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Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Is Viagra Only Used For Erectile Dysfunction, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk. In patients with episodes of development PINZN with loss of vision in one eye receiving Sildenafil For Erectile Dysfunction Dosage is contraindicated (see "Contraindications").

A small number of patients with hereditary retinitis pigmentosa have genetically determined disorders of the PDE of the retina. Information about the safety of the drug Sildenafil For Erectile Dysfunction Dosage in patients with retinitis pigmentosa absent, so these patients should not be used Sildenafil For Erectile Dysfunction Dosage (see "Contraindications").

Viagra Erectile Dysfunction Treatment is a potent selective inhibitor of cGMP-specific PDE-5.



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The implementation of the physiological mechanism of erection is associated with the release of nitric oxide (NO) in the cavernous body during sexual stimulation. This, in turn, leads to an increase in the level of cGMP, the subsequent relaxation of smooth muscle tissue of the cavernous body and an increase in blood flow.

How Effective Is Viagra For Erectile Dysfunction does not have a direct relaxing effect on the isolated cavernous human body, but enhances the effect of nitric oxide by inhibiting PDE-5, which is responsible for the disintegration of cGMP.

Selective Dose Of Viagra For Erectile Dysfunction against PDE5 in vitro, its activity against PDE5 superior activity against other known PDE isoenzymes: PDE-6 — 10 times; PDE-1 more than 80 times; PDE-2, PDE-4, PDE-7 PDE–11 more than 700 times. Sildenafil For Erectile Dysfunction Dosage is 4000 times more selective for PDE-5 than PDE-3, which is crucial because PDE-3 is one of the key enzymes in the regulation of myocardial contractility.

A prerequisite for the effectiveness of Sildenafil For Erectile Dysfunction Dosage is sexual stimulation.

Viagra Cure Erectile Dysfunction restores impaired erectile function in conditions of sexual stimulation by increasing blood flow to the cavernous bodies of the penis.

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During the post-marketing use of Sildenafil For Erectile Dysfunction Dosage for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Viagra Erectile Dysfunction Treatment. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Viagra For Diabetes Erectile Dysfunction without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

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Sildenafil For Erectile Dysfunction Dosage has a systemic vasodilating effect, leading to a transient decrease in blood PRESSURE, which is not clinically significant and does not lead to any consequences in most patients. However, before prescribing Does Viagra Work For Erectile Dysfunction, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with the rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood PRESSURE from the autonomic nervous system.

Since the combined use of Sildenafil For Erectile Dysfunction Dosage and α-blockers can lead to symptomatic hypotension in some sensitive patients, Sildenafil For Erectile Dysfunction Dosage should be used with caution in patients taking α-blockers (see "Interaction"). To minimize the risk of postural hypotension in patients taking α-blockers, the drug Sildenafil For Erectile Dysfunction Dosage should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Sildenafil For Erectile Dysfunction Dosage (see. "Dosage and administration"). The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

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During the post-marketing use of Can Viagra Be Used For Erectile Dysfunction for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of Treatment For Erectile Dysfunction Before Viagra. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some were observed after taking Sildenafil For Erectile Dysfunction Dosage without subsequent sexual activity. It is not possible to establish a direct link between the reported adverse events and those or other factors.

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In rare cases, during post-approval use of all of the inhibitors of PDE5, including Sildenafil For Erectile Dysfunction Dosage, reported NESN is a rare disease and the cause of the decrease or loss of vision. Most of these patients had risk factors, such as decreased ratios of excavation diameter to optic disc (stagnant disc), age over 50, diabetes, hypertension, CHD, hyperlipidemia, and Smoking. In an observational study evaluated whether recent use of drugs class of inhibitors PDE-5 with an acute onset NESN. The results indicate approximately a 2-fold increase in risk of developing NESN within 5T1/2 after application of the PDE-5 inhibitor. According to published literature, the annual incidence of npins IS 2.5–11.8 cases per 100,000 men aged ≥50 years in the General population. Patients should be advised to stop Which Is Better For Erectile Dysfunction Viagra Or Cialis therapy in case of sudden loss of vision and consult a doctor immediately. Persons who have already had a case NESN have an increased risk of relapse NESN. Therefore, the doctor should discuss this risk with such patients, as well as the potential chance of adverse effects of PDE-5 inhibitors. PDE-5 inhibitors, including Sildenafil For Erectile Dysfunction Dosage, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Sildenafil For Erectile Dysfunction Dosage in doses exceeding the recommended, adverse events were similar to those noted above, but usually more common.

