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After oral administration, sumatriptan is rapidly absorbed, 70% of the maximum plasma concentration is reached after 45 minutes. After receiving 100 mg of the maximum concentration in plasma is on average 54 mg / ml. Bioavailability is 14% as a result of the intensive first-pass metabolism and incomplete absorption.Relationship to plasma proteins dianabol side effects. Sumatriptan is metabolized by monoamine oxidase A. The main metabolite – indoleacetic analog output of sumatriptan, preferably in the urine in the form of free acid and glucuronide conjugate.

Relief of migraine attacks with or without aura.


  • Hypersensitivity to any component of the formulation.
  • Hemiplegic, basilar migraine and oftalmoplegicheskaya form.
  • Coronary heart disease (CHD) (including myocardial infarction, myocardial infarction, angina, Prinzmetal), as well as the presence of symptoms to suggest the presence of coronary artery disease.
  • Occlusive peripheral vascular disease.
  • Stroke or transient ischemic attack (in Vol. H. In history).
  • Uncontrolled hypertension.
  • Receiving simultaneously with ergotamine or derivatives thereof (including methysergide).
  • The use of monoamine oxidase inhibitors (MAOIs), or earlier than 2 weeks after the cancellation of these drugs.
  • Severe liver and / or kidneys.
  • Age 18 years and older than 65 years (the safety and effectiveness of sumatriptan has not been established).
  • Pregnancy and lactation.


  • controlled hypertension;
  • diseases in which may change the absorption, metabolism or excretion of the drug (eg, renal or hepatic function);
  • epilepsy (including any condition with a reduction in seizure threshold);
  • in patients with hypersensitivity to sulfonamides (administration sumatriptan can cause allergic reactions, the severity of which varies from cutaneous manifestations of anaphylaxis. Data on the cross-sensitivity is limited, however, caution should be exercised in the appointment of sumatriptan in these patients).

dianabol side effects bodybuildingInside, swallowing the tablet whole and with water. If not indicated differently: the recommended dose is – one tablet of 50 mg. Some patients may need a higher dose – 100 mg. If migraine symptoms do not disappear or diminish after the first dose, then re-take the drug should not be for the relief of the attack dice. However, the drug can be used for subsequent migraine relief.

If the patient has felt the reduction or disappearance of symptoms after the first dose, and then resumed symptoms can take a second dose for the next 24 hours, provided that the interval between the reception of at least 2 hours. The dianabol side effects maximum dose of sumatriptan should not exceed 300 mg for 24- hour period, dianabol for sale.


pain, feeling of pressure or heaviness, sensation of heat or tingling in different parts of the body.

Hot flashes, dizziness, weakness, feeling, feeling of tiredness, sleepiness usually are mild or moderate and transient in nature are.

Cardio-vascular system
Lowering blood pressure, bradycardia, tachycardia, a transient increase in blood pressure (observed shortly after administration of sumatriptan). Rarely – cardiac arrhythmias, transient ischemic ECG changes in the type of myocardial infarction, coronary artery spasm. Sometimes develops Raynaud’s syndrome.

On the part of the gastrointestinal tract
Nausea, vomiting, ischemic colitis (but link these side effects with sumatriptan has not been established); dysphagia, abdominal discomfort.

On the part of the central nervous system and sensory organs
Dizziness, rarely seizures (in some cases they have been observed in patients with a history of seizures or in conditions predisposing to seizures, some patients predisposing factors have been identified).Sometimes after taking sumatriptan noted diplopia, flashing before the eyes, nystagmus, scotoma, reduced visual acuity. Very rarely develops partial transient loss of vision. However, it should be borne in mind that visual impairment may be associated with a migraine attack itself.

Hypersensitivity reactions
ranging from cutaneous manifestations (rash, urticaria, pruritus, erythema) to rare cases of anaphylaxis.

From the laboratory parameters
Minor changes in the activity of “liver” transaminases.

reception sumatriptan oral dose of 400 mg did not cause any side effects other than those listed above.

In case of overdose should be observed for the patients’ condition for at least 10 hours and spend symptomatic therapy if necessary. No data on the effect of hemodialysis or peritoneal dialysis on plasma concentrations of sumatriptan.

