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Active Ingredient: Sildenafil

Analogs of Penegra.

Penegra affects the response to sexual stimulation.

Product Description

The main component of Penegra is Sildenafil.

SildenafiL affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.

Sildenafil is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.

Sildenafil may also be used for other purposes not listed above.

Dosage and direction

It is taken by mouth with a glass of water approximately 0,5-1 hour before sexual activity. Penegra should not be taken more than once a day.

A high fat meal may delay the time of the effect of this drug.

Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil.

Precautions

Before you start taking Sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Aged people may be more sensitive to the side effects of the drug.

Contraindications

Penegra is contraindicated in patients taking another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.

This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.

A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.

Many people using this medicine do not have serious side effects.

In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.

Consult your doctor or pharmacist for more details.

Missed dose

PenegrA is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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Active Ingredient: Amitriptyline. Elavil is used for the relief of symptoms of mental depression. It is also used to treat bulimia (an eating disorder), to control chronic pain, to prevent migraine headaches, and to treat a pathological weeping and laughing syndrome associated with multiple sclerosis.

Analogs of Elavil: Amitriptyline, Endep.

Other names for this medication:
Amineurin, Amitril, Amitrip, Amitriptilina, Amitriptylinum, Anapsique, Apo-amitriptyline, Deprelio, Eliwel, Laroxyl, Lentizol, Levate, Loxaryl, Mutabase, Mutabon, Novoprotect, Novotriptyn, Redomex, Saroten, Sarotena, Sarotex, Syneudon, Triptanol, Tryptacab, Tryptanol, Tryptizol.

Detailed description of the drug:

  1. Important information
  2. Before taking this medicine
  3. How should i take elavil?
  4. Elavil Dosage Information
  5. What happens if I miss a dose?
  6. What happens if I overdose?
  7. What should I avoid while taking Elavil?
  8. Side effects of Elavil
  9. What other drugs will affect Elavil?
  10. Where can I get more information?

What is Elavil?
Elavil (amitriptyline) is a tricyclic antidepressant.
Elavil acts on chemicals in the brain that may be unbalanced in people with depression.
Elavil is used to treat symptoms of depression.

Important information
You should not use Elavil if you have recently had a heart attack.

Do not use Elavil if you have used an MAO inhibitor in the past 14 days, such as isocarboxazide, linezolid, methylene blue injection, phenelzine, razagilin, selegiline, or tranylcypromine.

Before taking Elavil, tell your doctor if you have used the SSRI antidepressant in the last 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil) , or sertraline (Zoloft).

You ballplayer get opinions of killer when you basic first entrancing an medicine much as Elavil , largely whether you are below 24 age aged. Your dr. desire require to analysis you with fixture gos, at littlest during the basic 12 hebdomads of treatment of behaviour towards.

Report any new or worsening symptoms to your doctor, such as changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, anxious, hyperactive (mentally or physically), more Depressed or thinking of suicide or self-harm.

Before taking this medicine
You should not use Elavil if you are allergic to amitriptyline, or if you have recently had a heart attack.

Do not use Elavil if you have used an MAO inhibitor in the past 14 days. Dangerous drug interactions may occur. MAO inhibitors include isocarboxazide, linezolid, methylene blue injection, phenelzine, razagilin, selegiline, tranylcypromine and others.
To make sure Elavil is safe for you, tell your doctor if you have:

  • Bipolar disorder (manic depression) or schizophrenia;
  • a history of mental illness or psychosis;
  • liver disease;
  • Heart disease;
  • a history of heart attack, stroke, or seizures;
  • Diabetes (amitriptyline may increase or decrease blood sugar);
  • Glaucoma;
  • Problems with urination.

Any adolescent humans get dangerous opinions when they basic capture an medicine. Your dr. should analysis your progression with fixture sojourns. Your kinfolk or additional caregivers should furthermore be knowing of substitution in your condition or evidence.

Whatever juvenile man move unsafe impressions when they fundamental hire an prescription. Your dr. should review your circuit with mend stay. Your kinsfolk or extra caregivers should moreover be learned of exchange in your shape Elavil .

Amitriptyline can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Elavil.

Elavil is not approved for use by anyone younger than 12 years old.

How should i take elavil?
Take Elavil exactly as prescribed by your doctor. Follow all directions on the recipe label. Do not take this medicine in larger or smaller amounts, or for longer than recommended.

It may take up to 4 weeks before your symptoms improve. Continue to use the medicine as directed and tell your doctor if your symptoms do not improve.

If you need surgery, inform the surgeon in advance that you are using Elavil. You may need to stop using the medicine for a short time.

Achieve not break exploitation Elavil all at once, or you ballplayer get disagreeable backdown evidence. Enquire your dr. how to safely break exploitation Elavil .

Store at room temperature away from moisture, heat and light.

Elavil Dosage Information
Usual Adult Dose of Elavil for Depression:

Outpatient:

  • Usual dose: 75 mg orally per day in divided doses. It can be increased to 150 mg per day if necessary;
  • Alternative dose: 40-100 mg orally in a single dose at bedtime. This can be increased by 25 or 50 mg, if necessary, at bedtime to 150 mg per day;
  • Maximum dose: 150 mg orally per day

Hospitalized:

  • Initial dose: 100 mg orally per day;
  • Maintenance dose: 40-100 mg orally in a single dose at bedtime;
  • Maximum dose: 300 mg orally per day.

The dosage should be reduced to the minimum amount that will support symptom relief when satisfactory improvement is achieved.
The dose increase should preferably be done in the late afternoon or at bedtime due to the sedative effect.
The full therapeutic effect may take up to 30 days.
Support therapy should be continued for 3 months or longer to reduce the likelihood of relapse.

Using:

  • Relieving symptoms of depression
  • Usual geriatric dose of Elavil for depression:
    10 mg orally 3 times a day with 20 mg at bedtime

What happens if I miss a dose?
Capture the incomprehensible measure as presently as you mention. Bounce the forgone measure whether it is most age representing your following plotted measure. Achieve not capture additional prescription to create up representing the incomprehensible measure.

