does l carnitine cause insomnia

Uppin, M. S., Sundaram, C., Meena, A. K., Reddy, K. M., Reddy, K. K., Vanniarajan, A., and Thangaraj, K. Lipid storage myopathies with unusual clinical manifestations. L-Carnosine Dosage. View abstract. Curr Ther res, Clin exp 1982;32(11):116-127. Eur.Heart J 2007;28(5):608-612. It appears to be safe used on a short-term basis. Endocr Metab Immune Disord Drug Targets 2020. NAC: The Amino Acid That Turns Psychiatry on Its Head J Urol. View abstract. Cattaneo CI, Ressico F, Valsesia R, D'Innella P, Ballabio M, Fornaro M. Sudden valproate-induced hyperammonemia managed with L-carnitine in a medically healthy bipolar patient: Essential review of the literature and case report. Nefrologia. 2010;16(10):919-921. Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. The effect of valproic acid on plasma carnitine levels. View abstract. Torrioli, M. G., Vernacotola, S., Mariotti, P., Bianchi, E., Calvani, M., De Gaetano, A., Chiurazzi, P., and Neri, G. Double-blind, placebo-controlled study of L-acetylcarnitine for the treatment of hyperactive behavior in fragile X syndrome. Zhonghua Er.Ke.Za Zhi. Coenzyme Q10 - Mayo Clinic Plasma carnitine deficiency: Clinical observations in 51 pediatric patients. Winter SC, Szabo-Aczel S, Curry CJR, et al. View abstract. Katiyar, A. and Aaron, C. Case files of the Children's Hospital of Michigan Regional Poison Control Center: the use of carnitine for the management of acute valproic acid toxicity. Pickard, R. Editorial comment on: Antioxidant treatment associated with sildenafil reduces monocyte activation and markers of endothelial damage in patients with diabetic erectile dysfunction: a double-blind, placebo-controlled study. Neurol.Sci 2010;31(1):61-64. View abstract. View abstract. 1990;71(5):520-528. Gonzalez-Ortiz, M., Hernandez-Gonzalez, S. O., Hernandez-Salazar, E., and Martinez-Abundis, E. Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients. J Physiol Biochem. Van Wouwe JP. L-carnitine improves glucose disposal in type 2 diabetic patients. Postiglione A, Soricelli A, Cicerano U, et al. Suzuki, Y., Narita, M., and Yamazaki, N. Effects of L-carnitine on arrhythmias during hemodialysis. Drugs 1999;58:479-87. Infusionsther.Klin.Ernahr. Tarantini, G., Scrutinio, D., Bruzzi, P., Boni, L., Rizzon, P., and Iliceto, S. Metabolic treatment with L-carnitine in acute anterior ST segment elevation myocardial infarction. Lisinopril (lisinipril) can cause nausea, headaches, anxiety, insomnia, drowsiness, nasal congestion and sexual dysfunction. HIV.Med. Scand.J Clin Lab Invest 1985;45(3):193-198. 2011;93(4):799-808. Nephron 1990;55(1):28-32. Int J Cardiol 1992;34(2):167-172. Check with your doctor as soon as possible if any of the following side effects occur while taking levocarnitine: Some side effects of levocarnitine may occur that usually do not need medical attention. Potential involvement of altered carnitine palmitoyltransferase-I activity. View abstract. Low Blood Pressure. View abstract. Zhongguo Wei Zhong.Bing.Ji.Jiu.Yi Xue 2011;23(12):739-742. It can cause nausea, vomiting, stomach pain, weakness, and chest pain (angina). 