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Buy Cytotec online

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Other names for this medication:
Alsoben, Arthotec, Artotec, Artrenac, Artrotec, Asotec, Citrosol, Cyprostol, Cytil, Cytofine, Cytolog, Cytomis, Gastrul, Gymiso, Mesopil, Misodex, Misofenac, Misolast, Misolup, Misoprost, Misoprostolum, Misotrol, Noprostol, Normulen, Symbol.
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Composition
One tablet of the drug Cytotec contains 200 mcg of misoprostol.
Additional ingredients: castor oil, sodium carboxymethyl cellulose, microcrystalline cellulose, silicon dioxide.

Release Form
White Valium tablets notch.
10 tablets in a blister; one, two, five or three blisters in a box made of cardboard.

Pharmachologic effect
Antiulcer action.

Pharmacodynamics and pharmacokinetics
Cytotec tablets are antisecretory, anti-ulcer drugs and have also cytoprotectors properties.

Misoprostol is a synthetic analogue of prostaglandin E1, which has a protective effect on the intestinal mucosa and gastric. It improves the stability of the inner membrane of the stomach to the action of negative factors: malnutrition, alcohol, stress, non-steroidal anti-inflammatory agents; helps prolong peptic ulcers, stops the occurrence of erosive and ulcerative disorders.
Cytoprotective effect of the drug is associated with an increase in mucus production in the stomach and increase its own gastric mucosal bicarbonate secretion. The drug has also antisecretory activity, reacting with receptors of prostaglandin E-type. It has a direct effect on the cells of the stomach, slows down the night, both basal and stimulated secretion of hydrochloric acid, and reduces the amount of proteolytic activity of gastric juice. It weakens the basal production of endogenous pepsin. It increases blood flow to the stomach. The drug begins half an hour after administration and lasts a minimum of 3 hours. The effect has a pronounced dose-dependent. It increases strength and frequency of contractions of the myometrium and the muscles of the intestine.
Pharmacokinetics
Rapidly absorbed (food intake slows absorption). The walls of the intestine and the liver to form biotransformed misoprostol pharmacologically active misoprostol acid. The largest concentrations are in about 12 minutes, it circulates in the bloodstream in a complex with proteins (90%). The half-life time may be up to 40 minutes. The equilibrium concentration of active substance in the blood is reached after 2 days, accumulation is not observed. Up to 80% of the dose is excreted by the kidneys, in violation of their operation may increase the half-life and an increase in the maximum concentration of 2 times.

Indications
Treatment and prevention of gastric mucosal lesions and 12 duodenal ulcer, ulcerative erosive nature, caused by including taking anti-inflammatory non-steroidal agents.
Medication abortion (medical abortion in most countries the drug is used without authorization and without the need for patient information on safe use).

Contraindications
-Cardiovascular disease.
-Hypersensitivity to the drug.
-Liver and kidneys.
-Endocrinopathies and destruction of the endocrine system.
-Diseases associated with dependence on prostaglandins.
-Anemia.
-Hormone-dependent tumors.
-Lactation.
-Age up to 18 years.
-Suspected ectopic pregnancy.
-The use of intrauterine contraceptive devices.
-Pregnancy (if the drug is not used for the purpose of an interruption).

Side effects
Frustration on the part of digestion: stomach pain, vomiting, diarrhea, dyspepsia, nausea, flatulence, constipation.
Disorders of the reproductive sphere: pain in the lower abdomen floor hypermenorrhoea, dysmenorrhea, postmenopausal vaginal discharge bloody nature.
Other disorders: headaches, cramps in women paraklimaktericheskom period, asthenia, fatigue, weight change, rashes.

Instructions for use (Method and Dosage)
Instructions on Cytotec provides a use of the drug for the treatment and prevention of peptic ulcer disease and does not spread the recommendations on the use of funds for abortion. The drug is taken orally with meals.
To treat ulcers caused by the use of nonsteroidal anti-inflammatory agents, manual prescribes Cytotec take 800 mg of the drug twice a day for 1-2 months.
For the prevention of ulcers caused by the use of non-steroidal anti-inflammatory agents, medicine taking 200 mg 2-4 times a day during the treatment period, non-steroidal anti-inflammatory agents.
Cytotec Abortion
Use for abortion up to 63 days only in combination with mifepristone, trained personnel in institutions with the ability to provide emergency assistance. In the later stages of the drug ineffective.

Overdose
No data on misoprostol toxicity in humans. Symptoms indicating excess dosage: drowsiness, bradycardia, seizures, tremor, abdominal pain, palpitations, fever, hypotension.

Interaction
When used together with antacids decreases the concentration of active substance in the blood.
When using a magnesium-containing antacids can not be ruled strengthening diarrhea.
In a joint application with diclofenac, or indomethacin stimulated side effects of the latter.

Storage conditions
Store in a dry place at temperatures up to 30 ° C. Keep away from children.

Shelf life
3 years.