What happens if I overdose?
Seek emergency medical attention. An overdose of amitriptyline can be fatal.
Overdose symptoms may include irregular heartbeats, severe drowsiness, confusion, agitation, vomiting, hallucinations, a feeling of heat or cold, muscle stiffness, cramps (convulsions), or fainting.

What happens if I overdose?
Seek emergency medical attention. An overdose of amitriptyline can be fatal.
Overdose symptoms may include irregular heartbeats, severe drowsiness, confusion, agitation, vomiting, hallucinations, a feeling of heat or cold, muscle stiffness, cramps (convulsions), or fainting.

Side Effects of Elavil
Get emergency medical help if you have signs of an allergic reaction to Elavil:

  • cramps;
  • labored breathing;
    swelling of the face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, anxious, hyperactive (mentally or physically), more Depressed or thinking of suicide or self-harm.

Call your doctor right away if you have:

  • Unusual thoughts or behavior;
  • Frivolous feeling, how could you disappear;
  • Chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
  • Heart palpitations or chest pain;
  • Confusion, hallucinations;
  • Attack (convulsions);
  • Painful or difficulty urinating;
  • Severe constipation;
  • Light bruising, unusual bleeding;
  • Sudden weakness or poor feeling, fever, chills, sore throat, mouth ulcers, red or swollen gums, difficulty swallowing.

This is not a complete list of side effects, and others may occur. Ask your doctor about side effects.

What other drugs will affect Elavil?
Taking this medicine with other drugs that make you sleepy can make this effect worse. Ask your doctor before taking Elavil with sleeping pills, medicine for narcotic pain, muscle relaxation, or medicines for anxiety, depression, or seizures.

Tell your doctor if you have used the SSRI antidepressant in the last 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone or Vilazodone.

Tell your doctor about all of your current medicines and what you start or stop using, especially:

  • Other antidepressants;
  • cimetidine;
  • Heart rhythm medicine, such as flecainide, propafenone, quinidine and others;
  • Medicine for the treatment of mental illness.

This list is not complete. Other drugs may interact with amitriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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Active Ingredient: Methotrexate.

Active Ingredient: Methotrexate 2.5 mg

Release form, composition and packaging
Coated tablets 1 tab.

Methotrexate is used for treating certain types of cancer, severe psoriasis, or rheumatoid arthritis in certain patients.

Pharmachologic effect
An antitumor agent from the group of antimetabolites – folic acid antagonists. Acts in the S-phase of mitosis. The mechanism of action is associated with the inhibition of the synthesis of purine nucleotides and thymidylate as a result of irreversible binding to dihydrofolate reductase, which prevents the restoration of dihydrofolate to active tetrahydrofolate. More active against rapidly growing cells. It has some immunosuppressive effect.

Pharmacokinetics
To a small extent penetrates the BBB (depending on the dose used). With intrathecal administration, a significant amount enters the systemic circulation. Binding to plasma proteins (mainly with albumin) of plasma is about 50%. Biotransformed in the liver. It is excreted by the kidneys (unchanged) and with bile (less than 10%). T1 / 2 depends on the dose used and has significant individual differences. With repeated administration, it accumulates in the tissues in the form of metabolites.

Indications
Acute lymphocytic leukemia, trophoblastic disease, skin cancer, cervical and vulvar cancer, esophageal cancer, squamous cell carcinoma of the head and neck, cancer of the renal pelvis and ureter, osteogenic and soft-cell sarcoma, Ewing’s sarcoma, lung cancer, breast cancer, germ cell tumors of the testis and testicles , liver cancer, kidney cancer, retinoblastoma, medulloblastoma, penile cancer, lymphogranulomatosis.

Severe forms of psoriasis (in case of failure of standard therapy).

Severe form of rheumatoid arthritis (in case of failure of standard therapy).

Dosage regimen
It is taken orally, administered iv, intramuscularly, intramuscularly. Installed individually, depending on the indications and stage of the disease, the state of the hematopoietic system, anti-tumor therapy regimen.
Side effect
From the digestive system: possible ulcerative stomatitis, anorexia, gingivitis, pharyngitis, nausea; rarely – diarrhea, melena, enteritis, pancreatitis; in some cases (with prolonged daily use) – liver necrosis, cirrhosis, fatty atrophy, periportal liver fibrosis.

From the hemopoietic system: leukopenia, anemia, thrombocytopenia.

From the side of the central nervous system: feeling tired, dizziness; rarely – headache, aphasia, drowsiness, cramps.

From the reproductive system: disorders of oogenesis and spermatogenesis, oligospermia, menstrual irregularities, decreased libido, impotence.

From the urinary system: hematuria, cystitis, severe renal dysfunction.

Allergic reactions: chills, decreased resistance to infection; rarely – urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome.

Dermatological reactions: skin rash, photosensitivity, pigmentation disorders, telangiectasia, acne, furunculosis.

Contraindications
Severe impaired liver and / or kidney function, leukopenia, thrombocytopenia, pregnancy. Methotrexate should not be used in immunodeficiency conditions.

Pregnancy and lactation
Methotrexate is contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.

Women of childbearing age should use reliable methods of contraception while using methotrexate.

In experimental studies, the embryotoxic and teratogenic effects of methotrexate have been established.

Use for impaired liver function
Contraindicated in severely impaired liver function.
Use for impaired renal function
Contraindicated in severe renal impairment.
special instructions
Methotrexate should not be used for ascites, pleural effusion, gastric ulcer and duodenal ulcer, ulcerative colitis, gout or nephropathy (including a history).

It is not recommended for use in patients with chickenpox (including recently transferred or after contact with patients), herpes zoster, and other acute infectious diseases.

