Viagra Connect Uae is a potent selective inhibitor of cGMP-specific PDE-5.
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.
Viagra In The Uae 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 Viagra Uae Price 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. Natural Viagra Uae 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 Viagra Uae Souq is sexual stimulation.
Viagra Medicine Uae restores impaired erectile function in conditions of sexual stimulation by increasing blood flow to the cavernous bodies of the penis.
Clinical data
Cardiac studies. The use of Viagra Medicine Uae 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 Alternative Uae 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 Uae Souq 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 Tablets In Uae 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 In Uae 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 Buy Viagra In Uae (up to 100 mg) in men (n=568) with erectile dysfunction and hypertension, taking more than two antihypertensive drugs, was studied. Viagra Pills Uae 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 Lady Viagra Uae 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. Female Viagra In Uae had no effect on visual acuity, contrast perception, electroretinogram, IOP or pupil diameter.
In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Viagra Connect Uae 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 Viagra Pills Uae 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 Viagra For Sale Uae, 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 Female Viagra In Uae Pharmacy 25 mg), 74% (dose Female Viagra Uae 50 mg) and 82% (dose Viagra Pills Uae 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 Viagra Uae Legal 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 Viagra Uae Legal.
Pharmacokinetics
The pharmacokinetics of Viagra In Uae in the recommended dose range is linear.
Suction. After intake of Viagra Alternative Uae is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Viagra Uae Dubai at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Female Viagra In Uae Pharmacy 100 mg average Cmax free Lady Viagra Uae in plasma men is about 18 ng/ml (38 nm). Cmax when taking Pink Viagra Tablets Uae 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 Natural Viagra Uae is 105 l. the Association of Viagra Pills Uae 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 Alternative Uae (an average of 188 ng) was found in sperm 90 minutes after taking the drug.
Metabolism. Viagra For Sale Uae 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 Viagra From Uae, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Herbal Viagra In Uae, and its activity against PDE-5 in vitro is about 50% of the activity of Viagra Uae Legal. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Viagra Tablet Uae. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.
Breeding. The total clearance of Herbal Viagra In Uae is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Herbal Viagra In Uae is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).
Special patient groups
Old age. In healthy elderly patients (over 65 years), the clearance of Herbal Viagra In Uae is reduced, and the concentration of free Viagra In The Uae in blood plasma is approximately 40% higher than in young (18-45 years). Age has no clinically significant effect on the incidence of side effects.
Renal impairment. With mild (Cl creatinine 50-80 ml/min) and moderate (Cl creatinine 30-49 ml/min) degree of renal failure pharmacokinetics Taking Viagra To Uae after a single oral dose of 50 mg does not change. In severe renal failure (Creatinine CL ≤30 ml/min), Viagra In Uae clearance decreases, resulting in approximately a twofold increase in AUC (100%) and Cmax (88%) compared to those in normal renal function in patients of the same age group.
Hepatic impairment. In patients with liver cirrhosis (classes A and B according to the child-Pugh classification), Viagra Tablets In Uae clearance decreases, which leads to an increase in the value of AUC (84%) and Cmax (47%) compared with those in normal liver function in patients of the same age group. Pharmacokinetics of Viagra In Uae Pharmacy in patients with severe hepatic impairment (class C according to the classification of child-Pugh) has not been studied.
Indications of Viagra Uae Legal
Treatment of erection disorders characterized by inability to achieve or maintain a penis erection sufficient for satisfactory sexual intercourse.
Viagra Pills Uae is only effective in sexual stimulation.
Contraindications
hypersensitivity to Taking Viagra To Uae 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 Medicine Uae enhances the hypotensive effect of nitrates (see "Interaction»);
the combined use of inhibitors of PDE5, including Viagra Uae Price, 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 Connect Uae 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.
Side effect
The most common side effects were headache and tides.
Usually the side effects of Female Viagra Uae are mild or moderate and are transient.
Studies using a fixed dose have shown that the frequency of some adverse events increases with increasing dose.
The frequency of adverse reactions is presented in the following classification: very often — ≥10%; often — ≥1% and <10%; infrequently — ≥0.1% and <1%; rarely — ≥0.01% and <0.1%; very rarely — <0.01%; frequency unknown — cannot be determined based on available data.
Co side of the immune system: infrequently — hypersensitivity reactions (including skin rash), allergic reactions.
On the part of the organ of vision: often — blurred vision, blurred vision, cyanopsia; rarely, eye pain, photophobia, photopsia, chromatopsia, eye redness/injection of the sclera, changing the brightness of cvetovete, mydriasis, conjunctivitis, hemorrhage in the tissue of the eye, cataract, a disorder of the lacrimal apparatus; rarely — swelling of the eyelids and adjacent tissues, a feeling of dryness in the eyes, the presence of iridescent circles in the field of view around the light source, increased fatigue of the eyes, vision of objects in yellow (xanthopsia), vision of objects in red (erythropsia), conjunctival hyperemia, irritation of the mucous membrane of the eyes, unpleasant sensations in the eyes; the frequency is unknown — NPINZN, occlusion of retinal veins, visual field defect, diplopia*, temporary vision loss or decreased visual acuity, increased IHD, edema retina, retinal vascular disease, vitreous detachment/vitreal traction.
