Veozah vs Lynkuet: Which Hot Flash Treatment Should You Ask Your Doctor About? (2026)
The short answer:
No study has ever tested the two drugs against each other — there’s no single winner. Both are FDA-approved, non-hormonal daily pills for moderate-to-severe hot flashes and night sweats from menopause. Veozah (approved 2023) blocks one brain signal, has the longer track record, but carries the FDA’s most serious safety label — a “boxed warning” for rare liver injury — and needs about 6 liver blood tests in year one. Lynkuet (approved October 2025) blocks two brain signals, has stronger sleep data, a lighter non-boxed liver warning with only ~2 liver tests in year one— but it can cause next-day drowsiness, and it’s brand new.
Disclosure: We may earn a commission if you book a visit through some of the provider links on this page, at no extra cost to you. No drug maker paid for this comparison. This is educational information, not medical advice. Veozah and Lynkuet are prescription medicines — decisions about them should be made with a licensed clinician.
One honest note up front: These two drugs are not hormones, and they’re not HRT. If you can safely take estrogen, hormone therapy usually works better for hot flashes and costs far less — generic HRT can run $15–$60/month vs. ~$600+ for either of these. See our Veozah vs HRT guide and HRT provider comparison. If hormones are off the table for you, keep reading — this is your page.
Quick verdict
| Factor | Veozah (fezolinetant) | Lynkuet (elinzanetant) |
|---|---|---|
| Generic name | Fezolinetant | Elinzanetant |
| FDA approved for | Moderate-to-severe hot flashes from menopause | Moderate-to-severe hot flashes from menopause |
| How it works | Blocks one brain signal (NK3) | Blocks two brain signals (NK1 + NK3) |
| Approved | May 2023 (longer track record) | October 2025 (brand new) |
| Dose | One 45 mg tablet daily, any time | Two 60 mg capsules at bedtime |
| Biggest catch | Boxed liver warning; ~6 liver tests in year 1 | Can cause next-day drowsiness; brand new |
| Cash price (no insurance) | ~$550–$780/month | ~$625/month |
| With commercial insurance + savings card | As low as ~$30/month | As low as ~$25/month (via BlinkRx) |
| Ask your doctor about it first if… | You want the longer track record and don’t mind regular lab checks | Bad sleep is your worst symptom and you want lighter lab monitoring |
The most important sentence on this page:No one has ever run a study putting Veozah and Lynkuet head-to-head. Anyone who tells you one flatly “beats” the other is guessing. The smart move isn’t picking a winner — it’s matching the right drug to your body, your sleep, and your medicine list.
Veozah vs Lynkuet: what’s the real difference?
Both are prescription, non-hormonal pills for moderate-to-severe hot flashes from menopause, but they are not the same drug. The one-sentence version: Veozah turns down one thermostat switch in the brain; Lynkuet turns down two — and that second switch is tied to sleep.
Why the brain matters here (simplified):
During menopause, falling estrogen throws off nerve cells deep in your brain that act like a thermostat. A brain chemical called neurokinin B becomes part of the misfire — triggering hot flashes, night sweats, and 3 a.m. wake-ups. Both drugs calm that thermostat down via neurokinin receptors.
Veozah blocks NK3 only
Think of it as turning down one switch — the main hot-flash switch. One 45 mg tablet, any time of day. Flexible. Has been used in the U.S. since 2023.
Lynkuet blocks NK3 and NK1
It turns down the hot-flash switch plus a second one tied to sleep. Two 60 mg capsules at bedtime — every night. Lynkuet’s trials measured sleep as a real outcome. Available in the U.S. since late 2025.
The five differences that actually change a decision:
- Liver monitoring. Veozah has a boxed warning and needs ~6 liver blood tests in year one. Lynkuet needs ~2. This is the biggest one — full breakdown below.
- Sleep. Lynkuet’s trials measured sleep and showed it improved. Veozah mainly tackles the hot flashes themselves.
- Track record. Veozah has been used since 2023. Lynkuet is months old.
- Daytime drowsiness. Lynkuet can leave some people groggy the next morning, and its label says so. Veozah doesn’t carry that specific warning.
- Timing. Veozah: any time of day. Lynkuet: at bedtime — every night.
Cost, by the way, is not one of the big differences. They’re close. Real numbers are in the cost section below.
