Selinkro not been studied in patients with unstable over mental illness. It should appoint Selinkro with caution in patients with concomitant mental illness in the phase of decompensation, including patients with a diagnosis of “major depressive disorder”. Convulsive disorders Experience winstrol pills in the use of the drug in patients with convulsive disorders in history, including seizures, developing the abolition of alcohol is limited. We recommend caution when Selinkro used to reduce alcohol consumption in this group of patients. Renal or hepatic function Selinkro extensively metabolised in the liver and excreted primarily in the urine. For this reason, care should be taken when appointing Selinkro patients with mild or moderate renal or hepatic insufficiency. Care should be taken when appointing Selinkro patients with elevated levels of ALT and AST (more than 3 times the upper limit of normal), since this patient category is excluded in clinical trials.
Elderly patients ( > 65 years) Clinical data on the use of Selinkro in alcohol-dependent patients aged 65 years and older is limited. Care should be taken when appointing Selinkro patients aged 65 years and older. Others should be careful while applying Selinkro with potent inhibitors of isoenzyme . Lactose Patients with these rare hereditary problems such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not use the drug.
Pregnancy and lactation
Data on the use of nalmefene in pregnant women is limited (less than 300 pregnancy outcomes). Studies in animals have revealed nalmefene reproductive toxicity.
Studies in animals have not revealed a direct harmful effect of nalmefene in relation to fertility, pregnancy, embryo-fetal development, childbirth and postnatal development. In a study of embryo-fetal toxicity was observed in rabbits, decreased fetal weight and ossification delay (the process of bone formation), any other serious violations have been identified. The exposure (AUC) when receiving the highest non-toxic dose winstrol pills under these adverse effects was lower than the exposure at the therapeutic doses recommended for humans. Increased frequency of stillborn pups and decrease their postnatal survival was observed in the pre- and postnatal toxicity studies in rats. This effect was considered as indirect and associated with toxicity in females. Preclinical data revealed no special hazard nalmefene for humans based on conventional pharmacological safety studies, toxicity after repeated use, genotoxicity and carcinogenic potential.
Selinkro not recommended for use during pregnancy.
Available pharmacodynamic and toxicological data in animals have shown the ability to nalmefene and metabolites enter the breast milk . It is not known whether nalmefene in human breast milk.
At the present time we can not exclude the potential risk to newborns / infants, so Selinkro not recommended for use during breast-feeding. Fertility Studies in rats have not revealed the effect of nalmefene on fertility, mating process, pregnancy, or process spermatogenesis.
Effect on driving and operate machinery
Influence of nalmefene on ability to drive and operate machinery has not been studied.
Selinkro may cause adverse reactions such as nausea, dizziness, insomnia and headache. Mos winstrol pillst of these reactions was mild to moderate severity and occurred only at the beginning of treatment.
Patients taking , it is not recommended to drive and use machines as long as there is no ascertained individual reaction to the drug.