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Information

Cardiovascular complications

During the post-marketing use of Alternative To 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 Herbal Viagra For Erectile Dysfunction. 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 Sildenafil For Erectile Dysfunction Dosage 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 Natural Viagra For 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 Alternative To Viagra 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 Alternative To Viagra For 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 Alternative To 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 And Other Erectile Dysfunction Drugs

The metabolism of Alternative To Viagra For Erectile Dysfunction occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis, and inducers, respectively, increase the clearance of Alternative To Viagra For Erectile Dysfunction. A decrease in the clearance of Alternative To Viagra For 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 Alternative To Viagra For Erectile Dysfunction (50 mg) causes an increase in the concentration of Alternative To Viagra For Erectile Dysfunction in plasma by 56%.

A single dose of 100 mg of Uses For Viagra Other Than 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 Natural Viagra For Erectile Dysfunction by 182%.

When co-administered Viagra And Other Erectile Dysfunction Drugs (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 Viagra Tablet 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 Viagra Cure Erectile Dysfunction.

The simultaneous use of Alternative To Viagra 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 Is Viagra Only For Erectile Dysfunction by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis in blood plasma is about 200 ng/ml (after a single application of one Generic Viagra For Erectile Dysfunction — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Alternative To Viagra For Erectile Dysfunction does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Alternative To Viagra For Erectile Dysfunction is not recommended. In any case, the maximum dose of Dose Of Viagra For Erectile Dysfunction under any circumstances should not exceed 25 mg for 48 hours. If Alternative To Viagra For Erectile Dysfunction is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Alternative To Viagra For 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 Without 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 Sildenafil For Erectile Dysfunction Dosage in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Viagra And Other Erectile Dysfunction Drugs by 62.6 and 52.4%, respectively. Alternative To Viagra For Erectile Dysfunction increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Alternative To Viagra For Erectile Dysfunction with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Can Viagra Be Used 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 Alternative To Viagra For Erectile Dysfunction.

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

The pharmacokinetics of Alternative To Viagra For Erectile Dysfunction in the recommended dose range is linear.

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

Metabolism. Viagra Stress Erectile Dysfunction 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 Alternative To Viagra For Erectile Dysfunction, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Viagra For Diabetes Erectile Dysfunction, and its activity against PDE-5 in vitro is about 50% of the activity of Viagra For Non Erectile Dysfunction. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Alternative To Viagra For Erectile Dysfunction. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

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

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 Dose For Erectile Dysfunction. 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 And Other Erectile Dysfunction Drugs, consult a doctor immediately.

Bleedings

Viagra For Erectile Dysfunction enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Alternative To Viagra For Erectile Dysfunction in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Alternative To Viagra For Erectile Dysfunction 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 (Uses For Viagra Other Than Erectile Dysfunction — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Viagra Cure Erectile Dysfunction — 3%, placebo — 2.4%). Patients receiving Viagra For Non Erectile Dysfunction 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 Alternative To Viagra For Erectile Dysfunction together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Alternative To Viagra For Erectile Dysfunction (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 Tablet For Erectile Dysfunction any negative effect on the ability to drive a car or other means was not observed. However, since when taking Alternative To Viagra For Erectile Dysfunction 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.

Influence of Alternative To Viagra For Erectile Dysfunction on other drugs

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

Viagra Tablet 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 Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Alternative To Viagra For 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 Natural Viagra For 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.

Alternative To Viagra For 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 Alternative To Viagra For 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.

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

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



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