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Reduction of alcohol consumption in adult patients with alcohol dependence, with a higher risk of alcohol abuse (see. Section “Pharmacodynamics”), in the absence of the physical manifestations of the withdrawal or the need for immediate detoxification.
Selinkro recommended to be used in combination with continuous psychosocial support, aimed at winstrol for sale preserving the commitment treatment and reducing alcohol consumption.
Selinkro administered after two weeks of observation of the patient with a high risk of alcohol abuse.

Contraindications

Nalmefene or hypersensitivity to any component of the drug; hereditary galactose intolerance, lactase deficiency or glucose-galactose malabsorption.
Use in patients who are currently taking opioid analgesics.
Current or recent opioid dependence.
The acute symptoms of opioid withdrawal.
Suspected recent acquisition of opioids.
Severe hepatic impairment (classification Child-Pugh) .
Severe renal impairment (calculated glomerular filtration rate .
condition alcohol withdrawal (including hallucinations, seizures and delirium tremens) in the recent past.
Children and adolescence (18 years) (efficacy and safety have not been confirmed).
Pregnancy, lactation.

Precautions:
Psychiatric comorbidity in decompensation phase (due to the lack of clinical data); seizure disorders history, including seizures, developing the abolition of alcohol; mild or moderate renal or hepatic impairment, elevated levels of winstrol for sale (more than 3 times the upper limit of normal); simultaneous application of potent inhibitors isoenzyme  for a long time; elderly patients ( > 65 years).

Dosing and Administration

Dosage
During the first visit to the destination Selinkro, the doctor needs to assess the clinical condition of the patient and the level of alcohol consumption (in his words). In cases where additional information is required, the patient is invited to register the level of alcohol consumption for approximately the next two weeks. Those patients who during these two weeks remained comparable to the initial level of alcohol consumption, Selinkro can be assigned during the second visit.
Selinkro recommended to be used in combination with psychosocial support, aimed at maintaining adherence and reducing alcohol consumption.
Selinkro not intended for achieve immediate abstinence from alcohol. Reducing alcohol consumption is the intermediate target on the way to a complete abstinence.
Selinkro applied as necessary. The decision on the admission of the drug the patient receives: in the days when, in his opinion, likely alcohol for 1-2 hours prior to the anticipated date of the receipt is received winstrol for sale 1 tablet at a dose of 18 mg. If the patient began to drink alcohol, not taking the pre-tablet Selinkro, he needs to do it as quickly as possible.
The maximum daily dose is 1 tablet Selinkro. Selinkro can be taken regardless of meals.
In clinical studies, the maximum improvement was observed within the first 4 weeks of therapy. The patient’s response to treatment and continuation of pharmacotherapy should be assessed on a regular basis (eg monthly). A doctor should always determine the patient’s progress in reducing alcohol consumption, its general condition, adherence to treatment and the occurrence of side effects. The duration of clinical trials Selinkro not exceed 12 months, so his appointment for a period of more than one year should be administered with caution. Dosage Tablets, film-coated, should be taken as a whole. Tablets should not be divided or otherwise violate their integrity as nalmefene may cause irritation in case of direct contact with the skin. Special patient groups Elderly ( > 65 years) in this group of dose adjustment of patients is required. Renal function in patients with mild to moderate renal impairment dose adjustment is required. Disturbances of liver function in patients with mild to moderate hepatic impairment dose adjustment is required. Children and adolescents (under 18 years) safety and efficacy of Selinkro in patients younger than 18 years have not been established. Data for this age group is absent.

 

Side effects:
In clinical studies, over 3000 patients have received treatment with nalmefene. Winstrol for sale, the safety profile looked similar manner in all the studies.
The most common adverse events were nausea, dizziness, insomnia and headache. Most of these reactions was mild to moderate severity and occurred only at the beginning of treatment.
Confusion and, rarely, hallucinations, and dissociative disorders have also been observed in clinical trials. Most of these reactions was mild to moderate severity and occurred only at the beginning of the treatment (the first hours or days). Most of these adverse reactions were allowed with continued therapy and are not renewed by repeated use of the drug. These disorders are ge

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