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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:


  • 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


  • 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.


  • 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.

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.

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.

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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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.

☞ 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.

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

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)

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.

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.

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.

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.

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).

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.

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.

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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Active Ingredient: Pantoprazole.

Other names for this medication:
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1 tablet drug Pantoprazole contains 20 mg of the active substance of the same name.
Additional components: sucrose, sodium carbonate, talc, mannitates, silica, calcium stearate, polyethylene glycol, hypromellose, triethyl citrate, methacrylate copolymer, titanium dioxide, iron oxide, Opacode black.

Pharmachologic effect
Antiulcer action.

Pharmacodynamics and pharmacokinetics

Suppresses products in the stomach of hydrochloric acid by the action of a proton pump on gastric cells. The active substance is transformed into the active form in the channels of the walls of the parietal cells and blocks the enzyme H-K-ATP-azu, that is, at the final stage of the synthesis of hydrochloric acid. In most patients, relief of symptoms occurs after 2 weeks of therapy. Like other proton pump blockers and H2-type receptors, drug therapy causes a decrease in acidity and an increase in gastrin content.

Pantoprazole is actively absorbed, the highest concentration in the blood is achieved after a single dose. On average, the highest concentration in the blood occurs 2.5 hours after application.

⌚The half-life is about an hour. There have been a number of cases of delayed withdrawal.

Reaction with plasma proteins approaches 98%. The original drug is almost completely transformed in the liver.

The kidneys excrete about 80% of the metabolites, the rest is excreted in the feces. The main metabolite is desmethyl-pantoprazole, its half-life is approximately 1.5 hours.

Indications for use

☛Zollinger-Ellison syndrome;
☛peptic ulcer in the acute phase;
☛H.pylori eradication;
☛reflux esophagitis.


☛hypersensitivity to the drug;
☛cirrhosis, complicated by severe liver failure.

Side effects

Reactions from the digestive system: nausea, diarrhea, increased appetite, dry mouth, vomiting, belching, flatulence, constipation, gastrointestinal carcinoma, abdominal pain, increased transaminases.
Reactions from nervous activity and sense organs: drowsiness, headache, dizziness, asthenia, insomnia, depression, nervousness, tremor, photophobia, paresthesias, tinnitus, visual disturbances.
Reactions from the urinogenital sphere: edema, hematuria, impotence.
Skin reactions: alopecia, exfoliative dermatitis, acne.
Allergic reactions: rash, urticaria, angioedema, pruritus.
Other reactions: eosinophilia, hyperglycemia, myalgia, hyperlipoproteinemia, fever, hypercholesterolemia.

Instructions for use Pantoprazole (method and dosage)

Pantoprazole tablets must not be chewed or broken, they must be swallowed whole, taken before meals and washed down with water.

In the treatment of mild reflux disease and associated symptoms (acid regurgitation, heartburn, pain when swallowing) the recommended initial dose is 20 mg per day. Improvement is achieved after about 2-4 weeks, for the treatment of esophagitis, which appeared on the background of the disease usually need monthly therapy. If the specified time period is insufficient, recovery occurs within the next month. Recurrence of the disease is controlled by consuming 20 mg of Pantoprazole once a day, if necessary. If acceptable symptom control cannot be maintained in this way, it is allowed to consider switching to permanent therapy.

With prolonged treatment of reflux esophagitis, a maintenance dosage of 20 mg per day is recommended. In case of frequent relapses, the dosage is increased to 40 mg per day. After stopping the symptoms of relapse, the dosage can again be reduced to 20 mg per day.

For the prevention of peptic ulcer disease induced by non-steroidal anti-inflammatory drugs, the recommended dosage for people with risk factors is 20 mg of the drug per day.

In the elderly and patients with kidney failure, the daily dosage of Pantoprazole should not be higher than 40 mg.

Patients with severe liver failure should not exceed the dosage of Pantoprazole 20 mg per day. These patients during the period of therapy should be determined by the content of liver enzymes. If their concentration begins to increase, pantoprazole therapy must be canceled.

Cases of overdose should be treated according to the standard practice of treatment of toxic conditions.

