ABACAVIR SULFATE, LAMIVUDINE AND ZIDOVUDINE (Page 6 of 7)

13.2 Animal Toxicology and/or Pharmacology

Myocardial degeneration was found in mice and rats following administration of abacavir for 2 years. The systemic exposures were equivalent to 7 to 24 times the expected systemic exposure in humans at a dose of 600 mg. The clinical relevance of this finding has not been determined.

14 CLINICAL STUDIES

The following trial was conducted with the individual components of abacavir, lamivudine and zidovudine tablet [see CLINICAL PHARMACOLOGY (12.3)].

CNA3005 was a multicenter, double-blind, controlled trial in which 562 HIV-1-infected, therapy-naive adults were randomized to receive either ZIAGEN® (300 mg twice daily) plus COMBIVIR® (lamivudine 150 mg/zidovudine 300 mg twice daily), or indinavir (800 mg 3 times a day) plus COMBIVIR® twice daily. The trial was stratified at randomization by pre-entry plasma HIV-1 RNA 10,000 to 100,000 copies per mL and plasma HIV-1 RNA greater than 100,000 copies per mL. Trial participants were male (87%), Caucasian (73%), black (15%), and Hispanic (9%). At baseline the median age was 36 years,; the median pretreatment CD4+ cell count was 360 cells per mm3 , and median plasma HIV-1 RNA was 4.8 log10 copies per mL. Proportions of subjects with plasma HIV-1 RNA less than 400 copies per mL (using Roche AMPLICOR HIV-1 MONITOR® Test) through 48 weeks of treatment are summarized in Table 5.

Table 5. Outcomes of Randomized Treatment Through Week 48 (CNA3005)
Outcome ZIAGEN ® plus Lamivudine / Zidovudine ( n = 262 ) Indinavir plus Lamivudine / Zidovudine ( n = 265 )
*
Subjects achieved and maintained confirmed HIV-1 RNA less than 400 copies/mL.
Includes viral rebound and failure to achieve confirmed less than 400 copies/mL by Week 48.
Includes consent withdrawn, lost to follow-up, protocol violations, those with missing data, clinical progression, and other.
Responder * 49% 50%
Virologic failure 31% 28%
Discontinued due to adverse reactions 10% 12%
Discontinued due to other reasons 11% 10%

Treatment response by plasma HIV-1 RNA strata is shown in Table 6.

Table 6. Proportions of Responders through Week 48 by Screening Plasma HIV-1 RNA Levels (CNA3005)
Screening HIV 1 RNA ( copies / mL ) ZIAGEN ® plus Lamivudine / Zidovudine ( n = 262 ) Indinavir plus Lamivudine / Zidovudine ( n = 265 )
< 400 copies / mL n < 400 copies / mL n
≥10,000 -≤100,000 50% 166 48% 165
>100,000 48% 96 52% 100

In subjects with baseline viral load greater than 100,000 copies per mL, percentages of subjects with HIV-1 RNA levels less than 50 copies per mL were 31% in the group receiving abacavir vs. 45% in the group receiving indinavir.

Through Week 48, an overall mean increase in CD4+ cell count of about 150 cells per mm3 was observed in both treatment arms. Through Week 48, 9 subjects (3.4%) in the group receiving abacavir (6 CDC classification C events and 3 deaths) and 3 subjects (1.5%) in the group receiving indinavir (2 CDC classification C events and 1 death) experienced clinical disease progression.

16 HOW SUPPLIED/STORAGE AND HANDLING

Abacavir, lamivudine and zidovudine is available as tablets. Each tablet contains 300 mg of abacavir as abacavir sulfate, 150 mg of lamivudine, and 300 mg of zidovudine. The tablets are blue-green colored, oval shaped, biconvex, film-coated, debossed with “LU” on one side and “N51” on the other side. They are packaged as follows:

Bottles of 60 Tablets NDC 68180-286-07

Bottles of 100 Tablets NDC 68180-286-01

Bottles of 500 Tablets NDC 68180-286-02

Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].

