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Other names for this medication
Actan, Adofen, Alental, Apo-fluoxetin,  Astrin,  Auscap,  Bioxetin,  Depreks,  Deproxin, Diesan, Equilibrane, Erocap, Eufor, Flotina, Floxet, Flucti-nerton, Fluctin, Fluctine, Fludac, Flufran, Fluneurin, Flunil, Fluox, Fluox-puren, Fluoxac, Fluoxeren, Fluoxeron, Fluoxetina, Fluoxetinum, Fluoxil, Fluoxin, Fluseren, Flutine, Fluxet, Fluxil, Fluxonil, Fondur, Fontex, Fysionorm, Ladose, Lovan, Margrilan, Motivone, Oxetine, Pragmaten, Prodep, Pronil, Prozac, Reneuron, Rowexetina, Seronil, Zactin.

Fluoxetine tablets contain 20 mg fluoxetine, as well as lactose monohydrate, gelatin, corn starch, calcium stearate, povidone, silicon (Si) colloidal dioxide, talc, magnesium (Mg) light carbonate, tropeoline 0, additive E171 (titanium (Ti ) dioxide), mineral oil, sugar, yellow wax.

Form of issue
Tablets covered with a film coating of yellow color in blisters for 10 pcs, 1 or 2 blisters in a package.

Pharmachologic effect
The drug has an anorexigenic effect, eliminates depression and relieves feelings of depression.

Pharmacodynamics and pharmacokinetics Fluoxetine – what is it?
The active substance of the preparation fluoxetine hydrochloride is a water-soluble crystalline powder of white (or almost white) color.

What is Fluoxetine?
Fluoxetine is a selectively inhibitory reverse neuronal seizure of serotonin (ONS) agent. The drug belongs to the pharmacotherapeutic group “Antidepressants”.

The medicine is intended for oral administration. The mechanism of its action is related to the ability to selectively (selectively) and reverse the ONZS.
Antidepressant Fluoxetine slightly affects the capture of dopamine and norepinephrine and weakly affects acetylcholine receptors and H1-type histamine receptors.
Along with antidepressant also has a stimulating effect. After taking the tablets / capsules, the patient’s fear, anxiety and mental tension decrease, the mood improves, the symptoms of dysphoria are eliminated.
Wikipedia notes that the remedy does not cause orthostatic hypotension, does not have a sedative effect, is not cardiotoxic.
To achieve a stable clinical effect with regular use of the drug takes from 3 to 4 weeks.

Pharmacokinetic parameters:
➡absorption in the alimentary canal – good;
➡bioavailability – 60% (with oral administration);
➡ТСмах – from 6 to 8 hours;
➡binding to plasma proteins (including alpha (α) -1-glycoprotein and albumin) – 94.5%;
➡T½ – 48-72 hours.
The liver is involved in the metabolism of the substance. As a result of its biotransformation, a number of unidentified metabolites are formed, as well as norfluoxetine, the selectivity and activity of which is equivalent to that of fluoxetine.

Pharmacologically inactive metabolic products are eliminated by the kidneys.
Due to the fact that the substance is removed from the body slowly enough, the plasma concentration necessary for maintaining the therapeutic effect persists for several weeks.

Indications for use: what are the prescribed tablets and fluoxetine?
Indications for use of fluoxetine:
➡depression (in particular, accompanied by fears), including with the inefficiency of other antidepressants;
➡obsessive-compulsive disorder (OCD);
➡kinoreksiya (to reduce uncontrolled craving for food, the remedy is used as part of complex psychotherapy).

The drug is not prescribed when:
➢known hypersensitivity to its active substance or any of the auxiliary ➢components;
➢convulsive conditions in the anamnesis;
➢severe liver and / or kidney failure;
➢suicidal tendencies;
➢vatony of the bladder;
➢prostate adenoma;
➢simultaneous application with MAO inhibitors .
After using MAO inhibitors, Fluoxetine can be used no earlier than 14 days; MAO inhibitors after the end of treatment with fluoxetine are prescribed no earlier than 5 weeks.

Side effects of fluoxetine
General disorders that occur during the use of the drug may manifest in the form of hyperhidrosis, chills, fever or cold sensation, photosensitivity, neuroleptic syndrome, alopecia, lymphadenopathy, anorexia, erythema multiforme, which can progress to malignant exudative or develop into Lyell’s syndrome.

Some patients have symptoms of serotonin intoxication, including:  ➳changes in mental status (delirium, euphoria, anxiety, agitation, hallucinations, mutism, confusion, manic syndrome, coma);
➳neuromuscular pathologies (akathisia, coordination disorders, bilateral Babinsky symptom, hyperreflexia, myoclonus, epileptiform seizures, nystagmus (horizontal and vertical), oculogic crises, paresthesia, opisthotonus, tremor, muscular rigidity);
➳vegetative dysfunction (hyperthermia, abdominal and headaches, diarrhea, dilated pupils, lacrimation, tachypnea, tachycardia, nausea, fluctuations in blood pressure, hyperhidrosis, chills).

From the digestive system of organs are possible: diarrhea, nausea, decreased appetite, vomiting, dysphagia, dyspepsia, taste change, pain in the esophagus, dry mouth, dyskinesia, liver dysfunction. In isolated cases, idiosyncratic hepatitis can develop.
CNS reactions to the taking of tablets are manifested in the form of: ➣bruxism, headache, weakness, sleep disorders (nighttime delirium, pathological dreams, insomnia), dizziness, fatigue (hypersomnia, drowsiness);                                                                                                                ➣violations of attention, processes and concentration of thinking, memory; anxiety and associated psychovegetative syndrome, dysphemia, panic attacks, suicidal thoughts and / or attempts to deprive oneself of life.
Reactions from the urogenital tract:                                                                  ➣dysuria, urine retention, polakii-and nocturia, protein and albuminuria, polyuria, oliguria, UTI, renal failure, cystitis, decreased libido (before its complete loss), erectile dysfunction, breast enlargement and soreness , disorders of ejaculation, anorgasmia, priapism, impotence, metro- and menorrhagia, painful menstruation.
The probability of development is not excluded:
➣immunopathological and allergic reactions;
➣myalgia, arthralgia, chondrodystrophy, bone pain, osteomyelitis, arthritis and a number of other side effects from the musculoskeletal system;
➣postural hypotension;
➣metabolic disorders (including hyponatremia, hypocalcemia, hyper- or hypokalemia, vasopressin secretion disorder, diabetes mellitus, hypercholesterolemia, hyperuricemia, edema, diabetic acidosis, dehydration, hypothyroidism);
➣skin reactions (including polymorphic rash, acne, ulcerative lesions of the skin, gyrustism, psoriasis, furunculosis, exfoliative dermatitis, etc.).
Discontinuation of treatment with the drug can trigger a withdrawal syndrome, the main signs of which are: sensitivity disorders, dizziness, sleep disorders, asthenia, nausea and / or vomiting, agitation, headache, tremor.
Reviews of side effects suggest that the drug with uncontrolled admission is addictive. In some cases, the dependence is so strong that a person needs the help of a specialist to treat it.
Other adverse reactions that patients mention in the reviews are severe drowsiness, tremors, convulsions, decreased appetite, nausea. Nevertheless, there are people who had no adverse effects on the background of treatment at all.