The drug can reduce the absorption of agents whose bioavailability correlates with pH (for example, Itraconazole, Ketoconazole, Atazanavir).

The use of proton pump blockers is prohibited during treatment with Atazanavir.

The drug is metabolized in the liver under the influence of cytochrome P450, however, significant interactions with Diazepam, Carbamazipyrin, Caffeine, Diclofenac, ethanol, Digoxin, Glibenclamide, Naproxen, Metoprolol, Nifedipine, Piroksikam, Teofillin, a draphotoxorset, a teofillin, a headset, a tefillin, a draped body, a teofillin, a draped body, a teofillin, a tefillino, a tefillinom, a tefillinom, a tefillinom, a tefillinom, a tefillinom, a tefillinom, a tefillinom, tefillinom, tefillinoma

If the patient uses coumarin anticoagulants, it is recommended to measure the prothrombin period and the INR value during and after pantoprazole treatment.

Storage conditions
Keep out of the reach of children. Store at temperatures up to 25 degrees.

Shelf life
3 years.

Special instructions
Persons with severe liver failure in the treatment with pantoprazole are recommended to regularly measure the content of liver enzymes. In case of an increase in the level of liver enzymes, therapy should be discontinued. The use of Pantoprazole 20 mg tablets to prevent the appearance of gastric and duodenal ulcers induced by nonsteroidal anti-inflammatory drugs is indicated for patients who need long-term use of NSAIDs and have an increased risk of developing complications from the digestive system.

With low acidity, the number of bacteria present in the gastrointestinal tract, as a rule, grows. Therefore, therapy with drugs that reduce acidity, can lead to a weak increase in the risk of gastrointestinal infections.

Pantoprazole is able to lower the absorption of vitamin B12 as a result of hypochlorhydria or achlorhydria.

Before treatment, it is necessary to exclude the presence of malignant tumors of the esophagus or stomach, since treatment with Pantoprazole may mask the symptoms of such diseases and lead to their late diagnosis.

For children
Not applicable in children under 12 years.

During pregnancy and lactation
The drug is prohibited to use during lactation.

Use during pregnancy is possible only under strict indications.

Reviews of the drug characterize it as an effective and inexpensive drug for the treatment of peptic ulcer and GERD. Side effects occur infrequently, while respecting the reception regimen.

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Analogs Of Dutas: Avodart.

Dutasteride – instructions for use, price, analogues.
Disruption of the hormonal balance in the male body, in particular, an increase in the level of the hormone dihydrotestosetron, leads to the development of prostatic hyperplasia, a concomitant manifestation of which is the difficulty of urine outflow in the acute or latent form. For inhibiting (preventing the production) of dihydrotestosterone, a synthetic substance of selective action is used – Dutasteride, which is part of preparations with various trade names.

Active ingredient and its focus
Dutasteride was developed and patented for the first time in the United States of America. It was released into mass production in 2001 as part of the drug under the trade name Avodart, which is still used today. In 2015, the term of the patent for a substance ended and it was used in the production of generic drugs.

Increasing the level of the hormone dihydrotestosterone in men leads to uncontrolled proliferation of prostate tissue, followed by possible degeneration of them into a malignant form.

In addition, the increased background of dihydrotestosterone in men is the cause of alopecia (hair loss on the head) and hirsorutism (body hair in women).

Prostate hyperplasia is considered as a precancerous condition of the body, it requires increased attention and corrective therapeutic and sometimes surgical interventions. One of the substances that selectively reduces the level of dihydrotestosterone is Dutasteride.

The substance inhibits the activity of enzymes 5-alpha-reductase of the 1st and 2nd types, acting on the hormone testosterone, preventing it from turning into an excess amount of dihydrotestosterone.

The prostate gland, without receiving an excess of the hormone dihydrotestosterone, stops the uncontrolled proliferation of its tissues and the process of hyperplasia stops. As a result of a decrease in the volume of the gland, compression of the urinary tract is stopped and urine output is facilitated, and, consequently, inflammatory congestion also disappears.

Thanks to the action of this medication, many patients managed to avoid surgery and control the condition of the gland, restraining the progression of its growth.

