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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 Sildenafil Btc Pharmacy Online 100 mg, the second tablet of Generic Kamagra For Btc 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 Buy Sildenafil With Btc 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 Buy Viagra With Btc Or Credit Card significantly slows down when used in combination with fatty foods.

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Renal impairment. In mild to moderate renal failure dose adjustment is not required, in severe renal failure (Creatinine CL <30 ml/min) Buy Sildenafil With Btc dose should be reduced to 25 mg.

Hepatic impairment. Since the excretion of Buy Sildenafil With Btc is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Buy Sildenafil With Btc 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 Buy Sildenafil With Btc under any circumstances should not exceed 25 mg, and the frequency of application — 1 time in 48 h (see "Interaction").

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

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

Breeding. The total clearance of Buy Sildenafil With Btc is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Buy Sildenafil 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).

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The incidence of nosebleeds in patients with pulmonary hypertension associated with diffuse connective tissue diseases was higher (Discount Red Viagra With Btc — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Buy Sildenafil With Btc — 3%, placebo — 2.4%). Patients receiving Buy Sildenafil With Btc 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 Buy Sildenafil With Btc together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Buy Sildenafil With Btc (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 Buy Sildenafil With Btc any negative effect on the ability to drive a car or other means was not observed. However, since when taking Buy Sildenafil With Btc 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.



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