Interactions with other drugs
not mentioned sumatriptan interact with propranolol, flunarizine, pizotifenom and ethanol.

When concomitantly with ergotamine celebrated long vasospasm.

Sumatriptan may be administered no earlier than 24 hours after administration of preparations containing ergotamine; Conversely, the preparations containing al-gotamin can be administered no sooner than 6 hours after administration of sumatriptan.

Perhaps the interaction between sumatriptan and MAO inhibitors as well as sumatriptan and drugs from the group of selective inhibitors of serotonin reuptake (SSRIs). There are some reports about the weakness of the development, hyperreflexia and poor coordination in patients after administration of sumatriptan and drugs from the SSRI. In the case of co-administration of sumatriptan and SSRIs should be closely monitored condition of the patient.

sumatriptan should dianabol side effects be used only if the diagnosis of migraine is no doubt that when it should be used as soon as possible after the onset of a migraine attack, although it is equally effective when used at any stage of attack.

It can not be used as a preventive measure.

As with other protivomigrenoznyh funds, the appointment of sumatriptan in patients with previously diagnosed with migraine or patients with atypical migraine is necessary to exclude other potentially serious neurological conditions. It should be noted that patients with migraine are at increased risk of certain cerebrovascular events (stroke or transient ischemic attack).

Sumatriptan should not be administered to patients with suspected heart disease without prior examination in order to avoid cardiovascular disease. Such patients include postmenopausal women, men over the age of 40 years and patients with risk factors for coronary heart disease. Although the survey has not always possible to detect heart disease in some patients, in very rare cases, they develop side effects to the cardiovascular system. After receiving sumatriptan may experience transient intense pain and tightness in the chest, extending to the neck.

If there is reason to believe that these symptoms are a manifestation of coronary heart disease, it is necessary to conduct appropriate diagnostic testing. Do not exceed the recommended dose of sumatriptan.

Effects on ability to drive and / or other mechanisms
in patients with migraine may occur drowsiness, associated, with both the disease itself and the reception of sumatriptan, so they need to be especially careful while driving and working with moving machinery. steroids side effects

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Combined medication. Paracetamol has analgesic and antipyretic activity. Dianabol for sale histamine receptors I generation, eliminating the effects of histamine mediated through this receptor type. The action on the central nervous system caused by the blockade of H 3 histamine receptors in the brain, and inhibition of central cholinergic structures. It has a pronounced antihistamine activity, reduces or prevents histamine-induced smooth muscle spasms, increased capillary permeability, tissue edema, itching and flushing.

INDICATIONS Pain of mild to moderate severity (headache, toothache, pain when coughing and sinusitis, arthralgia, myalgia.) Disalgomenoreya; pain accompanied by sleeplessness.

CONTRAINDICATIONS Hypersensitivity, children under 12 years, pregnancy, breastfeeding.

DOSAGE AND ADMINISTRATION Inside, 1 to 2 tablets dianabol steroid every 6 hours until the disappearance of pain (no more than 8 tablets per day). For insomnia due to pain – 2 tablets before going to bed. Duration dianabol for sale of reception without consulting a doctor – not more than 10 days.

real dianabol for saleSIDE EFFECTS : Allergic reactions (skin rash, pruritus, urticaria, angioedema), nausea, epigastric pain; anemia, thrombocytopenia, agranulocytosis. Drowsiness, dry mouth, numbness of the oral mucosa, dizziness, tremor, nausea, headache, fatigue, decreased psychomotor speed reactions, photosensitivity, accommodation paresis, incoordination. Children may develop paradoxical insomnia, irritability and euphoria. With prolonged use at high doses – gepatotokeicheskoe effects, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia; nephrotoxicity (renal colic, Glycosuria, interstitial nephritis, papillary necrosis).

Overdose symptoms (caused by diphenhydramine): central nervous system depression, excitation of development (especially in children), or depression, dilated pupils, dry mouth, paresis of the gastrointestinal tract. Symptoms related to paracetamol: pale skin, loss of appetite, nausea, vomiting; gepatonekroz (necrosis due to the severity of intoxication is directly dependent on the degree of overdose). The increased activity of “liver” transaminases, increased prothrombin time (after 12-48 hours after admission); detailed clinical picture of liver damage manifests itself in 1-6 days. Rarely liver failure develops lightning dianabol review speed and can be complicated by renal insufficiency (tubular necrosis). Treatment: gastric lavage, if necessary – symptomatic therapy, including oxygen therapy, plasma substituting agents, donators of SH-groups and precursors of glutathione synthesis, methionine dianabol for sale – in 8-9 hours after the overdose and N-acetylcysteine – 12 h Do not use epinephrine..

