buy primobolan

Side effects Digestive system : possible abdominal pain, constipation, flatulence, nausea, diarrhea, pancreatitis, vomiting, hepatitis, increased activity of “liver” enzymes, alkaline phosphokinase, and creatine phosphokinase buy primobolan. The nervous system and sensory organs : asthenic syndrome, headache , dizziness, insomnia, muscle cramps, paresthesia, peripheral neuropathy, blurred vision, taste disturbance. Allergic and immunopathological reactions : angioedema, polymyalgia rheumatica, vasculitis, thrombocytopenia, increased erythrocyte sedimentation rate, fever, arthritis, rash, photosensitivity, skin flushing, hot flushes , shortness of breath, lupus-like syndrome, eosinophilia. Dermatological reactions : rare skin rash, pruritus, alopecia, dermatomyositis.

From the musculoskeletal system: myopathy, myalgia, muscle cramps, weakness; rarely – rhabdomyolysis. Other : anemia, palpitation, acute renal failure (due to rhabdomyolysis), reduced potency.

 

Overdose
None of the few known cases of overdose (maximum dose of 450 mg adopted) specific symptoms have been identified.
Treatment: Induce vomiting, take activated charcoal. Symptomatic therapy.
It should monitor liver and kidney function, creatine kinase levels in the blood serum.
With the development of myopathy with rhabdomyolysis and acute renal failure (rare but severe side effects), stop taking the drug and put the patient a diuretic and sodium bicarbonate (intravenous infusion).If you want to show hemodialysis.
Rhabdomyolysis can cause hyperkalemia, which can be eliminated by intravenous administration of calcium chloride or calcium gluconate, infusion of buy primobolan glucose with insulin, using the potassium ion exchangers or, in severe cases, by hemodialysis.

Interaction with other drugs Cytotoxic agents, antifungal agents (ketoconazole, itraconazole), fibrates, high doses of nicotinic acid, immunosuppressants, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, nefazodone increase the risk of myopathy. Cyclosporine or Danazol : the risk of myopathy / rhabdomyolysis increased by a joint appointment of cyclosporine or danazol with higher doses of simvastatin. other gipolipidemteskie agents can cause myopathy development : the risk of myopathy is increased by concomitant use of other lipid-lowering drugs that are not potent inhibitors of , but can cause myopathy in monotherapy conditions. Such as gemfibrozil and other fibrates (except fenofibrate), and niacin (nicotinic acid) in a dose of > 1 g per day.

Amiodarone and verapamil : risk of myopathy is increased by coadministration of amiodarone or verapamil with high doses of simvastatin. Diltiazem : risk of myopathy slightly increased in patients receiving diltiazem along with simvastatin at a dose of 80 mg. simvastatin potentiates the action of oral anticoagulants (eg., fepprokumon, warfarin) and increases the risk of bleeding, which requires the need for monitoring indicators of coagulation prior to treatment, and often enough in the initial period of therapy. Once reached a stable level indicator prothrombin time or international normalized ratio (MHO), it should be carried out further inspections at the intervals recommended for patients receiving anticoagulant therapy. If you change the dosage or discontinuation of simvastatin should also conduct monitoring of prothrombin time or MHO according to the above scheme. Therapy with simvastatin did not cause changes in prothrombin time and the risk of bleeding in patients not taking anticoagulants. It increases the level of digoxin in the blood plasma.Cholestyramine and colestipol reduce bioavailability (application simvastatin possibly through 4 hr. after administration of these drugs, while noting additive effect). grapefruit juice contains one or more components which inhibit and can increase the concentration in blood means a plasma metabolized .

Increased activity buy primobolan reductase inhibitors after consuming 250 ml juice per day is minimal and has no clinical significance. However, the consumption of a large volume of juice (more than 1 liter per day) while taking simvastatin significantly increases the level of inhibitory activity against buy primobolanreductase inhibitor in blood plasma. In this connection, to avoid consumption of grapefruit juice in large quantities.

