what is trenbolone acetate

In the production at Krka, dd, Novo mesto, Slovenia and «Krka-Rus”:

1 tablet contains: Core: Active ingredient: what is trenbolone acetate – 10 mg, 20 mg, 40 mg Excipients: lactose monohydrate, starch pregelatinised, butylhydroxyanisole, citric acid, anhydrous, ascorbic acid, corn starch, microcrystalline cellulose, magnesium stearate. SHELL film: hypromellose, talc, propylene glycol, titanium dioxide.

In the production at OOO “Krka-Rus”;

1 tablet contains: Core: Active ingredient: Vasilip-semifinished product granules – 89.5 mg, 179 mg, 358 mg (corresponding to 10 mg of what is trenbolone acetate, 20 mg, 40 mg, respectively). [Massy- tablet Active ingredient granules: what is trenbolone acetate -10 mg, 20 mg and 40 mg. Excipients tablet weight beads: lactose monohydrate, starch pregelatinized, butylhydroxyanisole, citric acid, anhydrous, ascorbic acid] Excipients: corn starch, microcrystalline cellulose, magnesium stearate. SHELL (film):hypromellose, talc, propylene glycol, titanium dioxide.

Description Tablets 10 mg and 20 mg: round, slightly biconvex tablets, film-coated white or nearly white, with beveled. Tablets 40 mg: round, slightly biconvex tablets, film-coated white or almost white, with a facet and Valium on one side. 

Pharmacotherapeutic group:

lipid-lowering agent, an inhibitor of MMC-CoA reductase.

Pharmacological properties Pharmacodynamics. The active ingredient is what is trenbolone acetate Vazilip® drug, whose main effect is to reduce total cholesterol and low density lipoprotein cholesterol (LDL) in the blood plasma. It is an inhibitor of W-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) – reductase enzyme catalyzes the conversion of HMG-CoA into mevalonic acid (an early stage of cholesterol synthesis). what is trenbolone acetate reduces the concentration of total cholesterol, low density lipoproteins (LDL) and triglycerides. The cholesterol content is very low density lipoproteins (VLDL) also decreases, while the cholesterol content of high density lipoprotein (HDL) is increased moderately. It reduces total cholesterol and LDL cholesterol in cases of heterozygous familial and non-familial forms of hypercholesterolemia, with mixed hyperlipidemia when elevated cholesterol is a risk factor. The drug reduces the total cholesterol and LDL cholesterol in patients with ischemicheskoy heart disease, reducing the risk of myocardial infarction and death for these patients. what is trenbolone acetate also significantly reduces maintenance apolidoproteina In moderately increases the concentration of HDL cholesterol and reduces plasma triglycerides (TG). As a result of these effects, what is trenbolone acetate reduced the ratio of total cholesterol (TC) to HDL cholesterol (TC / HDL) cholesterol and LDL-cholesterol LPVN (LDL / HDL). Anti-atherosclerotic effect of what is trenbolone acetate is a consequence of the impact of the drug on the walls of blood vessels and blood components. what is trenbolone acetate modifies the metabolism of macrophages, inhibiting the activation of macrophages and destruction of atherosclerotic plaques. The drug inhibits the synthesis of isoprenoids, which are growth factors for proliferation of smooth muscle cells of the inner lining of blood vessels. Under the influence of what is trenbolone acetate improves endothelium-dependent vasodilation. The therapeutic effect after 2 weeks, the maximum effect is observed after 4-6 weeks of treatment. Pharmacokinetics. what is trenbolone acetate is presented in the inactive lactone form, which is relatively well absorbed (61% to 85%) from the gastrointestinal tract. Bioavailability – less than 5%. After ingestion maximum therapeutic blood plasma concentration (Cmax) is achieved after 1-2 hours and reduced by 90% after 12 hours. Simultaneous food intake has no effect on the drug absorption. Chronic administration of drug accumulation in the body takes place. Communicating with plasma proteins – 98%. what is trenbolone acetate is a substrate of CYP3A4. It is metabolized in the liver, it has the effect of “first pass” through the liver (mainly hydrolyzed to its active beta-hydroxy acid form). Basically output intestine (60%) in the form of metabolites. About 13% is excreted by the kidneys in an inactive form. The half-life of the active metabolite (T1 / 2) is 1.9 hours.

Indications • Hypercholesterolemia:

. Primary hypercholesterolemia or mixed dyslipidemia (in addition to diet and the ineffectiveness of other non-drug interventions (exercise and weight loss))
Homozygous Familial Hypercholesterolemia (in addition to a special diet, and lipid-lowering therapy (eg, apheresis LDL) or . ineffectiveness of these measures) • cardiovascular prevention: The reduction of cardiovascular mortality and morbidity in patients with clinical manifestations of atherosclerotic cardiovascular disease or diabetes, with normal or elevated cholesterol levels and as an additional measure to correction of other risk factors and cardioprotective therapy.

