Eltrog 25 Tablet 7's
MRP ₹821
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Genuine Products
Synonym :
ELTROMBOPAGUM
Composition :
ELTROMBOPAG-25MG
Manufacturer/Marketer :
Glenmark Pharmaceuticals Ltd
Consume Type :
ORAL
Return Policy :
Not Returnable
Expires on or after :
About Eltrog 25 Tablet
Eltrog 25 Tablet is used to treat low blood platelet count in patients with idiopathic thrombocytopenic purpura (ITP) and hepatitis C virus (HCV) infections. Eltrog 25 Tablet is also used to treat severe aplastic anemia (SAA) in adults. Idiopathic thrombocytopenic purpura is an immune condition associated with low levels of platelets. Hepatitis C is an infection and inflammation of the liver caused by the hepatitis C virus. Severe aplastic anemia is a condition in which the bone marrow doesn't make enough blood cells.
Eltrog 25 Tablet contains Eltrombopag, which belongs to the class of 'thrombopoietin receptor agonists. Thrombopoietin is a glycoprotein hormone that stimulates the formation of megakaryocytes (large bone marrow cells) and further regulates platelet production. Eltrog 25 Tablet works by increasing these large bone marrow cells responsible for the production of platelets. Thus, Eltrog 25 Tablet helps increase these bone marrow cells, thereby stimulating the number of platelets, which further lowers the risk of bleeding.
In some cases, Eltrog 25 Tablet can cause common side effects like nausea, diarrhea, headache, muscle pain, tiredness, loss of appetite, fever, anemia (lack of blood cells), cough, and tingling numbness. If you notice any side effects that are not manageable, please consult your doctor.
Let your doctor know if you have any allergic reactions to Eltrog 25 Tablet or any other medicines before starting Eltrog 25 Tablet. Consult the doctor if you are pregnant or planning to conceive. Eltrog 25 Tablet is not indicated for use in breastfeeding since it passes into the breast milk.
Uses of Eltrog 25 Tablet
Eltrog 25 Tablet is used to treat low platelet count and severe aplastic anemia (SAA). The detailed uses of Eltrog 25 Tablet are as follows:
- Chronic immune thrombocytopenia (ITP): Eltrog 25 Tablet helps prevent excessive bleeding in patients with low platelet counts.
- Severe aplastic anemia: Eltrog 25 Tablet is used to treat severe aplastic anemia when other treatments have failed.
- Chronic hepatitis C-related thrombocytopenia: Eltrog 25 Tablet helps maintain platelet levels before and during interferon therapy.
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Directions for Use
- Eltrog 25 Tablet can be taken with or without food.
- Follow your doctor's instructions on the dosage and timing of this medication.
- Shake well before use. Measure the prescribed dose using a measuring cup and administer it orally.
- Avoid using regular household spoons, as they may not measure the dose correctly.
Medicinal Benefits
- Eltrog 25 Tablet contains 'Eltrombopag,' which belongs to the class of 'thrombopoietin receptor agonists' used to treat low blood platelet count in patients with immune (idiopathic) thrombocytopenic purpura (ITP), hepatitis C virus (HCV) infections, and severe aplastic anemia (SAA).
- Eltrog 25 Tablet works by increasing megakaryocytes, the large bone marrow cells responsible for the production of platelets.
- The increase in these bone marrow cells stimulates the production of platelets.
- Thus, Eltrog 25 Tablet prevents bleeding episodes by increasing the number of platelets in the blood.
How Eltrog 25 Tablet Works
Eltrog 25 Tablet contains Eltrombopag, which belongs to the class of 'thrombopoietin receptor agonists. Thrombopoietin is a glycoprotein hormone that stimulates the formation of megakaryocytes (large bone marrow cells) and further regulates platelet production. Eltrog 25 Tablet works by increasing these large bone marrow cells responsible for the production of platelets. Thus, Eltrog 25 Tablet helps increase these bone marrow cells, stimulating the number of platelets and further lowering the risk of bleeding.
