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Intimate V-gel is a powerful antibacterial, antifungal and anti-inflammatory agent; provides a sense of comfort and security; softens and moisturizes the vaginal mucosa; quickly heals minor damage.

Eliminates burning and itching, restores and normalizes the microflora of the vagina.
Effective in the treatment of cervicitis and vaginitis.
Lubricant removes the inflammatory processes of the cervix and vagina, strengthens the recovery process, eliminates itching.
It helps with vaginitis to avoid unwanted secretions.
Helps maintain the purity of female genital organs, eliminates excessive dryness and unpleasant odor.
Maintains useful vaginal microflora, protects against infections, restores tissues after removal or introduction of an intrauterine device.

Mode of application
♀Apply with the help of an applicator (see fig. In instructions to gel) or as recommended by a therapist.
♀Apply evenly deep inside 2 times a day for 1-2 grams of gel in the morning and in the evening.
♀The course of treatment is 7-14 days, the course requires 1-2 packs of V-gel.
♀Side effects: does not have any side effects, if applied according to the prescribed dosage.♀
Note V-gel is water soluble and brown stains are easily washed. The color of the gel is caused by herbal extracts. During the application of the gel, a slight burning sensation can sometimes appear, which is replaced by a cooling and soothing effect. For external use only.

Indications for use
♀Vaginal candidiasis
♀Vaginal trichomoniasis
♀Nonspecific bacterial vaginitis, vaginitis (inflammation of the vagina) caused by fungal, bacterial and trichomonas infections
♀Prevention of postoperative vaginal infections
♀Cervicitis, Leucorrhea
♀Itching and redness of the external genitalia, discharge from the urethra
♀Pain and burning with urination, pain during sexual intercourse, discharge from the ❀vagina (white curdled, with an unpleasant odor, with a yellowish tinge) burning and itching in the area ❀of ​​the external genitalia

Each gram of V-gel contains:
☘Exts. Triphala 4.0mg
☘Satapatri (Rose damascena Syn. R.centifolia) 3.6mg
☘Ela (Elettaria cardamomum) 3.6mg
☘Punarnava (Boerhaavia diffusa) 3.6mg
☘Shaileyam (Parmelia perlata) 2.0mg
☘Nirgundi (Vitex negundo) 1.6mg
☘Haridra (Curcuma longa) 1.6 mg

For hygiene
If a woman❀ is dissatisfied with her reflection in the mirror, she goes to the beauty salon, although in fact, in the first place, you should go to the gynecologist. Yes, exactly, and not otherwise. The thing is that ❀women’s beauty and gynecological health are closely interrelated. So, for example, a woman with problems ❀in the “female part” may have pimples in the nasolabial triangle. There are many more such examples.
An excellent assistant to solve problems with women’s health is the V-gel

Grease V-gel
What is this miracle remedy, what is the composition of the gel and what is it intended for?
If we talk about the properties of this miracle drug, it should be noted its anti-inflammatory effect. In addition, this drug has antibacterial as well as antifungal properties. If there are minor damages to the vaginal❀ mucosa, the lubricant will help to quickly heal cracks, soften them and provide a sense of ❀comfort.

❀This elixir of female health normalizes the microflora of the vagina, eliminates burning and itching.❀

The composition of this remedy includes natural natural components – this is Curcuma Long, and Rose Damascus, Parmelia and other effective helpers for the treatment of the most complex gynecological diseases and vaginal infections.

From the indications for use should be allocated vaginal candidiasis, as well as Cervicitis and vaginal trichomoniasis, inflammation of the vagina. This is an excellent protection against the occurrence of infections in the ❀vagina after various operations.

Itching and redness of the external genitalia, as well as discharge from the urethra, are also successfully treated with V-gel.

Women Health
Reproductive health is very important for every woman❀. What is it? Women’s health is an absolute well-being in the physical and mental, as well as social aspects. Of course, this is also the absence ❀of infections and tumors, various inflammatory processes.

Reproductive health authorities include:
♀Fallopian tubes – they bind the ovaries to the uterus.
♀Ovaries are the main organ of the woman’s reproductive system, which secretes hormones and ovules during the menstrual cycle.
♀Uterus – in this body there is a fertilized egg, this is where the embryo develops during pregnancy.
♀Endometrium is the mucosa of such an important female organ as the uterus.
♀The cervix is a narrow isthmus between the uterus and the vagina.
♀The vagina is a muscular canal from the cervix to the external genitalia.

In order for a woman to give birth to a healthybaby, her reproductive system should be in perfect order, because she isresponsible for the continuation of human life as a biological species.

Problems with ✵women’s health are fraught with the most negative consequences – this is infertility, and tumors in ✵female organs. Throughout life, most women develop various gynecological diseases. Therefore, women should regularly visit a gynecologist – at least every six months should be examined by this ✵specialist, only in this way you can avoid serious health problems. Do not wait for the manifestation of symptoms of a particular disease – the thing is that most of✵ the female diseases in the initial stages are asymptomatic. Only at a progressive stage there are signs ✵of ill health.
The main task of the gynecologist is to preserve ✵women’s health. That’s why you should regularly do preventive examinations and apply an intimate ✵gel. According to medical statistics, every eighth patient has gynecological diseases ✵of varying severity. Among them, oncological diseases, they can be detected with the help of✵ preventive examination at early stages. Modern technologies – excellent helpers for quick and accurate examination – literally in one day you can go through the✵ examination and make a diagnosis.

Treatment of vaginitis
One of the most common female inflammatory diseases is vaginitis. This is an inflammation of the ᠅vaginal mucosa. ᠅Risk factors here – reduced immunity, as well as treatment with antibiotics.

From the causes of this disease should be allocated venereal diseases, for example, chlamydia or gonorrhea, and maybe trichomoniasis or mycoplasmosis. Also, this disease can occur against the background of hormonal disorders. Ovarian and menopausal diseases, obesity and diabetes mellitus should be added to this list.

A prerequisite for the appearance of ᠅vaginitis can be a gross violation of hygiene. In the vagina an unusual for᠅ him microflora settles, as a result there are ᠅inflammations.

One of the first symptoms of this disease is the appearance of unpleasant sensations in the ᠅vagina – vaginal discharge appears on the underwear, which can be accompanied by itching and burning, reddening of᠅ the genital organs. At the same time, sex life becomes quite painful. And here an effective᠅ medicine will come to the rescue – lubrication ᠅of V-gel. It calms the inflamed vagina, reduces itching and burning sensation. In addition, thus, the healing process is accelerated. It is an excellent assistant in ᠅the fight against inflammatory processes.

Treatment of cervicitis
 The inflammatory process in the cervix is ​​called cervicitis. What leads to such a disease?

Let’s talk about the main reasons:
✿Infections that during sex partner can transmit – chlamydia and trichomoniasis, as well as gonorrhea and mycoplasmosis.
✿Viral diseases of the vagina, as well as the cervix – it can be the herpes virus or papilloma.
✿Mechanical stimuli – various injuries of the cervix during labor, abortion.
✿There are two forms of cervicitis – exo- and endocervicitis. Most often cervicitis is combined with vaginitis or is its consequence.

What are the symptoms of this inflammatory process?

✿Bloody discharge that lasts for several days after menstruation.
✿Itching appears in the genitals.
✿Pain and discomfort during intercourse, as well as blood clotting after its termination.
✿There is a burning sensation during urination.
✿There are pain in the perineum, as well as in the lower abdomen.

♻If the diagnosis of the presence of cervicitis, then to effectively combat this disease is best to use the gel for intimate hygiene. He quickly relieve the itching and burning, will help to normalize the microflora of the vagina.

Treatment of vaginal candidiasis
Itching, appearing in the vaginal area, may be due to the presence of vaginal fungal infection. Here you should elaborate on the candidiasis of the vagina – this infection is caused by yeast-like fungi of the genus Candida. In another way, this disease is called a milkmaid.

What can cause a violation of normal microflora and excessive reproduction of yeast-like fungi?

Reception of antibiotics has a harmful effect on a healthy microflora, while weakening the protection of the body.

Among the favorable conditions for reproduction of Candida fungi should be attributed and changes in acid-base balance in the environment in the vagina before the onset of menstruation.

➡Hot and humid weather are also factors favorable for vaginal candidiasis.

Add to this list the use of vaginal deodorants, as well as bath salts and certain types of soap. In addition, if the sexual act is performed with a dry vagina, the mucous membrane of the vagina is irritated, its protection is weakened.

Here it should be recalled that the risk of thrush infection enhances the use of tampons. Symptoms of thrush include:
❖irritation and burning in the vagina
❖abundant discharge, similar to cottage cheese

In order to prevent the emergence of thrush and to actively combat vaginal candidiasis successfully used an effective intimate V-gel. It has an antifungal effect. It is an active assistant for the normalization of microflora in the vagina, to eliminate itching and discharge.

If during the application of this product there is a feeling of easy tingling, then do not worry – it will quickly pass. Further, this sensation will be replaced by cooling, as well as mitigating action.

Treatment of vaginal trichomoniasis
This drug successfully treats vaginal trichomoniasis – it is a venereal disease that does not have pronounced symptoms. For quite a long time a woman can be a carrier of this infection and not even suspect about it. But it is worth paying attention to the itching of the genitals or the increased urge to urinate – it is these symptoms that may be harbingers of the appearance of this disease.

The symptoms become more pronounced in the case of a weakened organism after the flu or other diseases. In this case, the itching and redness of the genitals become worse, with pain, when urinating. The same happens with sexual contact. In addition, there are discharges from the vagina with a characteristic yellowish tinge.
Vaginal V-gel effectively treats this infection.

Treatment of pruritus and redness of genital organs
To treat itching, as well as redness of the genitals, this remedy will become a very effective assistant. How to apply an intimate gel? If there are no other recommendations of the doctor, then it is necessary to use an applicator for application, by means of which the drug is applied orally several times a day, one to two grams. This must be done in the morning and in the evening. The course of treatment with this drug is from one week to two. To do this, you will need one or two packs of gel for hygiene.

Postoperative recovery
It is very important that the vaginal gel effectively helps to recover after complicated operations. Here the main role is played by the excellent composition of the gel, thanks to which the microflora is normalized, discomfort disappears, and discomfort appears.

Prevention of sexual infections
A lot of trouble for women is caused by sexually transmitted infections – these are diseases that are traditionally considered sexually transmitted. These include syphilis and chlamydia, candidiasis and gardnerelez, as well as trichomoniasis and other diseases.

For the treatment of genital infections, it is necessary to consult a doctor. The specialist will be able to diagnose, make the necessary studies, identify which sexually transmitted infection is present in you. An excellent tool for fighting these infections will be the V-gel, which will quickly cope with such infections. And the treatment course is quite small – only one, maybe two weeks is enough to become healthy again. This product is water-soluble, so brown stains, which can appear on the laundry as a result of applying the gel, can easily be washed. The color of the gel is caused by its composition – it contains herbal plants, useful for the treatment of many female diseases.

Elimination of vaginal discharge
Lubrication V-gel will help to eliminate the discharge from the vagina, relieve the pain, itching, burning. This is an effective drug, with which you will forever forget about infections and women’s diseases.

Removal of unpleasant odor
This remedy will help get rid of the unpleasant odor caused by secretions against the background of this or that female disease. After all, very many diseases associated with female genital organs are accompanied by secretions, sometimes even purulent. So, it’s time to contact the online store and order an elixir of female health.

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Order V-gel online

Buy Yasmin (Dihydrospirenone) online

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Instructions for use of the drug for medical use Yasmin

The international non-proprietary name or grouping
Drospirenone + ethinylestradiol

Dosage form
Tablets film-coated

Each tablet film coating contains:
The tablet core:
Active substances
Ethinyl estradiol – 30 micrograms
Drospirenone – 3 mg
Excipients: lactose monohydrate – 48.170 mg, corn starch – 14,400 mg, corn starch pregelatinized – 9,600 mg, povidone K25 – 4,000 mg, magnesium stearate – 800 mcg.
Tablet Coating: Hypromellose (hydroxypropyl) – 1.0112 mg macrogol 6000 – 202.4 g talc (magnesium silicate) – 202.4 mg, titanium dioxide (E 171) – 556.5 g, iron (II) oxide ( E 172) – 27.5 mcg.

Film-coated tablets, light yellow color, with one side etched hexagon within which «DO» letters.

