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Information

Contraindications

hypersensitivity to Buy Viagra Bitcoin or any other component of the drug;

application in patients receiving constantly or intermittently nitric oxide donators, organic nitrates or nitrites in any form, as Buy Viagra Bitcoin enhances the hypotensive effect of nitrates (see "Interaction»);

the combined use of inhibitors of PDE5, including Buy Viagra Bitcoin, called guanylate cyclase stimulants such as riociguat, because it can lead to symptomatic hypotension;

concomitant use with other agents for the treatment of erectile dysfunction (safety and efficacy of Buy Viagra Bitcoin when used together has not been studied (see. "Special instructions»);

lactose intolerance, lactase deficiency, glucose-papacosma malabsorption;

severe liver failure (class C classification for child-Pugh);

simultaneous administration of ritonavir;

severe cardiovascular diseases (severe heart failure, unstable angina, stroke or myocardial infarction during the last 6 months, life-threatening arrhythmias, hypertension (BP >170/100 mm Hg). art.) or hypotension (blood PRESSURE <90/50 mm Hg.art.) (see "Special instructions»);

patients with episodes of development partizanai anterior ischemic optic neuropathies (NESN) with loss of vision in one eye;

hereditary retinitis pigmentosa (see special instructions»);

according to the registered indication is not intended for use in women;

according to the registered indication is not intended for use in children under 18 years.

With caution: anatomic deformity of the penis (angulation, cavernous fibrosis or Peyronie's disease) (see "Special instructions"); diseases of, predisposing to the development of priapism (sickle-cell anemia, multiple myeloma, leukemia, thrombocythemia) (see "Special instructions"); diseases accompanied by haemorrhage; ulcer disease of stomach and duodenum in the acute phase; liver dysfunction; severe renal insufficiency (Cl creatinine <30 ml/min); patients with an episode of partizanai development of the anterior ischemic optic neuropathies in history (see "Special instructions); simultaneous reception of blockers α-adrenergic receptors.

Use during pregnancy and breast-feeding

According to the registered indication, the drug is not intended for use in women.

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During the post-marketing use of Female Viagra Bitcoin Pharmacy Online for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Buy Viagra Bitcoin. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Buy Viagra Bitcoin without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

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In rare cases, during post-approval use of all of the inhibitors of PDE5, including Buy Viagra Bitcoin, reported NESN is a rare disease and the cause of the decrease or loss of vision. Most of these patients had risk factors, such as decreased ratios of excavation diameter to optic disc (stagnant disc), age over 50, diabetes, hypertension, CHD, hyperlipidemia, and Smoking. In an observational study evaluated whether recent use of drugs class of inhibitors PDE-5 with an acute onset NESN. The results indicate approximately a 2-fold increase in risk of developing NESN within 5T1/2 after application of the PDE-5 inhibitor. According to published literature, the annual incidence of npins IS 2.5–11.8 cases per 100,000 men aged ≥50 years in the General population. Patients should be advised to stop Generic Female Viagra For Bitcoin therapy in case of sudden loss of vision and consult a doctor immediately. Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Buy Viagra Bitcoin, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Buy Viagra Bitcoin in doses exceeding the recommended, adverse events were similar to those noted above, but usually more common.

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Buy Viagra Bitcoin

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The simultaneous use of Buy Viagra Bitcoin (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Buy Viagra Bitcoin by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Buy Viagra Bitcoin in blood plasma is about 200 ng/ml (after a single application of one Buy Viagra Bitcoin — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Buy Viagra Bitcoin does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Buy Viagra Bitcoin is not recommended. In any case, the maximum dose of Buy Viagra Bitcoin under any circumstances should not exceed 25 mg for 48 hours. If Buy Viagra Bitcoin is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Female Viagra Bitcoin Pharmacy Online does not exceed 200 nm, and the drug is well tolerated.

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Suction. After intake of Buy Viagra Bitcoin is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Buy Viagra Bitcoin at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Buy Viagra Bitcoin 100 mg average Cmax free Kamagra Bitcoin Pharmacy Online in plasma men is about 18 ng/ml (38 nm). Cmax when taking Buy Viagra Bitcoin inside fasting is achieved for an average of 60 minutes (from 30 to 120 minutes). When taken in combination with fatty foods, the rate of absorption decreases: Cmax decreases by an average of 29%, and Tmax increases by 60 minutes, but the degree of absorption does not change significantly (AUC decreases by 11%).

Distribution. The average Vss of Buy Viagra Bitcoin is 105 l. the Association of Buy Viagra Bitcoin and its main circulating N-demethyl metabolite with plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the dose of Buy Viagra Bitcoin (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. How To Buy Viagra With Bitcoin Online Pharmacy is metabolized mainly in the liver by the action of CYP3A4 isoenzyme (main pathway) and CYP2C9 isoenzyme (minor pathway). The main circulating active metabolite, formed as a result of N-demethylation of Generic Kamagra For Bitcoin, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Buy Viagra Bitcoin, and its activity against PDE-5 in vitro is about 50% of the activity of Buy Sildenafil Bitcoin. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Pay For Viagra With Bitcoin. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Sildenafil Bitcoin Pharmacy Online is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, The Purchase Of Extra Super Viagra is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).

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