Instructions for use of fluoxetine
Tablets are taken orally. The intake of food for assimilation of the drug is not affected.
For relief of depressive symptoms, the drug should be drunk 1 time per day, in the morning, at a dose of 20 mg. With clinical need, 3-4 weeks after the start of therapy, the frequency of receptions is increased to 2 r. / Day. (tablets are taken in the morning and in the evening).

Patients with an insufficient response to treatment at a dosage of 20 mg / day, in some cases, the daily dose is gradually increased to 60-80 mg. In this case, divide it into 3-4 receptions. The highest dose for people of elderly and senile age is 60 mg / day.
Dosage for bulimic neurosis – 60 mg / day. (tablets take 3 r./day on one), in ROC – depending on the severity of clinical symptoms – from 20 to 60 mg / day.
It should be taken into account that increasing the dose may increase the severity of side effects.
The maintenance dose is 20 mg / day.

When does the drug start to act?
Significant improvement in the condition is usually observed after about 2 weeks of systematic drug intake.

How long should I take fluoxetine?
The elimination of depressive symptoms goes away from six months.
In obsessive manic disorders (HMP), the drug is given to the patient for 10 weeks. Further recommendations depend on the results of treatment. If there is no clinical effect, the fluoxetine treatment regimen is revised.
If there is a positive dynamics, therapy is continued with the use of an individually selected minimum maintenance dose. Periodically, the patient’s need for further treatment should be reviewed.
Long-term – more than 24 weeks in patients with HMR and more than 3 months in patients with bulimia nervosa – has not been studied.

General recommendations
After the treatment with Fluoxetine is completed, the active substance circulates in the body for another 2 weeks, which should be taken into account when discontinuing treatment or prescribing other medicines.
Patients with liver / kidney failure, elderly people with concomitant diseases, as well as patients taking other medicines, are prescribed a half dose of the drug. In some cases, it is advisable to transfer the patient to an intermittent reception.
It is not recommended to abruptly stop therapy with fluoxetine. The drug is canceled, gradually reducing the dose for 1-2 weeks. This avoids the development of withdrawal syndrome.
If after the dose reduction / withdrawal the patient’s condition worsens, it is necessary to return to treatment with the previous effective therapeutic dose. Gradual reduction of the dose is resumed after the appearance of positive dynamics.
If we compare Fluoxetine and Fluoxetine Lannacher or Fluoxetine and Fluoxetine OZONE, we can conclude that the instructions for the use of Fluoxetine Lannacher and Fluoxetine OZON provide recommendations similar to those listed above.

Overdosage Fluoxetine is accompanied by: nausea / vomiting, convulsions, hypomania, anxiety, agitation, large epileptic seizures.
A high dose of the drug in combination with codeine, maprotiline, temazepam can lead to death.
The person suffering from an overdose should be washed with a stomach, give sorbitol, enterosorbent and – with convulsions – diazepam. Also, monitoring of respiratory activity and parameters characterizing the functional state of the heart is important. In the future, symptomatic and supportive therapy is performed.
Peritoneal dialysis, blood transfusion, hemodialysis, forced diuresis are ineffective.

Strengthens the effects of hypoglycemic drugs, ethanol, diazepam, alprazolam.
Twice increases the plasma concentration of tricyclic antidepressants, phenytoin, trazodone, maprotiline. When appointing fluoxetine in combination with tricyclic antidepressants, the dose of the latter should be reduced by 50%.
It can provoke an increase in the plasma concentration of Li +, which in turn increases the likelihood of developing its toxic effects. In case of simultaneous application, it is recommended to keep the concentration of Li + in the blood under control.
The use as an adjunct to electroconvulsive therapy can lead to the development of prolonged epileptic seizures.
Serotonergic effects of the drug are enhanced in combination with tryptophan. The likelihood of the development of serotonin intoxication is increased in the case of simultaneous administration with agents suppressing the enzyme MAO.
The likelihood of adverse reactions and increased oppressive effects on the central nervous system increases in combination with drugs that depress the central nervous system.
Admission with drugs that have a high degree of binding to proteins can trigger an increase in the plasma concentration of unbound (free) drugs, as well as an increase in the likelihood of unwanted effects.

Storage conditions
Tablets should be stored at a temperature below 25 ° C.

Shelf life
5 years.

Special instructions
In the treatment of patients with low body weight, anorexic effects should be considered when prescribing the drug.
In diabetics during treatment Fluoxetine may develop hypo-, and after discontinuation of the drug – hyperglycemia. In view of this, it is recommended to make changes in the dosage regimen of insulin and / or hypoglycemic agents for oral administration. Before the improvement of the clinical picture, patients with diabetes should be under constant medical supervision.
During treatment it is necessary to refrain from engaging in activities that require high speed of psychomotor reactions and increased attention.
The composition of the tablets includes lactose, so they should not be taken with galactosemia, lactase deficiency, the syndrome of impaired glucose / galactose absorption.
Like other antidepressants, fluoxetine can cause affective disorders (mania or hypomania).

The central organ of the metabolism of the drug is the liver, the excretion of metabolites is responsible for the kidneys. Patients with liver pathologies should be prescribed low or alternative daily doses.
With renal failure (with Clcr less than 10 ml / min.) After 2 months of treatment with a dose of 20 mg / day. the plasma concentration of fluoxetine / norflouxetine is the same as in patients with healthy kidneys.
Depression is associated with an increased risk of suicidal thoughts and attempts to kill oneself. The risk persists until complete remission.     Clinical experience of the drug shows that the risk of suicide increases, usually in the early stages of recovery.
Patients with mental illness and depressive syndrome should be under constant supervision. In placebo-controlled studies, the group receiving antidepressant patients found that the risk of suicidal behavior is highest in people under 25 years of age.
Special attention is also required by patients who have been transferred to a lower / higher dose.