In modern urology, for the treatment of prostatic hyperplasia, two active substances with similar pharmacological action are used – this is Dutasteride and its analogue – Finasteride.

They have few fundamental differences from each other, but still it is worth noting some of their differences.

Dutasterid is recognized as more effective due to the fact that it can combine with the alpha reductase enzyme of the 1st and 2nd type (which is why it is called a double inhibitor) and can reduce a high level of dihydrotestosterone by 98%, while Finasteride forms compounds only with the 1st type of enzyme and its effectiveness is slightly lower due to this – 70%.

⚠Intensive metabolism of such active ingredients occurs through the liver, so it is very important that during the course of treatment with means containing Dutasteride, the liver is healthy and able to cope with its functions.⚠

Dosage Form
Generic Avodart is made in the form of capsules-cases of white color, soluble in the stomach and containing the active substance dutasteride in the amount of 0.5 mg. Capsules are located in contour cells of 10 pieces. One pack contains 30 or 90 capsules.

Capsules are taken orally, one piece per day, washed down with water. The capsule itself can not be chewed or pour its contents into the oral cavity, since the active substance can damage the mucous membrane of the mouth and pharynx.

According to the instructions for use, the tool is recommended to take, regardless of the meal, but there is evidence that simultaneous ingestion with food reduces the absorbability and level of concentration of the active ingredient in the body.

The maximum concentration of a substance in the blood plasma is recorded already after 3 hours from the moment of use. On condition of daily ingestion of 0.5 mg of dutasterid after one month of its administration, its concentration in blood serum is 65 percent, and after 3 months it reaches a level of 90 percent.

Improving the dynamics of the urological orientation is manifested in the first month of treatment. It is necessary to take Avodart from 3 to 6 months in a mono or combination therapy format. In patients with gland hyperplasia, a decrease in the level of prostate specific antigen has been clinically proven, compared to baseline, by 50 percent after two weeks from the start of the drug.

The same indicators were observed in patients with the carcinogenic form of the disease.

With prolonged therapy to the active component does not occur addiction, and its effectiveness is not reduced. Used by adult males, including the elderly.

Contraindications and side effects

Of the contraindications for use are noted:

  • individual intolerance to the active substance;
  • From the special instructions for use it follows that dutasteride is well absorbed through the skin, therefore it is impossible to extract the contents from the capsules and to protect children and women who are at any time during pregnancy from getting it onto the mucous membranes and skin.

Scientifically based and confirmed data were obtained that Avodart, containing dutasteride, causes anomalies of the genitals in boys in the prenatal phase.

For the period of treatment, partners are recommended to refrain from unprotected sexual intercourse, since even 6 months after the end of the drug intake, sperm contains residual amounts of dutasteride, and there is no absolutely accurate evidence that sperm is not absorbed into the female genital tract during contact

reasonably apply, or completely refuse to take in case of liver diseases;
Before starting treatment, it is necessary to exclude malignant neoplasms of prostate tissue, and already in the course of treatment – to control the level of a specific prostate antigen.

Of the side effects may be the following:

    • a significant decrease in sexual desire, erectile dysfunction, impotence, impaired control over the function of ejaculation;
    • gyrsorutism, gynecomastia;
    • individual intolerance to the components in the form of allergic manifestations;
    • when taking the combined options, which contain adrenaline blockers, it is necessary to control the work of the heart, as the risk of side effects increases.

The frequency of manifestations of adverse events is directly related to the individual characteristics of each individual organism and the duration of the course of administration – the longer the application time, the more likely the risk of undesirable effects.