Special instructions
The drug should be used with caution in patients with coronary heart disease, arterial hypertension, cerebral circulatory disorders, diarrhea, epilepsy, koronarokardiosklerozom, enterocolitis, hypersensitivity to prostaglandins.
In appointing the patients of childbearing age must first carry out a pregnancy test. The test should be negative for 2 weeks prior to application of the drug. Treatment is allowed to start only 2 days after the start of menstruation. Throughout the period of the reception should use reliable methods of contraception. Misoprostol increases uterine tone and can trigger a miscarriage.

For Kids
Do not use in patients under 18 years.

During pregnancy (and lactation)
The product may not be used during these periods with the exception of applications for the purpose of termination of pregnancy.

ATTENTION!

Information about medications online is a reference generalizing collected from publicly available sources and can not serve as a basis for decision-making on the use of medicines in the course of treatment. Before using the drug Cytotec you should consult with your doctor.

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Other names for this medication:Acmecilin, Agrocillina, Albipen, Albipenal, Alfasid, Alfasilin, Allégrocine, Alphapen, Alpovex, Ambigel, Ambiopi, Amblosin, Amfipen, Aminoxidin-sulbactam, Amipenix, Amp equine, Ampecu, Ampen, Ampenina, Ampexin, Ampi, Ampibactan, Ampibenza, Ampibex, Ampibos, Ampicaps, Ampicare, Ampicat, Ampicher, Ampicil, Ampicilin, Ampicilinã.

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The popular medication for many years, “Ampicillin” is an effective antibiotic. Despite the fact that there are new drugs, it is still in demand among physicians and patients. This semisynthetic penicillin antibiotic effective against many bacteria, sepsis, and purulent infection makes it better than others. Not everyone knows exactly from which “Ampicillin” helps, but its low price and availability in pharmacies make it one of the most purchased products. Many patients prescribed it currently own, what to do, of course, should not be. Application “Ampicillin” should be strictly prescribed by a doctor, which takes into account the patient’s health, and particularly his disease. We need to know exactly from what “Ampicillin” helps not to cause the development of superinfection, insensitive to antibiotics.

Characteristics of the drug

This drug belongs to a group of semi-synthetic penicillins and has a broad spectrum of action.
Ampicillin” tablets used for many years since it is active against most bacteria. Its main active ingredient effectively destroys the cell walls of microorganisms. “Ampicillin” inhibits metabolism in the membranes of cells. Under its influence die many gram-positive and gram-negative bacteria and certain pathogens of intestinal infections. But there are microorganisms that produce a special enzyme beta-lactamase. It destroys penicillin, and the drug is powerless to cure infections caused by bacteria, such as staphylococcus. But he effectively treats a variety of mixed infection, purulent infection and sepsis.
Method of production preparation

1. Previously pills were quite popular “Ampicillin“. Instructions for applying are encouraged to use it in many infections. And now it is fairly common antibiotics. Many patients do buy for different ailments “Ampicillin“. Its price is low, and the drug – one of the most affordable. Although it is not recommended to drink antibiotics without a prescription.
2. In severe infections and is increasingly used in hospitals “Ampicillin” in the form of injections. Putting it intravenously or intramuscularly. The powder was dissolved in a special water for injection.

3. Now the drug is available as a powder for suspension for oral administration. It is more convenient for patients, which is difficult to take a pill, especially children.
How does the drug?

The drug destroys the cells of the bacteria. This leads to their death.
Ampicillin” is rapidly absorbed into the blood, the maximum plasma concentration observed after a few hours. A by intravenous or intramuscular administration – even earlier. But “Ampicillin” tablets is fairly efficient. After preparation resistant to gastric acid and are not destroyed in the gastrointestinal tract. Within a short time, it accumulates in all body fluids and tissues: penetrates not only in blood, but in the lymph, bile duct, and intra-spinal fluid, bone and skin. Displayed “Ampicillin” with the urine, but also actively allocated with breast milk, so nursing moms do not recommend taking it.
What does the “ampicillin” is used?

It helps the tool in the following diseases:
bronchitis, pneumonia and even lung abscess;
Otitis media, sinusitis, tonsillitis and pharyngitis;
Infections of the kidneys and gall bladder, it is particularly useful in cystitis and urethritis;
Severe intestinal infections, including typhoid fever and salmonellosis;
Effective drug against septic wounds, infections of the skin and soft tissues, such as the face or dermatosis, postoperative inflammation;
It is one of the few drugs that help with gonorrhea, chlamydia and meningitis;
Treats “Ampicillin” various infections musculoskeletal system, rheumatism, arthritis and osteomyelitis. What does “Ampicillin” appointed yet? Effective when it is listeriosis and cons. It is used as a medicine as a preventive agent for endocarditis – inflammation of the heart muscle.
Unlike other antibiotics penicillin group, this drug is very effective against pyogenic and hemolytic streptococci.
Contraindications to receive