 

Specific guidance
At the beginning of therapy  possibly a transient increase in “liver” enzymes.
Before starting therapy and then regularly liver function tests (to monitor the activity of “liver” enzymes every 6 weeks during the first 3 months., And then every 8 weeks during the remaining the first year and then every six months 1) and with increasing doses of test should be conducted to determine liver functions. By increasing the dose to 80 mg of the test should be carried out every 3 months. When persistent elevations of transaminases (3 times as compared to baseline) reception Simvastol ® should be discontinued.  Reductase inhibitors, should not be applied at an elevated risk of rhabdomyolysis and renal insufficiency (on background severe acute infection, hypotension, planned major surgery, trauma, severe metabolic disorders).
Cancel lipid-lowering drugs during pregnancy has no significant impact on the long-term treatment of primary hypercholesterolemia. Due to the fact that inhibitors  reductase inhibitors inhibit the synthesis of cholesterol and cholesterol and other products of its synthesis are essential in fetal development including synthesis of steroids and cell membranes, simvastatin may have adverse effects on the fetus when assigning it to pregnant women (women reproductive age should avoid conception). If in the course of treatment became pregnant, the drug should be withdrawn and the woman warned of the possible danger to the fetus.
Application  is not recommended for women of childbearing age who do not use contraceptives.
In patients with low thyroid function (hypothyroidism), or if there is some kidney disease (nephrotic syndrome) with an increase in cholesterol levels should first carry out treatment of the underlying disease.

With caution buy primobolan appoint persons who abuse alcohol and / or have a history of liver disease.
Before and during treatment the patient should be on hypolipidemic diet. Simultaneous administration of grapefruit juice may enhance the severity of side effects associated with taking  , so avoid their simultaneous reception.
The risk of myopathy is also increased in patients with severe renal insufficiency. All patients who start therapy  , as well as patients who need to increase the dose of the drug should be warned of the possibility of myopathy and need immediate treatment to the doctor in case of unexplained pain, pain in the muscles, weakness or muscle weakness, particularly if accompanied by malaise or fever. Drug therapy should be discontinued immediately if myopathy is diagnosed or suspected. In order to diagnose myopathy is recommended to conduct regular measurements of the . In the treatment of the drug may increase the content of serum , which should be considered in the differential diagnosis of chest pain. Drug withdrawal criterion is an increase in serum  more than 10 times the upper limit of normal. Patients with myalgia, myasthenia and / or marked increase in buy primobolan drug treatment is stopped. The drug is effective as a monotherapy, or in combination with bile acid sequestrants. In case of missing the current drug dose must be taken as soon as possible. If it is time for your next dose, do not double the dose. Patients with severe renal insufficiency ^ treatment is carried out under the control of renal function. The duration of the drug is determined by the physician individually.

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primobolan acetate

Active metabolite inhibits  reductase ), an enzyme that catalyzes the initial reaction of mevalonate . Since the conversion  to mevalonate is an early step in cholesterol synthesis, the use of simvastatin does not cause accumulation in the body is potentially toxic sterols.  Is easily metabolized to acetyl-CoA, which is involved in many processes of synthesis in the body. It is a decrease in blood plasma triglycerides, low density lipoprotein  very low density lipoproteins  and total cholesterol (in cases . heterozygous familial and non-familial forms of hypercholesterolemia, with mixed hyperlipidemia when elevated cholesterol is a risk factor) increases the content of high density lipoprotein primobolan acetate cholesterol and decreases the ratio  and total  ratio. onset of effect – 2 weeks from the start of the reception , the maximum therapeutic effect is achieved within 4-6 weeks. Action is maintained with continued treatment, at the termination of therapy cholesterol gradually returned to baseline.