Before starting therapy and against the background of the treatment, the picture of peripheral blood, liver and kidney function, chest x-ray should be monitored.

In the treatment of rheumatoid arthritis or psoriasis, a comprehensive blood count should be done at least 1 time per month, and laboratory tests of liver or kidney function at least 1 time in 1-2 months.

When used for psoriasis, the local treatment of the disease should not be interrupted. In case of an overdose, the use of calcium folinate is recommended (but not later than 4 hours later).

When conducting combination antitumor therapy, special care should be taken while using methotrexate in high doses with drugs that have a nephrotoxic effect (for example, with cisplatin).

It is not recommended to vaccinate patients and their families.

Methotrexate (even at low doses) with acetylsalicylic acid should be combined with caution.

In experimental studies, the carcinogenic and mutagenic effects of methotrexate have been established.

Drug interaction
With simultaneous use with vitamin preparations containing folic acid or its derivatives, a decrease in the effectiveness of methotrexate is possible.

The simultaneous use of NSAIDs in high doses can lead to an increase in the concentration of methotrexate in plasma and to an increase in its T1 / 2, as well as to an increase in the concentration of methotrexate not associated with plasma albumin, which in turn enhances the toxic effects of methotrexate (primarily on the gastrointestinal tract and system hematopoiesis).

With the simultaneous use of methotrexate with penicillins (even at low doses), its toxic effects may increase.

With simultaneous use with sulfonamides, especially with co-trimoxazole, there is a risk of increased myelodepressive effect.

When nitrous oxide is used in patients receiving methotrexate, severe unpredictable myelodepression and stomatitis may develop.

With the simultaneous use of valproic acid with methotrexate, a decrease in its concentration in blood plasma is possible.

Colestyramine binds methotrexate, reduces its enterohepatic recirculation, which leads to a decrease in its concentration in blood plasma.

With simultaneous use with mercaptopurine, it is possible to increase its bioavailability due to metabolic disorders during the “first passage” through the liver.

Neomycin and paromomycin reduce the absorption of methotrexate from the gastrointestinal tract.

In patients receiving omeprazole, an increase in the concentration of methotrexate in blood plasma is possible.

With simultaneous use with probenecid, a 3-4-fold increase in the concentration of methotrexate in blood plasma is possible due to a decrease in its renal excretion.

With the simultaneous use of methotrexate with retinoids, an increased risk of hepatotoxic action is possible.

Salicylates potentiate the effect of methotrexate due to a decrease in its renal excretion.

After a course of treatment with tetracycline, methotrexate, used even in low doses, can have a toxic effect.

With the sequential administration of methotrexate and fluorouracil, a synergy of action is possible; fluorouracil introduced before methotrexate may reduce its toxicity.

Cisplatin has a nephrotoxic effect and therefore can reduce the renal excretion of methotrexate, which leads to an increase in its toxicity.

Possible increased toxicity with cyclosporine in patients receiving methotrexate.

A description of the active substances of the drug is provided. The scientific information provided is generalized and cannot be used to decide on the possibility of using a particular drug.

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Just like most male enhancement pills found on the US market, ProSolutioN is a FDA approved male potency product which is recommended to men having erectile problems but also for men to improve their sexual performances. Most common among male users aged between 45- 60 years and very popular among younger users which administrate themselves with such product for a better sexual performance

Dosage and directions

The recommended dose is two tablets a day between a meal but in some cases your doctor might recommend a different daily dose with 1 tablet a day or in some cases, three tablets a day. If you have no erectile problems at all or any other type of male dysfunction, make sure to consult your doctor before taking ProSolution. Although a reliable male supplement with mainly natural ingredients like Ginseng, various fruits and types of roots, these pills might cause some forms of side effects if used improperly.

Precautions

If you have a family history of health problems or in case you are already using other supplements based on herbs, make sure to consult your doctor for further instructions on how or if you should use ProSolution. Before use, carefully read the ingredients table to see if you suffer from any type of allergies regarding one or several ingredients displayed there.

Contraindications

Do not use if you suffer from sever heart problems, have a blood pressure condition or you have had any type of surgical interventions in last few months. Ask your doctor before you start using male enhancement pills and always read the instructions accordingly.

 Possible side effects

Due to it’s highly concentrated formula of herbal compounds, there are no reported side effects for ProSolution. Although it’s not known to cause important side effects, short head aches, light vomiting or nausea might occur if taken improperly or in higher that prescribed doses.

Missed dose

In case you miss a dose, simply skip it and proceed taking ProSolution with the next pill. Although these is no time period in which you should take the two recommended pills, it’s best to take them after your breakfast and after your lunch, that way reducing the risk of missing a dose.

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Storage

Keep ProSolution pills in their original box, safe from the direct sun light, extreme heat or humidity. Make sure to store the box in a cool and safe environment, out of the reach of children or animals.

Disclaimer
All products presented at this site are not intended to diagnose, treat, cure, or prevent any disease. Don’t hesitate to consult your health care practitioner before taking any herbal supplement.

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Dosage and directions

The normal dosage for Gen F20 is 4 tablets a day, 2 in advance of lunch and the other two ahead of the dinner. In some cases doctors can prescribe increased doses but that is only up to their decision and should not be taken by you on your own. An increased dosage might lead to unwanted side effects if unnecessary. The pills should be taken with water and not chewed or directly swallowed.

Precautions

It’s very important to take Gen F20 ahead of a meal and not on an empty stomach. Like most supplements and pills, administrated on an empty stomach can lead to unwanted stomach aches. Hygiene is recommended ahead of every dose and both pills in a dose should be taken with a minimum amount of 100ml of water.

Contraindications

Gen F20 is not recommended to young patients or pregnant women. Also, patient suffering from heart problems or liver problems should consult their doctor before starting treatment with Gen F20. The anti-aging product contains a lot of vitamins, herbal plants and root extracts which might cause unwanted side effects to persons allergic to some of the ingredients or with intolerance to sugars.

