Category Archives: supplements side effects

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.

test prop cycle

Treatment of patients with hepatic or renal insufficiency should start with low doses under strict medical supervision. Some side effects observed in clinical trials were often associated with symptoms of depression, not to treatment test prop cycle .
General disorders: asthenia, malaise.
Violations of the heart: palpitation, tachycardia.
Violations of the gastrointestinal tract: abdominal pain, constipation, diarrhea, dry mouth, dyspepsia, nausea, , vomiting.
Disorders of the nervous system: irritability, anxiety, agitation, dizziness, insomnia or drowsiness, tremor, headache.
Disorders of the skin and subcutaneous tissue disorders: sweating.
Violations of the metabolism and nutrition: anorexia.
Violations of the vessels: orthostatic hypotension
Violations of the musculoskeletal and connective tissue disorders: arthralgia, myalgia.
Disorders of the nervous system: ataxia, extrapyramidal disorders.
Mental Disorders: State of confusion, hallucinations.
Violations of the genital organs and the breast: violation (delayed) ejaculation.
Violations of the skin and subcutaneous tissue: skin hypersensitivity reactions (including rash, pruritus, angioedema).
Violations of the liver: liver dysfunction (elevated liver enzymes).
Violations of the nervous system: convulsions.
Mental disorders: mania
Violations of the genital organs and the breast: galactorrhoea.
Violations skin and subcutaneous tissue disorders: photosensitivity reactions.

In addition to the side effects described in clinical studies during the post-marketing use of fluvoxamine it was reported the following side effects. The exact frequency can not be test prop cycle provided, and therefore classified as “unknown.”

Violations of the blood and lymphatic system: hemorrhage (eg, gastrointestinal bleeding, ecchymosis, purpura).

Disorders of the endocrine system: inadequate secretion of antidiuretic hormone.

Violations of the Metabolism and nutrition: hyponatremia, weight gain, weight loss.

Disorders of the nervous system: serotonin syndrome; phenomenon; like neuroleptic malignant syndrome; akathisia / psychomotor agitation; paresthesia; dysgeusia.

Mental disorders: during treatment with fluvoxamine or shortly after the end of the reported cases of suicidal ideation and suicidal behavior.

Violations of the kidney and urinary tract: urination disorders (including urinary retention, urinary incontinence, urinary frequency, nocturia and enuresis).

Violations of the genital organs and the breast: anorgasmia.

General disorders: drug withdrawal syndrome, including withdrawal symptoms in newborns.

Overdose

Symptoms
The most characteristic symptoms are gastrointestinal disorders (nausea, vomiting and diarrhea), somnolence and dizziness. In addition, there are reports of violations. cardiac (tachycardia, bradycardia, hypotension), liver function disturbances, convulsions and coma.

Fluvoxamine has great therapeutic breadth dose safety against overdosage. Since its release to the market reports of deaths attributed to overdose of fluvoxamine alone, rarely observed. The highest registered dose of fluvoxamine adopted one patient was in ’12, this patient was completely cured. More serious complications were observed in cases of deliberate overdose of fluvoxamine in combination with other drugs.

Treatment
No specific antidote to fluvoxamine does not exist: In case of overdose gastric lavage is recommended, which should be conducted as soon as possible after taking the drug, and symptomatic treatment. In addition, we recommend multiple dose activated charcoal, the appointment of osmotic laxatives if necessary. Forced diuresis or dialysis are not effective.

The interaction with other drugs.
Fluvoxamine can not be used in combination ).
Fluvoxamine largely inhibits cytochrome test prop cycle. Drugs which are largely metabolized by these isoenzymes, displayed slower and may have higher plasma concentrations, in the case of co-administration with fluvoxamine. This is particularly important for drugs that have a narrow range of therapeutic action. Patients in need of careful observation, it is recommended to adjust the dose of these drugs, if necessary.

Fluvoxamine has a minimal inhibitory effect on cytochrome  isoenzyme and probably does not affect the non-oxidative metabolism and renal excretion.