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Mechanism of action

The implementation of the physiological mechanism of erection is associated with the release of nitric oxide (NO) in the cavernous body during sexual stimulation. This, in turn, leads to an increase in the level of cGMP, the subsequent relaxation of smooth muscle tissue of the cavernous body and an increase in blood flow.

Purchase Viagra For Bitcoin Online Pharmacy does not have a direct relaxing effect on the isolated cavernous human body, but enhances the effect of nitric oxide by inhibiting PDE-5, which is responsible for the disintegration of cGMP.

Selective Purchase Viagra For Bitcoin Online Pharmacy against PDE5 in vitro, its activity against PDE5 superior activity against other known PDE isoenzymes: PDE-6 — 10 times; PDE-1 more than 80 times; PDE-2, PDE-4, PDE-7 PDE–11 more than 700 times. Purchase Viagra For Bitcoin Online Pharmacy is 4000 times more selective for PDE-5 than PDE-3, which is crucial because PDE-3 is one of the key enzymes in the regulation of myocardial contractility.

A prerequisite for the effectiveness of Buy Viagra With Bitcoins is sexual stimulation.

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During the post-marketing use of Purchase Viagra For Bitcoin Online Pharmacy 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 Sildenafil Bitcoin Pharmacy Online. 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 Purchase Viagra For Bitcoin Online Pharmacy 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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Generic Female Viagra For Bitcoin has a systemic vasodilating effect, leading to a transient decrease in blood PRESSURE, which is not clinically significant and does not lead to any consequences in most patients. However, before prescribing Purchase Viagra For Bitcoin Online Pharmacy, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with the rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood PRESSURE from the autonomic nervous system.

Since the combined use of Purchase Viagra For Bitcoin Online Pharmacy and α-blockers can lead to symptomatic hypotension in some sensitive patients, Purchase Viagra For Bitcoin Online Pharmacy should be used with caution in patients taking α-blockers (see "Interaction"). To minimize the risk of postural hypotension in patients taking α-blockers, the drug Purchase Viagra For Bitcoin Online Pharmacy should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Buy Kamagra With Bitcoin (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

Dosage and administration

Inside, can be taken with or without water. When taking the drug, you should put a tablet, dispersed in the oral cavity, on the tongue, after which it will quickly dissolve, and it can be swallowed. The tablet should be taken immediately after opening the blister. Patients who are recommended a dose of Generic Kamagra For Bitcoin 100 mg, the second tablet of Purchase Viagra For Bitcoin Online Pharmacy 50 mg should be taken after complete dissolution of the first tablet.

The recommended dose for most adult patients is 50 mg approximately 1 hour before sexual activity. Taking into account the effectiveness and tolerability of the dose can be increased to 100 mg or reduced to 25 mg (only tablets coated with a film, the appropriate dosage). The maximum recommended dose is 100 mg. Patients who are recommended a dose of Purchase Viagra For Bitcoin Online Pharmacy 100 mg, it is necessary to take 2 table., dispersible in the oral cavity, dosage 50 mg consecutively one after another. The maximum recommended frequency of use — 1 time per day. It should be borne in mind that the absorption of Purchase Viagra For Bitcoin Online Pharmacy significantly slows down when used in combination with fatty foods.

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Renal impairment. In mild to moderate renal failure dose adjustment is not required, in severe renal failure (Creatinine CL <30 ml/min) Purchase Viagra For Bitcoin Online Pharmacy dose should be reduced to 25 mg.

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Joint application with other drugs. Joint use with ritonavir is not recommended. In any case, the maximum dose of Purchase Viagra For Bitcoin Online Pharmacy under any circumstances should not exceed 25 mg, and the frequency of application — 1 time in 48 h (see "Interaction").

When combined with inhibitors of CYP3A4 isoenzyme (erythromycin, saquinavir, ketoconazole, Itraconazole), the initial dose of Purchase Viagra For Bitcoin Online Pharmacy should be 25 mg (see "Interaction").

To minimize the risk of postural hypotension in patients taking α-blockers, Purchase Viagra For Bitcoin Online Pharmacy should be started only after achieving hemodynamic stabilization in these patients. Consideration should also be given to reducing the initial dose of Purchase Viagra For Bitcoin Online Pharmacy (see special instructions and Interactions).

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Clinical data

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Efficiency. The efficacy and safety of Purchase Viagra For Bitcoin Online Pharmacy were evaluated in 21 randomized double-blind placebo-controlled studies lasting up to 6 months in 3000 patients from 19 to 87 years with erectile dysfunction of different etiology (organic, psychogenic or mixed). The efficacy of the drug was evaluated globally using an erection diary, an international erectile function index (validated questionnaire on the state of sexual function) and a partner survey.

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According to the generalized data, 59% of patients with diabetes, 43% of patients who underwent radical prostatectomy and 83% of patients with spinal cord injuries (against 16, 15 and 12% in the placebo group, respectively) were reported to have improved erection in the treatment of Purchase Viagra For Bitcoin Online Pharmacy.

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