8122

side effects of winstrol

When administered drug is well absorbed from the gastrointestinal tract (up to 95% of the dose), the use of food slows the absorption of fluoxetine significantly. Peak plasma concentrations are reached in 6-8 hours. The side effects of winstrol bioavailability after oral administration of fluoxetine is more than 60%. The drug was well accumulates in tissues readily penetrates the blood-brain barrier, binding to plasma proteins is above 90%. It is metabolized in the liver by demethylation to the active metabolite norfluoxetine and a number of unidentified metabolites. Report the news, the magnitude of the clearance of fluoxetine is 94-704 ml / min, norfluoxetine 60-336 ml / min. About 12% of the drug is released through the gastrointestinal tract. The half-life of fluoxetine is about 2-3 days, norfluoxetine – 7-9 days. In patients with hepatic failure half-lives of fluoxetine and norfluoxetine is prolonged. The drug is excreted in breast milk (25% of the serum concentration).

Indications

 

  • Depression different genesis.
  • Obsessive-Compulsive Disorder
  • Bulimic neurosis.

The drug is used strictly on prescription.

Contraindications

Hypersensitivity to the drug, simultaneous reception with inhibitors of monoamine oxidase (MAO), thioridazine and pimozide, severe renal dysfunction (creatinine clearance less than 10 ml / min) and liver, breastfeeding, pregnancy.

Precautions : diabetes, convulsions and epilepsy of various origins (including history), Parkinson’s disease, compensated renal and / or hepatic insufficiency, excessive weight loss, suicidal thoughts.

Dosing and Administration

The drug is taken orally.
In depression, obsessive disorders kompulsivnyh starting dose is 20 mg of fluoxetine per day (in the morning), regardless of the meal. If necessary, the dose may be increased to 40 – 60 mg / day, divided into 2-3 doses. The maximum daily dose is 80 mg. The clinical effect develops within 1-4 weeks after the start of treatment in some patients it can be achieved later.
In bulimia nervosa, the drug is used in a daily dose of 60 mg, divided into 2-3 receptions.
In elderly patients the recommended daily dose is 20 mg.
Patients renal and hepatic insufficiency, side effects of winstrol as well as with low body weight is recommended to use a lower dose -. 10 mg fluoxetine per day and lengthening the interval between receptions of
duration determined by the attending physician acceptance and can last for several years.

Side effect

CNS: hypomania or mania, increased suicidal tendencies, anxiety, irritability, agitation, dizziness, headache, tremor, insomnia or drowsiness, asthenic disorders, seizures. On the part of the gastrointestinal tract: loss of appetite, taste disturbance, nausea , vomiting, dry mouth or hypersalivation and diarrhea. With the genitourinary system: . incontinence or urinary retention, dysmenorrhea, vaginitis, decreased libido, sexual dysfunction in men (delayed ejaculation) are rare: allergic reactions such as skin rash, hives, itching , chills, fever, pain in muscles and joints (use of antihistamines and steroids); increased sweating, hyponatremia, tachycardia, disturbance of the visual acuity, erythema multiforme, vasculitis. May develop anorexia and weight loss. Such side effects frequently occur at the beginning or fluoxetine with increasing dose.

Overdose

Symptoms: agitation, seizures, cardiac arrhythmia, tachycardia, nausea, vomiting. Treatment: specific antagonists to fluoxetine were found. Symptomatic therapy, gastric lavage with the appointment of activated charcoal, in convulsions – diazepam, maintenance of respiration, cardiac activity, body temperature.

