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Viagra (sildenafil citrate)

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Information

Clinical data

In a placebo-controlled cross-examination of patients with proven early age macular degeneration (n=9), Viagra Without 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 Viagra Without 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 Dose, 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 Viagra Without Erectile Dysfunction 25 mg), 74% (dose Viagra Works Erectile Dysfunction 50 mg) and 82% (dose Which Is Better For Erectile Dysfunction Viagra Or Cialis 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 Which Is Better For Erectile Dysfunction Viagra Or Cialis 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 Without Erectile Dysfunction.

Pharmacokinetics

Cardiovascular complications

During the post-marketing use of Viagra Without 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 Viagra Without 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 Without 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

Viagra Without Erectile Dysfunction 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 Viagra Without 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 Viagra Without Erectile Dysfunction and α-blockers can lead to symptomatic hypotension in some sensitive patients, Can Viagra Be Used 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 Viagra Erectile Dysfunction Treatment should be started only after achieving stabilization of hemodynamic parameters in these patients. It should also consider reducing the initial dose of Can Viagra Be Used 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.

Cardiovascular complications

During the post-marketing use of Using Viagra 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 Viagra Without 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 Without 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.

Visual impairment

In rare cases, during post-approval use of all of the inhibitors of PDE5, including Viagra Without Erectile Dysfunction, 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 Viagra Without Erectile Dysfunction 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 Used For Erectile Dysfunction, in such patients should be used with caution and only in situations where the expected benefit outweighs the risk.

When using the drug Viagra Temporary Erectile Dysfunction 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 Viagra Without Erectile Dysfunction

The metabolism of Viagra Without Erectile Dysfunction occurs mainly under the action of CYP3A4 isoenzyme (main pathway), so inhibitors of this isoenzyme can reduce the clearance of Viagra For Diabetes Erectile Dysfunction, and inducers, respectively, increase the clearance of Viagra Without Erectile Dysfunction. A decrease in the clearance of Will Viagra Work For 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 Viagra Temporary Erectile Dysfunction in plasma by 56%.

A single dose of 100 mg of Which Is Better For Erectile Dysfunction Viagra Or Cialis 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 Viagra Without Erectile Dysfunction by 182%.

When co-administered Natural Viagra For 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 Is Viagra For Erectile Dysfunction 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 Viagra Without Erectile Dysfunction.

The simultaneous use of Viagra Without 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 Cure Erectile Dysfunction by 300% (4 times), a AUC by 1000% (11-fold). After 24 h, the concentration of Viagra Without Erectile Dysfunction in blood plasma is about 200 ng/ml (after a single application of one Viagra Without Erectile Dysfunction — 5 ng/ml). This is consistent with the ritonavir effect on a wide range of cytochrome P450 substrates. Viagra Without Erectile Dysfunction does not affect the pharmacokinetics of ritonavir. Given these data, the simultaneous reception of ritonavir and Viagra Without Erectile Dysfunction is not recommended. In any case, the maximum dose of Viagra Without Erectile Dysfunction under any circumstances should not exceed 25 mg for 48 hours. If Viagra Without Erectile Dysfunction is taken in the recommended doses, patients receiving strong inhibitors of CYP3A4 isoenzyme at the same time, then Cmax free Viagra Without Erectile Dysfunction 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 Viagra Without Erectile Dysfunction.

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 Viagra Without Erectile Dysfunction in Css (80 mg 3 times a day) showed a decrease in AUC and Cmax Viagra Without Erectile Dysfunction by 62.6 and 52.4%, respectively. Viagra Without Erectile Dysfunction increased the AUC and Cmax of bosentan by 49.8 and 42%, respectively.

It is assumed that the simultaneous use of Viagra Stress Erectile Dysfunction with powerful inducers of CYP3A4 isoenzyme, such as rifampicin, can lead to a greater decrease in the concentration of Dose Of Viagra For Erectile Dysfunction 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 Is Viagra For Erectile Dysfunction.

Azithromycin (500 mg/day for 3 days) has no effect on AUC, Cmax, Tmax, excretion rate constant and T1/2 Viagra Without Erectile Dysfunction or its main circulating metabolite.

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 Stress 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 Without Erectile Dysfunction, consult a doctor immediately.

Bleedings

Viagra Without Erectile Dysfunction enhances the antiplatelet effect of sodium nitroprusside, a nitric oxide donator, on human platelets in vitro. Data on the safety of Will Viagra Work For Erectile Dysfunction in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, so the drug Viagra Without 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 For Erectile Dysfunction — 12.9%, placebo — 0%) than in patients with primary pulmonary arterial hypertension (Is Viagra Only For Erectile Dysfunction — 3%, placebo — 2.4%). Patients receiving Viagra Without 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 Viagra Without Erectile Dysfunction 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 Viagra Without Erectile Dysfunction any negative effect on the ability to drive a car or other means was not observed. However, since when taking Dose Of Viagra 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.



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