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The efficacy and safety of Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis were evaluated in 21 randomized double-blind placebo-controlled studies lasting up to 6 months in 3000 patients from 19 to 87 years with erectile dysfunction of different etiology (organic, psychogenic or mixed). The efficacy of the drug was evaluated globally using an erection diary, an international erectile function index (validated questionnaire on the state of sexual function) and a partner survey.


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Information

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Sildenafil Used For Erectile Dysfunction was well tolerated at a single dose of 100 mg. There were no clinically significant changes in vision evaluated by special visual tests (visual acuity, Amsler lattice, color perception, color simulation, Humphrey perimeter and photostress).

Efficiency. The efficacy and safety of Sildenafil Used For Erectile Dysfunction were evaluated in 21 randomized double-blind placebo-controlled studies lasting up to 6 months in 3000 patients from 19 to 87 years with erectile dysfunction of different etiology (organic, psychogenic or mixed). The efficacy of the drug was evaluated globally using an erection diary, an international erectile function index (validated questionnaire on the state of sexual function) and a partner survey.

The effectiveness of Viagra Erectile Dysfunction Treatment, defined as the ability to achieve and maintain an erection sufficient for satisfactory sexual intercourse, has been demonstrated in all studies and confirmed in long-term studies lasting 1 year. In studies with the use of fixed-dose proportion of patients reporting that treatment improved their erections were 62% (dose of Sildenafil Used For Erectile Dysfunction 25 mg), 74% (dose Generic Viagra For Erectile Dysfunction 50 mg) and 82% (dose Sildenafil Used For Erectile Dysfunction 100 mg) compared to 25% in the placebo group. Analysis of the international index of erectile function showed that in addition to improving erection treatment Sildenafil Used For Erectile Dysfunction also increased the quality of orgasm, allowing to achieve satisfaction from sexual intercourse and overall satisfaction.

According to the generalized data, 59% of patients with diabetes, 43% of patients who underwent radical prostatectomy and 83% of patients with spinal cord injuries (against 16, 15 and 12% in the placebo group, respectively) were reported to have improved erection in the treatment of Sildenafil For Erectile Dysfunction.

Pharmacokinetics

The pharmacokinetics of Herbal Viagra For Erectile Dysfunction in the recommended dose range is linear.

Suction. After intake of Sildenafil Used For Erectile Dysfunction is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Viagra Erectile Dysfunction Dose at a concentration of about 1.7 ng/ml (3.5 nm) inhibits the activity of PDE-5 50%. After a single dose of Viagra Erectile Dysfunction Dose 100 mg average Cmax free Sildenafil Used For Erectile Dysfunction in plasma men is about 18 ng/ml (38 nm). Cmax when taking Sildenafil Used For Erectile Dysfunction inside fasting is achieved for an average of 60 minutes (from 30 to 120 minutes). When taken in combination with fatty foods, the rate of absorption decreases: Cmax decreases by an average of 29%, and Tmax increases by 60 minutes, but the degree of absorption does not change significantly (AUC decreases by 11%).

Distribution. The average Vss of Sildenafil Used For Erectile Dysfunction is 105 l. the Association of Herbal Viagra For Erectile Dysfunction and its main circulating N-demethyl metabolite with plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the dose of Sildenafil Used For Erectile Dysfunction (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Sildenafil Used For Erectile Dysfunction is metabolized mainly in the liver by the action of CYP3A4 isoenzyme (main pathway) and CYP2C9 isoenzyme (minor pathway). The main circulating active metabolite, formed as a result of N-demethylation of Is Viagra Only Used For Erectile Dysfunction, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Sildenafil For Erectile Dysfunction Dosage, and its activity against PDE-5 in vitro is about 50% of the activity of Sildenafil Used For Erectile Dysfunction. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Sildenafil Used For Erectile Dysfunction. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Will Viagra Work For Erectile Dysfunction is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Sildenafil Used For Erectile Dysfunction is excreted as metabolites, mainly by the intestine (about 80% oral dose) and to a lesser extent by the kidneys (about 13% oral dose).

Hearing impairment

Some post-marketing and clinical studies have reported cases of sudden hearing loss or impairment associated with the use of all PDE-5 inhibitors, including Generic Viagra For Erectile Dysfunction. Most of these patients had risk factors for sudden impairment or hearing loss. There is no causal relationship between the use of PDE-5 inhibitors and sudden hearing impairment or hearing loss. In case of sudden hearing impairment or hearing loss while taking Sildenafil Used For Erectile Dysfunction, consult a doctor immediately.

Bleedings

Sildenafil Used For Erectile Dysfunction enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Sildenafil Used For Erectile Dysfunction in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Sildenafil Used For Erectile Dysfunction in these patients should be used with caution (see With caution).

The incidence of nosebleeds in patients with pulmonary hypertension associated with diffuse connective tissue diseases was higher (Viagra Dose For Erectile Dysfunction — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Sildenafil Used For Erectile Dysfunction — 3%, placebo — 2.4%). Patients receiving Will Viagra Work For Erectile Dysfunction in combination with an antagonist of vitamin K, the frequency of nasal bleeding was higher (8.8 percent) than patients who were not taking an antagonist of vitamin K (1.7 percent).

Use in conjunction with other means for the treatment of erectile dysfunction

The safety and efficacy of Sildenafil Used For Erectile Dysfunction together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Natural Viagra For Erectile Dysfunction (eg, Revatsio®), or other means for the treatment of erection disorders have not been studied, so the use of such combinations is not recommended (see "Contraindications").

Influence on the ability to drive and mechanisms. In patients receiving Sildenafil For Erectile Dysfunction Dosage any negative effect on the ability to drive a car or other means was not observed. However, since when taking Viagra Tablet For Erectile Dysfunction may develop dizziness, lowering blood PRESSURE, the development of chromatopsia, blurred vision, etc. side effects, care should be taken when driving and doing other potentially dangerous activities that require increased concentration and speed of psychomotor reactions. Also, you should be careful about the individual action of the drug in these situations, especially at the beginning of treatment and when changing the dosage regimen.

Cardiovascular complications

During the post-marketing use of Sildenafil 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 Sildenafil Used For Erectile Dysfunction. 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 Human 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.

Hypotension

Which Drug For Erectile Dysfunction Is Better Viagra Or Cialis 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 Sildenafil Used 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 Used For Erectile Dysfunction and α-blockers can lead to symptomatic hypotension in some sensitive patients, How Effective Is Viagra For Erectile Dysfunction 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 Used For Erectile Dysfunction should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Generic Viagra For Erectile Dysfunction (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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