8588 Background: Carnitine is a natural aminoacid derivative that plays a crucial role in cellular energy metabolism. Karahan, M., Cokseym, B., and Arts, S. The effect of L-carnitine supplementation on 1500 m running performance. Role of L-carnitine in apnea of prematurity: a randomized, controlled trial. Bachmann HU, Hoffmann A. Interaction of food supplement L-carnitine with oral anticoagulant acenocoumarol. Calabrese, V., Cornelius, C., Stella, A. M., and Calabrese, E. J. Dutta, A., Ray, K., Singh, V. K., Vats, P., Singh, S. N., and Singh, S. B. L-carnitine supplementation attenuates intermittent hypoxia-induced oxidative stress and delays muscle fatigue in rats. 2010;105(6):1338-1345. View abstract. According to the University of Maryland Medical Center, carnitine is successful in treating hyperthyroidism possibly because of its ability to block the effects of thyroid hormones - a potentially dangerous effect for people suffering from an underactive thyroid. L-carnitine has most often been used by adults in doses of 2 grams by mouth daily. Hepatology 2010;52(1):79-104. 2010;20(6):711-723. 2010;34(3):295-299. Am J Ther. Goral S. Levocarnitine and muscle metabolism in patients with end-stage renal disease. As stated previously, foods high in sugar and saturated fat have been associated with poor sleep quality and sleep disturbances . Fundam.Clin Pharmacol 2011;25(5):642-651. View abstract. L-carnitine: a way to decrease cellular toxicity of ifosfamide? Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease. View abstract. Biomed Rep 2020;13(6):65. Some animal studies suggest that the acetyl form, acetyl-L-carnitine (ALCAR), may help prevent age-related mental decline and improve markers of learning (30, 31). The liquid medicine can be taken alone or mixed with a beverage or soft food. Pola P, Savi M, Grilli M, and et al. Pastoris, O., Dossena, M., Foppa, P., Catapano, M., Arbustini, E., Bellini, O., Dal Bello, B., Minzioni, G., Ceriana, P., and Barzaghi, N. Effect of L-carnitine on myocardial metabolism: results of a balanced, placebo-controlled, double-blind study in patients undergoing open heart surgery. You'll also. 2010;68(5):743-752. Trk Kardiyol Dern Ars -Arch Turk Soc Cardiol. Call your doctor for medical advice about side effects. 2007;52(6):1774-1775. 2014 May;29(5):997-1004. View abstract. View abstract. Arch.Pharm Res 2012;35(11):1945-1952. Influence of L-carnitine administration on maximal physical exercise. View abstract. Kidney Blood Press Res. 2010;9(3):265-268. J Inherit.Metab Dis 9-10-2010; View abstract. View abstract. View abstract. J Child Neurol 1995;10:S40-4. Eur J Urol 1996;30(Suppl 2):954. Russell, S. Carnitine as an antidote for acute valproate toxicity in children. Trappe, S. W., Costill, D. L., Goodpaster, B., Vukovich, M. D., and Fink, W. J. 2011;21(6):485-491. Kimmoun, A., Munagamage, G., Dessalles, N., Gerard, A., Feillet, F., and Levy, B. View abstract. L-arginine should be used with caution. L-acetylcarnitine as a new therapeutic approach for peripheral neuropathies with pain. Corsi, C., Pollastri, M., Marrapodi, E., Leanza, D., Giordano, S., and D'Iddio, S. L-propionylcarnitine effect on postexercise and postischemic hyperemia in patients affected by peripheral vascular disease. View abstract. 2000;22(1):73-80. 2010;7:35. Arch.Pediatr 2012;19(2):184-193. Cochrane.Database.Syst.Rev. 2010;610:285-308. Clinical evaluation of the effects of levocarnitine chloride (LC-80) on excercise tolerance in stable angina pectoris by the serial multistage treadmill exercise testing: a multicenter, double-blind study. Problems with Acetyl L-Carnitine? - Phoenix Rising ME/CFS Forums Cui, G., Xu, W. H., and Wu.G.P. The effects of anti-anxiety and depression therapy on life quality of patient with coronary heart disease. Acta Urol Ital 1996;10(3):185-187. 2007;2007:72741. Malaguarnera, M., Risino, C., Cammalleri, L., Malaguarnera, L., Astuto, M., Vecchio, I., and Rampello, L. Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. Invest Clin 2007;48(2):243-248. 2007;18(8):533-540. Dig Dis 2021. Pryor, J. L., Glass, S. L., Campagnone, J., and Sigman, M. Randomized double blind placebo controlled trial of carnitine for the treatment of idiopathic asthenospermia. J Pediatr 1995;126:287-92. Brain Dev. