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-Initial dose: 10 mg orally once a day, as needed, approximately 60 minutes before sexual activity. Increase to 20 mg or decrease to 5 mg based on efficacy and tolerability.
-Maximum dose: 20 mg once a day

Patients on stable alpha blocker therapy:
-Initial dose: 5 mg orally once a day

Comments:
-Sexual stimulation is required for a response to treatment.
-A time interval between dosing should be considered when administering this drug concomitantly with alpha-blockers.

Use: Erectile dysfunction

Topoisomerases (I and II) are enzymes that regulate the separating of DNA strands so DNA can be replicated. DNA gets unwound when a phenolic nucleophile attacks the 3' end of DNA, causing it to bind to Tyr723 on the TopoI enzyme, which allows DNA to unwind and relax; it is eventually then attacked by the 5' end of the DNA and the two ends reunite in a process called religation. Topoisomerase I basically holds the 3' end for a bit while DNA gets replicated. [44] Topoisomerase I inhibitors can prevent DNA from religating, and induce cytotoxicity (cell death); which is actually a good idea for cancer cells that overexpress Topoisomerase I as they die much faster than regular cells.

Physiological effects of steroids can be estimated reasonably well because it can reasonably be supposed that few if any potential users are going to have significant pre-existing medical problems. But when trying to evaluate mental effects, that supposition has no basis. As Darkes (see farther below) and many others have pointed out, one of the chief failings of many studies of steroids and psychiatry is the failure to design the studies so that the cause-and-effect relationship is not tangled. While there are, in some reports, evidences of some possible correlation of steroid use and mental problems, what few if any of those studies address is which is cause and which effect .

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Paromomycin Sulfate Capsules and other antibacterial drugs, Paromomycin Sulfate Capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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To reduce the development of drug-resistant bacteria and maintain the effectiveness of Paromomycin Sulfate Capsules and other antibacterial drugs, Paromomycin Sulfate Capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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