testosterone propionate dosage

Ketoprofen well penetrates through the skin and has a local anti-inflammatory and analgesic effect. Bioavailability gel – 5%. Suck part of ketoprofen bound to plasma proteins for about 99%. The drug is metabolized in the liver. About 80% of the dose excreted in urine as metabolites, less than 10% is excreted unchanged form. Not accumulates in the body.

Indications

  • It is used topically testosterone propionate dosage as an analgesic and anti-inflammatory drug for the symptomatic treatment: back pain, neuralgia, myalgia,
  • inflammatory and degenerative diseases of the musculoskeletal system (including arthritis, bursitis, synovitis, tendonitis, lumbago)
  • uncomplicated injuries, in the above privacy sports injuries, sprains, strains or tears the ligaments and tendons, bruises, post-traumatic pain,
  • in a combination therapy for inflammatory diseases of the veins (phlebitis, periflebit), lymph vessels, lymph nodes (lymphangitis, superficial lymphadenitis).

Dosage and administration:
For external use only.
2-3 times a day a small amount (3-5 cm) of gel applied to the skin in the painful place and easily rub.
No need for laying dry dressings, as the gel is well absorbed through the skin, has no odor does not contain dyes, leaves no oily stains, does not stain clothes.

Contraindications

  • Hypersensitivity to ketoprofen and / or other components of the preparation,
  • increased sensitivity to other non-steroidal anti-inflammatory drugs,
  • moist dermatitis, eczema, infected abrasions, wounds, burns
  • pregnancy, lactation.

Ketoprofen may cause bronchospasm in susceptible individuals to acetylsalicylic acid and other nonsteroidal anti-inflammatory drugs.

 

Side effects
: Allergic reactions, skin flushing, photosensitivity, skin rash, purpura.

Interaction with other drugs
in cases of frequent and prolonged use testosterone propionate dosage can appear symptoms of interaction with other drugs, such as when administered systemically.
Joint reception with other non-steroidal anti-inflammatory drugs, corticosteroids, ethanol, corticotropin may lead to ulceration and the development of gastro-intestinal bleeding. Co-administration with oral anticoagulants, heparin, thrombolytics, antiplatelet, tsefaperazon, cefamandole increases the risk of bleeding. It reduces the effect of antihypertensive drugs and diuretics (inhibition of prostaglandin synthesis). Increases the hypoglycemic effect of insulin and oral hypoglycemic agents (requires recalculation of the dose). Co-administration with sodium valproate causes a disturbance of platelet aggregation. Increases concentration of plasma verapamil and nifedipine.

Special instructions:
Avoid contact with the drug on the mucous membranes and eyes. Do not use on damaged skin.
During long-term use caution should be exercised in patients with severe liver failure and / or kidney disease.
In cases of rash appears necessary to stop treatment and spend the appropriate therapy.

Use of the drug during pregnancy and lactation
in the I and II trimes testosterone propionate dosage

testosterone propionate cycle

Inhibitors of microsomal oxidation testosterone propionate cycle reduce the risk of hepatotoxicity. Long-term sharing of paracetamol and others. Nonsteroidal anti-inflammatory drugs increase the risk of “analgesic” nephropathy and renal papillary necrosis, onset of end-stage renal failure.

Simultaneous administration of paracetamol in prolonged high doses of salicylates and increases the risk of kidney or bladder cancer. Diflunisal increases the plasma concentration of paracetamol by 50% – the risk of hepatotoxicity.

Myelotoxicity drugs increase the expression gematotoksichnosti drug.

Conditional pheniramine:
Antidepressants, antipsychotics and antiparkinsonian (phenothiazines) drugs increase the risk of side effects pheniramine (urinary retention, dry mouth, constipation), glkzhokortikosteroidy  increase the risk of developing glaucoma.

Conditional ascorbic acid:
Increases blood concentration of penicillin and tetracyclines; at a dose of 1 g / day of ethinyl estradiol increases the bioavailability (including a member of the oral contraceptives).

Improves the intestinal absorption of iron (ferric iron translates into divalent.

Reduces the effectiveness of heparin and indirect anticoagulants.

Acetylsalicylic acid , oral contraceptives, fresh juices and alkaline water reduces the absorption and assimilation.

In an application with increased urinary excretion of ascorbic acid and reduced excretion testosterone propionate cycle.

It increases the risk of crystalluria in the treatment of salicylates and sulfonamides short-acting, slow excretion by the kidneys of acids, increases the excretion of drugs that have an alkaline reaction (including alkaloids), lowers blood levels of oral contraceptives. Increases total clearance of ethanol, which in turn reduces the concentration of ascorbic acid in the body.

