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masteron hair loss

Pharmacodynamic dihydropyridine derivative – blocker “slow” calcium channels II generation, has antianginal and hypotensive action. Communicating with the dihydropyridine receptor, blocks calcium channels reduces the transmembrane passage of calcium ions into the cell (mainly in vascular smooth muscle cells than cardiac myocytes). Antianginal effect is due to the expansion of the coronary and peripheral arteries and arterioles: angina reduces the severity of myocardial ischemia; expanding peripheral arterioles, decreases total peripheral vascular resistance, decreases the preload on the heart, reducing myocardial oxygen demand. Expanding the major coronary arteries and arterioles in the unaltered and ischemic myocardial areas, increases the supply of oxygen to the myocardium (especially in vasospastic angina); It prevents the development of constriction of the coronary arteries (including those caused by smoking). In patients with angina single daily dose increases the run-time physical activity slows the development of angina and ‘ischemic »ST-segment depression, reduces the frequency of angina attacks and nitroglycerin consumption.

It has a long dose-dependent hypotensive effect. The antihypertensive effect is due to the direct vasodilating effect on vascular smooth muscle. When hypertension single dose provides a clinically significant reduction in blood pressure (BP) for 24 hours (in the position of the patient “lying” and “standing”). It does not cause a sharp decline in blood pressure, reduce exercise tolerance, left ventricular ejection fraction. It reduces the degree of left ventricular hypertrophy, has anti-atherosclerotic and cardioprotective effect in ischemic heart disease (IHD). No effect on myocardial contractility and conductivity, does not cause reflex increase in heart rate (HR), inhibits platelet aggregation, increases glomerular filtration rate, has a weak natriuretic effect. In diabetic nephropathy does not increase the severity of microalbuminuria. It has no adverse effects on metabolism and plasma lipids. Time of onset of effect – 2 – 4 hours; effect duration – 24 hours.

Pharmacokinetics

After oral masteron hair loss slowly absorbed from the gastrointestinal tract. The mean absolute bioavailability of 64%, the maximum concentration in serum is observed after 6 – 9 hours. The concentration of stable equilibrium is reached after 7 days of treatment. Food does not affect the absorption of the drug. The mean volume of distribution of 21 l / kg body weight, indicating that most of the drug is in the tissues and relatively smaller – in the blood. Most of the drug present in the blood (95%), bind to plasma proteins.

masteron hair loss undergoes slow but extensive metabolism (90%) in the liver into inactive metabolites, has the effect of “first pass” through the liver. Metabolites not possess significant pharmacological activity.

After a single oral half-life (T 1/2 ) ranges from 31 to 48 hours when re-assigning the T 1/2 of about 45 hours. About 60% of an oral dose is excreted in the urine primarily as metabolites, 10% unchanged, and 20 – 25% in the feces and in breast milk. masteron hair loss Total clearance is 0.116 ml / sec / kg (7 ml / min / kg and 0.42 L / h / kg).

In elderly patients (65 years) masteron hair loss slowed elimination (T 1/2 – 65 hours) compared to younger patients, but the difference has no clinical significance.

Patients with liver failure elongation assumed T 1/2 and prolonged drug accumulation assignment will be higher in the body (T 1/2 to 60 hours). Renal failure has no significant effect on the kinetics of masteron hair loss. The drug crosses the blood-brain barrier. When hemodialysis is not removed.

Indications

Arterial hypertension (Monotherapy or in combination with other antihypertensive agents-governmental).
Angina, vasospastic angina (Prinzmetal angina)

Contraindications

– Hypersensitivity to masteron hair loss and other derivatives of dihydropyridine;
– Severe hypotension;
– Collapse, cardiogenic shock;
– Unstable angina (except Prinzmetal’s angina)
– Pregnancy and lactation;
– The age of 18 years (effectiveness and safety have been established).

Carefully: liver dysfunction, sick sinus syndrome (bradycardia, tachycardia), chronic heart failure decompensation, mild or moderate degree of hypotension, aortic stenosis, mitral stenosis, hypertrophic obstructive cardiomyopathy, acute myocardial infarction (and for 1 month after ), diabetes mellitus, older age.

Dosing and Administration

Inside, the initial dose for the treatment of hypertension and angina is 5 mg once in one day. The dose may be increased to a maximum of 10 mg once a day. When hypertension maintenance dose may be 2.5 – 5 mg per day. When angina and vasospastic angina – 5 – 10 mg per day, once. For the prevention of angina attacks – 10 mg / day.

Thin patients, patients with a short, elderly patients, patients with impaired liver function as antihypertensive, masteron hair loss is administered in an initial dose of 2.5 mg, as anti-anginal agents – 5 mg.

Do not you want to change the dose while the appointment with thiazide diuretics, beta-blockers and angiotensin-converting enzyme (ACE) inhibitors. Not required dose modification in patients with renal insufficiency.

Side effect

Cardio-vascular system, palpitations, shortness of breath, marked reduction in blood pressure, fainting, vasculitis, edema (swelling of the ankles and feet), “tides” of blood to the face, rarely – arrhythmias (bradycardia, ventricular tachycardia, atrial flutter), chest pain, orthostatic hypotension, very rarely – the development or exacerbation of congestive heart failure, arrythmia, migraine.

On the part of the central nervous system: headache, dizziness, fatigue, drowsiness, mood changes, seizures, rare – loss of consciousness, hypoesthesia, nervousness, paresthesia, tremor, vertigo, fatigue, malaise, insomnia, depression, abnormal dreams, very rarely – ataxia, apathy, agitation, amnesia .

From the digestive system: nausea, vomiting, epigastric pain, rarely -increasing the level of “liver” transaminases and jaundice (caused by cholestasis), pancreatitis, dry mouth, flatulence, gingival hyperplasia, constipation or diarrhea, very rarely -gastrit, increased appetite.

