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buy dianabol

Pregnancy and lactation
Use of the drug Betiol ® during pregnancy and lactation is possible if the benefit to the mother outweighs the potential risk to the fetus and child.

Dosing and Administration
buy dianabol 1-3 suppository per day, but not more than 10 suppositories a day, after cleansing enema or spontaneous bowel cleansing.

Side effects:
dry mouth, thirst, constipation, tachycardia, mydriasis, accommodation paresis, and allergic reactions.

Overdose
If overdose possible dry mouth, thirst, constipation, tachycardia, mydriasis and other temporary visual impairment, in more severe cases – psychomotor agitation, seizures, urinary retention.

Interaction with other medicinal products
are not described.

Cautions
During treatment caution should be exercised when driving and occupation of other potentially hazardous activities that require high concentration of attention, psychomotor speed reactions and good vision.

Release form
Valium buy dianabol. 5 suppositories in blisters.
Two blisters with instruction on use of the drug is placed in a carton pack. where to buy anabolic steroids online

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Pharmacological properties  agonist H1 histamine receptors and blood vessels of the inner ear antagonist NZ- histamine receptors of the vestibular nuclei of the central nervous system.According to preclinical studies by relaxing the sphincter prekapilyarnyh vessels of the inner ear improves blood circulation in the inner ear vascular ledge. Dose-dependently reduced the generation of action potentials in the neurons of the lateral and medial vestibular nuclei. It accelerates the recovery of vestibular function after unilateral vestibular neyrektomii, accelerating and facilitating central vestibular compensation (due to antagonism with the NC-histamine receptors). It eases symptoms of the syndrome of Meniere and vertigo.

Pharmacokinetics
When taken orally dianabol steroid rapidly and almost completely absorbed in the gastrointestinal tract. After absorption of the drug is rapidly and almost completely metabolised to form inactive metabolite 2-pyridylacetic acid.

Before the drug at a dose of about 8-48 mg of 85% of the initial dose is found in the urine as a 2-pyridylacetic acid. Elimination of dianabol steroid kidneys or via the gut slightly. Elimination rate constant remains dianabol steroid after oral administration 8-48 mg, ukazshaya dianabol steroid pharmacokinetic linearity, and suggests that the metabolic pathway involved remains unsaturated. When taken with food preparation dianabol steroid maximum concentration is lower than in the fasting state. However, the total absorption of dianabol steroid same in both cases, indicating that ingestion of only slows down the absorption of dianabol steroid.

Indications
Ménière’s syndrome, characterized by the following main symptoms:

  • dizziness (accompanied by nausea / vomiting)
  • hearing loss (deafness)
  • noise in ears

Symptomatic treatment of vestibular vertigo (vertigo).

Contraindications

  • hypersensitivity to any component of the drug.

Betaserk ® is not recommended for use in children under the age of 18 years due to lack of efficacy and safety data.

Application of pregnancy and during breastfeeding

Pregnancy
The available data on the use of dianabol steroid in pregnant women is not enough.

The potential risk for humans is unknown. The use of dianabol steroid during pregnancy is permitted if the benefits from the use of the mother outweighs the potential risk to the fetus.

Lactation
It is not known whether dianabol steroid is excreted in breast milk. Do not take the medication during breastfeeding. The appointment of a medicinal drug to the mother should be taken only after a comparison of the benefits of breastfeeding to the potential risk to the infant.

Precautions:
in the treatment of patients with gastric ulcer and 12 duodenal ulcer history. Patients with pheochromocytoma and asthma during treatment should be monitored regularly by a doctor.

Dosing and Administration
Always take Betaserk ® exactly as your doctor has prescribed. If you have any questions, consult your doctor.

Inside, during a meal.

Dose for adults is 48 mg per day of dianabol steroid.

Betaserk ® 24 mg should take 1 tablet 2 times a day. The tablet can be divided into two equal parts, as shown in Fig.

Place the tablet on a hard surface and push the notch up his thumb on it.

The dose should be individualized depending on the response to treatment. The improvement sometimes seen in just a few weeks of treatment. The best results are obtained sometimes after several months of treatment. There is evidence that the appointment of treatment early in the disease to prevent its progression and / or hearing loss in later stages. Correction of the dose in elderly patients and in patients with renal and / or hepatic impairment is not required.

Side effects
If you notice any side effects not listed in this manual, or any side effect has taken serious, report, please your doctor.

Gastrointestinal disorders: Most (by> 1/100 to <1/10): nausea and dyspepsia. In addition to these effects identified in clinical trials, during post-marketing use and in scientific literature reported the following adverse effects. Available data are insufficient to estimate their frequency.

Immune system: hypersensitivity reactions, including anaphylaxis reported.

From the gastrointestinal tract: moderate disorders, such as vomiting, pain in the gastrointestinal tract, bloating. Typically, these effects usually disappear after dosing with food or after a dose reduction.

Skin and subcutaneous tissue: Hypersensitivity reactions such as angioneurotic edema, urticaria, pruritus and rash.

Overdose
Several cases of overdose. Some patients experienced light to moderate symptoms (nausea, drowsiness, abdominal pain) after taking the drug at doses up to 640 mg. More serious complications (spasm, cardiopulmonary complications) were observed at higher doses deliberate dianabol steroid, especially in combination with other drugs overdose. Recommended symptomatic treatment.

Interaction with other medicines
If you are currently or in the recent past, you are taking other medicines, including those without a doctor’s prescription, report it, please your doctor. Studies in vivo, aimed at studying the interactions with other drugs have not been conducted. These in vitro studies suggest no activity inhibiting cytochrome P450 isozymes in vivo.

Effects on ability to drive car and other machines.
It is believed that the effect of betagietina on ability to drive and other mechanisms is absent or negligible, as in clinical trials involving the use of betagietina, effects, potentially influencing this ability were found.