 

Pharmacokinetics
Absorption of simvastatin high. After oral administration the maximum plasma concentration is reached after about 1,3-2,4 hours, and reduced by 90% after 12 hours. Communication to plasma proteins is approximately 95%.
It is metabolized in the liver, it has the effect of “first pass” through the liver (hydrolyzed to form an active derivative: a beta – hydroxy acid, found and other active and inactive metabolites). The half-life of the active metabolite is 1.9 hours.
Excreted mainly with faeces (60%) in the form of metabolites. Approximately 10-15% is excreted by the kidneys in an inactive form.

Indications Hypercholesterolemia :

  • Primary Hypercholesterolemia (type IIa and IIb), when poor diet low in cholesterol and other non-drug interventions (exercise and weight reduction) in patients with an increased risk of coronary atherosclerosis;
  • combined hypercholesterolemia and hypertriglyceridemia, is not correctable special diet and exercise.

Coronary heart disease :
for the prevention of myocardial infarction, to primobolan acetate reduce the risk of death, reducing the risk of cardiovascular events (stroke or transient ischemic attacks), slowing the progression of atherosclerosis of the coronary vessels, reducing the risk of revascularization procedures.

Contraindications

  • Hypersensitivity to simvastatin or to other components of the preparation (including hereditary lactose intolerance), as well as several other statin drugs (HMG-CoA reductase) in history;
  • liver disease in the active phase, a persistent increase in activity of “liver” enzymes of unknown etiology;
  • diseases of skeletal muscles (myopathy);
  • age of 18 years (effectiveness and safety have been established).

Be wary appoint patients who abuse alcohol, transplant patients undergoing immunosuppressive therapy (due to an increased risk of rhabdomyolysis and renal failure); in conditions that can lead to severe renal insufficiency, such as hypotension, acute infectious diseases heavy currents expressed metabolic and endocrine disorders, disorders of water balance -elektrolitnogo, surgery (including dental), or injury;patients with low or high tone of the skeletal muscles of unknown etiology; epilepsy, liver disease history.

Pregnancy and lactation
Primobolan acetate is contraindicated in pregnant women. There are several reports of malformations in newborns whose mothers took simvastatin. Women of childbearing age who take simvastatin should avoid conception. If during treatment pregnancy yet occurred,  should be abolished, and the woman should be advised of the potential hazard to the fetus. Data on the allocation of simvastatin in breast milk are not available. The appointment  during lactation should be borne in mind that many drugs are excreted in breast milk, and there is a threat of severe reactions, so breast-feeding during treatment is not recommended.

The time of the drug should not be linked with the meal. The recommended dose for the treatment of hypercholesterolemia varies from 10 to 80 mg 1 time per day in the evening. The recommended starting dose for patients with hypercholesterolemia is 10 mg. The maximum daily dose -. 80 mg changes (selection) the dose should be performed at intervals of 4 weeks . In most patients, the optimal effect is achieved by taking the drug at doses up to 20 mg per day. In patients with homozygous familial hypercholesterolemia recommended daily dose is 40 mg 1 time per day in the evening or 80 mg in three divided doses (20 mg in the morning, 20 mg day and 40 mg in the evening). in the treatment of patients with coronary heart disease (CHD) or at high risk , effective  are 20-40 mg per day. Therefore, the recommended initial dose in these patients – 20 mg per day. Change (selection) of the dose should be performed at intervals of 4 weeks, if necessary dose can be increased to 40 mg per day. If the  content of less than 75 mg / dl (1.94 mmol / l), total cholesterol – less than 140 mg / dl (3.6 mmol / L), the dose should be reduced. In elderly patients and in patients with mild or moderate degree of renal failure dosage changes drug is not required. in patients with chronic renal failure (creatinine clearance less than 30 mL / min) or receiving cyclosporin, danazol, gemfibrozil or other fibrates (except fenofibrate), nicotinic acid lipid-lowering doses ( > 1 g / day) in combination with simvastatin, the maximum recommended dosage of simvastatin should not exceed 10 mg per day. in patients taking amiodarone or verapamil simultaneously  should not exceed 20 mg.