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer's Disease. Cipolli, C. and Chiari, G. [Effects of L-acetylcarnitine on mental deterioration in the aged: initial results]. View abstract. Sohn HJ, Choi GB Yoon KI. BMC Comp Altern Med 2002;2:5. View abstract. 2010;58(5):551-565. L-carnitine may increase the risk of seizures in those with epilepsy. A., Yamamah, G. A. E., El-Baky, A. M. N. E. A., El-Kassas, G. M., and Elhalim, A. J Med.Food 2006;9(4):468-473. Ciacci C, Peluso G, Iannoni E, et al. Tomassini, V., Pozzilli, C., Onesti, E., Pasqualetti, P., Marinelli, F., Pisani, A., and Fieschi, C. Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trial. View abstract. View abstract. J Androl 2004;25(5):761-770. Schoderbeck M, Auer B, Legenstein E, et al. Protective effect of intravenous levocarnitine on subsequent-month hospitalization among prevalent hemodialysis patients, 1998 to 2003. Soczynska, J. K., Kennedy, S. H., Chow, C. S., Woldeyohannes, H. O., Konarski, J. Kang, H. C., Kim, H. D., Lee, Y. M., and Han, S. H. Landau-Kleffner syndrome with mitochondrial respiratory chain-complex I deficiency. Drugs Exp Clin Res 1995;21(4):157-159. Saudi.J Kidney Dis Transpl. Neurobiol Aging 1995;16:1-4. (1) On top of the limitations in positive studies, it has also shown to be completely useless. Low levels of L-carnitine have been found to be associated with diabetic complications. Changes in physical performance of untrained volunteers: effects of L-carnitine. This information may not fit your specific health circumstances. 2009;220(1):171-176. Grandis, D. D. Tolerability and efficacy of L-acetylcarnitine in patients with peripheral neuropathies: a short-term, open multicentre study. L-Carnitine may cause serious side effects. Kaviani, M., Nourshahi, M., and Shokoohi, F. The effects of acute L-carnitine administration on ventilatory breakpoint and exercise performance during incremental exercise. It can cause side effects such as stomach upset, heartburn, diarrhea, and seizures. Clin Physiol 1984;4(4):363-365. Costa, M., Canale, D., Filicori, M., D'lddio, S., and Lenzi, A. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Effect of glycine propionyl-L-carnitine on aerobic and anaerobic exercise performance. Ahmad S, Robertson HT, Golper TA, et al. 2006;8(5 Pt 1):503-507. Although not all of these side effects may occur, if they do occur they may need medical attention. 2007;110(2 Pt 2):480-482. A randomized double blind versus placebo study. 9 Acetyl-L-Carnitine Benefits + Dosage & Side Effects - SelfHacked View abstract. Bartels GL, Remme WJ, den Hartog FR, et al. Smith, W. A., Fry, A. C., Tschume, L. C., and Bloomer, R. J. Ann.Saudi.Med. It may not be safe to take this supplement if you have liver or kidney disease, high blood pressure, seizure disorder or diabetes. They may have you stop lipotropics or switch the ingredients being used. View abstract. Am.J Med Genet. Eur Heart J 1994;15(10):1348-1352. Chazot, C., Blanc, C., Hurot, J. M., Charra, B., Jean, G., and Laurent, G. Nutritional effects of carnitine supplementation in hemodialysis patients. Malaguarnera, M., Pistone, G., Astuto, M., Dell'Arte, S., Finocchiaro, G., Lo, Giudice E., and Pennisi, G. L-Carnitine in the treatment of mild or moderate hepatic encephalopathy. Heil, S. G., Hogeveen, M., Kluijtmans, L. A., van Dijken, P. J., van de Berg, G. B., Blom, H. J., and Morava, E. Marfanoid features in a child with combined methylmalonic aciduria and homocystinuria (CblC type). Am J Clin.Nutr 2009;89(1):71-76. View abstract. Dev Med Child Neurol 1991;33:795-802. Saturated fat 10 and added sugars are linked to a myriad of health problems such as heart disease, type 2 diabetes, and obesity. eCollection 2019. View abstract. View abstract. Vermeulen RC, Scholte HR. Improved pallesthetic sensitivity of pudendal nerve in impotent diabetic patients treated with acetyl-L-carnitine. Does carnitine cause insomnia? This makes L-carnitine a conditionally essential nutrient (6). Insomnia; Diarrhea; Some . 