With the genitourinary system: rare – pollakiuria, tenesmus, nocturia, sexual dysfunction (including reduced potency); very rarely – dysuria, polyuria.

For the skin: very rarely – dermatoxerasia, alopecia, dermatitis, purpura, skin discoloration.

Allergic reactions: pruritus, rash (including erythematous, maculopapular rash, urticaria), angioedema.

From the musculoskeletal system: rarely – arthralgia, arthrosis, myalgia (with prolonged use); very rarely – myasthenia gravis.

Other: rare – a gynecomastia, poliurikemiya, increase / decrease in body weight, thrombocytopenia, leukopenia, hyperglycemia, impaired vision, diplopia, conjunctivitis, eye pain, tinnitus, back pain, dyspnoea, epistaxis, increased sweating, thirst; very rarely – a cold clammy sweat, cough, rhinitis, parosmiya. taste disturbance, disturbance of accommodation, xerophthalmia.

 

Overdose

Symptoms: pronounced reduction in blood pressure, tachycardia, excessive peripheral vasodilation.

Treatment: gastric lavage, the appointment of activated carbon, the maintenance function of the cardiovascular system, the control performance of the heart and lungs, limbs elevated position, control of blood volume and diuresis. To restore vascular tone – use of vasopressors (in the absence of contraindications to their use); to eliminate the effects of calcium channel blockade – intravenous calcium gluconate. Hemodialysis is not effective.

 

Interactions with other drugs

Inhibitors of microsomal oxidation increase the concentration of masteron hair loss in plasma, increasing the risk of side effects, and inducers of microsomal liver enzymes decrease.

Antihypertensive effect of weakening nonsteroidal anti-inflammatory drugs, especially indomethacin (sodium retention and renal prostaglandin synthesis blockade), Alpha adrenostimulyatorov, estrogens (sodium retention), sympathomimetic.

Thiazide and “loop” diuretics, beta-blockers, verapamil, ACE inhibitors and nitrates increase antianginal and antihypertensive effects.

Amiodarone, quinidine, alpha 1 adrenoblokatory, antipsychotic drugs (neuroleptics) and blockers “slow” calcium channels may increase the hypotensive effect.

It has no effect on the pharmacokinetic parameters of digoxin and warfarin.

Cimetidine does not affect the pharmacokinetics of masteron hair loss.

In a joint application with drugs lithium may increase manifestations of neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

Calcium can reduce the effect of blockers “slow” calcium channels.

Procainamide, quinidine, and other drugs that cause elongation interval QT, Reinforce the negative inotropic effect and may increase risk of significant lengthening of the interval QT.

Grapefruit juice may reduce masteron hair loss plasma concentration, but this decrease is so small that it does not significantly alter the effect of masteron hair loss.

special instructions

During the period of treatment is necessary to control body weight and sodium intake, the appointment of an appropriate diet.

It is necessary to maintain dental hygiene and frequent visits to the dentist (to prevent soreness, bleeding and gingival hyperplasia).

The dosage regimen for the elderly is the same as for the patients in other age groups.

By increasing the dose should be carefully monitored for elderly patients.

Despite the lack of blockers “slow” calcium channels “cancellation” syndrome, before stopping treatment recommended a gradual reduction in dose.

masteron hair loss has no effect on plasma concentrations of K + , glucose, triglycerides, total cholesterol, LDL cholesterol, uric acid, creatinine and uric acid nitrogen.

 

The effect on the ability to drive the vehicle and the mechanisms

There were no reports on the effect of masteron hair loss on driving or using machinery. However, some patients in the early treatment preferably may occur drowsiness and dizziness. If this happens, the patient must take special precautions when driving and operating machinery.

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oral masteron

oral masteron is a class III antiarrhythmic agent (inhibitor of repolarization). It has also antianginal, vasodilatig, alpha- and beta-adrenoceptor blocking, thyrotropin and hypotensive action. Antianginal effect is due to the influence on the electrophysiological processes of the myocardium; prolongs the action potential of cardiomyocytes; increases the effective refractory period of atrial, ventricular, atrioventricular (AV) node, bundle of His and the Purkinje fibers, additional ways of excitation. By blocking the “fast” sodium channels, it has effects that are typical of class I antiarrhythmic drugs. Hinders slow (diastolic) depolarization of the membrane of the sinus node cells, causing bradycardia, depresses AV conducting (antiarrhythmics of class IV effect).

Antianginal effect is due koronarorasshiryayuschee and antiadrenergicheskim action, decrease myocardial oxygen demand. It has an inhibitory effect on alpha- and beta-adrenergic receptors of the cardiovascular system (without their complete blockade). It reduces sensitivity to hyperstimulation of the sympathetic nervous system, the resistance of the coronary vessels; increase coronary blood flow; It slows the heart rate (HR); It increases the energy reserves of the myocardium (by increasing the content of creatine phosphate, adenosine triphosphate and glycogen). The structure is similar to oral masteron thyroid hormones.The iodine content is about 37% of its molecular weight. Influences the metabolism of thyroid hormones, inhibits the conversion of thyroxine (T4) into triiodothyronine (T3) (block thyroxine-5-deiodinase) and blocks the capture of these hormones cardiocytes and hepatocytes, which leads to a weakening of the stimulating effect of thyroid hormones on the myocardium (T3 deficiency can lead to overproduction of thyroid-stimulating hormone, and hyperthyroidism).

Pharmacokinetics. The ingestion time required to reach maximum plasma concentration (TSmah) is 2-10 hours.