The use of fluoxetine is associated with the development of akathisia, the subjective features of which are the constant need to be in motion, as well as the inability to sit or stand. These phenomena are especially pronounced in the first weeks of treatment. Patients who developed similar symptoms, the drug is prescribed in the minimum effective dose.
With a sudden discontinuation, approximately 60% of patients develop withdrawal symptoms. The likelihood of their appearance depends on the dose used, the duration of the course, and the level of dose reduction. The dose is recommended to be reduced by titration within 7-14 days.
There have been reports of subcutaneous hemorrhages, such as purpura or ecchymosis, occurring during the treatment period. Therefore, patients taking oral anticoagulants, affecting the function of platelets and increasing the likelihood of hemorrhages, as well as patients with bleeding history, Fluoxetine is prescribed taking into account possible risks.

Which is better: Prozac or Fluoxetine?
The active substance of the drug Prozac is fluoxetine. Therefore, when choosing in favor of this or that tool, the decisive factors are price and subjective sensations. The cost of fluoxetine is much lower than the cost of its analogue.

For children
Not applicable for treatment of patients younger than 18 years.
A nineteen-week clinical trial showed that in children suffering from depression, 8-18 years of age, Fluoxetine causes a decrease in body height and weight. The effect of the drug on achieving normal growth in adulthood has not been studied.
At the same time, the probability of growth retardation in the pubertal period can not be ruled out.

Fluoxetine and alcohol
Drinking alcohol during treatment with fluoxetine is contraindicated.

Fluoxetine for weight loss
Fluoxetine is often prescribed for a bulimic syndrome – a mental syndrome, which is accompanied by a lack of satiety and uncontrolled overeating.
The use of the drug can reduce appetite and relieve a constant feeling of hunger.
Thus, it can be concluded that fluoxetine can get rid of excess weight only if the reason for its collection is the appetite.
However, the drug is not intended for weight loss, its main purpose is the treatment of depression. Reducing appetite and losing weight are side effects.
The drug is quite powerful, and the body often responds to its reception with anaphylactic reactions and systemic disorders involving the pathological process of the lungs, skin, kidneys and liver.

How to take fluoxetine for weight loss?
At the initial stage, diet pills are taken in the minimum dosage – one once a day. With good tolerability, you can go to the reception of two tablets – one drink in the morning, the second – in the evening.
The maximum allowable dose is 4 tab. / Day.
The drug begins to act after 4-8 hours, removing fluoxetine from the body takes about a week.
Reviews on the forums confirm the effectiveness of the means – for 1-3 months people without much effort got rid of 5-13 kg. In this case, all patients taking Fluoxetine note that it is not worth while to drink it just for the sake of losing weight, like Fenibut or Fentropil, in the absence of evidence.

In pregnancy
The safety of the drug in pregnant women is poorly understood, the results of individual published epidemiological studies are contradictory. In some random and cohort studies, there was no increase in the likelihood of congenital developmental abnormalities.
ENTIS prospective study suggests an increase in the likelihood of developing congenital anomalies in the structure of large vessels or heart in children whose mothers took fluoxetine in the 1st trimester of pregnancy, compared with children whose mothers did not receive this medication.
It was not possible to establish a reliable relationship between the use of the drug in the early stages of pregnancy and the formation of malformations in the fetus. The specific group of CCC abnormalities was also not determined.
The use of SSRIs in the last weeks of pregnancy contributes to the development of complications in newborns, in particular, the prolongation of the duration of ventilation and probe nutrition and the duration of hospitalization.
There are mentions of the development of apnea, respiratory distress syndrome, seizures, hypoglycemia, lability of body temperature and blood pressure, tremor, hyperreflexia, vomiting, cyanosis, difficulties with adequate nutrition, constant crying, excitability, nervous irritability.
The listed pathological conditions can be a consequence of the syndrome of withdrawal of SSRIs or the manifestation of their toxic effects.

Reviews of fluoxetine
Feedback from the host fluoxetine (APO, Lannacher, Kanon) patients leave the impression of the efficacy of this remedy for depression, bulimic neuroses and OCD.
At forums also the possibility of application of a preparation for the control of appetite and correction of weight is quite often discussed.
Reviews of doctors about fluoxetine for weight loss are unequivocal: you can use a medicine to fight excess pounds only if the cause of weight gain is a mental disorder.
When excess weight is the result of depression caused by stress or overeating, the drug for 2-3 weeks can completely get rid of binge eating attacks and for the first month to remove up to 5 kg.
Reviews losing weight about Fluoxetine (Lannacher, OZONE, etc.) allow you to conclude that to reduce weight on this drug is not possible to all: someone has completely lost appetite (right up to aversion in food), someone has left it the former.
However, in most cases, the remedy has serious side effects: many people who took it noted a decrease in sexual desire and a deterioration in sexual life, a sense of inhibition, severe pain, drowsiness, increased aggression, the appearance of suicidal thoughts.
In addition, for many of the debilitated drugs, the need to stop driving and drinking alcohol, and the fact that fluoxetine is highly addictive.
Summarizing reviews, the following conclusions can be drawn: Fluoxetine is primarily a cure for depression and can only be taken if there is evidence and only under the supervision of a doctor.

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 Bentyl (Dicyclomine)

♻Description of the active substance Dicyclomine / Dicyclomine.
Formula: C19H35NO2, the chemⅈcal name: 1-cyclohexylcyclohexanecarboxylⅈc acⅈd, beta- (diethylamino) ethyl ether (as hydrochlorⅈde).

♻Pharmacologⅈcal group: vegetotrophⅈc agents / cholⅈnolytⅈc agents / m-cholⅈnolytⅈcs; organotropⅈc agents / antⅈspasmodⅈc myotropⅈc.

♻Pharmacologⅈcal actⅈon: myotropⅈc, antⅈcholⅈnergⅈc, spasmolytⅈc.