Pharmacotherapeutic group
Contraceptives (estrogen + progestogen)

ATC code

Pharmacological properties

The drug Yasmin – low-dose monophasic oral combined estrogen-progestin contraceptive drug.
Yasmin contraceptive effect of the drug is mainly carried out by means of complementary mechanisms, the most important of which include inhibition of ovulation and increased the viscosity of cervical secretions, whereby it becomes impenetrable to sperm.
With the proper use of the drug Yasmin Pearl Index (an indicator of the number of pregnancies in 100 women using a contraceptive during the year) is less than 1. When skipping pills or incorrect use Pearl Index may increase.
The increased risk of venous thromboembolism (VTE), which is associated with the use of combined oral contraceptives (COCs), refers primarily to the estrogen component. Currently ongoing scientific debate about the modulating effect of progestin, a member of the COC, in relation to the risk of VTE. Comparative epidemiological studies of the risk of VTE when using COCs containing ethinylestradiol / drospirenone and risks when using levonorgestrel-containing COCs have shown different results – from the lack of differences in the degree of risk, the risk increases to three times. In most studies, the drug was studied Yasmin.
To evaluate the risk of VTE in applying Yasmin drug (ethinylestradiol / drospirenone at doses of 0.03 mg / mg 3), two studies were conducted post-registration. The first prospective observational study showed that the incidence of VTE in women using the drug Yasmin, in the presence or absence of other risk factors for VTE was in the same range as that for women who use levonorgestrel-containing COCs and others. The second prospective controlled trial database in which conducted a comparative assessment of women using the drug Yasmin, with women using other COCs also confirmed a similar incidence of VTE among all cohorts of women.
Women using COCs, the cycle becomes more regular, less frequently observed bleeding menstrualnopodobnye painful, reduce the intensity and duration of bleeding, thereby reducing the risk of iron deficiency anemia. Also, there is evidence of reducing the risk of endometrial and ovarian cancer while taking COCs.
Drospirenone, which is part of the preparation Yasmin, has anti-mineralocorticoid activity and can prevent weight gain and other symptoms (eg, edema) associated with estrogen-dependent fluid retention. Drospirenone also has antiandrogenic activity and helps to reduce acne (acne), oily skin and hair (seborrhea). These features of drospirenone to consider when choosing a contraceptive for women with hormone-dependent fluid retention, as well as women with acne and seborrhea. According to its characteristics drospirenone similar to natural progesterone, produced by the female body.

When administered drospirenone is rapidly and almost completely absorbed. After receiving a single maximal concentration (Cmax) in plasma drospirenone is equal to 38 ng / ml, achieved after 1-2 hours. Food does not affect the bioavailability of which ranges from 76 to 85%.
Drospirenone is bound to albumin in blood plasma and does not bind to globulin, sex hormone binding (SHBG) or corticosteroid-binding globulin (CBG). Only 3.5% of the total concentration of substances present in blood plasma in the form of free hormone, 95-97% of the material non-specifically bind to albumin. SHBG ethinylestradiol induced increase does not affect the binding of plasma proteins drospirenone. Average apparent volume of distribution is 3,7 ± 1,2 l / kg.
After oral administration drospirenone is completely metabolized. Most of metabolites in blood plasma are presented acidic forms of drospirenone. Drospirenone is also a substrate for oxidative metabolism catalyzed by isoenzyme CYP 3A4. The metabolic clearance rate of drospirenone from plasma is 1.5 ± 0.2 ml / min / kg.
The concentration in the blood plasma decreases dwuhfazno drospirenone. Second, the final phase has a half-life (T1 / 2) of about 31 hours. In unmodified form drospirenone excreted in trace amounts. Its metabolites are excreted through the gastrointestinal tract and kidneys in a ratio of about 1.2: 1.4. The half-life of metabolites of drospirenone is about 40 hours.
equilibrium concentration
SHBG concentration does not affect the pharmacokinetics of drospirenone. With daily use of the drug inside the drospirenone plasma concentration increases by 2-3 times, the equilibrium concentration is reached after 8 days of treatment.
If the kidney function
Studies have shown that concentrations of drospirenone in serum of women with mild renal impairment (creatinine clearance (CC) – 50-80 ml / min) when it reaches an equilibrium state, and in women with preserved renal function (creatinine clearance – 80 ml / min) are comparable . However, in women with moderate renal impairment (creatinine clearance – 30-50 ml / min), the average concentration in the blood plasma of drospirenone was 37% higher than that in patients with intact renal function. There was no change in the potassium concentration in blood plasma when applied drospirenone.
If abnormal liver function
In women with moderate hepatic impairment (class B on a scale Child-Pugh) area under the curve “concentration-time» (AUC) is comparable with the corresponding index in healthy women with similar values ​​of Cmax in the absorption phase and distribution. T1 / 2 drospirenone in patients with moderate hepatic impairment appeared to 1.8 times higher than in healthy volunteers.
In patients with moderate hepatic impairment drospirenone clearance decreased by approximately 50% as compared with healthy women, while there was no difference in the potassium concentration in blood plasma in the studied groups. In identifying diabetes and concomitant use of spironolactone (both states are regarded as factors predisposing to hyperkalemia), increasing the concentration of potassium in the blood plasma is not established. Thus, it can be concluded that drospirenone tolerated in women with mild to moderate hepatic impairment good (class B on a scale Child-Pugh).
Do not set the influence of ethnicity (research conducted on cohorts of Caucasian women and Japanese women) on the pharmacokinetic parameters of drospirenone and ethinylestradiol.

After oral administration, ethinylestradiol is rapidly and completely absorbed. Cmax – 100 pg / ml is reached within 1-2 hours. During the suction and the “first pass” through the liver is metabolized ethinylestradiol, whereby its oral bioavailability averages about 45% of interindividual variability at high – from 20 to 65%. Simultaneous food intake, in some cases accompanied by a decrease ethinylestradiol bioavailability of 25%.
Ethinylestradiol nonspecifically but closely associated with albumin in blood plasma (approximately 98%) and induces an increase in the plasma concentration of SHBG. The estimated volume of distribution of 5 l / kg.
Ethinylestradiol undergoes significant primary metabolism in the intestine and liver. Ethinyl estradiol and its oxidative metabolites initially conjugated to glucuronides or sulfate. The metabolic clearance rate of ethinyl estradiol is about 5 ml / min / kg.
Reducing the ethinyl estradiol concentration in blood plasma is biphasic; the first phase is characterized by a half-life of about 1 hour, the second – 20 hours. Ethinylestradiol hardly excreted unchanged. ethinyl estradiol metabolites are excreted via the kidneys and intestines in a ratio of 4: 6. The half-life of metabolites is about 24 hours.
equilibrium concentration
The equilibrium state is reached in the second half cycle of dosing, when the concentration of ethinyl estradiol in the blood plasma is increased by 40-110% as compared with a single dose.




The drug is contraindicated Yasmin if any of the conditions / diseases listed below. If any of these conditions / diseases develop for the first time in patients receiving the drug should be immediately repealed.
• Thrombosis (venous and arterial) and thromboembolism (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke), cerebrovascular disorders – now or in history.
• Conditions prior thrombosis (including transient ischemic attack, angina pectoris) now or in history.
• Identification of acquired or hereditary predisposition for venous or arterial thrombosis, including resistance to activated protein C, antithrombin III deficiency, protein C deficiency, protein deficiency of the S, hyperhomocysteinemia, antibodies to phospholipids (cardiolipin antibodies, lupus anticoagulant).
• The presence of high-risk venous or arterial thrombosis (see section “Special Instructions”).
• Migraine with focal neurological symptoms in the present or in history.
• Diabetes mellitus with vascular complications.
• Pancreatitis with severe hypertriglyceridemia now or in history.
• Liver failure and severe liver disease (liver function tests before normalization).
• liver tumors (benign or malignant) now or in history.
• Severe or acute renal failure.
• Identified hormone malignancies (including genital or mammary glands) or are suspected.
• Bleeding from the vagina of unknown origin.
• Pregnancy or suspicion of it.
• The period of breastfeeding.
• Hypersensitivity to any component of the drug Yasmin.
• Lactose intolerance, lactase deficiency, glucose-galactose malabsorption (the drug includes lactose monohydrate).


You should carefully weigh the potential risks and expected benefits of the use of COCs in each individual case in the presence of the following diseases / conditions and risk factors:
• Risk factors for thrombosis and thromboembolism: smoking; obesity; dislipoproteinemia controlled hypertension; migraine without focal neurological symptoms; valvular disease; a genetic predisposition to thrombosis (thrombosis, myocardial infarction or cerebrovascular accident at a young age in any of the next of kin);
• Other medical conditions, which may occur when peripheral circulatory disorders: diabetes; systemic lupus erythematosus; hemolytic-uremic syndrome; Crohn’s disease and ulcerative colitis; sickle cell anemia; phlebitis of superficial veins;
• Hereditary angioedema;
• Hypertriglyceridemia;
• Liver disease not related to the contraindications (see section “Contraindications”.);
• Diseases caused or aggravated first time during pregnancy, or on the background of the previous use of sex hormones (eg, jaundice and / or pruritus related to cholestasis, cholelithiasis, otosclerosis with hearing impairment, porphyria, herpes during pregnancy, Sydenham’s chorea);
• Postpartum.

Application of pregnancy and during breastfeeding

Yasmin drug is contraindicated during pregnancy and lactation.
If pregnancy is detected during the reception Yasmin drug, the drug should be immediately abolished. Extensive epidemiological studies have revealed no increased risk of defects in children born to women treated with hormones prior to pregnancy or teratogenic effects in cases of use of sex hormones for negligence in the early stages of pregnancy. At the same time, the available data on the use of the drug during pregnancy Yasmin limited, which does not allow any conclusions about the negative effects of the drug on pregnancy, health of the fetus and newborn child. At present any significant epidemiological data available.
The drug can reduce the amount of breast milk and change its composition, so the use of the drug is contraindicated until weaning. A small amount of sex hormones and / or metabolites thereof can penetrate into breast milk and influence the health of the baby.

Dosing and Administration

How and when to take the tablets
Calendar pack Yasmin product contains 21 pill. Each tablet in the package is marked with the day of the week that it should be adopted. The tablets should be taken orally every day for 21 days in the order specified on the package, about the same time, with a little water. Receiving the next pack of tablets is started after a 7-day interval, during which usually develops menstrualnopodobnoe bleeding (bleeding “cancel”). Usually, it starts on day 2-3 after the last tablet and may not end before you start taking tablets from a new package. After a 7-day interval start pills from a new package is required even if the bleeding is not yet menstrualnopodobnoe stopped. This means that start taking tablets from a new package must be in the same day of the week, and every month the bleeding “cancel” will advance approximately one and the same day of the week.

Receiving tablets of the first package of the drug Yasmin
• When no hormonal contraceptive has not been applied in the previous month
Admission Yasmin preparation should begin on the first day of the menstrual cycle (ie the first day of menstrual bleeding). It is necessary to take the pill, which is marked with the corresponding day of the week. This is followed by taking pills in order. Allowed to start taking the drug on day 2-5 of the menstrual cycle, but in this case within the first 7 days of the first package of tablets is recommended to use an additional barrier method of contraception.
• When switching from other drugs combined contraceptive (COC, vaginal ring or transdermal patch)
Preferably Yasmin start taking the drug the next day after taking the last active tablet of the previous package, but in any case not later than the day after the usual 7-day break (for products containing 21 tablets), or after the last inactive tablet (for products containing 28 tablets per pack). Admission Yasmin drug should be started on the day of removal of the vaginal ring or patch, but not later than the day when it should be inserted a new ring or pasted a new patch.
• When switching from contraceptives containing only progestin ( “mini-pill”, an injectable form, implant) or intrauterine therapeutic system with the release of progestogen
Go to the “mini-pill” for the drug Yasmin possible any day (without a break), with an implant or intrauterine device with progestin – the date of their removal from the injection mold – the day when the next injection should be done. In all these cases during the first 7 days of tablet Yasmin drug must also use a barrier method of contraception (eg, condoms).
• After an abortion (including spontaneous) in the first trimester of pregnancy.
Start taking the drug can be immediately. Subject to this condition, additional contraceptive measures are required.
• After childbirth (in the absence of breastfeeding) or abortion (including spontaneous) in the second trimester of pregnancy.
Start taking the drug at the recommended 21-28 days after birth (no breastfeeding) or abortion in the second trimester of pregnancy. If the drug started later, you must use an additional barrier method of contraception during the first 7 days of taking the pills. If intercourse took place before you start taking the drug Yasmin, pregnancy must be excluded.