Composition
Tablets 24 mg: 20 tablets in PVC / PVDC / Al blister, 1, 2, 3 or 5 blisters together with instructions for use in a cardboard box. On 25 tablets in PVC / PVDC / Al blister, 1, 2 or 4 blisters with instruction for use in a cardboard box. tumor marker does hcg increase testosterone injections weight loss results

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dianabol review

Pharmacological properties dianabol review – atypical antipsychotic (neuroleptic), also has a stimulating, antidepressant and antiemetic effect. Antipsychotic effect due to blockade of dopamine receptors 02 and Mesocortical mesolimbic system. Antipsychotic effect seen at doses over 600 mg / day, in doses up to 600 mg / day is dominated by stimulating and antidepressant effects.
It stimulates the secretion of prolactin, has no significant impact on adrenergi Sanchez Kie, cholinergic, serotonin, histamine and GABA receptors.
Antiemetic effect due to blockade dopamine D2-receptor trigger zone of the vomiting center. Peripheral action based on the inhibition of presynaptic receptors. In gastric ulcer and duodenal ulcers, providing selective effect on the hypothalamus, suppressing arousal centers of the sympathetic nervous system and improves blood flow to the stomach, increases the secretion of mucus in the stomach; It accelerates the proliferation of granulation tissue forms a regenerated epithelium, proliferation of capillaries improves tissue.

Pharmacokinetics
After oral administration, maximum plasma concentrations are reached in 1.5-3 hours. The bioavailability of dianabol review at intake – 27%. dianabol review Plasma protein binding is less than 40%. Quickly penetrates the liver and kidneys, slowly – in brain tissue (basic amount of drug accumulated in the pituitary gland).Concentration dianabol review in the central nervous system is 2 – 5% of the concentration in plasma. dianabol review excreted in breast milk (0.1% of the daily dose).
dianabol review in the human body is not metabolized and excreted virtually unchanged through the kidneys by glomerular filtration (92%). Total clearance – 126 ml / min. The half-life (T ½ ) is about 7 hours. This value is significantly increased in patients with moderate to severe renal insufficiency (20 – 26 hours after intravenous administration). Such patients should reduce the dose of dianabol review and / or increase the interval between doses of the drug.

Indications
Betamax should be taken strictly on prescription.
As a monotherapy or in combination with other psychotropic drugs:

  • acute and chronic schizophrenia;
  • acute delirious state;
  • Depression different etiology;
  • neuroses;
  • dizziness of various etiologies (vertebro-basilar insufficiency, vestibular neuritis, Ménière’s disease, traumatic brain injury, otitis media);
  • migraine;
  • adjuvant therapy in gastric ulcer, duodenal ulcer and irritable bowel syndrome.

 

Contraindications

  • Acute poisoning with alcohol, hypnotics, narcotic analgesics;
  • hypersensitivity to the drug;
  • manic psychosis;
  • seizures;
  • Parkinson’s disease;
  • pheochromocytoma;
  • prolaktinzavisimye tumors (including breast cancer);
  • hyperprolactinemia;
  • affective disorders, aggressive behavior;
  • hypertension stage 2-3;
  • breastfeeding;
  • children under 18 years.

Precautions

epilepsy, hypertension, dysmenorrhea, severe diseases of the heart, angina, liver failure, neuroleptic malignant syndrome, a history of glaucoma, prostatic hyperplasia, urinary retention, old age.
Care should be exercised in the appointment of dianabol review in patients with impaired renal function, as as a 95% dianabol review eliminated via the kidneys. These patients are recommended to reduce the dose of the drug (see. Section Dosage and administration ).
It should also take precautions when appointing dianabol review patients with Parkinson’s, young women with irregular menstrual cycles.

Pregnancy and lactation
During pregnancy dianabol review prescribed in cases where the doctor to weigh the risks and benefits for the pregnant woman and the fetus, decides that the use of the drug is needed. It is recommended, whenever possible, to limit the dose and duration of treatment. The drug is contraindicated during lactation.

Dosing and Administration
Is inwards in the morning (before 16:00), regardless of the meal, washed down with a small amount of liquid. Acute and chronic schizophrenia, acute delirious psychosis: initial dose of the drug Betamax depend on the clinical picture of the disease and up to 600 – 1200 mg per day, divided into several stages; . Maintenance doses – 300 – 800 mg daily maximum recommended daily dose – 1600 mg.Depression: 150 – 200 megawatts to 600 mg per day, divided into several stages. neuroses: 400-600 mg per day, divided into several stages. Dizziness: . 150 – 200 mg per day, in severe conditions the dose can be increased to 300 – 400 mg Duration of treatment should be not less than 14 days. Migraine: 100 – 300 mg per day. Adjuvant therapy in gastric ulcer and duodenal ulcer , irritable bowel syndrome: 150 Betamax mg per day in 3 divided doses, for 4-6 weeks. the doses in patients with impaired renal function: in connection with what dianabol review excreted primarily through the kidneys, it is advisable to reduce the dose of the drug Betamax and / or increase the interval between administration of individual doses, depending on the performance of creatinine clearance:

Creatinine clearance (ml / min) Betamax drug dose relative to the standard (%) Increasing the interval between doses of the drug Betamax
30-60 70 1.5 times
10-30 50 2 times
less than 10 thirty ZA times

The doses for elderly patients:
an initial dose of the drug should be Betamax ¼ – ½ adult dose. When pregnancy prescribe the lowest dose and for a long time.

 

Side effects
Adverse events, developing as a result of receiving dianabol review, like adverse events caused by other psychotropic drugs, but the frequency of their development, mostly less. On the part of the endocrine system: may develop reversible hyperprolactinemia, the most common manifestations of which are galactorrhea, menstrual disorders , at least – gynecomastia, impotence and frigidity. During treatment with dianabol review may experience excessive sweating, increased body mass index. From the digestive system: dry mouth, heartburn, nausea, vomiting, constipation, increased activity of hepatic transaminases and alkaline phosphatase (ALP). On the part of the central nervous system (CNS): extrapyramidal syndrome (usually occurs at doses above 400 mg / day), tremor, early and late dyskinesia (spasmodic torticollis, oculomotor disturbances, spasm of the masticatory muscles), akathisia (disturbance of posture), insomnia, drowsiness, anxiety, irritability, agitation, sleep disturbance, headache, neuroleptic malignant syndrome (pallor, vegetative disorders, hyperthermia). With the development of hyperthermia, the drug should be discontinued! Cardio-vascular system: increased blood pressure (BP), rarely – decreased blood pressure, orthostatic hypotension, dizziness, tachycardia, prolongation of QT-yntervala, rarely, arrhythmia such as “torsade de pointes”. Allergic reactions : possible skin rash, eczematous rash, pruritus. Vision: Violations of visual acuity.

Overdose Symptoms: dyskinesia (spasm of the masticatory muscles, spasmodic torticollis), extrapyramidal disorders. In some cases – marked parkinsonism, coma. Treatment: symptomatic.Anticholinergics central action.

