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Date: Patient Name: DOB: Address: City: State: Phone: Allergies: Call When Ready Text Message When Ready Delivery Mail Out Acyclovir 5%/Lidocaine HCl 5%/DeoxyDGlucose 2% Vaginal Gel (Color) (circle
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Wash your hands with soap and water before handling the medication.
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Open the package of acyclovir 5% lidocaine HCl 5% deoxy-D-glucose carefully, taking care not to touch the tip of the tube.
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Acyclovir 5lidocaine hcl 5deoxy-d-glucose is a medication that combines acyclovir, lidocaine HCl, and deoxy-D-glucose for various medical purposes.
Healthcare professionals or pharmacists may be required to file acyclovir 5lidocaine hcl 5deoxy-d-glucose for patient records or regulatory purposes.
Acyclovir 5lidocaine hcl 5deoxy-d-glucose should be filled out according to the specific instructions provided by the healthcare provider or regulatory agency.
The purpose of acyclovir 5lidocaine hcl 5deoxy-d-glucose is to provide medical treatment or symptom relief for certain conditions or ailments.
Information such as dosage, administration route, patient's name, medical history, and adverse reactions must be reported on acyclovir 5lidocaine hcl 5deoxy-d-glucose.
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