Storage
• Store in a cool and dry place away from sunlight.• Keep Eltrog 25 Tablet out of reach and sight of children.• Non cold chain - To be stored in cool places at 10ºC to 25ºC or below 30ºC.
Side effects of Eltrog 25 Tablet
- Get plenty of rest and sleep.
- Keep your body warm.
- Drink plenty of fluids to stay hydrated.
- Avoid strenuous activities.
- Maintain good hygiene to prevent flu from spreading.
Dealing with Medication-Induced Headache:
- Hydrate your body: Drink enough water to prevent dehydration and headaches.
- Calm Your Mind: Deep breathing and meditation can help you relax and relieve stress.
- Rest and Recharge: Sleep for 7-8 hours to reduce headache triggers.
- Take rest: lie down in a quiet, dark environment.
- Cold or warm compresses can help reduce tension.
- Stay Upright: Maintain good posture to keep symptoms from getting worse.
- To treat headaches naturally, try acupuncture or massage therapy.
- Over-the-counter pain relievers include acetaminophen and ibuprofen.
- Prescription Assistance: Speak with your doctor about more substantial drug alternatives.
- Severe Headaches: Seek emergency medical assistance for sudden, severe headaches.
- Frequent Headaches: If you get reoccurring headaches, consult your doctor.
- Headaches with Symptoms: Seek medical attention if your headaches include fever, disorientation, or weakness.
Here are the precise steps to cope with diarrhoea caused by medication usage:
- Inform Your Doctor: Notify your doctor immediately about your diarrhoea symptoms. This allows them to adjust your medication or provide guidance on managing side effects.
- Stay Hydrated: Drink plenty of fluids to replace lost water and electrolytes. Choose water, clear broth, and electrolyte-rich drinks. Avoid carbonated or caffeinated beverages to effectively rehydrate your body.
- Follow a Bland Diet: Eat easy-to-digest foods to help firm up your stool and settle your stomach. Try incorporating bananas, rice, applesauce, toast, plain crackers, and boiled vegetables into your diet.
- Avoid Trigger Foods: Steer clear of foods that can worsen diarrhoea, such as spicy, fatty, or greasy foods, high-fibre foods, and dairy products (especially if you're lactose intolerant).
- Practice Good Hygiene: Maintain good hygiene to prevent the spread of infection. To stay healthy, wash your hands frequently, clean and disinfect surfaces regularly, and avoid exchanging personal belongings with others.
- Take Anti-Diarrheal Medications: If your doctor advises, anti-diarrheal medications such as loperamide might help manage diarrhoea symptoms. Always follow your doctor's directions.
- Keep track of your diarrhoea symptoms. If they don't get better or worse or are accompanied by severe stomach pain, blood, or dehydration signs (like extreme thirst or dark urine), seek medical help.
Overcome Medication-Induced Nausea: A 9-Step Plan
- Inform your doctor about the nausea and discuss possible alternatives to the medication or adjustments to the dosage.
- Divide your daily food intake into smaller, more frequent meals to reduce nausea.
- Opt for bland, easily digestible foods like crackers, toast, plain rice, bananas, and applesauce.
- Avoid certain foods that can trigger nausea, such as fatty, greasy, spicy, and smelly foods.
- Drink plenty of fluids, such as water, clear broth, or electrolyte-rich beverages like coconut water or sports drinks.
- Use ginger (tea, ale, or candies) to help relieve nausea.
- Get adequate rest and also avoid strenuous activities that can worsen nausea.
- Talk to your doctor about taking anti-nausea medication if your nausea is severe.
- Record when your nausea occurs, what triggers it, and what provides relief to help you identify patterns and manage your symptoms more effectively.
Here are the steps to manage Joint Pain caused by medication usage:
- Please inform your doctor about joint pain symptoms, as they may adjust your medication regimen or prescribe additional medications to manage symptoms.
- Your doctor may prescribe common pain relievers if necessary to treat joint discomfort.
- Maintaining a healthy lifestyle is key to relieving joint discomfort. Regular exercise, such as low-impact sports like walking, cycling, or swimming, should be combined with a well-balanced diet. Aim for 7-8 hours of sleep per night to assist your body in repairing and rebuilding tissue.
