Many men in our time often face a depressing problem, whose name is erectile dysfunction. Provided that timely measures are taken to combat this violation, sexual activity is successfully resumed. The main thing is to correctly prepare a course of therapy. If doctors find physiological factors that indicate impotence and prescribe a medicine for Viagra - the instructions for use will tell you how to use it properly. The drug has repeatedly proved its effectiveness in practice, so you can rely on it.
What is Viagra
The drug is intended for the treatment of impotence. Viagra is a powerful inhibitor that normalizes sexual functions in a natural way. Following the instructions in the instructions for use, with this medication the patient will be able to resume sexual activity with minimal risk of damage to the body .Reviews of men about the effectiveness of Viagra confirm this fact.
Composition of Viagra
The active component of the drug is sildenafil citrate. He restores the sexual function of a man and provides a prolonged erection, sufficient for a full sexual intercourse. To improve the assimilation of the active substance the body is supplemented with a number of auxiliary components. The complete composition of the preparation is detailed in the table below:
| Ingredient name | Volume, mg |
|---|---|
| sildenafil citrate | 35.11 |
| microcrystalline cellulose | 78.29 |
| calcium hydrogen phosphate | 26.09 |
| sodium croscarmellose | 7.51 |
| magnesium stearate | 3.02 |
Form
Biconvex tablets of blue color, film-coated. In pharmacies there are several variations of the drug, differing dosage of the active ingredient. In addition, the manufacturer provides an opportunity to choose the number of tablets in the package - 1, 2, 4 and 12 pcs. For each specific case of reducing erection, doctors prescribe the necessary dosage and duration of treatment.
Pharmacodynamics and pharmacokinetics
Sildenafil is a selective inhibitor of cyclic guanosine monophosphate of specific type 5 phosphodiesterase. This component is widely used for erectile dysfunction for several decades. Pharmacists abbreviated as its inhibitor PDE-5.The physiological mechanism is realized due to the release of nitric oxide in the cavernous body during sexual stimulation. This effect leads to an increase in the level of cGMP, a flow of blood and the subsequent relaxation of smooth muscle tissues of cavernous bodies.
Sildenafil enhances the effect of nitric oxide by inhibiting PDE-5, which provides cGMP decay. The full effect of the drug is possible only with sexual arousal. To evaluate the safety and effectiveness of sildenafil, 21 studies were conducted on 3000 patients aged 19 to 87 years with diagnosed erectile dysfunction of various etiologies. The effectiveness of the drug was fully confirmed.
In the recommended dosage range, the pharmacokinetics of sildenafil are linear. When administered orally, the drug is quickly absorbed and immediately begins to act. The absolute bioavailability index varies from 25 to 63%.The average value is 40%.After a single application of Viagra in a dose of 100 mg, the maximum concentration of sildenafil in the blood plasma is about 18 ng / ml. When administered on an empty stomach this indicator is achieved in 60-90 minutes. Combination of the preparation with fatty food reduces the suction rate of .
Indications for use
Doctors prescribe to men of Viagra to combat violations in the genital area, characterized by a lack of ability to achieve or maintain an erection penis, sufficient for a full sexual intercourse. Treatment is required if the incidence of such cases exceeds 25%.Achievement and preservation of a normal erection can be hampered by many physiological factors, not associated with pathology requiring the use of Viagra.
How to take Viagra
According to the instructions for use, for the successful occurrence of an erection it is necessary to apply the drug 45-60 minutes before sexual contact. In most cases, the recommended dose is 50 mg. Taking into account the tolerability and effectiveness, the required volume of active substance can be increased to 100 mg or reduced to 25 mg. The maximum recommended frequency of application is 1 time per day.
Special instructions
To obtain an accurate diagnosis of erectile dysfunction, to determine the possible causes of their appearance and to choose the optimal method of treatment, you need to collect a detailed medical history, as well as conduct a physical examination. Unauthorized use of Viagra before receiving appropriate doctor's instructions can be dangerous for the health of men.
Analysis of application of Viagra will allow a number of important nuances that must be considered physicians prescribing this drug, and patients taking it:
- men with anatomical deformation of the penis and / or risk factors for the emergence of priapism need to use Viagra with caution;
- if the erection persists for more than 4 hours, the patient should urgently seek medical help( if priapism therapy is not performed immediately, this can lead to serious damage to the tissues of the penis and an irreversible loss of potency);
- is not recommended to prescribe Viagra to men for whom sexual activity is not desirable;
- for men with hypotension, the drug is prescribed only after a thorough diagnosis( the doctor's task is to exclude the risk of developing unwanted manifestations against the background of sexual activity).
In case of violations of the kidney and liver
In patients with liver damage, excretion of sildenafil is disrupted( for example, with cirrhosis), so they require a dose adjustment. In such cases, the maximum allowable amount of the drug is 25 mg. Men suffering from renal insufficiency of mild and moderate degree are allowed to take the drug in the required dosage. Care should be taken to avoid the occurrence of unwanted reactions of the body. For men with severe renal insufficiency, the dose of sildenafil is reduced to 25 mg.
Drug Interaction
The cases of sildenafil entering into a chemical reaction with the active ingredients of other drugs recorded by medicine:
- The metabolism of sildenafil is carried out under the influence of isoenzymes of the liver. The main components involved in this process are CYP2C9 and CYP3A4.Inhibitors of isoenzymes can reduce the clearance of sildenafil, and inductors - on the contrary, increase it.
