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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 Pay For Sildenafil With Bitcoin, 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 Pay For Sildenafil With Bitcoin 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 Pay For Sildenafil With Bitcoin in patients with retinitis pigmentosa absent, so these patients should not be used Pay For Sildenafil With Bitcoin (see "Contraindications").

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Pay For Sildenafil With Bitcoin 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 Buy Viagra With Bitcoins 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 Buy Female 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 Pay For Sildenafil With Bitcoin 25 mg), 74% (dose Buy Viagra Online Bitcoin Or Credit Card 50 mg) and 82% (dose Pay For Sildenafil With 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 Pay For Sildenafil With Bitcoin 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 Pay For Sildenafil With Bitcoin.

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Clinical data

Cardiac studies. The use of Pay For Sildenafil With Bitcoin 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 Pay For Kamagra 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 Pay For Sildenafil With Bitcoin 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%. Pay For Sildenafil With Bitcoin 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 Pay For Sildenafil With Bitcoin 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 Pay For Sildenafil With Bitcoin (up to 100 mg) in men (n=568) with erectile dysfunction and hypertension, taking more than two antihypertensive drugs, was studied. Pay For Sildenafil With Bitcoin 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 Buy Sildenafil With Bitcoin 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 Sildenafil With Bitcoin had no effect on visual acuity, contrast perception, electroretinogram, IOP or pupil diameter.

The pharmacokinetics of Pay For Sildenafil With Bitcoin in the recommended dose range is linear.

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

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

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

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