Sorafenib is a multi-kinase inhibitor. Reduces the proliferation of tumor in vitro cells. It has been shown that the Sorafenib inhibits multiple intracellular kinases. It is trenbolone acetate stack with believed that some of these kinases involved in tumor cell signaling systems in the processes of angiogenesis and apoptosis.Sorafenib inhibits the growth of tumors in liver-cell carcinoma and renal cell carcinoma in humans. Equilibrium sorafenib plasma concentrations are reached within 7 days, the ratio of the maximum / minimum concentration is less than 2. Absorption and distribution Maximum concentration (C max ) achieved sorafenib in plasma after about 3 hours after ingestion. When taken with meals with moderate fat sorafenib bioavailability approximately corresponds to the bioavailability in the fasting state. When taken with a meal high in fat bioavailability is reduced by approximately 29% compared to drug-fasting conditions. When assigning oral doses exceeding 400 mg 2 times a day, the mean C max and the area under the curve “concentration – time» (AUC) increased is not proportional. Communication with the proteins – 99.5%.Metabolism and excretion Metabolism sorafenib carried out mainly in the liver by oxidation mediated isoenzyme CYP3A4, as well as by glyukuronirovaniya mediated by UGT1A9. Conjugates sorafenib can be cleaved in the gastrointestinal tract due to the activity of bacterial glucuronidase, which allows reabsorbed nekonyutirovannomu drug. The simultaneous use of neomycin affects the process, reducing the average bioavailability of sorafenib to 54%. Upon reaching equilibrium at Sorafenib accounts for approximately 70-85%. 8 sorafenib metabolites identified, 5 of them were found in the plasma. The main circulating metabolite in plasma sorafenib – pyridine N-oxide, has in vitro activity similar to the activity of sorafenib, and is about 9-16%. After oral dose of 100 mg sorafenib in the form of a solution within 14 days of 96% is output from the prescribed dose, 77% excreted in the feces and 19% – in the urine in the form of glucuronides.Unmodified sorafenib in an amount of 51% of the administered dose is determined in the feces. Pharmacokinetics in special populations Analysis Demographic data indicate that the correction of the dose depends on the age or gender is not required. Children Data on the pharmacokinetics have no children.Renal failure The pharmacokinetics of sorafenib studied after a single dose of 400 mg in patients with normal renal function and patients with mild (creatinine clearance (CC) 50-80 ml / min.), trenbolone acetate stack with moderate (creatinine clearance 30 to <50 ml / min.) and heavy ( creatinine clearance <30 mL / min.) reduction in renal function not requiring dialysis. Effect of renal function decline pharmacokinetics sorafenib detected. For patients with mild, moderate or severe loss of kidney function, not requiring hemodialysis need to reduce the dosage absent. Hepatic impairment Sorafenib is derived primarily by the liver. In patients with mild (Class A according to the classification of Child-Pugh) to moderate (Class B classification Child-Pugh) hepatic impairment, the pharmacokinetic parameters of sorafenib were the same as in patients with normal hepatic function. In patients with severely impaired hepatic function (class C Child-Pugh classification), the pharmacokinetics of sorafenib has not been studied. IndicationsMetastatic renal cell carcinoma. Hepatocellular carcinoma.
: Hypersensitivity to sorafenib or any other component of the drug.
Pregnancy and lactation
Children’s age (efficacy and safety have not been established).
Precautions : skin diseases, arterial hypertension, with increased bleeding or bleeding in the history of unstable angina, myocardial infarction, in conjunction with irinotecan therapy and docetaxel.
Dosage and administration
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The recommended daily dose of sorafenib is 800 mg (4 tablets of 200 mg). The daily dose administered in two doses (2 tablets 2 times a day) or between meals or with meals containing low or moderate amounts of fat. Tablets swallow a glass trenbolone acetate stack with of water.
The treatment is continued as long as the clinical efficacy of the drug or until its unacceptable toxic effect. online anabolic steroids pharmacy
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