INTERACTION WITH OTHER DRUGS increases the effects of ethanol and drugs which depress the central nervous system. Monoamine oxidase inhibitors enhance the anticholinergic activity of diphenhydramine. Reduces the effectiveness of apomorphine prescribed as an emetic drug for the treatment of poisoning. The antagonistic interaction is marked with a joint appointment with psychostimulants. Increases anticholinergic effects of the drug with the m-anticholinergic activity. It enhances the action of monoamine oxidase inhibitors. Reduces the effectiveness of uricosuric drugs. Under the influence of paracetamol during removal of chloramphenicol increases 5 times. Chronic administration of acetaminophen may increase the effects of indirect anticoagulants. Simultaneous treatment with paracetamol and ethanol increases the risk of hepatotoxic effects and acute pancreatitis. Barbiturates, phenytoin, ethanol, rifampicin, phenylbutazone, tricyclic antidepressants and other stimulants microsomal oxidation dbol dosage increase the production of hydroxylated active metabolites, causing the possibility of severe intoxication with dianabol for sale small overdoses. Inhibitors of microsomal oxidation (cimetidine) reduce the risk of hepatotoxicity dianabol side effects. Metoclopramide and domperidone to increase, and cholestyramine reduces the absorption. Myelotoxic drugs increase the expression gematotoksichnosti drug.

Cautions Avoid UV radiation. In the period of treatment should refrain from the use of ethanol (development of hepatotoxicity), motor vehicles and other driving activities potentially hazardous activities that require high concentration and psychomotor speed reactions. online anabolic steroids pharmacy dianabol for sale

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The maximum concentration dianabol steroid of ibuprofen in blood plasma after oral administration at a dose of 400 mg is achieved within 1-2 hours, bond to plasma proteins, about 99%. Distributed in the synovial fluid, where large concentrations than in plasma. Metabolism metabolized mainly in the liver by hydroxylation and carboxylation isobutyl group. The metabolites are pharmacologically inactive. Excreted by the kidneys (unchanged no more than 1%) and, to a lesser extent in the bile.

Indications for use:

  • dianabol steroid tabletsheadache,
  • migraine,
  • toothache,
  • neuralgia,
  • pain in the muscles and joints,
  • menstrual pain,
  • a feverish syndrome with colds and flu.


  • hypersensitivity to ibuprofen or any of the components that make up the product;
  • complete or incomplete combination of bronchial asthma, recurrent polynosis or paranasal sinuses and intolerance of aspirin or other NSAIDs (including history);
  • erosive and ulcerative changes in gastric mucosa and 12 duodenal ulcer, active gastrointestinal bleeding (including rectal, cerebrovascular bleeding or other);
  • during coronary artery bypass surgery;
  • hemophilia and other bleeding disorders (including anticoagulation), hemorrhagic diathesis;
  • inflammatory bowel disease (Crohn’s disease, ulcerative colitis) in the acute phase;
  • severe liver or renal function dianabol steroid (creatinine clearance less than 30 mL / min);
  • severe heart failure;
  • pregnancy (III trimester);
  • children under 6 years and children weighing less than 20 kg.With care
    the elderly, severe somatic diseases, heart failure, arterial hypertension, liver failure, liver cirrhosis with portal hypertension, hyperbilirubinemia, renal failure (Kretinina clearance less than 60 mL / min), nephrotic syndrome, gastritis, enteritis, colitis, peptic ulcer and duodenum (including history), the presence of Helicobacter Pylori infection, post major surgery, autoimmune diseases (systemic lupus erythematosus), dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, smoking, frequent alcohol use, illness blood of unknown etiology (leukopenia and anemia), prolonged use of NSAIDs, concomitant use of oral corticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective neuronal serotonin reuptake inhibitors (including tsirolopram, fluoxetine, paroxetine, sertraline) dianabol stack.Pregnancy and lactation
    Usein the first six months of pregnancy is allowed only after consulting your doctor. In the last three months of pregnancy, the use of the drug is contraindicated due to an increased risk of complications for mother and fetus.
    Ibuprofen is released in breast milk in small quantities. If necessary, long-term use of the drug dianabol steroid during lactation breastfeeding at the time of the drug should be discontinued.Dosing and Administration
    Inside. Take the without chewing, drinking plenty of water during or after meals

