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Vega Extra Cobra (sildenafil citrate)

Vega Extra Cobra (sildenafil citrate)

$ 1.02 per pill

Quick Overview

Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Extra Vega, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk. In patients with episodes of development PINZN with loss of vision in one eye receiving Extra Vega is contraindicated (see "Contraindications").

Vega Extra Cobra® (Signature)

Vega Extra Cobra (Sildenafil citrate) 120 mg

Vega Extra Cobra
Sildenafil citrate
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Information

Cardiovascular complications

During the post-marketing use of Sildenafil Vega Extra 120 for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Vega Extra Cobra. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Vega Extra Cobra 130 Mg without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Vega Extra Cobra 130 Mg, reported NESN is a rare disease and the cause of the decrease or loss of vision. Most of these patients had risk factors, such as decreased ratios of excavation diameter to optic disc (stagnant disc), age over 50, diabetes, hypertension, CHD, hyperlipidemia, and Smoking. In an observational study evaluated whether recent use of drugs class of inhibitors PDE-5 with an acute onset NESN. The results indicate approximately a 2-fold increase in risk of developing NESN within 5T1/2 after application of the PDE-5 inhibitor. According to published literature, the annual incidence of npins IS 2.5–11.8 cases per 100,000 men aged ≥50 years in the General population. Patients should be advised to stop Vegah Extra 120 Indication therapy in case of sudden loss of vision and consult a doctor immediately. Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Vegal Extra, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Vega Extra Cobra 130 Mg in doses exceeding the recommended, adverse events were similar to those noted above, but usually more common.

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Vega Visa

The metabolism of Cobra Vega occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Sildenafil Vega Extra 130 Mg Cobra, and inducers, respectively, increase the clearance of Vega Extra Cobra 130 Mg. A decrease in the clearance of Vega Extra Cobra 130 Mg with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Vega Extra Cobra 130 Mg (50 mg) causes an increase in the concentration of Vega Extra Cobra 120 in plasma by 56%.

A single dose of 100 mg of Vega Extra Cobra 130 Mg together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Vega Extra Cobra 130 Mg by 182%.

When co-administered Cobra Vega Extra (once 100 mg) and saquinavir (1200 mg/day 3 times daily), an inhibitor of HIV protease and of CYP3A4, on the background to achieve a constant concentration of saquinavir in the blood, Cmax of Cobra Vega Extra Strong 120 Mg was increased by 140% and the AUC increased by 210%.

Stronger inhibitors of CYP3A4 isoenzyme, such as ketoconazole and Itraconazole, can cause more pronounced changes in the pharmacokinetics of Vega Extra Cobra 130 Mg.

The simultaneous use of Vega Extra Cobra 130 Mg (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Vega Extra Strong 120 by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Vega Extra Cobra 130 Mg in blood plasma is about 200 ng/ml (after a single application of one Vega Extra Cobra 130 Mg — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Vega Extra Cobra 130 Mg does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Signature Cobra Vega is not recommended. In any case, the maximum dose of Vega Extra Cobra 130 Mg under any circumstances should not exceed 25 mg for 48 hours. If Vega Coin is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Vega Cobra 120 Mg does not exceed 200 nm, and the drug is well tolerated.

Single administration of antacid (magnesium hydroxide/aluminum hydroxide) does not affect the bioavailability of Vega Extra Cobra 130 Mg.

Studies involving healthy volunteers with simultaneous use of endothelin receptor antagonist, bosentan (CYP3A4 isoenzyme inducer (moderate), CYP2C9, and possibly CYP2C19) in Css (125 mg 2 times a day) and Cobra Vega in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Extra Vega by 62.6 and 52.4%, respectively. Cobra 120 Vega Extra increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Cobra Vega Extra Strong 120 Mg with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Vega Extra Cobra 130 Mg in blood plasma.

CYP2D6 isoenzyme inhibitors (SSRIs, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists have no effect on the pharmacokinetics of Sildenafil Vega Extra 130 Mg Cobra.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Vega Cobra or its main circulating metabolite.

