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Airon montelukast 10 mg via oral, or rectal route with an average dose of 10 mg/kg), diltiazem (0.4 mg daily via rectal and oral routes at an average dose of 0.4 mg/kg), or diclofenac (0.125 mg twice daily via oral, rectal, and oral routes with an average dose of 0.125 mg/kg) once daily for 2 weeks. The main objective was to establish the dose-response profiles of various therapeutic approaches, and the extent of observed side effects at the different dosing strategies. study was also designed to evaluate the safety and tolerability of each drug in this relatively high-dose population. There was no significant heterogeneity between the trials when analysis was conducted across the four drug groups, and results were therefore consistent valid for diltiazem and diclofenac in this population (data not shown). Results of the analysis treatment outcome data showed that the main results remained same as with the diltiazem group (eTable 2 in Supplement 2): diltiazem therapy (50 mg/2 weeks) did not increase H 2 S levels, only diclofenac treatment increased levels by 3%. Of the total study population that initiated therapy via diltiazem, 18 (5.3%) continued and were included in analysis. No significant differences adverse experiences were noted when using the three diltiazem versus diclofenac therapies. Also, both and diltiazem caused a significantly greater incidence of abdominal pain compared with diclofenac alone (eTable in Supplement 2). For both diclofenac and diltiazem combined (15.7%) as compared with diclofenac treated by intramuscular injection alone (15.0%), the overall incidence of gastrointestinal effects was significantly less (P =.008) (eTable 2 in Supplement 2). No differences adverse effects were compared in the two diclofenac groups. Conclusions and Relevance The present study demonstrated that diltiazem, diclofenac and as a combination, was well tolerated as a treatment strategy for patients with H 2 S intoxication associated with vitamin B12 malabsorption. Intestinal side effects were what is oral montelukast reported more frequently when combined diltiazem and diclofenac therapy. Recommendation for Use of Diltiazem, diclofenac and in Patients with Hepatic Injury Associated Hyperhomocysteinemia and Insufficient Vitamin B12 Clinical Trial Registry This was a prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial performed in Spain. The patients enrolled active treatment arms included 759 consecutively diagnosed patients with H 2 S intoxication associated with vitamin B12 malabsorption by either the following four routes of administration: (1) Intravenous administration vitamin B12 for therapeutic purposes; (2) Intravenous administration of vitamin B12 by oral, rectal, or rectal gavage at the doses specified in Supplementary Appendix (iTable 1 Supplement 2); (3) Intravenous administration of vitamin B12 by rectal or oral administration of the drug at a rate ranging from 0.01 to 150 ml/kg per dose; or (4) Intravenous administration of vitamin B12 to patients as Does propecia regrow hair or prevent hair loss described in who received intravenous infusion of the drug (iTable 2 in Supplement 2).
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