Absorption slow and variable – 30-50% bioavailability – 40% -50%, connection with plasma proteins krovi- 95% (62% – Albumin,% 33.5 – beta-lipoproteins). The range of therapeutic plasma concentrations – 1-2.5 mg / L (but in determining the dose should be kept in mind and the clinical picture). The volume of distribution of large – 66 L indicating the intensity distribution masteron enanthate in the tissue. It has a high lipid solubility, high concentrations stored in fatty tissue and organs with a good blood supply (concentration in adipose tissue, liver, myocardium, kidney higher than in plasma at 300, 200, 50 and 34 times, respectively).Pharmacokinetics of oral masteron necessitate the use of the drug in high doses load. Penetrates through the blood-brain barrier (BBB) and the placenta (10-50%), is secreted in breast milk (25% of the dose received by the mother). Metabolized mainly in the liver and partly in the intestinal mucosa. In the liver, oral masteron is metabolized via the cytochrome P450 (isoenzyme CYP3A4) by dezetilirovaniya, -By N-dealkylation in the intestinal mucosa. The main metabolite – dezetilamiodaron – is pharmacologically active and may enhance the antiarrhythmic effect of a basic compound, possibly also by deiodination (a dose of 300 mg is released about 9 mg of elemental ‘iodine). In long-term treatment of iodine concentrations may be as high as 60-80% concentration of oral masteron. Given the ability to cumulation and the associated greater variability of pharmacokinetic parameters, data on half-life (T1 / 2) are contradictory.

T1 / 2 after a single dose is, on average, from 3.2 to 20.7 hours, and the clearance – from 0.14 to 0.69 l / min. When long-term therapy the half-life is significantly increased, up to 13-103 days (mean 53 ± 24 days). After discontinuation of oral masteron for removal from the body takes several months. Displayed through the gut (85-95%), kidney output of less than 1% of an oral dose (so when impaired renal function there is no need for dose adjustment). Neither oral masteron or its metabolites undergo dialysis.

During the first few days of therapy, the drug accumulates in the body. Breeding begins in just a few days. Equilibrium plasma concentrations are reached gradually over a few weeks or months. Therefore, treatment is initiated with full loading dose to rapidly achieve a therapeutic concentration of the drug in the tissues.

Clinically significant antiarrhythmic effect develops after about 7 days, and the maximum effect- 15-30 days. After the cessation of treatment the therapeutic effect lasts for 10-30 days.

Indications Prevention of recurrence of paroxysmal arrhythmias: a life-threatening ventricular arrhythmia (including ventricular tachycardia and ventricular fibrillation): supraventricular arrhythmias (including the organic diseases of the heart, and the ineffectiveness of or inability to use another antiarrhythmic therapy) ; documented episodes of recurrent sustained supraventricular paroxysmal tachycardia in patients with Wolff-Parkinson-White syndrome; atrial fibrillation (AF) and atrial flutter.

Contraindications

  • Hypersensitivity to any component of a drug or iodine;
  • sick sinus syndrome (SSS) (sinus bradycardia and sinoatrial block, in the absence of a pacemaker (risk of cardiac sinus node);
  • atrioventricular block degree II-III, two and Three-beam blockade (without pacemaker);
  • severe hypotension;
  • thyroid dysfunction (hypo- and hyperthyroidism); preliminary laboratory should determine the functional state of the thyroid gland;
  • concomitant use with drugs that may prolong the QT interval and cause the development of paroxysmal tachycardia, including polymorphic ventricular tachyarrhythmias such as “pirouette» ( «torsade de pointe»):
    • antiarrhythmics class IA (quinidine, disopyramide, procainamide), class III antiarrhythmic drugs (dofetilide, Ibutilide, bretylium tosylate), sotalol;
    • other (non-antiarrhythmic) tools, such as: bepridil; vincamine; some antipsychotics: phenothiazines (chlorpromazine, tsiamemazin, Levomepromazine, thioridazine, trifluoperazine, fluphenazine), benzamides (amisulpride, sultopride, sulpiride, tiaprid, veraliprid), butyrophenones (droperidol, haloperidol, sertindole, pimozide, cisapride, tricyclic antidepressants, macrolide antibiotics ( particularly with intravenous erythromycin, spiramycin) azoles; antimalarials (quinine, chloroquine, mefloquine, halofantrine), pentamidine when administered parenterally; difemanila methylsulfate, mizolastine, astemizole, terfenadine, fluoroquinolones;
  • hypokalemia and hypomagnesemia, refractory to adequate therapy
  • pregnancy (except in urgent cases where the expected benefit justifies the risk);
  • lactation;
  • interstitial lung disease;
  • concomitant use of monoamine oxidase inhibitors (MAOIs);
  • age of 18 years (effectiveness and safety have been established);
  • Hereditary lactose intolerance, Lapp lactase deficiency or malabsorption syndrome glucose-galactose.

Precautions: chronic heart failure (III-IV functional class NYHA classification), AV blockade degree I, liver failure, asthma, older age (higher risk of severe bradycardia).

Pregnancy and lactation should not be used in pregnancy oral masteron, because in this period thyroid iodine newborn begins to cumulate and oral masteron in this period may trigger the development of hypothyroidism because of increasing concentrations of iodine. Application of pregnancy and lactation is possible only in life-threatening rhythm disturbances after failure of other antiarrhythmic therapy because It causes dysfunction of the thyroid gland of the fetus.

oral masteron is excreted in breast milk in significant quantities, and the drug is contraindicated during lactation. If necessary, use during lactation, it is necessary to cancel the breastfeeding.

Dosing and Administration Inside, the tablets should be swallowed whole, drinking plenty of fluids. The drug can be taken with or after a meal.

Dosage is determined individually according to the patient’s condition and needs and adjusted by your doctor.

Load ( “saturates”) the dose in a hospital: initial dose (divided in several (2-3) techniques) is 600-800 mg / day (up to a maximum dose of 1200 mg / day), up to a total dose of 10 grams (typically within 5-8 days).

