Nitrogen balance is improved only when there is sufficient intake of calories and protein. Testim (1 percent testosterone gel) is supplied in tubes and applied once daily. See WARNINGS. At the height of the testosterone litigation, more than 25,000 lawsuits had been filed against AbbVie Inc., Eli Lilly & Co., Pfizer Inc., Endo International and other manufacturers. This data element matches the “Document Type” field of the Structured Product Listing. The implant induced cervical-uterine tumors in mice, which metastasized in some cases. Patients with serious cardiac, hepatic or renal disease (see Warnings). Testosterone topical gel is used for the treatment of males whose bodies do not make enough natural testosterone, a condition called hypogonadism. The suggested dosage for testosterone cypionate injection varies depending on the age, sex, and diagnosis of the individual patient. This web page contains comprehensive information about Drug Adverse Reports that contain a Substance name testosterone cypionate. The contents of the National Drug Codes List website are provided for educational purposes only and are not intended in any way as medical advice, medical diagnosis or treatment. Since you asked, my TRT (which has until now included 100mg testosterone cypionate split into two subcutaneous injections per week) has done very well by me. There are rare reports of hepatocellular carcinoma in patients receiving long-term therapy with androgens in high doses. For unapproved drugs, this field will be null. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. Androgen - [EPC] (Established Pharmacologic Class), Androgen Receptor Agonists - [MoA] (Mechanism of Action). Ask your health care provider any questions you may have about how to use Testosterone Cypionate Actavis. Serious adverse reactions have been reported in individuals who abuse anabolic androgenic steroids and include cardiac arrest, myocardial infarction, hypertrophic cardiomyopathy, congestive heart failure, cerebrovascular accident, hepatotoxicity, and serious psychiatric manifestations, including major depression, mania, paranoia, psychosis, delusions, hallucinations, hostility and aggression. This adverse effect may result in compromised adult stature. Testosterone Cypionate Actavis may interfere with certain lab tests. HCl. - Testosterone Cypionate 10ml - $65 (Perrigo) - Testosterone Enanthate - $35 (West-ward Pharmaceuticals) - Testoviron 250 1 amp - $9$ - Clomid 30 tabs - $25 . This drug has not been shown to be safe and effective for the enhancement of athletic performance. Labeler Name: Actavis Pharma, Inc. Labeler Code: 0591 FDA Application Number: ANDA091244 What is the FDA Application Number?This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. Drug abuse is intentional non-therapeutic use of a drug, even once, for its rewarding psychological and physiological effects. The Radicalisation of Bradley Manning was performed by National Theatre Wales across Wales in April 2012. In 2013, the play won the James Tait Black Prize for Drama. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The steroid‑receptor complex is transported to the nucleus where it initiates transcription events and cellular changes related to androgen action. Counsel patients concerning the serious adverse reactions associated with abuse of testosterone and anabolic androgenic steroids. Propranolol hydrochloride is a stable, white, crystalline solid which is readily soluble in water and ethanol. The information in this website is intended for healthcare providers and consumers in the United States. Prior to initiating testosterone cypionate, confirm the diagnosis of hypogonadism by ensuring that serum testosterone concentrations have been measured in the morning on at least two separate days and that these serum testosterone concentrations are below the normal range.Testosterone cypionate injection is for intramuscular use only.It should not be given intravenously. Bitter or strange taste in mouth; change in how food tastes; gum or mouth irritation (eg, gum pain, tenderness, or swelling); headache. Testosterone Enanthate 200 mg / mL Injection Vial 5 mL CIII Actavis 00591322126 This book provides a background of essential knowledge on testosterone deficiency in men, including diagnosis and treatment. The chemical name for Testosterone Cypionate, USP is androst-4-en-3-one,17-(3-cyclopentyl-1-oxopropoxy)-, (17β )-. Until the first publication of the Handbook of Aqueous Solubility Data, this information had been scattered throughout numerous sources. Now newly revised, the second edition of CrazyBulk D-Bal is a formulation that is well designed and executed towards helping people gain the strength, stamina and gain amount of lean muscle mass desirable for normal body condition. Warming and shaking the vial should redissolve any crystals that may have formed during storage at temperatures lower than recommended. The implant induced cervical-uterine tumors in mice, which metastasized in some cases. About 90 percent of a dose of testosterone is excreted in the urine as glucuronic and sulfuric acid conjugates of testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the unconjugated form. