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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).

▫ In case of violation of the excretory function of the kidneys, correction of the dosage regimen is necessary: ​​when the concentration of creatinine in the blood is 120-250 μmol / l, 15 mg / kg 2 times a day; 250-500 µmol / l – in the same single dose 1 time per day; more than 500 µmol / l – 7.5 mg / kg 1 time per day.

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Active Ingredient: Pantoprazole.

Other names for this medication:
Aciban, Acipan, Anagastra, Anesteloc, Anulacid, Apazol, Apton, Caprol, Ciproton, Contix, Contracid, Controloc, Cool pan, Digene, Eupanol, Eupantol, Fulpan, Gastromax, Gastroprozal, Gastrowell, Hasanloc, Inipomp, Kuppam, Leminter, Loxid, Lupipan, Natrii pantoprazolum, Newpan, Noacid, Nolpaza, Normocid, Oritop, Ozepran, Pacid, Palio, Panbloc, Pandev, Pandon, Pangest, Panloc, Panopaz, Panpac, Panpot, Panpra, Panprabene, Panpro, Panprozole, Pansa, Pansafe, Pansec, Pantabol, Pantac, Pantacid, Pantact, Pantagon, Pantaz, Pantecta, Panthec, Pantid, Pantin, Pantip, Pantium, Panto, Panto basics, Panto-byk, Pantobex, Pantoc, Pantocal, Pantocalm, Pantocar, Pantocas, Pantocid, Pantocip, Pantodac, Pantodar, Pantofin, Pantogamma, Pantogen, Pantoloc, Pantolup, Pantonis, Pantonix, Pantop, Pantopan, Pantopaz, Pantopep, Pantopra, Pantoprazol, Pantoprazolum, Pantoprem, Pantor, Pantorc, Pantosec, Pantosil, Pantotab, Pantozol, Pantozole, Pantpas, Pantra, Pantrafar, Pantry, Pantul, Pantus, Panum, Panz, Panzo, Panzol, Penkool, Penta, Pentagon, Pentalink, Pentastar, Pentium, Pentozed, Pents, Pepcinova, Pepmark, Peptac, Peptazol, Pepticool, Pepzol, Pms-pantoprazole, Pole, Prasocid, Prazocid, Prazolan, Prazosan, Prazotel, Progen, Proloc, Prolus-dsr, Propanta, Propanz, Protin-p, Protium, Protonex, Protonil, Pulcet, Razon, Regad, Rifun, Segregam, Singastril, Sipar, Sunpraz, Supracam, Tecta, Tifizol, Tonval, Topan, Topra, Topraz, Topzole, Tropaz, Trupan, Ugarpan, Ulcemex, Ulcepraz, Ulcoreks, Ulcotenal, Ulrid, Unigastrozol, Zacpac, Zanpan, Zepoxin, Zimpax, Zipant, Zipantola, Ziprol, Zolpanz, Zoltex, Zovanta, Zovanta-40, Zurcal, Zurcale, Zurcazol.

Composition

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

Pharmacodynamics
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.

Pharmacokinetics
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.

Contraindications

☛hypersensitivity to the drug;
☛hepatitis;
☛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.

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

Interaction
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
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.

Instruction
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.

Composition
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.

Pharmacokinetics
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).

Contraindications
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.

Overdose
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.

Interaction
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.

⚠NOTE!
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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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.

Apcalis

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
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.

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It is much more convenient than in a typical city pharmacy, because:
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Fildena 100 – tablets to strengthen potency based on sildenafil

One of the most popular and modern means for correcting erectile dysfunction is the Fildena 100 preparation. This effective and safe remedy is prescribed for men of any age and with varying degrees of severity of erectile dysfunction. To buy tablets to improve the potency of Fildena 100 is also recommended in case a man can not only reach, but also keep an erection long enough for full sexual intercourse.

As an active ingredient, this drug comprises a Sildenafil substance in the amount of one hundred milligrams. Sildenafil belongs to the class of substances that inhibit phosphodiesterase. Elimination of erectile dysfunction and persistent erection is due to the fact that when the onset of stimulation the drug contributes to a powerful blood flow to the penis of a man. Tablets for the potency of Fildena 100, buy and which is recommended only after consultation with a doctor, can be used both once, and by the course, with individually set dosage. It is also important to take into account the general state of health and the existing diseases. Order Fildena 100 can safely and those who are planning a healthy offspring, because the drug does not affect the motility of sperm and male sex hormones.

