Varfareks belongs to the group of anticoagulants – medicines that prevent blood clotting, and is designed for long-term use. It exerts indirect anticoagulant effect by inhibiting hepatic synthesis of a number of factors involved in the regulation of blood coagulation. Varfareks no effect on the already formed clots, but prevents them from increasing and prevents the formation of new blood clots.
The drug is a racemic mixture of stereoisomers, R and S. S stereoisomer is 2-5 times more active stereoisomer R, but its action is shorter. Varfareks (winstrol for women) is completely absorbed in the gastrointestinal tract. The concentration of drug in the blood reaches a maximum in about 4 hours after administration. Therapeutic plasma concentration is 1-5 mg / ml (0,003-0,015 mg / l). Binding to blood proteins 97-99%.
Varfareks (winstrol for women) is subjected to chemical reactions involving the liver microsomal enzyme system containing cytochrome P-450, to form a less active or inactive metabolites. The metabolites are excreted in urine and in a small amount -. With bile
elimination half-life after a single oral administration of 20-60 (mean 40) hours, 92% of administered drug is excreted in the urine as metabolites and only a minimal amount -.. Unchanged in
Essential varfareksa changes pharmacokinetics (winstrol for women) in older patients is observed. It was found that this group of patients are more sensitive to anticoagulants, but the nature of this phenomenon is not clear. In the presence of liver function disorders synthesis of clotting factors is reduced, and metabolism varfareksa (winstrol for women) is slowed down, resulting in a strengthening of its inhibitory effect on blood clotting.
Prevention and treatment of diseases caused by the formation of clots in blood vessels (deep vein thrombosis, pulmonary embolism, atrial fibrillation, myocardial infarction, prosthetic heart valves).
Bleeding or threat of bleeding in certain severe diseases, bacterial endocarditis. Severe liver failure or kidney disease, severe liver disease or kidney disease, obstructive jaundice, and diabetes, hypersensitivity to the drug, acute DIC, deficiency of protein C, and S, hemorrhagic diathesis, thrombocytopenia, gastric ulcer and duodenal ulcer in the process of acute, bleeding in the brain, alcoholism, severe arterial hypertension, recently transferred or implied complicated operations and diagnostic procedures, lack of capacity status of the blood coagulation system of evaluation using laboratory methods, children’s age.
Varfareks should not be administered to pregnant women in connection with the identified teratogenic and the development of bleeding in the fetus and fetal death.
The drug is excreted in breast milk in small amounts and little or no effect on the blood of a child clotting, so the drug can be applied during lactation, but it is desirable to refrain from breastfeeding during the first 3 days of therapy with winstrol for women.
Dosage and administration
The dosage, mode and duration of application varfareksa doctor determines individually, guided by the severity of the disease and the results of the control of blood clotting (MHO) for each patient. Without the permission of a doctor can not arbitrarily change the dose or stop treatment varfareksom!
Varfareks taken orally once a day, preferably at the same time.
Treatment usually start with 2.5-5 mg varfareksa day. This initial dose take the first 2 days, gradually selecting it according to the individual patient’s blood coagulation reaction (MHO). After reaching the desired level of MHO (2,0-3,0, and in some cases, 3.0-4.5) prescribe a maintenance dose.
Elderly, debilitated, or at risk patients to prescribe a lower starting dose and caution when they increase . Babies varfareks not usually prescribed.
Early treatment for MHO laboratory control is carried out every day for the next 3-4 weeks, the control is carried out 1-2 times a week, 1-4 weeks later -Every. More frequent additional control is needed in cases where the patient’s state of health is changing before elective surgery or other procedures, as well as appoint or cancel any other medication.
The most frequent adverse events observed during treatment with anticoagulants are bleeding and bleeding in various organs and tissues. Possible risk of these side effects can be significantly reduced by strictly adhering to physician recommendations relating to the reception varfareksa.
In some cases, treatment with anticoagulants can cause poor circulation in the limbs or internal organs. Violation of circulation often show pain and dark red color of the skin of my toes. When these symptoms should immediately seek medical attention.
