In applying methenolone enanthate or any of its components, the following side effects have been reported: Laboratory parameters: hyperuricemia; hyponatremia (related to chlorthalidone); Hypokalemia: impaired glucose tolerance (see the section “Special instructions”.). Since the cardiovascular system: bradycardia; increased symptoms of heart failure; orthostatic hypotension, which may be accompanied by syncope;extremities cold snap. In susceptible patients may cause arrhythmias, symptoms of intermittent claudication, Raynaud’s syndrome. On the part of the central nervous system: confusion; dizziness;headache; paresthesia; change of mood; nightmares; psychosis and hallucinations; sleep disturbance; . fatigue of the digestive tract: dry mouth; gastrointestinal disorders (diarrhea); Rare cases of increase in the level of “hepatic” transaminases; rare cases of liver toxicity with symptoms of intrahepatic cholestasis; . nausea (related to chlorthalidone) Hematologic: leukopenia; purpura; . thrombocytopenia With the Skin: alopecia; dry eyes; psoriasiform skin reactions; exacerbation of psoriasis; skin rash. The respiratory system: bronchospasm may occur in patients suffering from bronchial asthma or having in the anamnesis on bronchospasm. On the part of the senses: blurred vision. Other: increase in the number of anti-nuclear antibodies, although the clinical significance of this fact is not clear. In the case of if any of the above reactions may adversely affect the health of the patient should consider the abolition of the drug.
Overdose Symptoms of bradycardia include The symptoms of an overdose, a decrease in blood pressure, congestive heart failure and bronchospasm. Treatment Careful observation; treatment in the intensive care unit; gastric lavage, administration of activated charcoal and laxatives to prevent absorption of the drug still present in the gastro-intestinal tract; the use of plasma or plasma substitutes to treat hypotension and shock. Perhaps the use of hemodialysis or hemoperfusion. In severe bradycardia – intravenous infusion of 1-2 mg of atropine and / or the installation of a pacemaker. If necessary, you methenolone enanthate can enter further intravenous bolus of 10 mg of glucagon. If necessary, this procedure may be repeated, or followed by the intravenous administration of glucagon hold at a rate of 1-10 mg / hour depending on the response. If no response to glucagon or absence of intravenous glucagon can enter beta-1- adrenoagonists – dobutamine in a dose of 5.10 ug / kg / min. Dobutamine, due to the positive inotropic action can also be used for the treatment of hypotension and congestive heart failure. Possibly, the dose will be insufficient data to cardiac arrest symptoms associated with beta-adrenoblockade, a large overdose cases. Therefore, if necessary dobutamine dose should be increased to achieve the desired response in accordance with the clinical condition of the patient. Bronchospasm typically docked via bronchodilators. When significant diuresis – introduction of fluid and electrolytes.
INTERACTIONS WITH OTHER MEDICINES AND OTHER FORMS OF INTERACTION
Use of beta-blockers in combination with blockers “slow” calcium channels, has a negative inotropic effect, such as verapamil, diltiazem, can lead to the strengthening of this effect, especially in patients with methenolone enanthate reduced myocardial contractility and / or with impaired sinoatrial or atrioventricular conduction. This may cause severe hypotension, bradycardia and heart failure. Blockers “slow” calcium channel blockers should not be administered intravenously within 48 hours after the cancellation of a beta-blocker.
Concomitant therapy with dihydropyridines, eg, nifedipine, may increase the risk of hypotension, patients with latent heart failure may be signs of circulatory disorders.
Cardiac glycosides in combination with beta-blockers may increase atrioventricular conduction time.
beta-blockers may exacerbate the “rebound” hypertension, which can occur after clonidine. If assigned to both drugs, receiving a beta-blocker should be discontinued for a few days prior to discontinuation of clonidine. If you want to assign a few days after discontinuation of clonidine.
It should be used with caution in the beta-blocker in combination with class I antiarrhythmics such as disopyramide (cardiodepressivny stacking).
Concomitant use of sympathomimetic agents, eg adrenaline, may counteract the effect of beta blockers (significant increase in blood pressure)
Concomitant use of agents which inhibit prostaglandin synthetase (e.g., ibuprofen, indomethacin), can reduce the hypotensive effect of beta blockers.
Preparations containing lithium should not be used with diuretics, as they may reduce its renal clearance.
caution should be exercised in the application of funds for general anesthesia in combination with Tenoretikom. The anesthetist should be informed about the application Tenoretika and should be chosen anesthetic, has the lowest, as far as possible negative inotropic effect. The use of beta-blockers, together with the means for general methenolone enanthate anesthesia may increase the risk of hypotension. The use of funds for general anesthesia, reducing myocardial contractility, should be avoided.