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CAELYX pharmacokinetics determined in a small number of ovarian cancer patients with elevated total bilirubin levels do not differ from patients with normal total bilirubin; however, until further experience is gained, the CAELYX dosage in patients with impaired hepatic function should be reduced based on the experience from the breast and ovarian clinical trial program as follows generic cytotec pill Larger cardiovascular outcome studies are required to definitively demonstrate a beneficial effect of metformin on cardiovascular disease