♻Pharmacologⅈcal propertⅈes

Dicyclomine ⅈs a quaternary amⅈne. Dicyclomine has antⅈcholⅈnergⅈc actⅈvⅈty, elⅈmⅈnates spasm of smooth muscles of the gastroⅈntestⅈnal tract and reduces the paⅈn syndrome caused by ⅈt. ⅈn anⅈmal studⅈes (ⅈn vⅈtro studⅈes usⅈng ⅈsolated guⅈnea-pⅈg small ⅈntestⅈne), ⅈt has been establⅈshed that the effect of Dicyclomine ⅈs medⅈated by the followⅈng mechanⅈsms: dⅈrect actⅈon on smooth muscles, as ⅈndⅈcated by the abⅈlⅈty of dⅈcycols to block hⅈstamⅈne and bradykⅈnⅈn-ⅈnduced spasms (atropⅈne does not alter the response to these two agonⅈsts); a specⅈfⅈc antⅈcholⅈnergⅈc effect on the acetylcholⅈne receptor sⅈtes, whⅈch ⅈs sⅈmⅈlar to the actⅈon of atropⅈne (antⅈmuscarⅈnⅈc actⅈvⅈty). ⅈn ⅈn vⅈvo studⅈes ⅈn dogs and cats, Dicyclomine was approxⅈmately equally effectⅈve agaⅈnst ⅈntestⅈnal spasms, whⅈch are caused by barⅈum chlorⅈde and acetylcholⅈne. The absence of a sⅈgnⅈfⅈcant effect of Dicyclomine on the secretⅈon of salⅈvary glands (ⅈn studⅈes ⅈn rabbⅈts, dⅈcyclosterⅈn showed 1/300 of atropⅈne actⅈvⅈty), and also on the pupⅈl (ⅈn studⅈes on mⅈce, the actⅈvⅈty of mydrⅈatⅈc effects was about 1/500 of atropⅈne actⅈvⅈty).
Data on the possⅈble mutagenⅈcⅈty and carcⅈnogenⅈcⅈty of Dicyclomine hydrochlorⅈde ⅈn humans are absent. There were no long-term anⅈmal studⅈes to assess the possⅈble carcⅈnogenⅈcⅈty of Dicyclomine.
Dicyclomine dⅈd not have a dangerous effect on reproductⅈon, conceptⅈon and labor ⅈn studⅈes ⅈn rats when admⅈnⅈstered at doses up to 100 mg / kg per day.
Dicyclomine ⅈs well absorbed, and faster and easⅈer after ⅈntramuscular ⅈnjectⅈon (10 to 20 mⅈnutes) than after oral admⅈnⅈstratⅈon (after 1 to 1.5 hours). The elⅈmⅈnatⅈon half-lⅈfe ⅈs 1.8 hours. ⅈt ⅈs excreted from the body after 9 to 10 hours maⅈnly wⅈth urⅈne (approxⅈmately 80%) and ⅈn small amounts – wⅈth feces.

Colⅈc (renal, hepatⅈc, ⅈntestⅈnal), algodⅈsmenorea.

♻Method of applⅈcatⅈon of Dicyclomine and dose

Dicyclomine ⅈs admⅈnⅈstered ⅈntramuscularly, taken ⅈnternally. The dose ⅈs set ⅈndⅈvⅈdually.
Before usⅈng Dicyclomine, ⅈt should be clarⅈfⅈed whether the patⅈent has tachycardⅈa, because Dicyclomine can ⅈncrease the heart rate.
Cautⅈon ⅈs prescrⅈbed Dicyclomine at hⅈgh ambⅈent temperature (due to decreased sweatⅈng, the rⅈsk of hyperthermⅈa and heat stroke ⅈncreases). ⅈt ⅈs necessary to know that dⅈarrhea can be an early symptom of ⅈncomplete ⅈntestⅈnal obstructⅈon, especⅈally ⅈn patⅈents wⅈth colostomy or ⅈleostomy. ⅈn these cases, dⅈcyclosterⅈn hydrochlorⅈde therapy ⅈs not ⅈndⅈcated and, possⅈbly, wⅈll be dangerous.
There are reports that ⅈn patⅈents wⅈth hypersensⅈtⅈvⅈty antⅈcholⅈnergⅈc drugs can cause psychosⅈs.
Actⅈon on the central nervous system manⅈfests ⅈtself ⅈn the development of symptoms such as dⅈsorⅈentatⅈon, confusⅈon, short-term memory loss, dysarthrⅈa, hallucⅈnatⅈons, ataxⅈa, euphorⅈa, coma, decreased anxⅈety, ⅈnsomnⅈa, weakness, mannerⅈsms, agⅈtatⅈon, ⅈnadequate emotⅈonal reactⅈons. After dⅈscontⅈnuatⅈon of dⅈcyclosterⅈne, these symptoms usually decrease wⅈthⅈn 12 to 24 hours.
When treatⅈng Dicyclomine, potentⅈally dangerous actⅈvⅈtⅈes that requⅈre ⅈncreased attentⅈon, rapⅈd mental and motor reactⅈons (ⅈncludⅈng the management of vehⅈcles, mechanⅈsms) should be avoⅈded.

♻Contraindications for use
Hypersensⅈtⅈvⅈty, obstructⅈve dⅈseases of the gastroⅈntestⅈnal, urⅈnary and hepatⅈc tracts, reflux-esophagⅈtⅈs, peptⅈc ulcer and duodenal ulcer, severe ulceratⅈve colⅈtⅈs (there may be a decrease ⅈn ⅈntestⅈnal perⅈstalsⅈs, up to the development of paralytⅈc ⅈntestⅈnal obstructⅈon, the appearance or exacerbatⅈon of toxⅈc megacolon), myasthenⅈa gravⅈs , glaucoma, unstable cardⅈovascular system wⅈth acute bleedⅈng, hypovolemⅈc shock, chⅈldren’s age (up to 6 months), pregnancy, ne The rate of breastfeedⅈng.

♻Restrictions on the use
Impaⅈred lⅈver and kⅈdney functⅈon (decreased kⅈdney excretⅈon may ⅈncrease the rⅈsk of adverse reactⅈons), autonomⅈc neuropathy, tachycardⅈa, ⅈncludⅈng ⅈn hyperthyroⅈdⅈsm (possⅈbly amplⅈfⅈcatⅈon), heart dⅈsease (ⅈncludⅈng coronary heart dⅈsease, congestⅈve heart faⅈlure, tachyarrhythmⅈa), hypertensⅈon (possⅈbly exacerbatⅈon), hypertrophy of the prostate gland, hernⅈa of the esophageal openⅈng of the dⅈaphragm, ulceratⅈve colⅈtⅈs, age under 18 years.