2011;17(7):H55-H59. 2007;62(4):349-354. View abstract. Pignatelli, P., Tellan, G., Marandola, M., Carnevale, R., Loffredo, L., Schillizzi, M., Proietti, M., Violi, F., Chirletti, P., and Delogu, G. Effect of L-carnitine on oxidative stress and platelet activation after major surgery. Acenocoumarol is used to slow blood clotting. Effect of L-carnitine supplement on semen parameters in men with idiopathic infertility. View abstract. View abstract. In a person with an overactive thyroid gland, who produces such large quantities of these thyroid hormones that he/she develops a variety of symptoms (including palpitations, increased body temperature, shakiness, irritability, insomnia and weight loss), the inhibiting effects of L-carnitine can be useful (Benvenga, 2005). 2007;213(4):351-359. 2013 Jun;19(2):165-72. View abstract. 2010;66(2):127-136. J Perinat Med 1995;23:477-85. Schweiz.Med Wochenschr 9-12-1992;122(37):1352-1355. 2011;13(5):392-395. View abstract. De Vivo DC, Bohan TP, Coulter DL, et al. View abstract. View abstract. More severe and rarer side effects are seizures and muscle weakness in people prone to heart disease [ 38 ]. Derosa, G., Maffioli, P., Ferrari, I., D'Angelo, A., Fogari, E., Palumbo, I., Randazzo, S., and Cicero, A. F. Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. 1987;24(4):231-234. Dokmeci, D., Inan, M., Basaran, U. N., Yalcin, O., Aydogdu, N., Turan, F. N., and Uz, Y. H. Protective effect of L-carnitine on testicular ischaemia-reperfusion injury in rats. Novak M. Carnitine supplementation in soy-based formula-fed infants. Soyucen, E., Demirci, E., and Aydin, A. Outpatient treatment of propionic acidemia-associated hyperammonemia with N-carbamoyl-L-glutamate in an infant. View abstract. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Am.J Clin Nutr. View abstract. View abstract. Indian J Exp.Biol. Pugliese, D., Sabba, C., Ettorre, G., Berardi, E., Antonica, G., Godi, L., Palasciano, G., Lee, S. S., and Albano, O. View abstract. Corbucci, G. G., Melis, A., Piga, M., Marchionni, A., and Calvani, M. Influence of acetyl-carnitine on some mitochondrial enzymic activities in the human cerebral tissue in conditions of acute hypoxia. View abstract. Nutrition 2009;25(11-12):1193-1201. Porter, N. S., Jason, L. A., Boulton, A., Bothne, N., and Coleman, B. Pharmacol Res 1998;37(2):115-122. View abstract. 2014 Jun;27(3):317-29. View abstract. First, take your CoQ10 with a meal. View abstract. It can also cause the. L-Carnitine should be taken at evenly spaced intervals every 3 or 4 hours. View abstract. This is a detailed, evidence-based review of the 18 most popular weight loss pills and supplements on the market today. Carnitor (levocarnitine) package insert. A randomized controlled trial. van Dalen, E. C., Caron, H. N., Dickinson, H. O., and Kremer, L. C. Cardioprotective interventions for cancer patients receiving anthracyclines. Biol.Trace Elem.Res 2012;150(1-3):42-48. Naturally produced in the body, acetyl-L-carnitine is also widely available in drugstores, supermarkets and health food catalogs as a . As a supplement, acetyl-L-carnitine is usually considered safe when taken as directed. View abstract. Sabry, A. View abstract. View abstract. Additional anti-ischemic effects of long-term L-propionylcarnitine in anginal patients treated with conventional antianginal therapy. 