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. Filter by condition. Manufactured by: The second part of the volume concerns potential nonadrenal causes of hypertension, such as growth hormone excess or deficiency, primary hyperparathyroidism, vitamin D deficiency, testosterone deficiency, insulin resistance, obesity ... In Reality Bites Back, media critic Jennifer L. Pozner aims a critical, analytical lens at a trend most people dismiss as harmless fluff. At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH). Testosterone belongs to a class of drugs known as androgens. Cases involved popular products such as AndroGel and Depo-Testosterone. Check with your doctor if you have questions about your risk of prostate cancer while you use Testosterone Cypionate Actavis. If a venous thromboembolic event is suspected, discontinue treatment with testosterone cypionate and initiate appropriate workup and management. Sun is notorious for terrrible manufacturing practice though, FDA is always warning them. Ask your doctor before you change the dose of your diabetes medicine. Contact your health care provider at once if you have any unusual side effects. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction. Testosterone Cypionate Injection contains testosterone, a Schedule III controlled substance in the Controlled Substances Act. actavis testosterone cypionate package insert testosterone cypionate 1 cc 200 mg difference between testosterone cypionate and test enanthate Males with carcinoma of the breast3. Depo-testosterone is the most popularly prescribed TRT medication in the US. The most common dose is 200 milligrams (mg) in 1 milliliter (ml) 18. although it is available in two doses: 100 mg/ml and 200 mg/ml. Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, testosterone cypionate can be given at intervals of two to four weeks. Testosterone Cypionate, USP is a white or creamy white crystalline powder, odorless or nearly so and stable in air. Tell your doctor if you have ever had a blood clot. Testosterone cypionate 200 mg results may suffer if you attempt to buy unregulated testosterone from internet websites that do not require prescriptions. However, testosterone levels may be in the normal or subnormal range in men abusing synthetic testosterone derivatives. The companies behind these sites are typically in other countries that do not abide by US laws for the sale of pharmaceuticals. Deficiency of testosterone may result in a condition called androgen deficiency, or hypogonadism, which may include increased body fat, reduced muscle size, . Hypercalcemia may occur in immobilized patients. Testosterone cypionate injections, such as Depo-Testosterone and Watson (Actavis) are considered by most people to be the leaders in this field. West-Ward Testosterone Cypionate 200 mg/mL 10mL Vial and Enanthate 200mg/mL are manufactured by West-Ward Pharmaceuticals, and is purchased as a Hikma Farmacia injectable testosterone. The bottle of Actavis Testosterone Enanthate you have pictured have the lot and exp date in ink, that is not what the lot and exp date on that bottle should look like. Diabetes patients - Testosterone Cypionate Actavis may affect your blood sugar. Use Testosterone Cypionate Actavis as directed by your doctor. Women who are pregnant (see PRECAUTIONS, Pregnancy)5. Product Type: Human Prescription Drug What kind of product is this?Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. Dailymed. The chronological and skeletal ages must be taken into consideration, both in determining the initial dose and in adjusting the dose.For replacement in the hypogonadal male, 50 to 400 mg should be administered every two to four weeks.Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of testosterone between free and bound forms, and the free testosterone concentration will determine its half-life. It is not known if AndroGel is safe or effective to treat men who have low testosterone due to aging. Testosterone Drug Types. The generic name of Testosterone Cypionate is testosterone cypionate. It may also be used to treat certain types of breast cancer in women. Androgel is a gel containing testosterone. There is suggestive evidence that injection of testosterone into some strains of female mice increases their susceptibility to hepatoma. In Get Paid What You're Worth, Robin L. Pinkley and Greogry B. Northcraft tell you how you can begin getting paid what you're worth--today! The drug is a generic version of AbbVie's AndroGel 1.62%. for Testosterone Cypionate Injection USP, 200 mg/mL, packaged in 2,000 mg/10 mL Multiple-dose Vials. Serum cholesterol may increase during androgen therapy. Do not store the removed tablet for future use. HCG is combined with Testosterone Therapy for Men by the doctors of Men's Health Center to protect the patient against . Intramuscular injections should be given deep in the gluteal muscle.The suggested dosage for testosterone cypionate injection varies depending on the age, sex, and diagnosis of the individual patient. Testosterone Cypionate Actavis should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed. Testosterone Cypionate Injection, USP, 200 mg/mL is a clear, pale yellow oleaginous viscous, sterile solution intended for intramuscular administration