Interaction with other drugs

The drug can not be applied simultaneously with  inhibitors (e.g., selegiline, furazolidone, procarbazine and the like), including antidepressants side effects of winstrol inhibitors; and tryptophan (a precursor of serotonin), pimozide, as may develop serotonin syndrome, which manifests itself in confusion, hypomania, agitation, convulsions, dysarthria, hypertensive crises, chills, tremor, nausea, vomiting, diarrhea (see. “Cautions “).
Co-administration of fluoxetine with alcohol or with centrally acting drugs that cause depression of the central nervous system, enhances their effect.
fluoxetine blocks the metabolism of tricyclic and tetracyclic antidepressants, trazodone, carbamazepine, diazepam, metoprolol, terfenadine, phenytoin (phenytoin), which leads to an increase in their concentration in the blood serum, reinforcing their action and increasing the incidence of complications.
The combined use of fluoxetine and lithium salts requires close monitoring of the concentration of lithium in the blood as possible its increase.
fluoxetine enhances the effect of hypoglycemic drugs.
in an application with drugs, possessing high protein binding, especially with anticoagulants and digitoxin, may increase the plasma concentration of free (unbound) drugs and increase the risk of adverse effects.

special instructions

Patients with diabetes may develop hypoglycemia during therapy with fluoxetine and hyperglycaemia after its cancellation.
On the background of electroconvulsive therapy may develop prolonged epileptic seizures.
After applying the appointment of  inhibitors fluoxetine may be no earlier than 14 days. Do not use  inhibitors and / or thioridazine earlier than 5 weeks after discontinuation of fluoxetine.
With the development, on a background of reception of fluoxetine, convulsions drug should be discontinued.
In the treatment of patients with deficiency of body weight should be considered anorectic effects (possible progressive loss of body weight ).
After discontinuation side effects of winstrol stanozolol of its therapeutic serum concentrations may persist for several weeks.
during treatment with fluoxetine intake of alcoholic beverages is not allowed.
fluoxetine may adversely affect the performance of work requiring a high rate of mental and physical reactions (drive motor vehicles, mechanisms, working at height, etc.).

8123

stanozol

Treatment should be continued until the replacement of the infected nail (uninfected nail sprouting). For the re-growth of nails on the fingers and feet normally requires 3-6 months. and 12.6 months, respectively. In deep endemic mycosis may require the use of the drug in a dose of 200 mg (4 capsules of 50 mg) – 400 mg (8 capsules 50 mg) per day for up to 2 years. The duration of therapy is determined individually; it can be 11-24 months. with coccidioidomycosis; 2-17 months. When stanozol paracoccidioidomycosis; 1-16 months. with sporotrichosis and 3-17 months. at histoplasmosis. In children, as well as with similar infections in adults, the duration of treatment depends on the clinical and mycological effect. In children, the drug should not be applied in a daily dose that would be higher than that in adult, i.e. no more than 400 mg per day. The drug is used every day 1 time per day.

 

Side effect From the digestive system: loss of appetite, changes in taste, nausea, vomiting, abdominal pain, flatulence, diarrhea, rarely – liver dysfunction (hyperbilirubinemia, increased alanine aminotransferase activity, aspartate aminotransferase, increased activity of alkaline phosphatase, jaundice, hepatitis, hepatocellular necrosis ). From the nervous system: headache, dizziness, excessive fatigue, rarely – seizures. From the side of hematopoiesis: rarely – leukopenia, thrombocytopenia (bleeding, petechiae), neutropenia, agranulocytosis. On the part of the cardiovascular system: an increase in the duration of the interval stanozol, flickering / ventricular flutter. Allergic reactions: skin rash, rarely – exudative erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), anaphylactoid reactions (including angioedema, facial swelling, hives, itching of the skin). Other: rarely – renal dysfunction, alopecia, hypercholesterolemia, hypertriglyceridemia, hypokalemia.

Overdose symptoms: hallucinations, paranoid behavior. Treatment is symptomatic: . Gastric lavage, forced diuresis Haemodialysis for 3 hours decreases the plasma concentration of approximately 50%.