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The structure of all calcitonins shows a chain of 32 amino acids and a ring of seven amino acid residues at the N-end, the sequence of which is not the same in different species. Because salmon calcitonin has higher affinity for the receptor (as compared with calcitonin mammals), its action is expressed to the greatest degree both in strength and duration. By inhibiting osteoclast activity by acting on specific receptors, salmon calcitonin significantly reduces bone turnover rate to a normal level in conditions with increased rate of resorption, such as osteoporosis. As in animals and humans have shown that dianabol stack possess analgesic activity with pain of bone origin, which presumably is due to a direct effect on the central nervous system. Even after a single application nasal Spray in humans indicated a clinically relevant biological response that is manifested by increased urinary excretion of calcium, phosphorus, and sodium (by reducing their tubular reabsorption) and decreased excretion of hydroxyproline. In long-term (over 5 years!) Application achieved significant and sustained reduction in the level of biochemical markers of bone turnover such as serum C-telopeptides (sCTX) and skeletal isoenzymes of alkaline phosphatase. Application nasal spray results in a statistically significant increase (1- 2%) in bone mineral density of the lumbar vertebrae, which is defined in the first year of treatment and lasts up to 5 years. Maintains mineral density in the femur. Application nasal spray at a dose of 200 ME per day resulted in a statistically and clinically significant reduction (36%) the risk of new vertebral fractures in patients treated Miakaltsik (in combination with vitamin D th preparations calcium), compared with the group of patients treated with the placebo (in combination with the same agents). Calcitonin reduces gastric and exocrine pancreatic secretion.

dianabol stack cycleBioavailability Miakaltsik applied intranasally is 3.5% relative to the bioavailability of the drug applied parenterally. Miakaltsik rapidly absorbed through the nasal mucosa and the maximum plasma concentration is achieved within the first hour (mean of about 10 minutes). The half-life of about 20 minutes. Repeated use of the drug accumulation was observed. In applying the drug in doses greater than recommended, its concentration in the blood were higher (which was confirmed by an increase in the area under the curve “concentration-time» (AUC)), but the relative bioavailability is not increased.
Determination of concentration of calcitonin salmon in plasma, as well as concentrations of other polypeptide hormones, it is of little value, since the level of concentration is impossible to predict the therapeutic efficacy of the drug. Thus, Miakaltsik activity should be evaluated in clinical performance indicators.
Salmon calcitonin does not cross the placental barrier in humans.


  • Treatment of postmenopausal osteoporosis.
  • Bone pain associated with osteolysis and / or osteopenia.
  • Paget’s disease (osteitis deformans).
  • Neurodystrophic diseases (synonyms: algoneyrodistrofiya, Zudeka atrophy) caused by various etiological and predisposing factors such as post-traumatic painful osteoporosis, reflex dystrophy, frozen shoulder syndrome, causalgia, drug neurotrophic disorders.

: Hypersensitivity to synthetic salmon calcitonin or to any other component of the drug.

Pregnancy and lactation
In experimental studies had no embryotoxic and teratogenic effects and does not pass the placental barrier.
However, clinical data on the safety of use during pregnancy Miakaltsik not. In this regard, the drug should not be used in women during pregnancy dianabol steroid.
It is not known whether salmon calcitonin into breast milk in humans penetrates, so the period of drug therapy is recommended to stop breastfeeding.