Ambulatory . initial dose divided into several stages is 600-800 mg / day to a total dose of 10 grams (usually 10-14 days).

Maintenance dose When maintenance therapy is lowest effective dose depending on the individual response of the patient and is generally from 100-400 mg / day. (1 / pi 2-2) 1-2 reception.

Because of the long half-life period of the drug may be used in a day or to take a break in the reception of the preparation two times a week (receive therapeutic doses for 5 days per week, with an interval of 2 days at the weekend). In the treatment of elderly patients is recommended to use the lowest loading and maintenance dose of the drug Amiokordin ® .

The average therapeutic single dose – 200 mg, the average daily therapeutic dose – 400 mg. The maximum single dose – 400 mg, the maximum daily dose – 1200 mg.

Side effect

Classification of the incidence of side effects (WHO): often 10% and more often 1% or more; less than 10% sometimes 0.1% or more; less than 1% rarely 0.01% or more; less than 0.1% is rarely less than 0.01%, including isolated reports; the frequency is unknown (according to available data rate can not be determined).

Cardiovascular system: often – moderate sinus bradycardia (dose-dependent; refractory to anticholinergics); sometimes – sinoatrial block. atrioventricular block of various degrees, proaritmogennoe effect (strengthening existing or appearance of a new arrhythmia, including heart failure); very rarely – bradycardia, sinus arrest (in patients with sinus node dysfunction and in the elderly); the frequency is unknown – long-term use – the progression of chronic heart failure symptoms.

The respiratory system: often – alveolar or interstitial pneumonitis. bronchiolitis obliterans with pneumonia, including fatal, pleural effusion, pulmonary fibrosis; rarely -. bronchospasm in patients with severe respiratory failure patients (particularly in patients with asthma), acute respiratory syndrome, including fatal; the frequency is unknown – pulmonary hemorrhage.

From the digestive system: very often – nausea, vomiting, loss of appetite until his loss, dulling or loss of taste, metallic taste in the mouth, feeling of heaviness masteron steroid in the epigastric pain, abdominal pain, increased activity of “liver” transaminases (1.5 3 times higher than normal) serum; often – acute toxic hepatitis with increased activity of “liver” transaminases or jaundice, including hepatic failure, includingfulminant hepatitis; very rare – chronic liver failure (steatohepatitis (non-alcoholic), cirrhosis).

From a sight organ: very often – the deposition of lipofuscin in the corneal epithelium (often subjective complaints at the same time no, but if significant deposits and partially fill the pupil, may appeal to the appearance of colored ghosting or blurring); very rarely – optic neuritis / neuropathy, visual. From endocrine system: often – increase the T4 hormone concentrations in normal or slightly marked decrease in T3 hormone concentration (in the absence of clinical signs of thyroid medication should not stop dysfunction). Prolonged use may cause hypothyroidism, hyperthyroidism significantly less (necessary removal of the drug); very rarely – a syndrome of inappropriate secretion of antidiuretic hormone (ADH).

Dermatological reactions: very often – photosensitivity; often – lead-blue or bluish skin pigmentation (with prolonged use) after cessation of treatment disappears slowly for 10-14 days; very rarely – erythema (with simultaneous radiation therapy), rash, exfoliative dermatitis (connection with the drug intake is not installed), alopecia.

On the part of the central or peripheral nervous system: often – tremor and other extrapyramidal disorders, sleep disorders, including “Nightmarish” dream; rarely – peripheral neuropathy (sensory, motor, mixed) and / or myopathy; very rarely – cerebellar ataxia, benign intracranial hypertension (pseudotumor of the brain), headache.

Laboratory findings: very rarely with prolonged use – thrombocytopenia, hemolytic and aplastic anemia.

Other: very rarely – epididymitis, lower potency (connection with the drug intake is not installed), vasculitis, fatigue, impairment of renal function with an increase in the concentration of creatinine in the blood serum.

Overdose In case of toxicity in the form of pro-arrhythmogenic effect of the drug overturned. Symptoms: reduced blood pressure, sinus bradycardia, episodes of ventricular tachycardia, paroxysmal tachycardia type “pirouette”, atrioventricular block, aggravation of existing chronic heart failure, liver dysfunction, cardiac arrest.

Treatment: gastric lavage and administration of activated charcoal, if the drug has recently adopted. In other cases, symptomatic therapy. No specific antidote, hemodialysis is not effective, oral masteron and its metabolites are not removed by dialysis. With the development of bradycardia possible appointment of atropine, beta-agonists, or setting the pacemaker; tachycardia type “pirouette” – intravenous magnesium salts or pacing.

Interaction with other medicinal products is contraindicated in combination (as tachycardia increases risk of polymorphic ventricular type “pirouette» (torsade de pointe)):

  • with antiarrhythmics class IA (quinidine, gidrohinidin, disopyramide, procainamide), III of class (dofetilide, Ibutilide, bretylium tosylate), sotalol;
  • other (non-antiarrhythmic drugs), such as bepridil, vincamine, some antipsychotics: phenothiazines (chlorpromazine, tsiamemazin, Levomepromazine, thioridazine, trifluoperazine, fluphenazine), benzamides (amisulpride, sultopride, sulpiride, tiaprid, veraliprid), butyrophenones (droperidol, haloperidol) , sertindole, pimozide; tricyclic antidepressants, cisapride, macrolides (erythromycin when administered intravenously, spiramycin) azoles; antimalarial drugs (quinine, chloroquine, mefloquine, halofantrine, Lumefantrine); pentamidine (parenteral), difemanila methylsulfate, mizolastine, astemizole, terfenadine, fluoroquinolones (including moxifloxacin).