⚠However, it has been proven that even when the dose is exceeded many times, for those who normally tolerate Dutasterid, no side effects have occurred.⚠

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 Other names for this medication :  Abaglin, Algia, Alidial, Alpentin, Apo-gab, Bapex, Blugat, Bosrontin, Brilian, Dineurin, Edion, Epiven, Epleptin, Equipax, Gabadoz, Gabagamma, Gabahasan, Gabahexal, Gabalept, Gabalich, Gabamerck, Gabanet, Gabaneural, Gabantin, Gabapen, Gabapentina, Gabapentine, Gabapentinum, Gabapin, Gabaran, Gabaront, Gabastad, Gabatal, Gabatem, Gabateva, Gabatin, Gabatine, Gabator, Gabatur, Gabax, Gabental, Gabentin, Gabex, Gabexal, Gabexine, Gabictal, Gabin, Gabiton, Gaboton, Gabrion, Gabtin, Gabture, Galepsi, Ganin, Gantin, Gapentek, Gapentin, Gapridol, Garbapia, Gatilox, Gordius, Kaptin, Katena, Logistic, Medivapom, Mirgy, Mycovit-gb,  Nepatic,  Neugabin,  Neurexal,  Neuril,  Neurogabin,  Neuropen,  Neuros, Neurostil, Neurotin, Nopatic, Normatol, Nupentin, Nurabax, Pendine,  Progresse,  Rangabax,  Ritmenal,  Semerial,  Symleptic,  Tebantin,  Ultraneutral, Yalipent, Zincobal-g.

Active Ingredient: Gabapentin
▻ Neurontin is used for treating seizures associated with epilepsy.

Each tablet contains 600 mg or 800 mg of gabapentin, as well as auxiliary substances: corn starch, talc, magnesium stearate, copovidone, hypolase, poloxamer 407, polishing wax, white “Opadray”.

Capsules contain 100, 300 or 400 mg of gabapentin and excipients: corn starch, lactose, talc.

Form of issue
The drug Neurontin is available in the following forms:

➢ Capsules of 100 mg, 300 mg and 400 mg; outside the capsule, white (100 mg), light yellow (300 mg) or gray-orange (400 mg), with a blue or gray inscription (name of the drug, amount of active substance and “PD”), inside a white or almost white powdery substance;

➢ Tablets coated with a white coating, 600 mg and 800 mg, elliptical, with the inscription black (600 mg) or orange (800 mg) color.

Pharmachologic effect
Medication Neurontin refers to anticonvulsants, antiepileptic drugs.

Pharmacodynamics and pharmacokinetics
Gabapentin, the active substance of Neurontin, is able to prevent convulsions.

Gabapentin is similar in structure to GABA, but does not affect its metabolism. Once in the body, it combines with the alpha-2-beta subunits of voltage-dependent calcium channels, which leads to a decrease in the flow of calcium ions and a decrease in the likelihood of developing neuropathic pain.

Also, gabapentin reduces the level of glutamate-dependent death of nerve cells, increases the formation of GABA, reduces the release of neurotransmitters of the monoamine group.

The maximum level of bioavailability is 60%, but it decreases with increasing dose. The maximum concentration in the blood plasma is achieved 2-3 hours after taking the medication. Gabapentin almost does not bind to plasma proteins (no more than 3%).

The half-life is approximately 5-7 hours, regardless of the dose taken. It is excreted from the body in an unmodified form solely due to the work of the kidneys.

Indications for use
The use of Neurontin is indicated in such cases:

⓵ Neuropathic pain (medication can be prescribed only to persons who have reached the age of 18);
⓶ partial seizures, regardless of the presence of secondary generalization (can be taken from 3 years as an addition to the main treatment, with 12 – as a monotherapy).

It is forbidden to prescribe Neuronthin:

➣ children under 3 years;
➣ with hypersensitivity to gabapentin.
Care must be taken when treating elderly patients or with kidney failure.

Side effects
Treatment with Neurontin can cause side effects on the part of most organs and body systems:

➲ digestive system: stool disorders, flatulence, nausea and vomiting, dry mouth, abdominal pain, dental disease, a sharp decrease or increase in appetite;
➲ general condition: weakness, headaches, flu-like syndrome, pain in various parts of the body, edema on the peripheral parts of the limbs and face, weight gain, fever, reduced resistance to viral infections;
➲ nervous system: memory, speech, thinking, gait, sensitivity, confusion, drowsiness, dizziness, tremor, depression, sudden mood swings, insomnia, hostility;
➲ respiratory system: dyspnea, hypersensitivity to infectious diseases of the respiratory system;
➲ skin: a rash, itching;
➲ cardiovascular system: vasodilation, increased blood pressure;
➲ hematopoiesis system: leukopenia, bruising, purpura;
➲ musculoskeletal system: pains in the joints, spine, muscles, propensity to fractures.