 

Interactions with other drugs With simultaneous use: with levodopa decreases the effectiveness of dianabol review; with antihypertensive drugs – enhanced their hypotensive effect and increased risk of orthostatic hypotension. With drugs, CNS depressants (opioids, hypnotics and anxiolytic drugs (tranquilizers), clonidine, antitussive drugs of the central action), enhanced their inhibitory effect. Sucralfate, antacids containing of Mg 2+ and / or A 13+ , reduce bioavailability dianabol review 20 -. 40% antagonism of dopaminergic receptor agonists (amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribedil, pramipexole, kinagolid, roshpshrol) and neuroleptics. When extrapyramidal syndrome, neuroleptic induced without use of dopaminergic receptor agonists and anticholinergic drugs are used. If necessary, the treatment of patients with Parkinson’s disease during treatment with agonists of dopaminergic receptors, the last dose should be gradually reduced to a total abolition (abrupt withdrawal may lead to the development of neuroleptic malignant syndrome). In an application with sultopride increased risk of developing ventricular arrhythmias (incl . atrial fibrillation) The risk of developing ventricular arrhythmias such as “torsade de pointes” is increased by concomitant use: with antiarrhythmic drugs Ia class (quinidine, gidrohinidin, disopyramide) and class III (amiodarone, sotalol, dofetil, Ibutilide), some antipsychotics (thioridazine, chlorpromazine, Levomepromazine, trifluoperazine, tsiamemazin, amisulpride, tiaprid, haloperidol, droperidol, pimozide), with drugs that cause bradycardia (diltiazem, verapamil, beta-blockers, clonidine, guanfacine, digitalis preparations, donepizil, rivastigmine, tacrine, ambenonium chloride, galantamine, pyridostigmine, still hot from previous communes); with drugs that cause hypokalemia (kaliyvyvodyaschie diuretics, some laxatives, Amphotericin B intravenously glucocorticosteroids tetrakozaktid) with others (including bepridil, cisapride, difemanil erythromycin intravenously, mizolastine, vincamine intravenously, halofantrine, pentamidine, sparfloxacin, moxifloxacin) .

Special instructions:

In the event of hyperthermia during treatment drug should be discontinued (hyperthermia is a sign of development of neuroleptic malignant syndrome).
In the appointment of the drug in patients with epilepsy before treatment is necessary to pre-clinical and electrophysiological examination, because the drug lowers the threshold for seizure activity. In simultaneous treatment with drugs that increase the risk of ventricular arrhythmias is recommended that regular monitoring of the ECG. QT-interval lengthening – a dose-dependent effect. The use of ethanol in the background of the drug is contraindicated.

Effects on ability to drive and use machines
During treatment must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions. tambol? preparation h bodybuilding natural bodybuilding steroids bodybuilding and stretch marks

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Pharmacological properties dianabol reviews- β 1 adrenoblokator blocking β 1 receptors at much lower doses than the doses required to block the β 2 receptors.

dianabol reviews has an insignificant membrane-stabilizing effect and does not exhibit partial agonist activity.

dianabol reviews reduces or inhibits the agonistic effect that has on cardiac function catecholamines released during neural and physical stress.

This means that dianabol reviews has the ability to prevent an increase in heart rate (HR), cardiac output and increased cardiac contractility and blood pressure (BP), caused by the abrupt release of catecholamines.

Unlike conventional tablet dosage forms selective β 1 adrenoblokatorov (including dianabol reviews tartrate), when using the drug Betalok KRC observed plasma drug concentration constant and ensures stable clinical effect (β 1 -blokada) for more than 24 hours. Due to the absence of obvious peak plasma concentrations of clinically Betaloc ZOK has a better β 1 -selective compared to conventional tablet form β 1adrenoblokatorov. Moreover, substantially decreases the potential risk of side-effects observed at peak drug concentrations in plasma, for example, bradycardia and weakness in the legs while walking.Patients with symptoms of obstructive lung disease, if necessary, you can assign Betaloc ZOK in combination with β 2 – agonists. When combined with .beta. 2 – agonists Betaloc ZOK in therapeutic doses, to a lesser extent, affects the induced .beta. 2 – agonists bronchodilation than nonselective β-blockers. dianabol reviews less than nonselective β-blockers affect the production of insulin, and carbohydrate metabolism. Effect on cardiovascular reaction system under conditions of hypoglycemia is much less pronounced when compared to non-selective β-blockers.

Use of the drug when the KRC Betalok hypertension causes a significant decrease in blood pressure for more than 24 hours in both lying and standing position, and when the load. At the beginning of therapy with dianabol reviews there is an increase in vascular resistance. However, chronic administration may reduce blood pressure due to a decrease in vascular resistance with an unchanged cardiac output. In MERIT-HF (study of survival in chronic heart failure (class II-IV of NYHA classification) and a reduced fraction of cardiac output (≤ 0,40), which included 3991 patients) Betaloc ZOK has shown improved survival and reduced hospitalization rates. With long-term treatment of patients achieved total symptom improvement (in NYHA class). Also, with the use of Betaloc ZOK therapy showed improvement of left ventricular ejection fraction, reduced end-systolic and end-diastolic volume of the left ventricle.

The quality of life during treatment with Betaloc ZOK is not improving or deteriorating. Improving the quality of life in the treatment of drug Betaloc ZOK observed in patients after myocardial infarction.

Pharmacokinetics

On contact with fluid the tablet disintegrate rapidly, thus dispersing the active substance in the gastrointestinal tract. The release rate of the active substance depends on the acidity of the medium. The duration of therapeutic effect after administration of the drug in the dosage form Betalok KRC (sustained release tablets) is more than 24 hours, while achieving a constant release rate of the active substance over 20 hours. half-life is an average of 3.5 hours.

KRC Betalok completely absorbed after oral administration. Systemic bioavailability after oral administration of a single dose of approximately 30 to 40%. dianabol reviews undergoes oxidative metabolism in the liver. Three major metabolite of dianabol reviews showed no clinically significant β-blocking effect. About 5% of the oral dose excreted in the urine in unchanged form, the remainder of the drug is excreted as metabolites. Communication with low plasma proteins, approximately 5-10%.