PM quinoline series, calcium chloride, salicylates, corticosteroids prolonged use deplete ascorbic acid.

With prolonged use or application in high doses may interfere with the interaction of disulfiram and ethanol.

In high doses, increases excretion of mexiletine kidneys.

Barbiturates and primidone increase the excretion of ascorbic acid in the urine.

It reduces the therapeutic effect of anti-psychotic drugs (neuroleptics) – phenothiazine derivatives, tubular reabsorption of amphetamine and tricyclic antidepressants.

Special instructions:
The drug should not be taken simultaneously with other testosterone propionate cycle medications containing acetaminophen and ascorbic acid.

High doses of ascorbic acid enhance the excretion of oxalate, contributing to the formation of kidney stones.

In connection with the stimulating effect of ascorbic acid on the synthesis of corticosteroid hormones necessary to monitor the function – of the adrenal glands and blood pressure.

Ascorbic acid as a reducing agent can distort the results of the various laboratory tests (blood and urine glucose content in the blood plasma – bilirubin, activity of “liver” transaminases and lactate dehydrogenase, uric acid).

During the period of treatment should refrain from testosterone propionate cycle the use of ethanol (development of hepatotoxicity), motor vehicles and other driving activities potentially hazardous activities that require high concentration and psychomotor speed reactions.

testosterone propionate

Paracetamol has analyeziruyuschim and antipyretic action. Pheniramine – blocker of testosterone propionatereceptors and reduces rhinorrhea and lacrimation, eliminates spasticity. Ascorbic acid  up for an increased  in acute respiratory viral diseases and influenza.
Research pharmacokinetics of the drug was conducted.

Indications

  • symptomatic treatment of acute respiratory viral infections, including influenza, including those involving rhinorrhea, lacrimation, rhinopharyngitis, myalgia, headache.

Contraindications

  • increased sensitivity to one component of the drug;
  • portal hypertension;
  • state alcohol or drugs;
  • renal failure;
  • phenyl ketonuria;
  • deficiency of glucose-6-phosphate dehydrogenase;
  • diabetes;
  • hemochromatosis, sideroblastic anemia, thalassemia;
  • pregnancy;
  • lactation;
  • Children up to age 15 years.

Carefully:

  • congenital hyperbilirubinemia (Gilbert’s syndrome, Dubin-Johnson and Rotor);
  • angle-closure glaucoma;
  • liver failure;
  • viral, alcoholic hepatitis;
  • elderly age;
  • hyperoxaluria, nephrolithiasis;
  • prostatic hyperplasia.

Dosing and Administration
Inside. The contents of 1 sachet dissolved in a glass of warm water and drink regardless of the meal. A single dose – 1 sachet contents. If necessary repeat dose administered every 4 hours, but not more than four times within 24 hours. If the kidney, liver, in old age interval between doses must be increased to 8 hours.

If within 3 days after receiving testosterone propionate the drug did not reduce the observed symptoms, you should consult a doctor,

Side effect

Allergic reactions: skin rash, pruritus, urticaria, angioedema.

From the digestive system: dry mouth, nausea, vomiting, constipation, epigastric pain, long-term use at high doses – hepatotoxic effects, erosive and ulcerative lesions of the gastrointestinal tract, bleeding in the gastrointestinal tract.

Cardio-vascular system: tachycardia, increased blood pressure.

On the part of the central nervous system: decrease in speed of psychomotor reactions, fatigue, drowsiness, dizziness, insomnia.

From the urinary system: urinary retention, glycosuria, long-term use at high doses – nephrotoxicity.

From hemopoiesis system: long-term use at high doses – thrombocytopenia, anemia, methemoglobinemia.

Overdose symptoms (due to paracetamol): pale skin, loss of appetite, nausea, vomiting; gepatonekroz (necrosis due to the severity of intoxication is directly dependent on the degree of overdose). Toxic effects in adults may, after receiving more than 10-15 g of paracetamol: increased prothrombin time activity (through 12-48 h after administration). The detailed clinical picture of liver damage appear after 1-6 days. Rarely liver failure develops lightning speed and can be complicated by renal insufficiency (tubular necrosis).

Treatment: within the first 6 hours after the overdose – gastric lavage, administration of donor of testosterone propionate, and the synthesis of glutathione precursors – methionine for 8-9 hours after the overdose and acetyl cysteine for 8 hours The need for additional therapeutic (continued introduction of methionine in /. intravenous acetylcysteine) is determined by the concentration of paracetamol in the blood, as well as the time elapsed after the reception.