- Applying heat or cold packs to the affected joint can help reduce pain and inflammation.
- Please track when joint pain occurs and any factors that may trigger it, and share this information with your doctor to help manage symptoms.
- If your joint pain is severe or prolonged, consult a doctor to rule out any underlying disorders that may require treatment.
Managing depression as a side effect of medication: a comprehensive guide.
- Remember, managing depression as a side effect of medication requires patience, persistence, and collaboration with your healthcare team.
- Tell your doctor about your depression symptoms to adjust medication.
- Consult a therapist or counsel for emotional support.
- Engage in regular exercise to release endorphins (neurotransmitters).
- Practice stress-reducing techniques like meditation and deep breathing.
- Build a support network of friends, family, and support groups.
- Establish a consistent sleep schedule.
- Eat a nutritious diet rich in fruits, vegetables, and whole grains.
- Limit or avoid alcohol and recreational substances.
- Keep a mood journal to track symptoms and progress.
Here are the steps to manage the medication-triggered Upper respiratory tract infection:
- Inform your doctor about the symptoms you're experiencing due to medication.
- Your doctor may adjust your treatment plan, which could include changing your medication, adding new medications, or offering advice on managing your symptoms.
- Practice good hygiene, including frequent handwashing, avoiding close contact with others, and avoiding sharing utensils or personal items.
- Stay hydrated by drinking plenty of fluids to help loosen and clear mucus from your nose, throat, and airways.
- Get plenty of rest and engage in stress-reducing activities to help your body recover. If your symptoms don't subside or worsen, consult your doctor for further guidance.
What if I have taken an overdose of Eltrog 25 Tablet
Take Eltrog 25 Tablet only as prescribed by the physician. Avoid exceeding the recommended dose as it could lead to an overdose. Symptoms of overdose may include rash, slowed heartbeat, and excessive tiredness. It may also cause life-threatening blood clots. If you experience these symptoms or suspect you have taken an overdose, seek immediate medical attention.
Drug Warnings
- If you are known to be allergic to Eltrog 25 Tablet or other medicines, please inform your doctor in advance.
- Brief your medical history if you have blood clots, clotting disorders (Factor V Leiden), blood disorders like blood cancer, myelodysplastic syndrome, cataracts, liver or kidney diseases before starting Eltrog 25 Tablet.
- Take Eltrog 25 Tablet at least two hours before or four hours after consuming antacids, mineral and vitamin supplements (iron, calcium, magnesium, aluminium, selenium and zinc), dairy products, calcium-enriched foods and fortified juices since they interfere with the absorption of Eltrog 25 Tablet.
- It is not recommended during pregnancy since it may have harmful effects on the foetus.
- Consult your doctor before using Eltrog 25 Tablet if you are a breastfeeding mother.
- Do not drive or operate machinery since Eltrog 25 Tablet may cause side effects like dizziness and tiredness, affecting your ability to concentrate and drive.
- Avoid or limit alcohol consumption with Eltrog 25 Tablet as it may affect the efficacy of Eltrog 25 Tablet.
- It is not recommended for children less than one year of age in ITP and children less than two years of age in SAA.
Drug-Drug Interactions
Critical
EltrombopagAluminium hydroxide
Critical
Drug-Drug Interactions
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Critical
How does the drug interact with Eltrog 25 Tablet:
Coadministration of Magnesium oxide with Eltrog 25 Tablet can impair the absorption of Eltrog 25 Tablet which leads to increased levels in the blood. This can increase the risk and severity of side effects.
How to manage the interaction:
Taking Magnesium oxide with Eltrog 25 Tablet together is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. However, if you notice any body aches or pain, chills, cough, difficulty in breathing, fever, headache, or loss of voice you should contact a doctor immediately. Do not stop using any medications without talking to a doctor.
Coadministration of Magnesium oxide with Eltrog 25 Tablet can impair the absorption of Eltrog 25 Tablet which leads to increased levels in the blood. This can increase the risk and severity of side effects.