Indications

 

  • Arterial hypertension
  • Angina.
  • Stable symptomatic chronic heart failure with impaired left ventricular systolic function (as adjunct therapy to the main treatment of chronic heart failure).
  • Reducing mortality and frequency reuse after the acute phase of myocardial infarction.
  • Cardiac arrhythmias, including supraventricular tachycardia, reduction of ventricular rate during atrial fibrillation and ventricular arrhythmia.
  • Functional heart disorders accompanied by tachycardia.
  • Prophylaxis of migraine attacks.ContraindicationsAtrioventricular block II and III degree, heart failure decompensation, patients receiving long-term or intermittent therapy with inotropic agents and acting on beta-adrenergic receptors, clinically relevant sinus bradycardia, sick sinus syndrome, cardiogenic shock expressed by peripheral circulatory disorders, hypotension.

    Betalok is contraindicated in patients with acute myocardial infarction with heart rate less than 45 beats per minute, PQ interval of more than 0.24 seconds or systolic blood pressure less than 100 mmHg

    Known hypersensitivity to dianabol reviews and its components or to other β- blockers.

    Severe peripheral vascular disease with gangrene threat.

    Patients receiving β-blockers are contraindicated intravenous blockers “slow” calcium channels such as verapamil.

    Age 18 years (effectiveness and safety have been established)

    Precautions: atrioventricular block I degree, Prinzmetal angina, asthma, chronic obstructive pulmonary disease, diabetes, severe renal insufficiency, severe hepatic insufficiency, metabolic acidosis, co-administration with cardiac glycosides.

    Use in pregnancy and during breastfeeding

    Like most drugs Betaloc ZOK should not be administered during pregnancy and during breast-feeding unless the expected benefit to the mother outweighs the potential risk to the fetus and / or the child. As with other antihypertensive agents, β-blockers may cause side effects such as bradycardia in the fetus, infants or children who are breastfed. The amount of dianabol reviews, liberated into breast milk, and β- blocking action in a child who is breastfed (while taking dianabol reviews mother in therapeutic doses), are minor.

    Dosing and Administration

    Betaloc ZOK is intended for daily administration once a day, it is recommended to take the drug in the morning. Betaloc ZOK tablet should be swallowed with some liquid. The tablets (or tablets, divided in half) should not chew or crumble. Food intake has no effect on the bioavailability of the drug.
    In the selection of the dose necessary to avoid the development of bradycardia.

    Hypertension
    50- 100 mg once a day. If necessary, the dose may be increased to 100 mg per day, or add another antihypertensive agent, preferably a calcium antagonist and a diuretic dihydropyridine

    Angina pectoris
    100-200 mg Betaloc ZOK once a day. Other antianginal drug could be added if necessary to the therapy.

    Stable symptomatic chronic heart failure with left ventricular systolic dysfunction
    Patients should be in the stage of stable chronic heart failure without acute episodes during the past 6 weeks and no change in the basic therapy during the past 2 weeks.
    Treatment of heart failure beta-blockers may sometimes cause temporary impairment of symptomatic picture. In some cases continued therapy or dose reduction, in some cases you may need discontinuation of the drug.

    Stable chronic heart failure, functional class II of
    the recommended starting dose of Betaloc ZOK the first 2 weeks of 25 mg once daily. After 2 weeks of therapy, the dose can be increased to 50 mg once a day, and further can double every 2 weeks.
    The maintenance dose for prolonged treatment Betalok KRC 200 mg once a day.

    Stable chronic heart failure, III-IV functional class
    recommended starting dose the first 2 weeks of 12.5 mg Betaloc ZOK (half a tablet of 25 mg) once a day. The dose is adjusted individually. During increasing the dose the patient should be monitored, as some patients of heart failure symptoms may worsen.
    After 1-2 weeks the dose may be increased to 25 mg Betalok KRC once daily. Then, after two weeks, the dose may be increased to 50 mg once a day. Patients who tolerate the drug, it is possible to double the dose every 2 weeks up to a maximum dose of 200 mg Betalok KRC once per day.
    In the case of hypotension and / or bradycardia may require reduction of concomitant therapy or dose reduction Betalok KRC. Hypotension in the beginning of the therapy does not necessarily indicate that the dose of Betaloc ZOK is not carried on further long-term treatment. However, dose should not be increased up until the condition has stabilized. It may require monitoring of renal function.

    Cardiac arrhythmias
    100-200 mg Betaloc ZOK once a day.

    Maintenance treatment after myocardial infarction
    200 Betalok KRC mg once a day.

    Functional disorders of cardiac activity, accompanied by palpitations
    100 mg Betaloc ZOK once a day. If necessary, the dose may be increased to 200 mg per day.

    Prophylaxis of migraine attacks
    100-200 mg Betaloc ZOK once a day.

    Renal impairment
    There is no need to adjust the dose in patients with impaired renal function.

    Abnormal liver function
    usually due to the low degree of connection with dose adjustments dianabol reviews plasma proteins is not required. However, in severe hepatic impairment (patients with severe liver cirrhosis or portocaval anastomosis) may require dose reduction.

    Old age
    is not necessary to adjust the dose in elderly patients.

    Children
    Experience with Betaloc ZOK formulation in children is limited.

    Side effect

    Betaloc ZOK is well tolerated, side effects are generally mild and reversible.

    To assess the frequency of cases we used the following criteria: very common (> 10%), often (1-9,9%), rarely (0.1-0.9%), rarely (0,01-0,09%) and very rare (<0.01%).

    Cardiovascular system
    Common: bradycardia, orthostatic hypotension (very rarely accompanied by syncope), cold extremities, palpitations,
    not often: a temporary increase in heart failure symptoms, AV block of I degree; cardiogenic shock in patients with acute myocardial infarction;
    Rare: other disturbances of cardiac conduction, arrhythmias;
    Very rare: Gangrene in patients with previous severe impairment of the peripheral circulation.

    Central nervous system
    Very common: fatigue,
    Common: dizziness, headache
    rare: increased nervous irritability, anxiety, impotence / sexual dysfunction,
    not common: paraesthesia, convulsions, depression, weakening of attention, drowsiness or insomnia, nightmares
    Very rare : amnesia / memory impairment, depression, hallucinations.

    Gastrointestinal tract
    Common: nausea, abdominal pain, diarrhea, constipation,
    not common: vomiting
    Rare: Dry mouth.

    Liver
    Rare: abnormal liver function,
    Very rare: hepatitis.