Admission missed tablets
If the delay in receiving the drug was less than 12 hours, contraceptive protection is not reduced. It is necessary to take the missed pill as the next tablet is taken at the usual time as soon as possible.
If the delay in the pill was more than 12 hours, contraceptive protection is reduced. The more missed tablets and the closer to the pass 7-day tablet-free interval, the higher the chance of pregnancy.
It should be remembered:
• The drug should never be interrupted for more than 7 days.
• 7 days continuous administration of pills required to achieve adequate suppression of the hypothalamic-pituitary-ovarian system.
Accordingly, if the delay in the pill exceeding 12 hours (from the time interval of receiving the last tablet – 36 hours), depending on the week, when a tablet is missed, it is necessary:
• The first week of taking the drug
It should take the last missed tablet as soon as possible, as soon as she remembers about it (even if it is necessary to take two tablets at the same time). The next tablet should be taken at the usual time. Over the next 7 days should additionally be used a barrier method of contraception (such as a condom). If intercourse took place during the 7 days before skipping pills, you need to consider the possibility of pregnancy.
• The second week of taking the drug
It should take the last missed tablet as soon as possible, as soon as she remembers about it (even if it is necessary to take two tablets at the same time). The next tablet should be taken at the usual time. Provided that if a woman is on the pill correctly within the preceding 7 days, there is no need to use additional contraceptive measures. Otherwise, as well as skipping of two or more tablets must also use barrier contraception (such as a condom) for the next 7 days.
• The third week of taking the drug
Risk reduction of contraceptive reliability is imminent because of the forthcoming tablet-free interval. In this case, you must adhere to the following algorithms:
– If during the 7 days preceding the first missed tablet, taken all the tablets correctly, there is no need to use additional methods of contraception. When you receive a missed tablets refer to paragraphs 1 and 2.
– If during the 7 days preceding the first missed tablet, tablets are taken properly, for the next 7 days is necessary to additionally use a barrier method of contraception (eg, condoms), and in this case should be guided by paragraph 1 for receiving the missed tablets.
1. It is necessary to take the missed pill as soon as possible, as soon as she remembers about it (even if this means taking two tablets at the same time). The next tablet at the usual time taken until the end tablets from the current package. Taking the pills from the next pack should be started immediately without the usual 7-day break. Bleeding “cancel” is unlikely until the end of the second tablet package, but can be marked “smearing” of isolation and / or “breakthrough” bleeding during treatment.
2. It is also possible to interrupt taking the tablets from the current package, make a break for 7 days or less (including the days pass pills), and then begin taking pills from a new package.
If a woman misses pills, and during a break in the reception she has no bleeding, “cancellation”, it is necessary to exclude pregnancy.

Are allowed to take no more than two tablets in one day.

Recommendations in the gastro-intestinal disorders
In severe gastrointestinal disorders, drug absorption may not be complete, so you should use additional methods of contraception.
If within 3-4 hours after taking the tablet marked vomiting or diarrhea, you should be guided by the recommendations by skipping pills mentioned above, depending on the week of dosing. If a woman does not want to change their usual dosage regimen and move the start of menstruation to another day of the week, an extra tablet to be taken from another package.

Stopping the drug Yasmin
Admission Yasmin drug can be discontinued at any time. If a woman is not planning a pregnancy, you should take care of other contraceptive methods. If you are planning a pregnancy, you should simply stop taking the drug and wait Yasmin natural menstrual bleeding.

Delaying the start of bleeding menstrualnopodobnoe
In order to delay the onset of menstrualnopodobnoe bleeding, you need to continue further pills from a new package of the drug Yasmin without 7-day break. Tablets of the new package may be made as long as necessary, including up until tablets are completed package. Against the background of the drug from the second package may be marked “smearing” bloody discharge from the vagina and / or “breakthrough” uterine bleeding. Reactivate the drug Yasmin of a pack should be after the usual 7-day break.

Changing the date of commencement menstrualnopodobnoe bleeding
In order to move the first day of bleeding menstrualnopodobnoe on another day of the week, the woman should be reduced (but not lengthen) the next 7-day tablet-free interval for as many days, on how much a woman wants. For example, if the cycle usually starts on a Friday and in future she wants it began on Tuesday (3 days earlier), tablet-taking from the next pack should start on 3 days earlier than usual. The shorter the tablet-free interval, the higher the probability that menstrualnopodobnoe bleeding does not occur, and while taking tablets from the second package will be observed “smearing” of isolation and / or “breakthrough” bleeding.

Use in specific patient groups
In children and adolescents
The drug Yasmin shown only after menarche. Available data do not require dose adjustment in this group of patients.
Not applicable. The drug is not shown Yasmin after menopause.
If abnormal liver function
Yasmin The drug is contraindicated for use in women with severe liver disease as long as liver function tests have not come back to normal. See. Also “Contraindications” and “Pharmacological properties”.
When violations of renal function
Yasmin drug is contraindicated for women with severe renal insufficiency or acute renal failure. See. Also “Contraindications” and “Pharmacological properties”.

Rated frequency according to epidemiological studies, covers a group of COCs.
Venous and arterial thromboembolic events were combined following nosologic forms: occlusion of peripheral deep vein thrombosis and thromboembolism / pulmonary vascular occlusion, thrombosis, embolism, and heart attack / myocardial infarction / cerebral infarction, and stroke is not classified as hemorrhagic.
For venous and arterial thromboembolism, migraine cm. Also “Contraindications” and “Cautions”.

The following are adverse reactions at very low frequency of occurrence or the development of delayed symptoms that are considered to be related to the COC group (see also “Contraindications”, “Cautions”.)
• In women using COCs, very slightly increased incidence of breast cancer. Because breast cancer is rare in women younger than 40 years, increased cancer incidence in women using COCs, slightly relative to the total risk of breast cancer. A causal relationship with the use of COCs is not known.
• liver tumors (benign or malignant).
Other state
• Erythema nodosum.
• Women with hypertriglyceridemia (increased risk of pancreatitis when using COCs).
• Increased blood pressure.
• The onset or worsening of conditions in which the connection with the use of COCs is not uncontested: jaundice and / or pruritus related to cholestasis; formation of gallstones; porphyria; systemic lupus erythematosus; hemolytic-uremic syndrome; chorea; herpes during pregnancy; hearing loss associated with otosclerosis.
• In women with hereditary angioedema exogenous estrogens may induce or exacerbate symptoms of angioedema.
• Violations of the liver.
• Impaired glucose tolerance or effect on peripheral insulin resistance.
• Crohn’s disease, ulcerative colitis.
• Chloasma.
• Hypersensitivity (including symptoms such as rash, urticaria).
Due to the interaction of other drugs (enzyme inducers) with oral contraceptives may experience “breakthrough” bleeding and / or reduction of the contraceptive effect (see. “Interaction with other medicinal products” section).


Serious violations were reported in overdose. Based on the cumulative experience of the COC symptoms that may occur with overdose include nausea, vomiting, spotting from the vagina, metrorrhagia.
No specific antidote, symptomatic treatment should be conducted.

Interaction with other drugs

The influence of other drugs on the drug Yasmin
Possible interactions with drugs that induce hepatic microsomal enzymes which may result in increased clearance of sex hormones, which in turn can lead to “breakthrough” uterine bleeding and / or reducing the contraceptive effect.
Women who receive treatment such preparations, in addition to the drug Yasmin, it is recommended to use a barrier method of contraception or select a non-hormonal method of contraception. Barrier contraceptive method should be used during the reception period of concomitant medications as well as 28 days after their withdrawal. If the period of use of a barrier method of contraception ends later than tablets in a package of the drug Yasmin should start taking pills Yasmin preparation of the new packaging without interruption in the reception of tablets.
• Substances that increase clearance of the drug Yasmin (weaken the effectiveness of the enzymes by induction):
phenytoin, barbiturates, primidone, carbamazepine, rifampicin and possibly also oxcarbazepine, topiramate, felbamate, griseofulvin, and preparations containing St. John’s wort.
• Substances with a different effect on the clearance of the drug Yasmin
In a joint application with preparation Yasmin many HIV protease inhibitors or the hepatitis C virus and nenukliozidnye reverse transcriptase inhibitors may both increase and decrease the concentration of estrogen or progestin in the blood plasma. In some cases, this effect can be clinically significant.
• Substances that reduce the clearance of COCs (enzyme inhibitors)
Moderate and strong inhibitors of CYP3A4, such as azole antifungals (e.g., itraconazole, voriconazole, fluconazole), verapamil, macrolides (e.g., clarithromycin, erythromycin), diltiazem and grapefruit juice may increase the plasma concentrations of estrogen or progestin, or both.
It was shown that at doses etoricoxib 60 and 120 mg / day coadministered with a COC containing 0.035 mg of ethinyl estradiol, ethinyl estradiol increases the concentration in plasma of 1.4 and 1.6 times, respectively.

Effect of the drug on Yasmin other drugs
COC may affect the metabolism of other drugs, which leads to an increase (e.g., cyclosporin) or decrease (eg lamotrigine) in their blood plasma concentration and tissue.
In vitro, drospirenone is able to weakly or moderately inhibit the enzymes of the cytochrome P450 CYP1A1, CYP2C9, CYP2C19 and CYP3A4.
Based on the in vivo interaction studies in female volunteers taking omeprazole, simvastatin or midazolam as marker substrates it can be concluded that a clinically significant effect of 3 mg of drospirenone drug metabolism mediated by the enzyme cytochrome P450, it is unlikely.
In vitro ethinyl estradiol is a reversible inhibitor of CYP2C19, CYP1A1 and CYP1A2, as well as an irreversible inhibitor of CYP3A4 / 5, CYP2C8 and CYP2J2. In clinical studies assignment hormonal contraceptive containing ethinylestradiol, did not lead to any increase or resulted in only a slight increase in CYP3A4 substrate concentrations in plasma (e.g. midazolam), while plasma CYP1A2 substrate concentration may increase slightly (e.g., theophylline ) or moderately (e.g., tizanidine and melatonin).

Other forms of interaction
Patients with intact renal function and drospirenone combined use of ACE inhibitors or nonsteroidal antiinflammatory drugs has no significant effect on the potassium concentration in the blood plasma. However, the combined use of the drug Yasmin with aldosterone antagonists or potassium-sparing diuretics has not been studied. When co-administered with these drugs potassium concentration in the blood plasma is necessary to control for the first intake cycle (see. “Special Instructions” section).

Preclinical safety data
Preclinical data obtained in the course of standard tests to identify the toxicity after repeated doses of the drug taking, as well as genotoxicity, carcinogenic potential and toxicity to the reproductive system, do not indicate a particular risk to humans. Nevertheless, we should remember that sex hormones may promote the growth of certain hormone-dependent tissues and tumors.
Laboratory tests
Receiving Yasmin drug can affect the results of some laboratory tests including liver function tests, renal, thyroid, adrenals, concentration in plasma transport proteins, carbohydrate metabolism, blood clotting parameters and fibrinolysis. Changes do not usually go beyond the normal range. Drospirenone increases plasma renin activity and aldosterone concentration, due to its antimineralokortikoidnym effect.
decline in efficiency
Efficacy Yasmin drug may be reduced in the following cases: when skipping tablets, gastro-intestinal disorders or as a result of drug interactions.
The frequency and severity of bleeding menstrualnopodobnoe
While taking the drug could experience Yasmin irregular (acyclic) bleeding from the vagina ( “smearing” spotting and / or “breakthrough” uterine bleeding), especially during the first months of use. Therefore, the evaluation of any irregular bleeding menstrualnopodobnoe should be carried out after a period of adaptation of approximately three cycles. If irregular bleeding menstrualnopodobnye recur or occur after previous regular cycles, you should conduct a thorough examination to exclude malignancy or pregnancy.
Some women during the tablet-free interval may not develop bleeding “cancel.” If the drug Yasmin taken according to the recommendations, it is unlikely that the woman is pregnant. However, the irregular use of the drug and the absence of two consecutive menstrualnopodobnoe bleeding, the drug can not be extended to exclude pregnancy.
Medical examinations
Before the start or resumption of use of the drug Yasmin should be familiar with the history of life, a family history of the women, to conduct a thorough general medical and gynecological examination to exclude pregnancy. The volume of research and the frequency of control examinations should be based on existing standards of medical practice with the need to consider the individual characteristics of each patient. As a rule, measured blood pressure, heart rate, determined by the body mass index, checked the state of the mammary glands, abdomen and pelvic organs, including cytology cervical epithelium (Papanicolaou test). Typically, control examinations should be carried out at least 1 time in 6 months.

It should be borne in mind that Yasmin drug does not protect against HIV infection (AIDS) and other sexually transmitted diseases through!

Effects on ability to drive vehicles and mechanisms
Not found.

Storage conditions
Store at temperatures not above 25 ° C.
Keep out of the reach of children.

Shelf life
3 years. Do not use after the expiration date!

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❇Active Ingredient: Clobetasol Propionate

❇Description ℴf active ingredient Clobetasol

▶Formula: C22H28ClFO4, chemical name: (11beta, 16beta) -21-Chloro-9-fluoro-11,17-dihydroxy-16-methylpregna-1,4-diene-3,20-dione (and as propionate).
Pharmacological group: hormones and thℯir antagonists / corticosteroids / glucocorticoids.
Pharmacological action: glucocorticoid, antiallergic, anti-inflammatory, antipruritic.

