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Clinical data

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

The pharmacokinetics of Buy Kamagra With Btc in the recommended dose range is linear.

Suction. After intake of Generic Sildenafil For Btc is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Generic Sildenafil For Btc 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 Sildenafil For Btc 100 mg average Cmax free Buy Kamagra Btc in plasma men is about 18 ng/ml (38 nm). Cmax when taking Generic Sildenafil For Btc 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 Buy Kamagra Btc is 105 l. the Association of Generic Sildenafil For Btc 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 Generic Sildenafil For Btc (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

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

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

Influence of Generic Sildenafil For Btc on other drugs

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

Kamagra Btc 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 Btc in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Buy Sildenafil With Btc Or Credit Card (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 Buy Viagra With Btc Or Credit Card 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.

Generic Sildenafil For Btc (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 Cheap Viagra Accept Btc 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.

Generic Sildenafil For Btc (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

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In patients with hypertension, no signs of interaction of Buy Female Viagra With Btc (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 Generic Sildenafil For Btc in combination with antihypertensive agents does not lead to additional side effects.

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Mechanism of action

The implementation of the physiological mechanism of erection is associated with the release of nitric oxide (NO) in the cavernous body during sexual stimulation. This, in turn, leads to an increase in the level of cGMP, the subsequent relaxation of smooth muscle tissue of the cavernous body and an increase in blood flow.

How To Buy Viagra With Btc Online Pharmacy does not have a direct relaxing effect on the isolated cavernous human body, but enhances the effect of nitric oxide by inhibiting PDE-5, which is responsible for the disintegration of cGMP.

Selective Generic Sildenafil For Btc against PDE5 in vitro, its activity against PDE5 superior activity against other known PDE isoenzymes: PDE-6 — 10 times; PDE-1 more than 80 times; PDE-2, PDE-4, PDE-7 PDE–11 more than 700 times. Generic Sildenafil For Btc is 4000 times more selective for PDE-5 than PDE-3, which is crucial because PDE-3 is one of the key enzymes in the regulation of myocardial contractility.

A prerequisite for the effectiveness of Generic Sildenafil For Btc is sexual stimulation.

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