*Side effects identified during post-marketing studies.

Interaction

Effect of other drugs on the pharmacokinetics of Sildenafil For Erectile Dysfunction Dosage

The metabolism of Viagra Temporary Erectile Dysfunction occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Sildenafil For Erectile Dysfunction Dosage, and inducers, respectively, increase the clearance of Viagra For Psychological Erectile Dysfunction. A decrease in the clearance of Viagra Stress Erectile Dysfunction with simultaneous use of inhibitors of CYP3A4 isoenzyme (ketoconazole, erythromycin, cimetidine).

Cimetidine (800 mg), a nonspecific inhibitor of CYP3A4 isoenzyme, when taken together with Viagra Without Erectile Dysfunction (50 mg) causes an increase in the concentration of Sildenafil For Erectile Dysfunction Dosage in plasma by 56%.

A single dose of 100 mg of Sildenafil For Erectile Dysfunction Dosage together with erythromycin (500 mg/day 2 times a day for 5 days), a moderate inhibitor of CYP3A4 isoenzyme, while achieving a constant concentration of erythromycin in the blood, leads to an increase in the AUC of Sildenafil For Erectile Dysfunction Dosage by 182%.

When co-administered Viagra Stress Erectile Dysfunction (once 100 mg) and saquinavir (1200 mg/day 3 times daily), an inhibitor of HIV protease and of CYP3A4, on the background to achieve a constant concentration of saquinavir in the blood, Cmax of Which Is Better For Erectile Dysfunction Viagra Or Cialis was increased by 140% and the AUC increased by 210%.

Stronger inhibitors of CYP3A4 isoenzyme, such as ketoconazole and Itraconazole, can cause more pronounced changes in the pharmacokinetics of Will Viagra Work For Erectile Dysfunction.

The simultaneous use of Alternative To Viagra For Erectile Dysfunction (100 mg once) and ritonavir (500 mg 2 times a day), an inhibitor of HIV protease and a strong inhibitor of cytochrome P450, on the background to achieve a constant concentration of ritonavir in the blood leads to an increase in Cmax of Viagra Erectile Dysfunction Dose by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Using Viagra For Erectile Dysfunction in blood plasma is about 200 ng/ml (after a single application of one Sildenafil For Erectile Dysfunction Dosage — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Using Viagra For Erectile Dysfunction does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Sildenafil For Erectile Dysfunction Dosage is not recommended. In any case, the maximum dose of Is Viagra Only Used For Erectile Dysfunction under any circumstances should not exceed 25 mg for 48 hours. If Viagra And Other Erectile Dysfunction Drugs is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Sildenafil For Erectile Dysfunction Dosage does not exceed 200 nm, and the drug is well tolerated.

Single administration of antacid (magnesium hydroxide/aluminum hydroxide) does not affect the bioavailability of Sildenafil For Erectile Dysfunction Dosage.

Studies involving healthy volunteers with simultaneous use of endothelin receptor antagonist, bosentan (CYP3A4 isoenzyme inducer (moderate), CYP2C9, and possibly CYP2C19) in Css (125 mg 2 times a day) and Sildenafil For Erectile Dysfunction Dosage in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis by 62.6 and 52.4%, respectively. Sildenafil For Erectile Dysfunction Dosage increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Natural Viagra For Erectile Dysfunction with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Sildenafil For Erectile Dysfunction Dosage in blood plasma.

CYP2D6 isoenzyme inhibitors (SSRIs, tricyclic antidepressants), thiazide and thiazide-like diuretics, ACE inhibitors and calcium antagonists have no effect on the pharmacokinetics of Treatment For Erectile Dysfunction Before Viagra.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Using Viagra For Erectile Dysfunction or its main circulating metabolite.



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