    The skin is
    not common: rash (in the form of urticaria), increased sweating;
    rare: hair loss;
    Very rare: photosensitivity, exacerbation of psoriasis.

    Respiratory system
    Common: shortness of breath during physical effort;
    not often: bronchospasm
    Rare: Rhinitis.

    Sense organs
    Rare: blurred vision, dry and / or irritated eyes, conjunctivitis
    Very rare: Tinnitus, taste disturbance.

    From the musculoskeletal system:
    Very rare: arthralgia

    Metabolism
    is not often: weight gain.

    Blood
    Very rare: thrombocytopenia.

    special instructions

    Patients taking β-blockers should not be administered intravenously blockers “slow” calcium channels such as verapamil.

    Patients suffering from obstructive pulmonary disease, is not recommended for β- blockers. In case of poor tolerability of other antihypertensives or inefficiencies dianabol reviews can be administered as it is a selective drug. It is necessary to assign the minimum effective dose, if necessary, you can assign β 2 -adrenomimetika.

    Not recommended to prescribe non-selective β- blockers in patients with Prinzmetal angina. This group of patients selective β- blockers should be used with caution.

    When using .beta. 1 adrenoblokatorov risk of their influence on carbohydrate metabolism or the ability to mask the symptoms of hypoglycemia is much less than with nonselective β-blockers.

    In patients with chronic heart failure decompensation is necessary to achieve the stage of compensation, both before and during drug treatment.

    Very rarely patients with AV conduction disorders deterioration may occur (possible outcome – AV block). If during treatment developed bradycardia, the dose should be reduced or the drug should be phased out.

    dianabol reviews may aggravate the symptoms of peripheral circulatory disorders mainly due to blood pressure reduction.

    Caution should be exercised when administering the drug to patients with severe renal insufficiency, metabolic acidosis, concomitant use with cardiac glycosides.

    Patients taking β-blockers, anaphylactic shock occurs in more severe. Application of epinephrine at therapeutic doses do not always achieve the desired results in a clinical benefit in patients receiving dianabol reviews. Patients suffering from pheochromocytoma, in parallel with the preparation Betaloc ZOK should be given an alpha-blocker.

    In the case of surgery should inform the anesthetist that the patient is taking Betaloc ZOK. Patients who are to surgery, discontinue treatment for β-blockers is not recommended.

    Data from clinical studies for efficacy and safety in patients with severe stable symptomatic heart failure patients (IV class NYHA classification) are limited. Treatment of these patients should be performed by physicians with specialized knowledge and experience.

    Patients with symptomatic heart failure combined with acute myocardial infarction and unstable angina were excluded from the study, which were determined on the basis of the indications. The efficacy and safety of the preparation is not described for this group of patients. Use in unstable heart failure decompensation contraindicated.

    Avoid abrupt withdrawal of the drug. If necessary, drug withdrawal, the cancellation should be done gradually. The majority of patients receiving the drug can be canceled up to 14 days. Dose gradually reduced in several stages, to achieve a final dose of 25 mg once a day.

    The interaction with other drugs and other interactions

    dianabol reviews is a substrate of CYP2D6, and therefore, drugs that inhibit CYP2D6, (quinidine, terbinafine, paroxetine, fluoxetine, sertraline, celecoxib, propafenone and diphenhydramine) may affect the plasma concentration of dianabol reviews.

    Avoid joint use Betaloc ZOK with the following medicines:

    Barbituric acid derivatives: Barbiturates (the study was conducted with pentobarbital) enhance the metabolism of dianabol reviews, resulting enzyme induction.

    Propafenone: the appointment of propafenone to four patients treated with dianabol reviews, showed an increase in plasma concentrations of dianabol reviews by 2-5 times, while two patients had side effects that are typical of dianabol reviews. This interaction was confirmed in a study of 8 volunteers. Probably due to inhibition of the interaction of propafenone, like quinidine, dianabol reviews metabolism by cytochrome P4502D6 system. Taking into account the fact that propafenone has the properties of β-blocker, co-administration of dianabol reviews and propafenone does not seem appropriate.

    Verapamil: a combination of β-blockers (atenolol, propranolol and pindolol) and verapamil may cause bradycardia and lead to a reduction in blood pressure. Verapamil and β- blockers are mutually inhibitory effect on atrio-ventricular conduction and sinus node function.

    The combination preparation Betaloc ZOK the following drugs may require dose adjustment:

    Amiodarone: The combined use of amiodarone and dianabol reviews may lead to severe sinus bradycardia. Taking into account the extremely long half-life of amiodarone (50 days), to consider the possible interaction after a long time after the abolition of amiodarone.

    Class I antiarrhythmic agents: class I antiarrhythmics and β- blockers can lead to the summation of negative inotropic effect, which may result in serious haemodynamic side effects in patients with impaired left ventricular function. Also avoid such a combination in patients with sick sinus syndrome and AV conduction disorder.
    The interaction is described by the example of disopyramide.

    Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs weaken the antihypertensive effect of β-blockers. This interaction is documented for indomethacin. Probably, described the interaction will not be celebrated in cooperation with sulindac. Negative interaction has been observed in studies with diclofenac.

    Diphenhydramine: Diphenhydramine reduces the clearance of dianabol reviews to α- gidroksidianabol reviewsa 2.5 times. At the same time strengthening the dianabol reviews action observed.

    Diltiazem: Diltiazem and β-blockers reinforce inhibitory effect on AV conduction and sinus node function. When combined with dianabol reviews diltiazem were cases of severe bradycardia.

    Epinephrine (adrenaline) has been reported 10 cases of severe hypertension and bradycardia in patients treated with non-selective β-blockers (including pindolol and propranolol) and treated with epinephrine (adrenaline). Interaction observed in the group of healthy volunteers. It is assumed that these reactions can also occur when using epinephrine in conjunction with local anesthetics Accidental contact with the bloodstream. It is expected that this risk is much lower with cardioselective β-blockers.

    Phenylpropanolamine: Phenylpropanolamine (norephedrine) in single doses of 50 mg may cause an increase in diastolic blood pressure to pathological values in healthy volunteers. Propranolol generally prevents the increase in blood pressure caused by phenylpropanolamine. However, β-blockers can cause paradoxical reaction of hypertension in patients receiving high doses of phenylpropanolamine. A few cases of hypertensive crisis in patients receiving phenylpropanolamine.

