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Sildenafil – a drug to increase potency. Included in the group “Preparations for the treatment of erectile dysfunction.”
The mechanism of action of sildenafil: a drug increases the amount of blood flowing into the penis. It helps a man to call a natural erection. Sildenafil works only when a man feels a natural sexual arousal, and when sexual intercourse is completed, the penis naturally returns to the relaxed state. In other words, works only on natural mechanisms of erection.
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Pharmacological action
Selective inhibitor of cGMP-specific PDE5, which is responsible for the breakdown of cGMP in the cavernous body of the penis. Actively enhances the relaxing effect of the nitric oxide in the corpus cavernosum smooth muscle and increases blood flow to the penis. When you activate the chain NO-cGMP, observed during sexual arousal, inhibition of PDE5 increases cGMP in the cavernous body. The pharmacological effect is achieved only if there is sexual stimulation.
Indications
Treatment of erectile dysfunction characterized by the inability to achieve or retain penile erection sufficient for satisfactory sexual intercourse. It is effective only during sexual stimulation.
Contraindications
Hypersensitivity; concomitant use of nitric oxide donators or organic nitrates or nitrites in any LF; simultaneous reception of others. medicines that stimulate the erection of ritonavir; contraindication to have sex, including unstable angina; loss of vision due to ischemic optic neuropathy, severe liver failure, hypotension, stroke, or myocardial infarction, hereditary retinal degenerative diseases, including retinitis pigmentosa, female, age 18 years.
Side effects
Immune system: rarely – hypersensitivity. From the nervous system: very often – headache; often – dizziness; rarely – drowsiness, hypoesthesia; rarely – a stroke, fainting; the frequency is unknown – transient ischemic attack, seizures, including recurrent. From a sight organ: often – blurred vision, impaired color perception; rare – the defeat of the body including the defeat of the conjunctiva, lacrimation violation; the frequency is unknown – Front non arthritic ischemic optic neuropathy, retinal vascular occlusion, visual field loss. On the part of the organ of hearing: rare – vertigo, tinnitus; rarely – deafness. From the CCC: often – “tides”; Infrequent – palpitation, tachycardia, increased heart rate; rarely – increased or decreased blood pressure, myocardial infarction, atrial fibrillation; the frequency is unknown – ventricular arrhythmias, unstable angina, sudden cardiac death. The respiratory system: often – nasal congestion; rarely – nosebleeds. From the digestive system: often – indigestion; rarely – vomiting, nausea, dry mucous membranes of the mouth. For the skin: seldom – skin rash. From the musculoskeletal system: Infrequent – myalgias. Reproductive system: the frequency is unknown – priapism, a prolonged erection. Other: rarely – chest pain, fatigue.
Dosage and administration
Inside, approximately 1 hour before planned sexual activity. The single dose for adults – 50 mg 1 time a day. Given the efficacy and tolerability of the dose can be increased to 100 mg or decreased to 25 mg. The maximum daily dose – 100 mg. When mild to moderate degree of chronic renal failure (creatinine clearance 30-80 ml / min) dose adjustment is required. In severe chronic renal failure (creatinine clearance less than 30 ml/ min) or hepatic insufficiency begin with 25 mg. Before taking sildenafil should be succeeded again stable condition patient taking alpha-blockers; sildenafil start with 25 mg.
Special instructions
Before the start of drug therapy to diagnose erectile dysfunction and the reasons therefor, should be collected history and conduct a physical examination. Before the treatment of erectile dysfunction is necessary to assess the risk of cardiovascular complications resulting from sexual activity. Sildenafil causes mild reversible reduction in blood pressure. Before using sildenafil should eliminate the risk of adverse effects on the reduction of blood pressure, especially against sexual activity. Patients with obstruction of the left ventricle or the rare syndrome of multiple atrophy, expressed in violation of the regulation of blood pressure, are most susceptible to the hypotensive effect of vasodilators. Most side effects from the CCC develops in people with previous heart disease or blood vessels. Most often, these complications occur either immediately after intercourse, or shortly thereafter. In some cases these side effects occurred after sildenafil without subsequent intercourse. A causal relationship between these adverse events and factors described is not installed. Doses greater than 200 mg do not increase efficiency, but increases the frequency and severity of dose-related side effects.