Possible side effects

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A missed dose means that you should take it as soon as you remember or in case the next dose time is close, simply skip the missed one and proceed with taking Gen F20 as recommended. Missed doses for more than a day does not mean you should double the dose the next day. Simply proceed with the usual dose and skip the ones you missed.

Overdose

Gen F20 presents no risk of an over dose but if taken an increased dose or double the usual dose might lead to unwanted health situations like vomiting or nausea. Consult your doctor if any of these problems appear or persist and stop taking Gen F20 until your doctor tells you otherwise. The risk of an over dose is very limited but you should always pay great care to your daily dose and recommendations.

Storage

Keep the Gen F20 pack in a cool and dry place at room temperature. Keep it safe from children or pets and never dispose in clean waters. Extreme heat, direct sun light or humidity might affect the product and damage its properties. DO not take Gen F20 if the product is expired or stored in improper places.

Disclaimer

All products presented at this site are not intended to diagnose, treat, cure, or prevent any disease. Don’t hesitate to consult your health care practitioner before taking any herbal supplement.

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Product Description

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Dosage and directions

Although Amalaki is a natural product which needs no prescription from the doctor, it’s always best to consult your physician in order to settle the optimal dose and the right period of time for you to take these herbal pills. The normal dosage should be 1-3 times a day depending on the age, medical condition or weight. However, only your personal physician can tell you the exact dosage you should take for the best results.

Precautions

If you suffer from diabetes or you have an intolerance to sugar, it’s best to avoid using Amalaki as your rejuvenant remedy. Also, using Amalaki by younger persons is not recommended. Pregnant women should consult their doctor before taking Amalaki during and after pregnancy.

Contraindications

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Possible side effects

Used in larger doses or on an empty stomach, Amalaki might cause some forms of side effects. Although no reports of serious side effects existing in the present, always make sure to follow instructions in order to avoid unwanted head aches, stomach aches or even vomiting.

Missed dose

A missed dose does not pose any type of threat to your daily usage of Amalaki. In case you miss to take a dose, proceed with taking it when you remember or skip to the next one if more than five hours have passed. Missed dosed that have passed more than 24 hours should be ignored and skipped for you to return to the daily administration.

Overdose

Taking Amalaki in higher doses or without keeping in mind the instructions might lead to light forms of over dose which can be recognized when head aches, stomach aches or forms of nausea start to appear. In case of an over dose, stop taking Amalaki, drink lots of water and seek medical assistance as soon as possible. Forms of intoxication might follow an over dose which in turn might cause, itchiness, blisters or dry mouth.

Storage

AMalaki should be stored in cool and dry places, always in its original box. Not suitable for children or animals and forbidden from being disposed in clean waters. If expired, DO NOT take Amalaki.

Disclaimer
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Active Ingredient: Naltrexone hydrochloride.

Indications for use:
👉Opioid addiction (as an auxiliary drug after the withdrawal of opioid analgesics);
👉Alcoholism (as part of a combination treatment).

Other names for this medication:
Nal trex own, Naltrexone oral.

Release form and composition

Dosage forms of Naltrexone:
Capsules: gelatinous with a white body and a dark green cap; contents – white or almost white powder (10 each in a blister pack; 2 or 5 packs in a carton; 100, 200 or 300 packs in a carton (for hospitals));
Tablets (10 pieces each in blister packs; 1, 2 or 5 packs in a cardboard box; 100, 200 or 300 packs in a cardboard box (for hospitals)). Active substance: naltrexone hydrochloride – 50 mg in 1 capsule / tablet.

Additional components:
Capsules: lactose monohydrate, magnesium stearate;
Tablets: potato starch, low molecular weight polyvinylpyrrolidone medical (povidone), milk sugar (lactose), aerosil (colloidal silicon dioxide), magnesium stearate, crospovidone; The composition of the capsule shell: titanium dioxide 1% and 2%, gelatin, dye indigo carmine, dye iron oxide yellow.

Contraindications
☞ Withdrawal syndrome;
☞ Taking opiates;
☞ Liver failure;
☞ Acute hepatitis;
☞ A positive test for the presence of opioids in the urine;
☞ Age to 18 years;
☞ Pregnancy;
☞ Period of breastfeeding;
☞ Hypersensitivity to the components of the product.

Mode of application

Dosage Inside.
Treatment for opioid addiction. The phase of introduction to the course of therapy with naltrexone.
Treatment with naltrexone is prescribed after the patient refrains from taking opioids for 7-10 days (in the absence of withdrawal symptoms).
Abstinence from the use of opioids is identified by indicators of laboratory tests of urine for the content of opioids. Treatment begins with a negative provocative test with 0.5 g of naltrexone . Description of the naltrexone test: the patient must be administered 0.2-0.4 mg of naltrexone intravenously for 5 minutes. or as an injection subcutaneously or intramuscularly. If there is no reaction to the administration of naloxone within 15-30 minutes, a second dose of 0.4 mg intravenously or 0.4-0.8 mg subcutaneously is administered and the reaction is monitored. The test is considered positive with severe mydriasis, a change in affect from complacently-drowsy to dysphoric, behavioral disorders, the appearance of signs of opium withdrawal. A naloxone test is not performed in patients with withdrawal symptoms and in the detection of opioids in the urine. The naloxone test can be repeated after 24 hours. Treatment with naltrexone is begun with caution, gradually increasing the dose. The contents of the capsule are dissolved in 50 ml of water. Initially, 25 mg of naltrexone is prescribed orally (contained in 25 ml of the stock solution). The doctor should monitor the act of swallowing the drug solution. Maintenance therapy with naltrexone. The next day after the initial dose is administered, 50 mg of naltrexone is started every 24 hours (the use of naltrexone at the indicated dose is sufficient to block the effects of parenteral opioids, for example, 25 mg of heroin injected intravenously). 100 mg of naltrexone is prescribed every 2 days or 150 mg every 3 days. Alcoholism treatment As part of combination therapy. Daily intake of 50 mg of naltrexone, the minimum course is 3 months. Treatment should be part of an appropriate alcohol dependence elimination program. Throughout the course of treatment, it is necessary to monitor adherence to all components of the treatment of alcoholism that affect a favorable outcome. Medication is recommended to be accompanied by a course of psychotherapy.
The criteria for selecting patients for the treatment of alcoholism are:
1) a positive attitude towards treatment;
2) the willingness to abandon the use of alcohol (psychoactive substances);
3) participation in rehabilitation programs;
4) the beginning of a healthy lifestyle after the end of the course of treatment.