Cardiovascular complications

During the post-marketing use of Vega Extra Cobra 130 Mg for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Vega Cobra 120 Mg. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Vegah Cobra without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Hypotension

Vega Extra Cobra 130 Mg has a systemic vasodilating effect, leading to a transient decrease in blood PRESSURE, which is not clinically significant and does not lead to any consequences in most patients. However, before prescribing Vegah Extra 130, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with the rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood PRESSURE from the autonomic nervous system.

Since the combined use of Vega Extra Cobra 130 Mg and α-blockers can lead to symptomatic hypotension in some sensitive patients, Vega Extra Cobra 130 Mg should be used with caution in patients taking α-blockers (see "Interaction"). To minimize the risk of postural hypotension in patients taking α-blockers, the drug Vega Extra should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Sildenafil Tablets Vega Extra Cobra (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

The pharmacokinetics of Vega Extra Cobra 130 Mg in the recommended dose range is linear.

Suction. After intake of Vegah Extra 130 is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Vegal Extra at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Vega Extra Cobra 130 Mg 100 mg average Cmax free Vega Extra Cobra 130 Mg in plasma men is about 18 ng/ml (38 nm). Cmax when taking Vega Extra Cobra 130 Mg inside fasting is achieved for an average of 60 minutes (from 30 to 120 minutes). When taken in combination with fatty foods, the rate of absorption decreases: Cmax decreases by an average of 29%, and Tmax increases by 60 minutes, but the degree of absorption does not change significantly (AUC decreases by 11%).

Distribution. The average Vss of Cobra 120 Vega Extra is 105 l. the Association of Vega Extra Cobra 130 Mg and its main circulating N-demethyl metabolite with plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the dose of Vega Extra Cobra 130 Mg (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Vega Extra Cobra 130 Mg is metabolized mainly in the liver by the action of CYP3A4 isoenzyme (main pathway) and CYP2C9 isoenzyme (minor pathway). The main circulating active metabolite, formed as a result of N-demethylation of Vegal Extra, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Vega Extra Cobra 130 Mg, and its activity against PDE-5 in vitro is about 50% of the activity of Vega Extra Cobra 130 Mg. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Vega Extra Cobra 130 Mg. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Vega Visa is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Vega Coin is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).

Influence of Vega Extra Cobra 130 Mg on other drugs

Vega Extra Cobra 130 Mg is a weak inhibitor of cytochrome P450 — 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 ISOENZYMES (IC50 >150 µmol). When taking Vega Cobra in recommended doses, its Cmax is about 1 µmol, so it is unlikely that Vega Extra Cobra 130 Mg can affect the clearance of the substrates of these isoenzymes.

Vega Extra Strong 120 increases the hypotensive effect of nitrates both with long-term use of the latter, and with their appointment for urgent indications. In this regard, the use of Vega Extra Strong 120 in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Vega Coin (25, 50 and 100 mg) in patients with benign prostate hyperplasia with stable hemodynamics, the average additional decrease in sad/dad in the supine position was 7/7, 9/5 and 8/4 mm Hg.article, respectively, while in the standing position — 6/6, 11/4 mmHg, and 4/5.art. respectively. Reported rare cases of symptomatic postural hypotension in such patients, manifested in the form of dizziness (without fainting). In some sensitive patients receiving α-blockers, simultaneous use of Vega Extra Cobra 130 Mg can lead to symptomatic hypotension.

There were no signs of significant interaction with tolbutamide (250 mg) or warfarin (40 mg), which are metabolized by CYP2C9 isoenzyme.

Cobra Vega Extra Strong 120mg (100 mg) has no effect on the pharmacokinetics of the HIV protease inhibitor, saquinavir, which is a substrate of CYP3A4 isoenzyme, at its constant level in the blood.

The simultaneous use of Sildenafil Tablets Vegah Extra Cobra at equilibrium (80 mg 3 times a day) leads to an increase in the AUC and Cmax of bosentan (125 mg 2 times a day) by 49.8 and 42%, respectively.

Sildenafil Tablets Vegah Extra Cobra (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

Sildenafil Vega Extra 130 Mg (50 mg) does not increase the hypotensive effect of alcohol in healthy volunteers with Cmax of alcohol in the blood on average 0.08‰ (80 mg/DL).

