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Keep a list of all medicines to show the healthcare provider. There are no adequate and well-controlled studies of Seroquel use in pregnant women. In limited published literature, there were no major malformations associated with quetiapine exposure during pregnancy. In animal studies, embryo-fetal toxicity occurred. Quetiapine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. When treating pediatric patients with Seroquel for any indication, weight gain should be assessed against that expected for normal growth. nolpaza buy us

What other drugs will affect abilify

Although not reported with Seroquel, disruption of the body's ability to reduce core body temperature has been attributed to antipsychotic agents. OCD either when used alone or in combination with an SSRI. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness; abnormal thoughts; chest pain; confusion; decreased urination; disorientation; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; increased saliva production or drooling; increased sweating; memory loss; menstrual changes; muscle pain, weakness, or stiffness; new or worsening mental or mood changes eg, agitation, depression, hallucinations; one-sided weakness; seizures; severe or prolonged drowsiness, dizziness, or headache; shortness of breath; suicidal thoughts or actions; swelling of the hands, legs, or feet; symptoms of high blood sugar eg, increased thirst, hunger, or urination; unusual weakness; symptoms of high prolactin levels eg, enlarged breast size, decreased sexual ability, missed menstrual period, nipple discharge; tremor; trouble concentrating, speaking, or swallowing; trouble sitting still; trouble walking or standing; uncontrolled muscle movements eg, arm or leg movements, twitching of the face or tongue, jerking or twisting; unusual bruising; vision changes; yellowing of the skin or eyes.

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Many drugs can interact with quetiapine. Not all possible interactions are listed here. TR criteria for schizophrenia. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.

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The mechanism of action of Seroquel is unknown. However, it has been proposed that the efficacy of Seroquel in schizophrenia and its mood stabilizing properties in bipolar depression and mania are mediated through a combination of dopamine type 2 D 2 and serotonin type 2 5HT 2 antagonism. Antagonism at receptors other than dopamine and 5HT 2 with similar receptor affinities may explain some of the other effects of Seroquel. For the best possible benefit, it is important to receive each scheduled dose of this as directed. If you miss a dose, contact your doctor or right away to establish a new dosing schedule. Your doctor may direct you to also take by again for some time if more than a certain number of weeks have passed since your last injection. Follow your doctor's instructions carefully.



Food and Drug Administration

Avoid getting over-heated or dehydrated. Do not drink alcohol while you are using quetiapine. ABILIFY-treated patients mean age: 84 years; range: 7888 years. Rarely, very serious conditions such as may occur. Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs. Why do people take phenylalanine? Table 19: Schizophrenia Short-Term Trials Difference drug minus placebo in least-squares mean change from baseline. Doses that are statistically significant superior to placebo. Doses that are statistically significant superior to Seroquel 50 mg BID.



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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the suspect drug. Olanzapine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get olanzapine refilled. Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Schizophrenia: Overall, there was little difference in the incidence of discontinuation due to adverse reactions 4% for Seroquel vs. 3% for placebo in a pool of controlled trials. The death rate among users of Abilify Zyprexa and Geodon was similar to that of patients who took Risperdal. WBC in the absence of other causative factors. levothroid



How should I take Seroquel?

