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Analog.

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.

Pharmacokinetics
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.

Indications❛
⊳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.

Contraindications
⇨hypersensitivity to doxycycline, drug components, other tetracyclines;
⇨deficiency of lactase;
⇨Lactose intolerance;
⇨glucose-galactose malabsorption;
⇨porphyria;
⇨Severe hepatic impairment;
⇨Lakopenia;
⇨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.

Dosage
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.

Overdose
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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Analog

Active substance
Vardenafil
Active ingredient: vardenafil (vardenafil)
Rec.INN registered WHO
Dosage Form
LEVITRA®
Tab., cover. film coating is 5 mg: 1, 4 or 20 units.
Composition, structure and packing
The tablets covered with a film cover from light orange to gray-orange, round, biconcave, slightly rough, embossed with “5” on one side and the Bayer Cross trademark – on the other.
1 tab.
vardenafil hydrochloride trihydrate 5,926 mg,
which corresponds to the content of 5 mg vardenafil
Other ingredients: crospovidone – 4.35 mg magnesium stearate – 870 mg, microcrystalline cellulose – 75,419 mg colloidal anhydrous silica – 435 micrograms.
Cover structure: macrogol 400 – 555 mg, Valium – 1.664 mg of titanium dioxide – 455 mg, yellow iron oxide – 92 mg, iron oxide red – 7 g.
1 PC. – Blisters (1) – packs cardboard.
4 things. – Blisters (1) – packs cardboard.
The tablets covered with a film cover from light orange to gray-orange, round, biconcave, slightly rough, embossed with “10” on one side and the Bayer Cross trademark – on the other.
1 tab.
vardenafil hydrochloride trihydrate 11,852 mg,
which corresponds to the content of 10 mg vardenafil
Other ingredients: crospovidone – 6.25 mg magnesium stearate – 1.25 mg, microcrystalline cellulose – 105,023 mg colloidal anhydrous silica – 625 micrograms.
Cover structure: macrogol 400 – 797 mg, Valium – 2.391 mg of titanium dioxide – 653 micrograms of iron oxide yellow – 133 g, iron oxide red – 11 micrograms.
1 PC. – Blisters (1) – packs cardboard.
4 things. – Blisters (1) – packs cardboard.
The tablets covered with a film cover from light orange to gray-orange, round, biconcave, slightly rough, embossed with “20” on one side and the Bayer Cross trademark – on the other.
1 tab.
vardenafil hydrochloride trihydrate 23,705 mg,
which corresponds to the content of 20 mg vardenafil
Other ingredients: crospovidone – 8.85 mg magnesium stearate – 1.77 mg, microcrystalline cellulose – 141,797 mg colloidal anhydrous silica – 885 micrograms.
Cover structure: macrogol 400 – 1.128 mg, Valium – 3.385 mg of titanium dioxide – 925 micrograms of iron oxide yellow – 188 g, iron oxide red – 15 micrograms.
1 PC. – Blisters (1) – packs cardboard.
4 things. – Blisters (1) – packs cardboard.

Indications
– Erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).
ICD-10 code reading
F52.2 Lack of genital response (psychogenic impotence)
N48.4 Impotence of organic origin

