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Viagra (sildenafil citrate)

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A single dose of 100 mg of Viagra Cure Erectile Dysfunction together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Viagra Cure Erectile Dysfunction by 182%.


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Information

Cardiovascular complications

During the post-marketing use of Using Viagra For Erectile Dysfunction 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 Sildenafil For Erectile Dysfunction Dosage. 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 Cure Erectile Dysfunction without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Viagra Temporary Erectile Dysfunction, 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 of developing 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 Is Viagra Good For Erectile Dysfunction 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 Viagra Cure Erectile Dysfunction, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Herbal Viagra For Erectile Dysfunction in doses exceeding the recommended, adverse events were similar to those noted above, but usually more common.

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Viagra Cure Erectile Dysfunction

The metabolism of Herbal Viagra For Erectile Dysfunction occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Viagra Cure Erectile Dysfunction, and inducers, respectively, increase the clearance of Viagra Cure Erectile Dysfunction. A decrease in the clearance of Viagra Human Erectile Dysfunction with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Viagra Cure Erectile Dysfunction (50 mg) causes an increase in the concentration of Using Viagra For Erectile Dysfunction in plasma by 56%.

A single dose of 100 mg of Viagra Cure Erectile Dysfunction together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Viagra Without Erectile Dysfunction by 182%.

When co-administered Viagra Cure Erectile Dysfunction (once 100 mg) and saquinavir (1200 mg/day 3 times daily), an inhibitor of HIV protease and of CYP3A4, on the background to achieve a constant concentration of saquinavir in the blood, Cmax of Sildenafil For Erectile Dysfunction was increased by 140% and the AUC increased by 210%.

Stronger inhibitors of CYP3A4 isoenzyme, such as ketoconazole and Itraconazole, can cause more pronounced changes in the pharmacokinetics of Generic Viagra For Erectile Dysfunction.

The simultaneous use of Is Viagra A Cure For Erectile Dysfunction (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Viagra Erectile Dysfunction Dose by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Viagra Cure Erectile Dysfunction in blood plasma is about 200 ng/ml (after a single application of one Viagra Cure Erectile Dysfunction — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Viagra For Diabetes Erectile Dysfunction does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Is Viagra Only For Erectile Dysfunction is not recommended. In any case, the maximum dose of Viagra Erectile Dysfunction Treatment under any circumstances should not exceed 25 mg for 48 hours. If Viagra Cure Erectile Dysfunction is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Viagra Cure Erectile Dysfunction does not exceed 200 nm, and the drug is well tolerated.

Single administration of antacid (magnesium hydroxide/aluminum hydroxide) does not affect the bioavailability of Viagra Cure Erectile Dysfunction.

Studies involving healthy volunteers with simultaneous use of endothelin receptor antagonist, bosentan (CYP3A4 isoenzyme inducer (moderate), CYP2C9, and possibly CYP2C19) in Css (125 mg 2 times a day) and Uses For Viagra Other Than Erectile Dysfunction in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Viagra Cure Erectile Dysfunction by 62.6 and 52.4%, respectively. Viagra Stress Erectile Dysfunction increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Viagra Cure Erectile Dysfunction with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Viagra Tablet For Erectile Dysfunction in blood plasma.

CYP2D6 isoenzyme inhibitors (SSRIs, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists have no effect on the pharmacokinetics of Viagra Works Erectile Dysfunction.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Viagra Cure Erectile Dysfunction or its main circulating metabolite.

Contraindications

hypersensitivity to Viagra Cure Erectile Dysfunction 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 Viagra Cure Erectile Dysfunction enhances the hypotensive effect of nitrates (see "Interaction»);

the combined use of inhibitors of PDE5, including Viagra Cure Erectile Dysfunction, 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 Viagra Cure Erectile Dysfunction 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.

Influence of Herbal Viagra For Erectile Dysfunction on other drugs

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

Viagra For Erectile Dysfunction 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 Viagra For Non Erectile Dysfunction in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Viagra Without Erectile Dysfunction (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 Viagra Cure Erectile Dysfunction 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.

Viagra Cure Erectile Dysfunction (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 Viagra Cure Erectile Dysfunction 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.

Viagra Cure Erectile Dysfunction (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

Viagra Cure Erectile Dysfunction (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 Viagra Erectile Dysfunction Dose (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 Which Is Better For Erectile Dysfunction Viagra Or Cialis in combination with antihypertensive agents does not lead to additional side effects.

Clinical data

Cardiac studies. The use of Viagra Erectile Dysfunction Treatment 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 Viagra Cure Erectile Dysfunction 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 Cure Erectile Dysfunction 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 Cure Erectile Dysfunction 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 Cure Erectile Dysfunction 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 Viagra Cure Erectile Dysfunction (up to 100 mg) in men (n=568) with erectile dysfunction and hypertension, taking more than two antihypertensive drugs, was studied. Is Viagra A Cure For Erectile Dysfunction 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 Cure Erectile Dysfunction 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. Is Viagra A Cure For Erectile Dysfunction had no effect on visual acuity, contrast perception, electroretinogram, IOP or pupil diameter.



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