 

Interaction with other drugs
When using fluconazole and warfarin increased the prothrombin time (an average of 12%). In this connection, it is recommended to closely monitor the performance of the prothrombin time in patients receiving the drug in combination with coumarin anticoagulants.
May increase the half-life of oral hypoglycemic agents – sulfonylureas (chlorpropamide, glibenclamide, glipizide, tolbutamide) while receiving fluconazole.
Concomitant use of fluconazole phenytoin and may lead to an increase in the plasma concentration of phenytoin to a clinically significant degree. Therefore, if necessary, the joint use of these drugs need to monitor the concentration of phenytoin with the dose adjusted to maintain drug levels within the therapeutic range.
Combination with rifampschinom stanozol leads to decrease by 25% and shorten the half-life of fluconazole from plasma by 20%. Therefore, patients receiving concomitant rifampicin, the dose of fluconazole is expedient to increase.
It is possible increase of cyclosporine concentrations with the simultaneous use of fluconazole 200 mg / day.
In the case of simultaneous reception with theophylline may reduce the average clearance of theophylline plasma velocity.
With the simultaneous use of fluconazole and cisapride concentration cisapride plasma can significantly increase; described cases of adverse reactions on the part of the heart, including . flicker / ventricular flutter including (torsades de points), an increase in the QT interval on the ECG
Simultaneous administration of azole antifungals and terfenadine may lead to a significant increase in the level of terfenadine in the plasma. may cause serious arrhythmias by increasing the  interval
Concomitant use of fluconazole and hydrochlorothiazide may lead to an increase of 40% in the plasma concentration of fluconazole.
There have been reports about the interaction of fluconazole and rifabutin, the latter accompanied by an increase in serum levels. With simultaneous use of fluconazole and rifabutin uveitis cases are described. We must carefully monitor patients while receiving rifabutan and fluconazole.
Patients receiving the combination of fluconazole and zidovudine, increasing the concentration of zidovudine observed, which is caused by a decrease in the conversion of the latter into its main metabolite, so you should expect an increase in the side effects of zidovudine.
Increasing the concentration of midazolam, in connection with the what increases the risk of psychomotor effects (more pronounced when using fluconazole inside than intravenously).
increasing the concentration of tacrolimus and therefore increases the risk of nephrotoxicity.

Specific guidance
Treatment should continue until clinical remission. Premature discontinuation of treatment leads to relapse.
In rare cases, the use of fluconazole was accompanied by toxic liver changes, including fatalities, primarily in patients with serious underlying medical conditions. In the case of hepatotoxic effects associated with fluconazole, no obvious dependence of the total daily dose, duration of treatment, gender, and age of the patient. Hepatotoxic effects of fluconazole was usually reversible; its signs disappeared after discontinuation of therapy. When clinical signs of liver damage, which may be associated with fluconazole, the drug should be discontinued.
AIDS patients are more prone to the development of severe skin reactions in the application of many drugs. In cases where patients with superficial fungal infection develops a rash, and she is regarded as definitely related to fluconazole, the drug should be discontinued. When a rash in patients with invasive / systemic fungal infections, they should be monitored closely and fluconazole cancel the appearance of bullous erythema multiforme or changes. Care must be taken while taking fluconazole with rifabutin or other drugs metabolized by the cytochrome stanozol system.
When combined fluconazole and oral hypoglycemic agents (chlorpropamide, glibenclamide, glipizide, tolbutamide) in patients with diabetes should monitor blood glucose levels (possibility of hypoglycemia). It is recommended to monitor blood concentration of cyclosporine while the use of fluconazole.
Patients who concurrently with fluconazole receiving high dose theophylline or who have a chance of developing theophylline intoxication dolzhnynahoditsya monitored for early detection of the symptoms of theophylline overdose.

8124

stanozolol results

Hepatic and / or renal failure, rash during treatment with fluconazole in patients with superficial fungal infection and stanozolol results invasive / systemic fungal infections, concomitant use of terfenadine and fluconazole at a dose of less than 400 mg / day, simultaneous reception potentially hepatotoxic drugs, alcoholism potentially proaritmogennoe status in patients with multiple risk factors (organic heart disease, electrolyte disturbances, concomitant use of drugs that cause arrhythmias), pregnancy.