On the part of the organ of hearing: infrequent — a sudden decrease or loss of hearing, tinnitus, pain in the ears.
From the CCC: often — tides; infrequently — tachycardia, palpitations, decreased blood PRESSURE, increased heart rate, unstable angina, AV-blockade, myocardial infarction, cerebral thrombosis, cardiac arrest, heart failure, deviations in ECG readings, cardiomyopathy; rarely — atrial fibrillation, sudden cardiac death*, ventricular arrhythmia*.
The blood and lymphatic system: rarely — anemia, leukopenia.
On the part of metabolism and nutrition: infrequently — a feeling of thirst, swelling, gout, uncompensated diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemia, hypernatremia.
From the respiratory system: often — nasal congestion; infrequent — nosebleeds, rhinitis, asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, increased volume of sputum, increased cough; rarely — a feeling of tightness in the throat, dryness of the nasal mucosa, swelling of the nasal mucosa.
From the digestive tract: often — nausea, dyspepsia; uncommon — GERD, vomiting, pain in the abdomen, dryness of the mucous membrane of the mouth, glossitis, gingivitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, rejection of liver function tests from normal, rectal bleeding; rarely, hypesthesia of the mucous membrane of the oral cavity.
On the part of the musculoskeletal system: often — back pain; infrequently — myalgia, pain in the limbs, arthritis, arthrosis, tendon rupture, tenosynovitis, bone pain, myasthenia gravis, synovitis.
From the genitourinary system: infrequently — cystitis, nicturia, breast enlargement, urinary incontinence, hematuria, ejaculation disorders, genital edema, anorgasmia, hematospermia, damage to the tissues of the penis; rarely — prolonged erection and/or priapism.
From the Central and peripheral nervous system: very often — headache; often — dizziness; infrequently — drowsiness, migraine, ataxia, hypertension, neuralgia, neuropathy, paresthesia, tremor, vertigo, symptoms of depression, insomnia, unusual dreams, increased reflexes, hypesthesia; rarely — convulsions*, repeated convulsions*, fainting.
On the part of the skin and subcutaneous tissues: infrequently — skin rash, urticaria, herpes simplex, itching, sweating, skin ulceration, contact dermatitis, exfoliative dermatitis; the frequency is unknown — Stevens-Johnson syndrome, toxic epidermal necrolysis.
Other: infrequently — a feeling of heat, swelling of the face, photosensitivity reaction, shock, asthenia, fatigue, pain of various localization, chills, accidental falls, chest pain, accidental injuries; rarely — irritability.
Cardiovascular complications
During the post-marketing use of Viagra Uae Price 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 Female Viagra Uae. 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 Alternative Uae 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 Alternative Uae, 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 Viagra Tablet Uae 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 Tablet Uae, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.
When using the drug Viagra Tablet Uae 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 Taking Viagra To Uae
The metabolism of Viagra In Uae Price occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Viagra From Uae, and inducers, respectively, increase the clearance of Female Viagra In Uae. A decrease in the clearance of Female Viagra In Uae with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).
Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Herbal Viagra In Uae (50 mg) causes an increase in the concentration of Viagra Uae Legal in plasma by 56%.
A single dose of 100 mg of Viagra Uae Dubai 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 Uae by 182%.
When co-administered Viagra Medicine Uae (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 Female Viagra Uae 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 Tablet Uae.
The simultaneous use of Herbal Viagra In Uae (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 Pink Viagra Tablets Uae by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Taking Viagra To Uae in blood plasma is about 200 ng/ml (after a single application of one Viagra Connect Uae — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Viagra In Uae does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Best Viagra In Uae is not recommended. In any case, the maximum dose of Viagra Uae Dubai under any circumstances should not exceed 25 mg for 48 hours. If Viagra Tablets In Uae is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Lady Viagra Uae 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 Female Viagra In Uae Pharmacy.
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 Viagra In Uae in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Viagra For Sale Uae by 62.6 and 52.4%, respectively. Viagra For Sale Uae increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.
It is assumed that the simultaneous use of Viagra In Uae with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Taking Viagra To Uae 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 Lady Viagra Uae.
Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Viagra Buy Uae or its main circulating metabolite.
Influence of Viagra Medicine Uae on other drugs
Viagra Connect Uae is a weak inhibitor of cytochrome P450 — 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 ISOENZYMES (IC50 >150 µmol). When taking Viagra In Uae Pharmacy in recommended doses, its Cmax is about 1 µmol, so it is unlikely that Viagra Uae Price can affect the clearance of the substrates of these isoenzymes.
Female Viagra In Uae 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 From Uae in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Viagra Uae Legal (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 Buy Uae 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.
Herbal Viagra In Uae (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 Uae Dubai 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 Uae Souq (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).
Viagra Uae Price (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 Tablet Uae (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 Viagra Alternative Uae in combination with antihypertensive agents does not lead to additional side effects.