Interaction with other drugs

Conditional paracetamol:
Reduces the uricosuric drugs (drugs). Concomitant use of acetaminophen in high doses increases the effect of anticoagulant drugs (reduction synthesis of procoagulant factors in the liver).

Inductors microsomal oxidation in the liver (phenytoin, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes the possibility of severe intoxication, even with a small overdose.

Prolonged use of barbiturates, reduces the effectiveness of paracetamol.

Ethanol contributes to the development of acute pancreatitis.

test propionate

Recommended  is generally well tolerated. As with other drugs containing sulfonamides and pyrimethamine can cause the test propionate following side effects or hypersensitivity reactions.

Co Skin and appendages: rash, pruritus, urticaria, photosensitivity reactions and slight hair loss. Usually, these effects are mild and disappear on their own after the withdrawal of the drug. In rare cases, particularly in patients with hypersensitivity can develop such serious (possibly life-threatening), skin reactions like erythema multiforme, Stevens-Johnson syndrome and Lyell’s syndrome, exfoliative dermatitis, toxic epidermal necrolysis.

In case of skin reactions, stop taking the drug and consult a doctor.

On the part of the hemopoietic system : rarely – leukopenia, thrombocytopenia and megaloblastic anemia, usually asymptomatic, aplastic anemia, hemolytic anemia, hypoprothrombinemia, methemoglobinemia, eosinophilia. Very rarely – agranulocytosis or purpura, as a rule, these changes are reversible after discontinuation of the drug.

From the gastrointestinal tract : the feeling of fullness, nausea; rarely – vomiting, diarrhea, stomatitis, glossitis, abdominal pain, hepatitis, pancreatitis, hepatocellular necrosis. Described isolated cases of transient increase of liver enzymes, as well , will coincide with the appointment of Fansidar.

From the nervous system , depression, convulsions, ataxia, hallucinations, tinnitus, insomnia, nervousness, peripheral neuritis.

On the part of the urinary tract : renal failure, interstitial nephritis, increased blood urea nitrogen and serum creatinine, toxic nephrosis with oliguria and anuria, crystalluria.

Other: sometimes – general weakness, apathy, fatigue, muscle weakness, headache, dizziness, chills, conjunctival injection, and sclera, drug fever and polyneuritis, anaphylactoid reactions, periorbital edema, arthralgia, periarteritis nodosa, lupus-like syndrome; rarely – pulmonary infiltrates, similar to those with eosinophilic or allergic alveolitis. If during treatment Fansidar symptoms such as cough or shortness of breath, you should stop the drug. Also disclosed are isolated cases of serum sickness and allergic pericarditis, myocarditis.

The sulfonamides are similar in chemical structure to some goitrogens, diuretics (acetazolamide and thiazides) and oral hypoglycemic agents. Due to the cross-reactivity between these drugs in patients receiving sulfonamides, rarely occur polyuria and hypoglycemia.

 

Overdose

 

With imptomy : loss of appetite, headache, nausea, vomiting, signs of excitement, sometimes convulsions and haematological changes (megaloblastic anemia, leukopenia, thrombocytopenia), glossitis, crystalluria.

Treatment: in acute poisoning – washing stomach or vomiting, fluid replacement; in convulsions – parenteral administration of diazepam or barbiturates. Monitoring of renal function, liver and repeated determination of blood cells within 4 weeks after the overdose. In test propionate identifying reducing blood platelets and leukocytes administered intramuscular calcium folinate (leucovorin) at a dose of 5-15 mg / day for 3 or more days.

 

Interaction with other drugs

 

You should not assign Fansidar simultaneously with trimethoprim or trimethoprim combination with sulfonamides, because it can enhance the violation of folic acid metabolism and the subsequent development of hematologic adverse reactions.

There are reports of a possible increase in the frequency and severity of adverse reactions strengthening while appointing Fansidar with chloroquine, compared with monotherapy Fansidar.

 

special instructions

 

It should strictly avoid excessively long exposure to the sun.

Patients should be informed that a sore throat, fever, cough, shortness of breath or purple may be the first signs of serious side effects. In particular, taking test propionate should stop immediately at the first signs of skin rash, significant reduction in the number of blood cells, bacterial or fungal superinfection.

If the drug is continued for more than 3 months, it is recommended to regularly monitor hematologic parameters, “liver” enzymes and crystalluria.