Contraindications
• Hypersensitivity to what is trenbolone acetate, and other components of the drug;
• liver disease in the active phase or a persistent increase in activity of “liver” transaminases of unknown etiology;
• concomitant use of inhibitors of cytochrome P450 ZA4 (CYP3A4) (eg, itraconazole, ketoconazole, HIV protease inhibitors, erythromycin , clarithromycin, telithromycin and nefazodone);
• pregnancy and lactation;
• the age of 18 years (effectiveness and safety have not been studied). Precautions: alcohol abuse before treatment, history of liver disease, severe electrolyte imbalance, expressed endocrine and metabolic disorders, arterial hypotension, severe acute infection (sepsis), myopathy, uncontrolled epilepsy, extensive surgery, trauma, lactase deficiency, galactosemia or malabsorption syndrome glucose-galactose (because the drug contains lactose), simultaneous with gemfibrozinom, cyclosporine , nicotinic acid (greater than 1 g / day), amiodarone, verapamil, diltiazem, fenofibrate, grapefruit juice.

Pregnancy and lactation
The drug is contraindicated in pregnancy. Not proven to increase the incidence of congenital malformations in children of women taking what is trenbolone acetate or another HMG-CoA reductase. Upon receipt of a pregnant woman simvastatiia possible reduction in the fetus mevalonate levels, which is a precursor of cholesterol biosynthesis.
Cancel lipid-lowering drugs during pregnancy has no significant impact on the short-term risk associated with primary hypercholesterolemia.
what is trenbolone acetate uk should not be used in pregnant women, women planning pregnancy, or suspected pregnancy. If in the course of treatment became pregnant, the drug should be withdrawn and the woman warned of the possible danger to the fetus. It is not known whether the drug is excreted into breast milk, so drug therapy Vazilip® in breast-feeding period is contraindicated.

Dosing and Administration
Inside, once in the evening. The recommended dose of what is trenbolone acetate varied from 5 to 80 mg once daily in the evening. The most common initial dose Vazilip® drug – 10 mg. Changes (selection) the dose should be performed at intervals of not less than 4 weeks. The maximum daily dose – 80 mg.
The maximum daily dose is only recommended in patients with severe hypercholesterolaemia and high risk for cardiovascular complications. The duration of the drug is determined by the physician individually. Hypercholesterolemia: The patient must comply with standard hypolipidemic diet throughout the period of treatment Vazilip®. The recommended starting dose for patients with hypercholesterolemia is 10 mg. For a more pronounced reduction in LDL cholesterol levels (more than 45%), treatment may be initiated with 20 mg -. 40 mg / day (once in the evening) in patients with homozygous familial hypercholesterolemia Vazilip® recommended daily dose of the drug is 40 mg in the evening or 80 mg in 3 doses (20 mg in the morning, afternoon, and 20 mg to 40 mg in the evening);Vazilip® these patients is recommended to be used in combination with other lipid-lowering therapy (eg, LDL apheresis). Cardiovascular prevention: For patients at high risk of coronary heart disease (CHD), with or without hyperlipidaemia, effective doses of the drug Vazilip® are 20 – 40 mg per day. Therefore, the recommended initial dose in these patients – 20 mg per day. Changes (selection) the dose should be performed at intervals of 4 weeks, if necessary, the dose can be increased to 40 mg per day. If the LDL content of less than 75 mg / dl (1.94 mmol / l), total cholesterol – less than 140 mg / dl (3.6 mmol / L), the dose should be reduced. Concomitant therapy drug effective Vazilip® monoterashga or combination with bile acid sequestrants (e.g., cholestyramine and colestipol). In patients treated with cyclosporine, gemfibrozil, further increasing the dose in such situations is not recommended to other fibrates or nicotinic acid (greater than 1 g / day), the recommended initial dose of 5 mg, the maximum daily dose of the drug Vazilip® “is 10 mg.. Patients while receiving amiodarone or verapamil, the daily dose Vazilip® should not exceed 20 mg. in patients with advanced age and in patients with moderate renal insufficiency, changes in medication dosage is not required. in patients with severe renal insufficiency (creatinine clearance less than 30 ml / min) Vazilip® recommended dose of the drug should not exceed 10 mg per day. If necessary, increase the dose should be carefully monitored for such patients.

