Why take beta blockers at night

1 The renin-angiotensin-aldosterone system, known to be most active at night, is a target mechanism for BP control. Upsides. Drugs were administered in random order to 10 female volunteers who acted as their own controls. Beta blockers work mainly by slowing down the heart. Timing of Sep 26, 2022 · The answer is yes, you can take bisoprolol at night, however, it will depend on the dosage of your prescription and what has been advised to you from your doctor. The most common side-effects are feeling tired, cold fingers or toes, headache Stopping Beta Blocker Before Stress Test - Stressful!! On Monday I am scheduled for a nuclear stress test and an echo cardiogram. Not surprisingly, many people find they sleep more soundly while taking beta blockers, a happy side effect! Exercise: Many people find moderate physical activity counteracts side effects, brightens mood, and increases alertness. Jan 22, 2024 · Water-soluble beta blockers do not affect sleep, but fat-soluble beta blockers can interfere with sleep. Atenolol works by blocking the effects of epinephrine on beta-1 receptors within the heart tissue, causing the heart to pump more slowly and with less force. But it can take up to 2 to 6 weeks to take full effect. Kardia band on Apple Watch for EKGs, and Omron HEM 7280T for BP. Do not stop taking a beta blocker suddenly without consulting your doctor. 1-7 In our survey, three quarters of respondents use IV beta blocker, usually on the CT table with the rest employing Jan 12, 2023 · In these patients, it is okay to be on two beta-blockers. Aug 11, 2021 · Why would taking BP-lowering medications, regardless of class, regardless of pharmacodynamics or pharmacokinetics, work better when taken at night? For example, enalapril, an angiotensin-converting enzyme inhibitor, and amlodipine, a calcium channel blocker, are commonly used antihypertensive agents in Spain. Beta blockers usually come as tablets. Don’t use sotalol with another beta-blocker. Their effects occur due to the blocking of beta-1 receptors in the heart tissues. Oct 15, 2019 · As your pulse is higher during the day. Be sure to take the drug at about the same time or times each day. Beta-blockers should not be used to treat hypertension in patients older than age 60 unless they have another compelling indication to use these agents, such as heart failure or ischemic heart disease. Strength of recommendation. Time awake during the night was also halved. Dizziness, lightheadedness, feeling faint. Continue to take the tablets regularly unless you are told otherwise. Most people who take beta-blockers have no side-effects, or only minor ones. Dizziness. Jul 20, 2021 · Beta-blockers treat high blood pressure, heart rhythm problems, and chest pain. Nifedipine capsules should not be used to reduce blood pressure quickly as this may be fatal. Specifically, it is used alone or with other medicines to improve blood flow and Apr 1, 2024 · This medicine is a beta-blocker. Bisoprolol causes a reduction in heart rate both at rest and during exercise. Jan 17, 2018 · Beta blockers stop the effects of epinephrine (adrenaline), a hormone that plays a role in your body’s “flight-or-fight” response. Subjects were tested five times, each test period lasting 10 nights (2 baseline, 2 low dose, 4 high Jun 3, 2024 · So you can take it either in the morning or at night. Beta-blockers will slow your heart rate (pulse) and lower your blood pressure. Check if you can take beta blockers. Each of these is 1/2 the strength of the slow release I used to take. Cold hands and feet. 1, 2. This medicine is only available on prescription and comes as tablets. Thank you for the query. feeling tired. Whatever fits your schedule, as long as it is the same time every day. Beta blockers side effects. As heart Erectile dysfunction is occasionally a problem for some men who take beta blockers. The use of β-blockers is a critical part of study optimization. Nov 7, 2010 · Yes. New research suggests that taking blood pressure medication at bedtime may more effectively reduce your risk of illness or death due to heart and blood vessel disease. 8 and –12. I would take the evening dose as usual and then take the next dose between 12-2pm the next day and then adjust earlier by 2 hours per day over the next few days. Take your beta blocker at the same time every day. 5–70 mg). 7 mmHg). Examples of beta-blockers include: metoprolol; nadolol; atenolol Jul 5, 2022 · Since alcohol can deregulate blood pressure and beta-blockers can cause low blood pressure, the combination can force your levels to dip too low, resulting in a condition known as hypotension . Circadian rhythm–dependent mechanisms influence the natural rise and fall of blood pressure (BP). Doctor: Dr. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. Beta-blockers reduce the heart rate, lower the heart's oxygen demand, and reduce the frequency of angina attacks. Think I feel more awake and less sluggish - but halved my dose as well. The same time every day on my schedule. "One side effect is that the medications can decrease the body's natural levels of melatonin, a hormone that helps regulate your sleep-wake cycle. Mar 14, 2023 · Beta-blockers help manage high blood pressure, and blood thinners help prevent blood clots. These conditions may include chest pain, increased heart rate, increased blood pressure, and heart failure amongst others. Two different salts are available, metoprolol tartrate and metoprolol succinate. Im on 25mg of metoprolol time release tablets ( a beta blocker) the palps are basically gone, maybe a few a day. Try exercising in the morning to burn Sep 23, 2022 · Should beta blockers be taken at night? Yes, you can take Propranolol before bedtime. Mar 22, 2023 · Beta-blockers can reduce the number of migraine attacks if the attacks occur frequently. This keeps the heart from racing and can lower your blood pressure. However, Propranolol may cause insomnia or other sleep disturbances in some individuals which may make this timing a little off for you. People who take fat-soluble beta blockers may wake up frequently at night, experience more nightmares, and struggle to fall back asleep. Beta blockers and palpitations. May 16, 2024 · Release of renin (an enzyme that helps raise blood pressure) from your kidneys. However, using both together won't increase the risk of adverse effects. Hope this helps answer your question I do take mine at night it is easier for me to remember it. nausea (feeling sick) difficulty getting an erection or other problems with sex. versus a. Possible side effects of beta-blockers include: Beta-blockers can cause some side effects. Those who Oct 1, 2000 · A beta blocker is a prescription medicine used to treat heart problems and high blood pressure. With adrenaline blocked, you may experience symptoms similar to asthma, such as wheezing and trouble breathing. It’s not recommended to become pregnant while on ACE inhibitors or beta-blockers. Insomnia. Do not take two doses of beta blocker at the same time. They do this by blocking the action of hormones like adrenaline. If you drink alcohol regularly, your blood pressure may rise. Both types of beta blockers reduce the amount of time spent in REM sleep. The effects on sleep of four beta-blockers, atenolol, propranolol, metoprolol and pindolol, were studied in a placebo-controlled trial. But don’t take two doses within six hours of each other. (The stress hormone is epinephrine, also known as adrenaline. Practice changer. tremors. Ring 111 if you have any of the following: Jun 5, 2020 · Metoprolol Tartrate is a commonly prescribed medication. Metoprolol Tablets - Cleveland ClinicMetoprolol is a beta blocker that can treat high blood pressure, chest pain, and heart failure. However, all classes of beta blockers can cause Nov 6, 2019 · The bottom line. Aim: To compare HRV indices after morning or evening long-acting beta-blocker administration. But no matter what time you choose, remember to take it every day! Depending on the type of beta blocker you are taking, your doctor On the other hand, the emotional stress of the day (assuming one doesn't suffer from night mares) may make morning the best time. 1. There a minor drug interaction between H2 blockers and PPIs (proton pump inhibitors), but only in terms of their conflicting mechanisms of action. (use to be very bad for a while) but im wondering if anyone is on beta Background: There is a need to analyse the current approach to beta-blocker (BB) use in relation to exercise-based stress tests. For years, beta-blockers have been known to cause central nervous system (CNS) side effects, such as psychiatric conditions Nov 1, 2019 · A. – There is a small risk of bradycardia and hypotension with this combination- which should only occur in somewhere around < 15% of patients. Dec 20, 2010 · Taking a beta blocker at night will keep many people awake through the night. It is prescribed for heart problems and high blood pressure. Jun 1, 2006 · Beta-blockers can be safely administered to most patients for a successful CT coronary angiography examination. A: Based on a well-done meta-analyses. As a result, your heart does not have to work as hard because it needs less blood and oxygen. In my experience the effects of the Propranolol only last for about 6 hours so if you wanted to be able to have less anxiety at that time of the morning you would probably need to take it around midnight to 1a. These medications have shown to be dangerous for both baby and parent throughout pregnancy . Objective: We compared various guidelines regarding recommending abrupt vs. Tremors - beta-blockers can be used in benign hand tremors