17 PATIENT COUNSELING INFORMATION

Advise the patient to read the FDA-approved patient labeling (Medication Guide).

Hypersensitivity Reaction

Inform patients:

  • that a Medication Guide and Warning Card summarizing the symptoms of the abacavir hypersensitivity reaction and other product information will be dispensed by the pharmacist with each new prescription and refill of abacavir, lamivudine and zidovudine tablet, and instruct the patient to read the Medication Guide and Warning Card every time to obtain any new information that may be present about abacavir, lamivudine and zidovudine tablets. The complete text of the Medication Guide is reprinted at the end of this document.
  • to carry the Warning Card with them.
  • how to identify a hypersensitivity reaction [see WARNINGS AND PRECAUTIONS (5.1), MEDICATION GUIDE].
  • that if they develop symptoms consistent with a hypersensitivity reaction they should call their healthcare provider right away to determine if they should stop taking abacavir, lamivudine and zidovudine tablet.
  • that a hypersensitivity reaction can worsen and lead to hospitalization or death if abacavir, lamivudine and zidovudine tablet is not immediately discontinued.
  • to not restart abacavir, lamivudine and zidovudine tablet or any other abacavir-containing product following a hypersensitivity reaction because more severe symptoms can occur within hours and may include life-threatening hypotension and death.
  • that a hypersensitivity reaction is usually reversible if it is detected promptly and abacavir, lamivudine and zidovudine tablet is stopped right away.
  • that if they have interrupted abacavir, lamivudine and zidovudine tablet for reasons other than symptoms of hypersensitivity (for example, those who have an interruption in drug supply), a serious or fatal hypersensitivity reaction may occur with reintroduction of abacavir.
  • to not restart abacavir, lamivudine and zidovudine tablet or any other abacavir-containing product without medical consultation and only if medical care can be readily accessed by the patient or others.

Related Products that are Not Recommended

Inform patients that they should not take abacavir, lamivudine and zidovudine tablet with ATRIPLA®, COMBIVIR®, COMPLERA® , DUTREBIS , EMTRIVA® , EPIVIR® , EPIVIR-HBV® , EPZICOM® , RETROVIR® , STRIBILD® , TRIUMEQ® , TRUVADA® , or ZIAGEN®.

Neutropenia and Anemia

Inform patients that the important toxicities associated with zidovudine are neutropenia and/or anemia. Inform them of the extreme importance of having their blood counts followed closely while on therapy, especially for patients with advanced HIV-1 disease [see BOXED WARNING, WARNINGS AND PRECAUTIONS (5.2)].

Myopathy

Inform patients that myopathy and myositis with pathological changes, similar to that produced by HIV-1 disease, have been associated with prolonged use of zidovudine [see WARNINGS AND PRECAUTIONS (5.3)].

Lactic Acidosis/Hepatomegaly

Inform patients that some HIV medicines, including abacavir, lamivudine and zidovudine tablets, can cause a rare, but serious condition called lactic acidosis with liver enlargement (hepatomegaly) [see WARNINGS AND PRECAUTIONS (5.4)].

Patients with Hepatitis B or C Co-infection

Advise patients co-infected with HIV-1 and HBV that worsening of liver disease has occurred in some cases when treatment with lamivudine was discontinued. Advise patients to discuss any changes in regimen with their physician [see WARNINGS AND PRECAUTIONS (5.5)].

Inform patients with HIV-1/HCV co-infection that hepatic decompensation (some fatal) has occurred in HIV-1/HCV co-infected patients receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin [see WARNINGS AND PRECAUTIONS (5.6)].

Immune Reconstitution Syndrome

In some patients with advanced HIV infection, signs and symptoms of inflammation from previous infections may occur soon after anti-HIV treatment is started. It is believed that these symptoms are due to an improvement in the body’s immune response, enabling the body to fight infections that may have been present with no obvious symptoms. Advise patients to inform their healthcare provider immediately of any symptoms of infection [see WARNINGS AND PRECAUTIONS (5.7)].