♻Application in pregnancy and lactation
Durⅈng pregnancy, the use of dⅈcyclovⅈr ⅈs contraⅈndⅈcated. Strⅈctly controlled and adequate studⅈes ⅈn humans are not conducted. ⅈn reproductⅈve studⅈes ⅈn rabbⅈts and rats that receⅈved Dicyclomine hydrochlorⅈde ⅈn doses up to 33 tⅈmes hⅈgher than the maxⅈmum recommended doses for humans (3 mg / kg or 160 mg / day), undesⅈrable effects on the fetus or effects on fertⅈlⅈty have not been revealed. Dⅈcyclocerⅈdⅈne ⅈs contraⅈndⅈcated ⅈn breastfeedⅈng. ⅈt has been reported that Dicyclominee hydrochlorⅈde ⅈs excreted ⅈn breast mⅈlk; ⅈn chⅈldren who are breastfed, development of a respⅈratory dⅈstress syndrome ⅈs possⅈble. ⅈt ⅈs necessary to stop breastfeedⅈng for the duratⅈon of Dicyclomine therapy.

♻Side effects of Dicyclomine
Dⅈgestⅈve system: dry mouth, loss of taste, nausea, constⅈpatⅈon, anorexⅈa, dyspepsⅈa, vomⅈtⅈng, decreased appetⅈte.
Nervous system and sensory organs: dⅈzzⅈness, blurred vⅈsⅈon, drowsⅈness, weakness, nervousness, dⅈsorⅈentatⅈon, confusⅈon, psychosⅈs, short-term memory loss, dysarthrⅈa, hallucⅈnatⅈons, ataxⅈa, euphorⅈa, coma, decreased anxⅈety, ⅈnsomnⅈa, weakness, mannerⅈsms, agⅈtatⅈon, ⅈnadequate emotⅈonal reactⅈons, ⅈncreased ⅈntraocular pressure, paralysⅈs of accommodatⅈon.
Other: tachycardⅈa, decreased sweatⅈng, urⅈnary retentⅈon, allergⅈc reactⅈons.

♻Interactⅈon of Dicyclomine wⅈth other substances
The effects of Dicyclomine, ⅈncludⅈng sⅈde effects, may enhance drugs that have antⅈcholⅈnergⅈc actⅈvⅈty: class ⅈ antⅈarrhythmⅈcs (eg, quⅈnⅈdⅈne), amantadⅈne, antⅈhⅈstamⅈnes, benzodⅈazepⅈnes, antⅈpsychotⅈcs (eg phenothⅈazⅈnes), monoamⅈne oxⅈdase ⅈnhⅈbⅈtors, nⅈtrⅈtes and nⅈtrates, narcotⅈc drugs analgesⅈcs, trⅈcyclⅈc antⅈdepressants, sympathomⅈmetⅈcs.
Antⅈcholⅈnergⅈc drugs (ⅈncludⅈng Dicyclomine) counteract the effect of antⅈglaucoma drugs.
ⅈn the presence of ⅈncreased ⅈntraocular pressure, antⅈcholⅈnergⅈc drugs (ⅈncludⅈng Dicyclomine) can be dangerous when used ⅈn conjunctⅈon wⅈth cortⅈcosteroⅈds.
Antⅈcholⅈnergⅈc drugs (ⅈncludⅈng Dicyclomine) can affect the absorptⅈon ⅈn the dⅈgestⅈve tract dⅈgoxⅈn and ⅈncrease the concentratⅈon of dⅈgoxⅈn ⅈn the blood plasma.
Antⅈcholⅈnergⅈc drugs (ⅈncludⅈng Dicyclomine) can counteract the effects of drugs that alter the motor actⅈvⅈty of the gastroⅈntestⅈnal tract (metoclopramⅈde).
Antacⅈds can act on the absorptⅈon of antⅈcholⅈnergⅈc drugs (ⅈncludⅈng dⅈcyclosterⅈn), so avoⅈd sharⅈng them.
Oppressⅈon wⅈth antⅈcholⅈnergⅈc drugs (ⅈncludⅈng Dicyclomine) secretⅈon of hydrochlorⅈc acⅈd counteracts the actⅈon of drugs that are used to test gastrⅈc secretⅈon or therapy wⅈth achlorhydrⅈa.


Wⅈth an overdose of Dicyclomine, nausea, vomⅈtⅈng, dry mouth, dⅈffⅈculty swallowⅈng, headache, dⅈzzⅈness, dⅈlated pupⅈls, prolonged blurred vⅈsⅈon, tachycardⅈa, ⅈncreased respⅈratⅈon, fever, heat, dry skⅈn, excⅈtatⅈon of the central nervous system; perhaps curare-lⅈke actⅈon (ⅈ.e. neuromuscular blockade, whⅈch leads to muscle weakness and, possⅈbly, paralysⅈs).
Treatment: ⅈnductⅈon of vomⅈtⅈng, gastrⅈc lavage, the use of actⅈvated charcoal; for arrestⅈng excⅈtatⅈon used drugs wⅈth sedatⅈve effect (benzodⅈazepⅈnes, short-actⅈng barbⅈturates); as an antⅈdote, ⅈn the presence of ⅈndⅈcatⅈons, approprⅈate cholⅈnergⅈc drugs may be used.

♻Other names for thⅈs medⅈcatⅈon:
Algermin, Bentylol, Berclomine, Byclomine, Colchimax, Colicon, Colimix,  Cosaichill, Cyclominol, Cyclopam, Cyclopan, Cymine, Dibent, Diciclomina,  Dicicloverina, Dicomin, Dicycloverin, Dicycloverine, Dicycloverinum,  Dicymine, Difemic, Formulex, Kolantyl, Loverin,  Magesanp,  Mainnox, Merbentyl, Notensyl, Or-tyl, Relestal, Resporix, Trigan

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▶ Analogs of Clomid: Fertomid

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The Latin name of the substance: Clomiphenum(Clomipheni)

▶ Chemical name: 2- [4- (2-Chloro-1,2-diphenyl) phenoxy] -N, N-diethylethanamine (as citrate)

▶ Gross-formula: C26H28ClNO

▶ Therapeutic substance Clomiphene
Estrogens, progestins; antagonists, and their homologs

▶ The nosological classification (ICD-10)

  • E28.2 Syndrome of polycystic ovaries
  • N46 Male infertility
  • N91 lack of menstruation, scanty and rare menstruation
  • N93 Other abnormal bleeding from the uterus and vagina
  • N97 Female infertility
  • O92.6 galactorrhea

▶ Code CAS

▶ On sale is Clomid weight:

▶ Pharmacology
Mode of action – anti-estrogen.
It binds estrogen receptors in the hypothalamus and ovaries. If ingestion is well absorbed from the gastrointestinal tract. It is metabolized in the liver. Excreted in the bile, subjected to enterohepatic recirculation. Because the body is excreted in the faeces. T1 / 2 of 5-7 days. In small doses, it increases the secretion of gonadotropins (prolactin, FSH and LH) stimulates ovulation. At low levels of endogenous estrogens in the body has a mild estrogenic effect, at a high level – antiestrogen. By reducing the level of circulating estrogen, promotes the secretion of gonadotropins. In large doses slows secretion of gonadotropins. Progestogens, and androgen activity is not.

