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Clinical data

Cardiac studies. The use of Viagra Bitcoin Pharmacy Online in doses up to 100 mg did not lead to clinically significant ECG changes in healthy volunteers. The maximum decrease in systolic pressure in the supine position after taking Buy Sildenafil With Bitcoin at a dose of 100 mg was 8.3 mm Hg.art., and diastolic pressure — 5.3 mm Hg.a More pronounced, but also transient effect on blood PRESSURE was observed in patients taking nitrates (see "Contraindications" and "Interaction").

In a study of the hemodynamic effect of Viagra Bitcoin Pharmacy Online in a single dose of 100 mg in 14 patients with severe coronary artery disease (more than 70% of patients had stenosis of at least one coronary artery), systolic and diastolic resting pressure decreased by 7 and 6%, respectively, and pulmonary systolic pressure decreased by 9%. Viagra Bitcoin Pharmacy Online did not affect cardiac output and did not interfere with blood flow in stenotic coronary arteries, and also led to an increase (by about 13%) of adenosine-induced coronary flow in both stenotic and intact coronary arteries. In a double-blind placebo-controlled study of 144 patients with erectile dysfunction and stable angina, taking antianginal drugs (except nitrates), exercise was performed until the severity of symptoms of angina increased. The duration of the exercise was significantly longer (19.9 seconds; 0.9–38.9 seconds) in patients taking Viagra Bitcoin Pharmacy Online in a single dose of 100 mg, compared with patients receiving placebo.

In a randomized double-blind placebo-controlled study, the effect of changing the dose of Sale Super Viagra Accept Bitcoin (up to 100 mg) in men (n=568) with erectile dysfunction and hypertension, taking more than two antihypertensive drugs, was studied. Buy Sildenafil With Bitcoin Or Credit Card improved erection in 71% of men compared to 18% in the placebo group. The frequency of adverse effects was comparable to that in other groups of patients, as well as in those taking more than three antihypertensive drugs.

Studies of visual impairment. In some patients, 1 h after taking Viagra Bitcoin Pharmacy Online at a dose of 100 mg with the Farnsworth-Mansell test 100 revealed a slight and transient violation of the ability to distinguish shades of color (blue/green). After 2 hours after taking the drug, these changes were absent. It is believed that color vision impairment is caused by inhibition of PDE-6, which is involved in the process of color transmission in the retina. Buy Female Viagra With Bitcoin had no effect on visual acuity, contrast perception, electroretinogram, IOP or pupil diameter.

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 Viagra 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 Kamagra For 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.

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 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 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.

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 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 (Buy Female Viagra With Bitcoins — 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 Buy Viagra 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 Viagra Bitcoin Pharmacy Online any negative effect on the ability to drive a car or other means was not observed. However, since when taking Viagra 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.

Cardiovascular complications

During the post-marketing use of Buy Kamagra With Bitcoin 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 Viagra Bitcoin Pharmacy Online. 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.

Hypotension

Viagra Bitcoin Pharmacy Online 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 Viagra Bitcoin Pharmacy Online, 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 Viagra Bitcoin Pharmacy Online 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.

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