking to your doctor. You may need to use less and less before you stop the medication completely. Withdrawal Symptoms: Though not indicative of addiction, abrupt cessation of treatment after prolonged therapy may produce nausea, headache and malaise. These doses have provided adequate plasma and urine concentrations for the treatment of non-CNS infections. Imipenem has in vitro activity against a wide range of gram-positive and gram-negative organisms. Imipenem has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections treated with the intravenous formulation of imipenem-cilastatin sodium as described in the section. In addition, certain drugs inhibit the activity of this isozyme and make normal metabolizers resemble poor metabolizers. An individual who is stable on a given dose of TCA may become abruptly toxic when given one of these inhibiting drugs as concomitant therapy. The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme quinidine; cimetidine and many that are substrates for P450 2D6 many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide. The use of MAOIs intended to treat psychiatric disorders with Imipramine Pamoate or within 14 days of stopping treatment with Imipramine Pamoate is contraindicated because of an increased risk of serotonin syndrome. SERIOUS AND OCCASIONALLY FATAL HYPERSENSITIVITY ANAPHYLACTIC REACTIONS HAVE BEEN REPORTED IN PATIENTS RECEIVING THERAPY WITH BETA-LACTAMS. THESE REACTIONS ARE MORE APT TO OCCUR IN PERSONS WITH A HISTORY OF SENSITIVITY TO MULTIPLE ALLERGENS. Imipramine is used to treat symptoms of depression. Imipramine is sometimes used to treat bed-wetting in children ages 6 and older. Lower dosages are recommended for elderly patients and adolescents. Lower dosages are also recommended for outpatients as compared to hospitalized patients who will be under close supervision. Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerance. Following remission, oral maintenance medication may be required for a longer period of time, at the lowest dose that will maintain remission. This dose should be given one hour before bedtime. how to purchase differin



Imipramine drug interactions

Wort and with drugs that impair metabolism of serotonin in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue. Your dosage may need to be adjusted. Patients should be monitored for the emergence of serotonin syndrome. Do not use the patch if the individual pouch is open or damaged or if the patch is cut, torn, or damaged. Apply the patch to a different area on your body each time to avoid irritation. Wait at least a week before using the same application site. Apply a new patch if your patch falls off. Do not give this medicine to a child without medical advice. Lower dosages are recommended for elderly patients and adolescents. Lower dosages are also recommended for outpatients as compared to hospitalized patients who will be under close supervision. The safety and effectiveness of the drug as temporary adjunctive therapy for nocturnal enuresis in pediatric patients less than 6 years of age has not been established. Initially, 75 mg daily. a b May increase dosage to 150 mg daily and then if necessary to 200 mg daily. What are the possible side effects of imipramine Tofranil? Since overdosage is often deliberate, patients may attempt suicide by other means during the recovery phase. Psychiatric referral may be appropriate. Other medications can affect the removal of from your body, which may affect how quinidine works. Do not use medications containing quinine while using quinidine. atarax