Side effect
From the central and peripheral nervous system: ≥10% – headache; ≥1% – dizziness; ≥0.1% – <1% – lethargy; ≥0.01% – <0.1% – anxiety, fainting.
Cardio-vascular system: ≥10% – tides (periodic sudden reddening of the face, the sensation of heat); ≥0.1% – <1% – increase in blood pressure, reduced blood pressure, orthostatic hypotension; ≥0.01% – <0.1% – angina, myocardial ischemia.
From the digestive system: ≥1% – <10% – indigestion, nausea; ≥0.1% – <1% – change liver function tests (increased ALT, AST, GGT).
The respiratory system: ≥1% – <10% – congestive hyperemia of the nasal mucosa (mucosal edema, rhinitis, rhinorrhea); ≥0.1% – <1% – shortness of breath, nosebleeds; ≥0.01% – <0.1% – swelling of the larynx.
From a sight organ: ≥0.1% – <1% – increased lacrimation, blurred vision (of brightness); ≥0.01% – <0.1% – increased intraocular pressure.
Dermatological reactions: ≥0.1% – <1% – swelling of the face, photosensitivity.
From the musculoskeletal system: ≥0.1% – <1% – myalgia, back pain, increased CPK; ≥0.01% – <0.1% – increase in muscle tone. On the part of the reproductive system:> 0.01% – <0.1% – elongation erection or painful erection,priapism.
Other: ≥0.01% – <0.1% – hypersensitivity reactions.
There are rare post-marketing reports of cases of anterior ischemic optic neuropathy (PINZN), which leads to impaired vision, including permanent loss of vision associated in time with taking PDE5 inhibitors, including and Levitra, patients, many of whom have concomitant risk factors for developing this condition, such as an anatomical defect of the optic nerve, age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Not determined whether the development PINZN connected directly with PDE5 inhibitors or with existing patient associated cardiovascular risk factors and anatomical defect, or a combination of these factors, or other causes.
Reported cases of visual disturbances, including the temporary or permanent loss of vision, which are linked in time with taking PDE5 inhibitors, including and Levitra. Not installed, whether these cases directly with taking PDE5 inhibitors, or with concomitant vascular risk factors, or other causes.

Contraindications
– Simultaneous treatment with nitrates or drugs, which are nitric oxide donators;
– Combination with HIV protease inhibitors such as indinavir, or ritonavir;
– Hypersensitivity to the drug.
The drug is not intended for use in children and adolescents under the age of 16 years.
Caution should be used in patients with congenital prolongation of the interval QT, with anatomical deformation of the penis (contortion, cavernous fibrosis, Peyronie’s disease), diseases predisposing to priapism (sickle-cell anemia, multiple myeloma, leukemia), severe hepatic impairment, kidney disease in the terminal stage, hypotension (systolic pressure at rest less than 90 mmHg), recent stroke and myocardial infarction, unstable angina, hereditary retinal degenerative diseases (such as retinitis pigmentosa), with a tendency to bleeding and aggravation peptic ulcer disease, aortic stenosis and idiopathic hypertrophic subaortal stenosis.
Pregnancy and breast-feeding
The preparation is not intended for use in women.
Application for violations of liver function
With care use in patients with severe hepatic dysfunction.
In patients with severe hepatic slightly nedostatochnostyukorrektsii dosing regimen is required. In patients with moderate hepatic impairment initial dose is 5 mg sutki.Vdalneyshem depending on the efficacy and tolerability of treatment dose can be increased to 10 mg and then 20 mg.
Application for violations of renal function
With care use in patients with kidney disease in the terminal stage.
In patients with severe and moderate only slightly impaired renal function correct dosing regimen is not required

Use in children
The drug is not intended for use in children and adolescents under the age of 16 years.
Use in elderly patients
Correct dosing regimen in elderly patients is not required.
special instructions
Before prescribing the drug Levitra® (and other drugs used to treat erectile dysfunction), the physician should evaluate the state of the cardiovascular system, as there is the risk of cardiac events during sexual activity.

Vardenafil has vasodilator properties, which may be accompanied by minor or moderate decrease in blood pressure.
Patients with obstruction of the outflow tract of the left ventricle such as aortic stenosis, idiopathic hypertrophic subaortal stenosis, can be sensitive to the action of vasodilators, including PDE5 inhibitors.
Men who do not show sexual activity due to concomitant cardiovascular disease, drugs to treat erectile dysfunction is not appointed.
Since Levitra® in therapeutic doses (10 mg) causes elongation of the QT interval, medication should not be prescribed to patients with congenital QT prolongation and those who are taking antiarrhythmics class IA (quinidine, procainamide) or Class III (amiodarone, sotalol).
The safety and efficacy of vardenafil in combination with other drugs to treat erectile dysfunction has not been studied, so their combined use is not recommended.

