Hypersensitivity to trenbolone acetate price , other ingredients or other azole compounds; concomitant use of terfenadine (on the background of continuous use of 400 mg / day or more), astemizole or cisapride and other drugs prolonging the QT interval and increase the risk of severe arrhythmias; lactation; Children under 3 years of age (for a given dosage form). Hepatic trenbolone acetate price and / or renal failure, rash during treatment with in patients with superficial fungal infection and invasive / systemic fungal infections, concomitant use of terfenadine and at a dose of less than 400 mg / day, potentially proaritmogennoe status in patients with multiple factors risk (organic heart disease, electrolyte disturbances, concomitant use of drugs that cause arrhythmias); Patients with intolerance to acetylsalicylic acid and pregnancy.
Pregnancy and lactation
Use of the drug in pregnant women is inappropriate, except in severe or life-threatening forms of fungal infections if the intended effect is greater than the potential risk to the fetus.
is found in the breast milk at the same concentration as in plasma, so its function during lactation is not recommended.
Dosing and Administration
Inside. The daily dose depends on the nature and severity of the fungal infection.
Adults with cryptococcal meningitis and cryptococcal infections at other sites on the first day is usually prescribed 400 mg, and then continue treatment at a dose of 200-400 mg 1 time / day. The duration of treatment for cryptococcal infections depends on the clinical efficacy, confirmed by mycological examination; cryptococcal meningitis it is generally continued for at least 6-8 weeks.
For the prevention of recurrence of cryptococcal meningitis in AIDS patients, after completion of a full course of treatment of the primary, administered in a dose of 200 mg / day for a long period of time.
When candidemia, disseminated candidiasis, Candida and other invasive infections dose is usually 400 mg in the first day, and then – 200 mg. When insufficient clinical efficacy of the dose can be increased to 400 mg / day; in severe systemic candidiasis – may increase the dose to 800 mg per day. The duration of therapy depends on clinical efficacy; It should be continued for at least 2 weeks after receiving the negative blood cultures, or after the disappearance of symptoms.
In oropharyngeal candidiasis drug is usually administered 50-100 mg 1 time / day; Duration of treatment – 7-14 days. If necessary, in patients with severe depression of trenbolone acetate price immunity treatment may be longer (3 weeks).
If atrophic oral candidiasis associated with wearing dentures , usually administered one 50 mg once / day for 14 days in combination with local antiseptic agents for treatment of prosthesis.
In other locales candidiasis (except genital candidiasis), such as oesophagitis, noninvasive bronchopulmonary lesions, candiduria, candidiasis of the skin and mucous membranes, etc., the effective dose is usually 50-100 mg / day, with a duration of 14-30 days of treatment; in severe mucosal candidiasis – 100-200 mg / day. For the prevention of relapse of oropharyngeal candidiasis in patients with AIDS, after the completion of a full course of primary therapy, the drug can be assigned to 150 mg 1 time per week.
When vaginal candidiasis taking a single oral dose of 150 mg. To reduce the frequency of relapses vaginal candidiasis drug may be used in a dose of 150 mg 1 time per month. The duration of therapy is determined individually; it varies between 4 and 12 months. Some patients may require more frequent application.
When balanitis caused of Candida , administered a single dose of 150 mg orally.
For the prevention of candidiasis recommended dose of is 50-400 mg 1 time / day, depending on the degree of risk of fungal infection. If you have a high risk of generalized infection, eg in patients with severe or long-anticipated persistent neutropenia, the recommended dose is 400 mg 1 time / day. is administered a few days before the expected occurrence of neutropenia; after increasing the number of neutrophils more than 1000 / mm 3, treatment was continued for 7 days.
When skin fungal infections, including tinea pedis, knees, groin and skin candidiasis the recommended dose is 150 mg 1 time per week or 50 mg 1 time / day. Duration of therapy in ordinary cases is 2-4 weeks, but with athlete’s foot may require a more prolonged treatment (up to 6 weeks).