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 Viagra Uae Souq 100 mg, the second tablet of Viagra Tablets In Uae 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 Viagra From Uae 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 Female Viagra Uae significantly slows down when used in combination with fatty foods.
Special patient groups
Renal impairment. In mild to moderate renal failure dose adjustment is not required, in severe renal failure (Creatinine CL <30 ml/min) Lady Viagra Uae dose should be reduced to 25 mg.
Hepatic impairment. Since the excretion of Viagra Medicine Uae is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Viagra Uae Price 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 Pink Viagra Tablets Uae under any circumstances should not exceed 25 mg, and the frequency of application — 1 time in 48 h (see "Interaction").
When combined with inhibitors of CYP3A4 isoenzyme (erythromycin, saquinavir, ketoconazole, Itraconazole), the initial dose of Female Viagra In Uae Pharmacy should be 25 mg (see "Interaction").
To minimize the risk of postural hypotension in patients taking α-blockers, Viagra Uae Price should be started only after achieving hemodynamic stabilization in these patients. Consideration should also be given to reducing the initial dose of Pink Viagra Tablets Uae (see special instructions and Interactions).
Old age. Adjustment of the dose of Viagra For Sale Uae is not required.
Overdose
Symptoms: with a single dose of Viagra In The Uae at a dose of 800 mg adverse events were the same as when taking the drug in lower doses, but were more common. The use of a dose of 200 mg did not lead to an increase in the effectiveness of the drug, but the frequency of adverse reactions (headache, tides, dizziness, dyspepsia, nasal congestion, visual impairment) increased.
Treatment: symptomatic. Hemodialysis does not accelerate the clearance of Best Viagra In Uae, because the latter is actively associated with plasma proteins and is not excreted by the kidneys.
Special instruction
For diagnostics of violations of erection, determination of them possible reasons and choice of adequate treatment it is necessary to collect a complete medical history and conduct a thorough physical examination. Treatment of erectile dysfunction should be used with caution in patients with anatomical deformation of the penis (angulation, cavernous fibrosis, Peyronie's disease) or risk factors for priapism (SKA, multiple myeloma, leukemia) (see With caution).
During post-marketing studies have reported cases of prolonged erection and priapism. In case of maintaining an erection for more than 4 hours, you should immediately seek medical help. If priapism therapy has not been carried out immediately, it can lead to damage to the tissues of the penis and irreversible loss of potency.
Drugs intended for the treatment of erection disorders should not be prescribed to men for whom sexual activity is undesirable.
Sexual activity presents a certain risk in the presence of heart disease, so before any therapy for erectile dysfunction, the doctor should send the patient to the examination of the state of CCC. Sexual activity is undesirable in patients with heart failure, unstable angina, suffered in the last 6 months of myocardial infarction or stroke, life-threatening arrhythmias, hypertension (BP >170/100 mm Hg.art.) or hypotension (blood PRESSURE <90/50 mm Hg.V.). Female Viagra In Uae Pharmacy intake in such patients is contraindicated (see "Contraindications"). Clinical studies have shown no differences in the incidence of myocardial infarction (1.1 per 100 people per year) or mortality from cardiovascular disease (0.3 per 100 people per year) in patients receiving Buy Viagra In Uae, compared with patients receiving placebo.
Cardiovascular complications
During the post-marketing use of Female Viagra In Uae 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 Viagra Tablets In Uae. 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 Best Viagra In Uae without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.
Hypotension
Viagra From Uae has a systemic vasodilating effect, leading to a transient decrease in blood PRESSURE, which is not clinically significant and does not lead to any consequences in most patients. However, before prescribing Viagra Buy Uae, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with the rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood PRESSURE from the autonomic nervous system.
Since the combined use of Natural Viagra Uae and α-blockers can lead to symptomatic hypotension in some sensitive patients, Viagra Uae Price should be used with caution in patients taking α-blockers (see "Interaction"). To minimize the risk of postural hypotension in patients taking α-blockers, the drug Buy Viagra In Uae should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Viagra Connect Uae (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.
Visual impairment
In rare cases, during post-approval use of all of the inhibitors of PDE5, including Best Viagra In Uae, 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 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 Viagra Tablets In Uae 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 In The Uae, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk. In patients with episodes of development PINZN with loss of vision in one eye receiving Viagra Tablet Uae is contraindicated (see "Contraindications").
A small number of patients with hereditary retinitis pigmentosa have genetically determined disorders of the PDE of the retina. Information about the safety of the drug Viagra Pills Uae in patients with retinitis pigmentosa absent, so these patients should not be used Viagra Uae Legal (see "Contraindications").
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 Uae Souq. 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 For Sale Uae, consult a doctor immediately.
Bleedings
Viagra From Uae enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Ladies Viagra Tablet Uae in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Viagra In The Uae 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 (Viagra Connect Uae — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Ladies Viagra Tablet Uae — 3%, placebo — 2.4%). Patients receiving Viagra Uae Legal 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 Viagra Medicine Uae together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Viagra In The Uae (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 In Uae any negative effect on the ability to drive a car or other means was not observed. However, since when taking Female Viagra In Uae 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.
Viagra Uae Souq