Redistribution/Accumulation of Body Fat

Inform patients that redistribution or accumulation of body fat may occur in patients receiving antiretroviral therapy and that the cause and long-term health effects of these conditions are not known at this time [see WARNINGS AND PRECAUTIONS (5.8)].

Information about HIV-1 Infection

Abacavir, lamivudine and zidovudine tablet is not a cure for HIV-1 infection and patients may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. Patients must remain on continuous HIV therapy to control HIV-1 infection and decrease HIV-related illness. Inform patients that sustained decreases in plasma HIV RNA have been associated with a reduced risk of progression to AIDS and death.

Advise patients to remain under the care of a physician when using abacavir, lamivudine and zidovudine tablets.

Advise patients to take all HIV medications exactly as prescribed.

Advise patients to avoid doing things that can spread HIV-1 infection to others.

Advise patients not to re-use or share needles or other injection equipment.

Advise patients not to share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.

Advise patients to always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

Female patients should be advised not to breastfeed. Mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk.

Instruct patients that if they miss a dose, they should take it as soon as they remember. If they do not remember until it is time for the next dose, they should be instructed to skip the missed dose and go back to the regular schedule. Patients should not double their next dose or take more than the prescribed dose.

Instruct patients to read the Medication Guide before starting abacavir, lamivudine and zidovudine tablets and to reread it each time the prescription is renewed. Instruct patients to inform their physician or pharmacist if they develop any unusual symptom, or if any known symptom persists or worsens.

The brands listed are trademarks of their respective owners and are not trademarks of Lupin Pharmaceuticals, Inc. The makers of these brands are not affiliated with and do not endorse Lupin Pharmaceuticals, Inc. or its products.

Manufactured for:

Lupin Pharmaceuticals, Inc.

Baltimore, Maryland 21202

United States

Manufactured by:

Lupin Limited

Pithampur (M.P.) — 454 775

India

Revised: February 2016

MEDICATION GUIDE

Abacavir, Lamivudine and Zidovudine Tablets

(a-BAK-a-vir , la-MIV-ue-deen, zye-DOE-vue-deen)

What is the most important information I should know about abacavir, lamivudine and zidovudine tablets?

Abacavir, lamivudine and zidovudine tablets can cause serious side effects, including:

  • Serious allergic reactions (hypersensitivity reaction) that can cause death have happened with abacavir, lamivudine and zidovudine tablets and other abacavir-containing products. Your risk of this allergic reaction is much higher if you have a gene variation called HLA-B*5701. Your healthcare provider can determine with a blood test if you have this gene variation.

If you get a symptom from 2 or more of the following groups while taking abacavir, lamivudine and zidovudine tablets, call your healthcare provider right away to find out if you should stop taking abacavir, lamivudine and zidovudine tablets.

Symptom ( s )
Group 1 Fever
Group 2 Rash
Group 3 Nausea , vomiting , diarrhea , abdominal ( stomach area ) pain
Group 4 Generally ill feeling , extreme tiredness , or achiness
Group 5 Shortness of breath , cough , sore throat

A list of these symptoms is on the Warning Card your pharmacist gives you. Carry this Warning Card with you at all times.

If you stop abacavir, lamivudine and zidovudine tablets because of an allergic reaction, never take abacavir, lamivudine and zidovudine tablets or any other abacavir-containing medicine (EPZICOM® , TRIUMEQ® , or ZIAGEN®) again.

  • If you take abacavir, lamivudine and zidovudine tablets or any other abacavir-containing medicine again after you have had an allergic reaction, within hours you may get life-threatening symptoms that may include very low blood pressure or death.
  • If you stop abacavir, lamivudine and zidovudine tablets for any other reason, even for a few days, and you are not allergic to abacavir, lamivudine and zidovudine tablets, talk with your healthcare provider before taking it again. Taking abacavir, lamivudine and zidovudine tablets again can cause a serious allergic or life-threatening reaction, even if you never had an allergic reaction to it before.

