Dianabol for sale is structurally similar to the neurotransmitter gamma-aminobutyric acid (GABA), but its mechanism of action is different from other drugs that interact with GABA-receptors (valproate, barbiturates, benzodiazepines, inhibitors of GABA-transaminase reuptake inhibitors GABA GABA agonists and prodrugs of GABA). It has no GABA-ergic and does not affect the properties of grip and GABA metabolism.Preliminary studies showed that dianabol for sale is associated with α 2 -σ-subunit of voltage-dependent calcium channels and reduces the flow of calcium ions, which plays an important role in the onset of neuropathic pain. Other mechanisms of action of dianabol for sale for neuropathic pain is a decrease in glutamate-dependent neuronal death, increasing the synthesis of GABA, inhibition of monoamine neurotransmitter release group. dianabol for sale at clinically relevant concentrations, does not bind to receptors that are sensitive to other drugs (drug) or neurotransmitters, including GAMKd receptors, GABA B, benzodiazepine, glutamate, glycine, or N-methyl-d-aspartate. Unlike phenytoin and carbamazepine, dianabol for sale does not interact with sodium channels in vitro. dianabol for sale partially attenuated effects receptor agonist glutamate N-methyl-d-aspartate in some tests in vitro, but only at a concentration of more than 100 micromoles, which is not achieved in vivo.dianabol for sale slightly reduces the release of monoamine neurotransmitters in vitro. Pharmacokinetics : The bioavailability of dianabol for sale is not proportional to dose.Thus, by increasing the dose is reduced. After oral administration, maximum concentration (C max ) of dianabol for sale in plasma achieved in 2-3 hours. The absolute bioavailability of dianabol for sale capsules is approximately 60%. Food, including a high content of fat, has no effect on pharmacokinetics. The half-life (the T 1/2 ) in plasma is independent of dose and averages 5-7 hours Pharmacokinetics does not change with repeated use.; equilibrium plasma concentration can be predicted on the basis of the results of a single dose. dianabol for sale is almost bound to plasma proteins (<3%) and has a volume of distribution of 57.7 liters. Displays only the kidneys in an unmodified form, does not undergo metabolism. The drug does not induce liver oxidative enzymes mixed function involved in the metabolism of drugs. Clearance from plasma dianabol for sale reduced in the elderly and patients with impaired renal function. The constant rate of excretion, clearance from the plasma and renal clearance are directly proportional to creatinine clearance. dianabol for sale is removed from plasma by hemodialysis. In patients with impaired renal function and patients receiving hemodialysis, dose adjustment is recommended (see. Dosage and administration).
Indications for use :
- epilepsy: partial seizures with secondary generalization and without adults and children older than 12 years (moioterapiya); partial seizures with secondary generalization and without adults (extra HP); resistant form of epilepsy in children older than 3 years (extra HP).
- neuropathic pain in adults (18 years and older).Contraindications :
Hypersensitivity to any component of the drug, age under 12 years (due to the impossibility of accurate dosing).
Renal failure (see. “Dosage and administration”).
Pregnancy and lactation :
There are no data on the use of the drug in pregnant women, therefore, dianabol for sale should be used during pregnancy only if the expected benefit to the mother justifies the potential risk to the fetus.
dianabol for sale is excreted in breast milk, its effect on the breastfed child is unknown so in the time of treatment should abandon breastfeeding.
Dosage and administration :
Inside, swallowing a whole, regardless of the meal and abundantly with some liquid. If you need to reduce the dose, stop the drug or replace it with an alternative means, it should be done gradually over a minimum of one week. Neuropathic pain in adults The initial daily dose is 900 mg, divided into three stages; if necessary, the dose is gradually increased to the maximum – 3600 mg / day. Treatment can be started immediately with a dose of 900 mg / day (300 mg 3 times daily) or within the first 3 days the dose may be increased gradually to 900 mg a day as follows: 1st day: 300 mg 1 time per day day 2: 300 mg 2 times a day 3rd day: 300 mg 3 times daily partial seizures Adults and children from 12 years of age: The effective dose – from 900 to 3600 mg / day. Therapy can be started with a dose of 300 mg three times a day on the first day and increased gradually to 900 mg according to the scheme described above (see., “Neuropathic pain in adults” section). Subsequently, the dose may be increased to a maximum of 3600 mg / day (divided into three equal doses). . The maximum interval between doses at three receiving the drug should not exceed 12 hours in order to avoid the resumption of seizures . Dose selection in renal failure patients with renal insufficiency is recommended to decrease the dose of dianabol for sale according to the table:
Creatinine clearance (ml / min) Daily dose (mg / day) > 80 900-2400 50-79 600-1200 30-49 300-600 15-29 150 * -300 <15 150 *
* Appoint 300 mg every other day.