First, the honest part: should you even be choosing between these two?
These drugs are non-hormonal — which is exactly why they exist. But if you can safely take hormones, hormone therapy usually works better for hot flashes and costs far less.
About 9% of U.S. women have a true medical reason they can’t take hormone therapy — and that doesn’t count the many women who simply don’t want hormones, or those who’ve been through breast cancer and have been told estrogen is off-limits. That’s the gap Veozah and Lynkuet fill. They’re the first FDA-approved drugs built specifically to target the brain pathway behind hot flashes — instead of being borrowed from another condition.
Close this page if…
You can safely take estrogen and want the most effective, cheapest option. Look at HRT first. Generic options run a fraction of either drug. More in our HRT cost guide.
Stay and keep reading if…
Hormones are off the table — breast cancer history, clot risk, a doctor said no, or it’s just a hard no for you. Veozah vs Lynkuet is exactly the right conversation.
Not sure if a non-hormonal option fits your health history? Talk with a Midi menopause clinician who focuses on midlife women’s health — not a general line.
Check your fit with Midi →Affiliate link
Veozah vs Lynkuet: the full FDA-label comparison
Everything below comes straight from the FDA approval documents, the official prescribing information, and the makers’ own savings pages.
| What you’re comparing | Veozah (fezolinetant) | Lynkuet (elinzanetant) | Why it matters |
|---|---|---|---|
| Maker | Astellas | Bayer | — |
| FDA approved | May 12, 2023 | October 24, 2025 | Veozah has 2+ years of real-world use; Lynkuet is new. |
| Approved use (U.S.) | Moderate-to-severe hot flashes from menopause | Moderate-to-severe hot flashes from menopause | Same U.S. job. |
| Hormone? | No — blocks NK3 brain signal | No — blocks NK1 + NK3 brain signals | Both are for people avoiding hormones. |
| Dose & timing | One 45 mg tablet daily, any time, with or without food | Two 60 mg capsules (120 mg) at bedtime, swallowed whole | Lynkuet is a strict bedtime routine. |
| Liver warning | ⚠️ Boxed warning (FDA’s most serious) for rare but serious liver injury | Liver-enzyme warning — NOT boxed; FDA found it less likely to harm the liver than Veozah | The single biggest safety difference. |
| Liver blood tests, year 1 | ~6 (before starting + monthly for 3 months + months 6 & 9) | ~2 (before starting + one recheck at 3 months) | Veozah means more lab visits and more waiting on results. |
| Next-day drowsiness | Not a labeled warning | ⚠️ Labeled warning for daytime sleepiness; don’t drive until you know how it affects you | Matters a lot if you drive early or have a safety-sensitive job. |
| “Do not use” (contraindications) | Cirrhosis; severe kidney disease; CYP1A2 blockers (e.g., fluvoxamine) | Pregnancy | These are hard “no” rules; your history can trigger one. |
| Use with caution | Liver or kidney problems short of cirrhosis | Severe kidney or liver disease (not recommended); avoid strong CYP3A4 blockers + grapefruit; caution with seizure history | A clinician sorts this out for your case. |
| Common side effects | Abdominal pain, diarrhea, trouble sleeping, back pain, hot flushes, raised liver enzymes | Headache, tiredness, dizziness, drowsiness; also abdominal pain, rash, diarrhea, muscle spasms | Different profiles — don’t compare across separate trials. |
| Treats vaginal dryness? | No | No | Neither helps below the belt. |
| Cash price (no insurance) | ~$550–$780/month (no generic) | ~$625/month (no generic) | Close. Cost isn’t the main divider. |
| With commercial insurance + savings card | As low as $0 first month, then ~$30/refill | As low as ~$25/month (via BlinkRx) | Either can be affordable if you’re commercially insured and eligible. |
| Breast-cancer / endocrine-therapy use | Not well studied in this group | Strong trial evidence + EU-approved — but NOT a U.S.-approved use yet | A real, important nuance (full section below). |
CYP1A2 / CYP3A4 are liver pathways that break down medicines. Each drug can clash with certain other drugs — and Lynkuet can clash with grapefruit. A clinician or pharmacist should check your full list. Sources: Veozah prescribing information and Lynkuet prescribing information.
How well do Veozah and Lynkuet work?