Imipramine side effects

Possible pharmacokinetic decreased imipramine metabolism interaction with methylphenidate; imipramine dosage adjustments may be required. Do not use if the individual wrapper is open or damaged. Powder should be restored with 100 mL of diluent see list of diluents under and shaken until a clear solution is obtained. Less effective for insomnia and associated with more serious adverse reactions than conventional hypnotics. Oral: Independent studies in three species rat, mouse, and rabbit revealed that when Tofranil is administered orally in doses up to approximately 2 ½ times the maximum human dose in the first 2 species and up to 25 times the maximum human dose in the third species, the drug is essentiality free from teratogenic potential. In the three species studied, only one instance of fetal abnormality occurred in the rabbit and in that study there was likewise an abnormality in the control group. However, evidence does exist from the rat studies that some systemic and embryotoxic potential is demonstrable. This is manifested by reduced litter size, a slight increase in the stillborn rate and a reduction in the mean birth weight. In cases of relapse due to premature withdrawal of the drug, the effective dosage of imipramine should be reinstituted. Antidepressant medicines have other side effects. Talk to the healthcare provider about the side effects of the medicine prescribed for you or your family member. Repeated evaluation of the patient's condition is essential. If superinfection occurs during therapy, appropriate measures should be taken. Patients who develop a fever and a sore throat during therapy with Imipramine hydrochloride should have leukocyte and differential blood counts performed. Imipramine hydrochloride should be discontinued if there is evidence of pathological neutrophil depression. P450 2D6, they may vary in the extent of inhibition. The extent to which SSRI-TCA interaction may pose clinical problems will depend on the degree of inhibition and the pharmacokinetics of the SSRI involved. Nevertheless, caution is indicated in the coadministration of TCAs with any of the SSRIs and also in switching from one class to the other. Of particular importance, sufficient time must elapse before initiating TCA treatment in a patient being withdrawn from fluoxetine, given the long half-life of the parent and active metabolite at least 5 weeks may be necessary.



Your dosage may need to be adjusted

Consult your doctor before -feeding. Prior to elective surgery, imipramine hydrochloride should be discontinued for as long as the clinical situation will allow. Carefully consider these findings when assessing potential benefits and risks of imipramine in a child or adolescent for any clinical use. i j k l See Worsening of Depression and Suicidality Risk under Cautions. Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking Imipramine Pamoate. Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and lactation. Use with caution in patients with moderate to severe renal impairment. Clinical studies of Imipramine hydrochloride tablets, USP in the original application did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Post-marketing clinical experience has not identified differences in responses between the elderly and younger subjects. In general, dose selection for the elderly should be cautious, usually starting at the low end of the dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Anyone considering the use of Imipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. NDC 0006-3517-75 in trays of 10 infusion bottles. 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. Psychiatric Follow-up - Since overdosage is often deliberate, patients may attempt suicide by other means during the recovery phase. Psychiatric referral may be appropriate. If any of these effects persist or worsen, tell your doctor or promptly. See Pediatric Warnings under Cautions. This help may be anecdotal as to me, but it cured a problem no doctor could cure and it was just by chance. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have or have a family history of bipolar illness also called manic-depressive illness or suicidal thoughts or actions. Two patients were less than 3 months of age. generic venlafaxine order mastercard canada



Important information

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. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Certain long-acting brands of may appear as a whole tablet in the stool. This is the empty shell left after the medicine has been absorbed by the body. It is harmless. Children have been reported to be more sensitive than adults to an acute overdosage of Imipramine hydrochloride. An acute overdose of any amount in infants or young children, especially, must be considered serious and potentially fatal. Alcoholics found to have a threefold greater intrinsic clearance of imipramine. Bone and joint infections. Consideration should be given to instituting a drug free period following an adequate therapeutic trial with a favorable response. Dosage should be tapered off gradually rather than abruptly discontinued; this may reduce the tendency to relapse. Children who relapse when the drug is discontinued do not always respond to a subsequent course of treatment. Though not indicative of addiction, abrupt cessation of treatment after prolonged therapy may produce nausea, headache and malaise. canada casodex benefits