But not all you can drink “Ampicillin” (tablets). Instruction warns against ingestion of those who suffer from the following diseases:
renal failure or renal disease;
Hepatic impairment;
Bronchial asthma;
Allergic diseases;
Severe violations of the gastrointestinal tract;
Mononucleosis or leukemia;
A tendency to bleeding. You can not take as “Ampicillin” women breastfeeding. Tablet form is not prescribed kids up to 6 years.
Side effects

during the medication may cause unwanted symptoms. In this case it is necessary to consult with your doctor about discontinuing the drug. What side effects can cause “Ampicillin“?
Nausea, vomiting, abdominal pain and dry mouth. Very often develop intestinal dysbiosis.
Dizziness, drowsiness, trembling hands and feet.
Headache, seizures.
Rhinitis or conjunctivitis.
Body rash, hives and other allergic reactions up to anaphylactic shock.
Violation of the liver and hepatitis.
Changing behavior: depression, aggressive or anxiety.
The tendency to bleeding due to decreased number of platelets in the blood.
Is reduced as the amount of hemoglobin and white blood cells.
Often there is the development of fungal infections in patients receiving the drug.
Pills “Ampicillin”: instructions for use, depending on the health status and age of the patient is prescribed 250 mg and 1 g per reception. Drink the medicine should be on an empty stomach with plenty of water. Take “Ampicillin” four times a day at regular intervals of six hours
Usually I drink it half an hour before meals or one hour after. If the drug is taken with food, the absorption of it slows down, respectively, the therapeutic effect decreases. Duration of disease depends. In severe cases it is possible to extend the treatment for 3-4 weeks or even longer. But usually the drug was stopped after a couple of days after the disappearance of symptoms. The solution was “ampicillin” injection can be administered to children in the year, but the treatment is carried out in a hospital. The dose is calculated according to the weight of the child – 50 mg per kilogram. Injections are done less than two weeks and then treatment is continued for adults pills and change the drug to children.
Specific admission
prescribe drugs only after study sensitivity to microorganisms that caused the disease.
Strongly contraindicated alcohol intake during treatment.
In weakened patients may develop superinfection, especially during long-term medication. Bacteria acquire antibiotic sensitivity.
Simultaneously with the reception “Ampicillin” recommended to drink vitamins and vitamin C, as well as antifungal agents, for example, “Nystatin”.
Long-term treatment is necessary to monitor the preparation of the kidneys and liver, as well as of the blood, requires regular blood tests.
If you can not stop improving the state to take “Ampicillin” (tablets). Jeux Guide recommends drinking 2-3 days after symptoms disappear. This is also true for other forms of medicament.
As with other antibacterial agents “ampicillin” suppresses intestinal microflora and reduce the synthesis of vitamin K. Therefore the desired reception simultaneously with antibiotic drugs dysbacteriosis and vitamin complexes.
What does “Ampicillin” is now prescribed more often? It is more effective than other antibiotics for purulent wounds, ulcers, abrasions, inflammation of joints and cystitis.
Interaction with other drugs
Antacids and laxatives, as well as food slows the absorption of the drug and reduce its effect.
Akorbinovaya acid, on the contrary, accelerate absorption “Ampicillin“.
Other bactericidal antibiotics enhance the effect of the drug, and bacteriostatic agents – inhibit it.
NSAIDs diuretics increase and high concentration “Ampicillin” levels, thereby increasing its effect.
Upon receipt of this antibiotic decreases efficiency estrogensoderjath contraceptives.
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Valtrex order online

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Active Ingredient: Valacyclovir
Valtrex is used for treating shingles (herpes zoster), cold sores (fever blisters or herpes labialis), and treating, suppressing, or reducing transmission of genital herpes in patients with normal immune systems.

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clomidprednisolone.

Valtrex – an antiviral drug, the main active substance is valaciclovir. The medicament exhibits activity against viruses of herpes zoster, human herpesvirus 6, herpes simplex virus types 1 and 2, cytomegalovirus, varicella-zoster virus, Epstein-Barr virus. After absorption in the gastrointestinal tract by enzymes in the liver drug becomes valine and acyclovir. Acyclovir is built into the DNA chain of the virus, thereby cease DNA synthesis and blocks reproduction (replication) of the virus.Acyclovir is built into the DNA chain of the virus, thereby cease DNA synthesis and blocks reproduction (replication) of the virus.When immunocompetent patient rarely (less than 0.1%) found a reduced sensitivity of herpes simplex and herpes zoster to valacyclovir. In patients with severe immune disorders (for HIV infection, chemotherapy or bone marrow transplant) decrease in susceptibility to the drug more common – this is due to mutation of the virus and a violation of the structure of the viral DNA.Since proteins in the blood binds only 15% Valtrex. Valacyclovir is derived from the body in urine. The half-life of the drug is 3 hours, renal insufficiency – about 14 hours, which may lead to increased concentrations of the drug in the body.