Both significantly cut moderate-to-severe hot flashes in their trials, and both cleared the bar doctors consider clinically meaningful — about two fewer hot flashes a day than a placebo. But these were separate studies, so the numbers can’t crown a winner.
Veozah (SKYLIGHT 1 & 2)
- About 2 to 2.6 fewer moderate-to-severe hot flashes per day vs placebo by week 12
- 57% (SKYLIGHT 1) and 61% (SKYLIGHT 2) had hot flashes cut at least in half by 3 months
- Relief often began within the first week
Lynkuet (OASIS 1, 2 & 3)
- About 3 fewer hot flashes per day vs placebo by week 12 (−3.22 and −3.24 in OASIS 1 & 2)
- In OASIS 3 (52 weeks): daily hot flashes fell from ~6.7 to 1.6/day on Lynkuet vs ~3.4/day on placebo — roughly a 74% drop
- Sleep and quality-of-life scores also improved
Why you can’t call Lynkuet the stronger drug from these numbers: The studies enrolled different women, used different designs, and were never run against each other. A bigger number in a separate trial is not proof of superiority — it’s just a different study. Both clearly beat placebo. What is fair to say: Lynkuet’s trials actually measured sleepas a goal, and Veozah’s did not in the same way.
How fast do they start working?
Both start working fast — within about a week. In the trials for both drugs, hot flashes began dropping by week 1, with the full effect measured at weeks 4 and 12. You shouldn’t have to wait months to know if your drug is helping. A good rule from the trials: by week 4 to 12you and your clinician should be able to tell whether it’s doing its job. If it isn’t, that’s the moment to talk about adjusting or switching.
Which is better for sleep and night sweats?
Both drugs reduce hot flashes and night sweats. Lynkuet has the stronger sleep-data case: its trials measured sleep disturbance directly and showed it improved, and it’s taken at bedtime. That doesn’t prove Lynkuet beats Veozah on sleep head-to-head — but if broken sleep is your worst symptom, Lynkuet is the one to ask about first.
Worst symptom = sleep wrecked
Ask about Lynkuet first. Built and studied with sleep in mind; taken at bedtime; OASIS trials tracked sleep quality as a real outcome.
Worst symptom = daytime hot flashes, sleep is OK
Ask about Veozah. Flexible timing, no daytime-drowsiness warning, and two-plus years of real-world use.
One honest catch: Lynkuet’s same calming, sleep-friendly effect is also why it can leave some people groggy in the morning (next section). Veozah’s flexible timing is genuinely easier to live with if your sleep is fine and you just want the hot flashes gone.
Side effects and the liver difference
Both drugs have mild, common side effects — but their labels list different ones. The big safety difference is the liver: Veozah carries the FDA’s most serious “boxed” warning for rare but serious liver injury and needs about six liver blood tests in your first year. Lynkuet has a lighter, non-boxed liver warning and needs only about two.
Veozah’s common side effects (from label)
- Abdominal pain
- Diarrhea
- Trouble sleeping (insomnia)
- Back pain
- Hot flushes
- Raised liver enzymes
Lynkuet’s common side effects (from label)
- Headache
- Tiredness
- Dizziness
- Drowsiness
- Abdominal pain
- Rash
- Diarrhea
- Muscle spasms
The liver, in plain English
| Liver factor | Veozah | Lynkuet |
|---|---|---|
| Boxed warning? | Yes — rare but serious liver injury (FDA Dec 2024) | No boxed warning |
| FDA’s read on liver risk | Real risk; benefit still outweighs it; monitor closely | Possible cases in trials, none serious (no Hy’s Law); FDA reviewers found elinzanetant “unlikely to have a hepatotoxic potential comparable to” Veozah |
| Liver tests in year 1 | ~6 | ~2 |
The blood-test calendar, side by side
| When | Veozah | Lynkuet |
|---|---|---|
| Before you start | Liver blood test required | Liver blood test required |
| Month 1 | Liver test | — |
| Month 2 | Liver test | — |
| Month 3 | Liver test | Liver test (the one recheck) |
| Month 6 | Liver test | — |
| Month 9 | Liver test | — |
| Total, year 1 | ~6 blood draws | ~2 blood draws |
How we counted: baseline + months 1, 2, 3, 6, and 9 for Veozah; baseline + 3-month recheck for Lynkuet.