Dosing and Administration
The drug is to be applied intranasally. Introduction Miakaltsik nasal spray is recommended to turn it into one or the other nostril.
For treatment of osteoporosis a recommended dose of 200 ME per day. In order to prevent the progressive loss of bone mass at the same time using a nasal spray Miakaltsik recommended assignment of adequate doses of calcium and vitamin D. Treatment should be carried out for a long time. Bone pain associated with osteolysis and / or osteopenia . The daily dose is 200-400 ME daily. Daily dose of 200 ME, can be administered for 1 time. Higher doses should be divided into multiple administrations. The dose should be adjusted to the individual needs of the patient. To achieve the full analgesic effect may take several days. During the long-term therapy the initial daily dose is usually reduced and / or increase the interval between doses. Paget’s disease . The drug is administered daily at a daily dose of 200 ME. In some cases, the beginning of treatment may be required in a dose of 400 ME day appointed in several administrations. Duration of treatment is at least 3 months; it may be greater if required. The dose should be adjusted to suit individual patient needs. Note . In Paget’s disease treatment duration Miakaltsik should be from several months to several years. The treatment a significant decrease in the concentration of alkaline phosphatase in the blood and the urine hydroxyproline excretion, sometimes dianabol stack up to the normal range. However, in some cases, after an initial decrease in the values of these indicators may rise again. . In these cases, the doctor, guided by the clinical picture, has to decide whether to cancel the treatment should be and when it can be resumed after one or several months after discontinuation of treatment disorders of bone metabolism may recur; in this case it will require a new course. neurodystrophic disease . It is extremely important early diagnosis. Treatment should be started immediately after the confirmation of the diagnosis. Assign to 200 IU / day (single administration) each day for 2-4 weeks. Perhaps the additional appointment of 200 ME in a day for up to 6 weeks depending on the dynamics of the patient’s condition. Use in children Experience with Miakaltsik nasal spray in children is limited, therefore the nepredstavlyaetsya possible to make recommendations for this age group. Use in elderly patients age and individual patient groups Extensive experience with Miakaltsik nasal spray in elderly patients suggest that this age group is not marked deterioration tolerability or the need to modify the dosing regimen. The same applies to patients with reduced renal or hepatic function, although studies specifically patients have not been conducted for these groups.


Side effects
reported adverse effects such as nausea, vomiting, dizziness, slight flushing, accompanied by a sensation of heat, arthralgia. Nausea, vomiting, dizziness, hot flushes are dose dependent and often occur after intravenous than after intramuscular or subcutaneous administration. . Against the background of Miakaltsik may develop polyuria and fever, which usually disappear on their own, and only occasionally require temporary dose reduction
incidence of adverse events possibly related to use of the drug is estimated as follows: very common ( > 1/10); common ( > 1/100, <1/10); sometimes ( > 1/1 000, <1/100); rare ( > 1/10 000, <1/1 000), including isolated reports. Immune system : rarely – hypersensitivity; very rare anaphylactic or anaphylactoid reactions, anaphylactic shock; the nervous system : the frequency of headache, dizziness, taste disorders; From the sensory organs : rarely – visual impairment. Since dianabol stack the cardiovascular system : often -prilivy; sometimes – hypertension; the part of the respiratory tract : the frequency is very painful to the nose, congestion, swelling in the nasal mucosa, sneezing, rhinitis, dryness in the nose, allergic rhinitis, nasal mucosal erythema, irritation, odor, in the formation of excoriations nasal; often – nose bleeds, sinus infection, ulcerative rhinitis, pharyngitis; INB ^ yes – cough Gastro-intestinal tract : often – nausea, stomach pain, diarrhea; sometimes -rvota; Skin and subcutaneous tissue : rare – generalized rash.From the musculoskeletal system and connective tissue disorders : often – arthralgia; sometimes – pain in bones and muscles; From the urinary system : rarely – polyuria. On the part of the body in general and local reactions : often – fatigue; sometimes -grippopodobny syndrome, facial swelling, peripheral and generalized edema, rare – fever, injection site reactions drug itching.

For parenteral administration Miakaltsik nausea, vomiting, flushing and dizziness are dose-dependent. Therefore, when an overdose Miakaltsik applied intranasally, you can expect similar effects. However, there are reports of cases where Miakaltsik nasal spray was applied in a dose of up to 1600 and once in ME 800 ME dose per day for 3 days, while There were no serious adverse events. There have been reports of individual cases of overdose. Treat symptomatically.
In case of overdose may develop hypocalcaemia with symptoms such as muscle twitching, paresthesia. Treatment: administration of calcium gluconate.