which have no other underlying cause and are causing significant problems in daily activities. Other beta blockers, such as propranolol, work on the heart but affect other parts of the body as well. 5mg melatonin supplement one hour prior to going to sleep. sweating. m. Beta blockers are not suitable for everyone. Skin rashes. Time spent awake reduced from 20% to 12%. Some beta blockers need to be taken twice daily. This is not a side effect that is often mentioned when a prescription is written or filled, so it can be difficult to detect a medication causing nightmares. Beta (β) blockers stop the action of epinephrine (adrenaline) and norepinephrine (noradrenaline) on your lungs. Medications in the beta-blocker category (such as Coreg, Lopressor, and Tenormin) may have a protective effect on your heart. Dec 20, 2022 · Metoprolol belongs to a group of drugs called selective beta blockers. Feb 4, 2018 · Answer. Adrenaline increases your heart rate, sugar metabolism and blood pressure when you experience a strong emotion like anger or fear. 8 Finally, both lipophilic and hydrophilic beta blockers may negatively affect sleep architecture by suppressing REM sleep. Nov 15, 2023 · Only at 8 am. Propranolol, a beta-blocker medication, has been found to have a positive impact on sleep patterns. Oct 4, 2022 · Some beta blockers (such as labetalol or carvedilol) also block alpha receptors, which are another type of receptor found in the blood vessels. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. 2. 1,2. Sep 13, 2023 · 1. I am fine with this and eager to see if everything is OK after the ordeal of the last few months trying to get my blood pressure and heart rate under control. May 4, 2021 · Beta-adrenergic blocking agents, most commonly known as beta-blockers are a type of medicine that work by slowing down the rate at which the heart beats. Beta-Blockers. Jun 11, 2018 · a fast heart rate. This may be why our doctors have us take the pill in the morning and in the evening. Your body has 2 main beta receptors Metoprolol is a selective beta-blocker at dosages usually prescribed to lower blood pressure or relieve the symptoms of angina. Adrenaline helps to relax the small airways of your lungs and make breathing easier. Commonly used beta blockers include: Propranolol belongs to a group of medicines called beta blockers. I had to stop this practice for the same reason in the past. The alpha-blocker may help both problems at the same time. How it works. So overall I feel the benefits of no alcohol are worthwhile. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart. “The proton pumps in your body that reduce Dec 10, 2019 · Over 10 years, 19,168 adults taking one or more anti-hypertensive medications were randomised to take them in the morning or at night. Doing so can lower your heart rate and blood pressure too much. You should take these medications on your usual schedule with a sip of water unless your doctor specifically advises you to Mar 26, 2024 · Excessive and poorly tolerated hypotension (low blood pressure) is experienced by some people. If you take too much. Loss of taste. Apr 30, 2022 · Sometimes, a beta-blocker is combined with an alpha-blocker. Evening dosing also did not Nov 16, 2023 · Bisoprolol belongs to the class of drugs known as beta-blockers. (–10. MA. . ) Beta blockers slow your heart rate and relieve pressure on your heart. Average patient age was 61 years, 56% were male, 43% had obesity, 24% type 2 diabetes, 29% chronic kidney disease, and 10% had previously had a cardiovascular event. The results from taking this supplement showed that patients fell sleep approximately 10 minutes faster and progressed into deeper Nov 20, 2023 · I take bisoprolol, a different beta blocker. Some people taking Lipitor may also need to take beta-blockers or blood thinners, depending on their May 25, 2022 · Beta blockers are a class of medication that prevents adrenaline from affecting your heart, effectively relaxing it and your blood vessels. She said this would spread the dose and so minimise side effects. You’ll still be getting the benefits of the medicine. May improve the symptoms of angina and increase a person with angina's capacity to exercise. Take it exactly as directed by your doctor or pharmacist. Clinical pharmacist Curtis Alexander, PharmD, who works in a neurology clinic, cites a few reasons for beta blockers' recent rise in Jul 12, 2022 · Side effects of ACE inhibitors include: Persistent cough. It is in a class of medicines known as beta-blockers and is commonly used for heart conditions. Side effects — Most people notice only mild side effects when taking beta blockers. Remember, your blood pressure may change throughout the day. 5. Beta-blockers “block” the effects of adrenaline on your body’s beta receptors. In total, 53% were taking angiotensin Jun 5, 