Stop and call your clinician right away if you notice on either drug:
New tiredness, loss of appetite, nausea, vomiting, itching, yellowing of your skin or eyes, dark urine, pale stools, or pain in your upper-right belly.
The honest knock against Lynkuet
Lighter liver monitoring doesn’t make it the “easy” choice with no catch. Lynkuet can cause next-day drowsiness. In the OASIS trials, nervous-system effects — drowsiness, tiredness, dizziness, a spinning feeling, feeling faint — showed up in 11.9% of women on Lynkuet vs. 3.5% on placebo.A driving study found some people’s driving was affected after five days. The label says don’t drive or do anything risky until you know how it hits you.
The trade is real: Veozah asks more of your liver-test schedule; Lynkuet asks you to watch your mornings. If you drive early, run heavy machinery, or simply can’t afford to be foggy, that’s a genuine point in Veozah’s favor.
The lab work isn’t optional — it’s how either drug is used safely. A Midi clinician can order your baseline and follow-up tests.
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How do Veozah and Lynkuet interact with other medications?
The two drugs clash with different things, so your medicine list can decide the choice. A clinician or pharmacist should review your full list before you start either.
Veozah & CYP1A2
Veozah is broken down by the liver pathway CYP1A2. Certain medicines block that pathway — the antidepressant fluvoxamine is one example — and combining them with Veozah isn’t allowed.
Lynkuet & CYP3A4
Lynkuet is broken down by CYP3A4. Strong blockers + grapefruit are off-limits. With moderate blockers, the dose may be cut to one capsule. “Inducer” drugs can make Lynkuet work less well.
Bring every prescription, OTC medicine, and supplement you take — plus your grapefruit habit — to whoever writes the prescription. Drug-interaction lists change over time, so a current check beats anything you read online.
What Veozah and Lynkuet cost in 2026
Sticker prices are close. The bigger lever is insurance. Treat these as price signals, not a guaranteed bill — your exact cost shifts with your pharmacy, ZIP code, insurance, and which discount you use. See also our Veozah guide and Lynkuet guide.
| Cost question | Veozah | Lynkuet |
|---|---|---|
| Maker’s list price | ~$566.50/month (early 2025) | ~$625/month |
| Typical cash range (discount cards) | Roughly $485–$780 depending on pharmacy/coupon | Around $620 depending on pharmacy |
| Generic available? | No | No |
| With commercial insurance + savings card | $0 first month, then as low as ~$30/refill (eligibility rules apply) | As low as ~$25/month via BlinkRx (eligibility rules apply) |
| Yearly savings-card help | Up to about $4,000/year | Check current terms at lynkuet-us.com |
| Medicare / Medicaid / VA / TRICARE | Savings card NOT allowed | Savings card NOT allowed |
| If you’re uninsured | Patient-assistance program available | Patient-assistance program available (free if eligible) |
| Heads-up | Some pharmacies don’t keep it in stock | Ships through BlinkRx (mail-order pharmacy) |
- Veozah’s maker reports ~64% of U.S. commercial “covered lives” (as of mid-2024), but that includes plans requiring prior authorization or step therapy. Lynkuet is new, so coverage is still settling; expect prior authorization there too.
- The savings cards only work with commercial insurance and have eligibility rules. If you’re on Medicare or Medicaid, you can’t use the cards — but you may qualify for patient-assistance programs.
- Don’t pay sticker price without checking. Between insurance, savings cards, and assistance programs, very few people pay full cash.
Want to know your real out-of-pocket before you commit? Take the quiz to map your coverage questions → — or start a visit where a clinician can check your plan and handle prior authorization.
What if you’ve had breast cancer, or take tamoxifen, an aromatase inhibitor, or Lupron?