- Co-administration with CYP3A4 inhibitors is accompanied by a decrease in the clearance of sildenafil.
- The minimum concentration of erythromycin can be dangerous, since this drug increases the sildenafil AUC by almost 200%.
- The combination of Viagra and drugs such as Itraconazole and Ketoconazole is very harmful to the body. Their interaction leads to a mutual change in the pharmacokinetics of inhibitors and sildenafil.
- The active component of Viagra is an isoenzyme of cytochrome, so it is unlikely to affect the substrate clearance of this substance with a low probability.
- In patients with benign prostatic hyperplasia with stable hemodynamics with simultaneous use of Viagra with alpha-adrenoblockers of doxazosin, diastolic blood pressure decreases.
- The combination of sildenafil with antihypertensive drugs does not cause additional side effects.
Interaction of Viagra with alcohol
Instructions for use read: the use of alcohol after taking the drug is highly undesirable .According to the doctors' reviews, a small amount of alcohol is still allowed. The maximum allowable volume of pure alcohol is 40 g. To consume alcohol beyond this measure is not necessary, otherwise the effect of the tablet of Viagra can completely dissipate.
Contraindications
Cases in which the use of Viagra is prohibited:
- permanent or intermittent application of donators of oxide or organic nitrates( sildenafil enhances the hypotensive effect);
- concomitant use with other drugs aimed at treating erectile dysfunction;
- age to 18 years;
- hypersensitivity to sildenafil or other components that make up tablets;
- patients with hypertension and who underwent myocardial infarction less than 6 months ago should take the drug with extreme caution.
Side effects of Viagra
In men taking Viagra, the following undesirable reactions of the body can be noted:
- From the side of the eyes: cyanopsy, photophobia, chromatopsy, ischemic optic nerve neuropathy, retinal function disorders( in patients suffering from retinitis with distortion of pigments).
- Hearing side: deterioration or loss of hearing( in patients with relevant risk factors).
- On the part of the hematopoiesis system: leukopenia, anemia.
- On the part of nutrition and metabolism: swelling, gout, thirst, hyperglycemia.
- From the musculoskeletal system: back pain, myalgia, arthritis, arthrosis, pain in muscles and bones, synovitis, myasthenia gravis.
- On the part of the genitourinary system: nocturia, urinary incontinence, ejaculation disorder, edema of the genitals, hematospermia.
- From the central nervous system: headaches, dizziness, migraine, drowsiness, neuropathy, neuralgia, vertigo, tremor, fainting, convulsions.
Overdose of
A single application of the drug in a volume of 700-800 mg showed undesirable effects comparable to side effects that develop after taking sildenafil in low doses, but they were much more common. Viagra overdose requires urgent symptomatic treatment of .Hemodialysis in such cases is not suitable, because it does not accelerate the clearance of sildenafil.
Terms of Sale and Storage
Viagra is dispensed in over-the-counter pharmacies in the Russian Federation. Store the medicine in a dry place, protected from direct sunlight. The optimum temperature is not more than 30 ° C.Shelf life of the drug is 5 years.
Analogues
Patients who have been prescribed sildenafil can use alternative drugs with a similar principle of action instead of Viagra. The modern pharmaceutical market offers many tools with a similar principle of action. The most common analogues of the drug are listed in the list below:
- Levitra;
- Cialis;
- Visarsin;
- Impaza;
- Tribestan;
- Sealex;
- Kamagra;
- Maxigra;
- Erectile;
- Dynamics .
Price Viagra
The cost of the drug is acceptable for the average Russian budget. At the same time, pharmacies offer a lot of analogues, significantly different in price. Like Viagra, these drugs provide the desired effect in sexual arousal and require compliance with a certain regimen. As a rule, there is nothing complicated in this. After reading the instructions for use, any patient will be able to get the desired effect without causing damage to the body. The table below will help you to determine the cost of such drugs:
| Product name | Price( in rubles) |
|---|---|
| Viagra | 610 |
| Vizarsin | 105 |
| Dynamics | 390 |
| Maxigra | 330 |
| Tribestan | 1800 |
| Impaza | 450 |
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Reviews
Oksana, 39 years
At the age of 54, her husband had problems with erection. The doctor said that until the maximum reduction in potency is still very far away, so you need to be treated. Has appointed Viagra in tablets. We studied the instructions for use, and began to take the remedy according to all the rules. Now we do not remember the former embarrassments. The problem was solved easier than we thought!
Vladislav, 26
Erection problems occurred at the age of 22 years. I was very upset and did not know how to fix the situation. After the examination in the hospital, they said that by applying enzyme inhibitors, the potency can be maintained normally. I did not want to drink Viagra, but I tried it. I bought several packages and started drinking according to the instructions. Over time, I got used to and live a full life.
Alexander, 36 years old
Viagra perfectly helps me to lead a sexual life. First time it was wild to drink tablets before sex, and in safety sildenafila strongly doubted, but there was no choice. I must say that there is nothing terrible in this. The main thing - to learn how to apply the drug according to the instructions, so as not to harm. My wife is happy, but I do not need anything else!
Svetlana, 36
The husband was very upset when, due to erectile dysfunction, doctors appointed Viagra, but I did my best to support him. Together they studied the instruction, followed the regimen of taking the tablets together. In a few months for us it became the norm, and now we absolutely do not worry about it. As a woman I can say that it's only got better. To all who encounter this problem, I wish the same.