Overdose
Naltrexone is a moderately safe drug. According to studies, even large doses do not cause serious symptoms. There is evidence of a clinical study during which patients took 800 mg per day of naltrexone for a week without signs of intoxication.
If intoxication is suspected, symptomatic treatment should be prescribed.
At the preclinical study stage, with repeated administration of naltrexone at a dose of 100 mg / kg exceeding the maximum daily dose for treating a person by approximately 35 times, no significant changes were found in hematological and biochemical parameters of blood, as well as in the structure of internal organs. Naltrexone also has no local irritant effect.

Side effects
Digestive system: abdominal pain, dry mouth, nausea and / or vomiting, constipation, diarrhea, gastrointestinal upset, frequent bowel movements, flatulence, anorexia, taste change, decreased / increased appetite, erosive and ulcerative defects of the gastrointestinal tract, increased activity of liver enzymes, increased symptoms of hemorrhoids;
Respiratory system: hoarseness, cough, hyperemia of the vessels of the nasal cavity (nasal congestion), bronchial obstruction, sneezing, rhinorrhea, shortness of breath, nosebleeds, difficulty breathing, dry throat, increased sputum mucosa, pharyngitis (including streptococcal), sinusitis, nasopharyngitis;
Nervous system and sensory organs: nightmares, fatigue, nervousness, general weakness, restless sleep, dizziness, headache, blurred visual perception, hallucinations, confusion, drowsiness, irritability, fainting, depression of the central nervous system, disorientation, congestion and ringing ears, photophobia, burning sensation and pain in the eyes;
Cardiovascular system and hemopoietic system: chest pain, nonspecific changes in the electrocardiogram, increased blood pressure, tachycardia, palpitations, lymphocytosis, phlebitis;
Genitourinary system: increased urination, discomfort during urination, edema syndrome (swelling of the legs, feet, fingers, face), sexual disorders in men (decreased potency, delayed ejaculation);
Musculoskeletal system: arthritis, stiffness in joints, back pain, pain in joints / limbs, spasm and stiffness of muscles, muscle pain, muscle twitching;
Allergic reactions: skin rash, itching, flushing of the skin (including flushing of the face);
Other: decrease or increase in body weight, thirst, chills, fever, lymphadenopathy (including cervical adenitis), increased sweating.

Special instructions
Before starting the Naltrexone course, you need to make sure that there is no subclinical liver failure, during the period of treatment it is necessary to periodically monitor the level of transaminases. You can not use the drug with drugs that have a hepatotoxic effect.
In order to avoid the development of acute withdrawal symptoms, patients should stop using opioids and drugs containing them at least 7–10 days before the start of therapy, and be sure to conduct a provocative test with naltrexone . If these requirements are not observed, the development of withdrawal symptoms can occur 5 minutes after taking the drug and continue for 48 hours.
Before surgery, in which opioid analgesics will be used, the drug must be canceled at least 48 hours before the operation.
The use of Naltrexone is ineffective in the treatment of cocaine as well as non-opioid drug dependence.
When observing a persistent decrease in appetite and progressive weight loss, therapy should be discontinued. In case of emergency analgesia with narcotic drugs, it is necessary to prescribe opiates with extreme caution in an increased dosage (to overcome antagonism), since this will cause a deeper and longer respiratory depression.

Patients should know what is needed:

  • To inform, on a mandatory basis, medical personnel about treatment with naltrexone when seeking medical help;
  • Stop taking the medicine and consult a doctor if you observe yellowing of the sclera, darkening of urine and abdominal pain.
    It is required to take into account that there will be no effect from the independent use of heroin and other drugs in small doses, and a further increase in the doses of narcotic drugs will lead to death (respiratory arrest).

Drug interaction
Naltrexone reduces the effectiveness of drugs that include opioids (analgesics, antitussive drugs). In combination with hepatotoxic drugs, the threat of liver damage is aggravated (mutually). When combined with thioridazine, the risk of developing increased drowsiness or lethargy increases. Terms and conditions of storage Store in a place protected from moisture and light, out of the reach of children, at a temperature not exceeding 25 ° C.

Shelf life is 36 months.

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Active Ingredient: Cabergoline.

Analogs of Cabgolin:Dostinex.

Chemical name
1 – [(6-Allylergolin-8beta-yl) carbonyl] -1- [3- (dimethylamino) propyl] -3-ethylurea.

Chemical properties
This substance is a fairly common dopaminomimetic, a derivative of ergot alkaloids. The tool is synthesized in the form of a white fine powder, which is highly soluble in ethanol, N, N-dimethylformamide and chloroform. The chemical compound is slightly soluble in 0.1 n hydrochloric acid, n-hexane. The product does not dissolve in water.

In medicine, drugs based on Cabergoline are used to treat hyperprolactinemia, and the substance is also used by athletes.

Cabergoline in bodybuilding
The medicine is used to reduce prolactin levels and eliminate unwanted side effects from taking progestin anabolics – trenbolone and nandrolone. During the treatment, athletes monitor the level of prolactin and continue taking the medicine, depending on the results of the tests. It is believed that the substance eliminates fluid retention in the tissues and accelerates the growth of lean muscle mass.

Pharmachologic effect
Hypoprolactinemic.