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Seroquel is supplied for oral administration as 25 mg round, peach 50 mg round, white 100 mg round, yellow 200 mg round, white 300 mg capsule-shaped, white and 400 mg capsule-shaped, yellow tablets. There have been literature reports suggesting false positive results in urine enzyme immunoassays for methadone and tricyclic antidepressants in patients who have taken quetiapine. Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Repeated ECT treatments have been found to help improve OCD symptoms in some cases. A newer, surgical form of stimulation called deep stimulation involves implanting small electrodes into brain areas that are a part of the brain circuitry associated with OCD symptoms. You should not miss a dose of ABILIFY MAINTENA. Increase dose at weekly intervals in 200 mg per day increments using a 2 times a day regimen of extended release or a 3 times daily to 4 times daily regimen of the other formulations. HT1A receptors, and as an antagonist at serotonin 5-HT2A receptor. Quetiapine is extensively metabolized by the liver. The major metabolic pathways are sulfoxidation to the sulfoxide metabolite and oxidation to the parent acid metabolite; both metabolites are pharmacologically inactive. In vitro studies using human liver microsomes revealed that the cytochrome P450 3A4 isoenzyme is involved in the metabolism of quetiapine to its major, but inactive, sulfoxide metabolite and in the metabolism of its active metabolite N-desalkyl quetiapine. Did you take brand-name Lamictal in the past? Take with food to decrease gastrointestinal side effects. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; confusion; difficult or painful urination; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; increased saliva production or drooling; increased sweating; memory problems; menstrual changes; muscle pain, stiffness, or weakness; new or worsening mental or mood changes eg, aggressiveness, agitation, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, restlessness; numbness, burning, or tingling; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or prolonged dizziness, light-headedness, or headache; severe stomach or back pain with or without nausea or vomiting; shortness of breath; suicidal thoughts or actions; swelling of the arms, hands, legs, or feet; symptoms of high blood sugar eg, increased thirst, hunger, or urination; unusual weakness; symptoms of high prolactin levels eg, decreased sexual ability, enlarged breast size, missed menstrual period, nipple discharge; tremor; trouble concentrating, speaking, or swallowing; trouble sleeping; trouble walking or standing; uncontrollable or involuntary muscle movements eg, loss of balance, twitching of the face or tongue, uncontrollable arm or leg movements; unusual bruising or bleeding; vision changes eg, blurred vision, decreased vision. Mania with mixed features usually involves irritability, high energy, racing thoughts and speech, and overactivity or agitation. Narrator: Susie Sherrill has had success in using art as a therapy to help her clients unravel their problems. She cautions, however, that it is not a replacement for patients getting on the proper medication. canada albendazole online cheap albendazole



About abilify

Cognitive-behavioral therapy CBT: Can help the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings. What else do I need to know about antidepressant medicines? How should I receive ABILIFY MAINTENA? Monitor sedation and blood pressure. Adjust dose accordingly. If you miss a dose of olanzapine, contact your doctor right away. Inject immediately after reconstitution. Administer once monthly. Ask your health care provider any questions you may have about how to use quetiapine. shop for lanoxin



List of abilify side effects

Use risperidone regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Pediatric schizophrenia and bipolar I disorder are serious mental disorders, however, diagnosis can be challenging. For pediatric schizophrenia, symptom profiles can be variable, and for bipolar I disorder, patients may have variable patterns of periodicity of manic or mixed symptoms. It is recommended that medication therapy for pediatric schizophrenia and bipolar I disorder be initiated only after a thorough diagnostic evaluation has been performed and careful consideration given to the risks associated with medication treatment. Medication treatment for both pediatric schizophrenia and bipolar I disorder is indicated as part of a total treatment program that often includes psychological, educational and social interventions. Adverse events that were potentially dose-related with higher frequency in the 800 mg group compared to the 400 mg group included dizziness 8% vs. 15% dry mouth 4% vs. 10% and tachycardia 6% vs. 11%. People with schizophrenia often do not believe that they are ill or that they need treatment. Get emergency medical help if you have signs of an allergic reaction to Seroquel: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. In an acute 8-week Seroquel XR trial in children and adolescents 10-17 years of age with bipolar depression, in which efficacy was not established, the most commonly observed adverse reactions associated with the use of Seroquel XR incidence of 5% or greater and at least twice that for placebo were dizziness 7% diarrhea 5% fatigue 5% and nausea 5%. ABILIFY have not been conducted in pregnant women. The thing is, when my son isn't ticked off at the world, he's funny, insightful, and brilliant. He really is a genius--for real. However, about 6 months ago the testosterone kicked-in. Between wacky hormones and rivalry with an older brother, his raging and violence has picked up to the extreme. Now it's problems at school, home, and everywhere we go--that is, when he's not barricaded in his room and being anti-social. abov.info endometrin