Dosage should be tapered off gradually

Such reactions may necessitate discontinuation of the drug. If needed, imipramine hydrochloride may be resumed in lower dosage when these episodes are relieved. Nicotine and may harm an unborn baby. Repeat with an additional 10 mL of infusion solution to ensure complete transfer of vial contents to the infusion solution. The resulting mixture should be agitated until clear. Antidepressants increased the risk compared to placebo of suicidal thinking and behavior suicidality in children, adolescents, and young adults in short-term studies of major depressive disorder MDD and other psychiatric disorders. Anyone considering the use of imipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. The biochemical activity of the drug metabolizing isozyme cytochrome P450 2D6 debrisoquin hydroxylase is reduced in a subset of the Caucasian population about 7% to 10% of Caucasians are so-called “poor metabolizers”; reliable estimates of the prevalence of reduced P450 2D6 isozyme activity among Asian, African, and other populations are not yet available. Poor metabolizers have higher than expected plasma concentrations of tricyclic antidepressants TCAs when given usual doses. Depending on the fraction of drug metabolized by P450 2D6, the increase in plasma concentration may be small, or quite large 8-fold increase in plasma AUC of the TCA. NOTE: Imipenem is inactive in vitro against Xanthomonas Pseudomonas maltophilia and some strains of P. cepacia. Patients taking Imipramine Pamoate should avoid excessive exposure to sunlight since there have been reports of photosensitization. Medication should be given one hour before bedtime. If a satisfactory response does not occur within one week, increase the dose to 50 mg nightly in children under 12 years; children over 12 may receive up to 75 mg nightly. A daily dose greater than 75 mg does not enhance efficacy and tends to increase side effects. Children who relapse when the drug is discontinued may not respond to subsequent treatment with imipramine. Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication. Risk of suicidality; importance of patients, family, and caregivers being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment. i j k FDA recommends providing written patient information medication guide explaining risks of suicidality each time the drug is dispensed. Inhibitors of CYP2D6: Potential pharmacokinetic interaction increased plasma imipramine concentrations. a b Consider imipramine dosage adjustment whenever a CYP2D6 inhibitor is added or discontinued. cheapest stromectol buy now uk



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Reviews for imipramine

Do not start Imipramine Pamoate in a patient who is being treated with linezolid or intravenous methylene blue because there is increased risk of serotonin syndrome. 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. order real pramipexole online

General information about imipramine

The total daily dosage can be administered on a once-a-day basis, preferably at bedtime. In some patients it may be necessary to employ a divided-dose schedule. No longer have constipation or the opposite or abdominal pain. Read the Medication Guide that comes with you or your family member's antidepressant medicine. This Medication Guide is only about the risk of suicidal thoughts and actions with antidepressant medicines. Concurrent administration of Imipramine hydrochloride tablets, USP with electroshock therapy may increase the hazards; such treatment should be limited to those patients for whom it is essential, since there is limited clinical experience. domperidone cost basis

Imipramine adult dosage

Safety and effectiveness in the pediatric population other than pediatric patients with nocturnal enuresis have not been established see and . Anyone considering the use of Imipramine hydrochloride in a child or adolescent must balance the potential risks with the clinical need. Imipramine hydrochloride should be used with caution in patients with significantly impaired renal or hepatic function. The bactericidal activity of imipenem results from the inhibition of cell wall synthesis. Its greatest affinity is for penicillin binding proteins PBPs 1A, 1B, 2, 4, 5 and 6 of Escherichia coli, and 1A, 1B, 2, 4 and 5 of Pseudomonas aeruginosa.

How should I take imipramine Tofranil?

Neurological: Numbness, tingling, paresthesias of extremities; incoordination, ataxia, tremors; peripheral neuropathy; extrapyramidal symptoms; seizures, alterations in EEG patterns; tinnitus. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Psychiatric: Confusional states especially in the elderly with hallucinations, disorientation, delusions; anxiety, restlessness, agitation; insomnia and nightmares; hypomania; exacerbation of psychosis. Whether any of the symptoms described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that imipramine hydrochloride is not approved for use in treating bipolar depression.

Elderly patients and patients with cardiac disease or a prior history of cardiac disease are at special risk of developing the cardiac abnormalities associated with the use of Imipramine Pamoate. It should be kept in mind that the possibility of suicide in seriously depressed patients is inherent in the illness and may persist until significant remission occurs. Such patients should be carefully supervised during the early phase of treatment with Imipramine Pamoate and may require hospitalization. Prescriptions should be written for the smallest amount feasible. Depending on the histological section of the testes examined, the findings consisted of a range of degenerative changes up to and including complete atrophy of the seminiferous tubules, with spermatogenesis usually arrested. leflunomide

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