A comprehensive guide on the Most Popular ED Drug
Sildenafil is probably the most famous oral medication for curing erectile dysfunction (also known as ED or impotence). It has been used all over the world since 1998. Its appearance was a real revolution in the treatment of male sexual disorders, because previously the most effective medical remedies for impotence were penile injections, not very pleasant for patients. Initially, the exclusive rights to manufacture medicines with Sildenafil belonged to the American corporation Pfizer. However, now very popular are the generics of this medicament, which are produced primarily in India. Sildenafil from India is available in many countries. In this article, we will tell you everything about Sildenafil from India. So, let’s get started.
The medication is used to reduce the symptoms of ED. It cannot eliminate the causes of the ailment and completely liquidate it, since ED can be caused by various factors, from diabetes to psychological fears. However, Sildenafil completely eliminates the symptoms of the disease. According to official studies, it showed successful effectiveness in about 80 percent of patients. Males shouldn’t take the medicament “for fun” or “for improving sexual act”. Sildenafil may be administered only if a male has ED diagnosed by a healthcare expert.
The medical remedy is counter indicated for:
- persons under 18;
- individuals experiencing allergic reactions to the components of the drug;
- persons who take meds containing nitrates, as the medicament may enlarge the hypotensive action of these substances; it can lead even to lethal consequences.
Also, the medicament should be applied carefully or in low dosages in cases of:
- severe hypo- and hypertension;
- some heart ailments;
- ailments accompanied by bleedings;
- sever liver dysfunctions;
- hereditary retinitis pigmentosa, etc.
In addition, the medicament should be administered with caution by male persons suffering from penile anatomical deformities (in particular, cavernous fibrosis) and by people suffering from conditions that predispose to the occurrence of priapism (for example, sickle cell anemias, multiple myelomas or leukemias).
Sildenafil is quickly absorbed in the digestive tract. The medicament concentration in the plasma after its administration reaches a peak in 30-120 min (on average in 60 min). What determines the moment of onset of action of the medicament? First of all, it is meal consumption. If you take the medicament on an empty stomach, you’ll get the desired effect in half an hour with almost 100% probability. However, if you have eaten well, especially very fatty foods (fried pork, cheese, pilaf, and the like), you may have to wait for the desired effect for 2 hours.
How long does the medicament work? According to official instructions, the time of its action ranges from 4 to 6 hours. However, a study by Zinner N (2007) shows that in some men the duration of action of the remedy reaches 10 hours.
Drug Class and Mechanism of Action
Sildenafil belongs to the well-known class of meds used for curing impotence in male persons. This class is called PDE5 inhibitors. Their name is directly connected with their principle of action. Sildenafil Citrate, as well as its “relatives”, works by suppressing PDE5 enzyme in the male body. This enzyme blocks the formation of cGMP, the substance responsible for arteries dilation and normal blood current inside the penile organ.
The action of the med is peripheral. Sildenafil doesn’t directly affect the cavernous bodies of the male organ, but it powerfully wipes out the relaxing effect of NO on them. During the activation of cGMP and synthesis of NO, the medicament inhibits PDE5. This leads to an increase in the quantity of cGMP within the cavernous bodies. Thus, the drug works only in those situations when the patient is sexually excited and wants to have sex. Sildenafil doesn’t lead to the development of spontaneous penile erections, i.e. erections without any reason. The medicament also doesn’t improve male libido, although it can enhance sexual desire on a psychological level during sex. A male sees that everything turns out favorable for him, becomes more confident, and as a result, his sexual desire increases.
The medicament is used by male persons as needed, i.e. in situations when they plan to have sexual intercourse, unlike such meds as Cialis that may be used on everyday basis. Therefore, it’s unlikely that you can miss the dose. If you have forgotten to take a pill before coitus, you can still swallow it and wait a bit.
Keep the drug in the blister (package) in which you have bought it. It’s recommended to store it at room temperature (77 degrees Fahrenheit = 25 degrees Celsius). Short-term storage of Sildenafil at a lower temperature (not less than 15 °C = 59 °F) and at a higher temperature (not more than 35 °C = 86 °F) is allowed. Keep it away from children and your pets to prevent unpleasant consequences. In addition, it’s advised to store the medicine away from sources of light (sunlight, lamp), moisture (bathroom and kitchen), and heat (radiators, etc.)