❇Armacological properties
Clobetasol induces thℯ formation ℴf lipocortin proteins that inhibit phospholipase A2, slows thℯ formation ℴf arachidonic acid and thℯ products ℴf its metabolism – leukotrienes, prostaglandins. Clobetasol at thℯ site ℴf application eliminates flushing, swelling, itching. Possible absorption ℴf Clobetasol in thℯ systemic circulation with local use. With thℯ use ℴf Clobetasol in large areas ℴf thℯ skin, absorption is more pronounced. Clobetasol is metabolized mainly in thℯ liver; a small part ℴf thℯ drug is metabolized in thℯ kidneys. Clobetasol is excreted in thℯ urine.
When tested in mice teratogenicity ℴf Clobetasol, its fetotoxicity was shown when administered subcutaneously with a maximum dose ℴf 1 mg / kg, when administered at doses ℴf more than 0.03 mg / kg, teratogenicity ℴf Clobetasol was detected. thℯse doses are approximately 33% and 1%, respectively, ℴf thℯ recommended topical dose ℴf Clobetasol ointment for human use. thℯ following developmental defects were observed: split skull, cleft palate, othℯr disorders ℴf skeletal development. Teratogenic activity was also established when laboratory animals administered a relatively low dose. It was also found that some glucocorticosteroids have teratogenic activity when applied to thℯ skin by laboratory animals. With topical use, teratogenic activity ℴf Clobetasol has not been studied. But, given thℯ ability ℴf Clobetasol to be absorbed through thℯ skin, studies were performed in vivo with subcutaneous administration ℴf thℯ drug. In thℯse studies, pronounced teratogenicity ℴf Clobetasol in rabbit mice was established. Preparations ℴf Clobetasol have a higher teratogenic potential than preparations ℴf glucocorticosteroids with less activity. Long-term studies ℴf thℯ carcinogenicity ℴf Clobetasol have not been conducted. thℯ mutagenic activity ℴf Clobetasol was not detected in thℯ Ames test, using thℯ method ℴf accounting for gene conversions in yeasts ℴf thℯ species Saccharomyces cerevisiae. In studies on rats, more than 50 mg / kg per day ℴf Clobetasol was administered. thℯre was a decrease in thℯ number ℴf viable fetuses, an increase in thℯ cases ℴf embryo resorption.

Ointment, cream: chronic eczema, psoriasis (with thℯ exception ℴf common plaque and pustular), discoid lupus erythℯmatosus, lichen planus, skin diseases that are resistant to treatment with less active glucocorticoids for external use.
Shampoo: prevention and treatment ℴf relapses ℴf psoriasis ℴf thℯ scalp in adults (except for common plaque and pustular).

❇Method ℴf administration ℴf Clobetasol and dose
Clobetasol is used topically. Apply a thin layer ℴf cream or ointment 1 – 2 times a day to thℯ affected skin before improvement. With persistent skin lesions (especially with hyperkeratosis), thℯ effect ℴf Clobetasol is enhanced by thℯ application ℴf an occlusive dressing for thℯ night. Ointment is recommended for use in skin lesions, which are accompanied by dryness, thickening, hyperkeratosis, since thℯ ointment base contributes to thℯ preservation ℴf moisture in thℯ skin. thℯ cream is recommended for use in processes that are accompanied by severe inflammation and wetting. Shampoo should be applied only to thℯ scalp.
Clobetasol is recommended for short-term use only. It is possible to conduct short repeated courses if necessary. Atrophic changes in thℯ skin as a result ℴf prolonged use ℴf local glucocorticoids can appear on thℯ face more ℴften than in othℯr parts ℴf thℯ body. Avoid contact with ointment or cream in thℯ eyes (risk ℴf increased intraocular pressure). Before applying a fresh bandage, thℯ skin needs to be cleaned, since moisture and heat, which are created by hermetically sealed bandages, contribute to thℯ development ℴf a bacterial infection. Do not allow shampoo to get on thℯ ulcerated skin or eyelids and eyes (a danger ℴf cataracts, glaucoma). Shampoo is used only for thℯ treatment ℴf psoriasis ℴf thℯ scalp and should not be applied to othℯr parts ℴf thℯ body. In particular, shampoo should not be applied to eyelids, facial skin, folded skin areas (anal and genital area, axillary cavities) and to damaged areas ℴf thℯ skin, as thℯ risk ℴf developing local adverse events such as telangiectasia, atrophic skin changes or dermatitis increases. If Clobetasol ointment has caused irritation, thℯn it is necessary to cancel Clobetasol and take thℯ necessary thℯrapeutic measures. It should be borne in mind that thℯ development ℴf contact allergic dermatitis usually indicates thℯ lack ℴf thℯrapeutic effect from thℯ use ℴf thℯ drug, while with contact allergic dermatitis on topical preparations that do not contain corticosteroids, exacerbation ℴf thℯ course ℴf thℯ underlying disease is observed. thℯ allergic origin ℴf changes from thℯ skin should be confirmed with appropriate skin tests. thℯ duration ℴf treatment in patients who use potent glucocorticosteroids should not exceed 14 days. When applying Clobetasol ointment to small areas, longer use ℴf thℯ drug is possible. Ointment ℴf Clobetasol inhibited thℯ hypothalamic-pituitary-adrenal system when used in doses less than 2 g per day for 7 days in patients with eczema. When using Clobetasol, attention should be paid to thℯ accompanying skin lesions ℴf an infectious origin. You also need to know about thℯ risk ℴf developing such changes when using thℯ drug. In thℯse cases, appropriate fungicidal or antibacterial drugs must be used. If thℯre is no fast positive dynamics against thℯ accompanying skin lesions ℴf infectious nature against thℯ backdrop ℴf specific treatment, it is necessary to cancel thℯ Clobetasol ointment until sufficient control is achieved over thℯ infectious process. Do not use Clobetasol ointment for thℯ thℯrapy ℴf perioral dermatitis and rosacea. Also, do not apply it in thℯ face, groin, axillae. thℯre is no data on thℯ efficacy and safety ℴf Clobetasol ointment in children. It is not recommended to use thℯ drug in children under 12 years old. With thℯ use ℴf local glucocorticosteroids, thℯ development ℴf oppression ℴf thℯ hypothalamic-pituitary-adrenal system, Cushing’s syndrome in children is higher than in adults because ℴf a higher ratio ℴf thℯ surface area ℴf ​​thℯ body to its mass. For thℯ same reason, in children, thℯ risk ℴf developing adrenal insufficiency is higher during treatment, as well as after its termination. thℯre is information about thℯ development ℴf some adverse reactions, including thℯ formation ℴf striae, when using glucocorticosteroids in ℴff-label situations for topical application to newborns and children. thℯre is information about thℯ development ℴf Cushing’s syndrome, oppression ℴf thℯ hypothalamic-pituitary-adrenal system, increased intracranial pressure, delayed rates ℴf weight gain and growth in children who received local glucocorticosteroids. Manifestations ℴf adrenal insufficiency in children were revealed by a low level ℴf cortisol in thℯ blood serum, thℯ lack ℴf an adequate response to stimulation ℴf thℯ adrenal cortex with adrenocorticotropic hormone. Increase in intracranial pressure was detected by headaches, bulging fontanelles, bilateral edema ℴf thℯ optic disc.

❇Contraindications for use
Hypersensitivity, youth acne, acne, skin cancer, viral, bacterial and fungal skin infections (including chicken pox, herpes simplex, actinomycosis), perioral dermatitis, perianal and genital itching, skin tuberculosis, age under 18 years (shampoo) and up to 1 year (ointment, cream).

❇Application in pregnancy and lactation
thℯ use ℴf Clobetasol in pregnancy is possible if thℯ expected benefit to thℯ mothℯr is greater than thℯ possible risk to thℯ fetus. For thℯ duration ℴf Clobetasol thℯrapy, breastfeeding should be discontinued.

❇Side effects ℴf Clobetasol
Local reactions: skin itching, burning, acne, striae, dry skin, telangiectasia and skin atrophy, hypertrichosis, weakening ℴf skin barrier function, pigmentation disorder, development ℴf pustular psoriasis, hypopigmentation, allergic contact dermatitis, perioral dermatitis, secondary infection, phenomena irritation, sweating, ulceration, erythℯma, cracking ℴf thℯ skin, folliculitis, numbness in thℯ fingers.
Possible systemic reactions: ulceration ℴf thℯ mucous membrane ℴf thℯ gastrointestinal tract, gastritis, increased intraocular pressure, allergic reactions, symptoms ℴf hypercorticism, Cushing’s syndrome.

❇thℯ interaction ℴf Clobetasol with othℯr substances
It has been shown that thℯ sharing ℴf drugs that are capable ℴf inhibiting CYP3A4 (eg, itraconazole, ritonavir), depresses thℯ metabolism ℴf glucocorticosteroids and leads to an increase in thℯir systemic exposure. thℯ degree ℴf clinical significance ℴf this interaction depends on thℯ activity ℴf thℯ inhibitor CYP3A4 and thℯ method and dose ℴf glucocorticosteroids.

With an overdose ℴf Clobetasol, signs ℴf hypercortisy develop. It is necessary to cancel Clobetasol under thℯ supervision ℴf a doctor.

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Other names for this medication:Aramix, Celtium, Cipralex, Citoles, Citraz 5, Dexapron, E-zentius, Ectiban, Entact, Escitalopramum, Escitaloprim, Esertia, Esipram, Esita, Esital, Eslorex, Esram, Gaudium, Ipran, Lexamil, Lextor, Losiram, Losita, Meliva, Meridian, Neozentius, Nexcital, Oxapro, Seroplex, Sipralexa, Starcitin es, Tiopram.

The composition of the preparation is equivalent to three basic forms of release from the mass calculation for one tablet of the active substance of oxalate escitalopram – 6.39 / 12.77 / 25.54 mg:
Fine crystalline cellulose (MCC) – 72.49 / 97.49 / 195 mg;
Talcum ordinary 5.04 / 7/14 mg;
Sodium croscarmellose – 3.24 / 4.5 / 9 mg;
Magnesium stearate – 0.9 / 1.25 / 2.5 mg.
The film membrane of the tablets is an important component of the preparation of Cipralex. It consists of:
Hypromellose 5cP – 1.58 / 2.19 / 3.51 mg;
Titanium dioxide (E171) – 0.526 / 0.73 / 1.17 mg;
Macrogol 400 – 0.146 / 0.2 / 0.325 mg.

Form of issue
The preparation is issued in the form of round or oval biconvex tablets of white color, covered with a film membrane with various dosage:
5 mg of the active ingredient (“EC” label) – in a contoured cell package (usually aluminum foil or PVC) 14 tablets, in a carton 2 packs.
Cipralex 10 mg (symmetric marks “E” and “L” relative to the risks on one of the surfaces) – in the blister 14 tablets, 1, 2 or 4 contours in the box.
20 mg of the biologically active component (labeling “E” and “N” on either side of the dash on one side of the tablet) – in the box there are 2 blisters with 14 filled cells.

Pharmacological action
Cipralex refers to the pharmacological group of potent antidepressants. Due to the biologically active substance, which has an affinity for the allosteric center of the serotonin transfer enzyme, the drug inhibits the reuptake of the neurotransmitter in synaptic structures (the drug has a greater effect on the metabolic pathways of serotonin than on any other messengers). Accordingly, the physiological pulse transmitter is located in the synaptic gap of the neuronal contact for a longer period of time, which causes the enhanced, prolonged action of the postsynaptic membrane.
It should be noted that the drug is strong and long-acting, as it binds in two places with the serotonin transfer enzyme. First of all, the main active ingredient has a high affinity for the primary amino acid sequence of the transporter protein. Also, the components of the Cipralex bind to the allosteric center of the molecule, which again increases the effect of the drug, that is, leads to a more complete inhibition of the reuptake of the neurotransmitter.
Cipralex shows little activity towards such receptors as:
➠Serotonin 5-HT1A and 5-HT2;
➠Dopamine D1 and D2;
➠Alpha and beta adrenergic synapses;
➠Histamine H1 receptor cells;
➠Opioid and benzodiazepine;

Pharmacodynamics and pharmacokinetics
Absorption of the active ingredients does not depend on the intake of food, since the drug is an extremely strong pharmaceutical preparation. Absolute bioavailability is about 80 percent, and the average half-life is 4 hours (however, the parameter can vary depending on individual body parameters and environmental conditions).
Cipralex is metabolized in the liver. The constituent elements of the preparation even after oxidation remain biologically active and undergo certain changes in metabolic processes in the form of glucuronides. The metabolites are then sent to the kidneys, which excrete waste drug residues through urine. Clearance with oral administration of the drug is 0.6 l / min.
The kinetics of escitalopram oxalate is described linearly. Equilibrium concentrations in the systemic blood stream, with a daily dose of 10 mg (the optimal amount of active ingredient for an adult), is achieved after one week of a conservative course of treatment with Cipralex.
In elderly patients (over 65 years of age), the pharmacological drug is somewhat slower. Clinical trials have shown that during the therapeutic dose, after a single dose of Zipraplex, the amount of active component in the systemic bloodstream of the elderly is 50 percent greater than that of young volunteers.

Indications for use
Cipralex is recommended to be included in the conservative treatment regimen if neurological pathologies such as:
➣Long periods of depression of any severity;
➣Panic disorders (which can be explained by agoraphobia – fear of open spaces);
➣Depressive stage of manic-depressive psychosis;
➣Various kinds of social phobias or just anxiety among people;
➣Obsessive-compulsive disorder (medical explanation of “obsession with the idea”);
➣Obsessive-compulsive disorder;
➣Syndrome of generalized anxiety.

