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Viagra (sildenafil citrate)

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Information

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



Mechanism of action

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.

Viagra Temporary 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 Is Viagra Only Used 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. Viagra Temporary Erectile Dysfunction 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 Viagra Temporary Erectile Dysfunction is sexual stimulation.

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

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

Suction. After intake of How Effective Is Viagra For Erectile Dysfunction is rapidly absorbed. Absolute bioavailability averages about 40% (25 to 63%). In vitro Dose Of Viagra For Erectile Dysfunction 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 Temporary Erectile Dysfunction 100 mg average Cmax free Viagra Temporary Erectile Dysfunction in plasma men is about 18 ng/ml (38 nm). Cmax when taking Viagra Cure 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 Viagra Temporary Erectile Dysfunction is 105 l. the Association of Viagra Erectile Dysfunction Treatment 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 Viagra For Diabetes Erectile Dysfunction (an average of 188 ng) was found in sperm 90 minutes after taking the drug.

Metabolism. Viagra Temporary 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 Does Viagra Work For Erectile Dysfunction, undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of Viagra Temporary Erectile Dysfunction, and its activity against PDE-5 in vitro is about 50% of the activity of Viagra Temporary Erectile Dysfunction. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of Viagra Temporary Erectile Dysfunction. N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 no.

Breeding. The total clearance of Viagra Temporary Erectile Dysfunction is 41 l/h, and the final T1/2 — 3-5 h. After oral administration, as well as after I/V, Can Viagra Be 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).

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Treatment For Erectile Dysfunction Before Viagra 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 Viagra Temporary 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 Temporary Erectile Dysfunction, 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 Which Is Better For Erectile Dysfunction Viagra Or Cialis 25 mg), 74% (dose Viagra Temporary Erectile Dysfunction 50 mg) and 82% (dose Viagra Temporary 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 Viagra Temporary 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 Viagra Temporary Erectile Dysfunction.

Pharmacokinetics

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 Viagra Temporary 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 Viagra For Psychological Erectile Dysfunction, consult a doctor immediately.

Bleedings

Viagra Stress Erectile Dysfunction enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Viagra Without Erectile Dysfunction in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Viagra Temporary 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 Temporary Erectile Dysfunction — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Viagra Temporary Erectile Dysfunction — 3%, placebo — 2.4%). Patients receiving Viagra Stress 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 Which Is Better For Erectile Dysfunction Viagra Or Cialis together with other PDE-5 inhibitors or other drugs for the treatment of pulmonary hypertension containing Will Viagra Work 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 Alternative To Viagra For Erectile Dysfunction any negative effect on the ability to drive a car or other means was not observed. However, since when taking Viagra Erectile Dysfunction Dose 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.



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