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Vega Extra Cobra (sildenafil citrate)

Vega Extra Cobra (sildenafil citrate)

$ 1.02 per pill

Quick Overview

To minimize the risk of postural hypotension in patients taking α-blockers, Vegah Extra 130 should be started only after achieving hemodynamic stabilization in these patients. Consideration should also be given to reducing the initial dose of Vegah Extra 130 (see special instructions and Interactions).

Vega Extra Cobra® (Signature)

Vega Extra Cobra (Sildenafil citrate) 120 mg

Vega Extra Cobra
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Information

Dosage and administration

Inside, can be taken with or without water. When taking the drug, you should put a tablet, dispersed in the oral cavity, on the tongue, after which it will quickly dissolve, and it can be swallowed. The tablet should be taken immediately after opening the blister. Patients who are recommended a dose of Vegah Extra 130 100 mg, the second tablet of Vegah Extra 130 50 mg should be taken after complete dissolution of the first tablet.

The recommended dose for most adult patients is 50 mg approximately 1 hour before sexual activity. Taking into account the effectiveness and tolerability of the dose can be increased to 100 mg or reduced to 25 mg (only tablets coated with a film, the appropriate dosage). The maximum recommended dose is 100 mg. Patients who are recommended a dose of Vegah Extra 120 Mg 100 mg, it is necessary to take 2 table., dispersible in the oral cavity, dosage 50 mg consecutively one after another. The maximum recommended frequency of use — 1 time per day. It should be borne in mind that the absorption of Vegah Extra 130 significantly slows down when used in combination with fatty foods.

Special patient groups

Renal impairment. In mild to moderate renal failure dose adjustment is not required, in severe renal failure (Creatinine CL <30 ml/min) Cobra 120 Vega Extra dose should be reduced to 25 mg.

Hepatic impairment. Since the excretion of Vegah Extra 130 is disturbed in patients with liver damage (in particular, cirrhosis), the dose of Vegah Extra 130 should be reduced to 25 mg.

Joint application with other drugs. Joint use with ritonavir is not recommended. In any case, the maximum dose of Vegah Cobra under any circumstances should not exceed 25 mg, and the frequency of application — 1 time in 48 h (see "Interaction").

When combined with inhibitors of CYP3A4 isoenzyme (erythromycin, saquinavir, ketoconazole, Itraconazole), the initial dose of Vegah Extra 130 should be 25 mg (see "Interaction").

To minimize the risk of postural hypotension in patients taking α-blockers, Cobra Vega should be started only after achieving hemodynamic stabilization in these patients. Consideration should also be given to reducing the initial dose of Vega Extra 120 (see special instructions and Interactions).

Old age. Adjustment of the dose of Vegah Extra 130 is not required.

Cardiovascular complications

During the post-marketing use of Cobra Vega 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 Vegah Extra 130. 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 Extra 130 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 Vegah Extra 130, 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 130 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 Vegah Extra 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 Vega Cobra 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 Vegah Extra 130

The metabolism of Vegah Extra 130 occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Vegah Extra 130, and inducers, respectively, increase the clearance of Vegah Extra 130. A decrease in the clearance of Vegab Extra 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 130 (50 mg) causes an increase in the concentration of Cobra Vega Extra Strong 120 Mg in plasma by 56%.

A single dose of 100 mg of Vegah Extra 130 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 Vegah Extra 130 by 182%.

When co-administered Vegah Extra 130 (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 Vegah Extra 130 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 120 Mg.

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

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 Vegah Extra 130 in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Vegah Extra 130 by 62.6 and 52.4%, respectively. Sildenafil Tablets Vegah Extra Cobra increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

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

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

Influence of Vega Coin on other drugs

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

Sildenafil Vega Extra 130 Mg Cobra 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 Vegah Extra 130 in combination with nitrates or nitric oxide donators is contraindicated. While taking α-adrenoblocker doxazosin (4 and 8 mg) and Vegah Extra 130 (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 Vegah Extra 120 Indication 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.

Vegah Extra 130 (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 Vegab Extra 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.

Signature Cobra Vega (50 mg) does not cause an additional increase in bleeding time when taking acetylsalicylic acid (150 mg).

Vega Cobra 120 (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 Vegah Extra 130 (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 Vegah Extra 130 in combination with antihypertensive agents does not lead to additional side effects.

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 Sildenafil Tablets Vega Extra Cobra. 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 Vega Coin, 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 Vegal Extra in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Sildenafil Vega Extra 120 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 (Vegah Extra 130 — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Vegah Extra 130 — 3%, placebo — 2.4%). Patients receiving Vegah Extra 130 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 Vegah Extra 130 together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Vegah Extra 130 (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 Vegah Extra 130 any negative effect on the ability to drive a car or other means was not observed. However, since when taking Vegah Extra 130 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.



Sildenafil Tablets Vega Extra Cobra

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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! 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