From the pharmacological treatment of Cipralex should be abandoned when:
Hypersensitivity or intolerance to the constituent components of the drug;
Childhood and adolescence (the therapeutic course is not recommended to be performed until age 18);
Simultaneous sanation with monoamine oxidase inhibitors (antidepressants) or pimozide (antipsychotic medications);
Acute or chronic renal failure with creatinine clearance below 30 ml / min;
Epilepsy, which is not controlled by pharmacological agents.
Take Cipralex only under the supervision of qualified medical personnel in one of the following situations:
Insulin-independent diabetes mellitus (type I necessarily shows consultation with an endocrinologist);
elderly age;
Cirrhosis, acute or chronic liver failure;
Tendency to frequent hemorrhages due to insufficiency of the blood coagulation system;
Hereditary and acquired metabolic diseases.

Side effects
Cipralex is a strong drug, because its effect can be characterized by a large number of unwanted reactions from the body. So, for example, are noted:
☞ Dyspeptic disorders (nausea, vomiting, diarrhea, abdominal pain);
☞ Asthenic syndrome (insomnia ordeal, headache, constant fatigue, dizziness);
☞ Metabolic disorders in the form of sweating, hyperthermia and hyponatremia;
☞ Thrombocytopenia and, as a consequence, insufficiency of the blood coagulation system;
☞ Orthostatic collapse or hypotension;
☞ Decrease in reproductive function (decreased libido and potency, both in men and women);
☞ Allergic reactions (a range of undesirable effects affect the manifestations of angioneurotic edema of Quincke, down to anaphylactic shock);
☞ Arthralgia and myalgia of idiopathic genesis, which are not related to the load on the joints or muscles;
☞ Skin rash, purpura, ecchymosis.
It should be noted that the adverse effects of treatment usually occur during the first or second week of the conservative therapeutic course and significantly decrease in manifestations if the sanation is continued according to the plan.
Since the drug belongs to the list of B pharmacological products, then with a sharp discontinuation of Zipraplex after long-term treatment with the drug, withdrawal syndrome is possible. That is, the body lacks an active active substance. This manifests itself in the form of severe headache, irritability, nausea and frequent dizziness.

Instructions for the use of Zipraplex (Method and dosage)
The use of Cipralex does not depend on meals a day. The duration and intensity of the course of conservative treatment largely depends on the initial disease:
So to achieve an antidepressant effect, shock doses are used for 2-4 weeks (10 mg of Zipraplex per day for an adult patient) and the next 6 months of maintenance therapy to consolidate the results.
The instructions for Cipralex in panic disorders are very different – they begin pharmacological therapy with 5 mg of the drug with a further increase in the daily dose to 10 mg. Depending on the individual reaction of the body, the amount of the drug can be increased to 20 mg per day. The maximum effect is achieved after 3 months, however, sanation can last up to six months.
In patients with renal or hepatic insufficiency (both acute and chronic), but with absolute indications for the use of Cypralex, the maximum single dose is 5 mg. The increase is not recommended, but if the desired therapeutic effect is not achieved, the amount of the drug administered is doubled.

In clinical practice cases of overdose of Zipraplex are known, which usually manifest themselves as follows:
☞ Darkened consciousness, confusion;
☞ Tremor of extremities, violation of fine motor skills;
☞ Convulsive seizures;
☞ Agitation (a strong emotional excitement, which is accompanied by a sense of anxiety and an unreasonable need for movement);
☞ Significant changes in the electrocardiogram (expansion of the ventricular complex, depolarization of the depolarization segment);
☞ Arrhythmias by type of tachycardia;
☞ Metabolic acidosis, hypokalemia;
☞ Oppression respiratory function of the respiratory system.
There is no specific antidote or antagonist of Zipraplex, so the overdose treatment is based on symptomatic and palliative care to the patient. First of all, you should wash the stomach, in order to evacuate from the body are not absorbed the remains of the pharmaceutical product. Further, it is necessary to ensure sufficient oxygenation and constant monitoring of the vital systems of the human body.

It is strictly prohibited simultaneous application of Zipraplex and drugs that irreversibly inhibit monoamine oxidase, as the percentage of development of severe side effects increases several times (the percentage of respiratory or heart failure is statistically increased).
Based on pharmacological studies, it is not recommended to include in the course of treatment of cipralex and reversible MAO inhibitors because of the risk of serotonin syndrome (potentially deadly situation).
Do not use the drug with escitalopram in parallel with anticoagulants or drugs that reduce blood clotting, as this can lead to severe hemorrhagic syndrome and anemia, as an outcome of the pathological situation, which will complicate the patient’s treatment.
There are a number of pharmaceuticals that interact with the allosteric centers of carrier proteins to increase the activity of Cipralex. For example, omeprazole (against ulcer drug) leads to an increase in the concentration of active substance in the systemic circulation twice, and cimetidine (the blocker of H2-histamine receptors, which is prescribed in the pathology of the gastrointestinal tract) – by 70%.
Serotonin reuptake inhibiting agents, and Cipralex, as a typical representative of this pharmacological group, reduce the threshold of convulsive activity, that is, tremor and / or convulsive syndrome may manifest itself to less intense stimulation. This action will be potentiated if Cipralex and other strong antipsychotics (neuroleptics) are taken concomitantly, for example, Tramadol, Phenothiazine, Butirofenone, and so on.

Storage conditions
The drug should be stored in a warm, dry place, inaccessible to children of all ages and direct rays of light at a temperature of no higher than 25 degrees Celsius.

Shelf life
3 years.

special instructions
Cipralex does not exert a depressing effect on the intellectual or psychomotor sphere of the patient, however, while continuing the course of conservative treatment, it is recommended to refuse driving the car or controlling technical devices that require a long concentration of attention and fine motor skills.
The drug can contribute to a change in the concentration of glucose (a significant increase in it) and insulin (a relative decrease in the hormone) in the systemic blood stream, and accordingly this treatment requires a certain correction of hypoglycemic agents in patients with diabetes mellitus.
Therapy with antidepressants can lead to suicidal thoughts in the early stages of the sanation course. Increased risk of self-injury, suicidal tendencies remain until the remission of the underlying disease, therefore, conservative treatment with Cipralex should be carried out in special departments under the supervision of qualified medical personnel.

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Active Ingredient: Azithromycin
Zithromax is used to treat many different types of infections caused by bacteria, such as respiratory infections, skin infections, ear infections, and sexually transmitted diseases. In children, it is used to treat middle ear infection, pneumonia, tonsillitis, and strep throat.

 Product description


Zithromax is used for treating mild to moderate infections caused by certain bacteria. It may also be used alone or with other medicines to treat or prevent certain infections in persons with advanced HIV infection. Zithromax is a macrolide antibiotic. It slows the growth of, or sometimes kills, sensitive bacteria by reducing the production of important proteins needed by the bacteria to survive.


Use Zithromax as directed by your doctor.

  • Take Zithromax by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Do not take an antacid that has aluminum or magnesium in it within 1 hour before or 2 hours after you take Zithromax.
  • Zithromax works best if it is taken at the same time each day.
  • To clear up your infection completely, use Zithromax for the full course of treatment. Keep using it even if you feel better in a few days.
  • If you miss a dose of Zithromax, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Zithromax.


Store Zithromax below 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zithromax out of the reach of children and away from pets.

MORE INFO: Zithromax

Active Ingredient: Azithromycin.

Safety information

Do NOT use Zithromax if:

  • you are allergic to any ingredient in Zithromax, to other macrolide antibiotics (eg, erythromycin), or to ketolide antibiotics (eg, telithromycin)
  • you are taking dofetilide, nilotinib, pimozide, propafenone, or tetrabenazine.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Zithromax. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:if you are pregnant, planning to become pregnant, or are breast-feedingif you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplementif you have allergies to medicines, foods, or other substancesif you have liver or kidney problems, myasthenia gravis, or abnormal heart rhythms.Some medicines may interact with Zithromax. Tell your health care provider if you are taking any other medicines, especially any of the following:Antiarrhythmics (eg, disopyramide, dofetilide ), arsenic, astemizole, cisapride, domperidone, maprotiline, methadone, paliperidone, pimozide, propafenone, quinolone antibiotics (eg, levofloxacin), terfenadine, or tetrabenazine because the risk of heart problems, including irregular heartbeat, may be increasedNelfinavir because it may increase the risk of Zithromax’s side effectsRifampin because it may decrease Zithromax’s effectivenessAnticoagulants (eg, warfarin), carbamazepine, cyclosporine, digoxin, ergot derivatives (eg, ergotamine), nilotinib, phenytoin, rifampin, theophylline, triazolam, or tyrosine kinase receptor inhibitors (eg, dasatinib) because the risk of their side effects may be increased by Zithromax.This may not be a complete list of all interactions that may occur. Ask your health care provider if Zithromax may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Zithromax may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Zithromax with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Zithromax may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Zithromax. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
  • Tell your doctor or dentist that you take Zithromax before you receive any medical or dental care, emergency care, or surgery.
  • Long-term or repeated use of Zithromax may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
  • Be sure to use Zithromax for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
  • Zithromax only works against bacteria; it does not treat viral infections (eg, the common cold).
  • Zithromax should not be used in children; safety and effectiveness in children have not been confirmed.
  • Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zithromax while you are pregnant. It is not known if Zithromax is found in breast milk. If you are or will be breast-feeding while you use Zithromax, check with your doctor. Discuss any possible risks to your baby.
  • Side effects
  • All medicines may cause side effects, but many people have no, or minor, side effects.

    Check with your doctor if any of these most common side effects persist or become bothersome:

    Diarrhea; headache; loose stools; nausea; stomach pain; upset stomach; vomiting.

    Seek medical attention right away if any of these severe side effects occur:

    Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bloody stools; changes in hearing or hearing loss; chest pain; eye or vision problems; irregular heartbeat; muscle weakness; pounding in the chest; red, swollen, blistered, or peeling skin; ringing in the ears; seizure; severe diarrhea; stomach cramps/pain; trouble speaking or swallowing; yellowing of the skin or eyes.

    This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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Each tablet contains 100 mg of sildenafil

Duration: 4-6 hours

Onset of action: After 30-40 minutes

Active substance: Sildenafil (Sildenafil)

Description: Designed to address female sexual desire disorder and female sexual dysfunction. Created to satisfy the sexual needs and prolong pleasure.

Dosing: Action female Viagra begins 30 minutes after administration and lasts for a minimum of 4 hours. Most patients can take Female Viagra daily.

Female Viagra – the first generic, designed specifically for women. This drug helps to enhance libido, to fully enjoy the sexual life and contributes to obtaining orgasm. The active ingredient – Sildenafil. Generic comes in tablet form with a pink envelope.

• Reduced sex drive
• No response to stimulation
• Discomfort during intercourse due to dryness and the lack of excitement
• Sexual dysfunction
• menopause

The action of the drug
Female Viagra – a very effective generic, helps to restore normal physiological characteristics of the female body in sexual terms. After the drug returns natural lubrication and swelling of the labia, the clitoris is enhanced sensitivity. And all of these functions back on when there is sexual stimulation and without addiction to generics.
Tablets enhances the feeling directly during intercourse and orgasm strength. Women of all ages, to test female Viagra, noted the positive sensations of sexual contact, even if they previously had difficulty reaching orgasm. This is achieved thanks to sildenafil, which is an inhibitor of PDE-5. His action of this substance improves blood circulation of the vascular system in the pelvis. It has beneficial effects on the smooth muscle of arteries leading to the natural swelling of the labia minora and clitoris
In addition, the generic functionality improves the mucous glands, whereby the lubricant is released in the vagina. Such effects of the drug on the body eliminates the problem of dryness and discomfort during intercourse. The effect of one tablet lasts up to 5 hours. So, enjoy a full sex life and get maximum pleasure can any woman, even in the period of menopause.

Instructions for use
The drug is used to enhance libido in about 40-60 minutes prior to prospective sexual intercourse. Once the active ingredient gets into the bloodstream, it will work effectively in the next 5 hours. The optimum daily dose – 100 mg. You can start taking pills to 25-50 mg per day. If Generic Female Viagra is well absorbed by the body, but does not give the maximum effect, the daily dose increased to 100 mg. It is not desirable to increase the dose. If necessary, consult a doctor. Tablets can be taken no more often than once per day.


Generic Female Viagra should not be taken during pregnancy and lactation, and in the following diseases:
• rhythm disorders, and other cardiovascular diseases
• Anemia
• Hypertension
• Oncological diseases
• Problems with kidney or liver
• Stroke, heart attack or heart attack, brought over the last year

If the first reception of pills cause an allergic reaction, you must stop it and consult a physician.

As generic interacts with other medications?
With regular use of any other drugs, it is desirable to consult with your doctor. As a general rule, the specialist ban take Female Viagra in combination with nitrate or nitrite drugs. For example, nitroglycerin, Nitrosorbid etc. It is impossible to combine the generic with poppers.
If you start taking Viagra for women with the above drugs, the problem can start with pressure, and heart, until a stroke or heart attack.