Interactions with other drugs
When using calcitonin together with lithium therapy may decrease plasma concentrations of lithium. Thus, while the appointment and lithium Miakaltsik preparations may be necessary to correct the last dose.

Because salmon calcitonin is a peptide, there is a possibility of systemic allergic reactions. There are reports of allergic reactions including isolated cases of anaphylactic shock, which occurred in patients treated with Miakaltsik nasal spray. If you suspect that the increased patient sensitivity to salmon calcitonin prior to the start of treatment should be carried out skin tests using diluted sterile solution for injection, Miakaltsik. Note . When long-term therapy is possible the formation of antibodies to calcitonin, but the clinical efficacy is usually not affected. The phenomenon of habituation, which occurs mainly in patients with Paget’s disease receiving long-term therapy may be due to a saturation of binding sites and apparently not related to the formation of antibodies. Therapeutic effect Miakaltsik restored after interruption of treatment.

Effects on ability to drive vehicles and use machines
The effect of Miakaltsik on the ability to drive vehicles and operate machinery has not been studied. Some side effects of the drug, such as dizziness, fatigue and visual disturbances may negatively affect the ability to drive and perform potentially hazardous activities that require high concentration and speed of psychomotor reactions. Buy dmz prohormone online

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Inhibits hepatic gluconeogenesis, reduce the absorption of glucose from the intestine, increases peripheral glucose disposal, and also increases the sensitivity of tissues to insulin. When this has no effect on insulin secretion of pancreatic beta-cells causes hypoglycemic reactions. It reduces the level of triglycerides and low-density lipoprotein in blood. Stabilizes or reduces body weight. Has fibrinolytic action by inhibiting plasminogen activator inhibitor, tissue-type. After ingestion mёtformin absorbed from the gastrointestinal tract. The bioavailability after ingestion of standard dianabol pills doses of 50-60%. The maximum plasma concentration is reached 2.5 hours after oral administration. Almost does not bind to plasma proteins. It accumulates in the salivary glands, muscles, liver and kidneys. Provided unchanged by the kidneys. The half-life is 9-12 hours. When renal function is possible accumulation of the drug.

Diabetes mellitus type 2 without a tendency to ketoacidosis (especially in patients who are obese) when poor diet.

  • in combination with insulin – for diabetes mellitus type 2, especially when expressed by the degree of obesity accompanied by secondary insulin resistance.



  • diabetic ketoacidosis, diabetic precoma, coma;
  • impairment of renal function;
  • acute conditions with the risk of renal dysfunction: dehydration (diarrhea, vomiting), fever, severe infections, a condition of hypoxia (shock, sepsis, kidney infections, bronchopulmonary disease);
  • symptomatic manifestations of acute and chronic diseases which may lead to the development of tissue hypoxia (cardiac or respiratory failure, acute myocardial infarction, etc.);
  • major surgery and trauma (when shown holding insulin);
  • abnormal liver function:
  • chronic alcoholism, acute alcohol poisoning;
  • pregnancy, breast-feeding;
  • Hypersensitivity to the drug;
  • lactic acidosis (including history);
  • use for at least 2 days before and within 2 days after the radyoizotopnyh or radiological examinations with administration of iodine-containing contrast agent;
  • compliance with a hypocaloric diet (less than 1000 calories / day);

Do not use the drug in patients older than 60 years, performing heavy physical work, which is associated with an increased risk of developing lactic acidosis.


Application of pregnancy and breastfeeding period
when planning pregnancy, as well as in the event of pregnancy while taking metformin, it should be withdrawn and insulin. Since the data on the penetration into breast milk is not present, the drug is contraindicated in breastfeeding. If necessary, dianabol pills use of metformin during breast-feeding, breast-feeding should be discontinued.

Dosage and administration
dianabol pills resultsThe dose is established by the doctor individually, depending on the level of glucose in the blood.
The initial dose of 500-1000 mg / day. (1-2 tablets). . After 10-15 days may further gradual increase in the dose depending on the blood glucose level
maintenance dose of the drug is typically 1500-2000 mg / day (3-4 tablets) Maximum dose -. 3000 mg / day. (6 tablets).
In elderly patients the recommended daily dose should not exceed 1 g (2 tablets)
Tablets Metformin should be taken as a whole during or immediately after a meal, dianabol steroids washed down with a little liquid (a glass of water). To reduce the side effects from the gastrointestinal tract daily dose should be divided into 2-3 doses.
Due to the increased risk of lactic acidosis, the dose should be reduced in severe metabolic disorders.

