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Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Buy Viagra With Btc, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk. In patients with episodes of development PINZN with loss of vision in one eye receiving Generic Sildenafil For Btc is contraindicated (see "Contraindications").

A small number of patients with hereditary retinitis pigmentosa have genetically determined disorders of the PDE of the retina. Information about the safety of the drug Buy Viagra Btc in patients with retinitis pigmentosa absent, so these patients should not be used Generic Viagra For Btc (see "Contraindications").

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Metabolism. Buy Female Viagra With Btc is metabolized mainly in the liver by the action of CYP3A4 isoenzyme (main pathway) and CYP2C9 isoenzyme (minor pathway). The main circulating active metabolite, formed as a result of N-demethylation of Buy Female Viagra With Btc, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Generic Sildenafil For Btc, and its activity against PDE-5 in vitro is about 50% of the activity of Buy Kamagra With Btc. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Buy Sildenafil Btc. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Generic Sildenafil For Btc is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Pay For Viagra With Btc is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).

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