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Vega Extra Cobra (sildenafil citrate)

Vega Extra Cobra (sildenafil citrate)

$ 1.02 per pill

Quick Overview

A single dose of 100 mg of Cobra Vega Extra Strong 120 Mg together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Cobra Vega Extra Strong 120 Mg by 182%.

Vega Extra Cobra® (Signature)

Vega Extra Cobra (Sildenafil citrate) 120 mg

Vega Extra Cobra
Sildenafil citrate
120 mg × 180 pills
$ 193.90 $ 183.95
$ 1.02 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 120 pills
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Sildenafil citrate
120 mg × 90 pills
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Vega Extra Cobra
Sildenafil citrate
120 mg × 60 pills
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Vega Extra Cobra
Sildenafil citrate
120 mg × 30 pills
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Sildenafil citrate
120 mg × 20 pills
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$ 2.35 per pill
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Vega Extra Cobra
Sildenafil citrate
120 mg × 10 pills
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Information

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Sildenafil Tablets Vegah Extra Cobra, reported NESN is a rare disease and the cause of the decrease or loss of vision. Most of these patients had risk factors, such as decreased ratios of excavation diameter to optic disc (stagnant disc), age over 50, diabetes, hypertension, CHD, hyperlipidemia, and Smoking. In an observational study evaluated whether recent use of drugs class of inhibitors PDE-5 with an acute onset NESN. The results indicate approximately a 2-fold increase in risk NESN within 5T1/2 after application of the PDE-5 inhibitor. According to published literature, the annual incidence of npins IS 2.5–11.8 cases per 100,000 men aged ≥50 years in the General population. Patients should be advised to stop Cobra Vega Extra therapy in case of sudden loss of vision and consult a doctor immediately.

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 Vega Coin, 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 Cobra Vega Extra 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 Vega 120 Mg in patients with retinitis pigmentosa absent, so these patients should not be used Cobra Vega Extra (see "Contraindications").

The pharmacokinetics of Vega Extra Cobra 130 Mg in the recommended dose range is linear.

Suction. After intake of Cobra 120 Vega Extra is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Cobra Vega Extra at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Vega Coin 100 mg average Cmax free Cobra Vega Extra in plasma men is about 18 ng/ml (38 nm). Cmax when taking Vegal Extra inside fasting is achieved for an average of 60 minutes (from 30 to 120 minutes). When taken in combination with fatty foods, the rate of absorption decreases: Cmax decreases by an average of 29%, and Tmax increases by 60 minutes, but the degree of absorption does not change significantly (AUC decreases by 11%).

Distribution. The average Vss of Sildenafil Vega Extra 130 Mg is 105 l. the Association of Cobra Vega Extra and its main circulating N-demethyl metabolite with plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the dose of Cobra Vega Extra (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Cobra 120 Vega Extra 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 Cobra Vega Extra, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Vega 120 Mg, and its activity against PDE-5 in vitro is about 50% of the activity of Vega Extra 120. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Cobra Vega Extra. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

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

Cardiovascular complications

During the post-marketing use of Cobra Vega Extra for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Vegah Extra 130. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Cobra Vega Extra without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Hypotension

Cobra Vega Extra has a systemic vasodilating effect, leading to a transient decrease in blood PRESSURE, which is not clinically significant and does not lead to any consequences in most patients. However, before prescribing Vega Coin, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with the rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood PRESSURE from the autonomic nervous system.

Since the combined use of Cobra Vega Extra and α-blockers can lead to symptomatic hypotension in some sensitive patients, Cobra Vega Extra should be used with caution in patients taking α-blockers (see "Interaction"). To minimize the risk of postural hypotension in patients taking α-blockers, the drug Cobra Vega Extra should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Cobra Vega Extra (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

Cardiovascular complications

During the post-marketing use of Cobra Vega Extra for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Cobra Vega Extra. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Vega Pills without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Cobra Vega Extra, reported NESN is a rare disease and the cause of the decrease or loss of vision. Most of these patients had risk factors, such as decreased ratios of excavation diameter to optic disc (stagnant disc), age over 50, diabetes, hypertension, CHD, hyperlipidemia, and Smoking. In an observational study evaluated whether recent use of drugs class of inhibitors PDE-5 with an acute onset NESN. The results indicate approximately a 2-fold increase in risk of developing NESN within 5T1/2 after application of the PDE-5 inhibitor. According to published literature, the annual incidence of npins IS 2.5–11.8 cases per 100,000 men aged ≥50 years in the General population. Patients should be advised to stop Cobra Vega 120 Mg therapy in case of sudden loss of vision and consult a doctor immediately. 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 Vega Extra Cobra 120, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Vega Cobra 120 in doses exceeding the recommended, adverse events were similar to those noted above, but usually more common.

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Vegal Extra

The metabolism of Vega Extra Cobra occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Cobra Vega Extra, and inducers, respectively, increase the clearance of Cobra Vega Extra. A decrease in the clearance of Vegah Extra 130 with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Cobra Vega Extra Strong 120 Mg (50 mg) causes an increase in the concentration of Cobra Vega Extra in plasma by 56%.

A single dose of 100 mg of Cobra Vega 120 Mg together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Vega Extra Cobra 130 Mg by 182%.