Possible side effects

Testing generic found that a side effect of the drug is minimized. In rare cases, can be observed the following reactions:
• Vomiting and nausea
• Vertigo
• redness of the face
• Chest pain and headaches
• Indigestion.

Storage conditions
Viagra for women should be stored out of reach of pets and small children at room temperature. Expiry date is indicated on each blister.

Female Viagra allows you to be more sensitive to sexual stimulation and affection. The product provides maximum pleasure from intimate process that helps women improve their health and improve your mood. This is especially important for older women who are or have been through a difficult period of menopause.
However, it is understood that the female Viagra – the drug exclusively for women. Its composition is specially designed for the female body, so taking this drug should be strictly in accordance with your gender. For men developed many other medicines that can successfully deal with erectile dysfunction.

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Prednisone: instruction for receiving, analogues, price, reviews
Prednisone is an anti-inflammatory drug of the group of corticosteroids, which are analogues of the natural biological hormone of the adrenal cortex – cortisol.

Pharmacological interdiction
Glucocorticotropic disease. The drugs, which are used in the case of rheumatoid apteritis, spondylitis, rheumatism of inferior genesis, an apte, a traumatic shock, infectious diseases.

Pharmacological system
Anti-inflammatory, glucocorticoid and anti-inflammatory agent. Stabilizes the state of the cell membranes, inhibits the production of prostaglandins, which are indicative of the appearance of the bulbous syndrome in the case of opol-propellent vehicles.
Reduces the permeability of capillaries, anti-inflammatory agents are reduced by reducing the processing of specific antibodies, the antiprotochic agents are mediated by a cocodifying effect and by the stimulation of the work of the cep-caustic sys- tem. Bystro vsasyvayutsya pepopalnomu ppeeme, maksimmalnye kontsentratsii v krovi dostigayutcya cpustya dva chaca. Tpanfspopiruetcya in the song, deduced by the buds.
It shows effects on lipid, angular and iron metabolism. It will result in cumulation of glycogen glycogen in the liver and an increase in the level of glucose in the blood. The agent helps to keep the water and natrium in the organism, to stimulate the work of the cep-cadic system and to increase the tonus of the ape, to restore the muscle to the contraction. The unique CIC produces a stimulus, acts as a protic and immunodeficient action. It increases the acidity of the gastric juice and the cessation of the vesicle.

Indications for use
In the practice of the treatment of diseases of the opioid motor system and the musculature, it is used in rheumatism, rheumatoid apoptitis, apoptia, celepodermia, and demotomyositis.
It is used in the treatment of allergic diseases, adductor infections, when the functions of the adrenal gland function are absent in the acute form, the anterior spine and hepatitis, the penicle, the hypoglycemia.
It is used in the therapy of lipid infarction, agranulocytosis, leukemia of any etiology, lymphogranematosis, purpura of thrombocytopenic, hemolytic anemia.
B kotteva kompleknoy tepapii in infektsionnomu mononukleeoze, pankkpeatit e ostpoy pom pami, pemphlet, itch neevyatshennoy etiologii, eczema, remmatit, pcopiza, ceptopeinom dammitit, kpacnoy volchanka, eritpodermii. It is used as a prophylactic substance in the case of hock infections.

The proprietor of a product in case of a sensitive hypersensitivity to the existing substance or any other component in the body. He does not suffer from ulceration of the duodenum of the rectum and the throat, but only in the small phase. Heppemenim in otteeoopoze, Illinois-Massage, as well as in cases, if the patient cklonen to thromboembolism.
Ppotivopokazano ppimenenie ppepapata VARIATIONS nedoctatochnocti pochechnoy functions tyazheloy fopme aptepialnoy gipeptenzii and gipeptonii, genepalizovannyx zapazheniyax gpibkom (mikoz in tom chicle, kandidoz) DURING vipucnoy infektsii in octpoy or xponicheckoy faze.
It is forbidden to take this drug as a method of vaccination, when active tuberculosis, symptomatic psichicacheki patologiya.

C ostopozhnctyu
It is necessary to observe the condition when the drug is used. Give birth to patients with any form of caspatode, and also for non-specific infectious diseases, in this case, if the staphylococcus is not present, stent.
The condition requires the use of drugs in patients with latent tuberculosis, as well as comfort, the first – the third type.

!!!The use of drugs should be done solely – it is imperative to take an active dose of the doc- tation medication without help!!!

How to accept
The official instruction on the use of drugs Prednisone indicates that dosylvania and the return of the regimen are established individually by the lactating physician in the presence of the severity of the columoric system and the invasive prac- tice.
Suppovyaschie dosizkovki should be appointed after the release of the desired tepepevticheskogo effekta. The pacchet of the supporting force depends on the specified positioning in the active mode – the supporting force must be three times smaller than the one in the active mode.
At the lack of efficiency and in the solution of the lucid dentistry, the initial dosage can be 0.1 g, sup- pressive-0.015 g., While reducing the patient’s concentration of the neopodoma.
A search for the use of a detonator in a hotel paccounts from the body of the body. Paccitannoe a large number of drugs should be allocated for five times.
Single-dose mosaic dosage – not more than 15 mg, cotochnaya – not more than 100 mg. When the outbreak of unhealthy situations, life-threatening conditions, and also when there are shocking things, it is possible to introduce large amounts of equipment under the eye of a doctor.

Side Effects
Lechenie pepperatom can cause such unhealthy effects, such as low resistance to infectious and viral diseases, development of hyperemia, as well as inflammation before the middle child.
Bozmozhnye pobochnye effekty takie, kak nekpozipovanie koctnoy tkani, povyshenie kiclotnocti zheludka and HOW cledctvie, bolevoy cindpom, gipokaliemiya, zadepzhka and water at natpiya in opganizme c otechnoctyu FACE and konechnoctey in pezultate.
It is possible to observe the development of the Ischenka-Cushing syndrome, the increase in the volume of other active objects, the katapakt of the stereotype, which is hidden by the eye, the inapplicability of the cycle of ideas in women.
Co of the system of the central nervous system is also marked by such an irrelevant nature of the reception of the Princess, as if the sleep mode was switched off, the girl in bed, slept in the muscles, the pace of the hand.

When the rotation of the laser is switched off, the Prednisone is possible to develop the Syndrome, which is linked to the reduction of the function of the bag of opacifiers and their assaults.
Avoid the side effects and minimize the likelihood of their manifestations may be hard, pinched individually individual doses.

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Antibiotic “Amoxil”: instructions for use, testimonials

Active Ingredient: Amoxicillin

Other names for this medication:
Acimox, Alfamox, Almodan, Aloxyn, Amix, Amoclen, Amoksicilin, Amopen, Amoram, Amox, Amoxi, Amoxicilina, Amoxicillinum, Amoxiline, Amoxisol, Amoxivet, Amoxypen, Amurol, Apo-amoxi, Bimoxan, Bristamox, Cipmox, Clamoxyl, Flemoxin, Flemoxon, Galenamox, Gimalxina, Hidramox, Hydramox, Larotid, Lupimox, Moxa, Moxicillin, Novamoxin, Nu-amoxi, Ospamox, Penamox, Penimox, Polymox, Raylina, Reloxyl, Rimoxallin, Robamox, Servamox, Sintedix, Solciclina, Stacillin, Sumox, Tolodina, Utimox, Velamox, Wymox, Zimox

Pharmacology and pharmacokinetics
The main active substance of “Amoxil” is amoxicillin trihydrate. As auxiliary components, calcium stearate, potato starch and low molecular weight medical polyvinylpyrrolidone act. The main component, amoxicillin, is a broad-spectrum antibiotic that is part of the aminopenicillin group.
The substance is characterized by a bactericidal mechanism of action, which is an active suppression of the synthesis of the cell wall of bacteria sensitive to amoxicillin. In the sphere of influence of amoxicillin, there are such well-known gram-positive bacteria as staphylococcus and streptococcus.
The drug is active against a number of gram-negative and anaerobic microorganisms. In tandem with metronidazole, it affects bacteria that promote the development of peptic ulcer in the stomach and duodenum.

Getting inside the body, the antibiotic “Amoxil“, the instruction of which describes in detail all the information about the drug, is actively absorbed and after 2 hours reaches the maximum concentration in the blood serum. Half-life from the body is 1.5 hours. The drug appears through the kidneys almost unchanged (60-70%).

Main Customers
Since “Amoxil” has a wide sphere of influence, the patients taking the drug are people with a variety of diseases. Tablets “Amoxil” instruction recommends that patients suffering from respiratory tract infections: upper (tonsillitis, sinusitis, otitis media) and lower (pneumonia, bronchitis). It is also effective in the treatment of diseases of the bile duct and gastrointestinal tract.

Diseases of the urinary system are also amenable to “Amoxil“. Here we can talk about pyelonephritis, cystitis, asymptomatic bacteriuria in pregnant women. In addition, medical experts prescribe medication in the treatment of acute stages of uncomplicated gonorrhea, infections of the skin and soft tissues.

In addition, its combined (together with other drugs) application is possible and quite effective. “Amoxil” in tandem with clarithromycin or metronidazole is used for therapeutic therapy in diseases of the digestive system, provoked by the bacteria Helicobacter pylori (chronic forms of gastritis, stomach and duodenal ulcers).

Who is not recommended to take “Amoxil”?
Drug medication is contraindicated for people who are hypersensitive to the main active ingredient, auxiliary components, groups of penicillins and cephalosporins. Do not take this medication with mononucleosis and lymphocytic leukemia.
The joint appointment of “Amoxil” with metronidazole is unacceptable for diseases of the nervous system, deviations in the work of the hematopoiesis system. In the same tandem, it is not possible to prescribe a drug to patients younger than 18 years of age suffering from gastrointestinal diseases that are accompanied by prolonged vomiting or diarrhea.

Also, “Amoxil“, the instruction for the application of which describes in detail the contraindications to taking the drug, is forbidden to admit patients suffering from severe pathologies and abnormalities in the functioning of the liver. It is inadmissible to use alcohol during the combined treatment course.

Dosage regimens
Drug medication is manufactured by manufacturers in tablets with a dosage of 250, 500 and 625 mg. “Amoxil” is prescribed inside regardless of food intake. Dosage and treatment regimen is selected by the doctor taking into account the disease and the severity of the patient’s condition. For adults and children over 10 years of age (with a body weight of at least 40 kg), a single dose should be from 250 to 500 mg. In especially severe conditions, up to 1 gram of the drug “Amoxil” is prescribed.

Regardless of the patient’s age, the interval between doses should be at least 8 hours. In people with abnormalities in kidney function, the interval between doses should be increased to 12 hours. For individuals suffering from anuria, the daily norm of “Amoxil” can not exceed 2 grams.

In what cases is the drug “Amoxil-625″ prescribed? The instructions for use, in addition to all the above indications, recommend the use of this drug to suppress dental infections (including the treatment of dentoalveolar abscess), as well as joint and bone infections (including osteomyelitis). Effective medicament in this dosage for septic abortions, postpartum and intra-abdominal sepsis, burns, abscesses and wound infections.

Features of the application of “Amoxil”
In the process of treatment with medication (especially in high doses), experts recommend maintaining adequate diuresis. To avoid the development of crystalluria, it is necessary to take a sufficient amount of liquid.
Long-term use of “Amoxil” or repeated treatment with the same drug after a short period of time can give an impetus to the development of superinfections and to accelerate the growth of a stable microflora. Regardless of the dosage (250 mg or “Amoxil” 500), the instruction manual recommends that children maintain oral hygiene, since the main active ingredient is able to change the color of the tooth enamel.
Patients whose professional activities are associated with performing works that require high concentration of attention, “Amoxil” should be administered with caution, since side effects from the nervous system are possible.

During lactation it is undesirable to take this medicine, as it is excreted in breast milk, which can lead to sensitization of the baby (increased sensitivity to the active ingredient, the possibility of allergic reactions).

Any dosage of the drug, even Amoxil 250, is not recommended for women taking estrogen-containing contraceptives, since amoxicillin reduces their effectiveness. Slowed down the process of removing the drug through the kidneys, if in conjunction with “Amoxil” the patient takes indomethacin, acetylsallicyl acid (aspirin), sulfinpyrazone, oxyphenbutazone, phenylbutazone.

Exceeding the permissible dose
Symptoms of excess of a single dosage of medication are: nausea, vomiting, diarrhea, deviation from the norm of water electrolyte balance. To eliminate the consequences, gastric lavage is performed, the use of absorbent drugs (in particular activated charcoal), saline laxatives is prescribed, measures are taken to correct the water-electrolyte balance. In especially severe cases, a hemodialysis procedure may be required (purification of blood outside the kidneys).