Seroquel can be taken with or without food

Interactions. Phenylalanine can cause tardive dyskinesia in people taking antipsychotic medicines. Do not attempt to split the tablet. Use olanzapine as directed by your doctor. Check the label on the medicine for exact dosing instructions. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorder in these neonates. These complications have varied in severity; while in some cases symptoms have been self-limited, in other cases neonates have required intensive care unit support and prolonged hospitalization. Schwartz R, Avello E, Palisson F "Lamotrigine-induced toxic epidermal necrolysis treated with intravenous immunoglobulin and amniotic membranes. Bipolar disorder usually involves recurrences of mixed, manic, or depressed phases of illness. Therefore, it is usually recommended that be continued in an ongoing fashion after an acute episode resolves in order to prevent relapses. This list is not complete and many other drugs can interact with quetiapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you. It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased. But since what I was told today, he is to take one full mg 3 times a day to balance his system. This will mean he will have to get a dose in school and I'm not sure how that is going to play out. Maybe his system will accept the more frequent doses and he won't get drosey in the middle of the day at school, but we will have to see. I will have to ask one of his doctors at his next appointment about Abilify. I want to make sure he is on the best meds. for him that will help school and home and give me my little boy back. Continued How Is Delusional Disorder Treated? ABILIFY aripiprazole are at an increased risk of death compared to placebo. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away. Boot B "Recurrent lamotrigine-induced aseptic meningitis. If satisfactory response not achieved, measure plasma levels to determine if in therapeutic range.



How should I store ABILIFY?

Individual psychotherapy: Can help the person recognize and correct the underlying thinking that has become distorted. Table 14: Adverse Reactions in a 3-Week Placebo-Controlled Clinical Trial for the Treatment of Bipolar Mania in Children and Adolescent Patients Somnolence combines adverse reactions terms somnolence and sedation. Tachycardia combines adverse reaction terms tachycardia and sinus tachycardia. Delusions: These are false beliefs that someone refuses to give up, even in the face of facts. In case of acute overdosage, establish and maintain an airway and ensure adequate oxygenation and ventilation. Gastric lavage after intubation, if patient is unconscious and administration of activated charcoal together with a laxative should be considered. The possibility of obtundation, seizure or dystonic reaction of the head and neck following overdose may create a risk of aspiration with induced emesis. Cardiovascular monitoring should commence immediately and should include continuous electrocardiographic monitoring to detect possible arrhythmias. If antiarrhythmic therapy is administered, disopyramide, procainamide and quinidine carry a theoretical hazard of additive QT-prolonging effects when administered in patients with acute overdosage of Seroquel. Similarly it is reasonable to expect that the alpha-adrenergic-blocking properties of bretylium might be additive to those of quetiapine, resulting in problematic hypotension. All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. Although there are no lab tests to specifically diagnose delusional disorder, the doctor might use various diagnostic tests, such as imaging studies or tests, to rule out physical illness as the cause of the symptoms. Figure 15. Do not touch the spike tip of the adapter at any time. High blood sugar can happen if you have diabetes already or if you have never had diabetes. AUC after the same dose as a tablet. Take risperidone exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. So I stopped taking it and I've been severely depressed the majority of the years since. Abilify seems like a wonder drug but I'm scared of side effects. danocrine



