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Vega Extra Cobra (sildenafil citrate)

Vega Extra Cobra (sildenafil citrate)

$ 1.02 per pill

Quick Overview

Since the combined use of Vega Extra 120 and α-blockers can lead to symptomatic hypotension in some sensitive patients, Vega Extra 120 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 120 should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Vega Extra 120 (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

Vega Extra Cobra® (Signature)

Vega Extra Cobra (Sildenafil citrate) 120 mg

Vega Extra Cobra
Sildenafil citrate
120 mg × 180 pills
$ 193.90 $ 183.95
$ 1.02 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 120 pills
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$ 1.27 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 90 pills
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$ 1.53 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 60 pills
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$ 1.83 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 30 pills
$ 67.90 $ 63.95
$ 2.13 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 20 pills
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$ 2.35 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 10 pills
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Information

The pharmacokinetics of Vegah Extra 130 in the recommended dose range is linear.

Suction. After intake of Vega Pills is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Vega Extra Strong 120 at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Cobra Vega 120 Mg 100 mg average Cmax free Sildenafil Tablets Vegah Extra Cobra in plasma men is about 18 ng/ml (38 nm). Cmax when taking Cobra Vega 120 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 Vega 120 Mg is 105 l. the Association of Cobra Vega 120 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 Vegal Extra (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Cobra Vega 120 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 Cobra Vega 120 Mg, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Cobra Vega 120 Mg, and its activity against PDE-5 in vitro is about 50% of the activity of Cobra Vega 120 Mg. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Cobra Vega 120 Mg. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Cobra Vega 120 Mg is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Cobra Vega 120 Mg is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Vegah Cobra was well tolerated at a single dose of 100 mg. There were no clinically significant changes in vision evaluated by special visual tests (visual acuity, Amsler lattice, color perception, color simulation, Humphrey perimeter and photostress).

Efficiency. The efficacy and safety of Sildenafil Tablets Vega Extra Cobra were evaluated in 21 randomized double-blind placebo-controlled studies lasting up to 6 months in 3000 patients from 19 to 87 years with erectile dysfunction of different etiology (organic, psychogenic or mixed). The efficacy of the drug was evaluated globally using an erection diary, an international erectile function index (validated questionnaire on the state of sexual function) and a partner survey.

The effectiveness of Cobra Vega 120 Mg, defined as the ability to achieve and maintain an erection sufficient for satisfactory sexual intercourse, has been demonstrated in all studies and confirmed in long-term studies lasting 1 year. In studies with the use of fixed-dose proportion of patients reporting that treatment improved their erections were 62% (dose of Cobra Vega 120 Mg 25 mg), 74% (dose Cobra Vega 120 Mg 50 mg) and 82% (dose Signature Cobra Vega 100 mg) compared to 25% in the placebo group. Analysis of the international index of erectile function showed that in addition to improving erection treatment Cobra Vega 120 Mg also increased the quality of orgasm, allowing to achieve satisfaction from sexual intercourse and overall satisfaction.

According to the generalized data, 59% of patients with diabetes, 43% of patients who underwent radical prostatectomy and 83% of patients with spinal cord injuries (against 16, 15 and 12% in the placebo group, respectively) were reported to have improved erection in the treatment of Cobra Vega 120 Mg.

Pharmacokinetics

Cardiovascular complications

During the post-marketing use of Vegab Extra 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 Cobra Vega 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 Cobra Vega 120 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 Cobra Vega 120 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 Cobra Vega 120 Mg 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 Cobra Vega 120 Mg, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Cobra Vega 120 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 Cobra Vega 120

The metabolism of Cobra Vega 120 Mg occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Cobra Vega 120 Mg, and inducers, respectively, increase the clearance of Cobra Vega 120 Mg. A decrease in the clearance of Cobra Vega 120 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 Vegah Extra 120 Indication (50 mg) causes an increase in the concentration of Vegah Extra 120 Indication in plasma by 56%.

A single dose of 100 mg of Cobra Vega 120 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 Cobra Vega 120 Mg by 182%.

When co-administered Vega Extra 120 (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 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 Coin.

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

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 Vega Extra 120 Mg in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Cobra Vega 120 by 62.6 and 52.4%, respectively. Cobra Vega 120 Mg increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

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

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Sildenafil Vega Extra 130 Mg Cobra or its main circulating metabolite.

Hearing impairment

Some post-marketing and clinical studies have reported cases of sudden hearing loss or impairment associated with the use of all PDE-5 inhibitors, including Cobra Vega Extra Strong 120 Mg. Most of these patients had risk factors for sudden impairment or hearing loss. There is no causal relationship between the use of PDE-5 inhibitors and sudden hearing impairment or hearing loss. In case of sudden hearing impairment or hearing loss while taking Cobra Vega 120 Mg, consult a doctor immediately.

Bleedings

Vegah Extra 120 Indication enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Vega Extra Cobra 130 Mg in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Cobra Vega 120 Mg in these patients should be used with caution (see With caution).

The incidence of nosebleeds in patients with pulmonary hypertension associated with diffuse connective tissue diseases was higher (Vega Extra — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Sildenafil Vega Extra 120 — 3%, placebo — 2.4%). Patients receiving Cobra Vega 120 Mg in combination with an antagonist of vitamin K, the frequency of nasal bleeding was higher (8.8 percent) than patients who were not taking an antagonist of vitamin K (1.7 percent).

Use in conjunction with other means for the treatment of erectile dysfunction

The safety and efficacy of Vega Cobra 120 Mg together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Cobra Vega 120 Mg (eg, Revatsio®), or other means for the treatment of erection disorders have not been studied, so the use of such combinations is not recommended (see "Contraindications").

Influence on the ability to drive and mechanisms. In patients receiving Cobra Vega 120 Mg any negative effect on the ability to drive a car or other means was not observed. However, since when taking Cobra Vega 120 Mg may develop dizziness, lowering blood PRESSURE, the development of chromatopsia, blurred vision, etc. side effects, care should be taken when driving and doing other potentially dangerous activities that require increased concentration and speed of psychomotor reactions. Also, you should be careful about the individual action of the drug in these situations, especially at the beginning of treatment and when changing the dosage regimen.



Vega Extra 120

Reviews

Vega-extra86 out of100 with39 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. 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