Safety of vardenafil has not been studied, and its use is not recommended for the following groups of patients: severe liver, kidney disease in the terminal stage, requiring dialysis, hypotension (systolic pressure at rest While taking Levitra and other PDE5 inhibitors have reported cases of transient visual loss and nearteriitnoy ischemic optic neuropathy. In the event of a sudden loss of the patient should stop taking Levitra and immediately consult a physician.

Combined therapy of alpha-blockers and vardenafil may be accompanied by the development of arterial hypotension with the appropriate clinical picture, because these drugs have vasodilating effects. The combined purpose of Levitra and an alpha-blocker is permissible only if the stable performance of BP in patients receiving alpha-blockers, while Levitra should be given to the minimum recommended dose of 5 mg. It should not take Levitra at the same time with an alpha-blocker, with the exception of tamsulosin which reception can coincide in time with the reception of vardenafil. If you receive a dose of Levitra selected alpha-blocker therapy should be started at the minimum dose. The gradual increase in the dose of alpha-blockers to patients receiving drugs from the group of PDE-5 inhibitors may result in further reduction of blood pressure.
Levitra dose should not exceed 5 mg when it is combined with erythromycin, ketoconazole, itraconazole. The dose of ketoconazole and itraconazole thus should not exceed 200 mg.
The combination with indinavir and ritonavir is contraindicated.
Since vardenafil has not been used in patients with a tendency to bleeding in patients with acute exacerbation of peptic ulcer disease, its purpose in these cases is possible only after a careful assessment of benefit-risk ratio of the therapy.
Vardenafil does not affect the duration of the bleeding, as it does not affect the rate in the combined use with acetylsalicylic acid.
Vardenafil not enhance platelet aggregation induced by different agents. The above therapeutic concentrations vardenafil causes a slight increase in antiplatelet action of sodium nitroprusside, which is a donor of nitric oxide.
Effect of heparin and vardenafil, while the use of the length of bleeding is not known.
Effect of vardenafil on the hypotensive effect of nitrates in patients not studied, so the combined purpose of Levitra and nitrates is contraindicated.
Use in Pediatrics
Vardenafil is not intended for use in children.
Effects on ability to drive vehicles and management mechanisms
Before prescribing the drug to patients who are driving a vehicle and work with the mechanisms necessary to clarify their individual response to Levitra.

Conditions and terms
The drug should be stored out of reach of children, dry place at temperatures no higher than 30 ° C. Shelf life – 3 years.

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Analog.

Active Ingredient: Finasteride
Other names for this medication:
Alopec, Alopros, Alsteride, Ambulase, Andofin, Androfin, Andropel, Andropyl, Androstatin, Antiprost, Apeplus, Aprost, Ativol, Avertex, Borealis, Chibro-proscar,  Daric, Dilaprost,  Eucoprost, Finacapil, Finahair,  Finalop,  Finamed,  Finanorm, Finapil, Finar, Finarid, Finascar, Finaspros, Finaster, Finasterax, Finasterida, Finastéride, Finasteridum, Finasterin, Finastid, Finastir, Finazil, Fincar 5,  Finocar, Finol, Finpro, Finpros, Finprostat,  Finster, Fintex,  Fintral,  Fintrid, Finural, Firide, Fisterid, Fisteride, Fistrin, Flaxin, Flutiamik, Folcres, Folister, Fynasid, Gefina, Genaprost, Glopisine, Hyplafin, Kinscar, Lifin, Lopecia, Mostrafin, Nasteril, Nasterol, Penester, Poruxin, Pro-cure,  Prohair, Proleak, Pronor, Propeshia, Prosmin, Prostacide, Prostacom, Prostafin, Prostanil, Prostanorm, Prostanovag, Prostarinol, Prostasax, Prostene, Prosterid, Prosterit, Prostide, Q-prost, Recur,  Reduprost, Reduscar, Renacidin,  Reprostom, Sterakfin, Sutrico, Symasteride, Tealep, Tensen, Tricofarma, Ulgafen, Urototal, Vetiprost, Winfinas, Zasterid, Zerlon.

Propecia is a medicinal product that belongs to the group of inhibitors of 5-alpha-reductase, used to treat baldness in representatives of the strong half of humanity.