From this popular brand, we also recommend to consider the drug Fildena Super Active, released in the form of capsules, which is much faster and better absorbed.

Main characteristics of the drug Fildena 100
Full name of the drug Fildena 100 Sildenafil Citrate Tablets 100 mg. The manufacturer is a well-known Indian enterprise specializing in the production of high-quality medicines, Fortune Health Care.

The dosage of 100 milligrams in which the drug is released is standard, intended for a one-day daily intake. Take the tablet inside whole, it is recommended to drink with plain water. The effect of taking Fildena 100 mg occurs on average 45-50 minutes. The duration of the drug is about 4-5 hours. In this interval, a man can perform sexual intercourse. Do not be afraid of manifestations of uncontrolled erection – it will appear only under the condition of sexual stimulation and stimulation.

It should be noted that Fildena 100 has certain contraindications and is not taken with alcoholic drinks and certain medicines, for example, organic nitrates, alpha and beta blockers, a number of antifungal and antiviral agents. Grapefruit juice can increase the level of active substance and contribute to the appearance of side effects.

Contraindicated remedy for those who have severe diseases of the cardiovascular system, serious diseases of the liver and kidneys, suffers from instability of blood pressure, allergic reactions, hereditary diseases of the eyes or diabetes.

In general, Fildena 100 is well tolerated, but sometimes headaches, nausea, manifestations of rhinitis, diarrhea, ringing in the ears, photosensitivity are possible.

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Other names for this medication :
Baycip, Cifran, Ciloxan, Ciprofloksacin, Ciprofloxacina, Ciprofloxacinum,  Ciprofloxin, Ciproxin, Ciproxina, Ciriax, Floxelena, Kensoflex, Lucipro,  Novidat.

Cipro
Active Ingredient: Ciprofloxacin

Form of issue

Eye and ear drops 0,3%.
Concentrate for infusion therapy 2 mg / ml.
Pills coated with a film coat 250 mg, 500 mg, 1000mg and 750 mg.
Ointment ophthalmic 0,3%.

Composition

Ear and eye drops of Ciprofloxin contain Ciprofloxin hydrochloride at a concentration of 3 mg / ml (in terms of a pure substance), Trilon B, benzalkonium chloride, sodium chloride, purified water.

In the ophthalmic ointment, the active substance is also contained in a concentration of 3 mg / ml.

Pills Ciprofloxin: 250, 500,  and 750 mg 1000mg mg Ciprofloxin, MCC, potato starch, corn starch, hypromellose, croscarmellose sodium, talc, magnesium stearate, colloidal anhydrous silica, macrogol 6000, additive E171 (titanium dioxide), polysorbate 80.

The infusion solution contains the active substance at a concentration of 2 mg / ml. Excipients: sodium chloride, edetate disodium, lactic acid, dilute hydrochloric acid, water d / u.

 Pharmachologic effect

Bactericidal.

↘ Pharmacodynamics and pharmacokinetics ↙

Ciprofloxin is an anti-biotics or not?
Antibiotic Ciprofloxin is an early fluoroquinolone (1st generation drug) and is used primarily for hospital infections. The agent penetrates well into cells and tissues (including cells of bacteria and macroorganisms) and has good pharmacokinetic parameters.

➡ Pharmacodynamics

The mechanism of action of the drug is due to the ability to inhibit DNA-gyrase (enzyme of bacterial cells) with a violation of DNA synthesis, division and growth of microorganisms.

Wikipedia indicates that against the background of the use of the drug, resistance to other non-group inhibitors of gyrase, antibiotics is not developed. This makes Ciprofloxin highly effective against bacteria resistant to the action of penicillins, kaminoglikozidov, tetracyclines, cephalosporins and a number of other antibiotics.

The most active activity is with Gram (-) and Gram (+) aerobes: 

H. influenzae, N. gonorrhoeae, Salmonella spp., P. aeruginosa, N. meningitidis, E. coli, Shigella spp.

Effective in infections caused by: strains of staphylococci (including those producing penicillinase), individual strains of enterococci, legionella, campylobacteria, chlamydia, mycoplasmas, mycobacteria.

It is active against the producing beta-lactamase microflora.