This is a specialist conversation, not a blog decision — but here’s the key fact: Lynkuet has strong trial evidence for women on breast-cancer endocrine therapy and is approved for that use in Europe, yet in the U.S. it’s FDA-approved for menopause hot flashes only.Veozah hasn’t been well studied in this group.
| Drug | United States | Europe (EU) |
|---|---|---|
| Lynkuet | Approved for menopause hot flashes only | Approved for menopause hot flashes and hot flashes caused by endocrine therapy for breast cancer |
| Veozah | Approved for menopause hot flashes only | No endocrine-therapy indication |
A 2025 study in the New England Journal of Medicine (OASIS-4) tested Lynkuet in women on endocrine therapy for hormone-receptor-positive breast cancer. They had fewer hot flashes, better sleep, and better quality of life than women on placebo, and about 92% of those who finished the first year chose to keep taking it for two more. Europe approved Lynkuet for that exact use. The U.S. did not — at least not yet. In the U.S., a doctor canstill prescribe it for an endocrine-therapy patient, but it’s an off-label decision that belongs with the oncologist or menopause specialist.
Smart questions to bring to your oncology or menopause clinician:
- Is a non-hormonal pill like this safe with my cancer history and current treatment?
- Does either drug interact with my cancer medicines?
- Do my liver or kidney labs rule one of them out?
- Which is more likely to be covered by my plan?
- If one doesn’t work or causes side effects, what’s the safe plan to switch?
So which one should you ask about first?
Lean toward Veozah if you want the longer track record and don’t mind regular lab checks. Lean toward Lynkuet if broken sleep is your worst symptom, you’d prefer fewer blood tests, and you’re okay with a newer drug and watching your mornings. Your medicine list can also tip the scale. None of this replaces a clinician’s call.
| If your top concern is… | Ask your doctor about… | Why |
|---|---|---|
| Sleep and night sweats wrecking you | Lynkuet | Its trials measured sleep and showed it improved; taken at bedtime. |
| The option with the longer track record | Veozah | Approved in 2023, with more real-world use behind it. |
| Avoiding the boxed liver warning and frequent labs | Lynkuet | ~2 liver tests in year 1 vs ~6, and no boxed warning. |
| Staying sharp in the morning (you drive early / safety-sensitive job) | Veozah | No daytime-drowsiness warning; flexible timing. |
| You’re pregnant or could become pregnant | Neither — talk to your doctor | Lynkuet must not be used in pregnancy; Veozah data is limited. This needs a clinician. |
| You can safely take hormones and want max relief for less money | Look at HRT first | Usually more effective and far cheaper. |
| Liver disease, kidney disease, or a long medicine list | Don’t self-pick — get screened | Both have “do not use” rules that depend on your history. |
Found your situation above?
See if Veozah or Lynkuet is right for you with a focused Midi menopause visit — a clinician who works in menopause care, not someone seeing the topic for the first time.
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How to actually get Veozah or Lynkuet
Both drugs are prescription-only and need baseline liver bloodwork, so you’ll need a clinician. A menopause-focused telehealth service can review your history, tell you if either drug fits, prescribe the right one if it does, and order the labs — often faster than waiting months for a specialist.
What to have ready before your visit:
- Every prescription and OTC medicine and supplement you take
- Your grapefruit habit (yes, really — it matters for Lynkuet)
- A one-line summary of your liver, kidney, cancer, and seizure history
- Your insurance card and pharmacy preference
That bit of prep can save weeks. The visit covers your history, a medicine check (CYP1A2 for Veozah; strong CYP3A4 + grapefruit for Lynkuet), labs, and any prior-authorization paperwork.
Why we point people to Midi for this
For this specific decision — two FDA-approved, non-hormonal drugs that need real screening and lab orders — a menopause-specialist telehealth service is the right fit. Midi Health focuses on midlife women’s health; its clinicians can evaluate symptoms and history, talk through FDA-approved treatment options, prescribe when appropriate, and order the monitoring either drug requires. A menopause specialist helped run the trials called it “a significant advance for women’s health” and “an option with rapid onset, beneficial effects, very few side effects.” See our Midi Health review.
To be clear: it’s a clinician visit, not a vending machine. A menopause-focused clinician decides whether either drug is right for you — and will tell you no if it isn’t. That’s the point.
Ready for a real answer? Check your fit with Midi →Affiliate linkCan you switch from Veozah to Lynkuet?
Yes, but it’s a clinician-managed step, not a swap you do on your own — both drugs involve liver screening and different interaction rules. People usually switch because Veozah isn’t working well enough, the side effects are rough, the liver-test schedule is a hassle, or coverage fell through. Bring these questions to your clinician: Why are we switching? What labs do I need first? Will the new drug clash with anything I take? Will insurance cover it? What symptoms should make me call you? When’s my follow-up?