What are the composition and form of the preparation of Propecia?
The active component of the drug Propecia is represented by finasteride, the◦ amount of which is 1 milligram per tablet. Data on excipients of medicament are absent.
Propecia is produced in tablets of pink color, biconvex, rounded. Supplied in polyethylene bottles of 90 and in blisters for 10 pieces. You do not need a doctor’s prescription to◦ buy a medicine.

What means does Propecia have?
Medication Propecia is intended for the treatment of hair loss (alopecia) in the male type. I will clarify that the basis of this disease is the◦ toxic damage of the hair follicles male sex hormone – testosterone. Sometimes you can find the term androgenic and androgenetic alopecia, which is inherently the same disease.

The defeat of the hair follicles is due to the activity of dihydrotestosterone, which is a biologically active form of◦ the male sex hormone.

Finasteride – an active component of the drug, is able to suppress the◦ reactions of biological synthesis of this substance, as well as partially block its effects.

The suppression of dihydrotestosterone inhibits the progression of alopecia, slows the processes underlying hair loss. In some cases, even partial restoration of◦ hair follicles is possible.

The first results of treatment should not be expected too soon. As a rule, at least 3 months must elapse before a noticeable relief of◦ symptoms occurs. The degree of restoration of hair follicles depends on many factors, in particular, on age, the presence of metabolic diseases, bad habits and other factors.

The effect of the drug is short. After the end of treatment, for a certain period, measured by several months, hair loss will inevitably continue.

Information on the◦ rate of absorption of the active substance from the intestine, as well as its distribution in the body is absent.

What are the medicines Propecia indications for use?
Propecia is indicated as an agent for the treatment and prevention of◦ male hair loss. There are no other conditions involving the use of this drug.

Before starting treatment, you should consult a specialist for a comprehensive examination, primarily aimed at determining the level of dihydrotestosterone.

What are the tablets Propecia contraindications for use?
Propecia is contraindicated in the presence of the following conditions:

☞Pregnancy and lactation;
☞Age is less than 12 years;
☞Individual intolerance.

⚠Women should not resort to the use of◦ this medication. In addition, it is strongly recommended during pregnancy to avoid contact with the drug, even given that the active substance of◦ the dosage form is covered with a special coating.

What are Propecia’s use and dosage?
It is usually recommended to take 1 tablet of the drug a day, regardless of food. Do not crush or crush the medicine. If desired, it is acceptable to◦ take the tablet with a small amount of water. It is better to take medication at regular intervals.

As mentioned above, treatment should be of a lasting nature, as a rule, the◦ maximum therapeutic effect develops one year after the start of treatment. For detailed information on the timing of treatment, contact your doctor. Dosage adjustment for patients of◦ the older age group is not required.

Overdose from Propecia
Data on the manifestation of an overdose of the◦ drug Propecia instruction on the application does not lead, because they do not exist. Even taking 8 tablets per day for a long period of time did not lead to any negative symptoms.

However, taking a high dose of medication does not help to increase the therapeutic effect. It is also worth considering the rather high cost of a single package of a drug.

What are the side effects of Propecia?
In most cases, taking the medication is not accompanied by the◦ development of undesirable consequences. Nevertheless, in some cases, the following symptoms can not be avoided: a decrease in libido (level of sexual desire), erectile dysfunction, a decrease in the volume of ejaculate, allergic manifestations in the◦ form of itching, swelling of the face, tenderness in the testicles.

Special instructions
With the simultaneous administration of drugs used to treat prostatitis, for example, Proscar or its analogues, it is possible to enhance the◦ effect of the latter and increase the incidence of side effects. In most cases, a separate specialist consultation will be required.

Conclusion
To treat hair loss should follow a comprehensive campaign. To begin with, it is necessary to exclude any diseases that, one way or another, can lead to the◦ development of such symptoms. In addition, one should not write off the◦ importance of rational nutrition, the rejection of bad habits, the fight against stress.