Instructions for use Valtrex:
With the purpose of treatment Valtrex is used for such diseases: herpes zoster (shingles) reduces the severity and duration of pain in the acute stage and neuralgia after herpes; herpetic infection of mucous and skin caused by herpes simplex type 1 and 2 (including herpes of the lips and genital herpes); use of the drug in the early stages of the disease breaks.
From prevention to Valtrex is prescribed: for the prevention of exacerbations of herpes simplex virus (type 1 and 2), genital herpes; to reduce the risk of infection of the sexual partner genital herpes (in combination with safer sex admission); to prevent opportunistic infections (herpes simplex, cytomegalovirus infection, herpes zoster) and reducing rejection in organ transplants in adults and children after 12 years.

Contraindications:Individual intolerance to the drug or its components; chronic renal failure.
How to take Valtrex?

Valtrex pills is independent of food intake. Medicine washed down with water. Elderly patients and those with risk of dehydration should ensure that excessive drinking. Professional restrictions (transport management and work with dangerous equipment) during treatment Valtrex no.

 The dosage of Valtrex
When herpes zoster Valtrex is usually used at a dose of 1 g 3 p. per day for a week. Herpes infection, herpes simplex virus type 1 and 2 in the acute period of 7 days is treated Valtrex 500 mg 2 p. per day. At relapse of the disease – a course usually lasts 5-10 days, and the treatment should be started at the slightest manifestations of the disease as early as possible.Alternative treatment of herpes of the lips on the first day of Valtrex appointed 2 g 2 p. per day at 12 hour intervals. The drug should begin at the first sign of illness (burning, itching on the lip). For the prevention of recurrence of the disease (with normal immunity) receiving 500 mg 1 p. per day, and with frequent exacerbations (10 p. for a year or more) – 250 mg 2 p. per day. If immunodeficiency is dosed at 500 mg 2 p. per day.

The duration of treatment of 4 to 12 months.For the prevention of genital herpes have healthy sexual partner with normal immunity, it should take 500 mg of Valtrex 1 p. per day. Daily intake of the drug spend a year or more, if you have sex regularly, and at irregular – treatment is initiated 3 days prior to sexual intercourse. When an organ transplant in adults and adolescents after 12 years for the prevention of viral infections and rejection prescribed Valtrex as possible in the early postoperative period at a dose of 2 g 4 p. per day.

In chronic renal failure dose chosen physician individually depending on the creatinine clearance. Such patients need regular medical supervision, as they often develop complications of the nervous system. With hemodialysis Valtrex appointed after the meeting. Patients with liver disease, especially in severe cirrhosis of the liver, high dose Valtrex used with caution.

If overdose occur disorders of the digestive system (nausea, vomiting) and neurological disorders (headache, disturbance of consciousness, hallucinations) and may develop acute renal failure. Effective in this case is hemodialysis.
Valtrex children

Clinical Research on the use of Valtrex in children are not available. At the age of children under 12 years Valtrex is not applicable. Children 12 years after Valtrex assigned only for the prevention of viral infections (including CMV) and reduce the rejection reaction after organ transplantation. For all other indications Valtrex under 18 is not assigned.
Valtrex in pregnancy and lactation
Clinical safety data on the use of Valtrex in women during pregnancy is not enough, and they are not statistically significant. The preparation is allowed to apply only in cases where the therapeutic effect of the drug outweigh the risks for pregnant possible effects on the fetus. In experimental animal studies, teratogenic effects on the fetus Valtrex is not revealed. Given that Valtrex passes into breast milk, the drug may have effects on the child’s body. Prescribers women, breastfeeding should be cautious.
STORAGE
Store Valtrex between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Valtrex out of the reach of children and away from pets.
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V-Gel is a herbal gel that is used for the treatment of vaginitis, cervicitis, leucorrhea.

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INDICATIONS
V-gel is a powerful antibacterial, antifungal and anti-inflammatory agent; It provides a sense of comfort and security; It softens and moisturizes the vaginal mucosa; quickly heals minor damage.
Intimate gel eliminates burning and itching, regenerates and normalizes vaginal microflora.
Intimate gel is effective in the treatment of cervicitis and vaginitis.
Gel – gel lubricant V- relieves inflammation of the cervix and vagina, enhances the recovery process, eliminating the itching.
The gel helps with vaginitis avoid unwanted secretions.
Cleansing Gel – helps to maintain the purity of the female genital organs, eliminates the excessive dryness and unpleasant odor.
V- gel for intimate hygiene support useful microflora of the vagina, protects against infections, restores tissue after injection or removal of an intrauterine device.
INSTRUCTIONS1 to 2 gm applied deep inside the vagina twice a day through the calibrated applicator for 7 to 14 days.
DOSAGE
V – gel applied with an applicator (see Image B instructions to the gel), or as recommended by the therapist.
Apply evenly deep inside 2 times a day for 1-2 grams of gel in the morning and evening.
The treatment course is 7-14 days, the course must be 1-2 Packing V-gel.
Side effects: V-gel, as is known, has no – or side effects if used according to the prescribed dosage.
Note: V-gel is water soluble and easily washed brown spots. Color gel caused by herbal extracts. During the application of the gel can sometimes appear a sense of light burning, which is replaced by a cooling and soothing effect. For external use only.
STORAGEStore at the room temperature away from moisture and sunlight. Keep out of reach of children.
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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

Composition
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.