Anaerobes are moderately sensitive or resistant to the drug. Therefore, in patients with mixed anaerobic and aerobic infections, Ciprofloxin treatment should be supplemented with the administration of lincosamides or metronidazole.

Resistant to the antibiotic are: Ureaplasma urealyticum, Streptococcus faecium, Treponema pallidum, Nocardia asteroides.

➡ Pharmacokinetics

After taking the pill, the drug is quickly and completely absorbed in the digestive tract.

Main pharmacokinetic parameters:

▶ bioavailability – 70%;
▶ TSmax in blood plasma – 1-2 hours after administration;
▶ T½ – 4 hours.

Plasma proteins bind from 20 to 40% of the substance. Ciprofloxin is well distributed in body fluids and tissues, and its concentration in tissues and liquids can significantly exceed the plasma one.

Through the placenta penetrates the cerebrospinal fluid, excreted into breast milk, high concentrations are fixed in the bile. Up to 40% of the dose taken is eliminated within 24 hours in unchanged form by the kidneys, part of the dose is excreted with bile.

➡Indications for use Ciprofloxin

Ciprofloxin – from what these pills / solution?

Ciprofloxin is prescribed for the treatment of infectious diseases of the ENT organs, pelvic organs, bones, skin, joints, abdominal cavity, respiratory tract, urogenital and postoperative infections caused by a flora sensitive to the drug.

The drug can be used in patients with immunodeficiency states (including in conditions that develop with neutropenia, or due to the use of immunosuppressors).

Ciprofloxin (like other early fluoroquinolones) is the preferred drug in the treatment of UTI, including, among others, hospital infections.

Due to the ability to penetrate well into tissues and, in particular, into prostate tissue, fluoroquinolones have practically no alternative in the treatment of bacterial prostatitis.

Being highly active against the most likely pathogens of hospital pneumonia (Staphylococcus aureus, enterobacteria and Pseudomonas aeruginosa), it is important for pneumonia associated with the need for artificial ventilation.

If the causative agent of the disease is P. aeruginosa, before prescribing the drug, its sensitivity to Ciprofloxin should be established. This is due to the fact that in intensive care units more than a third of the Pseudomonas aeruginosa strains are resistant to the drug.

Importance of the drug has with intra-abdominal surgical infections and infections of the hepatobiliary system. To prevent infection, he can be assigned to a patient with pancreatic necrosis.

Fluoroquinolones are not used for CNS infections. This is due to their low penetration (penetration) into the cerebrospinal fluid. In this case, they are effective in meningitis, the causative agents of which are resistant to cephalosplorins of the third generation of Gram (-) bacteria.

The presence of several dosage forms allows the use of the drug for the stepwise therapy. When switching from Ciprofloxin IV administration to oral intake in order to maintain therapeutic concentration, the dose for oral administration should be increased.

So, if the patient was prescribed the administration of 100 mg intravenously, then he should take 250 mg inside, and if 200 mg was administered to the vein, then 500 mg.

What is the medicine in the form of eye / ear drops?
In ophthalmology it is used for superficial bacterial infections of the eye (eye) and its appendages, as well as for ulcerative keratitis.

Indications for use Ciprofloxin in otology: acute bacterial otitis of the external ear and acute bacterial otitis of the middle ear in patients with a tympanostomy tube.

Contraindications
Contraindications in systemic application:

➲ hypersensitivity;
➲ pregnancy;
➲ lactation;
➲ severe renal / hepatic dysfunction;
➲ indications of a history of chronic tendonitis caused by the use of  quinolones.

Drops for eyes and ears are contraindicated in fungal and viral infections of the eyes / ears, with intolerance to Ciprofloxin (or other quinolones), during pregnancy and lactation.

For children, pills and a solution for intravenous administration can be prescribed from the age of 12, eye and ear drops from 15 years.

▶ Side effects
The drug is good tolerability.

The most common side effects with intravenous administration and ingestion:

➲ dizziness;
➲ fatigue;
➲ headache;
➲ tremor;
➲ excitation.