Highlights for abilify

Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. During pregnancy, this medication should be used only when clearly needed. Mixed features refers to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. Oxford Health Foundation Trust, tells WebMD. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessness hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and nonpsychiatric. In a dose response analysis, somnolence including sedation was the only adverse reaction determined to have a dose response relationship in adult patients. ABILIFY may affect the way other medicines work, and other medicines may affect how ABILIFY works. Do not start or stop any medicines while taking ABILIFY without talking to your healthcare provider first. Dizziness; drowsiness; headache; nausea; vomiting. Family and caregivers must closely watch patients who take quetiapine. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor. Do not open the blister until ready to administer. Know all of the medicines that you or your family member takes. Taking Risperdal with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. Because the risk of relapse of illness is higher when antipsychotic drugs are taken irregularly or discontinued, it is important that people with schizophrenia follow a treatment plan developed in collaboration with their doctors and with their families. The treatment plan will involve taking the in the correct amount and at the times recommended, attending follow-up appointments, and following other treatment recommendations. cheap kenalog online free shipping



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Table 4 shows the percentage of adult patients with changes in total cholesterol, triglycerides, LDL-cholesterol and HDL-cholesterol from baseline by indication in clinical trials with Seroquel. Metabolic and Nutritional System: Infrequent: weight loss, alkaline phosphatase increased, hyperlipidemia, alcohol intolerance, dehydration, hyperglycemia, creatinine increased, hypoglycemia; Rare: glycosuria, gout, hand edema, hypokalemia, water intoxication. Injection site reactions reported with the aripiprazole extended-release IM formulation MaintenaR included pain, erythema, induration, pruritus, swelling, rash, inflammation, and hemorrhage. In both studies, Seroquel was superior to placebo in increasing the time to recurrence of any mood event. The treatment effect was present for increasing time to recurrence of both manic and depressed episodes. The effect of Seroquel was independent of any specific subgroup assigned mood stabilizer, sex, age, race, most recent bipolar episode, or rapid cycling course. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Abilify only for the indication prescribed. PANSS scores range from 30 to 210. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your or local waste disposal company. The dosage is based on your medical condition, response to treatment, and other you may be taking. Examination of population subsets race, gender, and age did not reveal any differential responsiveness on the basis of race or gender, with an apparently greater effect in patients under the age of 40 years compared to those older than 40. The clinical significance of this finding is unknown. travatan pills order now online



Before taking abilify

Your healthcare provider may do blood tests to check your prolactin levels. Drowsiness, confusion, and dizziness can increase the risk of falling. Tell your healthcare provider if you are having a urine drug screen because Seroquel may affect your test results. Tell those giving the test that you are taking Seroquel. Antidepressant medicines have other side effects. Talk to the healthcare provider about the side effects of the medicine prescribed for you or your family member. Seroquel use was associated with a mean increase in heart rate, assessed by ECG, of 7 beats per minute compared to a mean increase of 1 beat per minute among placebo patients. Abilify for treatment resistant depression 1mg a day because 2mg gave me panic attacks, so my pdoc advised I just split the pills in half, which dramatically relieved the issue and as far as my depression goes, it's been a godsend! Environmental Factors: There are environmental stressors that can trigger OCD in people with a tendency toward developing the condition. Certain environmental factors may also cause a worsening of symptoms. Olanzapine is to be used only by the patient for whom it is prescribed. Do not share it with other people. Table 26 the primary outcome measure of the study. Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness. Can Delusional Disorder Be Prevented? Even with continued treatment, some patients experience relapses. The risk of developing tardive dyskinesia and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase. However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses or may even arise after discontinuation of treatment. galantamine



Abilify ingredients

Nov. 30, 2009 -- The drug may help ease the symptoms of irritability related to in children and adolescents. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Seroquel compared to 4% of placebo patients. Sachs B, Ronnau AC, Ruzicka T, Gleichmann E, Schuppe HC "Lamotrigine and toxic epidermal necrolysis. Urogenital System: Infrequent: dysmenorrheal, vaginitis, urinary incontinence, metrorrhagia, impotence, dysuria, vaginal moniliasis, abnormal ejaculation, cystitis, urinary frequency, amenorrhea, female lactation, leukorrhea, vaginal hemorrhage, vulvovaginitis, orchitis; gynecomastia, nocturia, polyuria, acute kidney failure. We've had the police at our home several times over the last 4 months. OCD. The disorder usually first appears in childhood, adolescence, or early adulthood. It occurs about equally in men and women, and affects people of all races and socioeconomic backgrounds. How Is OCD Diagnosed? The most commonly reported adverse reactions in clinical trials of the extended-release IM formulation included increased weight, akathisia, injection site pain, and sedation. Quetiapine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get quetiapine refilled. Day 1: 25 mg twice daily.