Not recommended combinations:

  • with beta-blockers, some blockers “slow” calcium channel blockers (verapamil, diltiazem), because can develop disorders of automatism (bradycardia) and conduction;
  • with laxatives which can cause hypokalemia, which increases the risk of ventricular tachycardia type “pirouette”.

Combinations in which caution should be exercised:

  • with drugs that cause hypokalemia (diuretics, systemic corticosteroids, tetrakozaktid, amphotericin B (iv)), as may develop ventricular tachycardia type “pirouette”;
  • indirect anticoagulants (warfarin) as It increases the risk of bleeding (due to inhibition of CYP2C9 isoenzymes and increasing concentrations of warfarin). It is necessary to monitor the concentration of prothrombin, and to adjust the dose of anticoagulants;
  • with cardiac glycosides, since there may be a violation of automatism (severe bradycardia) and AV-conduction. In addition, is possible to increase the concentration of digoxin in plasma by lowering its clearance (necessary to monitor the concentration of digoxin in plasma requires clinical and ECG -control);
  • with esmolol – violation of contractility, automatism and conduction (suppression of compensatory reactions of the sympathetic nervous system);
  • phenytoin, fosphenytoin, and cyclosporin – the risk of neurological disorders, possibly increasing the concentration of these drugs in the blood plasma by isoenzyme inhibiting CYP2C9 (phenytoin concentration should be controlled or cyclosporine in the blood plasma);
  • with drugs metabolized with isoenzyme CYP3A4 (cyclosporine, fentanyl, lidocaine, tacrolimus, sildenafil, midazolam, triazolam, dihydroergotamine, ergotamine, statins, including simvastatin) – increases their concentration of oral masteron (risk of toxicity and / or pharmacodynamic effects);
  • with orlistat – reducing the concentration of oral masteron and its active metabolite in the blood plasma;
  • with clonidine, guanfacine, cholinesterase inhibitors (donepezil, galantamine, rivastigmine, tacrine, ambenonium chloride, pyridostigmine, neostigmine), pilocarpine -risk of bradycardia (cumulative effects);
  • with kolestiraminom – decrease absorption half-life of oral masteron and concentration;
  • cimetidine – slowing metabolism of oral masteron that can cause an increase in oral masteron concentration in plasma;
  • with means for inhalation anesthesia and oxygen therapy – increased risk of bradycardia (refractory to atropine), hypotension, conduction disturbances, reduced cardiac output, acute respiratory distress syndrome, including fatal, the development of which is associated with high concentrations of oxygen;
  • oral masteron can inhibit the absorption of sodium iodide (131-I, 123-I) and sodium pertechnetate (99mTc) the thyroid gland, which can distort the results of the thyroid gland of radioactive research;
  • combined use with lithium increases the risk of hypothyroidism;
  • oral masteron increases the toxicity of methotrexate;
  • rifampicin, and St. John’s wort preparations (potent inducers of the isoenzyme CYP3A4) reduce the concentration of oral masteron in serum dezetilamiodarona (acceleration of metabolism in the liver);
  • oral masteron slows the metabolism of budesonide, that can result in the appearance of Cushing’s syndrome;
  • HIV protease inhibitors (amprenavir, indinavir, nelfinavir, ritonavir) increase the concentration of oral masteron in serum (risk of arrhythmias).
  • with klipodogrelom – may decrease plasma concentrations of clopidogrel;
  • dextromethorphan (substrate isozymes CYP3A4 and CYP2D6) – may increase concentrations (oral masteron inhibits isozyme CYP2D6);
  • with simvastatin – increased risk of side effects depend on the dose, such as rhabdomyolysis. simvastatin dose should not exceed 20 mg per day. If this dose can not achieve a therapeutic effect, it is necessary to switch to another statin does not react this type;
  • drugs that cause photosensitivity exert additive photosensitizing effect
  • Grapefruit juice increases the area under the curve “concentration-time» (AUC) and maximum concentration (Cmax) of oral masteron at 50% and 84%, respectively
  • oral masteron increases the concentration in the blood plasma quinidine, flecainide, procainamide and N-acetylprocainamide metabolite.

Special instructions: Before treatment, as well as the need to conduct ECG monitoring (the width of the QRS complex and the duration of the QT interval) every 3 months, it should recognize that older patients have more severe bradycardia. It is also necessary to conduct X-ray examination of the lungs, to assess the function of the thyroid gland (levels of hormones), liver (with an increase in “liver” transaminases 3 times or 2 times, in case of the initially enhanced activity reduce the dose until the complete cessation of therapy) and electrolytes in the blood plasma.

The frequency and severity of side effects depend on the dose, so you should apply the minimum effective maintenance dose.

In applying the drug Amiokordin ® may ECG changes: QT prolongation with possible appearance of teeth U. When atrioventricular block II and III degree sinoatrial blockade, as well as bundle branch block blockade treatment with Amiokordin ® should be discontinued immediately.

Progressive dyspnea and nonproductive cough may be a sign of lung disease. It is recommended that chest X-ray and pulmonary function tests (every 6 months, and in the case of clinical signs of lung disease).

Before therapy is necessary to determine the blood plasma electrolyte content. During drug treatment Amiokordin ® regularly monitoring the activity of liver enzymes.

In the course of treatment should be carried out ophthalmological research (identifying significant deposits in the cornea, and impaired vision require discontinuation of the drug Amiokordin ® ).

If you cancel a possible recurrence of cardiac arrhythmias.

After discontinuation of the drug pharmacodynamic effect persists for 10-30 days. The drug contains iodine, so it can affect the test results of accumulation of radioactive iodine in the thyroid gland.Therefore, before starting treatment, during the meeting, and for several months after treatment is necessary to conduct studies of thyroid function.

Before the surgery, as well as oxygen therapy must notify your doctor about use of the drug oral masteron ® , as noted rare cases of acute respiratory distress syndrome in adult patients in the postoperative period.