Neurontin, instructions for use (Method and dosage)
The medicine is taken orally during a meal or at any other time.

Scheme of treatment of neuropathic pain in adults:

⊳ the first day – 1 reception of 300 mg of a medicine;
⊳ the second day – 2 receptions of 300 mg;
⊳ the third day – 3 doses of 300 mg; in some cases, this dosage is prescribed ⊳ from the very beginning;
The next days – the dose depends on the effect and condition of the body – it is either left unchanged or gradually increased (the maximum dose is 3.6 g per day).
Dosage in the treatment of partial seizures in patients aged 12 years is selected according to a scheme similar to that described above. In order to prevent the resumption of seizures, care must be taken to ensure that the interval between doses of the drug does not exceed 12 hours.

Features of treatment of partial seizures in children 3-12 years:

⊳ the required dose is calculated according to the weight of the child;
⊳ from the first day a three-time appointment is appointed, with intervals of no more than 12 hours;
⊳ the initial dose is 10-15 mg / kg per day;
⊳ within three days, the dose from the initial is increased to effective;
⊳ effective dose: in 3-5 years – 40 mg / kg during the day; in 5-12 years – 25-35 mg / kg / day.
If there is a kidney failure, the dosage can be reduced. When correcting, it is necessary to focus on the creatinine clearance.

The appearance of such symptoms may indicate overdose:

▶ dizziness;
▶ unclear or confused speech;
▶ double vision in the eyes;
▶ drowsiness, even before the development of lethargic sleep;
▶ diarrhea.
In case of an overdose, measures should be taken to remove symptoms. If a person does not work well enough kidneys, especially in severe forms of kidney failure, hemodialysis is indicated.

The joint administration of Neurontin with other medications does not cause clinically significant reactions on the part of the body or changes in the mechanism of action of the drugs.

If a person takes antacids that contain aluminum and magnesium, it is desirable to maintain a gap of at least 2 hours between taking this drug and Neurontin. Alternatively, the bioavailability of gabapentin may decrease by approximately 20%.

With simultaneous application with Morphine, the pain threshold may be increased, but this phenomenon is not of great clinical significance. Very rarely with this combination, if the doses of Morphine and Neurontin are high, drowsiness appears. In this case, you need to reduce the dosage of one of the drugs.

Storage conditions
Keep in a cool, inaccessible place for children.

Shelf life
Shelf life of tablets – 2 years, capsules – 3 years.

Special instructions
When treating elderly people and patients with renal insufficiency, it is desirable to reduce dosage. If the patient undergoes hemodialysis, it should be noted that in this procedure gabapentin is well excreted from the plasma, so there may be a need for dose adjustment.

It is undesirable to drive vehicles or work with mechanisms that move during therapy with Neurontin.

To cancel a medicine or reduce a dose it is necessary gradually. A sharp decrease in the dose in most cases causes insomnia, sweating, anxiety, a feeling of nausea, pain in different parts of the body, sometimes convulsions.

In pregnancy and lactation
Data on the safety and efficacy of the drug during pregnancy or during breastfeeding is not enough to arrive at a final conclusion. Therefore, he is appointed only when there is a very high risk for a woman’s health.

In breast milk of women who are being treated with Neurontin, gabapentin is found. As it affects the child, it is unknown, therefore, feeding should be stopped.

Information about medicines on the site is a reference-generalizing, collected from public sources and can not serve as a basis for making a decision about the use of medications in the course of treatment. Before using the drug Neurontin necessarily consult with your doctor.⚠

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Buy Apcalis SX 20 mg cheapest online 4.6/5 (5)

Discount 10%.
Other names for this medication:
Adcirca, Snafi, Zydalis.

Apcalis SX 20 mg
Are available
The drug is manufactured in India by Ajanta Pharma Ltd. Effective for 36 hours; the effect occurs approximately 30 minutes after ingestion. The main active ingredient is Tadalafil 20 mg. Form release – tablets in a blister. Possible side effects; there are contraindications. Before use, read the instructions.