In patients with hypertension, no signs of interaction of Cobra Vega Extra Strong 120mg (100 mg) with amlodipine were found. The average additional reduction in blood PRESSURE in the supine position is 8 mm Hg.V. (systolic) and 7 mm Hg.V. (diastolic).

The use of Vega Extra Cobra 130 Mg in combination with antihypertensive agents does not lead to additional side effects.



Extra Vega

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Vega-extra87 out of100 with41 ratings
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Vega-extra was the best investment I ever made.Rating:96 out of100, 71Vega-extraSince I invested in Vega-extra I made over 100,000 dollars profits. I don't always clop, but when I do, it's because of Vega-extra. Vega-extra is great.Rating:88 out of100, 71Vega-extraDefinitely worth the investment. Thank you so much for your help. Keep up the excellent work.Rating:93 out of100, 71Vega-extraNeedless to say we are extremely satisfied with the results.Rating:73 out of100, 71Vega-extraI am completely blown away. I wish I would have thought of it first. You won't regret it. It really saves me time and effort. Vega-extra is exactly what our business has been lacking.Rating:87 out of100, 71Vega-extraVega-extra is worth much more than I paid.Rating:96 out of100, 71Vega-extraDude, your stuff is the bomb! Vega-extra was worth a fortune to my company.Rating:95 out of100, 71Vega-extraI didn't even need training. Vega-extra is awesome! I wish I would have thought of it first. Thanks guys, keep up the good work!Rating:84 out of100, 71Vega-extraIt's really wonderful.Rating:87 out of100, 71Vega-extraIt really saves me time and effort. Vega-extra is exactly what our business has been lacking. Thanks for the great service. I have gotten at least 50 times the value from Vega-extra. Absolutely wonderful!Rating:86 out of100, 71Vega-extraGreat job, I will definitely be ordering again! Wow what great service, I love it! We're loving it. Vega-extra did exactly what you said it does.Rating:79 out of100, 71Vega-extraThe service was excellent.Rating:71 out of100, 71Vega-extra I don't know what else to say. I would gladly pay over 600 dollars for Vega-extra.Rating:78 out of100, 71Vega-extraAfter using Vega-extra my business skyrocketed! This is simply unbelievable!Rating:93 out of100, 71Vega-extraI am completely blown away. I will recommend you to my colleagues. I just can't get enough of Vega-extra. I want to get a T-Shirt with Vega-extra on it so I can show it off to everyone. I am really satisfied with my Vega-extra.Rating:82 out of100, 71Vega-extraI'm good to go. Vega-extra is the next killer app.Rating:75 out of100, 71Vega-extraWe're loving it. Vega-extra has completely surpassed our expectations.Rating:83 out of100, 71Vega-extraThank You! I love Vega-extra.Rating:100 out of100, 71Vega-extraWe can't understand how we've been living without Vega-extra. I was amazed at the quality of Vega-extra. Vega-extra was the best investment I ever made.Rating:96 out of100, 71Vega-extraSince I invested in Vega-extra I made over 100,000 dollars profits. I don't always clop, but when I do, it's because of Vega-extra. Vega-extra is great.Rating:88 out of100, 71Vega-extraDefinitely worth the investment. Thank you so much for your help. Keep up the excellent work.Rating:93 out of100, 71Vega-extraNeedless to say we are extremely satisfied with the results.Rating:73 out of100, 71Vega-extraI am completely blown away. I wish I would have thought of it first. You won't regret it. It really saves me time and effort. Vega-extra is exactly what our business has been lacking.Rating:87 out of100, 71Vega-extraVega-extra is worth much more than I paid.Rating:96 out of100, 71Vega-extraDude, your stuff is the bomb! Vega-extra was worth a fortune to my company.Rating:95 out of100, 71Vega-extraI didn't even need training. Vega-extra is awesome! I wish I would have thought of it first. Thanks guys, keep up the good work!Rating:84 out of100, 71Vega-extraIt's really wonderful.Rating:87 out of100, 71

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