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

Pharmacotherapeutic group
Contraceptives (estrogen + progestogen)

ATC code
G03AA12

Pharmacological properties

Pharmacodynamics
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.

Pharmacokinetics
Drospirenone
Absorption
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%.
Distribution
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.
Metabolism
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.
breeding
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).
Ethnicity
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.

Ethinylestradiol
Absorption
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%.
Distribution
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.
Metabolism
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.
breeding
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.

Indications

Contraception.

Contraindications

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).

Carefully

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.
elderly
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”.)
Tumors
• 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).
Interaction
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).

Overdose

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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Levitra
Brand Levitra
Vardenafil 20 mg
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Levitra – Vardenafil is a trade name, a new oral tablet means for probable stimulation and arousal of male erectile dysfunction.
The action of Levitra like Viagra – it also increases blood flow to the penis, helping to achieve an erection and maintain it, but in many cases possible Levitra will work more efficiently. As a result of many chemical tests proved the effectiveness of the drug Levitra, as a means of maintaining potency and possible stimulation and excitement of erectile dysfunction.

Levitra (Vardenafil) –

A more powerful impact of this chemical agent on the enzyme penile arteries PDE-5 allows to use it not only as a first-line treatment, but also as a drug of choice – when the ineffectiveness of other PDE-5 inhibitors – viagra(sildenafil) and cialis (tadalafil) .

this chemical agent “Levitra” and its generic forms of diabetic patients and in patients after radical prostatectomy is 72%, and men, previously unsuccessfully treated with Viagra (sildenafil) Contents komponentovlyaet 62%.

Levitra (Vardenafil) –

Levitra erectile dysfunction.

Levitra in patients with diabetes, prostatectomy resistant to other phosphodiesterase-5 inhibitors.

Levitra is reduced over time,

Levitra (Vardenafil) – the description of the chemical agent.

Levitra – a drug for the probable stimulation and arousal erectile dysfunction, phosphodiesterase type 5 inhibitors. It is used for the probability of stimulation and excitement erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).

Latin name:

LEVITRA / LEVITRA.

The content of the components and the form of:

Levitra film-coated tablets, 1, 2, 3, 4, 6, 8, 9 or 12 pieces. packaged.

1 tablet contains vardenafil, Levitra 2.5, 5, 10 or 20 mg (5.926, 11,852 or 23,705 mg of vardenafil hydrochloride trihydrate, respectively).

The active-active components:

Vardenafil / Vardenafil.

Properties / Action:

Levitra – a drug for the probable stimulation and arousal erectile dysfunction, an inhibitor of phosphodiesterase type 5 (PDE5).

Penile erection is a hemodynamic process based on the relaxation of smooth muscles of cavernous bodies and located in its arterioles. During sexual stimulation likely nerve endings of the cavernous bodies released nitric oxide (N0), activating the enzyme guanylate cyclase, which results in an increase in the content of the cavernous bodies of cyclic guanosine monophosphate (cGMP). The result is relaxation of corpus cavernosum smooth muscle, which increases blood flow to the penis.
Levitra (vardenafil) blocks PDE 5, under the influence of which the breakdown of cAMP, as a result of the action of endogenous NO in the cavernous bodies during sexual stimulation likely amplified, resulting in the ability of Levitra enhances the natural effect on sexual stimulation.

Pharmacokinetics:

Once inside Levitra rapidly penetrates and takes effect in 15 minutes (in most men after 25 minutes), the duration of Contents komponentovlyaet 4-5 hours.

Cmax is reached, usually after an average of 60 minutes (from 30 to 120 minutes). The absolute bioavailability of Contents komponentovlyaet about 15%. When receiving Levitra (vardenafil) together with a diet containing a large amount of fat, the absorption rate decreases: time to reach Cmax in plasma (Tmax) is increased to 60 m, an average Cmax is reduced by 20% without any significant change in AUC. When receiving Levitra with conventional feed containing no more than 30% fat, vardenafil pharmacokinetic parameters (Cmax, Tmax, AUC) are not changed.

Vardenafil and its major metabolite are highly bound to plasma proteins (95%), and this property is reversible and not dependent on the total concentration of the chemical agent. After 90 min after administration vardenafil in semen of healthy men found no more than 0.00012% of the administered dose.

Vardenafil is metabolized primarily in the liver, with the participation of enzymes of the cytochrome P450 – CYP3A4, and CYP3A5 and CYP2C9.
Middle T1 / 2 vardenafil content komponentovlyaet 4-5 hours and the major metabolite – about 4 hours. The total clearance vardenafil content komponentovlyaet 56 l / h, the final T1 / 2 – about 4-5 hours. After oral administration of vardenafil as metabolites excreted mainly through the intestine – 91-95% of the dose, to a lesser extent by the kidneys – 2-6% of dose.
In healthy older men (65 and older) compared with younger (45 years and younger) are not noted a significant reduction in hepatic clearance of vardenafil. In men older AUC increased on average by 52%. The chemical research Levitra no difference between the efficacy and safety of elderly and young individuals.
Patients with minor (QC> 55-80 mL / min), moderate (creatinine clearance> 30-50 mL / min) and severe (creatinine clearance In patients on hemodialysis, pharmacokinetics of vardenafil has not been studied.