▶ Application of the substance Clomiphene
Anovulatory infertility (ovulation induction), dysfunctional uterine bleeding, amenorrhea (disgonadotropnaya form secondary, postkontratseptivnaya), galactorrhea (on the background of the pituitary tumor), polycystic ovaries (Stein syndrome – Leventhal), Chiari-Frommelya syndrome, androgen deficiency, oligospermia, for diagnosis violations of gonadotropic pituitary function.

▶ Contraindications
Hypersensitivity, severe liver and / or kidney failure, metrorrhagia of unknown etiology, ovarian cysts, pituitary tumor or failure, pregnancy (including suspected it).

Pregnancy and breast-feeding
Contraindicated during pregnancy.
Category effects on the fetus by FDA – X.

▶ Side effects of substance Clomiphene
From the nervous system and sensory organs: headache, dizziness, depression, fatigue, anxiety, insomnia, slowing of mental and motor responses, impaired vision.

From the digestive tract: nausea, vomiting, gastralgia, flatulence, diarrhea.

With the genitourinary system: cystic enlargement of the ovaries, dysmenorrhea, pollakiuria, polyuria, multiple pregnancy.

▶ Other: hot flashes, weight gain, pain in the abdomen, the chest, the testes (in men), hyperthermia, reversible hair loss, allergic skin reactions.

▶ Interaction
Compatible with drugs gonadotropins.

▶ Overdose
Symptoms: Nausea, vomiting, flushing, visual disturbances, pain in the abdomen.
▶ Treatment: symptomatic therapy.

▶ Dosing and Administration
Inside. To stimulate ovulation appoint 50 mg 1 time a day at bedtime, starting from 5th day of the menstrual cycle during 5 days (in the absence of the cycle – at any time); if there is no effect (ovulation does not occur within 30 days) increase the dose to 150 mg / day or lengthen the course to 10 days. Heading dose should not exceed 1 g of ovulation is determined by the presence of a biphasic basal body temperature, the average cyclical increase in production of LH, increase in serum progesterone during the luteal phase of the likely medium or menstruation women with amenorrhea. If ovulation has occurred and pregnancy has not occurred, it is necessary to repeat the course. If held after ovulation was no menstrual bleeding, you should take into account the possible pregnancy.

Men are not to treat oligospermia appoint 50 mg 1-2 times a day for 3-4 months (requires systematic monitoring spermiogram).

▶ Precautions substance Clomiphene
Before and during treatment must be continued monitoring gynecologist should check ovarian function, vaginal exercise study to observe the phenomenon of “pupil” and others. With an increase in ovarian cystic transformation or clomiphene treatment suspended until the normalization of the size of the ovaries. The therapy continues with minimal doses or shorten the period of treatment. The treatment is recommended to monitor liver function. You can not assign an exemption from work to persons whose professional activity requires quick physical and mental reactions.

▶ Doping Information
This drug is added to the list of banned doping agents. Detection time is 3-6 months, depending on the method of detection.

▶ Clomid (clomiphene) or Nolvadex (tamoxifen), which is better?
In this article we will try to resolve doubts about the choice between the two drugs, as well as find the differences: Clomid and Nolvadex.
Clomiphene citrate (available in pharmacies under the brand names Clomid, Clomid) and tamoxifen (brand name Nolvadex) is an antiestrogen trifeniletilenov belonging to the same group. They are structurally similar and are classified as selective estrogen receptor modulators with mixed agonistic and antagonistic properties. This means that in certain tissue, they block the action of estrogen receptors by binding, while in other tissues could act as a real estrogen receptors activating. In men, both drugs act as anti-estrogens in their ability to interfere with estrogen negative feedback on the hypothalamus and stimulate the increased production of GnRH (gonadotropin-releasing hormone). This will result in increased production of luteinizing hormone by the pituitary gland, which in turn can increase the production of testosterone by the testes. This makes both drugs, but for some reason bodybuilders continue to think that only good for Clomid testosterone stimulation.
Studies conducted in the late ’70s in the University of Ghent in Belgium make clear the advantages of Nolvadex over Clomid to increase testosterone levels. Researchers have looked at the effect of Nolvadex and Clomid endocrine system healthy men, as well as those who have suffered a small amount of spermatozoids (oligospermia). also found that Nolvadex when used for 10 days at a dosage of 20mg per day increased testosterone in the serum 142% of the initial level that was comparable with the effect of Clomid 150mg per day over the same period of time (an increase in testosterone levels were slightly but not significantly greater with Clomid). We must remember that this is the effect of three 50mg tablets of Clomid. At about the same price 50mg Clomid and 20mg Nolvadex we can already see a difference in relation to the price / benefit result in Nolvadex.

▶ Clomid (clomiphene) or Nolvadex (tamoxifen): differences
Clomid (Clomid) acts on the estrogen receptors in the pituitary and ovaries. By linking estrogen receptors in the pituitary gland, Clomid breaks a negative feedback mechanism, ie, if usually estrogen, acting on the pituitary gland, reduce the production of FSH and LH, when taking Clomid does not happen. Directly on blood levels of estrogen Clomid does not work.
Nolvadex (tamoxifen) also has no effect on estrogen levels, as its mechanism of action is also reduced to the estrogen receptor blockade, including the pituitary gland. However, Clomid is a more selective (selective) blocker and Nolvadex – less selective. If Clomid binds to estrogen receptors in the pituitary and preferably testes Nolvadex then contacting them almost in the entire organism. The exception is the bone where clomid and tamoxifen contrary to activate estrogen receptors.
Thus, Clomid acts as an estrogen antagonist and eliminates their inhibitory effect on the hypothalamus and pituitary gland, contributing to a more rapid recovery of their functions. Nolvadex blocks the receptors in almost all tissues and helps to ensure that the body began to rebuild its own testosterone. Importantly, Nolvadex capable of blocking estrogen receptors in the pituitary less than Clomid.
Clomiphene and tamoxifen did not affect the metabolism of estrogenic hormones, so the intake of estrogens these means continue to erode the liver enzymes, and do not accumulate in the body.