available as:10 mL Multiple Dose Vials, Cartons of 1 vial            NDC 0591-4128-79Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].Protect From Light.Manufactured by:Hikma Farmaceutica (Portugal), S.AEstrada do Rio da Mó, nº8, 8A e 8B, Fervença2705-906 Terrugem SNT, PortugalDistributed by:Actavis Pharma, Inc. Parsippany, NJ 07054 USARevised: May 2017. AndroGel ® (testosterone gel) 1% and 1.62% are controlled substances, available by prescription, used to treat adult males who have low or no testosterone due to certain medical conditions.. Do not remove the system until it is time for the next dose. The following adverse reactions in the male have occurred with some androgens:Endocrine and urogenital: Gynecomastia and excessive frequency and duration of penile erections. DEA Schedule: Schedule III (CIII) Substances What is the Drug Enforcement Administration (DEA) CIII Schedule?The controlled substances in the CIII schedule have an abuse potential and dependence liability less than those in schedules CI and CII, and have an accepted medical use in the United States. Apply the next system about 12 hours after the original system that you applied first. Use Testosterone Cypionate Actavis twice a day, once in the morning and once in the evening (about 12 hours apart) unless otherwise instructed by your health care provider. Oligospermia may occur at high dosages. Allergic: Hypersensitivity, including skin manifestations and anaphylactoid reactions. Testosterone Cypionate 200mg / ml 10 x 1ml - Euro Pharmacies Testosterone Enanthate 250mg / ml - 10 x 1ml - Euro Pharmacies Letrozole 20 tablets 2.5 mg - Euro Pharmacies Other testosterone replacement products include Androderm, Axiron, Testim, and Fortesta.Testosterone is the major male sex hormone responsible for the normal growth and development of the male sex organs and secondary sex . Use the medicine immediately after opening the blister pack. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation. Withdrawal of the drugs did not lead to regression of the tumors in all cases. Do not take 2 doses at once. Some medical conditions may interact with Testosterone Cypionate Actavis. Check with your health care provider before you start, stop, or change the dose of any medicine. For replacement in the hypogonadal male, 50 to 400 mg should be administered every two to four weeks. Ask your health care provider if Testosterone Cypionate Actavis may interact with other medicines that you take. Testosterone Cypionate with NDC 0591-4128 is a a human prescription drug product labeled by Actavis Pharma, Inc.. 60%. Males with known or suspected carcinoma of the prostate gland4. 24 HR Androderm 0.0833 MG/HR Transdermal Patch, 24 HR Testosterone 0.0833 MG/HR Transdermal Patch [Androderm], 24 HR Testosterone 0.0833 MG/HR Transdermal System, 2500 MG Testosterone 0.0162 MG/MG Topical Gel, 5000 MG Testosterone 0.01 MG/MG Topical Gel, 60 ACTUAT Testosterone 20.25 MG/ACTUAT Topical Gel, 60 ACTUAT Testosterone 5.5 MG/ACTUAT Nasal Gel [Natesto], ANDRODERM 4 MG/Day 24HR Transdermal System, AndroGel 1 % (25MG / 2.5GM) Transdermal Gel, Androderm 2 MG per 24 HR Transdermal Patch, Vogelxo 12.5 MG/ACTUAT Transdermal Gel Pump, 60 ACTUAT, testosterone 1 % (25 MG / 2.5 GM) Transdermal Gel, testosterone 1.62 % (40.5MG / 2.5GM) Transdermal Gel, testosterone 2 % (30 MG/ACTUAT) Topical Solution, 60 ACTUAT, ANDROFIL 40 MG CAPSULE 1 strip(s) (10 capsules each), ANDROFIL 50 MG GEL 1 tube(s) (5 GM gel each), TESTOVIRON DEPOT 100 MG INJECTION 1 vial(s) (1 ML injection each), TESTOVIRON DEPOT 250 MG INJECTION 1 vial(s) (1 ML injection each). Tell your health care provider if you are taking any other medicines, especially any of the following: This may not be a complete list of all interactions that may occur. Testosterone is a male hormone responsible for the growth and development of the male sex organs and maintenance of secondary sex characteristics. These effects include growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution, such as beard, pubic, chest, and axillary hair; laryngeal enlargement, vocal cord thickening, and alterations in body musculature and fat distribution. Androgen therapy should be used cautiously in healthy males with delayed puberty. Its molecular formula is C27H40O3 and the molecular weight 412.61.The structural formula is represented below:Testosterone Cypionate Injection, USP is available in one strength, 200 mg/mL Testosterone Cypionate, USP.Each mL of the 200 mg/mL solution contains: Testosterone Cypionate, USP                      200 mgBenzyl Benzoate, USP                                 0.2 mLCottonseed Oil, USP                                    560 mgBenzyl Alcohol, USP (as preservative)        9.45 mg. Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. HIKMA FARMACÊUTICA (PORTUGAL), S.A.Estrada do Rio da Mó, 8, 8A e 8B – Fervença – 2705-906 Terrugem SNT, PORTUGAL, Distributed by: Other experts emphasize that higher dosages are needed to induce pubertal changes and lower dosages can be used for maintenance after puberty. Rooted in fieldwork conducted from 2005 to 2014, this book explores how and why consumers around the world leverage a wide range of products, services, and experiences to satisfy their fascination with the British Royal Family brand. Call your doctor right away if you have symptoms of a blood clot (eg, swelling, warmth, numbness, change of color, or pain in a leg or arm; chest pain; shortness of breath; coughing up blood). Edema, with or without congestive heart failure, may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease. Cipla USA - Top medicine manufacturers in USA, provides a wide range of high-quality pharmaceutical products at affordable price. Exclude Flag: N - NO What is the NDC Exclude Flag?This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA"s requests for correction to deficient or non-compliant submissions ("Y"), or because the listing certification is expired ("E"), or because the listing data was inactivated by FDA ("I"). Lab tests, including liver function, complete blood cell counts, blood cholesterol, prostatic specific antigen (PSA) levels, and blood Testosterone Cypionate Actavis, may be performed while you use Testosterone Cypionate Actavis. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Another generic brand is Perrigo Paddock Cypionate Injection and Actavis (Watson) Testosterone Injections. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. In the USA. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of testosterone between free and bound forms, and the free testosterone concentration will determine its half-life.About 90 percent of a dose of testosterone is excreted in the urine as glucuronic and sulfuric acid conjugates of testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the unconjugated form. "Testosterone: dailymed provides trustworthy information about marketed drugs in the united states. It should not be given intravenously. Safety and effectiveness in pediatric patients below the age of 12 years have not been established. Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking. Hypercalcemia may occur in immobilized patients. If the system falls off after 8 hours but before 12 hours, replace the original system. Androgens may increase sensitivity to oral anticoagulants. Testosterone Cypionate Injection, USP for intramuscular injection, contains testosterone cypionate, USP which is the oil-soluble 17 (beta)- cyclopentylpropionate ester of the androgenic hormone testosterone. URL Images Last Mod. Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Testosterone has been subject to abuse, typically at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids. Make sure that your hands are dry when you open Testosterone Cypionate Actavis. Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Serum cholesterol may increase during androgen therapy. Sabine . This book also highlights emerging evidence on the gender-specific effects of fluoxetine, its potential adverse features, including its addiction liability in combination with psychostimulants, and the impact of perinatal fluoxetine ... Testosterone is known to cause virilization of the female fetus when administrated to pregnant women. Cute Lovely Designed Notebook Blank for Diary and Journal Ruled Lined College Pages Large Size 8.5x11 110 Pages for Drawing Sketching and Taking Note Composition. It can be used as a notebook - journal or composition book. Hypogonadotropic hypogonadism (congenital or acquired): gonadotropin or luteinizing hormone-releasing hormone (LHRH) deficiency or pituitary-hypothalamic injury from tumors, trauma, or radiation.Safety and efficacy of testosterone cypionate in men with "age-related hypogonadism" (also referred to as "late-onset hypogonadism") have not been established. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. If any of these effects appear, the androgen should be stopped and if restarted, a lower dosage should be utilized. Testosterone Cypionate Actavis should not be used by women. Hematologic: Suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapy, and polycythemia. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Do NOT take more than the recommended dose without checking with your doctor. Popular testosterone supplements, testosterone cypionate, propionate and enanthate have traditionally been injected through Intramuscular means as this was previously seen as the only possible method for providing patients with the testosterone esters. Testosterone has been tested by subcutaneous injection and implantation in mice and rats. Hold the system firmly in place with a finger on the outside of your upper lip for 30 seconds to make sure it sticks. CODES (6 days ago) Actavis Testosterone Gel 1% 50mg Coupon - 07/2021. Same with Actavis however Actavis testosterone is made by Hikma so it's not actually made by Actavis. This medicine is available only with your doctor's . Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, testosterone cypionate can be given at intervals of two to four weeks.Testosterone in plasma is 98 percent bound to a specific testosterone-estradiol binding globulin, and about 2 percent is free. "Examining the intersection between the statutory and regulatory scheme governing approval of generic pharmaceuticals and U.S. patent law, this in-depth resource balances perspectives from both name-brand drug patentees and generic drug ... Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone. This guide offers a combination of plant-derived hormones, nutritional supplements, a plant-rich diet and an exercise programme, to eliminate or even reverse such problems. Misuse or abuse of testosterone can cause serious side effects such as heart disease (including heart attack), stroke, liver disease, mental/mood problems, abnormal drug-seeking behavior, or . This book tells the story of how the navy expanded from a tiny force to become the most complex industrial enterprise on earth; how the need to organise it laid the foundations of our civil service and our economy; and how it transformed ... Intramuscular - Administration within a muscle. Gently push the curved side of the system just above the incisor tooth (on either side of the mouth). Some studies, but not all, have reported an increased risk of MACE in association with use of testosterone replacement therapy in men. All contents of this website are provided on an "as is" and "as available" basis without warranty of any kind. Depo-testosterone (testosterone cypionate). Inactivation of testosterone occurs primarily in the liver. Patients should be informed of this possible risk when deciding whether to use or to continue to use testosterone cypionate.Edema, with or without congestive heart failure, may be a serious complication in patients with pre-existing cardiac, renal or hepatic disease.Gynecomastia may develop and occasionally persists in patients being treated for hypogonadism.The preservative benzyl alcohol has been associated with serious adverse events, including the “gasping syndrome”, and death in pediatric patients. Many of Over the Counter drugs are not reviewed by the FDA but they might be marketed to the public if the product complies with the applicable rules and regulations. Evaluate patients who report symptoms of pain, edema, warmth and erythema in the lower extremity for DVT and those who present with acute shortness of breath for PE. In a series of private interviews, conducted over sixteen years with the stipulation that they not be released until after his death, the former president offers a revealing, reflective self-portrait as he describes his relationships with ... The following adverse reactions in the male have occurred with some androgens: Endocrine and urogenital: Gynecomastia and excessive frequency and duration of penile erections. Actavis Pharma, Inc. Testosterone Cypionate Injection, USP for intramuscular injection, contains Testosterone Cypionate, USP which is the oil-soluble 17 (beta)- cyclopentylpropionate ester of the androgenic hormone testosterone. To date, epidemiologic studies and randomized controlled trials have been inconclusive for determining the risk of major adverse cardiovascular events (MACE), such as non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death, with the use of testosterone compared to non-use. Depo-testosterone (testosterone cypionate). Depo-testosterone is the most popularly prescribed TRT medication in the US. For topical dosage form (solution): Adults—At first, apply 60 milligrams (mg) (1 pump or 1 twist actuation of 30 mg) to each clean, dry, intact skin of your underarm once a day (usually in the morning). “part 341”). Various dosage regimens have been used to induce pubertal changes in hypogonadal males; some experts have advocated lower dosages initially, gradually increasing the dose as puberty progresses, with or without a decrease to maintenance levels. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Patients with serious cardiac, hepatic or renal disease. Testosterone Cypionate 200mg / ml 10 x 1ml - Euro Pharmacies Testosterone Enanthate 250mg / ml - 10 x 1ml - Euro Pharmacies Letrozole 20 tabs 2.5 mg - Blister - Euro Pharmacies The product's dosage form is injection and is administered via intramuscular form. Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking. Listing Expiration Date: 12-31-2021 What is the Listing Expiration Date?This is the date when the listing record will expire if not updated or certified by the product labeler. Parsippany, NJ 07054 USA, NDC 0591-4128-79 TESTOSTERONE CYPIONATE INJECTION, USP Testosterone Cypionate Injection USP 100 mg/mL Sterile Solution Androgens Cytex Pharmaceuticals Inc. 5545 Macara Street Halifax, Nova Scotia B3K 1W1 Submission Control Number: 110815 Date of Revision: December 21, 2007 . If the system sticks to your cheek and not your gum, there is no need to replace the system. Paddock had testosterone on shortage due to increased demand and shipping delays from their contract manufacturer. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); breast growth or pain; breathing problems while sleeping; calf or leg pain, swelling, or redness; change in the size or shape of the testicles; chest pain; frequent or prolonged erections; mood or mental changes (eg, anger, anxiety); new or worsening trouble urinating (eg, frequent urination, inability to urinate, weak stream); severe headache or dizziness; shortness of breath; swelling of the ankles, feet, or body; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, upper-right stomach pain, yellowing of the skin or eyes); unexplained or unusual weight gain. 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