In patients with mild and moderate hepatic impairment Vardenafil clearance is reduced in proportion to the degree of liver dysfunction. Compared with healthy men, patients with minor hepatic impairment may increase in AUC and Cmax 1.2-fold, and at moderate hepatic dysfunction – 2.6 times.

In patients with severely impaired hepatic function The pharmacokinetics of vardenafil has not been studied.

Admission Regulations:

erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).
Dosage and administration:

Inside. Levitra can be taken regardless of meals. Levitra possible will work only if a sufficient level of sexual stimulation probable.

The drug at the recommended dose of Levitra is 10 mg should be taken 25-60 minutes before sexual intercourse. The duration of action of Levitra Content komponentovlyaet 4-5 hours.

If there is no positive effect of the dose was increased to Levitra 20 mg (diabetes, prostatectomy).

In patients taking other drugs or conditions involving reduced metabolism of vardenafil, the dose of Levitra should Content komponentovlyat 2.5-5 mg.

The dose of 5 mg is recommended in elderly patients (over 65 years). Subsequently, depending on the efficacy and tolerability of Levitra dose may be increased to 10 mg.

In patients with moderate hepatic impairment there is a decrease in clearance of vardenafil, so the starting dose of Levitra should komponentovlyat Content 5 mg / day. In patients with minor hepatic impairment change the dosage of Levitra is not required.

Patients with mild, moderate and severe renal impairment change the dosage of Levitra is not required.

You should not take Levitra more than once a day.

The maximum recommended dose is 20 mg komponentovlyaet Contents 1 time per day.
Overdose:

Known cases receiving Levitra in a dose of 80 mg per day, which were accompanied by the development of serious adverse reactions. However, at the same time when used in a dose of 40 mg twice a day, there are marked pain without evidence of toxic effects on the nervous and muscular system.

Treatment: Symptomatic and supportive therapy. Since vardenafil is highly bound to plasma proteins, and only a small number of Levitra excreted by the kidneys, the effectiveness of hemodialysis is unlikely.
The anti Admission Regulations:

Levitra is not recommended for use in patients:

which sexual activity is contraindicated due to diseases of the cardiovascular system;

have had in the past 6 months, heart attack or stroke;

with very low blood pressure (systolic blood pressure at rest below 90 mm Hg. v.);

with uncontrolled high blood pressure;

with unstable angina;

with congenital prolongation of QT interval;

with aortic stenosis and idiopathic hypertrophic subaortal stenosis;

with severe hepatic insufficiency;

with end-stage renal disease requiring dialysis;

with hereditary degenerative diseases of the retina (eg, pigmentary retinopathy);

with anatomical deformation of the penis (contortion, cavernous fibrosis, Peyronie’s disease);

with diseases predisposing to priapism (sickle-cell anemia, multiple myeloma, leukemia);

with a tendency to bleeding and aggravation of ulcer disease;

hypersensitivity to any component of the chemical agent Levitra;

simultaneously applying nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate), or drugs, which are nitric oxide donators;

simultaneously applying the HIV protease inhibitors such as indinavir or ritonavir.

Levitra is not indicated for women and children up to 16 years.

Pregnancy and lactation:

Levitra is not intended for use in women.

Strong Side effects: as a rule, significantly or moderately expressed and are transient in nature.

In carrying out chemical tests of the chemical agent Levitra, there are side reactions were:

headache, dizziness, blurred vision, drowsiness, increased muscle tone;

indigestion, nausea, changes in functional “liver” tests, increased GGT;

“tides” of blood to the face, hypertension, syncope, myocardial ischemia, nosebleeds;

rhinitis, dyspnea;

anaphylactic reactions (including laryngeal edema), photosensitivity;

increase the level of creatine kinase, myalgia, back pain;
priapism.

Cautions and precautions:

Due to the fact that sexual activity is associated with a certain degree of fundamental risk before prescribing Levitra about erectile dysfunction is necessary to assess the state of the cardiovascular system of the patient.

Levitra (vardenafil) is not intended for use in children.
Effects on ability to drive vehicles and management mechanisms:

Before the appointment of Levitra in patients who control the means of transport and work with mechanisms necessary to clarify their individual effect on Levitra.

Drug Interactions:

Vardenafil is metabolized primarily in the liver with the participation isozymes of cytochrome P450, in particular – CYP3A4, as well as with some participation isozymes CYP3A5 and CYP2C9.
Some medicines may affect the metabolism of Levitra, in this regard, patients should consult a physician in case of appointment of a new drug. For example, patients taking cimetidine, ketoconazole, itraconazole, indinavir or ritonavir, the maximum dose of Levitra 5 mg Content komponentovlyaet. The dose of ketoconazole and itraconazole thus should not exceed 200 mg. In an application with the CYP3A4 inhibitor erythromycin did not exceed the maximum recommended dose of Levitra is 10 mg / day.