How to manage the interaction:
Taking Magnesium oxide with Eltrog 25 Tablet together is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. However, if you notice any body aches or pain, chills, cough, difficulty in breathing, fever, headache, or loss of voice you should contact a doctor immediately. Do not stop using any medications without talking to a doctor.
EltrombopagAluminium hydroxide
Critical
How does the drug interact with Eltrog 25 Tablet:
Coadministration of Eltrog 25 Tablet and aluminum hydroxide may interfere with the absorption of Eltrog 25 Tablet and reduce its effectiveness.
How to manage the interaction:
Taking Eltrog 25 Tablet with aluminum hydroxide is not recommended as it can possibly result in an interaction, but it can be taken if your doctor has advised it. Do not stop using any medications without first talking to your doctor.
Coadministration of Eltrog 25 Tablet and aluminum hydroxide may interfere with the absorption of Eltrog 25 Tablet and reduce its effectiveness.
How to manage the interaction:
Taking Eltrog 25 Tablet with aluminum hydroxide is not recommended as it can possibly result in an interaction, but it can be taken if your doctor has advised it. Do not stop using any medications without first talking to your doctor.
Critical
How does the drug interact with Eltrog 25 Tablet:
When Eltrog 25 Tablet is mixed with Calcium chloride, the amount of Eltrog 25 Tablet in the blood can decrease. This can lead to low treatment outcomes.
How to manage the interaction:
Taking Eltrog 25 Tablet with calcium chloride is not recommended as it can possibly result in an interaction, but it can be taken if your doctor has advised it. Do not stop using any medications without talking to your doctor.
When Eltrog 25 Tablet is mixed with Calcium chloride, the amount of Eltrog 25 Tablet in the blood can decrease. This can lead to low treatment outcomes.
How to manage the interaction:
Taking Eltrog 25 Tablet with calcium chloride is not recommended as it can possibly result in an interaction, but it can be taken if your doctor has advised it. Do not stop using any medications without talking to your doctor.
EltrombopagFerric maltol
Critical
How does the drug interact with Eltrog 25 Tablet:
Ferric maltol can make Eltrog 25 Tablet less effective by reducing its absorption and lowering its concentration in the blood. This can lead to poor treatment outcomes.
How to manage the interaction:
Taking Ferric maltol with Eltrog 25 Tablet is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after ferric maltol. Do not discontinue any medication without consulting a doctor.
Ferric maltol can make Eltrog 25 Tablet less effective by reducing its absorption and lowering its concentration in the blood. This can lead to poor treatment outcomes.
How to manage the interaction:
Taking Ferric maltol with Eltrog 25 Tablet is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after ferric maltol. Do not discontinue any medication without consulting a doctor.
EltrombopagMagnesium citrate
Critical
How does the drug interact with Eltrog 25 Tablet:
Taking magnesium citrate with Eltrog 25 Tablet can make it less effective by reducing its absorption and lowering its concentration in the blood.
How to manage the interaction:
Taking Magnesium citrate with Eltrog 25 Tablet is not recommended as it can result in an interaction. It can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after magnesium citrate. Do not discontinue any medication without consulting a doctor.
Taking magnesium citrate with Eltrog 25 Tablet can make it less effective by reducing its absorption and lowering its concentration in the blood.
How to manage the interaction:
Taking Magnesium citrate with Eltrog 25 Tablet is not recommended as it can result in an interaction. It can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after magnesium citrate. Do not discontinue any medication without consulting a doctor.
EltrombopagFerrous gluconate
Critical
How does the drug interact with Eltrog 25 Tablet:
Ferrous gluconate can make Eltrog 25 Tablet less effective by reducing its absorption in the body. This can lead to low treatment outcomes.
How to manage the interaction:
Taking Eltrog 25 Tablet with Ferrous gluconate is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after ferrous gluconate. Do not discontinue any medication without consulting a doctor.
Ferrous gluconate can make Eltrog 25 Tablet less effective by reducing its absorption in the body. This can lead to low treatment outcomes.
How to manage the interaction:
Taking Eltrog 25 Tablet with Ferrous gluconate is not recommended as it can result in an interaction, it can be taken if your doctor has advised it. You should take Eltrog 25 Tablet on an empty stomach at least 2 hours before or 4 hours after ferrous gluconate. Do not discontinue any medication without consulting a doctor.