2022 · Beta-blockers are one of the most widely prescribed classes of drugs to treat hypertension (high blood pressure) and are a mainstay treatment of congestive heart failure. A large 2016 study that included data from 194,456 people found that taking beta-blockers Mar 22, 2023 · Beta-blockers can reduce the number of migraine attacks if the attacks occur frequently. This helps lower pressure in your eye and, hopefully, saves your vision. Common side effects include: dizziness. This kind of medicine blocks the harmful effects of your body’s stress hormones on your heart. If it happens- reduce the doses of one or both of the beta-blockers. Beta-2 receptors are mainly located in the smooth muscle of your respiratory system, blood vessels, and nervous system. gradual discontinuation of BB prior to exercise tests. Emotional lability (rapid, extreme changes in mood) Inability to concentrate or think clearly. Lightheadedness. Studies have suggested that by reducing heart rate and blood pressure, the medication can promote a calmer state, making it easier for individuals to fall asleep and stay asleep throughout the night. It worked. Angiotensin receptor blockers (ARBs) should be taken at the same time every day. Learn about the dosage, side effects, and interactions of this medication from the Cleveland Clinic, a leading health care provider. Get up slowly to give your blood vessels time to adjust. Beta blockers are a prescription only medicine and are Depending on your past medical history, drug tolerances, and the advice of your primary care provider, some of the most commonly prescribed beta blockers for atrial fibrillation that you may be recommended include: Cardioselective beta blockers (that bind with only Beta-1 receptors): Metoprolol (Lopressor) (Metoprolol is the most commonly Oct 3, 2019 · Yes, you can take beta-blockers at night, especially that it is generally recommended. Metoprolol should not be stopped abruptly. Beta blockers can be taken at night, this would help with better blood pressure control in concordance with sleeping. 7 and –13. It is called a cardioselective beta-blocker because at low dosages it only works on beta1 receptors in the heart and is unlikely to affect beta2 receptors located in the airways. a cold feeling in your hands and feet. Again, I think it doesn't matter. (ARBs), cause side effects like leg cramps and coughing that can keep you up at night. But you can also take these drugs during the day, depending upon your doctor’s suggestion. Take metoprolol at the same time each day. They include: new or worsening chest pain; slow or uneven heartbeats; a light-headed feeling, like you might pass out; shortness of breath (even with mild exertion), swelling, rapid weight gain; or. 5mg bisoprolol, with the instructions to take one in the morning and one at night. Increased potassium retention. If you are dizzy or feel like you might faint, sit or lie down right away. 5–150 mg), staggered dosing (50–100 mg), a combination of oral and IV medication and finally IV only (2. Beta-blockers work by reducing the amount of fluid your eye produces. Once it is diagnosed, using a continuous positive airway pressure mask at night can restore a normal sleeping pattern and increase daytime energy. This article will guide you through everything you should know about bisoprolol, what time of day is best to take it, and also any issues you should be aware of. 6 and –13. Abstract. on night-time BP, early morning BP and morning BP surge. These are not interchangeable. Tiredness. We also analyse the shortcomings of the currently recommended approach and suggest a Metoprolol is known as a beta blocker. As heart Mar 1, 2017 · This medicine is a beta-blocker. In many cases, managing your health condition or changing your medication will resolve your leg cramps. Beta-blockers also block the impulses that can cause an arrhythmia. The best time of day to take your blood pressure pill may be at night, if that is possible. Feb 16, 2024 · Most side effects go away when the medicine is stopped. I take the regular release BB and thus take one in the morning and one before bedtime. Actually yes. 3 mmHg) and p. This is important because when you take a beta blocker regularly, your body becomes used to it. It gradually rises as we awaken thanks to release of cortisol from the adrenal glands. marjorie zych 19 May 2010. Metoprolol (Lopressor, Toprol) belongs to a class of drugs known as beta blockers. Customer. Nov 15, 2018 · Treatment with bisoprolol is usually long-term. Beta-blockers that target beta-1 receptors help slow heart rate, lower blood pressure, and relieve chest pain. Metoprolol ( Toprol) and other beta blockers can cause nightmares. Several different protocols for beta blocker administration have been published and include oral only (2. It is common for your blood pressure