If your healthcare provider tells you that you can take abacavir, lamivudine and zidovudine tablets again, start taking it when you are around medical help or people who can call a healthcare provider if you need one.

  • Blood problems. Zidovudine (RETROVIR®), one of the medicines in abacavir, lamivudine and zidovudine tablets., can cause serious blood cell problems. These include reduced numbers of white blood cells (neutropenia) and extremely reduced numbers of red blood cells (anemia). These blood cell problems are especially likely to happen in people with advanced human immunodeficiency virus type 1 (HIV-1) disease or AIDS. Your healthcare provider should check your blood cell counts regularly during treatment with abacavir, lamivudine and zidovudine tablets.
  • Muscle pain or weakness (myopathy) can happen during treatment with abacavir, lamivudine and zidovudine tablets Zidovudine (RETROVIR®), one of the medicines in abacavir, lamivudine and zidovudine tablets, can cause muscle pain or weakness when used for a long time.
  • Build-up of acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take abacavir, lamivudine and zidovudine tablets. Lactic acidosis is a serious medical emergency that can cause death. Call your healthcare provider right away if you get any of the following symptoms that could be signs of lactic acidosis:
    • feel very weak or tired
    • unusual (not normal) muscle pain
    • trouble breathing
    • stomach pain with nausea and vomiting
    • feel cold, especially in your arms and legs
    • feel dizzy or light-headed
    • have a fast or irregular heartbeat
  • Serious liver problems can happen in people who take abacavir, lamivudine and zidovudine tablets. In some cases, these serious liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:
    • your skin or the white part of your eyes turns yellow (jaundice)
    • dark or “tea-colored” urine
    • light colored stools (bowel movements)
    • loss of appetite for several days or longer
    • nausea
    • pain, aching, or tenderness on the right side of your stomach area

You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking nucleoside analogue medicines for a long time.

  • Worsening of hepatitis B virus in people who have HIV-1 infection. If you have HIV-1 and hepatitis B virus (HBV) infection, your HBV may get worse (flare-up) if you stop taking abacavir, lamivudine and zidovudine tablets. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. Worsening liver disease is serious and may lead to death.
    • Do not run out of abacavir, lamivudine and zidovudine tablets. Refill your prescription or talk to your healthcare provider before your abacavir, lamivudine and zidovudine tablets are all gone.
    • Do not stop abacavir, lamivudine and zidovudine tablets without first talking to your healthcare provider.
    • If you stop taking abacavir, lamivudine and zidovudine tablets, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your liver.
  • Resistant Hepatitis B Virus (HBV). If you have HIV-1 and hepatitis B, the hepatitis B virus can change (mutate) during your treatment with abacavir, lamivudine and zidovudine tablets and become harder to treat (resistant).
  • Use with interferon and ribavirin-based regimens. Worsening of liver disease that has caused death has happened in people infected with both HIV-1 and hepatitis C virus who are taking antiretroviral medicines, and are also being treated for hepatitis C with interferon with or without ribavirin. If you are taking abacavir, lamivudine and zidovudine tablets and interferon with or without ribavirin, tell your healthcare provider if you have any new symptoms.

What are abacavir, lamivudine and zidovudine tablets?

Abacavir, lamivudine and zidovudine tablet is a prescription HIV-1 (Human Immunodeficiency Virus type 1) medicine used alone or with other antiretroviral medicines to treat HIV-1 infection. HIV-1 is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Abacavir, lamivudine and zidovudine tablet contains 3 prescription medicines, abacavir (ZIAGEN®), lamivudine (EPIVIR®) and zidovudine (RETROVIR®).

Abacavir, lamivudine and zidovudine tablets should not be used in children weighing less than 88 pounds (40 kg).