In other rarely occurring side effects include allergic skin reactions (itching, rash, dermatitis), nausea, vomiting, diarrhea, abdominal pain, abnormal liver activity (increase in liver enzymes in the blood, jaundice) , fever, general weakness, changes in the blood picture, transient hair loss.
Symptoms of chronic intoxication: bleeding gums, nosebleeds, excessive menstrual bleeding, severe or prolonged bleeding with minor surface damage, bleeding in the skin, blood in the urine or faeces, as well as other signs of bleeding.
Treatment: If the prothrombin time is more than 5% and there are no other possible sources of bleeding (nefrourolitaz and others), the correction is not required dosing regime. When minor bleeding is necessary to reduce the dose or stop treatment for a short period. In the case of severe bleeding – vitamin K to recover coagulant activity. When threatening bleeding – transfusion concentrates factors prothrombin complex or fresh frozen plasma, or whole blood.
The high content of vitamin K in foods (spinach, broccoli, lettuce and other leafy vegetables) may reduce the effect of varfareksa. Use a normal, balanced diet, do not change his character too abruptly, without consulting a doctor, do not use vitamins and nutritional enrichers.
Smoking may reduce the anticoagulant effect of the drug.
Varfareksa effect may vary under the influence of a large number of drugs.
NSAIDs, dipyridamole, valproic acid inhibitors cytochrome P450, cimetidine, chloramphenicol, laxatives increase the risk of bleeding . Avoid concomitant use of these prepraty and varfareksa (cimetidine can be replaced by ranitidine or famotidine). If necessary, treatment with chloramphenicol anticoagulant therapy may temporarily stop. Diuretics can reduce the effects of anticoagulants (when expressed hypovolemic action that may result in increased clotting factor concentrations). Loosen action: barbiturates, vitamin K, glutetimid, griseofulvin, dicloxacillin, carbamazepine, mianserin, paracetamol, retinoids, rifampicin, sucralfate, phenazone, . cholestyramine Heighten action: allopurinol, amiodarone, anabolic steroids (alkylated at C-17), ASA and other NSAIDs, heparin, glibenclamide, glucagon, danazol, diazoxide, disopyramide, disulfiram, isoniazid, ketoconazole, clarithromycin, clofibrate, levamisole, metronidazole, , miconazole, nalidixic acid, nilutamide, omeprazole, paroxetine, proguanil, oral hypoglycemic agents are the derivatives of sulfonamides sulfonamides, tamoxifen, thyroxine, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, quinolones, chloral hydrate, chloramphenicol, cephalosporin, cimetidine, erythromycin, ethacrynic acid, ethanol. Varfareksa When used in combination with the above drugs MHO necessary to control the start and end of treatment and, if possible, 2-3 weeks of therapy. If you are using drugs that may increase the risk of bleeding due to a decrease of normal coagulation (inhibition of coagulation factors or liver enzymes), anticoagulation strategy should be determined by the ability of the laboratory control. If possible frequent laboratory control, the need for therapy at a dose varfareksa similar means can be reduced by 5-10%. When conducting laboratory testing is difficult, treatment should be discontinued varfareksom if necessary, the appointment of these drugs.
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Use of anticoagulants increases the risk of bleeding. To monitor the status of the blood coagulation system, during treatment varfareksom should see your doctor regularly and carry out assigned tests.
When referring to doctors, dentists or pharmacists to always inform them that you are taking varfareks.
It is necessary to consult a doctor if there are digestive disorders, accompanied by diarrhea , diarrhea, fever.
Pregnancy during treatment varfareksom highly undesirable, so you must use effective methods of preventing it.
Be careful when handling sharp or dangerous objects, avoid activities associated with the risk of injury and subsequent bleeding.
in the period of treatment should refrain from the use of ethanol (risk of hypoprothrombinemia).
The safety of the drug in children in clinical trials has been poorly studied.
Data on adverse effects varfareksa on ability to drive and serve no other mechanisms.
Patients with lactose intolerance should be borne in mind that one varfareksa tablet contains 106-112 mg lactose. anabolic steroids online pharmacy
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