Pregnancy and lactation
Use of the drug in pregnant women – is impractical, except for serious or life-threatening forms of fungal infections, where the potential benefits from the use of fluconazole for the mother is much higher than the risk to the fetus. Since fluconazole concentration in breast milk and in the plasma of the same, use the drug during lactation is contraindicated.

Dosing and Administration
Inside, swallowing whole. Adults and children over 15 years (with a body weight over 50 kg) in cryptococcal meningitis and cryptococcal infections at other sites on the first day is usually prescribed 400 mg (8 capsules of 50 mg), and then continue treatment 200 mg (4 capsules of 50 mg) – 400 mg (8 capsules of 50 mg), 1 time per day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, confirmed by mycological examination; cryptococcal meningitis treatment should be at least 6-8 weeks. For the prevention of recurrence of cryptococcal meningitis in  patients, after completion of a full course of primary therapy fluconazole administered in a dose of 200 mg (4 capsules of 50 mg) per day for a long period of time. when candidemia, disseminated candidiasis, Candida and other invasive infections in the first day dose was 400 mg (8 capsules of 50 mg), and then – 200 mg (4 capsules of 50 mg) per day.

When insufficient clinical efficacy of the dose can be increased to 400 mg (8 capsules 50 mg) per day. The duration of therapy depends on clinical efficacy. In oropharyngeal candidiasis drug is usually prescribed at 150 mg 1 times / day; Duration of treatment – 7-14 days. If necessary, in patients with a severely reduced immune treatment may be longer. For the prevention of relapse of oropharyngeal candidiasis in patients with AIDS, after the completion of a full course of primary therapy – 150 mg 1 time per week. In atrophic oral candidiasis associated with stanozolol results wearing dentures, – 50 mg 1 time per day for 14 days in combination with local antiseptic drugs for the treatment of the prosthesis. in other localizations candidiasis (except genital candidiasis), such as esophagitis, noninvasive bronchopulmonary defeat candiduria candidiasis of the skin and mucous membranes, etc. .d., the effective dose is usually 150 mg / day when the duration of treatment 14-30 days. vaginal candidiasis fluconazole receive a single oral dose of 150 mg. To reduce the frequency of relapses vaginal candidiasis drug may be used in a dose of 150 mg 1 time per month.

The duration of therapy is determined individually; it varies between 4 and 12 months. Some patients may require more frequent application. When balanitis caused of Candida, fluconazole administered single oral dose of 150 mg per day. For the prevention of candidiasis recommended dose – 50-400 mg 1 time per day, depending on the degree of risk of fungal infection. To prevent candidiasis in patients with cancer the recommended dose of fluconazole is 150-400 mg 1 time / day, depending on the degree of risk of fungal infection. If you have a high risk of generalized infection, eg in patients with severe or long-anticipated persistent neutropenia, the recommended dose – 400 mg / day. Fluconazole is administered a few days before the expected occurrence of neutropenia; after increasing the number of neutrophils over one thousand / ml treatment continued for 7 days. At mycosis of the skin, including tinea pedis, smooth skin, inguinal, and skin candidosisrecommended dose stanozolol results is 150 mg 1 time per week or 50 mg 1 time per day , the dosage regimen depends on the clinical and mycological effect. Duration of therapy in ordinary cases is 2-4 weeks, but with athlete’s foot may require a more prolonged treatment (up to 6 weeks). When pityriasis versicolor – 300 mg (two 150 mg capsules) 1 time per week for 2 weeks, some patients It required a third dose of 300 mg per week, while in some cases it is sufficient single dose of 300-400 mg; alternative treatment is the use of 50 mg 1 time a day for 2-4 weeks. In onychomycosis the recommended dose is 150 mg 1 time per week.