Side effect On the part of the digestive system organs: . Nausea, vomiting, “metallic” taste in the mouth, loss of appetite, diarrhea, flatulence, abdominal pain These symptoms are particularly common at the beginning of treatment and usually disappear on their own. These symptoms can be reduced by appointment antotsidov derivatives of atropine or antispasmodics. On the part of metabolism: rarely – lactic acidosis (requires discontinuation of treatment); long-term treatment – B12 vitamin deficiencies (malabsorption). From the side of hematopoiesis: in some cases – megaloblastic anemia. From the Endocrine:hypoglycemia. Allergic reactions: skin rash.

If overdose of Metformin may develop lactic acidosis fatal. The reason for the development of lactic acidosis may also be the accumulation of the drug due to renal dysfunction. Early symptoms of lactic acidosis include nausea, vomiting, diarrhea, drop in body temperature, abdominal pain, pain in the muscles, in the future may be marked shortness of breath, dizziness, impaired consciousness and coma develop. Treatment: In the case. occurrence of lactic acidosis symptoms, treatment with metformin must be stopped immediately, the patient hospitalized immediately and determine the concentration of lactate, to confirm the diagnosis. The most effective measure for the excretion of lactate and metformin is hemodialysis. Spend as symptomatic treatment. If the drug metformin combination therapy with sulfonylurea may develop hypoglycaemia.

Interaction with other medicinal products is not recommended combinations: not recommended for concomitant use of danazol to avoid hyperglycemic action of the latter. If necessary, treatment with danazol and after discontinuation of the latter require dose adjustment of metformin under the control of blood glucose levels. Combinations requiring special care: chlorpromazine – when taken in high doses (100 mg daily) improves glycemia, reducing the release of insulin. When neuroleptic treatment and after discontinuation of the last required correction dose of metformin under the control of blood glucose levels. While the use of sulfonylureas, acarbose, insulin, non-steroidal anti-inflammatory drugs, monoamine oxidase inhibitors, oxytetracycline, angiotensin converting enzyme inhibitors, derivatives of clofibrate, cyclophosphamide, β-blockers may strengthening of hypoglycemic action of metformin. While the use of corticosteroids, oral contraceptives, epinephrine, sympathomimetics, glucagon, thyroid hormones, thiazide and “loop” diuretics, phenothiazine derivatives, derivatives of nicotinic acid may reduce the hypoglycemic dianabol pills action of metformin. Cimetidine slows the elimination of metformin, thus increasing the risk of lactic acidosis. Mёtformin may weaken the effect of anticoagulants (coumarin derivatives). Drinking alcohol increases the risk of lactic acidosis in acute alcohol intoxication, particularly in cases of starvation or low calorie diet compliance, as well as liver failure.

During treatment necessary to monitor renal function. At least 2 times a year, as well as the appearance of myalgia should determine the content of lactate in plasma.
In addition, 1 every 6 months is necessary to monitor the level of creatinine in serum (especially in patients of advanced age) should be appointed Mёtformin if creatinine level in the blood above 135 umol / l for men and 110 umol / l for women.
It is possible to use the drug Mёtformin in combination with sulfonylureas. In this case it is necessary osrbenno careful control of blood glucose levels in the blood.
For 48 hours before and 48 hours after the rentgenokontrastpogo (urography, intravenous angiography) should stop taking Metformin.
When the patient bronchopulmonary infection or infectious disease urinary organs should be reported immediately the attending physician.
During the treatment should refrain from drinking alcohol, and drugs containing ethanol.

Effects on ability to drive vehicles and operate machinery
Use of the drug as a single agent does not affect the ability to drive vehicles and operate machinery.
With the combination of Metformin with other hypoglycemic agents (sulfonylureas, insulin, etc.) may develop hypoglycemic conditions under which worsens ability to road management and occupation of other potentially hazardous activities that require increased attention and rapid psychomotor reactions. steroiden kaufen


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