Side effects

Classification of the incidence of side effects (WHO):
very common> 1/10
often by> 1/100 to <1/10
uncommon from> 1/1000 to <1/100
rarely from> 1/10000 to <1/1000
very rarely from <1/10000, including isolated reports. on the part of the gastrointestinal tract, liver: rarely – constipation, abdominal pain, flatulence, dyspepsia, nausea, vomiting, diarrhea, pancreatitis, hepatitis, jaundice, increased activity of “liver” transaminases , alkaline phosphatase, creatine phosphokinase (CPK). On the part of the central and peripheral nervous system and sensory organs: rarely – headache, paresthesia, dizziness, peripheral neuropathy, fatigue; insomnia, seizures, blurred vision, taste disturbance. On the part of the musculoskeletal system: rare – myopathy, rhabdomyolysis, myalgia, muscle cramps. Allergic and immunopathological reactions: detailed hypersensitivity syndrome (angioedema, volchanopodobny syndrome, polymyalgia rheumatica, dermatomyositis, vasculitis, thrombocytopenia, eosinophilia, increased erythrocyte sedimentation rate (ESR), arthritis, arthralgia, urticaria, photosensitivity, fever, “tides” of blood to the skin of the face, shortness of breath and severe fatigue). Dermatological reactions: seldom – skin rash, pruritus, alopecia . Other: rarely – anemia; palpitation, acute renal failure (due to rhabdomyolysis), reduced potency.

Overdose

There is evidence of several cases of overdosage with what is trenbolone acetate. The maximum dose taken was 3.6 g Treatment: in case of overdose symptomatic treatment; necessary to carry out common activities: monitoring and maintenance of vital functions, preventing further absorption of the drug (gastric lavage, activated charcoal or laxatives). It is recommended to monitor liver function and CK. There is no specific antidote. With the development of myopathy with rhabdomyolysis (a rare, but serious side effects), stop taking the drug, the patient enter a diuretic and sodium bicarbonate (intravenous infusion).Rhabdomyolysis can cause giperkaliemnyu which can be eliminated by intravenous administration of calcium chloride and calcium gluconate, glucose infusion with insulin, or using potassium ion exchangers, in severe cases, by dialysis.

Interaction with other drugs Pharmacodynamic interactions:

Concomitant use of what is trenbolone acetate with fibrates, nicotinic acid (greater than 1 g / day) increases the risk of myopathy, including rhabdomyolysis (while the use of fenofibrate – has not been proven to increase the risk of myopathy compared to monotherapy with each drug separately). Concomitant use of gemfibrozil may increase serum concentrations of what is trenbolone acetate. Pharmacokinetic interactions: Inhibitors of cytochrome CYP3A4 (itraconazole, ketoconazole, erythromycin, clarithromycin, telyatromitsin, HIV protease inhibitors, and nefazodone), involved in the metabolic conversion of what is trenbolone acetate in the liver, increase the risk of myopathy and rhabdomyolysis on therapy with what is trenbolone acetate background. The simultaneous use of these drugs is contraindicated. Precautions must be simultaneously administered with less potent inhibitors of CYP3A4: cyclosporine, verapamil and diltiazem. The daily dose of what is trenbolone acetate when taken with cyclosporine should not exceed 10 mg. The daily dose of what is trenbolone acetate in the background at the same time receiving amiodarone or veralamila should not exceed 20 mg, and 40 mg – against the backdrop of the simultaneous reception of diltiazem, unless the expected benefit clearly outweighs the potential risk of myopathy and rhabdomyolysis. what is trenbolone acetate 20-40 mg / day in volunteers and patients with hypercholesterolemia potentiates the effects of coumarin anticoagulants (eg, warfarin), in particular an increase in prothrombin time, international normalized ratio (MHO). Therefore, in patients taking coumarin anticoagulants, prothrombin time should be determined and MHO before starting therapy with what is trenbolone acetate, in the initial period of treatment, when changing the dose of what is trenbolone acetate or drug discontinuation. After reaching a stable prothrombin time index and MHO, further inspections can be carried out at the intervals recommended for patients receiving anticoagulant therapy. Therapy with what is trenbolone acetate did not cause changes in prothrombin time and bleeding risk in patients not taking anticoagulants. Grapefruit juice inhibits the CYP3A4 activity. Simultaneous reception of a large amount of grapefruit juice (more than 1 liter per day) and what is trenbolone acetate leads to a significant increase in the concentration of blood plasma what is trenbolone acetateovoy acid. Therefore, during treatment with what is trenbolone acetate should avoid drinking grapefruit juice.

