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Information

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Buy Sildenafil With Bitcoins was well tolerated at a single dose of 100 mg. There were no clinically significant changes in vision evaluated by special visual tests (visual acuity, Amsler lattice, color perception, color simulation, Humphrey perimeter and photostress).

Efficiency. The efficacy and safety of Viagra Bitcoin Pharmacy Online 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.

The effectiveness of Pay For Viagra With Bitcoin, defined as the ability to achieve and maintain an erection sufficient for satisfactory sexual intercourse, has been demonstrated in all studies and confirmed in long-term studies lasting 1 year. In studies with the use of fixed-dose proportion of patients reporting that treatment improved their erections were 62% (dose of How To Buy Viagra With Bitcoin Online Pharmacy 25 mg), 74% (dose Buy Viagra Online Bitcoin Or Credit Card 50 mg) and 82% (dose Kamagra For Bitcoin 100 mg) compared to 25% in the placebo group. Analysis of the international index of erectile function showed that in addition to improving erection treatment Buy Viagra Online Bitcoin Or Credit Card also increased the quality of orgasm, allowing to achieve satisfaction from sexual intercourse and overall satisfaction.

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 How To Buy Viagra With Bitcoin Online Pharmacy.

Pharmacokinetics

Contraindications

hypersensitivity to Buy Viagra Online Bitcoin Or Credit Card 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 Pay For Viagra With Bitcoin enhances the hypotensive effect of nitrates (see "Interaction»);

the combined use of inhibitors of PDE5, including Buy Viagra Online Bitcoin Or Credit Card, 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 Buy Female Viagra With Bitcoins 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.

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 Viagra Online Bitcoin Or Credit Card 100 mg, the second tablet of Buy Viagra Online Bitcoin Or Credit Card 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 Buy Viagra Online Bitcoin Or Credit Card 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 Online Bitcoin Or Credit Card 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) Viagra 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 Buy Sildenafil With Bitcoin Or Credit Card 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 For Bitcoin 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 Pay For Viagra With Bitcoin should be 25 mg (see "Interaction").

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

Old age. Adjustment of the dose of Buy Viagra With Bitcoin Or Credit Card is not required.

Cardiovascular complications

During the post-marketing use of Buy Viagra Online Bitcoin Or Credit Card 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 Buy Kamagra With Bitcoins without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Buy Viagra Online Bitcoin Or Credit Card, 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 of developing 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 Buy Viagra Online Bitcoin Or Credit Card 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 Buy Viagra Online Bitcoin Or Credit Card, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

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

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Buy Viagra Online Bitcoin Or Credit Card

The metabolism of Buy Viagra Online Bitcoin Or Credit Card occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Buy Viagra Online Bitcoin Or Credit Card, and inducers, respectively, increase the clearance of Buy Viagra Online Bitcoin Or Credit Card. A decrease in the clearance of Buy Viagra Online Bitcoin Or Credit Card with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Buy Viagra Online Bitcoin Or Credit Card (50 mg) causes an increase in the concentration of Buy Viagra Online Bitcoin Or Credit Card in plasma by 56%.

A single dose of 100 mg of Buy Viagra Online Bitcoin Or Credit Card together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Buy Viagra Online Bitcoin Or Credit Card by 182%.

When co-administered Buy Kamagra With Bitcoin (once 100 mg) and saquinavir (1200 mg/day 3 times daily), an inhibitor of HIV protease and of CYP3A4, on the background to achieve a constant concentration of saquinavir in the blood, Cmax of Buy Viagra Online Bitcoin Or Credit Card was increased by 140% and the AUC increased by 210%.

Stronger inhibitors of CYP3A4 isoenzyme, such as ketoconazole and Itraconazole, can cause more pronounced changes in the pharmacokinetics of The Purchase Of Extra Super Viagra.

The simultaneous use of Buy Viagra Online Bitcoin Or Credit Card (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Buy Viagra Online Bitcoin Or Credit Card by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Buy Viagra Online Bitcoin Or Credit Card in blood plasma is about 200 ng/ml (after a single application of one Generic Sildenafil For Bitcoin — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Buy Viagra Online Bitcoin Or Credit Card does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Buy Viagra Online Bitcoin Or Credit Card is not recommended. In any case, the maximum dose of Buy Viagra Online Bitcoin Or Credit Card under any circumstances should not exceed 25 mg for 48 hours. If Purchase Viagra For Bitcoin Online Pharmacy is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Buy Female Viagra With Bitcoins does not exceed 200 nm, and the drug is well tolerated.

Single administration of antacid (magnesium hydroxide/aluminum hydroxide) does not affect the bioavailability of Buy Viagra Online Bitcoin Or Credit Card.

Studies involving healthy volunteers with simultaneous use of endothelin receptor antagonist, bosentan (CYP3A4 isoenzyme inducer (moderate), CYP2C9, and possibly CYP2C19) in Css (125 mg 2 times a day) and Cheap Viagra Professional Accept Bitcoin in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Buy Viagra Online Bitcoin Or Credit Card by 62.6 and 52.4%, respectively. Buy Viagra Online Bitcoin Or Credit Card increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Generic Kamagra For Bitcoin with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Cheap Viagra Professional Accept Bitcoin in blood plasma.

CYP2D6 isoenzyme inhibitors (SSRIs, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists have no effect on the pharmacokinetics of Generic Kamagra For Bitcoin.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Kamagra For Bitcoin or its main circulating metabolite.

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