Chronic administration of high doses of the drug, for example, in the treatment of toxoplasmosis for the prevention of folic acid deficiency prescribe folic acid and calcium folinate.

testosterone phenylpropionate

With simultaneous use of fluvoxamine observed increase in concentrations of tricyclic antidepressants (clomipramine, imipramine, amitriptyline) and neuroleptics (clozapine, olanzapine), which largely metabolized by cytochrome testosterone phenylpropionate. In this regard, if treatment is started fluvoxamine should be considered reduced doses of these drugs.

Patients simultaneously receiving fluvoxamine, and drugs with a narrow therapeutic range of action metabolized by cytochrome (such as tacrine, theophylline, methadone, mexiletine) should be carefully monitored. If necessary, adjust the recommended dose of these drugs. It was reported a few cases of cardiotoxicity while receiving fluvoxamine and thioridazine. When interacting with fluvoxamine propranolol was an increase in the plasma concentration of propranolol. In connection with this reduction can be recommended dose of propranolol in the case of simultaneous reception fluvoxamine. While receiving fluvoxamine plasma concentrations of caffeine may increase. Thus, patients who consume large amounts of beverages containing caffeine should reduce their consumption while taking fluvoxamine, and when there are adverse effects of caffeine, such as tremor, palpitations, nausea, restlessness, insomnia.

At the same time taking fluvoxamine and ropinirole ropinirole may increase the concentration in plasma, thereby increasing the risk of overdose. In such cases, control, or, if necessary, dose reduction or cancellation of ropinirole during treatment with fluvoxamine.
Patients simultaneously receiving fluvoxamine, and drugs with a narrow therapeutic range of action is metabolized isoenzyme cytochrome  (such as phenytoin) should be carefully monitored and, if necessary, recommend a dose adjustment of these drugs.

When applied in combination with fluvoxamine was observed a significant increase warfarin warfarin plasma concentrations and prolonged prothrombin time.

Isozyme cytochrometestosterone phenylpropionate
terfenadine, astemizole, cisapride: combination therapy with fluvoxamine concentrations of terfenadine, astemizole, or cisapride plasma may increase, increasing the risk of lengthening the interval ventricular tachycardia type “pirouette”. Therefore, fluvoxamine should not be administered with these drugs.

Patients simultaneously receiving fluvoxamine, and drugs with a narrow therapeutic range of action is metabolized cytochrome  (such as carbamazepine, ciclosporin) should be carefully monitored, we recommend a dose adjustment of these drugs.

When concomitant administration with fluvoxamine benzodiazepines undergoing oxidative metabolism, such as triazolam, midazolam, alprazolam and diazepam, may increase their concentration in plasma.The dosage of these benzodiazepines should be reduced at the time of fluvoxamine.

Glucuronidation
Fluvoxamine has no effect on plasma concentration of digoxin.

Renal excretion
Fluvoxamine has no effect on the plasma concentration of atenolol.

Pharmacodynamic interactions
In case fluvoxamine combined with serotonergic drugs (such as triptans, tramadol, selective serotonin reuptake inhibitors and drugs testosterone phenylpropionateperforatum) may increase serotonergic effects of fluvoxamine (see. “Special Instructions”). Fluvoxamine was used in combination with lithium preparations for the treatment of patients with severe, poorly responsive to pharmacotherapy. It should be noted that lithium (and possibly also tryptophan) enhances the serotonergic effects of the drug, and therefore such combination pharmacotherapy must be carried out with care.

At the same time taking oral anticoagulants and fluvoxamine may increase the risk of hemorrhage.

These patients should be under a doctor’s supervision.

Cautions
As with other psychotropic drugs during treatment  is not recommended to consume alcohol.

Suicide / suicidal thoughts or clinical deterioration
Depression is associated with an increased risk of suicidal thoughts or suicidal behavior (self-harm or suicide). This risk persists until significant improvement. As improvement may not occur during the first few weeks of treatment or longer, patients should be closely monitored until such improvement.

In clinical practice widely increased risk of suicide at the early stages of recovery.

Obsessive-compulsive disorders can also be associated with an increased risk of suicidal events. Also, these states can accompany major depression. Therefore, the treatment of patients with obsessive-compulsive disorders have observed the same precautions as in the treatment of patients with major depression.

It is known that patients with suicide-related events in history or substantially exhibiting suicidal ideation, before treatment are at greater risk of suicidal thoughts or suicidal behavior, and should be monitored closely during treatment.

Careful monitoring of patients, especially at high testosterone phenylpropionate risk should accompany drug therapy especially in its early stages and following dose changes. It is necessary to warn patients (and caregivers) about the need to keep track of any clinical deterioration, suicidal behavior or suicidal thoughts and unusual changes in behavior, and immediately seek the advice of a specialist with the appearance of symptoms.