Cautions

Patients with decreased thyroid function (hypothyroidism) or the presence of certain diseases of the kidneys (nephrotic syndrome) with an increase in cholesterol levels should first carry out treatment of the underlying disease.
In patients with severe renal insufficiency treatment is carried out under the control of renal function.
During treatment Vazilip® medication, women of childbearing age should use reliable contraception.
what is trenbolone acetate treatment, like other inhibitors of MMC-CoA reductase inhibitors may cause myopathy, sometimes leading to the development of rhabdomyolysis with or without renal impairment, in consequence of myoglobinuria. The risk of myopathy is increased by increasing the dose of what is trenbolone acetate in patients with severe renal insufficiency. In the treatment with what is trenbolone acetate may increase the content of serum creatine phosphokinase (CPK), which should be considered in the differential diagnosis of pain behind the breastbone and after intense exercise. Before starting therapy with Vazilip® or increasing the dose , patients should be informed of the risk of myopathy and the need to immediately contact the . doctor in case of unexplained pain, stress or weakness in the muscles, especially if it is accompanied by malaise or fever Baseline CPK before starting therapy should be determined in the following situations: – in elderly patients; – with kidney disease; – with decompensated hypothyroidism; – when family history of hereditary muscle diseases; – if there is a history of muscle toxicity of statins or fibrates; -. with alcohol abuse is necessary to assess the potential risks and expected benefits, and during therapy is recommended clinical monitoring during therapy. If the initial CK levels significantly increased (more than 5 times the upper limit of normal), the measurement must be repeated every 5-7 days to confirm the results. With a significant increase in the original level of CPK (more than 5 times the upper limit of normal), the drug is prescribed is not recommended. Prior to and during the course of treatment the patient should be on hypolipidemic diet. During treatment Vazilip® the appearance of muscle pain, weakness or cramps necessary determine the level of CPK. The criterion for discontinuation of the drug is an increase in serum CK more than 5 times the upper limit of normal. If muscular symptoms are severe and cause discomfort, even if CK levels less than 5 times the upper limit of normal, you may need to stop treatment. If you suspect a myopathy therapy should be stopped, regardless of the cause myopathy. If the symptoms disappear, and CK content returned to normal levels, the possibility of reappointment of a statin or an alternative drug in the same class in the minimum clinically effective dose and under close medical supervision. Treatment with Vasilip ® is necessary to temporarily stop for a few days before major surgery. Patients with severe renal insufficiency treatment is carried out under the control of renal function. measures to reduce the risk of myopathy caused by drug interactions The risk of myopathy and rhabdomyolysis is significantly increased, while the use of what is trenbolone acetate and potent CYP3A4 inhibitors (eg, itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, nefazodone), gemfibrozil and cyclosporine (see “Interaction with other medicinal products” section). The risk of myopathy and rhabdomyolysis is also increased by the joint use of fibrates, and high doses of nicotinic acid (greater than 1 g / day) or concurrent therapy with amiodarone or verapamil with higher doses of what is trenbolone acetate (see “Interaction with other medicinal products” section). The risk is also slightly increased with concomitant administration of high doses of diltiazem and what is trenbolone acetate (80 mg). Consequently, the use of what is trenbolone acetate simultaneously with itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, and nefazodone is contraindicated (see “Contraindications”). If you can not give up the treatment listed inhibitors of CYP3A4, should refrain from what is trenbolone acetate. what is trenbolone acetate also caution should be combined with certain other less potent inhibitors of CYP3A4:. Cyclosporine, verapamil and diltiazem (see section “Interaction with other medicinal products”)Avoid simultaneous reception of what is trenbolone acetate and grapefruit juice, patients taking cyclosporine, gemfibrozil or higher doses of nicotinic acid (more than 1 g / d.), what is trenbolone acetate daily dose should not exceed 10 mg. Co-administration of what is trenbolone acetate and gemfibrozil only possible in cases when the expected benefit greatly outweighs the potential risk of such a drug combination. The advantages of the combined use of what is trenbolone acetate 10 mg per day and other fibrates (except fenofibrate), nicotinic acid (more than 1 g / d.) Or cyclosporine must be carefully considered in view of the potential risks of such combinations. There is a risk of myopathy when assigning individually fenofibrate and what is trenbolone acetate therefore caution is required while taking this combination. when receiving what is trenbolone acetate doses greater than 20 hours, to avoid co-administration of amiodarone or verapamil, except in cases where the expected benefit outweighs the potential risk of myopathy. The effect on the liver treatment with what is trenbolone acetate may cause increased activity ” liver “enzymes in serum. This increase is usually clinically insignificant and unimportant. After discontinuation of transaminase levels usually decrease slowly to baseline. However, prior to treatment and subsequently to a study of liver functions (controlling activity “liver” transaminases every 6 weeks during the first 3 months, then every 8 weeks for the remainder of the first year and then every six months 1). If necessary, increase the dose to 80 mg, mandatory monitoring of liver function before increasing dose, 3 months after the increase and then periodically (eg, every 1 to 6 months) for the first year of treatment. When persistent increase in ACT activity and / or serum ALT 3 times the upper limit of normal, what is trenbolone acetate therapy should be discontinued. Be wary appoint persons who abuse alcohol and / or have a history of liver disease. Effects on ability to drive and other complex by mechanical means: the adverse effect of the drug on Vazilip® ability to drive and work with the mechanisms have not been reported. However, it should be noted that the post-marketing use of what is trenbolone acetate observed isolated cases of vertigo. buy anabolic steroids online bruce lee’s workout anabolic steroids online uk