When co-administered Cobra Vega Extra (once 100 mg) and saquinavir (1200 mg/day 3 times daily), an inhibitor of HIV protease and of CYP3A4, on the background to achieve a constant concentration of saquinavir in the blood, Cmax of Vega Extra Cobra 120 was increased by 140% and the AUC increased by 210%.

Stronger inhibitors of CYP3A4 isoenzyme, such as ketoconazole and Itraconazole, can cause more pronounced changes in the pharmacokinetics of Cobra Vega Extra.

The simultaneous use of Cobra Vega Extra (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Sildenafil Vega Extra 120 by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Cobra Vega Extra in blood plasma is about 200 ng/ml (after a single application of one Vega Extra Strong 120 — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Cobra Vega Extra does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Sildenafil Tablets Vegah Extra Cobra is not recommended. In any case, the maximum dose of Cobra Vega Extra under any circumstances should not exceed 25 mg for 48 hours. If Vegal Extra is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Cobra Vega Extra does not exceed 200 nm, and the drug is well tolerated.

Single administration of antacid (magnesium hydroxide/aluminum hydroxide) does not affect the bioavailability of Vega Cobra 120.

Studies involving healthy volunteers with simultaneous use of endothelin receptor antagonist, bosentan (CYP3A4 isoenzyme inducer (moderate), CYP2C9, and possibly CYP2C19) in Css (125 mg 2 times a day) and Cobra Vega Extra in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Vega 120 Mg by 62.6 and 52.4%, respectively. Vegah Extra 120 Mg increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Cobra Vega Extra with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Cobra Vega Extra in blood plasma.

CYP2D6 isoenzyme inhibitors (SSRIs, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists have no effect on the pharmacokinetics of Cobra Vega Extra.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Vegah Cobra or its main circulating metabolite.



Cobra Vega Extra Strong 120 Mg

Reviews

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You won't regret it. It really saves me time and effort. Vega-extra is exactly what our business has been lacking.Rating:87 out of100, 71Vega-extraVega-extra is worth much more than I paid.Rating:96 out of100, 71Vega-extraDude, your stuff is the bomb! Vega-extra was worth a fortune to my company.Rating:95 out of100, 71Vega-extraI didn't even need training. Vega-extra is awesome! I wish I would have thought of it first. Thanks guys, keep up the good work!Rating:84 out of100, 71Vega-extraIt's really wonderful.Rating:87 out of100, 71Vega-extraIt really saves me time and effort. Vega-extra is exactly what our business has been lacking. Thanks for the great service. I have gotten at least 50 times the value from Vega-extra. Absolutely wonderful!Rating:86 out of100, 71Vega-extraGreat job, I will definitely be ordering again! Wow what great service, I love it! We're loving it. Vega-extra did exactly what you said it does.Rating:79 out of100, 71Vega-extraThe service was excellent.Rating:71 out of100, 71Vega-extra I don't know what else to say. I would gladly pay over 600 dollars for Vega-extra.Rating:78 out of100, 71Vega-extraAfter using Vega-extra my business skyrocketed! This is simply unbelievable!Rating:93 out of100, 71Vega-extraI am completely blown away. I will recommend you to my colleagues. I just can't get enough of Vega-extra. I want to get a T-Shirt with Vega-extra on it so I can show it off to everyone. I am really satisfied with my Vega-extra.Rating:82 out of100, 71Vega-extraI'm good to go. Vega-extra is the next killer app.Rating:75 out of100, 71Vega-extraWe're loving it. Vega-extra has completely surpassed our expectations.Rating:83 out of100, 71Vega-extraThank You! I love Vega-extra.Rating:100 out of100, 71Vega-extraWe can't understand how we've been living without Vega-extra. I was amazed at the quality of Vega-extra. Vega-extra was the best investment I ever made.Rating:96 out of100, 71Vega-extraSince I invested in Vega-extra I made over 100,000 dollars profits. I don't always clop, but when I do, it's because of Vega-extra. Vega-extra is great.Rating:88 out of100, 71Vega-extraDefinitely worth the investment. Thank you so much for your help. Keep up the excellent work.Rating:93 out of100, 71Vega-extraNeedless to say we are extremely satisfied with the results.Rating:73 out of100, 71Vega-extraI am completely blown away. I wish I would have thought of it first. You won't regret it. It really saves me time and effort. Vega-extra is exactly what our business has been lacking.Rating:87 out of100, 71Vega-extraVega-extra is worth much more than I paid.Rating:96 out of100, 71Vega-extraDude, your stuff is the bomb! Vega-extra was worth a fortune to my company.Rating:95 out of100, 71Vega-extraI didn't even need training. Vega-extra is awesome! I wish I would have thought of it first. Thanks guys, keep up the good work!Rating:84 out of100, 71Vega-extraIt's really wonderful.Rating:87 out of100, 71Vega-extraIt really saves me time and effort. Vega-extra is exactly what our business has been lacking. Thanks for the great service. I have gotten at least 50 times the value from Vega-extra. Absolutely wonderful!Rating:86 out of100, 71Vega-extraGreat job, I will definitely be ordering again! Wow what great service, I love it! We're loving it. Vega-extra did exactly what you said it does.Rating:79 out of100, 71

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