In Vidal’s handbook it is reported that in single cases the patients were recorded:

➲ sweating;
➲ violation of gait;
➲ peripheral sensory disorders;
➲ tides;
➲ intracranial hypertension;
➲ depression;
➲ feeling of fear;
➲ visual impairment;
➲ flatulence;
➲ stomach ache;
➲ indigestion;
➲ nausea, vomiting;
➲ diarrhea;
➲ hepatitis;
➲ necrosis of hepatocytes;
➲ tachycardia;
➲ arterial hypertension (rarely);
➲ itching;
➲ the appearance of rashes on the skin.

Exceptionally rare side effects: bronchospasm, anaphylactic shock, Quincke’s edema, arthralgia, petechiae, malignant erythema exudative, vasculitis, Lyell’s syndrome, leuko- and thrombocytopenia, eosinophilia, anemia, hemolytic anemia, thrombotic or leukocytosis, increased plasma LDH concentration, bilirubin, LF, transaminase of the liver, creatinine.

Application in ophthalmology is accompanied by:

⓵. often – a sense of discomfort and / or foreign body presence in the eye, the appearance of white plaque (usually in patients with ulcerative keratitis and with frequent use of drops), the formation of crystallites / scales, supergiosis and conjunctival hyperemia, tingling and burning;

⓶. in isolated cases – keratitis / keratopathy, eyelid edema, corneal staining, hypersensitivity reactions, lacrimation, decreased visual acuity, photophobia, corneal infiltration.

Side effects that are associated with or possibly related to the use of the drug are usually mild, do not pose a threat and go untreated.

In patients with ulcerative keratitis, the emerging white coating does not adversely affect the treatment of the disease and the parameters of vision and disappears on its own. As a rule, it appears in the period from 1-7 days after the beginning of the course of application of the drug and disappears immediately or within 13 days after its termination.

Neofthalmological disorders when using drops: the appearance of an unpleasant aftertaste in the mouth, in rare cases – nausea, dermatitis.

When used in otology, the following are possible:

  • often – a run-off in the ear;
  • in some cases – ringing in the ears, headache, dermatitis.

Pills Ciprofloxin: instructions for use

The daily dose for an adult varies from 500 mg to 1.5 g / day.  It should be divided into 2 receptions with an interval of 12 hours.
To prevent the crystallization of salts in the urine, the antibiotic should be taken with a large volume of liquid.

A single dose is selected depending on the diagnosis:

☞ urogenital infections – from 2 * 250 to 2 * 500 mg with uncomplicated acute, from 2 * 500 to 2 * 750 mg with complicated;
☞ cystitis in women before menopause – 500 mg (once);
☞ infection of the respiratory tract (depending on the pathogen and severity of the disease) – from 2 * 500 to 2 * 750 mg;
☞ gonorrhea – 500 mg once for acute uncomplicated and from 2 * 500 to 2 * 750 mg mg, if the patient is diagnosed with an extragenital form of the disease, and also in cases when the disease occurs with complications;
☞ joint and bone lesions, severe, life-threatening patients, infections, septicemia, peritonitis (in particular, in the presence of Pseudomonas,   Streptococcus or Staphylococcus) – 2 * 750 mg;
☞ gastrointestinal infections – from 2 * 250 to 2 * 500 mg;
Inhalation form of anthrax – 2 * 500 mg;
prevention of invasive infections caused by N. meningitidis – 1 * 500 mg.

The treatment continues until clinical symptoms stop, and a few more days after their disappearance and the normalization of body temperature. In most cases, the course lasts from 5 to 15 days, with lesions of joints and bone tissue it is prolonged to 4-6 weeks, with osteomyelitis – up to 2 months.

Patients with renal dysfunction require a dose adjustment and / or duration of the interval.

Application of ampoules
Ciprofloxin in ampoules is recommended to be administered intravenously in the form of a drop infusion. The dose for an adult is 200-800 mg / day. The duration of the course is on average from 1 week to 10 days.

With urogenital infections, joints and bones or ENT disorders, a patient is administered 200-400 mg twice a day during the day. With infections of the respiratory tract, intra-abdominal infections, septicemia, soft tissue and skin lesions, a single dose at the same multiplicity of applications is 400 mg.

With kidney dysfunction, the starting dose is 200 mg, and subsequently it is adjusted for Clcr.

In the case of the use of ampoules in a dose of 200 mg, the duration of the infusion is 30 minutes, with the administration of the drug at a dose of 400 mg – 1 hour.

Ciprofloxin injections are not prescribed.

