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Information

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 Kamagra Bitcoin Pharmacy Online 100 mg, the second tablet of Kamagra 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 Sildenafil Bitcoin Pharmacy Online 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 Kamagra 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 Kamagra Bitcoin Pharmacy Online is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Kamagra 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 Kamagra 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 Kamagra Bitcoin Pharmacy Online should be 25 mg (see "Interaction").

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

Old age. Adjustment of the dose of Kamagra Bitcoin Pharmacy Online is not required.

Cardiovascular complications

During the post-marketing use of Kamagra Bitcoin Pharmacy Online 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 Pay For Sildenafil With Bitcoin. 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 Kamagra 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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Kamagra 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 Kamagra 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 Kamagra Bitcoin Pharmacy Online and α-blockers can lead to symptomatic hypotension in some sensitive patients, Sildenafil 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 Buy Sildenafil With Bitcoin Or Credit Card should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Kamagra 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.

Influence of Viagra Bitcoin Pharmacy Online on other drugs

Kamagra Bitcoin Pharmacy Online is a weak inhibitor of cytochrome P450 — 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 ISOENZYMES (IC50 >150 µmol). When taking Kamagra For Bitcoin in recommended doses, its Cmax is about 1 µmol, so it is unlikely that Kamagra Bitcoin Pharmacy Online can affect the clearance of the substrates of these isoenzymes.

Kamagra Bitcoin Pharmacy Online increases the hypotensive effect of nitrates both with long-term use of the latter, and with their appointment for urgent indications. In this regard, the use of Buy Viagra With Bitcoin Or Credit Card in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Kamagra Bitcoin Pharmacy Online (25, 50 and 100 mg) in patients with benign prostate hyperplasia with stable hemodynamics, the average additional decrease in sad/dad in the supine position was 7/7, 9/5 and 8/4 mm Hg.article, respectively, while in the standing position — 6/6, 11/4 mmHg, and 4/5.art. respectively. Reported rare cases of symptomatic postural hypotension in such patients, manifested in the form of dizziness (without fainting). In some sensitive patients receiving α-blockers, simultaneous use of Kamagra Bitcoin Pharmacy Online can lead to symptomatic hypotension.

There were no signs of significant interaction with tolbutamide (250 mg) or warfarin (40 mg), which are metabolized by CYP2C9 isoenzyme.

Buy Female Viagra With Bitcoin (100 mg) has no effect on the pharmacokinetics of the HIV protease inhibitor, saquinavir, which is a substrate of CYP3A4 isoenzyme, at its constant level in the blood.

The simultaneous use of Buy Sildenafil Bitcoin at equilibrium (80 mg 3 times a day) leads to an increase in the AUC and Cmax of bosentan (125 mg 2 times a day) by 49.8 and 42%, respectively.

Kamagra Bitcoin Pharmacy Online (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

Pay For Viagra With Bitcoin (50 mg) does not increase the hypotensive effect of alcohol in healthy volunteers with Cmax of alcohol in the blood on average 0.08‰ (80 mg/DL).

In patients with hypertension, no signs of interaction of Buy Sildenafil With Bitcoins (100 mg) with amlodipine were found. The average additional reduction in blood PRESSURE in the supine position is 8 mm Hg.V. (systolic) and 7 mm Hg.V. (diastolic).

The use of Kamagra Bitcoin Pharmacy Online in combination with antihypertensive agents does not lead to additional side effects.

The pharmacokinetics of Kamagra Bitcoin Pharmacy Online in the recommended dose range is linear.

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

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

Breeding. The total clearance of Kamagra Bitcoin Pharmacy Online is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Buy Viagra 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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