In addition, combined methods of treatment, suggesting the use of drugs like Propecia, as well as the use of◦ ointment, cream and gel, are well proven.

The patient should be instructed to use the prescribed medication alone. Be healthy!

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Active Ingredient: Propranolol.

Other names for this medication:
N-propranolol.

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.

Contraindications
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,
☞emphysema,
☞diabetes mellitus,
☞hypoglycemia,
☞acidosis,
☞impaired liver and kidney function,
☞psoriasis,
☞spastic colitis,
☞myasthenia gravis,
☞elderly age.

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

Interactions
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
Symptoms:
➲dizziness,
➲bradycardia,
➲arrhythmia,
➲heart failure,
➲hypotension,
➲collapse,
➲difficulty breathing,
➲acrocyanosis,
➲convulsions.

➡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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Product descriptionSafety INDICATIONS Fluoxetine is used for treating premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve mood.

Pharmachologic effect
Antidepressant group of selective serotonin reuptake inhibitors. Timoanalepticheskim and has a stimulating effect.
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When administered drug is well absorbed from the gastrointestinal tract (up to 95% of the dose), the use of food slows the absorption of fluoxetine significantly. Cmax plasma levels are reached in 6-8 hours. The bioavailability after oral administration of fluoxetine is greater than 60%. The drug was well accumulates in the tissues, readily crosses the blood-brain barrier, binding to plasma proteins is 90%.It is metabolized in the liver by demethylation to the active metabolite nor fluoxetine and several unidentified metabolites. Excreted by the kidneys as metabolites (80%) and bowel (15%), mainly in the form of glucuronides. T1 / 2 fluoxetine after reaching equilibrium concentration in plasma is about 4-6 days. T1 / 2 of the active metabolite, nor fluoxetine with single dose and after reaching equilibrium concentration in the plasma is from 4 to 16 days. In patients with hepatic failure half-life of fluoxetine and norfluoxetine is prolonged.

Dosage
The drug is taken orally, at any time, regardless of the meal.
doldrums The initial dose is 20 mg 1 time / day in the first half of the day, regardless of meals. If necessary, the dose may be increased to 40-60 mg / day, divided into 2-3 doses (20mg / day weekly). The maximum daily dose – 80 mg 2-3 reception.The recommended dose is 20-60 mg / day.

Friend Interaktions
You can not use the drug simultaneously with MAO inhibitors, including antidepressants – MAO inhibitors; furazolidone, procarbazine, selegiline, and tryptophan (a precursor of serotonin), as may develop serotonin syndrome, which manifests itself in confusion, hypomania, agitation, convulsions, dysarthria, hypertensive crisis, chills, tremors, nausea, vomiting, diarrhea.

Conditions and terms
In a dry, dark place at a temperature no higher than 25 ° C. Keep out of the reach of children. Shelf life – 3 years.

Indications.
– Depression of various origins;
– Obsessive-compulsive disorder;
– Bulimic neurosis.

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Seek medical attention if some symptom is bothering you.

What are Motilium Possible Side Effects?

Motilium can cause not only desired medical effects, but also side effects which are different in their strength and duration. It’s vitally important to react to serious side effects by seeking immediate medical attention.

Less common serious side effects may include:
– swelling of the mouth;
– loss of muscle control;
– loss of balance.

Rare serious side effects may be:
– abnormal (pounding, fast, irregular or racing) heartbeat;
– swelling of legs, lower legs, face, hands.

You shouldn’t much worry about some mild side effects that may manifest at the beginning of the treatment as a body reaction to a new medicine unless they are bothersome. As you get used to Motilium, they will go away.

Less common of them are:
– hives;
– dry mouth;
– swelling of male breast;
– pain in the breast;
– breast milk release;
– skin itching;
– headache;
– menstrual irregularities;
– eye problems.

Rare mild side effects may be:
– palpitations;
– tiredness;
– weakness;
– nervousness;
– difficulty speaking;
– dizziness;
– hearburn;
– difficulties urinating;
– irritability;
– diarrhea;
– constipation.

All in all, side effects caused by Motilium are rather rare. If you are interested to know the complete list of undesirable effects, turn to your doctor for more information.

