It may increase your risk of stomach bleeding. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Frequently asked questions: Dosage. Crushing or dispersing should always be used as a last resort but current text books and resources suggest it is likely to be safe.Clinicians should be aware that this is an unlicensed use of the medication. To crush or not to crush. For any unexpected effects while taking ALEVE, contact your doctor or pharmacist. If you are having trouble swallowing the large tablets ask your . All rights reserved. However, the dose is usually not more than 1375 mg per day. doi:10.1371/journal.pone.0193683. Do not break, crush, cut, chew, or dissolve it. Contraindications include people with heart, liver, kidney, and gastrointestinal problems. How to Dislodge a Pill Stuck in Your Throat, When Your Child or Teenager Can't Swallow Pills, Morphine: Forms, Use, Side Effects, and How It's Given. Keep in mind that they can occur at any time and may show up without warning. If you have ever had hives, facial swelling, asthma (wheezing), shock, rash, skin reddening or blisters after taking a pain reliever or fever reducer, do not take ALEVE. The powdered medication can collect in the corners of the bag, making it hard to retrieve. Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. No problems: Aleve has a long half life, it is not a special form of the pill/capsule that makes it last long, so crushing it and swallowing it will not effect it. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. I took 2 tablets of naproxen sodium about two hours ago. It can increase the risk of side effects such as sedation and respiratory depression and increase blood levels of Dilaudid to potentially fatal levels. Sustained-release pills are similar to enteric-coated pills in that they are meant to be absorbed slowly. Get emergency medical help if you have signs of an allergic reaction to Aleve (runny or stuffy nose, wheezing or trouble breathing, hives, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). I have tried orajel, naproxen, and salt water. Safely store Aleve by keeping it tightly closed in the container it came in. An allergic reaction is possible if you are allergic to naproxen sodium (the active ingredient) or any of the non-medicinal ingredients in ALEVE. You will need to learn which foods you can and cannot mix with crushed medications. PubChem Database [internet]. Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath. Pills crushed in a pill crusher or a mortar and pestle can be dissolved in a small amount of water or mixed into a small amount of soft food. It may also pass through breast milk. If your child is using Aleve or any form of naproxen, be sure to tell your doctor about any changes in their weight, as the dose is weight-based. B 2. Can it reverse with proper care? Aleve. Do not drive or operate machinery if Dilaudid affects you in this way. Anaprox is a registered trademark of Syntex Pharmaceuticals International Limited. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Some drugs are also enteric-coated to avoid teeth staining or to prevent stomach acids from destroying the active drug. National Center for Biotechnology Information. Taking higher doses for more extended periods may increase your risk. What should I do? What to do if i just had one Aleve (naproxen) pill at 7 this morning, could i take a zzzquil with it? Goldstein JL, Cryer B. Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies. Harvard Health Publications, Harvard Medical School. Will i be okay? Created for people with ongoing healthcare needs but benefits everyone. Absorption may be slightly delayed with meals. doi:10.1093/ehjcvp/pvw041. Naproxen vs. Ibuprofen: Which Should You Take for Pain? doi:10.5152/eurasianjmed.2018.0010. When used for severe or continuing arthritis, this medicine must be taken regularly as ordered by your doctor in order for it to help you. Not all possible interactions are listed in this medication guide. Do not take this medicine in larger amounts or for longer than recommended. 2015;7:3141. * Tylenol is a registered trademark of Johnson & Johnson. Symptoms can include: rash blistering and peeling skin blistering and peeling inside your mouth or nose, or on your eyes or genitals Breast growth in males . To make sure the lisinopril tablets you're prescribed can be crushed, split, or chewed, talk with your pharmacist or doctor first. Doing so can release all of the drug at once, increasing the risk of side effects. Crush: Since aleve (naproxen) is not a capsule, you can crush it and combine with something sweet like apple sauce. indigestion, heartburn, stomach pain, nausea; This is not a complete list of side effects and others may occur. It is 1230am now. How to put medicines down an enteral feed tube, How to prescribe for administration via enteral feed tube, How to prescribe for patients with dysphagia. Taking too much of this medicine may increase the chance of unwanted effects, especially in elderly patients. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Not every pill can be crushed. However, the dose is usually not more than 1500 mg per day. Stop using Aleve and seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Hives for 5 days after naproxen ONCE for water on knee - they are ONLY in a band of about 6in around the affected knee and thick - why and what to do? Check with your doctor first before changing dosage forms (eg, tablets, suspension). doi:10.1016/j.drugalcdep.2012.05.013, Thong MYT, Manrique YJ, Steadman KJ. For these reasons, enteric-coated pills or tablets should never be crushed, broken, or chewed. The dose of this medicine will be different for different patients. What are the problems with tablet crushing? Aleve comes in capsule and gel form. 433 reviews of Crush "Got a chance to try out mgm newest restaurant. Schmidt M, Lamberts M, Olsen AM, et al. If you use Aleve long-term, you may need frequent medical tests. Naproxen vs. Ibuprofen: Which Is Better for Arthritis? I have abused Aleve (naproxen) and motrin along with not drinking water because of my job and drinking a lot of protein drinks. For these, please consult a doctor (virtually or in person). OTC medications, including Aleve, need to be used correctly and with caution. Can Aleve be taken if I have high blood pressure? Created for people with ongoing healthcare needs but benefits everyone. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This not only reduces the drug's effectiveness but also increases the risk or severity of side effects. 2013 Nov;85(3 Pt B):1337-47. doi:10.1016/j.ejpb.2013.09.009, Vosburg SK, Jones JD, Manubay JM, Ashworth JB, Benedek IH, Comer SD. Some of the medication can get stuck in the plastic itself. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. These conditions can occur without warning while you are using naproxen, especially in older adults. Available as something for placing under your tongue? Continue reading, Naprosyn, Anaprox, Anaprox-DS, Naprelan, +3 more. What's the Difference Between Oxycodone and Hydrocodone? There are certain pills that are designed to be dispersed in certain parts of the digestive tract or at a specific rate. Grapefruit juice and some drugs don't mix. Other drugs may interact with naproxen, including prescription and over-the-counter medicines, vitamins, and herbal products. It also temporarily reduces fever. This content does not have an Arabic version. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Aleve is not for children under 12 unless directed by their doctor. Speak with your doctor before adding any drug to your current medication(s). ALEVE can interact with some blood pressure medications, so talk to your doctor or pharmacist to determine whether ALEVE is appropriate for you. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Keep from freezing. Aleve is an NSAID fever and pain reducer that people frequently use to manage chronic pain. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Naproxen information for Healthcare Professionals. Is it safe to take? You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Aleve is a nonsteroidal anti-inflammatory drug (NSAID). Always ask your physician and/or pharmacist about crushing pills in. U.S. Food and Drug Administration. You may have a serious reaction. Adults750 milligrams (mg) for the first dose, then 250 mg every 8 hours until the attack is relieved. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Verywell Health's content is for informational and educational purposes only. 2016:pvw041. Read our. Since Aleve is sometimes used only when needed, you may not be on a dosing schedule. Available for Android and iOS devices. Aleve, Aleve-D, Aleve PM,AleveX and Aleve Arthritis Pain Gelcontain different active ingredients. Do not crush, chew, or attempt to dissolve slow-release forms of Dilaudid. Aleve may also be used for purposes not listed in this medication guide. Your bot have been rated as a harmful activity and will be blocked to prevent potential damage, please get in touch with support team: This article explains Aleve's dosage, safety, side effects, and drug interactions. Doing so can release the drug too quickly, increasing the risk of side effects. Naproxen is usually safe, but it has beenassociated with severe and even fatal side effects. All rights reserved. Aleve (naproxen) directions say you may take 2 pills IF taken within 1st hour of the 1st onehow strange. Small amount of fluid around the heart, given naproxen every 12 hours. What are the new treatment options for migraines? Available as a licensed liquid or special? This information is intended for healthcare professionals only, I confirm that I am a healthcare professional. Stop using Aleve and call your doctor at once if you have: shortness of breath (even with mild exertion); the first sign of any skin rash, no matter how mild; signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; liver problems - nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); kidney problems - little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; low red blood cells (anemia) - pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or. Generic name: naproxen [na-PROX-en] Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Additional information for Healthcare Professionals. If you are pregnant or breastfeeding, talk to your doctor about alternatives to Aleve. You can cut or crush the oral tablet. to start registration process of a harmless bot. For potential or actual medical emergencies, immediately call 911 or your local emergency service. If you are on a schedule, use the missed dose as soon as you remember. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Can You Take Tylenol With an Anti-Inflammatory Like Aleve? without giving you more pain relief than meloxicam alone. Ask a doctor or pharmacist if it is safe for you to use this medicine if you have: heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke; a history of heart attack, stroke, or blood clot; if you take aspirin to prevent heart attack or stroke. For naproxen sodium (eg, Anaprox, Anaprox DS) tablet dosage form: AdultsAt first, 275 or 550 milligrams (mg) 2 times a day, in the morning and evening. Thank you, {{form.email}}, for signing up. Thank you, {{form.email}}, for signing up. While we recommend that the product be swallowed whole with a full glass of water, you can chew or crush the tablet or caplet. That said, a 2016 Danish study found an association between short-term ibuprofen or diclofenactreatment and cardiovascular events. Call your doctor or 911 if you think you may have a medical emergency. Ask your doctor before using an antacid, and use only the type your doctor recommends. PLoS One. If you can crush a pill, use a recommended method like a pill crusher or a mortar and pestle to grind the pill to a fine powder. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Can Aleve cause allergic reactions? include protected health information. 2018;50(2). Naproxen doses are based on weight in children, and any changes may affect your child's dose. Each Aleve pill has the strength to last 12 hours. Do not break, crush, or chew the tablets. You should not use Aleve if you are allergic to naproxen, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. Doctors typically provide answers within 24 hours. Copyright 2023 Bayer. However, not every pill can be crushed as doing so can affect the absorption and effectiveness of certain medications. It is also available in combination with a sleep aid25 milligrams (mg) diphenhydramine hydrochloride. No pain reliever, including ALEVE, should be taken while using any of these other products unless youre directed to do so by your doctor. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. Skip the missed dose if it is almost time for your next scheduled dose. Both the Aleve tablets and caplets contain the same amount of medicine. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. information submitted for this request. JUST ONE PILL CAN LAST UP TO 12 HOURS LIVE WELL BEYOND PAIN UNDERSTAND PAIN Warnings Naproxen can increase your risk of fatal heart attack or stroke. Prescription naproxen is available in regular and extended-release formulations. Ibuprofen is short acting, while naproxen is long acting and more likely to cause an upset stomach. Available as something for placing on your gum? Bitter taste. Also, be sure you're getting only one dose of an NSAID at a time. It relieves the spasms, cramping, and tightness of muscles caused by medical problems, including multiple sclerosis or certain injuries to the spine. In addition, its best to take no more than the recommended dosage for the shortest time necessary. These side effects can be severe. This medicine usually begins to work within one week, but in severe cases up to two weeks or even longer may pass before you begin to feel better. You can take two pills within one hour for your first dose. 2 cocktail, 3 small plates, 2 big plates $160." European Heart Journal - Cardiovascular Pharmacotherapy. However, it is best to take this medicine at the start of a meal or snack to avoid an upset stomach. Took Naproxen at 8am today without water. Stay as close to your regular dosing schedule as possible. Is Aleve safe? (Ref. If you don't see a warning label, ask your healthcare provider or pharmacist before crushing any pill or tablet. But first, I was worried about "does Aleve help with acne"? I just now took one nyquil gel. It is not recommended to use any over-the-counter product beyond the labeled expiration date. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. This is commonly done to persons with swallowing difficulties or feeding tubes. How can I get rid of the pain I have had a horrible toothache for two days, and can't get an appointment yet. For these, please consult a doctor (virtually or in person). AleveX Pain Relieving Lotion With Rollerball Applicator. Learn which pills can and cannot be crushed. If a person takes 14 220mg naproxen Aleve pills, what will be the effects on the person? The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. However the dose is usually not more than 1500 mg (taken as two 750 mg or three 500 mg tablets) per day. It's not recommended to crush the pills but if you can't swallow tablets you can crush them. This drug has the potential to cause an allergic reaction. Food and Drug Administration. health information, we will treat all of that information as protected health Aleve ( naproxen) is a non-steroidal anti-inflammatory drug (NSAID) that is sold over-the-counter (OTC) in 220 mg doses. Feels like it's suck in my chest but is probably my lower esophagus. Get rid of medication that is outdated or if you dont need it anymore. How quickly can acute migraines be treated. I cant swallow my tablets are there any alternatives. Ask your doctor before taking any other medication for pain, arthritis, fever, or swelling. Aleve should not be taken for more than 10 days for pain or 3 days for a fever without consulting your doctor. This medicine should come with a Medication Guide. Aleve -D Sinus & Cold may also be used for purposes not listed in this medication guide. Stop use and get emergency medical attention IMMEDIATELY if you experience: difficulty breathing, facial swelling, hives, rash or itching. Each dose should be swallowed with a full glass of water and can be taken with or without meals. Naproxen vs ibuprofen: What's the difference? Aleve may be helpful for your condition, but to make the most of it, you need to use it safely. OTC instructions are to take one 220 mg pill every 8-12 hours. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 2018;3(3), e0193683. The crushed pill might also irritate the gums, mouth, esophagus, or stomach if it is released quicker than intended. It is also not a good idea to mix crushed pills. 2023. Aleve vs Ibuprofen: What's the difference? HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Yes, allopurinol oral tablets can be crushed, split, or chewed. We comply with the HONcode standard for trustworthy health information. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine. Get answers from Anesthesiologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Learn how we can help severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. This is not a complete list of side effects. You should not use Aleve if you are allergic to naproxen, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. Gunaydin C, Bilge S. Effects of nonsteroidal anti-inflammatory drugs at the molecular level. Get answers from Gastroenterologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. The average household teaspoon may not hold the right amount of liquid. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. The coating is gradually dissolved as it passes through the stomach so that the drug begins to be released as it travels to the intestine. Store this medication at room temperature, 77F (25C). . Connect with a U.S. board-certified doctor by text or video anytime, anywhere. I twisted my ankle and would like to know if it's safe to take an aleve (naproxen). Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. As with all NSAIDs, you should aim for the lowest effective dose for the shortest duration possible. Aleve may also cause stomach or intestinal bleeding, which can be fatal. Many medicines available over the counter contain aspirin, salicylates, or other medicines similar to naproxen (such as ibuprofen or ketoprofen). Nicely decorated intimate place. 2023 Dotdash Media, Inc. All rights reserved. or drink before you do thisSome medications cannot , or should not be crushed..Most meds are ok to crush, but just to be sure, ask first.. I am 6'2'' 180 lbs. Take this medication with a full glass of water (8 ounces/240. No, you should not chew, crush, or split letrozole tablets. If you're starting naproxen for the first time, you can take 440 mg within the first hour. Your doctor may adjust the dose as needed. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. ESCITALOPRAM 1. i can not sollow pills i have to crush them when i take them can i crush naproxen up when i take it n is it safe to ? Aleve should not be taken for more than 10 days for pain or 3 days for fever without consulting your doctor. If in doubt, ask your pharmacist. Get Pain Relief With the Most Common Arthritis Medications. Aleve belongs to a class of medication known as non-steroidal anti-inflammatory drugs (NSAIDs) but is not indicated as an anti-inflammatory. This kind of reaction may show up as: If any of these symptoms occur, stop taking naproxen and seek emergency medical attention. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It can create holes in the bag, causing you to lose medication. If it's delayed release then please don't crush it. for longer than 7-10 days please consult your health care practicioner. Read and follow these instructions carefully. If you are taking any other drug, talk to a doctor or pharmacist before use to determine whether ALEVE is appropriate for you. Naprosyn is indicated for treatment of acute pain, chronic (continuing) pain and inflammatory conditions under a doctor's supervision. Keep the bottle tightly closed when not in use. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Regardless of how it is taken, it is recommended that it be taken with a full glass of water. I tried mint, water, juice. Video chat with a U.S. board-certified doctor 24/7 in a minute. NSAIDs come with the risk of ulcers, bleeding in the stomach lining, and other GI problems. By mixing the crushed pill into a large amount of water or food, you risk losing some of the medication on the plate, bowl, or utensil and may end up being underdosed. Taking certain products together can cause you to get too much of this type of medication. Swallow the Oxaydo or OxyContin tablet whole with water. Is it safe to take naproxen and Prednisolone togethet? You can often tell that a pill is enteric-coated when it has a slight sheen or gloss. Lybalvi (Olanzapine and Samidorphan) - Oral, How Coffee Interferes With Synthroid (Levothyroxine), Top 10 Items You Need During Cancer Treatment. Don't take more than 660 mg in a 24-hour period. Drug loss while crushing tablets: Comparison of 24 tablet crushing devices. U.S. Food and Drug Administration. 2016;37(13):1015-23. doi:10.1093/eurheartj/ehv505. Anaprox is indicated for treatment of acute pain, chronic (continuing) pain and inflammatory conditions under a doctor's supervision. For this reason, it's crucial to read all medication labels (OTC and prescribed) before using them. What is the advantage of using Aleve over other pain relievers? Read our. Ask a doctor before giving Aleve to a child younger than 12 years old. In: StatPearls [Internet]. All medicines in the NSAID class, including naproxen, work by blocking the formation of chemicals in the body known asprostaglandins. Aleve is not approved for use by anyone younger than 2 years old. My bun is 25, not drinking water &abusing aleve, (naproxen) motrin, drinking protein drinks. I'm presently drinking plenty of water. Adults1000 to 1500 milligrams (mg) (taken as two to three 500 mg tablets) once a day for the first dose, then 1000 mg (taken as two 500 mg tablets) once a day until the attack is relieved. Is It Safe to Cut Cholesterol-Lowering Drugs in Half? If you already have GI problems, work with your healthcare provider to determine an appropriate pain relief solution. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Aleve only for the indication prescribed. Chewed pills can get stuck in your teeth, reducing the dose, or cause a bitter taste. Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. Is it just a normal/immediate release naproxen or a delayed release tablet. 25mg/ml, 50mg/ml, 125mg/5ml - licensed; 200mg/5ml - special, Licensed for administration via enteral tube, Advice on administration via enteral tube. For acute gout: Adults750 milligrams (mg) for the first dose, then 250 mg every 8 hours until the attack is relieved. Curfman, G. FDA strengthens warning that NSAIDs increase heart attack and stroke risk. I had a gastric bypass and was prescribed naproxen 550 mg to take, is it safe to take? Carefully follow the instructions and take the medicine mixture right away. However, the dose is usually not more than 1500 mg per day. Feeling chest pain after dry swallowing an aleve (naproxen). * Electrolyte imbalance, such as. Naproxen works by reducing hormones that cause inflammation and pain in the body. Created for people with ongoing healthcare needs but benefits everyone. Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public. Enteric coated/modified release products should not be crushed. Make sure to follow the dosage instructions and be aware of the possible side effects and interactions. Storage. If you are using the suspension, shake it gently before using it. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Taking more than one NSAID can raise your risk for severe side effects (e.g., heart problems, kidney problems, bleeding problems, etc.) Ask your doctor if you have any questions. Do not give this medicine to a child without medical advice. Aleve-D Sinus & Cold is a combination medicine used to treat stuffy nose, sinus congestion, headache, fever, and minor aches and pains caused by the common cold or flu. Avoid taking aspirin or other NSAIDs unless your doctor tells you to. Your doctor may adjust your dose as needed. Advertising revenue supports our not-for-profit mission. This content does not have an English version. Drug class: Nonsteroidal anti-inflammatory drugs. There are three types of pills, among others, that should never be crushed: Enteric-coated drugs are coated to reduce stomach irritation. To learn more, please visit our, ) is not a capsule, you can crush it and combine with something sweet like apple sauce. Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Swallow the extended-release tablet whole. Naproxen can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease.
