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Information

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Viagra Bitcoin Pharmacy Online, 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 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 Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk. In patients with episodes of development PINZN with loss of vision in one eye receiving Viagra Bitcoin Pharmacy Online is contraindicated (see "Contraindications").

A small number of patients with hereditary retinitis pigmentosa have genetically determined disorders of the PDE of the retina. Information about the safety of the drug Viagra Bitcoin Pharmacy Online in patients with retinitis pigmentosa absent, so these patients should not be used Viagra Bitcoin Pharmacy Online (see "Contraindications").

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 Viagra Bitcoin Pharmacy Online 100 mg, the second tablet of Pay For Kamagra With Bitcoin 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 Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online significantly slows down when used in combination with fatty foods.

Special patient groups

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

Hepatic impairment. Since the excretion of Buy Sildenafil With Bitcoins is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Viagra Bitcoin Pharmacy Online should be reduced to 25 mg.

Joint application with other drugs. Joint use with ritonavir is not recommended. In any case, the maximum dose of Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online should be 25 mg (see "Interaction").

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

Old age. Adjustment of the dose of Viagra Bitcoin Pharmacy Online is not required.

Viagra Bitcoin Pharmacy Online is a potent selective inhibitor of cGMP-specific PDE-5.



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.

Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online 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. Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online is sexual stimulation.

Viagra Bitcoin Pharmacy Online restores impaired erectile function in conditions of sexual stimulation by increasing blood flow to the cavernous bodies of the penis.

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Some post-marketing and clinical studies have reported cases of sudden hearing loss or impairment associated with the use of all PDE-5 inhibitors, including Viagra Bitcoin Pharmacy Online. Most of these patients had risk factors for sudden impairment or hearing loss. There is no causal relationship between the use of PDE-5 inhibitors and sudden hearing impairment or hearing loss. In case of sudden hearing impairment or hearing loss while taking Viagra Bitcoin Pharmacy Online, consult a doctor immediately.

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Viagra Bitcoin Pharmacy Online enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Viagra Bitcoin Pharmacy Online in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Viagra Bitcoin Pharmacy Online in these patients should be used with caution (see With caution).

The incidence of nosebleeds in patients with pulmonary hypertension associated with diffuse connective tissue diseases was higher (Viagra Bitcoin Pharmacy Online — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Viagra Bitcoin Pharmacy Online — 3%, placebo — 2.4%). Patients receiving Viagra Bitcoin Pharmacy Online in combination with an antagonist of vitamin K, the frequency of nasal bleeding was higher (8.8 percent) than patients who were not taking an antagonist of vitamin K (1.7 percent).

Use in conjunction with other means for the treatment of erectile dysfunction

The safety and efficacy of Viagra Bitcoin Pharmacy Online together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Viagra Bitcoin Pharmacy Online (eg, Revatsio®), or other means for the treatment of erection disorders have not been studied, so the use of such combinations is not recommended (see "Contraindications").

Influence on the ability to drive and mechanisms. In patients receiving Viagra Bitcoin Pharmacy Online any negative effect on the ability to drive a car or other means was not observed. However, since when taking Kamagra For Bitcoin may develop dizziness, lowering blood PRESSURE, the development of chromatopsia, blurred vision, etc. side effects, care should be taken when driving and doing other potentially dangerous activities that require increased concentration and speed of psychomotor reactions. Also, you should be careful about the individual action of the drug in these situations, especially at the beginning of treatment and when changing the dosage regimen.

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