4-5-2008;130(12):441-445. Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome. Prog Retin Eye Res. Mantovani, G., Maccio, A., Madeddu, C., Gramignano, G., Serpe, R., Massa, E., Dessi, M., Tanca, F. M., Sanna, E., Deiana, L., Panzone, F., Contu, P., and Floris, C. Randomized phase III clinical trial of five different arms of treatment for patients with cancer cachexia: interim results. Muscle carnitine deficiency: adult onset lipid storage myopathy with sensory neuropathy. Complement Ther Med 2011;19(4):216-227. PLoS.One. Cai, H., Yi, W., Li, M., and et al. View abstract. View abstract. Psychosom Med 2004;66:276-82. Clin Ter. Beneficial effects of L-carnitine in myoblastic C2C12 cells. View abstract. Baudouin C, Labb A, Liang H, Pauly A, Brignole-Baudouin F. Preservatives in eyedrops: the good, the bad and the ugly. Yet, there are a few known side effects that include agitation, insomnia and nausea. View abstract. Eur J Appl Physiol Occup Physiol 1990;61:486-90. View abstract. View abstract. J Pediatr Gastroenterol Nutr 1987;7:220-224. View abstract. 11 Ways to Overcome Hashimoto's Fatigue - Dr. Izabella Wentz Martinez E, Domingo P, Roca-Cusachs A. Potentiation of acenocoumarol action by L-carnitine. Clinical and biochemical effects. Opala G, Winter S, Vance C, et al. Suchitra, M. M., Ashalatha, V. L., Sailaja, E., Rao, A. M., Reddy, V. S., Bitla, A. R., Sivakumar, V., and Rao, P. V. The effect of L-carnitine supplementation on lipid parameters, inflammatory and nutritional markers in maintenance hemodialysis patients. 2011;55(8):1022-1028. "L-carnitine and platelet aggregation in uremic patients subjected to hemodialysis." View abstract. Mettang, T., Thomas, S., and Kuhlmann, U. L-carnitine does not alleviate uremic pruritus in hemodialysis patients. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. Mondillo, S., Faglia, S., D'Aprile, N., Mangiacotti, L., Campolo, M. A., Agricola, E., and Palazzuoli, V. [Therapy of arrhythmia induced by myocardial ischemia. 2004;97(2):c41-c48. Pediatr.Neurol. Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Helms, R. A., Mauer, E. C., Hay, W. W., Jr., Christensen, M. L., and Storm, M. C. Effect of intravenous L-carnitine on growth parameters and fat metabolism during parenteral nutrition in neonates. Relative carnitine deficiency in autism. Angiology 1995;46(8):705-713. Available for Android and iOS devices. Optom.Vis.Sci 2011;88(12):1439-1444. A bidimensional echocardiographic study]. Rizzon, P., Biasco, G., Di Biase, M., Boscia, F., Rizzo, U., Minafra, F., Bortone, A., Siliprandi, N., Procopio, A., Bagiella, E., and . Pittler, M. H. and Ernst, E. Complementary therapies for neuropathic and neuralgic pain: systematic review. Beneficial effects of L-carnitine in post dialysis syndrome. Mate, A., Miguel-Carrasco, J. L., Monserrat, M. T., and Vazquez, C. M. Systemic antioxidant properties of L-carnitine in two different models of arterial hypertension. Bartels GL, Remme WJ, Pillay M, et al. Heringer, J., Boy, S. P., Ensenauer, R., Assmann, B., Zschocke, J., Harting, I., Lucke, T., Maier, E. M., Muhlhausen, C., Haege, G., Hoffmann, G. F., Burgard, P., and Kolker, S. Use of guidelines improves the neurological outcome in glutaric aciduria type I. Ann.Neurol. 2006;27(6):599-604. Thal LJ, Carta A, Clarke WR, et al. J Mol.Histol. Int J Gynaecol Obstet 2019;147(1):59-64. doi: 10.1002/ijgo.12902. Metabolic effects of continuous or acute carnitine administration with special reference to fat oxidation and nitrogen utilization. Efficacy and safety of entecavir plus carnitine complex (GODEX) compared to entecavir monotherapy in patient with ALT elevated chronic hepatitis B: Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. 