Veozah vs Lynkuet: frequently asked questions
- Is Lynkuet better than Veozah?
- No study has tested them head-to-head, so neither is proven “better” overall. Lynkuet has the edge on sleep data and needs fewer liver blood tests; Veozah has the longer track record and no daytime-drowsiness warning. The right pick depends on your symptoms, your history, and your medicine list.
- Does Lynkuet have the same liver warning as Veozah?
- No. Veozah carries a boxed warning — the FDA’s most serious — for rare but serious liver injury, and needs frequent early liver tests. Lynkuet has a lighter, non-boxed liver warning; FDA reviewers found it less likely to harm the liver than Veozah, and it needs only a baseline test plus one recheck at three months. Both require bloodwork before you start.
- Are Veozah and Lynkuet hormones?
- No. Both are non-hormonal and work on brain signals that control body temperature, not on estrogen. That’s why they’re options for women who can’t or don’t want to take hormones.
- Which is cheaper, Veozah or Lynkuet?
- Cash prices are close — about $550–$780 a month for Veozah and around $625 for Lynkuet, with no generic for either. With commercial insurance and a savings card, eligible patients can pay roughly $25–$30 a month. Your real cost depends on your plan.
- Can I take Lynkuet after breast cancer?
- There’s strong trial evidence for Lynkuet in women on breast-cancer endocrine therapy, and it’s approved for that use in Europe — but in the U.S. it’s approved for menopause hot flashes only. Using it for endocrine-therapy hot flashes here is an off-label decision to make with your oncologist.
- Which is better for night sweats and sleep?
- Lynkuet has the stronger case for sleep because its trials measured sleep and it’s taken at bedtime. Both reduce night sweats. If sleep is your worst symptom, Lynkuet is the one to ask about first.
- Do I need a prescription and lab tests for either one?
- Yes. Both are prescription-only, and both require baseline liver bloodwork before you start — plus follow-up liver tests, more often for Veozah than for Lynkuet.
- Can online menopause doctors prescribe Veozah or Lynkuet?
- Yes, licensed clinicians — including menopause-focused telehealth services — can prescribe FDA-approved non-hormonal options when appropriate. Whether a specific drug is the right fit depends on your history, your state, your labs, and the clinician’s judgment.
- Is there a generic for Veozah or Lynkuet?
- Not as of 2026. Both are brand-name only, which is why cash prices are high. Drug availability can change, so it’s worth asking your pharmacist.
- Can you take Veozah and Lynkuet together?
- Do not combine Veozah and Lynkuet unless a clinician specifically tells you to. They work on overlapping brain signals, and doubling up isn’t how either is meant to be used.
How we put this comparison together
Medical and regulatory facts — FDA approval dates, warnings, dosing, contraindications, and liver-monitoring schedules — came from the FDA’s approval materials, the Veozah prescribing information, and the Lynkuet prescribing information.
The trial results came from the SKYLIGHT studies (published in The Lancet) for Veozah and the OASIS studies (published in JAMA, JAMA Internal Medicine, and the New England Journal of Medicine) for Lynkuet.
Prices and savings programs came from the manufacturers’ own pages, plus GoodRx and SingleCare — these change often, so treat them as signals.
Expert context came from named clinicians quoted in medical publications.
Last verified: . What still needs a fresh check before you rely on it: the exact price at your pharmacy, current savings-card eligibility, and any FDA label updates after this date.
Sources
- U.S. FDA — FDA Approves Novel Drug to Treat Moderate to Severe Hot Flashes (Veozah approval, May 2023)
- U.S. FDA — Boxed warning for serious liver injury with Veozah (Dec 16, 2024)
- Veozah (fezolinetant) Prescribing Information, Astellas
- Lynkuet (elinzanetant) Prescribing Information / FDA label, Bayer
- U.S. FDA — elinzanetant NDA 219469 review documents (Hy’s Law analysis; hepatotoxicity comparison)
- JAMA / JAMA Internal Medicine — OASIS 1, 2, and 3 trial results
- New England Journal of Medicine — OASIS-4 (Lynkuet in breast-cancer endocrine therapy)
- The Lancet — SKYLIGHT 1 and 2 trial results (Veozah)
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