Severe
How does the drug interact with Eltrog 25 Tablet:
Co-administration of Eltrog 25 Tablet with Pomalidomide can increase the risk or severity of developing blood clots.
How to manage the interaction:
Taking Eltrog 25 Tablet with Pomalidomide together can result in an interaction, it can be taken if a doctor has advised it. However, if you notice any symptoms of chest pain, difficulty breathing, coughing up blood, sudden loss of vision, pain, redness, or swelling in an arm or leg, and numbness or weakness on one side of the body, contact a doctor immediately. Do not discontinue any medications without a doctor's advice.
Co-administration of Eltrog 25 Tablet with Pomalidomide can increase the risk or severity of developing blood clots.
How to manage the interaction:
Taking Eltrog 25 Tablet with Pomalidomide together can result in an interaction, it can be taken if a doctor has advised it. However, if you notice any symptoms of chest pain, difficulty breathing, coughing up blood, sudden loss of vision, pain, redness, or swelling in an arm or leg, and numbness or weakness on one side of the body, contact a doctor immediately. Do not discontinue any medications without a doctor's advice.
How does the drug interact with Eltrog 25 Tablet:
Co-administration of Eltrog 25 Tablet and Calcium gluconate may interfere with the absorption of Eltrog 25 Tablet and reduce its effectiveness.
How to manage the interaction:
Although there is an interaction, Calcium gluconate can be taken with Eltrog 25 Tablet if prescribed by the doctor. However, take Eltrog 25 Tablet on an empty stomach, i.e., 2 hours before or 4 hours after taking calcium gluconate. Do not discontinue any medication without consulting a doctor.
Co-administration of Eltrog 25 Tablet and Calcium gluconate may interfere with the absorption of Eltrog 25 Tablet and reduce its effectiveness.
How to manage the interaction:
Although there is an interaction, Calcium gluconate can be taken with Eltrog 25 Tablet if prescribed by the doctor. However, take Eltrog 25 Tablet on an empty stomach, i.e., 2 hours before or 4 hours after taking calcium gluconate. Do not discontinue any medication without consulting a doctor.
Severe
How does the drug interact with Eltrog 25 Tablet:
When Pazopanib and Eltrog 25 Tablet are taken together, the body's ability to break down Pazopanib may be reduced. This increases the risk or severity of side effects.
How to manage the interaction:
Taking Eltrog 25 Tablet with Pazopanib together can result in an interaction, but it can be taken if your doctor has advised it. If you are having any of these symptoms like irregular heart rhythm, bleeding, fever, chills, joint pain, swelling, bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark-colored urine, bleeding, sudden dizziness, lightheadedness, fainting, fast or pounding heartbeats, chest pain, pain in your arms, back, neck, shortness of breath, numbness, weakness on one side of your body, slurred speech or difficulty speaking, make sure to contact a doctor right away. Do not discontinue any medications without consulting a doctor.
When Pazopanib and Eltrog 25 Tablet are taken together, the body's ability to break down Pazopanib may be reduced. This increases the risk or severity of side effects.
How to manage the interaction:
Taking Eltrog 25 Tablet with Pazopanib together can result in an interaction, but it can be taken if your doctor has advised it. If you are having any of these symptoms like irregular heart rhythm, bleeding, fever, chills, joint pain, swelling, bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark-colored urine, bleeding, sudden dizziness, lightheadedness, fainting, fast or pounding heartbeats, chest pain, pain in your arms, back, neck, shortness of breath, numbness, weakness on one side of your body, slurred speech or difficulty speaking, make sure to contact a doctor right away. Do not discontinue any medications without consulting a doctor.
Severe
How does the drug interact with Eltrog 25 Tablet:
Coadministration of Eltrog 25 Tablet with Teriflunomide can increase the risk or severity of liver damage.