In order to avoid the development of photosensitivity, patients should avoid sun exposure or use effective protective measures.

Effects on ability to drive and other complex mechanical means: at the beginning of therapy, during dose adjustment should refrain from driving motor vehicles and activities potentially hazardous activities that require high concentration and psychomotor speed reactions.

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Pharmacodynamics main therapeutic effect Aminoplazmalya B. Braun E 5 consists in supplying the organism with a substrate protein synthesis parenteral nutrition. Introduction of amino acids necessary for protein synthesis (including conditionally-essential and nonessential amino acids) contained in Aminoplazmale E5 B. Brown, provides high the nutrient efficiency and reduces the load on the body by protein synthesis. To eliminate the input of amino acids as an energy source, it is necessary, simultaneous administration with Aminoplazmalem B. Braun E 5 donators energy such as fat emulsions and carbohydrate steroid masterons. In addition to amino acids Aminoplazmal B. Braun E5 contains minerals necessary to maintain water and electrolyte and acid-base balance.

Pharmacokinetics of intravenous amino acids enter into intravascular and endogenous intracellular depot and free amino acids as well as they function as a substrate for the synthesis of proteins of the organism. Bioavailability of all components Aminoplazmalya B. Braun E 5 with intravenous injection is 100%. In Aminoplazmale B. Braun E 5 individual concentration of amino acids selected in such a way as to not go beyond the norm with the intravenous administration of the steroid masteron biomex labs relative growth of each amino acid plasma concentrations that maintains the homeostasis of plasma amino acids. The amino acids not involved in protein synthesis, are metabolized as follows: as a result separated from the transamination of an amino group of a carbon skeleton or carbon chains further oxidized to CO 2 , or used as a substrate in the gluconeogenesis alpha pharma usa in the liver reactions. Amino groups are metabolized in the liver to urea.

Therapeutic indications Parenteral nutrition for the prevention and treatment of conditions of protein deficiency due to excessive loss of protein and / or an increased need for them:

  • Injuries moderate and severe, polytrauma, burns, peritonitis, sepsis, polirrgannaya failure according to the metabolic needs;
  • Conditions after major surgery;
  • Inflammatory bowel disease (including Crohn’s disease, ulcerative colitis), intestinal fistula;
  • Eating disorders of various origins (cachexia).Contraindications
  • Hypersensitivity to the drug;
  • Inborn errors of amino acid metabolism;
  • Severe circulatory disorders (shock);
  • Severe hypoxia;
  • Severe metabolic acidosis;
  • Progressive liver failure;
  • Acute renal failure, if it is impossible to conduct hemodialysis or hemofiltration;
  • Exceeding the maximum allowable concentration of electrolytes that are part of the drug in the blood plasma;
  • Children under 2 years old;
  • General contraindications for infusion therapy (decompensated heart failure, acute pulmonary edema, hyperhydration).Precautions Aminoplazmal B. Braun E 5 can only be used after careful assessment of risk / benefit ratio in the following cases:
  • Renal or hepatic insufficiency,
  • Increased plasma osmolality,
  • Hypotonic dehydration, as well as in all cases of violation of metabolism of amino acids, due to the reasons, is not a contraindication to the use of the drug.Use during pregnancy and lactation At present, insufficient clinical data on the use Aminoplazmalya B. Braun 5 E during pregnancy and lactation is not therefore possible its use in pregnant and lactating women only when the expected benefit from drug treatment than the potential risk of complications.Dosing and Administration Aminoplazmal B. Braun E 5 is introduced into the peripheral and central veins. To introduce Aminoplazmalya B. Braun E 5 is necessary to use only sterile system for intravenous infusion. During the use of the drug is necessary to control the injection site (the puncture site, or catheter) for signs of inflammation or infection. The drug is supplied in bottles designed for a single application. Any unused amounts of the drug can not be stored and should be discarded. Do not use the medication if the steroid masteron is not transparent, on the bottle there are clear signs of damage or broken seal. Dose Aminoplazmalya B. Braun E 5 is dependent on nutritional status and the individual patient’s needs in amino acids, electrolytes and liquid.Adults and children from 14 years of average daily dose of 20-40 ml / kg body weight, which corresponds to 1-2 g amino acids / kg body weight, 1400-2800 ml of the drug to patients with a body weight of 70 kg. The highest daily dose of 40 ml / kg body weight, which corresponds to amino acids 2 g / kg body weight, 140 g of amino acids, or 2800 ml of the drug for a patient weighing 70 kg. The maximum injection rate of 2 ml / kg body weight / hour, which corresponds to amino acids-0.1 g / kg body weight / hour, 45 drops / min or 2.34 ml / min for a patient weighing 70 kg. Babies Given below are the average dose. The dose should be selected according to the child’s age, stage and severity of the disease. For children from 2 to 5 years: 30 ml / kg body weight, which corresponds to amino acids 1.5 g / kg body weight. For children from 5 to 14 years: 20 ml / kg body weight, which corresponds to amino acids 1.0 g / kg body weight. The maximum injection rate of 2 ml / kg body / weight per hour, which. corresponds to amino acids 0.1 g / kg body weight / hour. If the need for amino acids is greater than 1 g / kg of body weight per day may use more concentrated steroid masterons of amino acids to reduce the water load. Duration of limitation on the duration of use of the drug is not revealed.Side effects

    In compliance with the recommendations in respect of these precautions, the speed of administration and dosage, side effects were observed, however, may develop allergic reactions. Rarely occurring adverse events (> 1: 1000, <1: 100): nausea, vomiting, headache, chills, fever may be associated with the beginning of parenteral nutrition and are not specific for B. Braun Aminoplazmalya E5.