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While it is crucial that women continue treatment during pregnancy, risks to the baby are also considered. So treatment regimens may change to minimize risk. The 25 mg tablets contain red ferric oxide and yellow ferric oxide and the 100 mg and 400 mg tablets contain only yellow ferric oxide. Aripiprazole accumulation is predictable from single-dose pharmacokinetics. Four methods were used to measure EPS: 1 Simpson-Angus total score mean change from baseline which evaluates Parkinsonism and akathisia, 2 Barnes Akathisia Rating Scale BARS Global Assessment Score, 3 incidence of spontaneous complaints of EPS akathisia, akinesia, cogwheel rigidity, extrapyramidal syndrome, hypertonia, hypokinesia, neck rigidity, and tremor and 4 use of anticholinergic medications to treat emergent EPS. This can help you to think clearly and take part in everyday life. How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member? Although the ritual may temporarily alleviate anxiety, the person must perform the ritual again when the obsessive thoughts return. This OCD cycle can progress to the point of taking up hours of the person's day and significantly interfering with normal activities. People with OCD may be aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop them. CI: unadjusted confidence interval. cheap neurontin from canada online



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Global Impression-Improvement CGI-I scale. Brief psychotic disorder is rare. These symptoms have varied in severity. meclizine

Common side effects of abilify

It is 83% bound to plasma proteins at therapeutic concentrations. In vitro, quetiapine did not affect the binding of warfarin or diazepam to human serum albumin. In turn, neither warfarin nor diazepam altered the binding of quetiapine. In pediatric patients 13 to 17 years of age, extrapyramidal disorder, somnolence, and tremor displayed possible dose response relationship in patients with schizophrenia, while extrapyramidal disorder, somnolence, and akathisia displayed possible dose response relationship in pediatric patients with bipolar mania. Brief psychotic disorder with obvious stressor also called brief reactive psychosis: This type happens shortly after a trauma or major stress, such as the death of a loved one, an accident, assault, or a natural disaster. It's usually a reaction to a very disturbing event.

Do not exercise too much

ABILIFY-treated patients was 3% vs. 9% for placebo. Abilify, and colleagues say irritability is a common symptom of autism and is often difficult to manage. Lens changes have also been observed in adults, children and adolescents during long-term Seroquel treatment, but a causal relationship to Seroquel use has not been established. Nevertheless, the possibility of lenticular changes cannot be excluded at this time. Therefore, examination of the lens by methods adequate to detect cataract formation, such as slit lamp exam or other appropriately sensitive methods, is recommended at initiation of treatment or shortly thereafter, and at 6-month intervals during chronic treatment.

I'll try to keep this brief

This medicine is a white, round tablet imprinted with "TV" and "7582". Esfahani FE, Dasheiff RM "Anemia associated with lamotrigine. Your healthcare provider may do blood tests to check your thyroid hormone level. You should not take this medicine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline.

Quetiapine is an atypical antipsychotic. Exactly how it works is not known. It is thought to affect certain substances in the brain. ABILIFY aripiprazole. Extremely high blood sugar can lead to coma or death. Use quetiapine with caution in the ELDERLY; they may be more sensitive to its effects, especially uncontrolled muscle movements. Keep Seroquel and all medicines out of the reach of children. Contact your doctor or health care provider right away if any of these apply to you. buy terazosin online singapore

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