When used alone or with other antiretroviral medicines to treat HIV-1 infection, abacavir, lamivudine and zidovudine tablets may help:

  • reduce the amount of HIV-1 in your blood. This is called “viral load”.
  • increase the number of CD4+ (T) cells in your blood, that help fight off other infections.

Reducing the amount of HIV-1 and increasing the CD4+ (T) cells in your blood may help improve your immune system. This may reduce your risk of death or getting infections that can happen when your immune system is weak (opportunistic infections).

Abacavir, lamivudine and zidovudine tablets does not cure HIV-1 infection or AIDS. You must keep taking HIV-1 medicines to control HIV-1 infection and decrease HIV-related illnesses.

Avoid doing things that can spread HIV-1 infection to others.

  • Do not share or re-use needles or other injection equipment.
  • Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.
  • Do not have any kind of sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with any body fluids such as semen, vaginal secretions, or blood.

Ask your healthcare provider if you have any questions about how to prevent passing HIV to other people

Who should not take abacavir, lamivudine and zidovudine tablets?

Do not take abacavir, lamivudine and zidovudine tablets if you:

  • have a certain type of gene variation called the HLA-B*5701 allele. Your healthcare provider will test you for this before prescribing treatment with abacavir, lamivudine and zidovudine tablets.
  • are allergic to abacavir or any of the ingredients in abacavir, lamivudine and zidovudine tablets. See the end of this Medication Guide for a complete list of ingredients in abacavir, lamivudine and zidovudine tablets.
  • have liver problems.

What should I tell my healthcare provider before taking abacavir, lamivudine and zidovudine tablets?

Before you take abacavir, lamivudine and zidovudine tablets, tell your healthcare provider if you:

  • have been tested and know whether or not you have a particular gene variation called HLA-B*5701.
  • have or have had liver problems, including hepatitis B or C virus infection.
  • have kidney problems.
  • have low blood cell counts (bone marrow problem). Ask your healthcare provider if you are not sure.
  • have heart problems, smoke, or have diseases that increase your risk of heart disease such as high blood pressure, high cholesterol, or diabetes.
  • drink alcohol or take medicines that contain alcohol.
  • are pregnant or plan to become pregnant. It is not known if abacavir, lamivudine and zidovudine tablets will harm your unborn baby. Talk to your healthcare provider if you are pregnant or plan to become pregnant.

Pregnancy Registry. There is a pregnancy registry for women who take antiretroviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.

  • are breastfeeding or plan to breastfeed. Do not breastfeed if you take abacavir, lamivudine and zidovudine tablets.
    • You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby.

Tell your healthcare provider about all the medicines you take, including prescription and over-the counter medicines, vitamins, and herbal supplements.

Some medicines interact with abacavir, lamivudine and zidovudine tablets. Keep a list of your medicines to show your healthcare provider and pharmacist. You can ask your healthcare provider or pharmacist for a list of medicines that interact with abacavir, lamivudine and zidovudine tablets. Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take abacavir, lamivudine and zidovudine tablets with other medicines.

You should not take abacavir, lamivudine and zidovudine tablets. if you also take:

  • abacavir (EPZICOM® , TRIUMEQ® , or ZIAGEN®)
  • lamivudine (COMBIVIR® , DUTREBIS , EPIVIR® , EPIVIR-HBV® , EPZICOM® , or TRIUMEQ®)
  • zidovudine (COMBIVIR® or RETROVIR®)
  • emtricitabine (EMTRIVA® , ATRIPLA® , COMPLERA® , STRIBILD® , or TRUVADA®)

Tell your healthcare provider if you take:

  • any other medicine to treat HIV-1
  • ADRIAMYCIN® (doxorubicin)
  • CYTOVENE® (ganciclovir), interferon alfa, ribavirin, or other bone marrow suppressive medicines or cytotoxic medicines
  • methadone

How should I take abacavir, lamivudine and zidovudine tablets?