    Quinidine: quinidine inhibited the metabolism of dianabol reviews in a special group of patients with fast hydroxylation (in Sweden about 90% of the population), causing mostly a significant increase in plasma concentrations of dianabol reviews increased β- and blockade. It is believed that such interaction is characteristic of other β- blockers, metabolism involving cytochrome P4502D6.

    Clonidine: Hypertensive reaction at a sharp lifting of clonidine may be increased at the joint reception of β-blockers. In a joint application, in the case of clonidine, the termination of receiving β-blockers should start several days before clonidine.

    Rifampicin: Rifampicin may enhance the metabolism of dianabol reviews by reducing the plasma concentration of dianabol reviews.

    Patients simultaneously receiving dianabol reviews and other β-blockers (eye drops), or monoamine oxidase inhibitors (MAOIs) should be monitored carefully. While taking β-blockers inhalation anesthetics enhance cardiodepressive action. In patients receiving β-blockers in patients receiving hypoglycemic agents for oral administration may require dose correction last.

    The plasma concentration of dianabol reviews can increase when taking cimetidine or hydralazine.

    Cardiac glycosides when combined with β-blockers may increase atrioventricular conduction time and induce bradycardia.

    Overdose

    Toxicity: dianabol reviews dose of 7.5 g in an adult caused lethal intoxication with. At the 5-year-old child, who took 100 mg of dianabol reviews, after gastric lavage were observed signs of intoxication. Receiving 450 mg dianabol reviews teenager 12 years has led to a moderate intoxication. Admission 1.4 g and 2.5 g of dianabol reviews adult caused moderate and severe intoxication, respectively. Admission for adults 7.5 g resulted in extremely severe intoxication.

    Symptoms: an overdose of dianabol reviews are the most serious symptoms of the cardiovascular system, but sometimes, especially in children and adolescents, may predominate symptoms of the central nervous system and the suppression of lung function, bradycardia, AV block I-III degree, asystole, marked reduction of blood pressure , poor peripheral perfusion, cardiac failure, cardiogenic shock; inhibition of lung function, sleep apnea, as well as increased fatigue, impaired consciousness, loss of consciousness, tremors, convulsions, sweating, paresthesia, bronchospasm, nausea, vomiting, possible esophageal spasm, hypoglycaemia (especially in children), or hyperglycemia, hyperkalemia; to the kidneys; transient myasthenic syndrome; concomitant use of alcohol, antihypertensives, quinidine or barbiturates may aggravate the patient’s condition. The first signs of overdose can be observed after 20 min – 2 hours after dosing.

    Treatment: the appointment of activated charcoal, if necessary gastric lavage. IMPORTANT! Atropine (0.25-0.5 mg / in adults, 10-20 mg / kg for children) must be assigned to gastric lavage (the risk of stimulation of the vagus nerve). If necessary, maintain the airway (intubation), and adequate ventilation of the lungs. Restores the volume of circulating blood and glucose infusion. ECG monitoring. Atropine 1.0-2.0 mg / in repeated administration (particularly in the case of vagal symptoms) as needed. In the case of (suppression) shows myocardial depression or dobutamine infusion may also be used dopamine glucagon 50- 150 mg / kg / in intervals of 1 minute. In some cases, it may be effective to add epinephrine therapy. When arrhythmias and extensive ventricular (the QRS) complex is administered infusion solutions of sodium (chloride or bicarbonate). Installation of an artificial pacemaker. During cardiac arrest due to overdose may require resuscitation for several hours. Terbutaline can be used for the relief of bronchospasm (by injection or via inhalation). Symptomatic treatment.

    Effects on ability to drive and work with technical devices

    When driving vehicles and occupation of potentially hazardous activities that require high concentration and psychomotor speed reactions must be taken into account that dizziness and fatigue may occur in the application of Betaloc ZOK.

    Product form
    tablets with sustained release, coated at 25 mg, 50 mg and 100 mg.
    Tablets 25 mg 14 tablets in aluminum / PVC blister pack in a cardboard package with instructions for use.
    Tablets of 50 mg and 100 mg of 30 tablets per plastic bottle with a screw-top plastic cover with the control of the first opening, the vial 1 is placed in a cardboard box with instructions for use.

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dianabol side effects

In patients with myocardial infarction intravenous dianabol side effects reduces chest pain and reduce the risk of atrial fibrillation and atrial flutter. Intravenous administration of dianabol side effects at the first symptoms (within 24 hours after onset of symptoms) reduces the risk of myocardial infarction. Early treatment with dianabol side effects leads to better forecast future treatment of myocardial infarction.

It achieved a reduction in heart rate (HR) in paroxysmal tachycardia and blink (flutter) of the atria. dianabol side effects- β 1 adrenoblokator blocking β 1 receptors at much lower doses than the doses required to block β 2 – receptors. dianabol side effects has an insignificant membrane-stabilizing effect and does not exhibit partial agonist activity. dianabol side effects reduces or inhibits the agonistic effect. exerted on cardiac function catecholamines resulting from the nervous and physical stress. This means that dianabol side effects has the ability dianabol reviews to prevent an increase in heart rate, cardiac output and increased myocardial contractility and blood pressure lifting (BP), caused by a sharp release of catecholamines. Patients with symptoms of obstructive pulmonary disease, if necessary, can be assigned to dianabol side effects in combination with β 2 -adrenomimetikami. When combined with .beta. 2 – Betalok agonists in therapeutic doses, to a lesser extent, affects the induced .beta. 2 – agonists bronchodilation than nonselective β-blockers.

dianabol side effects less than nonselective β-blockers affect the production of insulin, and carbohydrate metabolism. Effect of the drug on the reaction Betalok cardiovascular system under conditions of hypoglycemia is much less pronounced when compared to non-selective β-blockers. Improving the quality of life in the treatment of drug Betalok observed in patients after myocardial infarction.

Pharmacokinetics

dianabol side effects undergoes oxidative metabolism in the liver to form the three major metabolites, none of which has no clinically significant β- blocking effect. About 5% of the dose is excreted in the urine in unchanged form. The average half-life of dianabol side effects from plasma is about 3 to 5 hours.

