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

Suction. After intake of Purchase Viagra For Bitcoin Online Pharmacy is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Buy Kamagra With 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 Purchase Viagra For Bitcoin Online Pharmacy 100 mg average Cmax free Buy Kamagra Bitcoin in plasma men is about 18 ng/ml (38 nm). Cmax when taking Purchase Viagra For Bitcoin Online Pharmacy 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 Purchase Viagra For Bitcoin Online Pharmacy is 105 l. the Association of How To Buy Viagra With Bitcoin Online Pharmacy 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 Viagra 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 How To Buy Viagra With Bitcoin Online Pharmacy, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Purchase Viagra For Bitcoin Online Pharmacy, and its activity against PDE-5 in vitro is about 50% of the activity of Kamagra For Bitcoin. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Purchase Viagra For Bitcoin Online Pharmacy. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

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

Clinical data

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

Contraindications

hypersensitivity to Buy Sildenafil With 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 Kamagra For Bitcoin enhances the hypotensive effect of nitrates (see "Interaction»);

the combined use of inhibitors of PDE5, including Pay For Viagra With Bitcoin, 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 Purchase Viagra For Bitcoin Online Pharmacy 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.

Clinical data

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

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