Ear and Eye Drops Ciprofloxin: Instructions for Use
With ulcerative keratitis, the treatment is carried out according to the following scheme:

✹ ➊ day – during the first 6 hours of the conjunctival cavity is administered 2 drops of the solution every 15 minutes, then the interval between instillation increased to half (a single dose of the same – 2 drops);
✹ ➋ days – 2 drops with an interval between instillations of 60 minutes;
3-14 days – 2 drops with an interval between instillations of 4 hours.
Treatment for ulcerative keratitis can last longer than 14 days. The treatment plan is selected individually by the attending physician.

With superficial bacterial infections of the eye and its appendages, the standard dose is 1-2 drops with a multiplicity of applications of 4 r. / Day. In especially severe cases, in the first 48 hours the patient is instilled with 1-2 drops every 2 hours.

Treatment lasts from 7 to 14 days.

After instillation, a nasolacrimal occlusion is recommended to reduce systemic absorption of the drug administered into the eye.

In the case of concomitant treatment with other drugs for ophthalmic topical use should withstand 15-minute time intervals between their administration and administration of Ciprofloxin.

In otology, the standard dose of the drug is 4 drops in the previously cleared auditory canal of the affected ear 2 r. / Day.

Patients who use ear pads, the dose is increased only with the first use of the drug: children are administered 6, adults – 8 drops.

The course should not last more than 10 days. If it is necessary to extend it, determine the sensitivity of the local flora.

In case of using other agents for topical application between their administration and administration of Ciprofloxin, it is necessary to maintain an interval of 10-15 minutes.

Dosage for children from 15 years: 3 drops twice a day.

The effect of renal / hepatic dysfunction on the pharmacokinetic parameters of the drug in the form of ear and eye drops has not been studied.

To avoid vestibular stimulation, the solution is warmed to body temperature before insertion into the auditory canal.

The patient should lie on the opposite side of the affected ear. In this position, it is recommended to stay for 5-10 minutes after instillation of the solution.

It is also permissible after local cleaning to insert for 1-2 days in the ear canal a tampon moistened with a solution of hygroscopic cotton wool or gauze. To saturate the drug, it should be moistened twice a day.

To avoid contamination of the tip of the dropper bottle and the solution, do not touch the dropper to the eyelids, the pinna, the external auditory canal, outdoor areas and any other surfaces.

Additionally

Fundamental difference in how to take drugs from different manufacturers, no:    instructions for use Ciprofloxin-Akos similar to the instructions on the Ciprofloxin-FPO, Ciprofloxin, Promed, Vero Ciprofloxin or Ciprofloxin-Teva.

For children and adolescents under the age of 18, the drug should be prescribed only if the pathogen is resistant to other chemotherapeutic agents.

▶ Overdose
Specific symptoms with an overdose of Ciprofloxin not. The patient is shown gastric lavage, taking emetic drugs, creating an acidic urine reaction, introducing a large volume of fluid. All activities should be conducted against the backdrop of maintaining the function of vital systems and organs.

Peritoneal dialysis and hemodialysis contribute to the elimination of 10% of the dose.

There is no specific antidote for the drug.

▶  Interaction
The use in combination with Teofillinum promotes an increase in plasma concentration and an increase in T1 / 2 of the latter.

Al / Mg-containing antacids help to slow the absorption of Ciprofloxin and thereby reduce its concentration in urine and blood. Between the methods of these drugs should be maintained intervals of at least 4 hours.

Probenecid delayed excretion of the drug.

Ciprofloxin increases the effect of coumarin anticoagulants.

The interaction of Ciprofloxin for use in otology and ophthalmology with other drugs has not been studied.

▶ Storage conditions

Store the drug at room temperature, in a place inaccessible to children.

▶ Shelf life

For solution, ear and eye drops – 2 g (the contents of the opened vial should be used for 28 days), for pills – 3 g.

▶ Special instructions

Because of the possibility of occurrence of side effects from the side of the central nervous system in patients with a history of its pathology, the drug can be used exclusively for life indications.

Ciprofloxin is cautiously prescribed when lowering the threshold of convulsive readiness, epilepsy, brain damage, severe cerebrosclerosis (increased risk of blood flow and stroke), serious violations of the liver / kidney function, in old age.

During treatment it is recommended to avoid UV and solar irradiation and increased physical activity, to control urine acidity and drinking regimen.