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Analog.

Considering high modern levels of consumption of salt which is ingested as a solid part of different foods (chunk food, barbecue, etc.), it is vitally important to get rid of excess “white death” in good time. In this case Lasix comes in handy. A water pill of Lasix will help your body absorb only a small amount of salt it typically needs and not a bit more. Instead of accumulating in your body, excess salt will get out of the body during next urination.
People who suffer from kidney problems (such as nephrotic syndrome), liver conditions or congestive heart failure buy Lasix to treat edema (fluid retention). The medicine can be used for treating hypertension equally well.
The secret lies in an active substance called furosemide. It provides the whole effect.

Where to Buy Lasix?

The next question that may cross your mind after you have already made up your mind to buy Generic Lasix online may be where to buy furosemide. The most convenient thing about this is that you can freely order Lasix without prescription on the Internet at quite an affordable furosemide price. However, you should keep in mind that it is necessary to, first of all, ask your doctor for a piece of advice on your Lasix treatment unless you want unpleasant health consequences. Buy cheap Lasix if you are willing to cleanse your body. You can purchase cheap furosemide online.

Before Your First Lasix Dose

Before starting treatment, you should find out if Lasix is good and safe for you. Your doctor as a qualified medical specialist will help you in that. Prior to buying Generic Lasix without prescription you should be sure of minimal potential risks for your health. These risks may be dangerous and even life-threatening if you do without your doctor’s recommendations.

You should discuss your chances of successful treatment if you have any of the following illnesses and conditions:
– diabetes;
– liver disease (such as cirrhosis);
– kidney conditions;
– increased levels of cholesterol or triglycerides;
– low magnesium or potassium in blood;
– different types of urination problems (enlarged prostate, bladder conditions, etc.);
– lupus;
– gout.

Your doctor is entitled either to change your treatment including dose adjustments and administration frequency or even to prohibit you from taking Lasix if you have any of the above mentioned conditions.
Lasix is not to be used when urination is impossible for some medical or other reasons.
If you have lately had an MRI or any other kind of a scan, you should tell your doctor about that.

Can Pregnant Women Take Lasix?

If you are planning to become pregnant or already pregnant, you should think twice before you buy furosemide online. Lasix belongs to pregnancy category C introduced by FDA. What does this mean? Scientific studies have not yet confirmed or refuted possible harm Lasix may do to an unborn baby.
You should also be careful if you are breast-feeding. Furosemide is reported to be capable of passing into mother’s milk, which may lead to bad health risks and consequences for a nursing baby. A breast feeding woman may also be faced with the risk of milk production slowdown in connection with furosemide.
In any case, you should listen to nobody but your doctor speaking to the point.

How to Take Lasix in a Proper Way?

The medicine is to be taken strictly according to your doctor’s prescription or recommendations. You should agree with the medical specialist on your dosage and frequency of medicine administration. Moreover, your doctor has the right to change your course of treatment in any direction if he finds this appropriate.
You may need to purchase some special pieces of medical equipment such as a medicine cup (a dose-measuring spoon) to measure your doses with. You can find one at the nearest pharmacy. It is strongly recommended that you don’t use a conventional table spoon for this purpose.
Since Lasix will make you urinate oftener, this may be fraught with the complete loss of fluid that means great harm to the body. You should add special potassium supplements and a daily needed amount of salt to your diet to avoid such a sort of problems. However, this all should be done by your doctor’s permission.
During the treatment you should see your doctor for regular blood tests.

What Are Lasix Possible Side Effects?

The following symptoms of an allergic reaction should serve you as a signal to stop your Lasix treatment at once:
– swelling;
– hives;
– difficulty breathing.

You should also cease your treatment if you have any of the following side effects:
– hearing loss and other hearing problems;
– low potassium or calcium;
– weight loss;
– pain (in the upper part of stomach, in chest);
– headache;
– abnormal skin reactions (pale skin, skin pain, etc.).

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If you feel any other symptoms that bother you, seek emergency medical attention immediately.

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