Indications for use

  • Supraventricular tachycardia.
  • Prevention and treatment of myocardial ischemia, tachycardia and pain in myocardial infarction or suspected it.counterindicationAtrioventricular block II and III degree, heart failure decompensation, clinically relevant sinus bradycardia, sick sinus syndrome, cardiogenic shock expressed by peripheral circulatory disorders, hypotension.

    dianabol side effects is contraindicated in patients with acute myocardial infarction with heart rate less than 45 beats per minute, PQ interval of more than 0.24 seconds or systolic blood pressure less than 100 mmHg

    Known hypersensitivity to dianabol side effects and its components or to other β-adrsnoblokatoram.

    In severe peripheral vascular disease with gangrene threat.

    In the treatment of supraventricular tachycardia in patients with a systolic blood pressure less than 110 mm Hg

    Patients receiving β-blockers are contraindicated intravenous blockers “slow” calcium channels such as verapamil.

    Age 18 years (effectiveness and safety have been established)

    Precautions: atrioventricular block I degree, Prinzmetal angina, chronic obstructive pulmonary disease (emphysema, chronic obstructive bronchitis, bronchial asthma), diabetes, severe renal insufficiency.

    Pregnancy and lactation

    Pregnancy As with most drugs, Betaloc should not be administered during pregnancy and during breast-feeding unless the expected benefit to the mother outweighs the potential risk to the fetus. As with other antihypertensive agents, β-blockers may cause side effects such as bradycardia in the fetus, infants or children who are breastfed, and therefore must be especially careful when assigning β-blockers in the last trimester of pregnancy and just before birth .

    Lactation The amount of dianabol side effects, liberated into breast milk, and β- blocking action in a child who is breastfed (when taking the mother of dianabol side effects in therapeutic doses), are minor.

    Dosing and Administration

    Supraventricular tachycardia. Begin with the introduction of 5 mg (5 ml) of the drug Betalok at a rate of 1 to 2 mg / min. You can repeat the introduction of 5-minute intervals to achieve a therapeutic effect. Typically, the total dose of 10-15 mg (10-15 ml). Recommended maximum dose intravenous administration of 20 mg (20 ml).

    Prevention and treatment of myocardial ischemia, and pain tachycardia myocardial infarction or suspected it. Intravenous 5 mg (5 ml) of the drug. You can repeat the introduction of a 2-minute intervals, the maximum dose-15 mg (15 ml). 15 minutes after the last injection administered dianabol side effects for oral administration at a dose of 50 mg (Betalok) every 6 hours for 48 hours.

    Renal impairment There is no need to adjust the dose in patients with impaired renal function.

    Abnormal liver function usually due to the low degree of connection to plasma proteins, dose adjustment is not required. However, if severe liver dysfunction (patients with portocaval anastomosis) may require dose reduction.

    Advanced age Peter need to adjust the dose in elderly patients.

    Children Experience with Betalok drug in children is limited.

    Side effect

    Betalok well tolerated, and side effects are generally mild and reversible.

    As a result of clinical trials or application Betalok drug (dianabol side effects tartrate), the following undesirable side effects have been described in clinical practice. In many instances, a causal relationship with drug treatment Betaloc has not been established. To assess the frequency of cases we used the following criteria: very common (> 10%), often (1-9,9%), rarely (0.1-0.9%), rarely (0,01-0,09%) and very rare (<0.01%).

    Cardiovascular system Common: bradycardia, postural disorders (very rarely accompanied by syncope), cold extremities, palpitations. Uncommon: temporary increase of symptoms of heart failure, cardiogenic shock in patients with acute myocardial infarction; . The AV blockade degree I rarely:. Other disturbances of cardiac conduction, arrhythmias Very rare: Gangrene in patients dianabol before and after with previous severe impairment of the peripheral circulation.

    Central nervous system Very common:. Fatigue Common: dizziness, headache. Rare: increased nervous irritability, anxiety, impotence / sexual dysfunction is not common: paraesthesia, convulsions, depression, weakening of attention, drowsiness or insomnia, nightmares. Very rare: amnesia / memory impairment, depression, hallucinations

    Gastrointestinal tract Common: nausea, abdominal pain, diarrhea, constipation. Uncommon: vomiting. Rare: dry PTY.

    Liver Rare: liver function abnormalities.

    Skin Not often:. Rash (in the form of urticaria), increased sweating Rare:. Hair loss Very rare: photosensitivity, exacerbation of psoriasis.

    Respiratory system often:. Shortness of breath during physical effort is not often:. Bronchospasm in patients with asthma Rare: Rhinitis.

    Sense organs Rare:. Blurred vision, dry and / or irritated eyes, conjunctivitis Very rare: Tinnitus, taste disturbance.

    Metabolism Uncommon: weight gain.

    From the musculoskeletal system: Very rare: arthralgia

    Blood Very rare: thrombocytopenia.

    Overdose

    Toxicity of dianabol side effects at a dose of 7.5 g in an adult caused lethal intoxication with. At the 5-year-old child, who took 100 mg of dianabol side effects, after gastric lavage were observed signs of intoxication. Receiving 450 mg dianabol side effects teenager 12 years has led to a moderate intoxication. Receiving 1.4 g and 2.5 g dianabol side effects adults caused moderate to severe intoxication, respectively. Admission for adults 7.5 g resulted in extremely severe intoxication.

    Symptoms In case of overdose of dianabol side effects are the most serious symptoms of the cardiovascular system, but sometimes, especially in children and adolescents, may predominate symptoms of the central nervous system and the suppression of lung function. Bradycardia, atrioventricular block I-III degree, asystole, marked reduction in blood pressure, poor peripheral perfusion, cardiac failure, cardiogenic shock.Inhibition of lung function, sleep apnea. As well, increased fatigue, impaired consciousness, loss of consciousness, tremors, convulsions, sweating, paresthesia, bronchospasm, nausea, vomiting, possible esophageal spasm, hypoglycaemia (especially in children), or hyperglycaemia, hyperkalaemia. To the kidneys. Transient myasthenic syndrome. Concomitant use of alcohol, antihypertensives, quinidine or barbiturates may aggravate the patient’s condition. The first signs of overdose can be observed 20 minutes – 2 hours after ingestion.