to increase in the morning and decrease in the evening. Doxazosin helps to reduce the symptoms of an enlarged prostate gland by relaxing the muscle around the bladder and prostate gland so you can pee more easily. Doctors typically turn to beta-blockers for high blood pressure when other medications, such as diuretics, aren’t working or have too many Oct 24, 2019 · Blood pressure normally drops as we fall asleep, reaching its lowest between midnight and 3-4 am. Beta-blockers work best Jul 18, 2014 · This effect is observed even after daytime administration and appears to be independent of their effect on nighttime sleep. ER-Rx Episode 86. If you often forget doses, it may help to set an alarm to remind you. Sleep apnea is common in heart failure. Erectile dysfunction is occasionally a problem for some men who take beta blockers. Apr 5, 2024 · Penbutolol ( Levatol) Pindolol ( Visken) Propanolol ( Inderal) Many people need to take a combination of a couple of different kinds of medicines (such as a beta-blocker and a calcium channel Jul 29, 2019 · Treatment. It can also reduce the risk of heart attack and stroke. They work by blocking the effects of the hormone epinephrine (also known as adrenaline), causing your heart to beat more slowly and with less force. If you forget to take your dose of beta blocker, take it as soon as you remember. 4,8,9 PGAs should be avoided by those who are pregnant or have an ophthalmic inflammatory condition. In view of the high frequency of sudden cardiac death in the morning, there is a question whether the evening beta-blocker administration would be more efficient than a morning dose. Never suddenly quit taking your medicine unless your doctor tells you to. Jul 4, 2023 · Interactions. For the last few weeks it has been good since I was taken Aug 16, 2020 · Beta-blockers. Nov 5, 2019 · In my own situation no alcohol at all, from one glass of wine with evening meal, resulted in lowered BP, and PVCs and PACs incidence reduced significantly. There are several different strengths of tablet. Oct 4, 2016 · Morning medications. Beta-blockers work by Beta-blockers, also known as beta-adrenergic blocking agents, reduce the effects of catecholamines (norepinephrine and epinephrine, the fight-or-flight hormones). As a result, the heart beats slower and decreases the blood pressure. An overdose of bisoprolol can slow down your heart rate and make it difficult to breathe. Common side effects of beta-blockers include: Dizziness. By slowing down the rate of the heart, beta blockers can treat quite a wide range of conditions from high blood pressure to anxiety. 1 Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are more effective (alone or in May 16, 2024 · Propranolol belongs to a class of medicines known as beta-adrenergic blockers or beta-blockers. Tips. Alpha blockers reduce blood pressure by relaxing your blood vessels so blood can pass through them more easily. I am on a Beta Blocker as well and my doctor says it doesn't matter if you take it in the morning or at night as long as I remember it at the same time each day. Therefore, a selective beta blocker like metoprolol works by slowing the heart rate while reducing the force of each beat and relaxing the blood vessels. Jun 14, 2021 · For example, beta-blockers may cause you to develop hyperkalemia, which is high blood levels of potassium. Beta-2 Receptors. In fact, the sustained-release dosage form of Propranolol is supposed to be taken at bedtime everyday. Nov 16, 2021 · migraine. They are prescription-only medicines, which means they can only be prescribed by a GP or another suitably qualified healthcare professional. Antidepressants. Dec 1, 2022 · Beta blockers. Take it at night: Let your body experience the side effects while you sleep. One time I went to pick up my prescription (5mg tablets) the Spanish pharmacist on duty that day gave me 2 packs of 2. Keep taking beta blockers even if you feel well. increase of your heart condition symptoms. Beta blockers such as metoprolol (Lopressor, Toprol XL) and atenolol (Tenormin) are used primarily to treat high blood pressure or an irregular heartbeat. Apr 15, 2017 · Patients with asthma, chronic obstructive pulmonary disease, bradycardia, heart block, congestive heart failure or those taking an oral beta blocker should not be treated with a topical B-blocker. Beta-blockers relax your blood vessels and slow down your heart rate to Dec 23, 2008 · Answer: Well, a lot of patients do not like taking beta blockers, because the way it works is it drops your heart rate, and if you drop your heart rate, the amount of blood that the heart is May 12, 2017 · I take 10mg Propranolol 3 times a day as well. “These medications are taken on an empty stomach to prevent future relapses of heartburn,” Verduzco said. Apr 24, 2024 · Long acting beta-agonist