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Guideline Statement 13 Clinicians may prescribe pharmacologic pain management agents (e.g., urinary analgesics, acetaminophen, NSAIDs, opioid/non-opioid medications) after counseling patients on the risks and benefits

These active sites react with peroxide to make selenenic acid (Se-OH), which is then reduced into glutathione (GSH) by the glutathione reductase (GR) enzyme to produce glutathiolated selenol (Se-SG) intermediate

While compounded versions are not FDA-approved drugs themselves, the active pharmaceutical ingredients and manufacturing processes meet rigorous safety criteria

For this reason, it is generally advised to avoid the therapy in these populations unless medically indicated and supervised by a specialist