    Treatment Assignment of activated charcoal, if necessary gastric lavage. IMPORTANT! Atropine (0.25-0.5 mg / in adults, 10-20 mg / kg for children) must be assigned to gastric lavage (the risk of stimulation of the vagus nerve). If necessary, maintain the airway (intubation), and adequate ventilation of the lungs. Restores the volume of circulating blood and glucose infusion. ECG monitoring. Atropine 1.0-2.0 mg / in repeated administration (particularly in the case of vagal symptoms) as needed. In the case of (suppression), depression of the myocardium shown infusion dobutamine or dopami. Glucagon can also be used 50 to 150 mg / kg / in intervals of 1 minute. In some cases, it may be effective to add epinephrine therapy. When arrhythmias and increasing the ventricular complex (the QRS) infusion solutions administered sodium (chloride or bicarbonate). Installation of an artificial pacemaker. During cardiac arrest due to overdose may require resuscitation for several hours. Terbutaline can be used for the relief of bronchospasm (by injection or via inhalation). Symptomatic treatment.

    The interaction with other drugs and other interactions

    Avoid concomitant administration of the drug Betalok with the following medications:

    Barbituric acid derivatives: Barbiturates (the study was conducted with phenobarbital) slightly increase the metabolism of dianabol side effects, resulting enzyme induction.

    Propafenone: the appointment of propafenone to four patients treated with dianabol side effects, showed an increase in plasma concentrations of dianabol side effects by 2-5 times, while two patients had side effects that are typical of dianabol side effects. This interaction was confirmed in a study of 8 volunteers. Probably due to inhibition of the interaction of propafenone, like quinidine, dianabol side effects metabolism by cytochrome P4502D6 system. Taking into account the fact that propafenone has the properties of β-blocker, co-administration of dianabol side effects and propafenone does not seem appropriate.

    Verepamil: a combination of β-blockers (atenolol, propranolol and pindolol) and verapamil may cause bradycardia and lead to a reduction in blood pressure. Verapamil and β-blockers are mutually inhibitory effect on atrioventricular conduction and sinus node function.

    Betalok combination with the following drugs the drug may require dose adjustment:

    Class I antiarrhythmic agents: antiarrhythmics class I and β-blockers may lead to the summation of negative inotropic effect, which may result in serious haemodynamic side effects in patients with impaired left ventricular function. Also avoid such a combination in patients with sick sinus syndrome and atrioventricular conduction violation. The interaction is described by the example of disopyramide.

    Amiodarone: The combined use of amiodarone and dianabol side effects may lead to severe sinus bradycardia. Taking into account the extremely long half-life of amiodarone (50 days), to consider the possible interaction after a long time after the abolition of amiodarone.

    Diltiazem: Diltiazem and β-blockers reinforce inhibitory effect on atrioventricular conduction and sinus node function. When combined with dianabol side effects diltiazem were cases of severe bradycardia.

    Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs weaken the antihypertensive effect of β-blockers. This reaction is the most documented of indomethacin. There was no interaction described for sulindac. In studies with diclofenac described reactions were noted.

    Diphenhydramine: Diphenhydramine reduces the clearance of dianabol side effects to α- gidroksidianabol side effectsa 2.5 times. At the same time strengthening the dianabol side effects action observed.

    Epinephrine (adrenaline) has been reported 10 cases of severe hypertension and bradycardia in patients treated with non-selective β- blockers (including pindolol and proprapolol) and treated with epinephrine (adrenaline). Interaction observed in the group of healthy volunteers. It is assumed that these reactions can also occur when using epinephrine in conjunction with local anesthetics Accidental contact with the bloodstream. It is expected that this risk is much lower with cardioselective β-blockers.

    Phenylpropanolamine: Phenylpropanolamine (norephedrine) in single doses of 50 mg may cause an increase in diastolic blood pressure to pathological values in healthy volunteers. Propranolol generally prevents the increase in blood pressure caused by phenylpropanolamine. However, β-blockers can cause paradoxical reaction of hypertension in patients receiving high doses of phenylpropanolamine. A few cases of hypertensive crisis in patients receiving phenylpropanolamine.

    Quinidine: quinidine inhibited the metabolism of dianabol side effects have a special group of patients with fast hydroxylation (in Sweden about 90% of the population), causing mostly a significant increase in plasma concentrations of dianabol side effects and increased β-blockade. It is believed that such interaction is characteristic of other β-blockers in the metabolism involving cytochrome P4502D6.

    Clonidine: Hypertensive reaction at a sharp lifting of clonidine may be increased at the joint reception of β-blockers. In a joint application, in the case of clonidine, the termination of receiving β-blockers should start several days before clonidine.

    Rifampicin: Rifampicin may enhance the metabolism of dianabol side effects by reducing the plasma concentration of dianabol side effects. The concentration of dianabol side effects in the blood plasma can be increased with concomitant use of cimetidine, hydralazine, selective serotonin inhibitors such as paroxetine, fluoxetine and sertraline. Patients simultaneously receiving dianabol side effects and other β-blockers (eye drops), or monoamine oxidase inhibitors (MAOIs) should be monitored carefully. Pa patients receiving β-blockers inhalation anesthetics enhance cardiodepressive action. In patients receiving β-blockers in patients receiving oral hypoglycemic agents may require dose correction last. Cardiac glycosides when combined with β-blockers may increase atrioventricular conduction time and induce bradycardia.

    special instructions

    Patients taking β-blockers should not be administered intravenously blockers “slow” calcium channels such as verapamil. Patients suffering from bronchial asthma or obstructive pulmonary disease. It must be assigned to concomitant bronchodilator therapy. When necessary to increase the dose of β 2 -adrenomimetika. When using .beta. 1 adrenoblokatorov risk of their influence on carbohydrate metabolism or masking hypoglycaemia is significantly less than with nonselective β-blockers.

    In patients with chronic heart failure decompensation is necessary to achieve the stage of compensation, both before and during drug treatment. Patients suffering from angina Prinzmetal, is not recommended for non-selective β-blockers.

    Very rarely in patients with impaired atrioventricular conduction deterioration may occur (possible outcome of atrioventricular block). If during treatment developed bradycardia, Betaloc dose should be reduced. dianabol side effects may aggravate the symptoms of peripheral arterial circulation mainly due to blood pressure reduction. Caution should be exercised when administering the drug to patients with severe renal insufficiency, metabolic acidosis, concomitant use with cardiac glycosides. Patients taking β-blockers, anaphylactic shock occurs in more severe. Patients suffering from pheochromocytoma, in parallel with the preparation Betaloc should be given an alpha-blocker. In the case of surgery should inform the anesthetist that the patient receives the .beta.-blocker. Do not re-appoint dozu- second or third at a heart rate less than 40 beats per minute, the PQ interval of more than 0.26 seconds, and systolic blood pressure less than 90 mmHg

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