▶ Nolvadex has drawbacks: quite toxic (sometimes it manifests itself loss of appetite and nausea, increased risk of thrombosis). Tamoxifen increases the amount of progesterone receptors, so it can not be used, if the rate is based on progestin drugs (nandrolone, trenbolone). In this case, you should use clomiphene.

Dosages clomiphene citrate determined depending on the degree of severity of the course. The more drugs were involved than in high dosages, and how these drugs were stronger, the longer you will need time to recover, and the greater the amount of Clomid need.

▶ Overall, the scheme can be described as follows:
Very tough course – 3 * 150/12 * 100/15 * 50/15 * 25
Hard course – 15 * 100/15 * 50/15 * 25
The average rate – 30 * 50/15 * 25
Easy Course -15 * 50/15 * 25/15 * 25 (every 2 days)
Very easy course – 15 * 50/15 * 25
* Note – the first digit, the number of days, the second digit after the asterisk – dosage of clomiphene. For example, 15 * 50/15 * 25 means that the first 15 days is necessary to take 50 mg of Clomid, and then for the next 15 days – 25 mg.

▶ Reviews of Clomid in bodybuilding
Any negative reviews on the use of Clomid in bodybuilding absent. Not surprisingly, since the side effects of the drug are absent (at least, not observed). Clomiphene citrate helps athletes recover quickly and incurring minimal losses after a course of steroids.

▶ Question: What is Clomid?
Answer: This is a synthetic estrogen that is mostly prescribed by doctors to girls, to stimulate ovulation in women.
Question: Why do bodybuilders use it while Clomid?
Answer: As you know, all anabolic steroids lead to a reduction in endogenous secretion of testosterone by the body (yes, everything, even oxandrolone 20 mg for 4 weeks and your test with LH and FSH greatly reduced). After discontinuation of AAS endogenous testosterone at zero, and hormonal therapy is finished. It enters the body in the catabolic process. In turn, Clomid is used during this period to quickly lower stimulate FSH and LH and testosterone levels to raise usual. This will reduce the catabolism of the period for your body.

▶ As a therapeutic drug Clomid for infertility have started to apply to the United States in the early 70s. Today it is already known around the world and is produced by pharmaceutical companies under the names Clomid, serofen, sepafar, omifin, pergotaym, gonafen, duinum, klostil, AYou and klostilbegit.

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Malegra – is a modern drug for treating erectile disorders and premature ejaculation. Due to the fact that the product has a similar structure and mechanism of action, it is an analogue of Viagra. Unlike the original, this means a low incidence of adverse reactions of the body and has fewer contraindications.
This favorable difference is made possible thanks to an improved drug formula and the presence of ancillary components, which soften the effects of the active substance sildenafil. Malegra shows men with poor potency, reduced sexual vigor and sexual dissatisfaction. The product is effective in normalizing the hormonal levels and increase testosterone levels. Already after the first dose, he prolongs sexual intercourse up to three times. Malegra can be taken occasionally to prolong sexual intercourse, or a course of treatment for a qualitative systematic premature ejaculation.

Malegra how the
The mode of action is to suppress Malegra ejaculation and increased blood flow to the pelvic organs. Due to the active ingredient drug relaxes the smooth muscles of the penis. This effect not only increases the flexibility and elasticity of body muscle tissue, making it more sensitive, but also provides a healthy blood circulation inside the genitals.
As a result of increased blood inflow erection in men is achieved much faster, it becomes stronger and persists for several hours. Slowing ejaculation occurs by blocking the action of the enzyme PDE-5, which is responsible for ejaculation and narrowing of the blood vessels of the penis. Thanks to the relaxing effect of the drug vessels to dilate, which promotes quality nutrition cavernous calf muscle and holding a long intercourse. Furthermore, the effect of sildenafil allows to obtain the necessary amount of oxygen.

Malegra reading
The main indication for the use of the drug Malegra is the presence of erectile dysfunction. This pathology manifests itself weak and short-lived erections, premature ejaculation, low sexual energy, the partial or complete absence of erection.
The last symptom is usually said about the threat of impotence, erectile disorders therefore should be of high quality, regular and long. Clinical trials have shown that the four-week course of treatment Malegroy significantly improves sexual health. After treatment, most patients feel a surge of vitality and energy, strengthening erections and increase the duration of intimacy.
Malegra no less effective for the treatment of prostatitis and infertility. In these diseases, the product can be used as an adjuvant. Malegra has an excellent protective effect. Its components have anti-viral and anti-microbial properties that restore the healthy microflora of the pelvic organs. In addition, the chronic administration of the product at the man there is an increase in testosterone levels and normalization of hormonal levels.

Malegra effect
Malegra prompt action and, at the same time, safe for the organism. The drug starts to work after only an hour after ingestion, and its effect lasts for six hours. Under the influence of money in men increased sexual experiences, sexual organ enhanced sensitivity and the erogenous zones, the penis increases of two to four centimeters, and the erection becomes more stable and long-term.
Increased testosterone that is seen with regular use of the product is due to the rupture of relations with hormone proteins. As a result, the level of free testosterone increases, and with increased potency and sexual activity with him. Malegra has a positive impact on the quality of reproductive function, increasing semen production and sperm increasing speed.

Malegra contraindications
Malegra has effective action and consists of a powerful selective agents. This tool has a number of contraindications, in which use of sildenafil may cause serious harm to the body. First of all, the drug is absolutely contraindicated with hypersensitivity to sildenafil. Using Malegry allergy to the active component may cause severe complications and in some cases death. Before taking this product it is necessary to exclude the presence of individual intolerance. Start using the medication is recommended with a minimum dose.
Malegra also contraindicated in severe heart disease, kidney and liver. The drug is dangerous for men with epilepsy. Contraindication is a medical condition in which a person is not recommended for sexual activity (eg, heart attack or stroke). Malegra can not be used for women, minors young people, young children and men over 65 years. Also contraindications include injury to the penis and the presence of inflammatory processes in the body.

Malegra intake with alcohol
Malegra drug is not compatible with alcohol. Ethanol reduces the level of efficiency of mineral trace elements. By its action in the body decreases the rate of absorption of the drug into the bloodstream. In addition, sildenafil increases the concentration of alcohol in plasma, which in turn can cause enhanced expression of adverse reactions and serious health problems. It should be understood that even a small dose of liquor in conjunction with Malegra may cause unexpected reaction of the body, poisoning and intoxication.

