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Mechanism of action

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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 The Purchase Of Extra Super Viagra 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 Pay For Viagra With Bitcoin 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.

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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) Viagra Bitcoin Pharmacy Online dose should be reduced to 25 mg.

Hepatic impairment. Since the excretion of Viagra Bitcoin Pharmacy Online 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 Cheap Viagra Professional Accept Bitcoin should be 25 mg (see "Interaction").

To minimize the risk of postural hypotension in patients taking α-blockers, Generic Kamagra For Bitcoin 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.

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

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 Buy Sildenafil With Bitcoin Or Credit Card, 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").

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