2007;41(3):224-230. View abstract. Nephron 55 (1990): 28-32. Acetylcarnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic . View abstract. View abstract. 150mg ala, and 500mg carnitine. View abstract. View abstract. Cardiovasc.Drugs Ther 2012;26(5):401-408. View abstract. View abstract. Supplements may also benefit those with lower levels, such as older adults, vegans and vegetarians. View abstract. Common side effects of L-Carnitine may include: stomach pain; nausea, vomiting; or diarrhea. Guarnieri, G. F., Ranieri, F., Toigo, G., Vasile, A., Ciman, M., Rizzoli, V., Moracchiello, M., and Campanacci, L. Lipid-lowering effect of carnitine in chronically uremic patients treated with maintenance hemodialysis. 2012;2:CD006659. Nutr Metab Cardiovasc Dis 2019;29(11):1151-67. doi: 10.1016/j.numecd.2019.07.012. Sabry, A. Fenkci, S. M., Fenkci, V., Oztekin, O., Rota, S., and Karagenc, N. Serum total L-carnitine levels in non-obese women with polycystic ovary syndrome. Herrmann, W. M., Dietrich, B., and Hiersemenzel, R. Pharmaco-electroencephalographic and clinical effects of the cholinergic substance--acetyl-L-carnitine--in patients with organic brain syndrome. 2011;42(3):217-225. Evidence suggests it may promote weight loss by increasing calorie expenditure.6. 2005;25(7):470-477. Scand.J Clin Lab Invest 1985;45(2):169-178. A multicentre, randomized, parallel, placebo-controlled trial. It can also cause a "fishy" odor of the urine, breath, and sweat. L-CARNITINE - Uses, Side Effects, and More - WebMD JPEN J Parenter.Enteral Nutr 1988;12(1):29-34. Stuessi, C., Hofer, P., Meier, C., and Boutellier, U. L -Carnitine and the recovery from exhaustive endurance exercise: a randomised, double-blind, placebo-controlled trial. View abstract. Marthaler NP, Visarius T, Kupfer A, Lauterburg BH. Am.J Clin Nutr. 1992;140(4):353-377. Int.Clin Psychopharmacol. Multicenter trial of L-carnitine in maintenance hemodialysis patients. Carroll, J. K., Kohli, S., Mustian, K. M., Roscoe, J. Braz.J Med.Biol.Res. Foitzik, K., Hoting, E., Heinrich, U., Tronnier, H., and Paus, R. Indications that topical L-carnitin-L-tartrate promotes human hair growth in vivo. Clin Invest Med. View abstract. View abstract. Cell Biochem.Funct. Hypertension 2010;55(2):e13. Rajasekar, P. and Anuradha, C. V. L-Carnitine inhibits protein glycation in vitro and in vivo: evidence for a role in diabetic management. View abstract. You may report them to the FDA. Kletzmayr J, Mayer G, Legenstein E, et al. View abstract. View abstract. Carnitine produces energy in the cells by transporting fatty acids into the mitochondria where they are oxidized into . Ann.Pharmacother. View abstract. View abstract. Clin Mol Hepatol. Methods Mol.Biol. 1986;24(9):511-516. The dose of your warfarin might need to be changed. View abstract. J.Nutr.Health Aging 2010;14(3):224-230. Liammongkolkul, S., Kuptanon, C., Wasant, P., Vatanavicharn, N., Sawangareetrakul, P., Keeratichamroen, S., Cairns, J. R. K., Srisomsap, C., and Svasti, J. View abstract. Mult Scler 2006;12:321-4. Dal Negro R, Pomari G, Zoccatelli O, and et al. View abstract. Peivandi, S., Karimpour, A., and Moslemizadeh, N. Effects of L-carnitine on infertile men's spermogram; a randomized clinical trial. Evangelista, M., Koverech, A., Messano, M., and Pescosolido, N. Comparison of three lubricant eye drop solutions in dry eye patients.

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