Possible side effects
What side effects does the antibiotic “Amoxil” have? Instructions for use describe possible problems from various body systems.
The gastrointestinal tract can respond to the reception of “Amoxil” with nausea, vomiting, diarrhea. In more severe cases, it is possible to develop hemorrhagic or pseudomembranous colitis, candidiasis of the intestine. From the side of the urinary system, interstitial nephritis is often observed. Manifestations of the same disease can be expected from the hemopoietic system. Also sometimes thrombocytopenia, leukopenia, hemolytic anemia, crystalluria develops. A negative reaction to “Amoxil” from the side of the nervous system can be expressed in the appearance of convulsions, dizziness and the state of hyperactivity.
Sometimes there are all kinds of allergic reactions (rash, itching, hives, conjunctivitis, allergic vasculitis, angioedema).

What else is dangerous, “Amoxil”? Instruction, patient reviews and numerous studies confirm that the action of the drug can trigger the development of anaphylaxis, multiforme erythema, candidiasis of the mucous membranes and skin, cholestatic jaundice, hepatitis, Stevens-Johnson syndrome (malignant erythema).

“Amoxil” and angina
Angina in the people is called the infectious process, which manifests itself in the inflammation of the components of the lymphatic pharyngeal ring. Most often, tonsils are involved in the process. Inflammation is caused by streptococci or staphylococci. In most cases, to combat this bacterial disease, medical professionals prefer to use antibiotics penicillin group. One of these drugs is “Amoxil“.
Tablets instructions for use recommend appointing regardless of food intake. In this case, they should be swallowed whole and washed down with water. Usually the drug is taken at intervals of not less than 8 hours. However, the treatment regimen and dosage can be selected individually by the attending physician depending on the severity of the patient’s condition.
Pediatricians usually receive pediatricians for treatment of “Amoxil” 250. The instruction describes dosage regimens depending on the age and weight of the child. Babies under 2 years are usually prescribed a daily rate equal to 30 mg of the drug per kilogram of weight. The total dose should be divided into 3 doses. Children of the age group from 2 to 5 years once a day prescribed 125 mg of medicament.
Starting from the age of 5 and up to 10 years, a single daily intake is 250 mg. From 12 years old, one tablet (625 mg) is prescribed for adolescents from the age of 12 for the treatment of angina. The interval between doses is 12 hours.

To treat bacterial sore throat in adult patients, therapists prescribe “Amoxil” 500. The instructions for use describe the treatment regimen in the form of a single dose of 500 mg. In the case of a severe process, the doctor may prescribe a single dose of the drug to 1 gram. The maximum daily dose for angina should not exceed 6 grams. “Amoxil” at a dosage of 625 mg is often prescribed in the treatment of tonsillitis.
Tablets are taken once with an interval of 12 hours. If a patient suffers chronic renal failure, he is prescribed a dose of 625 mg once a day for angina. Patients on hemodialysis after taking the procedure additionally take 1 tablet of the drug.

!!!In any case, the scheme of therapy with the drug “Amoxil” with angina should be selected by the treating doctor.!!!

Interaction of “Amoxil” with other drugs
As mentioned earlier, the use of Amkosil by women using oral contraceptives is undesirable, since the effectiveness of the latter is reduced. In addition, the development of bleeding is possible. If the patient suffers from cardiovascular diseases (in particular, arrhythmia) and takes digoxin, simultaneous reception of “Amoxil” will strengthen it (digoxin) absorption.
With the simultaneous administration of drugs that have a bacteriostatic effect (macrolides, tetracyclines, chloramphenicol) and “Amoxil” medication, the instructions for use inform the patients that the bactericidal action of amoxicillin, the main active ingredient in Amoxil, will be neutralized. If, for any reason, there was a need for an intensive diuresis (abundant drinking and simultaneous use of diuretics), the concentration of medication in the body will be lowered.
With the simultaneous administration of “Amoxil” and “Allopurinol” (prescribed for patients with elevated levels of uric acid in the blood), the frequency of allergic reactions from the skin can increase. Unsuitable joint administration of antacids (medications intended for the treatment of acid-dependent gastrointestinal diseases by neutralizing the hydrochloric acid of gastric juice) and the drug “Amoxil” (tablets) is not desirable.
Instruction for use informs that in this case the absorption of amoxicillin will be reduced. Carefully appointed a complex method of “Amoxil” and anticoagulants (substances and medications that depress the blood clotting system and prevent thrombosis). In this case, continuous monitoring of prothrombin time is necessary, since the probability of bleeding is quite high. Manifestations from the digestive system in the form of diarrhea reduce the absorption of drugs, as a result of which the action of “Amoxil” worsens.
The use of this antibiotic can reduce the content of estradiol (the most active female sex hormone – estrogen) in the urine of pregnant women.

In any case, no matter how simple the patient might feel his illness, self-medication is an unacceptably frivolous attitude to one’s own health. A drug that successfully cured a sore throat to a colleague at work can cause a lot of side effects in another patient, starting with a rash on the skin and ending with irreversible lesions of certain organs and systems that can cost you not only health but also life.
The modern pharmaceutical market is so complex and diverse that only a highly qualified medical specialist is able to understand all these scientific terms, doses and schemes, and to develop a course of treatment therapy individually for each individual patient, taking into account his state of health, while minimizing the risk of side effects .

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Clinical and pharmacological group
Antibiotic of the tetracycline group

Pharmachologic effect
Semisynthetic tetracycline, bacteriostatic broad-spectrum antibiotic. Penetrating into the cell, acts on intracellularly located pathogens. Suppresses the synthesis of proteins in a microbial cell, disrupts the binding of the transport aminoacyl RNA to the 30S subunit of the ribosomal membrane.
Gram-positive microorganisms are highly sensitive to it: Staphylococcus spp. (including Staphylococcus aureus, Staphylococcus epidermidis), Streptococcus spp. (including Streptococcus pneumoniae), Clostridium spp., Listeria spp .; Actinomyces israeli; and Gram-negative microorganisms: Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, Klebsiella spp., Escherichia coli, Shigella spp., Enterobacter, Salmonella spp., Bordetella pertussis. Bacteroides spp., Treponema spp. (including strains resistant to other antibiotics, such as modern penicillins and cephalosporins). The most sensitive are Haemophilus influenzae (91-96%) and intracellular pathogens.
Doxycycline is active against most pathogens of dangerous infectious diseases: plague (Yersinia spp.), Tularemia (Francisella tularensis), anthrax (Bacillus anthracis), legionella (Legionella spp.), Brucella (Brucella spp.), Cholera vibrio (Vibrio cholera) , Rickettsia (Rickettsia spp.), glanders pathogens (Actinobacillus mallei), Chlamydia (psittacosis pathogens (Chlamydia psittaci), psittacosis (Rickettsiaformis psittacosi), trachoma (Chlamydia trachomatis ;, venereal granuloma (Calymmatobacterium granulomatis), malaria (Plasmodium falciparum), amoebic dysentery (Entamoeba histolytica).

It acts on most proteic strains, Pseudomonas aeruginosa and fungi.
To a lesser extent than other antibiotics of the tetracycline, it oppresses the intestinal flora, differs from them by a more complete absorption and longer duration of action. By the degree of antibacterial activity, doxycycline is superior to natural tetracyclines. In contrast to tetracycline and oxytetracycline, it has higher therapeutic efficacy, which is manifested by treatment in 10 times smaller doses, and a longer action. There is cross-resistance to other tetracyclines, as well as to penicillins.

Absorption is fast and high (about 100%). The intake of food has no significant effect on the degree of absorption. Has a high degree of solubility in lipids and a low affinity for the binding of calcium ions (Ca2 +). After oral administration of 200 mg the time to reach the maximum concentration in blood plasma is 2.5 hours, the maximum concentration in the blood plasma is 2.5 μg / ml, after 24 hours after the intake – 1.25 μg / ml.
The connection with plasma proteins is 80-93%. It penetrates well into organs and tissues; 30-45 minutes after ingestion is found in therapeutic concentrations in the liver, kidneys, lungs, spleen, bones, teeth, prostate gland, eye tissues, pleural and ascitic fluids, bile, synovial exudate, exudate of maxillary sinuses and frontal sinuses, in fluid gingival sulci. Poor penetration into the cerebrospinal fluid (10-20% of the plasma level). Penetrates through the placental barrier, is determined in human milk. The volume of distribution is 0.7 l / kg.
Metabolised in the liver 30-60%. The half-life is 10-16 hours (basically 12-14 hours, on the average – 16.3 hours). With repeated administration, the drug can accumulate. It accumulates in the reticulo-endothelial system and bone tissue. In bones and teeth, it forms insoluble complexes with calcium ions (Ca2 +). It is excreted with bile, where it is found in high concentration. It is subjected to intestinal-hepatic recirculation, is excreted by the intestine (20-60%); 40% of the dose is given by the kidneys for 72 hours (of which 20-50% is unchanged), in severe chronic renal failure, only 1-5%.
In patients❛ with impaired renal function or azotemia, gastrointestinal secretion is an important way of excretion.

⊳Infectious-inflammatory❛ diseases caused by sensitive microorganisms: respiratory tract infections (pharyngitis, acute and chronic bronchitis, tracheitis, bronchopneumonia, lobar pneumonia, lung abscess, pleural empyema);

⊳infections❛ of the ENT organs (otitis media, tonsillitis, sinusitis, etc.);

⊳infections❛ of the genitourinary system (cystitis, pyelonephritis, prostatitis, urethritis, urethrocystitis, urogenital mycoplasmosis, endometritis, endocervicitis, acute orchypididitis, gonorrhea);

⊳infections❛ of the biliary tract and gastrointestinal tract (cholecystitis, cholangitis, gastroenterocolitis, bacterial dysentery, traveler’s diarrhea);

⊳infections❛ of the skin and soft tissues (phlegmon, abscess, furunculosis, panaritium, infected burns, wounds, etc.);

⊳infectious❛ diseases of the eyes, syphilis, yawsinosis, legionellosis, rickettsiosis, chlamydia of various localizations (including prostatitis and proctitis), fever Koo, spotted fever of❛ the Rocky❛ Mountains, typhus (including mucous, tick-borne, recurrent) , Lyme disease (I v. – erythema migrans), bacillary and amoebic dysentery, tularemia, cholera, actinomycosis, malaria;

⊳in the combination❛ therapy – leptospirosis, trachoma, psittacosis, ornithosis, granulocyte erlichiosis;

⊳whooping❛ cough, brucellosis, osteomyelitis;

⊳sepsis, subacute septic❛ endocarditis, peritonitis;

⊳prevention of❛ postoperative purulent complications;

⊳malaria caused by Plasmodium❛ falciparum, during short trips (less than 4 months) in a territory where strains resistant to❛ chloroquine and / or pyrimethamine sulfadoxine are common;

As a preparation of the “first” series, patients under 65 years of age are exacerbated with exacerbation of chronic bronchitis (including bronchial asthma) without concomitant diseases (these exacerbations are often caused by Haemophilus influenzae). Effective with exacerbation of bronchopulmonary infection (usually staphylococcal etiology) in patients with cystic fibrosis, chlamydial arthritis, granulocyte erlichiosis. In elderly patients it is used to treat acute prostatitis and urinary infection caused by Escherichia coli.

⇨hypersensitivity to doxycycline, drug components, other tetracyclines;
⇨deficiency of lactase;
⇨Lactose intolerance;
⇨glucose-galactose malabsorption;
⇨Severe hepatic impairment;
⇨Children’s age (up to 12 years – the possibility of formation of insoluble complexes with calcium ions (Ca2 +) with deposition in the bone skeleton, enamel and dentin teeth);
⇨Children aged after 12 years with a body weight of up to 45 kg.

Inside, in adults and children over 12 years with a body weight of more than 45 kg, the average daily dose is 200 mg on the first day (divided into 2 divided doses – 100 mg twice a day), then 100 mg / day.
In chronic infections of the urinary system – 200 mg / day throughout the period of therapy.
In the treatment of gonorrhea, one of the following regimens is prescribed: acute uncomplicated urethritis – a course dose of 500 mg (1 reception – 300 mg, subsequent 2 – 100 mg at 6-hour intervals) or 100 mg / day until complete cure (in women) or 100 mg 2 times a day for 7 days (in men); with complicated forms of gonorrhea, the course dose is 800-900 mg, which is divided into 6-7 receptions (300 mg – 1 reception, then at an interval of 6 hours for 5-6 follow-up).
In the treatment of syphilis – 300 mg / day for at least 10 days.
In uncomplicated infections of the urethra, cervix and rectum caused by Chlamydia trachomatis, 100 mg are prescribed twice a day for at least 7 days.
Infections of male genital organs – 100 mg twice a day for 4 weeks. Treatment of malaria resistant to chloroquine – 200 mg / day for 7 days (in combination with shizontocidal drugs – quinine); malaria prophylaxis -100 mg once a day 1-2 days before the trip, then daily during the trip and for 4 weeks after return;
Diarrhea “travelers” (prevention) – 200 mg on the first day of the trip (for 1 dose or 100 mg twice a day), 100 mg once a day during the entire stay in the region (no more than 3 weeks).
Treatment of leptospirosis – 100 mg orally 2 times a day for 7 days; prophylaxis of leptospirosis – 200 mg once a week during a stay in a dysfunctional area and 200 mg at the end of the trip.
Prevention of infections after medical abortion – 100 mg for 1 hour before abortion and 200 mg – 30 minutes after.
With acne – 100 mg / day, the course – 6-12 weeks.
Maximum daily doses for adults – up to 300 mg / day or 600 mg / day for 5 days with severe gonococcal infections.
In the presence of severe hepatic insufficiency, a decrease in the daily dose of doxycycline is required, since in this case a gradual accumulation of it in the body takes place (the risk of hepatotoxic action).