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primobolan dosage

At the beginning of therapy with simvastatin possible transient increase in the level of “liver” enzymes.
Before starting therapy and then regularly liver function tests (to monitor the activity of “liver” enzymes every 6 weeks during the first 3 months., And then every 8 weeks for the remainder of the first year, 1 and then every six months) and at higher doses of the test should be conducted to determine liver functions. By increasing the dose to 80 mg of the test should be carried out every 3 months. When persistent elevations of transaminases (3 times as compared to baseline) receiving simvastatin should be discontinued.
Simvastatin, like other inhibitors of primobolan dosage reductase inhibitors, should not be applied at an elevated risk of rhabdomyolysis and renal failure (on the background of severe acute infections, hypotension, planned major surgery, trauma, severe metabolic disorders).
Cancel lipid-lowering drugs during pregnancy has no significant impact on the long-term treatment of primary hypercholesterolemia.
in patients with low thyroid function (hypothyroidism) or the presence of certain diseases of the kidneys (nephrotic syndrome) with an increase in cholesterol levels should first carry out treatment of the underlying disease.
simvastatin with caution appoint primobolan dosage persons who abuse alcohol and / or have a history of liver disease.
Before and during treatment the patient should be on hypolipidemic diet.
Co-administration of grapefruit juice may enhance the severity of side effects associated with taking simvastatin should be avoided simultaneous reception.
simvastatin is not shown in those cases where there is hypertriglyceridemia I, IV and V types.
Treatment with simvastatin may cause myopathy, leading to rhabdomyolysis and renal failure. The risk of this disease increases in patients receiving simultaneously with simvastatin one or more of the following drugs: fibrates (gemfibrozil, fenofibrate), cyclosporine, nefazadon, macrolides (erythromycin, clarithromycin), antifungal agents of “azole” group (ketoconazole, itraconazole) and HIV protease inhibitors (ritonavir). The risk of myopathy is also increased in patients with severe renal insufficiency.
All patients who start therapy with simvastatin and patients who need to increase the dose of the drug should be warned of the possibility of myopathy and need immediate treatment to the doctor in case of unexplained pain, pain in muscle flaccidity or muscle weakness, particularly if accompanied by malaise or fever. Drug therapy should be discontinued immediately if myopathy is diagnosed or suspected.
In order to diagnose myopathy is recommended to conduct regular measurement.
In the treatment with simvastatin may increase the content , which should be considered when diagnosing differintsialnoy pain behind the breastbone. Drug withdrawal criterion is an increase in serum more than 10 times the upper limit of normal. Patients with myalgia, myasthenia and / or marked increase  drug treatment is stopped.
The drug is effective as a monotherapy, primobolan dosage or in combination with bile acid sequestrants.
In case of missing the current drug dose must be taken as soon as possible. When the time came the next dose, do not double the dose.
Patients with severe renal insufficiency treatment is carried out under the control of renal function.
The duration of the drug is determined by the physician individually. azab 500

primobolan for sale

From the digestive system: possible abdominal pain, constipation, flatulence, nausea, diarrhea, pancreatitis, vomiting, hepatitis, increased activity of “liver” enzymes, alkaline phosphokinase, and creatine phosphokinase primobolan for sale. From the nervous system and sensory organs: asthenic syndrome, headache, dizziness, insomnia, muscle cramps, paresthesia, peripheral neuropathy, blurred vision, taste disturbance.

On the part of the musculoskeletal system: myopathy, myalgia, muscle cramps, weakness; rarely – rhabdomyolysis. Allergic and immunopathological reactions: angioedema, polymyalgia rheumatica, vasculitis, thrombocytopenia, increased erythrocyte sedimentation rate, fever, arthritis, rash, photosensitivity, skin redness, flushing, shortness of breath, lupus-like syndrome, eosinophilia.Dermatological reactions: rare skin rash, itching , alopecia, dermatomyositis. Other: anemia, palpitation, acute renal failure (due to rhabdomyolysis), reduced potency.