Possible Side Effects
Taking any medicament is associated with certain risks of side effects. Indian Sildenafil isn’t an exception. Here is a list of possible side events that can occur after taking this anti-ED medication:
- Digestive disorders. Some male persons can experience stomach pain, dyspepsia, stomach inflammation etc.
- Flushes of blood to the head, headaches, back pain.
- Cardiovascular problems. This can be a deterioration of the heart rate, a sharp drop in blood pressure and the like.
- Vision impairments. In some individuals, 1 hour after administering the medicament (100mg dosage), a mild & short-time impairment of color difference (blue and green) was detected with special medicinal tests. 2 hours after taking the remedy, these visual impairments themselves disappeared. The presumed mechanism of color vision disorder is oppression PDE6 that takes part in the process of light transmission in the retina. In vitro experiments have shown that the influence of Sildenafil Citrate on PDE6 is 10 times weaker than its activity with respect to PDE5.
- Hearing loss. In research of Khan AS et el. (2011), it is indicated that Sildenafil (as well as other PDE5i meds) may induce sensorineural hearing loss through some physiological mechanisms. This side effect is quite rare. It is observed mainly in elderly patients.
- Priapism. This is a very rare condition that consists in extra-long erection causing painful sensations. Men with penile deformities are at a higher risk of developing this condition.
In addition, the drug can cause liver problems, allergic reactions, nasal congestion, etc. It should be noted that all adverse events aren’t common.
- Don’t use Sildenafil along with other ED meds. The safety and efficiency of the medicament taking simultaneously with other meds designed to treat ED (such as Tadalafil, Avanafil etc.) haven’t been studied. Due to this, the use of such combos is prohibited.
- Don’t combine the medicament with grapefruit. Multiple experiments have shown that grapefruit juice causes a slight inhibition of the enzyme CYP3A4 in the intestinal wall. This enzyme oxidizes various medicines to remove them from the body. Due to inhibition of CYP3A4, many medications, including Sildenafil, can enhance their effect. This increases the risk of adverse events. Therefore, it isn’t advised to eat grapefruit or any other products based on this fruit (juice, smoothies) to avoid the enhancing of the medicament effect. Other citrus fruits can also have an analogous effect, but it is much less significant.
- Try to not combine the drug with pomegranate juice. Grapefruit isn’t the only fruit that can induce adverse events of the med. There are studies that indicate a possible increase in the possibility of priapism occurring in the case of combining sildenafil and pomegranate juice. A study of several Indian scientists (Senthilkumaran S et al., 2012) have reported three cases of low flow priapism associated with the use of pomegranate juice during drug treatment. A possible mechanism is also associated with the suppression of the CYP3A4 enzyme. However, the scientists have stated that their conclusions are not final and require further research. In this respect, it is important to note that some researchers recommend pomegranate juice for improving erectile function.
- Don’t abuse alcohol when being treated with Sildenafil Citrate. Alcoholic beverages can lower arterial pressure, as the medicament does. Therefore, combining excessive amounts of beverages with Sildenafil therapy can enlarge the risk of rapid drop in arterial pressure. However, moderate dosages of beverages (1-3 units) are safe for health. If you drink one glass of beer or a couple of glasses of champagne, nothing bad will happen (unless alcohol is contraindicated for other reasons). The study by Leslie SJ et al. (2004) showed that there were no important hemodynamic interactions when combining moderate doses of red wine with the medical remedy.
- Don’t use the medicament without a prescription. Sildenafil may be purchased only by healthcare professional’s prescription. OTC Sildenafil (as well as Viagra without a prescription) isn’t available in most countries, including the US & Canada.
To diagnose ED, determine its possible causes and choose an adequate treatment. Your healthcare professional must collect a complete medical history and conduct a thorough physical examination. Sex activity represents a certain risk in the presence of heart disease. In this regard, before beginning any therapy for erectile problems, the doctor may consider it necessary to examine the patient’s cardiovascular system. Sildenafil shouldn’t be prescribed to male persons for whom sexual acts are undesirable.