Pharmacodynamics and pharmacokinetics
Cabergoline is a long acting dopamine receptor antagonist. The drug acts mainly on D2-dopamine receptors, to a lesser extent – on D1-dopamine, serotonin, alpha2- and alpha1-adrenergic receptors.

Laboratory data show that the drug has a direct effect on the synthesis of prolactin by lactotrophs in rats, lactotrophs are located in the pituitary gland. Plasma prolactin levels are significantly reduced, especially in reserpine individuals.

The hypoprolactinemic effect of the drug was carefully studied in two independent, randomized, double trials involving a placebo-controlled and comparative group. The effect of the substance was studied on women suffering from hyperprolactinemia. The test results improved, and the normal menstrual cycle was restored in about 77% of women who took the drug 2 times in 7 days at a dosage of 0.5 mg. In 73% of the subjects, galactorrhea disappeared.

Pharmacokinetic parameters are directly proportional to the dosage of the drug. Eating does not affect the processes of assimilation, metabolism and excretion. After penetration into the digestive tract, the maximum concentration of a substance in the blood plasma was observed after 2-3 hours. With systematic administration of the drug, its equilibrium concentration is several times higher than the concentration with a single dose.

It is not completely known what bioavailability Cabergoline has, but it is unambiguously exposed to the effect of “first passage” through the liver tissue. The degree of binding of the agent to plasma proteins ranges from 40 to 42%, depending on the dose taken. The medicine and its metabolites are quickly and well distributed in tissues and organs, the highest concentration was found in the pituitary gland.

The substance is metabolized by hydrolysis reactions involving urea residues or an acylurea bond in the liver tissues. Cytochrome P450 takes part to a small extent in the biotransformation of the drug. The half-life of the drug is about 65 hours. The substance and its metabolites are completely eliminated from the body within 20 days, mainly through the intestines and urine.

Mild to moderate renal failure and mild to moderate hepatic failure do not require dosage adjustment. With serious violations in the liver, an increase in the concentration of the drug in the blood plasma and AUC is observed. For elderly patients, the drug can be prescribed in the same dosages as for young ones, however, special care must be taken, taking into account all the concomitant diseases and the state of the body as a whole.

The effect of taking the drug is observed after 3 hours, after taking the tablets, reaching its maximum within 48 hours. The duration of the drug is 14 days. Cabergoline does not affect the secretion of other hormones of the anterior pituitary gland or cortisol level. The substance does not have mutagenic activity, slightly reduces fertility.

Indications for use
The tool is prescribed:

  • for the treatment of idiopathic hyperprolactinemia;
    – with macro- and microadenoma of the pituitary gland;
    – patients with amenorrhea, anovulation, oligomenorrhea and
  • – galactorrhea according to indications;
    – to suppress or prevent lactation after childbirth;
    -as part of complex therapy or as a monotherapy for Parkinson’s disease.

  • Contraindications
    The medicine should not be taken:
  • in the presence of hypersensitivity reactions to the active component or – – derivatives of ergoalkaloids;
    – during lactation;
    – patients with uncontrolled hypertension;
    – pregnant women
    – with fibrotic changes in the heart muscle or respiratory system, which – caused disturbances in the functioning of the organs.

  • Caution is recommended to observe:

– with low blood pressure;
– if parallel therapy with dopamine receptor antagonists, antihypertensive – drugs;
– with eclampsia or preeclampsia;
– persons suffering from liver disease;
– with psychosis, including a history of;
– to children.


Side effects
Adverse reactions due to treatment with this substance are quite rare, and in mild or moderate severity.

During clinical trials, the following adverse reactions have been identified.

Most often occur: constipation, headache and dizziness, nausea, pericarditis, peripheral edema, pericardial effusion.

Often develop:

hallucinations, confusion, depression;
indigestion, gastritis, angina pectoris, vomiting;
heart palpitations, flushing and redness of the face;
a decrease in the level of hemoglobin, red blood cells or hematocrit in the blood;
shortness of breath, increased sexual activity, asthenia, pain in the chest and lower back;
weakness, drowsiness (sudden falling asleep in people with Parkinson’s disease).


Less commonly observed:

hyperkinesia, psychotic disorders, fainting, delirium;
malfunctioning of the liver, dyskinesia of the gallbladder and biliary tract, spasm of the vessels of the fingers and toes;
respiratory failure, nosebleeds;
allergic rashes, alopecia, increased levels of creatine kinase in the blood, cramps of the fingers and muscles on the calves;
pulmonary fibrosis, hemionopsia, erythromelalgia, pleurisy, edema (rarely).

Cabergoline, instructions for use (Method and dosage)
Inside.

In order to prevent lactation in the postpartum period, the medicine is taken once, on the first day after birth, at a dosage of 1 mg. To stop the existing lactation, 250 μg of the drug is used, every 12 hours, 4 times. The duration of treatment, therefore, is 2 days.

The treatment of hyperprolactinemia is carried out in accordance with the recommendations of the attending physician.

As a rule, the initial dosage is 500 mcg per week at a time or distributed over 2 applications. If necessary, the dosage can be increased by 0.5 mg per week, for a month. If the likelihood of developing unwanted adverse reactions is increased, then treatment can begin with 250 mg per week.

The standard therapeutic dose is 1 to 2 mg in 7 days. The maximum amount of a drug that can be prescribed per week is 4.5 mg.

Patients with Parkinson’s disease during monotherapy are prescribed from 500 μg to 3 mg of the substance, 1 time per day. The duration of treatment is determined by the doctor.

Overdose
In case of an overdose, the victim has nasal congestion, hallucinations, increased side effects, and fainting. As a treatment, supportive and symptomatic therapy is used.

Interaction
It is better to avoid co-administration of this substance and ergot alkaloids (their derivatives).

The drug is not recommended to be combined with macrolide antibiotics, they increase its bioavailability, more often and more side effects are manifested.