inhalers, diuretics, and statins are the most common medications that cause leg cramps at night. Common atenolol side effects may include include: cold hands or feet; dizziness; tiredness; or. May be used to treat high blood pressure (hypertension), either alone or in combination with thiazide diuretics or other medicines for hypertension. If your tablets look unexpectedly different from before, ask your pharmacist to check them for you. This slows the heart rate. hyperthyroidism. What they do Beta-blockers work by slowing the heart rate and reducing the amount of force with which blood is circulated around the body, according to the American Heart May 22, 2020 · Metoprolol is a common medication used by the elderly because it is affordable and has proven to decrease mortality in cardiovascular disease such as congestive heart failure (CHF) and coronary artery disease (CAD). You may have some unwanted side effects when taking beta blockers. That's because metoprolol works mainly on the heart. These medications have the added benefit of dilating blood vessels. (–9. After three weeks of study, the researchers found melatonin had a significantly positive impact on the people taking beta blockers. Beta-blockers for glaucoma. hi guys, I may have finally found something that subsides my heart palpitations. Jan 7, 2015 · Mean 24-h ambulatory SBP change from baseline to Weeks 12 and 26 was comparable between valsartan a. It's used to treat heart problems, help with some of the symptoms of anxiety and prevent migraines. This may be useful for men who have hypertension and an enlarged prostate. Atenolol is a medication that may be used to treat certain heart conditions. Also it might take a few days for you to see the effect but hang in there it helps at One group took a placebo, and another took metoprolol and melatonin at the same time. As you mentioned, these drugs reduce your heart rate; they also lower blood pressure. Decreased performance on neuropsychological tests used to measure a psychological function. By decreasing your body’s physical reactions to stress, you may feel less anxious during stressful times. If you think you are experiencing side effects, speak to your GP as soon as possible. The risk is greater during initial therapy or upward dose titration and may be more common in those already taking beta-blockers. These medications slow your heartbeat and reduce the force with which blood Aug 20, 2018 · A clinical study conducted with patients taking beta-blockers showed significant improvement in people’s quality of sleep when they continually took a 2. 3 mmHg) and lisinopril (–10. There was no benefit of valsartan p. If it’s almost time to take your medicine, most doctors say to wait and take your next dose at the regular time. anxiety disorders. 7,8 More recent data published in 2007 support a hypothesis that carvedilol, an agent with mixed Sleep apnea is common in heart failure. Posted 4 years ago, 5 users are following. Adeel. Due to how these medications work, using them at the same time could make them less effective (which is discussed below). Beta-blockers side-effects. If you have a heart problem, you can take propranolol to: treat high blood pressure. May 19, 2010 · Answers. Pregnancy, heart conditions, and kidney or liver problems can also raise the risk of nighttime leg cramps. treat conditions that cause an irregular heartbeat ( arrhythmia ), like atrial fibrillation. shaky voice and hands. As radiologists become more involved with cardiac CT, a detailed understanding of the techniques needed for study optimization becomes critical. There are lots of other medicines to lower blood pressure and treat chest pain that work in a different way from beta blockers. Drowsiness or fatigue. Some people use beta-blockers such as Metoprolol Tartrate for migraine Jun 15, 2023 · Metoprolol is a prescription-based, orally administered (taken by mouth) beta-blocker used to treat various cardiovascular (heart)-related conditions. Confusion. dizziness. Nov 21, 2022 · Treatment. Beta blockers start to work after about 3 hours to reduce high blood pressure. Unfortunately, these changes, including Never take a double dose to make up for a forgotten one. This is why it is important to stop drinking alcohol before beginning your medication, as Discuss with your doctor whether you should or should not take a dose the night before surgery. This in turn slows the heart rate, relaxes blood vessels, and improves conduction signals in the heart, thereby lowering blood pressure. I switched the other way. Heartburn medications: Certain preventive medications should be taken 30 minutes before the first meal of the day—even if symptoms usually occur at night or at bedtime. That helped with beta blocker at night. This slows the nerve impulses that travel through the heart. xt oj vf zr uu hv pe gb ez mc