8125

stanozolol dosage

After oral administration fluconazole is well absorbed, bioavailability – 90%. The maximum concentration after oral administration of the drug on an empty stomach 150 mg sostavlyaet90% of plasma concentration after intravenous injection in a dose of 2.5-3.5 mg / l. Simultaneous food intake does not affect the absorption of fluconazole, taken orally.The time to maximum concentration after oral administration of 150 mg of the drug on an empty stomach – 0.5-1.5 hours. Plasma stanozolol dosage concentration is in direct proportion to the dose. The level of 90% of the equilibrium concentration is achieved in 4-5 day drug treatment (at reception 1 times / day). The introduction of “shock” dose (the first day), 2 times the usual daily dose, achieves a concentration level that corresponds to 90% of the equilibrium concentration of the second day. The volume of distribution close to the total water content in the body. Contact with blood plasma proteins – 11-12%. Fluconazole penetrates well into all body fluids. The concentration of active substance in breast milk, synovial fluid, saliva, sputum, and peritoneal fluids are similar to that of the plasma. Fixed values attained in vaginal secretions after 8 hours after oral administration and are maintained at this level for at least 24 hours. Fluconazole well penetrates into cerebrospinal fluid  in fungal meningitis concentration  is about 80% of its level in plasma. In the sweat fluid, the epidermis and stratum corneum (selective accumulation) in concentrations exceeding serum. On day 7 after ingestion of 150 mg fluconazole concentration in the stratum corneum is 23.4 g / g after 1 week after the second dose – 7.1 g / g. Concentration of fluconazole in healthy nails after 4 months of treatment at a dose of 150 mg 1 time per week was 4.05 g / g and 1.8 mg / g – in the affected nails. It is an inhibitor of CYP2C9 isoenzymes in the liver. Stanozolol dosage is detected in the peripheral blood.Report mostly kidneys (80% – unchanged, 11% – in the form of metabolites). The half-life of fluconazole -. About 30 hours clearance of fluconazole is proportional to the creatinine clearance. After dialysis for 3 hr in the plasma concentration of fluconazole is reduced by 50%.

Indications

  • cryptococcosis, including cryptococcal meningitis and other localization of the infection (including lung, skin), in patients with a normal immune response, and patients with various forms of immunosuppression ( patients, organ transplant ); drug can be used to prevent cryptococcal infection in  patients;
  • mucosal candidiasis, including oral cavity and pharynx (including atrophic oral candidiasis associated with wearing dentures), esophageal, non-invasive bronchopulmonary candidiasis, candiduria;Prevention of relapse of oropharyngeal kandidozau ;
  • genitalny candidiasis: vaginal candidiasis (acute and chronic recurrent); prophylactic use to reduce the frequency of relapses of vaginal candidiasis (3 or more episodes per year); Candida balanitis;
  • generalized candidiasis including candidemia, disseminated candidiasis and other forms of invasive Candida infections (infections of the peritoneum, endocardium, eyes, respiratory and urinary tract). The treatment can be carried out in patients with cancer, patients in intensive care units, patients undergoing a course of cytostatic or immunosuppressive therapy, as well as the presence of other factors predisposing to the development of candidiasis;
  • fungal infections of the skin, including tinea pedis, body, groin; pityriasis (multicolored) versicolor, onychomycosis and skin candida infection;
  • deep endemic mycoses, including coccidioidomycosis, paracoccidioidomycosis, sporotrichosis and histoplasmosis in patients with normal immune systems;
  • prevention of fungal infections in patients stanozolol dosage with malignancy who are predisposed to such infections as a result of chemotherapy, cytostatics or radiation therapy.

Contraindications

  • Hypersensitivity to fluconazole, other azole drug components or compounds with a similar structure of fluconazole;
  • concomitant use of terfenadine (on the background of continuous use of fluconazole 400 mg / day or more);
  • concomitant use of cisapride, astemizole, as well as other drugs prolonging the stanozolol dosageinterval;
  • lactation;
  • Children under 4 years of age.
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8127