    Overdose Overdose or a too rapid injection of the drug masteron can lead to phenomena such as fever, nausea, vomiting and increasing renal excretion of amino acids. In such cases, the drug administration should be resumed later prekraschenoi a lower infusion rate.

    Interactions with other drugs and other forms of interaction Drug interactions are not known. Mixing Aminoplazmalya B. Braun E 5 with the other components of parenteral nutrition (carbohydrates, fats, emulsions, vitamins, trace elements) should be carried out under aseptic conditions. It is necessary to check compatibility before use.

    Cautions To ensure complete digestion of amino acids, the introduction Aminoplazmalya B. Braun E 5 should be carried out simultaneously with drugs that provide the energy needs of the body (fat emulsions and carbohydrate steroid masterons), as well as vitamins and trace elements. It should be borne in mind that the possibility of introducing the above components in a peripheral vein will depend on the resultant osmolality of the steroid masterons. The period of treatment is necessary to control the water and electrolyte and acid-base balance, the level of serum proteins masteron steroid, osmolarity of blood serum concentration of glucose in the blood and liver. For patients with hepatic, renal, cardiac, pulmonary insufficiency necessary select an individual dosage regimen. When long-term administration (several weeks) should monitor coagulation and cellular composition of blood factors. In the case of hypotonic dehydration, first, it is necessary to restore an adequate balance of water and electrolytes, and then start parenteral nutrition. Storage at temperatures below 15 ° C can cause the formation of crystals which were dissolved by heating the steroid masteron to 25 ° C and gentle shaking.

    Product form steroid masteron for infusion. 250 ml, 500 ml and 1000 ml bottles hydrolytic glass class 2, sealed with a rubber stopper brick color matching requirements of the European Pharmacopoeia for infusion steroid masterons aluminum cap brick-red color and a plastic cap gray. By 10 bottles of 250 ml or 500 ml, 6 ml bottles 1000 together with instructions for use in an appropriate amount in a cardboard box (for hospitals).

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masteron (1)

masteron 100

Included in the masteron 100 preparation AMINE masteron 100 6% of natural amino acids are physiological komponentami.Posle parenteral administration, they are included in the free amino acid pool of the body and participate in all metabolicheckih processes, in particular, are used for protein synthesis.The bioavailability of the drug amine masteron 100e 6% by intravenous administration is 100%. Amino acids are included in the total pool of free amino acids in the body and distributed interstitial fluid and extracellular space of tissues and organs. The concentration of free amino acids in the cytoplasm of cells and blood plasma is regulated within a narrow range depending on the masteron 100 age, nutritional status and general condition of the patient. With the proper introduction (slowly and with constant speed) amine masteron 100e 6% does not violate the balance of amino acids. In severe violations of liver and kidney function regulation of amino acid balance is disrupted. In these cases, you should use special prescription amino acid solutions for parenteral nutrition. Only a small part of the amino acid is eliminated by the kidneys. Amino period plasma half-life masteron cycle is heavily dependent on age.

Indications for use:

Amine masteron 100e 6% for partial parenteral nutrition in neonates, masteron 100s and premature. Together with solutions of carbohydrates, fat emulsions, as well as vitamin preparations, electrolytes and trace elements provide total parenteral nutrition.

Contraindications:

As with other amino acid solutions of amine masteron 100e 6% should not be administered with amino acid metabolism disorders, and metabolic acidosis, overhydration, hypokalaemia. In hepatic and renal insufficiency requires an individual dosage.

Dosage and administration:

masteron 100 AMINE 6% for long intravenous drip, mainly in the central vein.

Maximum injection speed: 0.1 g of amino acids per 1 kg of body weight per hour = 1.67 ml / kg.

The maximum daily dose:

children under 1 year – amino 1.5-2.5 g per 1 kg of body weight, or from 25 ml to 40 ml of 6% aminic masteron 100e per 1 kg of body weight per day.

children 2-5 years – 1.5 g of amino acids per 1 kg of body weight or 25 ml per 1 kg of body weight per day.

masteron 100 AMINE 6% is applied as long as the need for parenteral nutrition.

Cautions:

In parenteral nutrition of young children should take into account the following indicators: nitrogen urine, ammonia, glucose, electrolytes, triglycerides (for additional administration of fat emulsions), liver enzymes, serum osmolarity, acid-base balance and water-salt metabolism.

Too rapid infusion could result in loss of amino acids through the kidneys, and thus, to the amino acid imbalance.

Solutions of amino acids due to the increased risk of microbial contamination should not be mixed with other drugs. Open vial amine ifant 6% should be stored in a refrigerator at a temperature no higher than 10 ° C for up to 24 hours.

Avoid add other drugs to the formulation AMINE masteron 100 6%, it may cause toxic reactions. In any case ensure compatibility agents, preserving sterility and thoroughly mixed. The solutions with the addition of other medications can not be stored.

Side effect:

When used properly, it is not revealed. When infusion of the drug amine masteron 100e 6% in peripheral veins may be observed signs of local reactions: redness, phlebitis, thrombosis. Recommended daily monitoring of the catheter insertion site.

Overdose:

If you exceed the dosage and rate of administration of the drug amine masteron 100e 6%, as an overdose of other amino acid solutions, there are chills, nausea, vomiting, kidney aminoatsidoz. Also may experience acute circulatory disorders. In this case, the introduction of the drug should be discontinued immediately. When hyperkalemia enter from 200 to 500 ml of 5% glucose solution with 3.1 IU insulin per 3.5 g of glucose.

