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Information

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 Kamagra Bitcoin Pharmacy Online 100 mg, the second tablet of Sildenafil Bitcoin Pharmacy Online 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 Female 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 Buy Viagra With Bitcoin 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) Kamagra Bitcoin Pharmacy Online dose should be reduced to 25 mg.

Hepatic impairment. Since the excretion of Pay For Female Viagra With Bitcoin is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Kamagra 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 Kamagra 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 Cheap Viagra Professional Accept Bitcoin should be 25 mg (see "Interaction").

To minimize the risk of postural hypotension in patients taking α-blockers, Kamagra 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 Kamagra Bitcoin Pharmacy Online (see special instructions and Interactions).

Old age. Adjustment of the dose of Kamagra For Bitcoin is not required.

Generic Sildenafil For Bitcoin 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.

Kamagra 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 Kamagra 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. Kamagra 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 Kamagra Bitcoin Pharmacy Online is sexual stimulation.

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

The pharmacokinetics of Purchase Viagra For Bitcoin Online Pharmacy in the recommended dose range is linear.

Suction. After intake of Kamagra Bitcoin Pharmacy Online is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Kamagra Bitcoin Pharmacy Online at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Kamagra Bitcoin Pharmacy Online 100 mg average Cmax free Kamagra Bitcoin Pharmacy Online in plasma men is about 18 ng/ml (38 nm). Cmax when taking Kamagra Bitcoin Pharmacy Online 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 Sildenafil With Bitcoins is 105 l. the Association of Kamagra Bitcoin Pharmacy Online 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 Kamagra Bitcoin Pharmacy Online (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Generic Viagra For Bitcoin 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 Kamagra Bitcoin Pharmacy Online, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Buy Sildenafil With Bitcoin, and its activity against PDE-5 in vitro is about 50% of the activity of Kamagra Bitcoin Pharmacy Online. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Kamagra Bitcoin Pharmacy Online. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

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

Hearing impairment

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 Kamagra 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 Buy Female Viagra With Bitcoin, consult a doctor immediately.

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Kamagra Bitcoin Pharmacy Online enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Generic Kamagra For Bitcoin in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Kamagra 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 (Buy Female Viagra With Bitcoins — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Kamagra Bitcoin Pharmacy Online — 3%, placebo — 2.4%). Patients receiving Kamagra 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 Kamagra Bitcoin Pharmacy Online together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Kamagra For Bitcoin (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 Kamagra Bitcoin Pharmacy Online any negative effect on the ability to drive a car or other means was not observed. However, since when taking Kamagra Bitcoin Pharmacy Online 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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