  • Take abacavir, lamivudine and zidovudine tablets exactly as your healthcare provider tells you.
  • Do not change your dose or stop taking abacavir, lamivudine and zidovudine tablets without talking with your healthcare provider. If you miss a dose of abacavir, lamivudine and zidovudine tablets, take it as soon as you remember. Do not take 2 doses at the same time. If you are not sure about your dosing, call your healthcare provider.
  • Stay under the care of a healthcare provider while taking abacavir, lamivudine and zidovudine tablets.
  • Abacavir, lamivudine and zidovudine tablets may be taken with or without food.
  • Tell your healthcare provider if you or your child has trouble swallowing abacavir, lamivudine and zidovudine tablets.
  • Do not run out of abacavir, lamivudine and zidovudine tablets. The virus in your blood may increase and the virus may become harder to treat. When your supply starts to run low, get more from your healthcare provider or pharmacy.
  • If you take too much abacavir, lamivudine and zidovudine tablets, call your healthcare provider or go to the nearest hospital emergency room right away.

What are the possible side effects of abacavir, lamivudine and zidovudine tablets?

  • Abacavir, lamivudine and zidovudine tablets can cause serious side effects including:
  • See “What is the most important information I should know about abacavir, lamivudine and zidovudine tablets?”
  • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having new symptoms after you start taking abacavir, lamivudine and zidovudine tablets.
  • Changes in body fat can happen in people who take HIV-1 medicines. These changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the middle of your body (trunk). Loss of fat from the legs, arms, and face may also happen. The exact cause and long-term health effects of these conditions are not known.
  • Heart attack (myocardial infarction). Some HIV-1 medicines including abacavir, lamivudine and zidovudine tablets may increase your risk of heart attack.

The most common side effects of abacavir, lamivudine and zidovudine tablets include:

  • nausea
  • headache
  • weakness or tiredness
  • vomiting

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of abacavir, lamivudine and zidovudine tablets. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store abacavir, lamivudine and zidovudine tablets?

  • Store abacavir, lamivudine and zidovudine tablets at 59°F to 86°F (15°C to 30°C).

Keep abacavir, lamivudine and zidovudine tablets and all medicines out of the reach of children.

General information for safe and effective use of abacavir, lamivudine and zidovudine tablets.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use abacavir, lamivudine and zidovudine tablets for a condition for which it was not prescribed. Do not give abacavir, lamivudine and zidovudine tablets to other people, even if they have the same symptoms that you have. It may harm them.

If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for the information about abacavir, lamivudine and zidovudine tablets that is written for health professionals.

For more information go to www.lupinpharmaceuticals.com or call 1-800-399-2561.

What are the ingredients in abacavir, lamivudine and zidovudine Tablets?

Active ingredients: abacavir, lamivudine and zidovudine

Inactive ingredients: crospovidone, magnesium stearate, microcrystalline cellulose, povidone, and yellow ferric oxide.

Tablet film coating contains: opadry green made of FD&C blue no. 2, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide and yellow ferric oxide.

This Medication Guide has been approved by the US Food and Drug Administration.

The brands listed are trademarks of their respective owners and are not trademarks of Lupin Pharmaceuticals, Inc. The makers of these brands are not affiliated with and do not endorse Lupin Pharmaceuticals, Inc. or its products.

Manufactured for:

Lupin Pharmaceuticals, Inc.

Baltimore, Maryland 21202

United States

Manufactured by:

Lupin Limited

Pithampur (M.P.) — 454 775

India

Revised: February 2016

All MedLibrary.org resources are included in as near-original form as possible, meaning that the information from the original provider has been rendered here with only typographical or stylistic modifications and not with any substantive alterations of content, meaning or intent.

This site is provided for educational and informational purposes only, in accordance with our Terms of Use, and is not intended as a substitute for the advice of a medical doctor, nurse, nurse practitioner or other qualified health professional.

Privacy Policy | Copyright © 2021. All Rights Reserved.