When pityriasis versicolor – 300 mg 1 time per week for 2 weeks, some patients required a third dose of 300 mg per week, while in some cases it is sufficient single dose of 300-400 mg; Alternative treatment scheme is the use of 50 mg 1 time a day for 2-4 weeks.
When onychomycosis the recommended dose is 150 mg 1 time per week. Treatment should be continued until the replacement of the infected nail (uninfected nail sprouting). For the re-growth of nails on the fingers and feet normally required 3-6 months and 6-12 months, respectively.
In deep endemic mycoses may require use of the drug at a dose of 200-400 mg / day for up to 2 years. The duration of therapy is determined individually; it can be 11-24 months with coccidioidomycosis; 2-17 months with paracoccidioidomycosis; 1-16 months with sporotrichosis and 3-17 months with histoplasmosis.
In children , as well as with similar infections in adults, the duration of treatment depends on the clinical and mycological effect. In children, the drug should not be applied in a daily dose that would be higher than that of adults. The drug is used every day 1 time / day.
When candidiasis mucous membranes of the recommended dose of is 3 mg / kg / day. The first day can be assigned to a loading dose of 6 mg / kg in order to more quickly achieve constant equilibrium concentrations.
For the treatment of Mr. eneralizovannogo candidiasis and cryptococcal infections the recommended dose is 6-12 mg / kg / day, depending on the severity of the disease.
For the prevention of fungal infections in children with reduced immunity, in which the risk of infection associated with neutropenia, developing as a result of cytotoxic chemotherapy or radiation therapy, the drug is prescribed for 3-12 mg / kg / day, depending on the severity and duration of preservation-induced neutropenia.
The maximum daily dose for children is – 12 mg / kg.
Dosing in patients with renal insufficiency
is derived mainly kidneys unchanged. When receiving a single dose of its change is not required.
Adult patients with impaired renal function when re-appointment of the drug should first appoint a “shock” dose of 50 mg to 400 mg. If creatinine clearance (CC) is greater than 50 ml / min, applied the usual dose (100% of the recommended dose). When CC from 11 to 50 ml / min is applied dose equal to 50% of the recommended or usual dose of 1 to 2 times of the day. Patients regularly on dialysis one dose is applied after each hemodialysis session.
In children with impaired renal function daily dose should be reduced (in the same proportion as in adults), in accordance with the severity of renal insufficiency.
In elderly patients without renal dysfunction should follow the usual dose regimen of the drug.
From the digestive system: nausea, trenbolone acetate price diarrhea, flatulence, vomiting, abdominal pain, change in taste, rarely – increased activity of “liver” enzymes and liver dysfunction (jaundice, hyperbilirubinemia, elevated alanine aminotransferase (ALT), asparaginaminotransferazy (ACT) and alkaline phosphatase (ALP), hepatitis, hepatocellular necrosis), including: fatal.
From the nervous system: headache, dizziness; rarely – seizures.
From the side of hematopoiesis: rarely – agranulocytosis, neutropenia. Patients Hematologic changes may occur with severe fungal infections (leukopenia and thrombocytopenia).
Since the cardiovascular system: an increase in the duration of the interval Q – T in the electrocardiogram (ECG), flickering / ventricular flutter.
Allergic reactions: skin rash, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), asthma (often in case of intolerance of acetylsalicylic acid), anaphylactoid reactions (including angioedema, face edema, urticaria, pruritus)
Other: rarely – renal dysfunction, alopecia, hypercholesterolemia, hypertriglyceridemia, hypokalemia.
Symptoms: nausea, vomiting, diarrhea, and in severe cases may experience seizures, hallucinations, paranoid behavior.
Treatment: symptomatic, gastric lavage; because is excreted by the kidneys recommended forced diuresis. Haemodialysis for 3 hours reduces the plasma concentration of 2-fold. steroiden kaufen
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