In patients with an alkaline urine reaction, cases of crystalluria were recorded. To avoid its development, it is inadmissible to exceed the therapeutic dose of the drug. In addition, the patient requires a lot of drinking and maintaining an acid reaction of urine.

Pain in the tendons and the appearance of signs of tendovaginitis are a signal to stop treatment, as the possibility of inflammation / rupture of the tendon is not ruled out.

Ciprofloxin can inhibit the rate of psychomotor reactions (especially against the background of alcohol), which should be remembered for patients working with potentially dangerous devices.

With the development of severe diarrhea, pseudomembranous colitis should be ruled out. this disease is a contraindication to the use of the drug.

If necessary, simultaneous in / in the introduction of barbiturates should monitor the function of SSS: in particular, the parameters of ECG, heart rate, blood pressure.

The liquid ophthalmic form of the drug is not intended for intraocular injections.

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♀ Female Sildenafil 100 mg. Buy a female agent with delivery. According to statistics, about 40-45% of women have sexual disorders, and 10% of women have never experienced orgasm during sexual intercourse.

Indications for use: increased female libido
Active substance: sildenafil
Lasts for: 4-6 hours
Compatibility with alcohol: not compatible

♀ Sexual dysfunctions, manifested in the absence or decrease of sexual desire, in painful sensations and inability to receive full pleasure from sex, do not allow a woman to lead a normal sexual life.

Violation of sexual function is a serious problem for women, not only from the physiological, but also from the psychological point of view, as self-esteem decreases, complexes arise and even rejection of intimacy is formed.

The mechanism of excitation in women is more complex than that of men, so the reason for the development of such disorders often has a psychological or emotional background.

This significantly complicates the development of drugs that increase the sexual activity of women and restore her the ability to experience vivid feelings.

♀ However, this drug has already been createdLady era (Female Viagra), designed to take into account the characteristics of the woman’s body.

This is a completely new unique drug, tested in practice, which increases sensitivity, helps to get rid of anorgasmia and enhances sexual pleasure.

♀ Storage
The preparation should be stored in its packaging at room temperature.

It is necessary to protect it from heat, light and moisture, as well as from small children.

♀ Contraindications
Some patients may be endowed with hypersensitivity to sildenafil or other components of the drug. It is also not recommended to use together with other possible means for the treatment of erectile dysfunction in males or similar problems in women, since the possible results of such interactions and combinations are not fully understood.

You can not use Viagra also for patients who constantly or from time to time receive organic nitrates, nitrites or donators of nitric oxide. The fact is that the sildenafil component can enhance the hypotensive nitrate effect.

With caution take this drug people with diseases that predispose to the development of priapism – it can be multiple myeloma, thrombocythemia, leukemia, sickle cell anemia. The same applies to diseases accompanied by heavy bleeding, exacerbation of peptic ulcer, pigmentary hereditary retinitis, heart failure, arterial hypertension.

If the patient has suffered a heart attack in the last six months, taking this medication is also not recommended.

It is forbidden to use Viagra for children under the age of 18 years.

♀ Side effects
Strongly expressed and strong side effects of the drug Viagra, as a rule, does not happen. If they are, they are weak enough and soon pass. This can be a violation of the general condition of the body: skin rash, seizures, epistaxis, fainting, vomiting. But this phenomenon is quite rare.

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NPHL in the capsules

NPHL consists of natural herbs, improves and restores blood flow to the genitals, gives the man a lot of strength and self-confidence and unforgettable insights from a healthy and prolonged erection, when your penis is 50% larger than before then and the level of self-esteem rises, which contributes to rapid restoration and strengthening of a sexual life.

Apply herbal NPHL one capsule in the morning and one capsule in the evening with milk.

The initial course of taking NPHL capsules is from forty to forty-five days, but one must understand that the longer NPHL capsules are taken, the more chances of complete penis enhancement, the enjoyment of a healthy erection during intercourse and a full, vigorous, sexual life!

Precautionary measures 

NPHL consists of natural ingredients, so the drug does not harm the body, but before use, you need to consult a specialist especially who uses other drugs.

NPHL begins to act about thirty minutes after admission

Customers who bought this product also bought:

Motilium, cialis, bentyl, levothroid, lisinopril, lady era, cipro, fildena, apcalis sx, neurontin, dutas, protonix, indinavir, cyklokapron.

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