The drug cannot be combined with dopamine receptor antagonists (phenothiazines, thioxanthene, butyrophenone, metoclopramide), this leads to a decrease in the effectiveness of the drug.

Cabergoline is better not to use along with medicines that lower blood pressure.

Storage conditions
Tablets are stored in the original packaging in a cool place.

Shelf life
2 years.

Special instructions
Extra care must be taken in the treatment of patients with cardiovascular diseases, gastric and duodenal ulcers, Raynaud’s syndrome, gastrointestinal bleeding, severe liver diseases (dosage must be adjusted).

The first few days of drug therapy, it is recommended to control the patient’s blood pressure. The drug may cause it to decrease. Also, once a month you need to determine the level of prolactin in the blood. After discontinuation of the drug, prolactin levels can remain at a normal level from 2 weeks to several months.

Before starting treatment, the patient must undergo an examination to identify possible pathologies of the heart valves, liver or kidneys. It is also recommended to do an ECG about 1 time per six months or once a year, in accordance with the doctor’s recommendations. If valve regurgitation worsens, the valve wall thickens, and the lumen narrows, the drug must be replaced.

If during the course of therapy with the agent new clinical symptoms of the respiratory system have appeared, an X-ray of the lungs must be taken. If a patient develops pleural effusion or fibrosis (accompanied by shortness of breath, cough, chest pain and rapid breathing), blood ESR levels increase, additional studies are also needed.

Before starting treatment, it is necessary to accurately determine the cause of the development of hyperprolactinemia in order to exclude the presence of a pituitary tumor.

If you are taking drugs based on Cabergoline, then you can not drive a car and perform potentially dangerous activities, it should be remembered that drugs can lower blood pressure.

For children
This substance, as a rule, is not used in pediatric practice.
With antibiotics
The medicine cannot be combined with erythromycin and some macrolide antibiotics.

During pregnancy and lactation
During pregnancy, the drug is used with extreme caution. Pregnant women can start or continue treatment with the drug only after consulting a specialist.

The drug and its metabolites were found in the milk of experimental rats; it is not known whether the substance is excreted in milk in women. Since the drug can have a negative effect on the infant, it is recommended to stop breastfeeding or replace the medicine.

With antibiotics
The medicine cannot be combined with erythromycin and some macrolide antibiotics.

During pregnancy and lactation
During pregnancy, the drug is used with extreme caution. Pregnant women can start or continue treatment with the drug only after consulting a specialist.

The drug and its metabolites were found in the milk of experimental rats; it is not known whether the substance is excreted in milk in women. Since the drug can have a negative effect on the infant, it is recommended to stop breastfeeding or replace the medicine.

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Indinavir is an HIV protease inhibitor used in combination with other medicines to manage human immunodeficiency virus (HIV).

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Other names for this medication: Avirodin, Avural, Ciplaindivan, Cirixivan, Compound j,  Crixivan, Elvenavir, Flamind, Forli, Virixit, Virotec .

Pharmachologic effect:
Antiviral drug, a specific inhibitor of HIV proteases. Active against HIV – inhibits HIV replication, incl. with resistance to reverse transcriptase inhibitors. By binding to the active site, it inhibits the HIV-1 protease (and to a lesser extent the HIV-2 protease), which participates in the assembly of the viral virion (which is considered the transport form of the virus) at the exit from the affected cell. As a result of the inhibition of HIV protease activity, inactive virus particles are formed.

Pharmacokinetics:
After ingestion, the fasting is quickly absorbed (high-calorie foods, especially rich in fats and proteins, slow down absorption, reduce Cmax and AUC). TCmax – 45-50 min. Communication with plasma proteins – 60%. It is metabolized in the liver with the participation of cytochrome CYP3A4, CYP3A5 and CYP3A7 with the formation of 6 oxidation products and one conjugate with glucuronic acid. It is an inhibitor of isoenzymes CYP3A4, CYP3A5 and CYP3A7. T1 / 2 – 1.5-2 hours. Not cumulated. About 80% of the accepted dose is excreted as metabolites (approximately in the same ratio by the kidneys and with bile), and 20% is excreted by the kidneys unchanged. In patients with liver failure, an increase in T1 / 2 to 2.8 h.

Indications:
Diseases caused by HIV-1 in adult patients: not previously treated with antiretroviral drugs (in combination with antiretroviral drugs or as monotherapy at the beginning of treatment of patients who are clinically inappropriate to administer nucleoside analogues); previously received antiretroviral drugs and having contraindications or resistance to drugs – reverse transcriptase inhibitors (in combination with antiretroviral drugs or as monotherapy).

Contraindications:
Hypersensitivity, pregnancy, lactation period. C caution. Hemophilia, liver failure, children and old age (safety and efficacy have not been established).

Side effects:
On the part of the digestive system: aphthous stomatitis, abdominal pain, heartburn, diarrhea, dry mouth, dyspepsia, flatulence, nausea, vomiting, taste disturbance, increased activity of liver transaminases, cholecystitis (including calculous), cholestatic hepatitis , hyperbilirubinemia (total bilirubin more than 2.5 mg / dL due to indirect bilirubin). Nervous system disorders: asthenia, dizziness, headache, hypoesthesia, sleep disturbances (drowsiness), nervousness, depression, paresthesias, tremor, peripheral polyneuropathy. On the part of the musculoskeletal system: arthralgia, myalgia, muscle cramps, stiff muscles, chest pain. On the part of the respiratory system: cough, respiratory failure, sinusitis, upper respiratory tract infections, pneumonia. On the part of the urinary system: dysuria, nocturia, nephrourolithiasis, pain in the kidney area, hematuria, proteinuria, hypercreatininemia. For the skin: dry skin, itching, dermatitis (including contact, seborrheic). From the side of blood-forming organs and the hemostatic system: spontaneous bleeding in patients with hemophilia A and B (who received protease inhibitors). Other: lymphadenopathy, fever, increased sweating, flu-like syndrome, hemolytic anemia.