Ajanta Pharma Limited is an Indian pharmaceutical company that has released a new drug for the treatment of erectile dysfunction – Apcalis SX. At the moment, Apcalis is one of the most popular generics of Cialis. Sale of Apcalis is conducted in twenty-five countries of the world. The guarantor of the highest quality of the drug is that it is approved by US experts. In addition, the company itself Ajanta Pharma Ltd – a solid manufacturer with a worldwide reputation. It has a network of scientific laboratories, and all the funds released to it have undergone numerous studies and tests. Therefore, you can buy Apcalis with full confidence in the excellent result and safety.

Apcalis. Description of the preparation
So, Apcalis is a high-quality generic Cialis. It is produced by the same chemical formula as Cialis, has all the properties and effectiveness of the original and contains the same active substance – Tadalafil, belonging to the group of selective inhibitors. Its effect begins 30 minutes after oral administration and lasts about 36 hours.


The effect of the drug appears during a natural sexual stimulation, which causes the release of nitric oxide, a delay in the production of PDE-5. In the cavernous body of the penis, the level of cGMP increases. As a result, there is a relaxation of the smooth muscles of the vessels and the blood flow to the penis is activated, which causes an erection. Without sexual stimulation, these processes are not started. Admission of low-fat and not too abundant food does not affect the degree and level of absorption of Tadalafil.

When to take the Apcalis
The drug is taken in all forms and degrees of severity of erectile dysfunction. In addition, its safety and good tolerance make it possible to buy Apcalis and use it to prevent such disorders and to improve the quality of sexual intercourse.

Method of taking the drug
Tablets of Apcalis SX should be chewed well and washed down with a small amount of water or juice. Do not drink the product with grapefruit juice. Some of the substances that it contains are not combined with Tadalafil and can cause unpredictable consequences up to the symptoms of an overdose.

Fatty foods delay the process of absorption of the active substance into the blood. Alcohol dramatically reduces the sensitivity of the penis, so large doses of it should not be consumed with the drug. If you have a feast before sex, then you can afford a light dinner with a glass of wine.

The recommended initial dose of Apcalis is 10 mg. If it does not give the desired effect, then you can increase it to 20 mg. The interval between receptions of the remedy should not be less than 24 hours.

Contraindications to admission
Sale of Apcalis is carried out without prescriptions. But before taking the drug, you should consult your doctor to rule out possible contraindications.

The drug is contraindicated:

☞ with increased sensitivity to Tadalafil;
☞ multiple myeloma;
☞ sickle-cell anemia;
☞ leukemia;
☞ renal failure;
☞ any deformation of the penis;
☞ hepatic insufficiency;

Drug use is inadmissible by women and children under 18 years of age.

Use Tadalafil not together with the means containing nitrates, nitrogen oxides. The drug does not combine with ketoconazole, rifampicin, ritonavir, sancvinavir, erythromycin, intraconazole, and other means against erectile dysfunction.

In addition, care should be taken when taking the remedy for those who have suffered a stroke or myocardial infarction, who suffer from unstable blood pressure.

Side effects
Side effects with the use of Apcalis – a phenomenon, quite rare. But there may be: flushing to the face, dizziness or headache, myalgia, back pain, nasal congestion, nausea, indigestion, visual impairment (briefly), arrhythmia, painful erection, heart attack.

Overdose can occur if the maximum allowable dose is exceeded – 20 mg or a reduction in the time between doses – less than 24 hours. In this case, there may be pronounced side effects. If you notice such symptoms, immediately call a doctor who will wash the stomach, cleanse the blood from toxins and prescribe the necessary treatment.

Buy Apcalis in a pharmacy online is more convenient and profitable.

It is much more convenient than in a typical city pharmacy, because:
no need to go anywhere. This saves time. It is enough to call the phone indicated on the site, or fill out the proposed order form and simply wait for the delivery of the purchase by mail or courier, doing your own business;
online purchase involves complete confidentiality, which can not be achieved with a purchase in a city pharmacy, where there are always other customers behind you. If you decide to order Apcalis online, then you will only deal with one manager by phone or by feedback form. If necessary, you will receive any advice from him.

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