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Information

Purchase Viagra For Bitcoin Online Pharmacy 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.

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 Purchase Viagra For Bitcoin Online Pharmacy is sexual stimulation.

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

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 Buy Kamagra With Bitcoins 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.

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) Buy Female Viagra With Bitcoin dose should be reduced to 25 mg.

Hepatic impairment. Since the excretion of Purchase Viagra For Bitcoin Online Pharmacy is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Purchase Viagra For Bitcoin Online Pharmacy 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 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, Buy Female Viagra With Bitcoins should be started only after achieving hemodynamic stabilization in these patients. Consideration should also be given to reducing the initial dose of Buy Sildenafil With Bitcoin Or Credit Card (see special instructions and Interactions).

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

Contraindications

hypersensitivity to Purchase Viagra For Bitcoin Online Pharmacy 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 Purchase Viagra For Bitcoin Online Pharmacy enhances the hypotensive effect of nitrates (see "Interaction»);

the combined use of inhibitors of PDE5, including Buy Female Viagra With Bitcoins, 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 Pay For Female Viagra With 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.

Cardiovascular complications

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 Purchase Viagra For Bitcoin Online Pharmacy. 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.

Hypotension

Purchase Viagra For Bitcoin Online Pharmacy 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 Buy Kamagra With Bitcoins should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Purchase Viagra For Bitcoin Online Pharmacy (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

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