 

Overdose

None of the few known cases of overdose (maximum dose of 450 mg adopted) specific symptoms have been identified.
Treatment: Induce vomiting, take activated charcoal, to spend symptomatic therapy. It is necessary to control the functions of the liver and kidneys, creatine kinase levels in the blood serum.
With the development of myopathy and rhabdomyolysis with acute renal failure (rare but severe side effects), stop taking the drug and the patient enter a diuretic and sodium bicarbonate (intravenous infusion). If you want to show primobolan for sale hemodialysis.
Rhabdomyolysis can cause hyperkalemia, which can be eliminated by intravenous administration of calcium chloride or calcium gluconate, infusion of glucose with insulin, using the potassium ion exchange sorbents, or, in severe cases, by hemodialysis.

Interaction with other drugs

Cytotoxic agents, antifungal drugs (ketoconazole, itraconazole), fibrates, high doses of nicotinic acid, immunosuppressants, erythromycin, clarithromycin, telithromycin,  protease inhibitors, nefazodone increase the risk of myopathy.
Cyclosporin or danazol: risk of myopathy / rhabdomyolysis increases when coadministered cyclosporin or danazol with higher doses of simvastatin.
other lipid-lowering drugs that can cause myopathy development: the risk of myopathy is increased by concomitant use of other lipid-lowering drugs that are not potent inhibitors , but can cause myopathy in monotherapy conditions. Such as gemfibrozil and other fibrates (except fenofibrate), and niacin dose ≥ 1 g per day.
Amiodarone and verapamil: risk of myopathy is increased by coadministration of amiodarone or verapamil with high doses of simvastatin.
Diltiazem: risk of myopathy is slightly increased in patients receiving diltiazem along with simvastatin at a dose of 80 mg.
simvastatin potentiates the action of oral anticoagulants (eg phenprocoumon, warfarin) and increases the risk of bleeding, which requires the need for monitoring indicators of coagulation prior to treatment, as well as quite often in the initial period of therapy . Once reached a stable level indicator prothrombin time or international normalized ratio , a further control be carried out at intervals recommended for patients receiving anticoagulant therapy. If you change the dosage or discontinuation of simvastatin should also conduct monitoring of prothrombin time  on the above chart.
Therapy with simvastatin did not cause changes in prothrombin time and the risk of bleeding in patients not taking anticoagulants.
It increases levels of digoxin in the blood plasma.
Cholestyramine and colestipol reduce bioavailability (application simvastatin is possible through 4 hours after administration of the drugs, while noting additive effect).
grapefruit juice contains one or more components which inhibit  and can increase the concentration in the blood plasma means, metabolized. Increased activity of primobolan for sale reductase inhibitor after consuming 250 ml juice per day is minimal and has no clinical significance. However, the consumption of a large volume of juice (more than 1 liter per day) while taking simvastatin significantly increases the level of inhibitory activity against  reductase inhibitor in blood plasma. In this connection, to avoid consumption of grapefruit juice in large quantities.

  decabol

primobolan steroid

Absorption primobolan steroid is high. After oral administration the maximum plasma concentration is reached after about 1,3-2,4 hours, and reduced by 90% after 12 hours. Communication with the plasma proteins is approximately 95%.
It is metabolized in the liver, it has the effect of “first pass” through the liver (hydrolyzed to form an active derivative: beta-hydroxyacids are found and other active and inactive metabolites). The half-life of the active metabolite is 1.9 hours.
Excreted mainly with faeces (60%) in the form of metabolites. Approximately 10-15% is excreted by the kidneys in an inactive form.