How to manage the interaction:
Co-administration of Eltrog 25 Tablet with Teriflunomide can result in an interaction, but it can be taken if your doctor has advised it. If you have any of these symptoms like fever, chills, joint pain, swelling, bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, bleeding, dark colored urine, it's important to contact a doctor right away. Do not discontinue any medications without consulting a doctor.
Coadministration of Eltrog 25 Tablet with Teriflunomide can increase the risk or severity of liver damage.
How to manage the interaction:
Co-administration of Eltrog 25 Tablet with Teriflunomide can result in an interaction, but it can be taken if your doctor has advised it. If you have any of these symptoms like fever, chills, joint pain, swelling, bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, bleeding, dark colored urine, it's important to contact a doctor right away. Do not discontinue any medications without consulting a doctor.
Drug-Food Interactions
No Drug - Food interactions found in our database. Some may be unknown. Consult your doctor for what to avoid during medication.
Drug-Food Interactions
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Diet & Lifestyle Advise
- Eat natural and healthy foods by cutting down on fatty and sodium-processed foods.
- Exercise regularly to maintain good health.
- Avoid smoking and alcohol intake.
- Avoid activities like contact sports and use sharp objects like nail cutters and razors to decrease bleeding risk.
- A high-protein diet, such as lean meat, chicken, crab, turkey, beef, and fish, can help increase platelet count.
- Eating Papaya is the best natural remedy to increase your platelet count, and you can also use Papaya leave's mixture.
- Include iron-rich foods like pomegranate, beetroot, green leafy vegetables, carrots, raisins, oranges, peanuts, kidney beans, and black-eyed peas in your diet.
- Vitamin C sources like guava, black currant, red pepper, kiwi, green peppers, orange, strawberries, pineapple, peas, mango, grapefruit, and broccoli can also boost your platelet count.
Habit Forming
No
Therapeutic Class
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Alcohol
Caution
Limit alcohol intake, along with Eltrog 25 Tablet, to attain the maximum efficacy of Eltrog 25 Tablet and rule out any possibility of worsening of side effects.
Pregnancy
Unsafe
Eltrog 25 Tablet is not recommended in pregnancy. It may affect and harm the developing baby. Please consult your doctor if you are pregnant or planning to conceive.
Breast Feeding
Consult your doctor
It is not known if Eltrog 25 Tablet is excreted into the breast milk. If you are a nursing mother, please consult your doctor for more information before taking Eltrog 25 Tablet.
Driving
Caution
Eltrog 25 Tablet may cause dizziness and tiredness affecting your ability to concentrate and drive. Hence, it is recommended not to drive or operate machinery until you are mentally alert.
Liver
Caution
Let your doctor know if you have any history of liver diseases before taking Eltrog 25 Tablet. It may cause an increase in liver enzymes. Your doctor may start the treatment with a lower dose of Eltrog 25 Tablet based on your health condition.
Kidney
Caution
Eltrog 25 Tablet should be used with caution in cases of renal impairment. Seek a doctor's advice before starting Eltrog 25 Tablet if you have any kidney problems is advised.
Children
Safe if prescribed
Eltrog 25 Tablet is not recommended for children less than one year of age in ITP and children less than two years of age in SAA.
Heart
If you have a heart disease or any related concerns, Please consult your doctor before using Eltrog 25 Tablet.
Geriatrics
Consult your doctor
Please consult your doctor before giving Eltrog 25 Tablet to elderly people.
FAQs
Country of origin
India
Manufacturer/Marketer address
Glenmark Pharmaceuticals Limited, B/2, Mahalaxmi Chambers, 22, Bhulabhai Desai Road, Mumbai €“ 400 026.
Other Info - ELT0103
Disclaimer
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Author Details
Reference
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/022291s037,207027s017lbl.pdf
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5858473/#:~:text=Eltrombopag%20is%20currently%20the%20only,thrombocytopenia%20(ITP)%20in%20children
- https://www.webmd.com/drugs/2/drug-151606/eltrombopag-oral/details
- https://www.drugs.com/mtm/eltrombopag.html
- https://www.ema.europa.eu/en/documents/product-information/revolade-epar-product-information_en.pdf
- https://www.medicines.org.uk/emc/files/pil.508.pdf
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