stanozolol side effects

Fluconazole potentiated the effect of coumarin anticoagulants may increase in prothrombin time. It promotes the prolongation of the prothrombin time in patients receiving warfarin. Appointing fluconazole in combination with anticoagulants, it is necessary to monitor the prothrombin index.
When concomitantly with fluconazole increased concentration of sulfonylureas – chlorpropamide, glibenclamide, glipizide and tolbutamide, which potentiates the risk of uncontrolled hypoglycemia. It is stanozolol side effects necessary to periodically monitor blood glucose levels and, if necessary, correct the dose of hypoglycemic agents (risk of hypoglycaemia!). Thiazide diuretics : may increase the level of fluconazole in plasma. Phenytoin : concomitant use with fluconazole results in an increase of phenytoin plasma concentrations at clinically relevant degree ( the combined use is necessary monitorirovnie phenytoin plasma concentrations). Rifampicin reduces the following pharmacokinetic parameters of fluconazole a more rapid elimination of fluconazole from plasma (20%) requires an increase in the dose. Cyclosporine A : while receiving fluconazole may increase the concentration of cyclosporine, which requires monitoring of its concentration, control over the performance of the plasma creatinine and dose adjustment.

Theophylline : while receiving with fluconazole may increase theophylline concentration in the blood by increasing its half-life (the risk of intoxication). Requires dynamic clinical monitoring and monitoring of theophylline with a possible correction dosage concentrations. Terfenadine, and cisapride : while receiving fluconazole possible increase in their concentration in the plasma, which is accompanied by a prolongation of the QT interval and potentiates the risk of ventricular arrhythmias including paroxysmal ventricular tachycardia (torsades de . pointes) zidovudine : while receiving fluconazole may increase zidovudine plasma concentrations. rifabutin : when taken with fluconazole may increase the levels of rifabutin plasma, in some cases – the development of uveitis. astemizole : simultaneous reception of astemizole and fluconazole, drugs, metabolism involving a system of enzymes of the cytochrome thestanozolol side effects, can be accompanied by an increase in their concentration in plasma.Tacrolimus : while receiving fluconazole increased risk of nephrotoxicity. at the same time taking fluconazole increases plasma concentration of benzodiazepine short-acting , which in some cases require correction of their doses. The solution  for intravenous administration is compatible with 0.9% sodium chloride solution, 5-10% dextrose, Ringer’s solution, potassium chloride solution in glucose solution Hartmann. in view of the likely pharmacological incompatibility does not add or mix Flukomabola solution ® with other drugs ! When assigning the patient a few drugs administered in / in, observe the sequence of administration, or administered Flukomabol ® through separate intravenous catheter or a system / in infusions.

 

Specific guidance
Treatment should be continued until clinical, and immunocompromised patients – also remission. Premature discontinuation of treatment leads to relapse. During treatment it is necessary to monitor blood counts, kidney and liver. In the event of severe impaired renal and hepatic function should stop taking the drug. Hepatotoxic action of Fluconazole is usually reversible, symptoms disappear after cessation of therapy. In the event of skin rash in patients with immunosuppression should be carefully monitored, and if the progression of skin reactions treatment should be discontinued (risk of the syndrome of Stevens-Johnson syndrome, Lyell’s syndrome). Requires monitoring prothrombin index while the use of coumarin anticoagulants. It is recommended to carry out dynamic monitoring of cyclosporine concentrations in the blood in patients after organ transplantation, while receiving  , as administration of fluconazole 200 mg / day leads to a slow increase in the concentration of cyclosporine, which can lead to toxic effects.
Taking certain azoles, including fluconazole, can be accompanied by a prolongation of the QT interval, so the appointment  in patients at risk of arrhythmias, especially heavy patients, who have organic lesion of the myocardium and the pathways of the heart, electrolyte imbalance and / or receiving supportive kardiotropnyh therapy should be strictly justified and carried out under close medical supervision and monitoring of ECG.
parenteral stanozolol side effects in preterm infants should be undertaken under close medical supervision.
Given dysfunction kidney in elderly (> 65 years) patients, the choice of dose and administration regimen is recommended to take into account the biochemical tests that characterize the function of the kidneys, as well as to conduct their dynamic monitoring.