The recommendations for patients on hemodialysis.
Patients on hemodialysis who had not previously received gabalentin, the drug is recommended to appoint in saturating dose of 300-400 mg, and then apply it to the 200-300mg every 4 hours of hemodialysis.
Side effects : Cardiovascular: vasodilation symptoms or increase in blood pressure, palpitations. Digestive system: flatulence, anorexia, gingivitis, abdominal pain, constipation, dental disease (including discoloration of tooth enamel), diarrhea, dyspepsia, increased appetite , dry mouth or throat, nausea, vomiting, pancreatitis, increased activity of “liver” transaminases, hepatitis, jaundice. blood system, lymphatic system: purpura (often it is described as bruising, occurred when a physical injury), leukopenia, thrombocytopenia. Bone -Muscular system: arthralgia, back pain, increased fragility of bones, myalgia. Nervous system: dizziness; headache; hyperkinesis; muscle dyskinesia and paging; choreoathetosis; weakening or absence of tendon reflexes; dysarthria; ataxia; nystagmus; paresthesia;convulsions; confusion; fatigue; asthenia; amnesia; depression; abnormal thinking; hostility; emotional lability; insomnia; anxiety; drowsiness; hallucinations, tremor; tics; . malaise Respiratory system:rhinitis, pharyngitis, bronchitis, pneumonia, cough, shortness of breath, respiratory infection. Skin and subcutaneous tissue disorders: acne, peripheral edema, allergic reactions: itching, skin rash, erythema multiforme exudative (including Stevens-Johnson syndrome .) Urogenital: urinary tract infection, impotence, incontinence, acute renal failure. Special senses: blurred vision, amblyopia, diplopia, tinnitus, otitis media. Other: fever, viral infection, weight gain, labile plasma glucose blood in patients with diabetes, pain of various localization, gynecomastia, breast enlargement, generapizovanny swelling.
Symptoms: dizziness, double vision, impaired speech, drowsiness, lethargy, diarrhea, and increased severity of other side effects.
Treatment: gastric lavage, activated charcoal, symptomatic therapy. Patients with severe renal insufficiency, hemodialysis may be indicated.
Interaction with other drugs :
Morphine: by sharing a dianabol for sale and morphine when morphine was taken 2 hours prior to receiving dianabol for sale was observed increase in the area average value under the curve “concentration – time» (AUC) of dianabol for sale by 44% compared to monotherapy dianabol for sale that was associated with an increase in the threshold brlevogo (Kholodov pressor test). The clinical significance of this change is not established, the pharmacokinetic characteristics of morphine is not changed. Side effects of morphine during coadministration with dianabol for sale did not differ from that of morphine when taking in conjunction with the placebo.
The interaction between dianabol for sale and phenobarbital, phenytoin, carbamazepine and valproic acid were observed. The pharmacokinetics of dianabol for sale in the equilibrium state is the same in healthy subjects and patients receiving other anticonvulsants. The simultaneous use of dianabol for sale with oral contraceptives containing norethisterone and / or ethinyl estradiol, was not accompanied by changes in the pharmacokinetics of both components.
The simultaneous use of dianabol for sale with antacids that contain aluminum and magnesium, followed by reduction of dianabol for sale bioavailability by approximately 20%. dianabol for sale is recommended to take approximately 2 hours after taking an antacid. Probenecid does not affect the renal excretion of dianabol for sale.
A slight decrease in renal excretion of dianabol for sale while taking cimetidine probably have no clinical significance.
Special instructions :
Although withdrawal syndrome with the development of seizures in the treatment of dianabol for sale is not checked, however, the abrupt discontinuation of therapy with antiepileptic drugs in patients with partial seizures can induce convulsions (see Dosage and Administration.).
dianabol for sale is not considered effective in treating absans- epilepsy. In patients who require combination therapy with morphine, may require increased doses of dianabol for sale. It is necessary to ensure thorough monitoring of patients for the development of such a sign of oppression of the central nervous system (CNS) such as drowsiness. In this case, the dose of dianabol for sale or morphine should be appropriately reduced (see. “Interaction with other medicinal products”). Laboratory studies When adding dianabol for sale to other anticonvulsant drugs have been reported false positive results in the protein determination of urine using test strips Ames N-Multistix SG®. For the determination of protein in urine it is recommended to use more specific sulfosalicylic acid precipitation method. Patients should avoid driving, as well as the performance of work requiring speed of performance of psychomotor reactions.