Malegra reception with fatty foods
Experts do not recommend to eat fatty foods during the period of treatment with drugs to increase potency and eliminate erectile dysfunction. Vegetable and animal fats prevent rapid absorption of useful trace elements into the bloodstream, resulting in product effect occurs much later than the expected time. In this case Malegra can not give a positive effect. In the treatment of erectile dysfunction with this drug the man recommended to eat light foods that are low or moderate in fat (30-35%).

Malegra side effects
Malegra cause side effects if you are hypersensitive to the active substance or an overdose. In such cases, a man may occur following adverse reactions of the body: headache, dizziness, temporary disruption of visual acuity, increased eye sensitivity to light, light rhinitis symptoms, nausea, vomiting, upset the gastrointestinal tract, increased body temperature, redness of the face and neck , tachycardia, spasms in the lumbar region.
These side effects are not a direct threat to the body. Almost 100% of the time they are within one or two hours, without the use of additional medication. When the manifestation of severe and prolonged adverse reactions person should seek medical care. At the hospital, the doctor will conduct a series of surveys and prescribe symptomatic therapy.

Malegra overdose
If overdose Malegra the man manifested reinforced side effects. Among the first symptoms of overdose include: severe headache beggars, nausea and vomiting, cutting pain in the eyes, increased body temperature and blood pressure, weakness. The drug at high doses is harmful to the body. Severe overdose can cause serious poisoning, in which should go to the hospital. With an overdose of selective inhibitors of patients compulsorily assigned stomach lavage with potassium permanganate.

Malegra interactions with other drugs
Malegra not compatible with a number of potent drugs. The drug should not be taken together with the nitrogen donators, inhibitors of other enzymes, nitrates all groups, medicines to treat HIV, antidepressants, amphetamines. In the treatment of substances which are not mentioned above, prior to use Malegra recommended to consult a specialist and undergo a medical examination. Admission Malegra incompatible drugs is dangerous not only to the emergence of adverse reactions, but serious complications. The product can be used in conjunction with vitamins, dietary supplements, mineral complexes.

Malegra Dosing and Administration
Malegra should be taken one hour before the start of sexual intimacy. The tablet or its part must be washed down with water or other liquid that does not contain alcohol. The maximum daily dose is 100 milligrams (one tablet). The manufacturer recommends taking the drug at a lower dose (50 mg).
Men are elderly, and patients with chronic diseases of the heart, blood vessels and liver should reduce the dose to a quarter of a tablet (25 mg). Malegra suitable for daily use. In the treatment of erectile disorder remedy can be used for three to four weeks. Before receiving read the instructions. Do not use the product after the expiration date. Keep it should be in a dry, dark and cool room at a temperature of 25 degrees Celsius.

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Sildalis is used to treat sexual dysfunction in men. This is a unique combination drug that can restore potency and sex drive. The composition of the tablets is really unique, because there is no similar analogues in the components of the pharmaceutical market. Numerous reviews indicate its high efficiency.

Sildalis available in tablet form for oral administration. Externally, the formulation is a tablet rectangular shape. The color is usually red. In the middle there is a dividing line, through which the tablet can be easily divided into two stages. Consisting of sildenafil and tadalafil. Instructions for use indicates that one tablet is chosen optimal therapeutic dose of both components, which is 100 mg and 20 mg, respectively.
Sildenafil and Tadalafil are a group of drugs – a fifth selective inhibitors of phosphodiesterase type, but each of them has specific characteristics with respect to the start and duration of action. In general, their effect is due to inhibition of the activity of this enzyme. As a result Sildalis causes vasodilation, in particular the corpora cavernosa of the penis. Enhancing blood flow and greater blood flow to the male genitals provide a full erection necessary for satisfactory sexual intercourse. The advantage of the preparation is that the two components potentiate each other’s effect. This fact is confirmed by many men reviews.

About the indications and contraindications
Instructions for use allocates some indications. Basically, they are all connected with the violation of erectile function. It should be noted that Sildalis demonstrates efficacy in reducing the potency of various origins. Also note reviews a positive effect on the libido and sexual desire. With regard to the contraindications, the instruction manual notes the following:
presence of congenital deformities and developmental abnormalities of the penis in men;
combination with medications containing nitrates;
the presence of liver disease and kidney disease, accompanied by severe disorders of functions;
an allergic reaction to the drug components;
diseases of the cardiovascular system.

Also it should be noted that the use of the drug in people older than 65 years may be accompanied by certain risks. Despite the fact that many of the responses deny the occurrence of side effects, the use of Sildalis funds for the elderly requires special attention. Since at this age, as a rule, there is a concomitant chronic pathology. And the action of the means to increase potency may cause its exacerbation or significant deterioration of health.
Side effects are not common, but about the likelihood of their occurrence should be remembered. Against the background of the use of funds can be a headache, a feeling of flushing, nasal congestion, dizziness, dyspepsia, allergic reactions and transient violation of color. If you still have any symptoms of the above, it is a chance to see a doctor. But the main thing – do not panic, because usually after the abolition of drugs such effects are alone.

How to use
Instructions for use not recommended to take more than one pill per day Sildalis funds. The best reception is a whole tablet or half an hour before intended sexual intercourse. The exact dose depends on the body’s needs. Importantly, the effect of the drug begins only if exciting factor. The duration of beneficial effect after administration of the tablet is up to 36 hours. During this period, a man capable of committing several sexual acts. At the same time period required for recovery after ejaculation significantly reduced over time, as evidenced by the reviews.
During the application Sildalis few simple rules must be observed. This will help reduce the likelihood of side effects and improve efficacy of the treatment of erectile dysfunction. So, against the backdrop of improving drug potency is recommended:
Do not take pills with fatty foods – is reduced drug efficacy.
– Can not be combined with alcohol – decreases the effectiveness of the drug, and can worsen the overall male body.
– The period between two doses of pills should not be less than 24 hours.

Сost of
To purchase a medicament for improvement of potency in the recipe is not necessary. However, before using it is better to consult a doctor. At a minimum, it is necessary to identify the root cause of erectile dysfunction, as well as to determine the presence or absence of indications to the use Sildalis.
The advantage is that there are several options for drug packaging date. Thus, if a suitable Sildalis, the packaging can be easily purchased from 12,18 or even 48 tablets. In this case, the price per pill is lower than the purchase of smaller size packages.

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