Avoid concurrent use of this chemical agent Levitra with nitrates (such as nitroglycerin, sodium nitroprusside) or blockers of alpha-adrenergic receptors (of the chemicals to the probable stimulation and excitement of benign prostatic hyperplasia and / or lowering blood pressure) as well as a joint application with the specified these chemical agents could lead to a sharp decrease in blood pressure and collapse.
Since PDE inhibitors affect the system of nitric oxide / cyclic AMP, PDE5 inhibitors may increase the hypotensive effect of nitrates.
Levitra should be applied not earlier than 6 hours after administration of alpha-blockers, and the dose should not exceed 5 mg. However, in combination with an alpha-blocker tamsulosin supplementation may coincide in time.
With simultaneous use of Levitra with glibenclamide, nifedipine, warfarin and digoxin were observed significant changes in the pharmacokinetics.
With the simultaneous use of Levitra with warfarin was not observed changes in prothrombin time and clotting factors.
With simultaneous use of Levitra with acetylsalicylic acid, antacids, ACE inhibitors (enalapril, captopril), beta-blockers (propranolol, atenolol, metoprolol, etc.), Diuretics, hypoglycemic these chemical agents (sulfonylureas and metformin), as well as histamine H2-receptor ranitidine and cimetidine pharmacokinetics of vardenafil has not changed.

In studies in humans, while the use of Levitra (vardenafil) with acetylsalicylic acid was not observed changes in bleeding time.

In studies on human platelets in vitro demonstrated that monotherapy vardenafil not inhibit platelet aggregation induced by various agonists platelets.
Since the safety and efficacy of combinations of Levitra with other agents likely to stimulation and arousal erectile dysfunction (sildenafil, tadalafil) has not been investigated, the use of such combinations is not recommended.

Storage conditions:

Store in a dry place at temperatures no higher than 30 ° C.

Shelf life: 3 years.

Conditions of supply of pharmacies – prescription.

Levitra – a drug for the probable stimulation and arousal erectile dysfunction, phosphodiesterase type 5 inhibitors. It is used for the probability of stimulation and excitement erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).

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Avanafil – innovation among agents for the treatment of erectile dysfunction
Even faster effect, and even fewer side effects
Avana-100 – the very generic “young” for the treatment of impotence Stendra. The drug is actually able to “outdo” all brand tablet for the treatment of impotence.

Avanafil – the quick cure of all: it takes effect within 15 minutes after the decision. Other advantages Avana-100 is its power (one tablet of 100 mg Avanafil does not lose its effectiveness even in severe forms of impotence) and the almost complete absence of side effects (principally new technologies have allowed drug makers to reduce the level of such effects to 1%). Time of the drug – 6 hours.

What is Avana 100 mg?
Avana 100 mg – a drug for the latest generation of an erection. He developed a small company Vivus Inc, which is headquartered in Mountain View (Calif., USA). The drug has been declared as the first tool that can completely restore control over an erection within 15 minutes. Following approval in April 2012 FDA Avanafil went on sale under the trade names Spedra (in Europe) and Stendra (in the US). It has established itself as a safe and reliable fast-acting drug. Widespread prevented just too high a price.

The well-known pharmaceutical company in our Sunrise Remedies decided to make medicine more affordable. Scientists from this company created a generic drug Stendra, which is a complete analog of the “original”. From the American Indian Avanafil it differs only in a very low price. All other characteristics of the drug Stendra (generic) are similar. Thanks to the efforts of “Sunrise” men in the world had the opportunity to take advantage of high-quality medicines at a reasonable price.

What is better – or Stendra Avana?
As we have said, Stendra – US drug developed by Vivus. Avana – Indian counterpart. Essentially, the drug is one manufactured by different manufacturers. Avana-100 (Stand) gained more widespread due to the lower price. The efficiency and speed are the same as the “original” preparation. It is no wonder that most men prefer to Avana. Reviews confirm the high popularity of the drug.

Avana (generic): principle of action
The most high-speed drug for erectile considered generic Stendra. Guide says that it belongs to the group of PDE-5 inhibitors. Like other active substances from this category Avanafil inhibits specific enzyme phosphodiesterase (type 5). Healthy men PDE5 need to go to the quiet state after sex. If you have sexual dysfunction, an enzyme found in the blood constant.

To enhance erection quality needed to increase blood flow to the penis and relax the smooth muscles of the corpora cavernosa. This “engaged” cyclic guanosine monophosphate. The level of cGMP is constantly decreasing the enzyme PDE-5. Before scientists were challenged to create a drug that blocks the action of phosphodiesterase. As a result, the drug was invented Avana (generic). Responses indicate that high efficiency of the tool has a unique degree of security.

How long does the effect of 100 mg pills Avana?
Searching for a cure, which in a few minutes to restore an erection? Try generic Avana. Reviews about this drug is always only positive. It is rapidly absorbed and becomes effective immediately. The effect of the reception Avanafil in 75% of cases after 15 minutes. Avanafil concentration in the blood reaches a maximum at 1-1.5 h. The validity period of 5-6 hours.