Interaction:
Enhances (mutually) the effect of reverse transcriptase inhibitors. Increases rifabutin concentration. With the simultaneous appointment of zidovudine and indinavir, AUC indinavir increases by 13%, zidovudine – by 17%; with simultaneous use of indinavir, zidovudine and lamivudine, the AUC of indinavir does not change, the AUC of zidovudine is increased by 36%, and the AUC of lamivudine is reduced by 6% (dose adjustment is not required). Decreases the metabolic rate and increases the toxicity of terfenadine, astemizole and cisapride, midazolam and thiazolide, which can lead to the occurrence of cardiac arrhythmias (simultaneous administration of drugs is not recommended). Ketoconazole increases the concentration of indinavir, and rifampicin reduces. In combination therapy with didanosine, drugs are taken on an empty stomach with an interval between doses of 1 hour.

Special instructions:
To ensure adequate hydration and prevention of nephroluritiasis, 1.5-2 liters of fluid should be drunk per day. During treatment, it is recommended to control the activity of amylase, ALT, AST, the concentration of bilirubin and glucose in plasma. Care should be taken when prescribing to patients with hemophilia (isolated cases of spontaneous bleeding of unknown etiology have been reported).

The information provided in this section is intended for medical and pharmaceutical professionals and should not be used for self-medication. The information is given for familiarization and can not be considered as official.

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👉Active Ingredient: Tranexamic acid.

Cyklokapron (Tranexamic acid) is used for short-term control of bleeding in hemophiliacs, including dental extraction procedures.


Other names for this medication:
Acide tranexamique, Acido tranexamico, Acidum tranexamicum, Amchafibrin, Anvitoff, Asamnex, Azeptil, Ciclokapron, Cyklo-f, Cyklonova, Ditranex, Espercil, Ethinex, Exacyl, Examic, Hemlon, Hemotran, Hemotrex, Hemsamic, Hexakapron, Hexamic, Hexatron, Intermic, Kalnex, Keisamine, Lunex, Lysteda, Medisamin, Nexa, Nexitra, Nicolda, Plasminex, Pletasmin, Ranobis, Rikavarin, Ronex, Spotof, Tacid, Tracapmin, Tranarest, Trand, Tranex, Tranexamsyra, Tranexid, Tranon, Transabon, Transamin, Transamine, Transcam, Tranxa, Traxyl, Trexam, Ugurol, Vanarin top, Vasolamin, Xamic.

👉Pharmacotherapeutic group

Fibrinolysis inhibitors

👉Pharmacological properties
Antifibrinolytic, antiallergic, anti-inflammatory. Competitively inhibits plasminogen activator, in higher concentrations binds plasmin. Extends thrombin time. It inhibits the formation of kinins and other peptides involved in inflammatory and allergic reactions. When ingestion absorbed 30-50% of the dose. The maximum concentration is reached 3 hours after administration. The initial volume of distribution – 9-12 liters. Easily passes through histohematogenous barriers, including BBB, placental. Concentration in cerebrospinal fluid is 1/10 of plasma. It is found in seminal fluid, where it inhibits fibrinolytic activity, but does not affect sperm migration. The insignificant part undergoes biotransformation. The main route of excretion is glomerular filtration. Excreted with urine. Antifibrinolytic concentration in various tissues is maintained for 17 hours, in plasma – up to 7-8 hours.

👉Indications for use Cyklokapron
Bleeding due to increased general and local fibrinolysis (treatment and prevention): hemophilia, hemorrhagic complications of fibrinolytic therapy, thrombocytopenic purpura, aplastic anemia, leukemia, bleeding during surgery and in the postoperative period, uterine during childbirth, pulmonary, nasal, gastrointestinal, meno- and metrorrhagia, gross hematuria, caused by bleeding from the lower urinary tract; aphthous stomatitis, tonsillitis, laryngopharyngitis, hereditary angioedema, eczema, allergic dermatitis, urticaria, drug and toxic rash.

👉Contraindications
Hypersensitivity, subarachnoid hemorrhage, renal failure, thrombophilic conditions (deep vein thrombosis, thromboembolic syndrome, myocardial infarction), impaired color vision, pregnancy.

👉Cautions when using
In case of renal insufficiency (depending on the degree of increase in serum creatinine), the dose and frequency of administration is reduced. During and after treatment for several days, an ophthalmologist should be observed with a check of acuity, margins and color vision, and examination of the fundus. With caution used in combination with tissue hemostatic drugs, hemocoagulase (in large doses), heparin. When treating hematuria of renal genesis, the risk of mechanical anuria increases as a result of a clot in the urethra.

👉Interaction with drugs
Incompatible with urokinase, noradrenaline bitartrate, desoxyepinephrine hydrochloride, metarmine bitartrate, dipyridamole, diazepam. In a solution, tranexamic acid reacts (cannot be mixed) with antibiotics (benzylpenicillin, tetracyclines), blood proteins.

👉Side effects
Dyspeptic phenomena (anorexia, nausea, vomiting, diarrhea), dizziness, weakness, drowsiness, tachycardia, chest pain, hypotension (with rapid on / in the introduction), impaired color vision, skin allergic reactions.

👉Application and dosage

▫ Inside, regardless of the meal – 250-500 mg 3-4 times a day.

▫ With profuse uterine bleeding – 1-1.5 g 3-4 times a day for 3-4 days.

▫ With repeated nasal bleeding – 1 g 3 times a day for 7 days.

▫ After surgery, cervix conization – 1.5 g 3 times a day for 12-14 days.

▫ Patients with coagulopathy, before extraction of the tooth – at 25 mg / kg 3-4 times a day, starting 1 day before the upcoming surgery and continuing for 6-8 days after.

▫ For hereditary angioedema, by mouth, 1-1.5 g 2-3 times a day (constantly or intermittently, depending on the presence of prodromal symptoms).

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