Indications

hypercholesterolemia :

  • Primary hypercholesterolemia (IIa and type IIb) when poor diet low in cholesterol and other non-drug interventions (exercise and weight reduction) in patients with an increased risk of coronary atherosclerosis;
  • The combined hypercholesterolemia and hypertriglyceridemia, is not correctable special diet and exercise.

Coronary heart disease :
for the prevention of myocardial infarction, to reduce the risk of death, reducing the risk of cardiovascular events (stroke or transient ischemic attacks), slowing the progression of atherosclerosis of the coronary vessels, reducing primobolan steroid the risk of revascularization procedures.

Contraindications

 

  • Hypersensitivity to simvastatin or to other components of the preparation (including hereditary lactose intolerance), as well as several other statin drugs (inhibitors MMC-CoA reductase) in history;
  • Liver disease in the active phase, a persistent increase in activity of “liver” enzymes of unknown etiology;
  • Diseases of the skeletal muscles (myopathy);
  • Age 18 years (effectiveness and safety have been established).

Be wary appoint patients who abuse alcohol, transplant patients undergoing immunosuppressive therapy (due to an increased risk of rhabdomyolysis and renal failure); in conditions that can lead to severe renal insufficiency, such as hypotension, acute infectious diseases heavy currents expressed metabolic and endocrine disorders, disorders of water and electrolyte balance, surgery (including dental), or injury; patients with low or high tone of the skeletal muscles of unknown etiology; epilepsy.

Pregnancy and lactation

Simvastatin can have adverse effects primobolan steroid on the fetus and is contraindicated in pregnant women. There are several reports of malformations in newborns whose mothers took simvastatin.
Women of childbearing age who take simvastatin should avoid conception. The use of simvastatin is not recommended in women of childbearing age, not using contraception. If during treatment pregnancy yet occurred, simvastatin should be discontinued, and the woman should be advised of the potential hazard to the fetus.
The data on the allocation of simvastatin in breast milk are not available. If necessary, simvastatin appointment during lactation should be borne in mind that many drugs are excreted in breast milk, and there is a threat of severe reactions, so breast-feeding during treatment is not recommended.

Dosing and Administration

Prior to treatment with simvastatin patient must assign a standard hypolipidemic diet, which should be respected during the entire course of treatment.
Simvastatin is taken orally 1 time a day in the evening, drinking plenty of water.
Time of the drug should not be linked with the meal.
The recommended dose of simvastatin for the treatment of hypercholesterolemia varies from 10 to 80 mg 1 time per day in the evening. The recommended starting dose for patients with hypercholesterolemia is 10 mg. The maximum daily dose -. 80 mg
changes (selection) the dose should be performed at intervals of 4 weeks. In most patients, the optimal effect is achieved by taking the drug at doses up to 20 mg per day.
In patients with homozygous familial hypercholesterolemia recommended daily dose of simvastatin 40 mg 1 time per day in the evening or 80 mg in three divided doses (20 mg in the morning, 20 mg in the afternoon and 40 mg in the evening).
in the treatment of patients with coronary heart disease or at high risk  effective doses of simvastatin are 20-40 mg per day. Therefore, the recommended initial dose in these patients – 20 mg per day. Change (selection) of the dose should be performed at intervals of 4 weeks, if necessary dose can be increased to 40 mg per day. If the  content of less than 75 mg / dl (1.94 mmol / l), total cholesterol – less than 140 mg / dl (3, the dose should be reduced.
In elderly patients and in patients with mild or moderate renal impairment changes medication dosage is necessary.
patients with primobolan steroid chronic renal failure (creatinine clearance less than 30 mL / min) or receiving cyclosporin, danazol, gemfibrozil or other fibrates (except fenofibrate), nicotinic acid as lipid-lowering doses (≥ 1g / day) in combination with simvastatin, the maximum recommended dose of simvastatin should not exceed 10 mg per day.
in patients taking amiodarone or verapamil with simvastatin at the same time, the daily dose should not exceed 20 mg.

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