Adverse reactions observed in the majority of patients receiving neotigazon. However, they usually disappear after dose reduction or discontinuation of the drug. Sometimes at the beginning of the treatment is observed worsening of symptoms. The most common side trenbolone acetate for sale effects are symptoms of hypervitaminosis A, eg dryness of the lips, which can eliminate the use of fat cream; cheilitis and cracks in the corners of the mouth, dryness and inflammation of the mucous membranes and transitional epithelium; sometimes – nosebleeds, rhinitis and ocular disturbances (xerophthalmia, conjunctivitis), and contact lens intolerance; rarely – corneal ulcers. There were also cases of thirst and dry mouth, and sometimes -. Stomatitis, gingivitis and taste disturbance, increased frequency of vulvovaginitis caused by Candida albicans. may occur thinning and peeling of the skin all over the body, especially on the palms and soles. We describe the frequent cases of “stickiness” of the skin, dermatitis, eczema and itching, hair loss, brittle nails and paronychia. There are anecdotal reports of the occurrence of bullous eruptions and changes in the structure of hair; rarely develop photosensitivity reactions. After the abolition of neotigazon these side effects are generally reversible. There are isolated reports of headaches, though increased intracranial pressure are rare. When severe headaches, nausea, vomiting and visual disturbances neotigazon should immediately cancel and send the patient to a neurologist. Sometimes there is a violation of dark adaptation. There may be pain in the muscles, bones and joints. Supportive therapy may increase the already existing hyperostosis of the spine, the emergence of new hyperostosis and calcification of soft tissues, as is the case with long-term systemic use and other retinoids. Cases of occurrence of peripheral edema and tides, rarely develop gastrointestinal disorders, hepatitis, jaundice, temporary and usually reversible increase in transaminases and alkaline phosphatase. in the treatment with high doses appeared neotigazon reversible increase serum cholesterol and triglycerides, particularly in high-risk patients (with lipid metabolism disorders, diabetes, obesity, alcoholism). If these violations persist, we can not exclude an increased risk of atherogenesis. In the treatment of acitretin in rare cases it may be peripheral neuropathy.
Overdose In case of acute overdose neotigazon should be lifted immediately. Other special measures taken are not required because the acute toxicity of the drug is low. Overdose symptoms are identical to those in acute hypervitaminosis A (headache, dizziness).
Interactions with other drugs Because of the risk of hypervitaminosis A should avoid simultaneous use of vitamin A and other retinoids. Since both neotigazon and tetracyclines can cause increased intracranial pressure, their concurrent use is contraindicated. There are reports of increased risk of hepatitis B in the combined use of methotrexate and Tigasona (etretinate), so the appointment of methotrexate simultaneously neotigazon also contraindicated. neotigazon does not affect the binding of anticoagulants coumarin (warfarin) to proteins. If neotigazon administered concurrently with phenytoin, it should be noted that neotigazon partially reduces the binding of phenytoin protein. Low-dose monopreparations progesterone (minipilli) may not be a reliable means of contraception during therapy, acitretin. no other interactions between neotigazon and other drugs (eg, digoxin, cimetidine, combined estrogen / progestogen oral contraceptives) have not been found to date. In a study in healthy volunteers single dose of acitretin together with ethanol led to the formation of etretinate (before it was discovered in vitro). In recent studies, some patients treated with neotigazon also revealed the formation of etretinate. As long as this phenomenon does not receive a full explanation must take into account the pharmacokinetic characteristics etretinate: because its half-life period is about 120 days, for two years after completion of treatment it is necessary to use contraceptives.
Cautions neotigazon can be administered only by physicians experienced in the use of systemic retinoids and understand the risk of teratogenicity acitretin. Women of childbearing age during treatment neotigazon should not drink alcohol and alcoholic beverages, food and drugs, as there is clinical evidence that the while taking acitretin and alcohol in the body can be formed etretinate. The mechanism – this metabolic transformation is not installed, so it is unclear as to whether to participate in it, and other substances. Etretinat highly teratogenic and has a longer T1 / 2 as compared with acitretin. Reception ethanol should be avoided for 2 months after cessation of acitretin therapy. Women of childbearing age should not be a blood transfusion from patients receiving neotigazon. . Therefore, during treatment neotigazon and within a year trenbolone acetate for sale after the completion of the blood donation is prohibited should monitor liver function before treatment neotigazon, every 1-2 weeks during the first month after starting treatment, and then – every 3 months. If the test results indicate the pathology, monitoring should be carried out weekly. If liver function returns to normal or deteriorates further, neotigazon to cancel. In this case it is recommended to continue to monitor liver function for at least another three months. It is necessary to monitor cholesterol and serum triglycerides, fasting, especially in patients at risk (lipid metabolism, diabetes, obesity, alcoholism), and long-term treatment. diabetic patients retinoids can improve or worsen glucose tolerance, so in the early stages of treatment the concentration of glucose in the blood should be checked more frequently than usual. adults receiving long-term therapy neotigazon should regularly carry out appropriate inspection, taking into account the possibility of anomalies of ossification (sm. “Side effects “). In the event of such violations should be discussed with the patient the question of the continuation of treatment, carefully correlating the possible risks and benefits of the drug. The children need to closely monitor the growth parameters and bone development. Because of the potential violations night vision, patients should be warned of the need to be careful when driving a car or work with machines and mechanisms at night. Careful monitoring should be carried out for the visually impaired. At present there are not all the effects of neotigazon that may arise throughout life. On the basis of available data on the degree of influence on the incidence of birth defects in fertilization female sperm and seminal fluid of male patients treated with trenbolone acetate for sale acitretin, it can be concluded minimal risk of teratogenic effects.
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