Medicine Avana-100, which can be bought on this page are completely eliminated from the body in the form of neutral metabolites. It is metabolized in the liver (isozyme CYP3A4) and is excreted in the feces. Via the kidneys displayed no more than 12-15% of active ingredient.

Generic Stendra: indications for use
One of the newest drugs to improve erections – generic Stendra. Reviews show that Avanafil starts to act faster than other drugs. It is used to treat erectile dysfunction. It is a special condition of the body, in which a man is not able to achieve an erection. There are also cases when the excitement of the reproductive system occurs, but the penis does not reach the desired hardness. Erectile dysfunction is also called impotence. Previously, it was considered an incurable disease. Today it is easy to cope Avanafil. Reviews of generic Stendra indicate that the drug is like a lot of men.

Can I take Avana100 women?
Many people wonder if the solution to raise the female libido Avana-100. Reviews of some women talking about the effectiveness of drugs in this direction. In particular, women often say that after taking Avanafil significantly enhanced sexual desire and orgasm becomes stronger. But special research studied the effects of the drug on women, was conducted. It is unknown how Avanafil affects lactating and pregnant women. Therefore, at this time Avana-100 is indicated for use only men who have reached 18 years of age.

Generic Avana: how to use
High speed and efficiency has generic Avana 100. Buy at the lowest price you can online pharmacy “ShopStoyal”. We always have the most advantageous offers for regular customers and new customers. Dosing of the drug:

Take Avana 100 mg 15 minutes before anticipated sexual intimacy.
minimum dose – ½ tablet.
The recommended dose – 1 tablet.
During the reception, you can use alcohol (in small amounts), and fatty foods.
Reviews Generic Stendra show that abundant and fatty food on Avanafila performance is not affected.

Avana100: Dosage
For preparation Avana-100 daily dose should not exceed 200 mg of active ingredient (two tablets). Doctors recommend at the initial stages of erectile dysfunction limited to 50 mg (half tablet). Only if the effect will not be possible to pass on the whole tablet Avana. The drug has a high degree of safety and almost never cause side effects. However, when exceeding the maximum daily dose (200 mg) adverse reactions are not only more frequent, but also increase.

Stendra (Avana): CONTRAINDICATIONS
Before you buy Avana 100 mg, check the list of contraindications. The drug is banned for use to people who have sexual activity can lead to a heart attack or fainting.

There are also diseases in which you need to carefully take the drug Avana-100. Instruction is one of them:

stomach ulcer or bowel;
stroke or myocardial infarction;
uncontrolled high or low blood pressure;
Penis deformation (fibrosis, injury, Peyronie’s disease, etc.);
ischemic optic neuropathy;
multiple myeloma.
Note that one of the safest drug is generic Stendra. Customer reviews show that it can still create a situation ugrozhayuschuie health when combined with other drugs.

Therefore it is impossible to combine the technique with Avanafil:

medications containing nitrates;
inhibitors of CYP3A4;
medicines for high blood pressure;
alpha-blockers;
antihypertensive agents.
We have tried to collect as much information about the drug generic Avana. Price, location, reviews, the principle of action – on this page there are all the necessary information. However, over the reception Avanafila must always consult a doctor.

Avana 100mg: Compatibility with alcohol
The manufacturer allows the use of small doses of alcoholic beverages while taking pills generic Avana 100. Responses indicate that a moderate amount of ethanol does not interact with the drug. But do not abuse alcohol. Alcohol promotes vasodilation. Avanafil has the same effect. As a result, blood pressure (especially in people with hypotension) may drop dangerously. In addition, the combination with alcohol drink Stendry can cause more severe side effects.

Generic Stendra: side effects
Before you buy generic Stendra Avana, check the list of possible side effects. As is known, Avanafil has an unprecedented level of security.

However, in rare cases (mainly in non-compliance with instructions) can occur:

runny nose;
headache;
back pain or lower back;
a sore throat.
Reviews of generics Avana say that these reactions are temporary. They completely disappear within 2-4 hours.

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This page contains all the information about Avana-100 preparation (instructions, reviews and other useful information). Buy it on the most favorable terms possible in our online pharmacy. We specialize in high-quality, proven generics. We have the lowest prices and the most fast delivery to any region. For the convenience of customers, we offer several options for the checkout:

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expert Opinion

When friends said they were abruptly tablets of Viagra, I did not believe. But I decided to try. For samples I ordered a package and went to the party to which I have just been invited. Avana is not afraid of wine and fatty foods (in reasonable quantities).

After drinking alcohol, I became a little more daring and quickly swallowed the pill. In a conversation with a woman it took me just 15 minutes. Further developments remember how sweet dream. Such power I still had. The night flew by like a flash. Well, it was Saturday. Then I could at least get some sleep. Now upakovochka Avanafila is constantly in my pocket. Certainly come in handy).

 

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