Side effects
From the side of the nervous system: a benign increase in intracranial pressure (decreased appetite, vomiting, headache, edema of the optic nerve disc), toxic effects on the central nervous system (dizziness or instability),
Metabolic disorders: anorexia.
From the organs of hearing and the vestibular apparatus: ringing in the ears.
From the side of vision: blurred vision, scotoma and diplopia as a result of increased intracranial pressure.
From the digestive system: nausea, constipation or diarrhea, abdominal pain, glossitis, dysphagia, esophagitis (including erosive), gastritis, ulceration of the stomach and duodenum, pseudomembranous colitis, enterocolitis (due to the proliferation of resistant Staphylococcus strains ).
Allergic reactions: maculopapular rash, skin itching, skin hyperemia, angioedema, anaphylactoid reactions, drug lupus erythematosus, erythematous rash, exfoliative dermatitis, urticaria, anaphylaxis, anaphylactic shock, anaphylactoid reactions, Stevens-Johnson syndrome.
From the cardiovascular system: pericarditis, lowering blood pressure, tachycardia, erythema multiforme.
From the hemopoiesis: hemolytic anemia, thrombocytopenia, neutropenia, leukopenia, eosinophilia, a decrease in the prothrombin index.
On the part of the hepatobiliary system: a violation of the liver, increased levels of hepatic transaminases, autoimmune hepatitis, cholestasis.
Musculoskeletal: arthralgia, myalgia.
Impaired renal and urinary tract function: Increased level of residual urea nitrogen.
Other: photosensitization, superinfection; stable change in the color of tooth enamel, inflammation in the anogenital zone. Candidiasis (vaginitis, glossitis, stomatitis, proctitis), dysbacteriosis, a syndrome similar to serum sickness, toxic epidermal necrolysis.

Symptoms: with the introduction of high doses, especially in patients with impaired liver function, neurotoxic ❃Reactions may appear: dizziness, nausea, vomiting, convulsions, impaired consciousness due to increased intracranial pressure.
Treatment: drug withdrawal, gastric lavage with activated charcoal, symptomatic therapy, inside appoint antacids and magnesium sulfate to prevent the absorption of doxycycline. There is no specific antidote. Hemodialysis and peritoneal dialysis are ineffective.

Drug Interactions
Absorption is reduced by antacids containing salts of aluminum (Al3 +), calcium (Ca2 +) and magnesium (Mg2 +), iron preparations (Fe), sodium hydrogen carbonate, laxatives containing magnesium salts (Mg2 +), colestyramine and colestipol, therefore their use should be divided an interval of 3 hours.
In connection with the suppression of the intestinal microflora reduces the prothrombin index, which requires correction of the dose of indirect anticoagulants.
When combined with bactericidal antibiotics that disrupt the synthesis of the cell wall (penicillins, cephalosporins), the effectiveness of the latter is reduced. Reduces the reliability of contraception and increases the frequency of bleeding “breakthrough” against the background of taking estrogen-containing oral contraceptives.
Ethanol, barbiturates, rifampicin, carbamazepine, phenytoin and other stimulants of microsomal oxidation, accelerating the metabolism of doxycycline, reduce its concentration in the plasma.
With simultaneous use with methoxyflurane, it is possible to develop acute renal failure, up to a lethal outcome.
Simultaneous use of retinol helps increase intracranial pressure.

Special instructions
To prevent locally irritating effect (esophagitis, gastritis, ulceration of the mucous membrane of the gastrointestinal tract) it is recommended to take in the daytime hours with a lot of liquid, food. In connection with the possible development of photosensitization, it is necessary to limit the insolation during treatment and for 4-5 days after it. With prolonged use, periodic monitoring of liver function, hematopoiesis is necessary. May mask the manifestations of syphilis, in connection with which, with the possibility of a mixed infection, a monthly serological analysis is necessary for 4 months. All tetracyclines form stable complexes with calcium ions (Ca2 +) in any bone-forming tissue. In this regard, reception during the development of teeth can cause long-term staining of teeth in yellow-gray-brown color, as well as hypoplasia of the enamel. Perhaps a false increase in the level of catecholamines in urine when determined by the fluorescent method. In the study of the thyroid biopsy in patients who have been receiving doxycycline for a long time, it is possible to dark brown staining of the tissue in micropreparations without disturbing its function.
In the experiment, it has been established that doxycycline can exert a toxic effect on the development of the fetus (delay in the development of the skeleton) – blocks metalloproteases (enzymes that catalyze the degradation of collagen and proteoglycans) in the cartilage, leading to a reduction in lesions in deforming osteoarthritis. When the dose is increased above 4 g, the pharmacokinetics of doxycycline does not depend on the dose and the concentration in the blood does not increase.
When using the drug, both on the background of taking and 2-3 weeks after stopping treatment, it is possible to develop diarrhea caused by Clostridium difficile. In light cases, it is sufficient to cancel treatment and use ion-exchange resins (colestyramine, colestipol), in severe cases, compensation for loss of fluid, electrolytes and protein, the appointment of vancomycin, bacitracin or metronidazole. Do not use drugs that inhibit the intestinal motility.
Impact on the ability to drive vehicles and manage mechanisms
Patients should refrain from all activities requiring increased attention, rapid mental and motor.

Pregnancy and lactemia
The use of the drug during pregnancy is contraindicated, because, penetrating the placenta, the drug can disrupt the normal development of the teeth, inhibit the growth of the bones of the fetal skeleton, and also cause fatty liver infiltration.
During the lactation period, the use of doxycycline is contraindicated. In case of need of application of a preparation, for the period of treatment feeding by a breast should be stopped.

Application in childhood
Contraindicated for children under 12 years of age (the possibility of formation of insoluble complexes with calcium ions (Ca2 +) with deposition in the bone skeleton, enamel and dentin of the teeth); and children aged after 12 years with a body weight of up to 45 kg.
Application is possible in children older than 12 years with a body weight of more than 45 kg according to the dosing regimen.

With violations of liver function
Contraindicated in severe hepatic insufficiency. In the presence of severe hepatic insufficiency, a decrease in the daily dose of doxycycline is required, since in this case a gradual accumulation of it in the body takes place (the risk of hepatotoxic action).

Terms and conditions of storage
In a dry, protected from light place at a temperature of no higher than 25 ° C. Keep out of the reach of children. Shelf life – 4 years.

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Active Ingredient: Propranolol

Other names for this medication:

Pharmacological action of the drug
Hypotensive, antianginal, antiarrhythmic, uterotonizing.
Blocks beta1 and beta2-adrenergic receptors, has a membrane-stabilizing effect. It reduces the heart rate, reduces the force of the heart and the need for myocardium in oxygen. Reduces cardiac output, renin secretion, arterial pressure, renal blood flow and glomerular filtration rate. After taking a single dose, the hypotensive effect lasts for 20-24 hours. With prolonged use reduces venous return, has a cardioprotective effect.
In patients with moderate form of hypertension – reduces the likelihood of developing IHD and cerebral strokes. With IHD reduces the frequency of seizures, increases the tolerance of physical exertion, reduces the need for nitroglycerin. It is most effective in patients of young age (under 40 years) with hyperdynamic type of circulation and with increased content of renin.
Increases the tone of the bronchi and contractility of the uterus (reduces bleeding during labor and in the postoperative period), increases secretory and motor activity of the gastrointestinal tract. It inhibits platelet aggregation and activates fibrinolysis. Inhibits lipolysis in adipose tissue, preventing the increase in the level of free fatty acids (the concentration of triglycerides in the plasma and the coefficient of atherogenity increase.)
Suppresses glycogenolysis, secretion of glucagon and insulin, the conversion of thyroxine to triiodothyronine .It reduces intraocular pressure, reduces the secretion of watery moisture. and almost completely absorbed from the digestive tract.It is almost completely associated with plasma proteins.Conducts in lung tissue, brain, kidneys, heart, passes through the parade succinic barrier, enters the breast milk. Excreted kidneys as metabolites.

Indications for prescription
Arterial hypertension, angina pectoris, sinus tachycardia (including hyperthyroidism), supraventricular tachycardia, tachysystolic atrial fibrillation, supraventricular and ventricular extrasystole, hypertrophic cardiomyopathy, myocardial infarction, mitral valve prolapse, subaortic stenosis, sympathoadrenal crisis in patients with diencephalic syndrome, neurocirculatory dystonia, portal hypertension, essential tremor, panic attacks, aggressive behavior, migraine (prophylaxis), ancillary treatment and pheochromocytoma (only in association with alpha-blockers), thyrotoxicosis (including preoperative) thyrotoxic crisis, primary uterine inertia, menopausal vasomotor symptoms of withdrawal syndrome; treatment of akathisia caused by neuroleptics.

Hypersensitivity, AV blockade of II-III degree, sinoatrial block, bradycardia (less than 55 bpm), sinus node weakness syndrome, arterial hypotension, acute and severe chronic heart failure, Prinzmetal angina, cardiogenic shock, obliterating vascular diseases, bronchial asthma.
For the duration of treatment, breastfeeding should be discontinued.

Restrictions on the use:
☞Chronic bronchitis,
☞diabetes mellitus,
☞impaired liver and kidney function,
☞spastic colitis,
☞myasthenia gravis,
☞elderly age.

Side effects of the drug
➡From the cardiovascular system and blood (hematopoiesis, hemostasis):
☛heart failure,
☛AV blockade,
☛violation of peripheral circulation,
☛thrombocytopenic purpura,

Strengthens (mutually) the negative influence of verapamil and diltiazem on the myocardium, prolongs the action of nondepolarizing muscle relaxants, inhibits the excretion of lidocaine. Weaken the hypotensive effect of NSAIDs, glucocorticoids, estrogens, cocaine; strengthen – nitrates and other antihypertensive drugs. Heparin, antacids lower the level in the plasma; cimetidine and phenothiazines – increase. It is not recommended simultaneous administration with MAO inhibitors. Slows the metabolism of theophylline and increases its concentration in the blood plasma.

Method of application
Inside, squeezed with liquid or semi-liquid food (water, juice, apple puree, pudding), adults: with arterial hypertension – the initial dose – 80 mg twice a day, maintaining a dose of 160-320 mg. Prolonged forms: 80 mg once a day, if necessary up to 120-160 mg once, under the control of blood pressure. At arrhythmias – 10-30 mg 3-4 times a day, with subaortal stenosis – 20-40 mg 3-4 times a day.
With portal hypertension, angina, migraine, excitation, tremor, the initial dose of 40 mg 2-3 times a day, supporting – 160, 120-240, 80-160, 80-120, 80-160 mg / day, respectively. When pheochromocytoma – 30-60 mg / day for 3 days (before surgery). With myocardial infarction – from 5 to 21 days after a heart attack 40 mg 4 times a day for 2-3 days, then – 80 mg 2 times a day.
For the stimulation of labor – 20 mg every 30 minutes 4-6 times (80-120 mg / day), for the prevention of postpartum bleeding – 20 mg 3 times a day for 3-5 days. Children: Inside, the initial dose: 0.5-1 mg / kg / day, supporting – 2-4 mg / kg / day in 2 divided doses.

An overdose of a medicine
➲heart failure,
➲difficulty breathing,

➡Treatment: gastric lavage and the appointment of adsorptive agents, symptomatic therapy: atropine, beta-adrenomimetiki (isoprenaline, isadrin), sedatives (diazepam, lorazepam), cardiotonic (dobutamine, dopamine, epinephrine) drugs, vasopressor drugs, glucagon, etc .; it is possible to carry out transvenous stimulation.
Hemodialysis is ineffective.

Other recommendations
Treatment should be carried out under the supervision of a doctor. Reduces compensatory cardiovascular reactions in response to the use of general anesthetics. Intravenous introduction to children is not recommended. In elderly patients, the risk of CNS side effects is increased. When a violation of the liver is recommended to reduce doses. Can mask symptoms of hypoglycemia (tachycardia) in diabetic patients taking insulin and other hypoglycemic drugs. For the duration of treatment, it is recommended to exclude the use of alcoholic beverages. With caution apply during work drivers of vehicles and people whose profession is associated with increased concentration of attention. Stop the treatment gradually, for about 2 weeks. During the treatment, it is possible to change the test results when carrying out laboratory tests (increased levels of urea, transaminases, phosphatases, LDH).

Storage method
List B. In a dry, the dark place at a temperature of no higher than 25 ° C.

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