Product form:

Glass bottles of 100 and 250 ml, with rubber stoppers and aluminum caps to break in, 10 bottles in a cardboard box with instructions for use.cheap testosterone cypionateanabolic steroids

isotretinion

masteron (2)

masteron steroids

The low molecular weight synthetic inducer of interferon, which stimulates the body’s all types of interferons (alpha, beta, gamma and lambda). Major producers of interferon in response to tilorona are intestinal epithelial cells, hepatocytes, T-lymphocytes, neutrophils, and granulocytes. After oral administration, maximum production of interferon is defined in the sequence intestine – liver – blood over 4-24 hours masteron steroids. ® has immunomodulatory and antiviral effect.

In human leukocytes induces the synthesis of interferon. It stimulates bone marrow stem cells, in a dose dependent increases antibody reduces the degree of immunosuppression, restores ratio T-suppressor and T-helper cells. It is effective against a variety of viral infections, including influenza virus, and other acute respiratory viral infections, hepatitis viruses and herpes viruses. The mechanism of antiviral action due to inhibition of translation of virus-specific proteins in the infected cells, whereby virus replication is inhibited.

Pharmacokinetics.

After intake of rapidly absorbed from the gastrointestinal tract. Bioavailability – 60%. About 80% of the drug binds to plasma proteins. Withdrawal of the drug virtually unchanged bradley martyn steroids through the intestines (70%) and the kidneys (9%). The half-life (T1 / 2) -. Preparation 48 hours no biotransformation and does not accumulate in the body.

Indications

In children older than 7 years: – for the treatment of influenza and other acute respiratory viral infections. In adults (over 18 years): – treatment and prevention of influenza and other acute respiratory viral infections; – the treatment of viral hepatitis A, B and C; – treatment of herpes and cytomegalovirus infections; – in the complex therapy of infectious-allergic and viral encephalomyelitis (multiple sclerosis, panencephalitis, uveoentsefalit et al.);- in the complex therapy of urogenital and respiratory chlamydia; – in the treatment of pulmonary tuberculosis.

Contraindications

Hypersensitivity to the drug. During pregnancy and lactation. Children under 7 years old.

Application of pregnancy and during breastfeeding

Use of the drug is contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.

Dosing and Administration

masteron steroids Inside, after a meal.

For children older than 7 years old: In uncomplicated forms of influenza and other acute respiratory viral infections – 60 mg 1 time per day on the 1st, 2nd and 4th day from the beginning of treatment. Heading dose – 180 mg (3 tablets). In the event of complications masteron dosage of influenza and other acute respiratory viral infections – 60 mg 1 time a day for 1 st, 2 nd, 4 th and 6 th day from the start of treatment. Heading dose – 240 mg (4 tablets).

For adults (over 18 years): For treatment of influenza and other acute respiratory viral infections – 125 mg of the first 2 days of treatment per day, then 125 mg every 48 hours. In the course – 750 mg (6 tablets). For the prevention of influenza and other acute respiratory viral infections – 125 mg 1 time per week for 6 weeks. In the course – 750 mg (6 tablets). For the treatment of herpes, cytomegalovirus infection – the first two days of 125 mg, followed 48 hours later by 125 mg. Heading dose – 1.25-2.5 g (10-20 tablets). For non-specific prevention of hepatitis A – 125 mg 1 time per week for 6 weeks. For the treatment of viral hepatitis A – on the first day on 125 mg 2 times and then 125 mg every 48 hours for the course -.. 1.25 g (10 tablets) for the treatment of acute hepatitis B – the first two days at 125 mg then 125 mg every 48 hours for treatment – 2 g (16 tablets ). In protracted course of hepatitis B – 125 mg 2 times a day on the first day, followed by 125 mg every 48 hours. Per course of treatment – 2.5 g (20 tablets). In chronic hepatitis B – initial phase of treatment (2.5 g – 20 tablets) – the first two days with 125 mg 2 times a day, and then 125 mg every 48 hours. Continuation phase (1.25 g – 10 2.5 g tablet – 20 tablets) – 125 mg per week. Heading dose masteron steroidsa ® from 3.75 g to 5 g, duration of treatment 3,5-6 months, depending on the results of biochemical, immunological, morphological studies, reflecting the degree of activity masteron side effects of the process. In acute hepatitis C – 125 mg per day the first 2 days treatment, followed by 125 mg every 48 hours. Treatments – 2.5 g (20 tablets). In chronic hepatitis C – initial phase of treatment (2.5 g – 20 tablets) – the first two days with 125 mg 2 times a day, and then 125 mg every 48 hours. Continuation phase (2.5 g – 20 tablets) – 125 mg per week.Heading dose masteron steroidsa ® – 5 g, duration of treatment – 6 months depending on the results of biochemical, immunological, morphological markers of activity of the process. When the complex treatment neyrovirusnyh infections – 125-250 mg per day the first 2 days of treatment, followed by 125 mg every 48 hours. Dose set individually, a course of treatment for 3-4 weeks. If urogenital and respiratory chlamydia – the first two days of 125 mg, followed 48 hours later by 125 mg. Heading dose – 1.25 g (10 tablets). In treatment of pulmonary tuberculosis – 250 mg of the first two days of treatment, followed by 125 mg every 48 hours. Course dose – 2.5 grams (20 tablets).

Side effect

Allergic reactions, dyspeptic symptoms, intermittent fever.

Overdose

Cases of overdose are not known.

Interaction with other drugs

Antibiotics and compatible with conventional drug treatment of viral and bacterial diseases. Clinically significant interaction masteron steroidsa ® with antibiotics and traditional means of treatment of viral and bacterial diseases have been identified.

Effects on ability to drive vehicles, mechanisms of drug has no negative impact on the ability to drive vehicles and other classes of potentially hazardous activities that require high concentration and psychomotor speed reactions.

release Form

Tablets, film-coated 60 mg, 125 mg. By 6 or 10 tablets in blisters; 6, 10 or 20 tablets in a polymer jar. 1 or 2 blisters or 1 jar polymer, together with instructions for use in a pile of cardboard.biomex labs reviews