Viagra

Viagra – means for treatment of disturbances of erectile function.

Form of release and structure

Tablets in a blue film cover, a biconvex rhomboid form with the cut-off rounded edges and an engraving of Pfizer on one of the parties (in cardboard packs with control of the first opening: 1 or 2 blisters according to 1 or 2 tab.; 1 or 3 blisters according to 4 tab.; 1 blister – 12 tab.).

– sildenafit the main active ingredient of Viagra (in the form of citrate), its contents corresponds to an engraving on the second party of a tablet and makes in tablets with a text:

• VGR of 25 - 25 mg;
• VGR of 50 - 50 mg;
• VGR of 100 - 100 mg.

Excipients: cellulose microcrystallic, calcium hydrophosphate, croscarmellose sodium, magnesium stearate.

Are a part of a film cover: a gipromelloza, lactose, triacetin, titanium dioxide (E171), an aluminum varnish on the basis of indigo carmine (E132), vanillin, biotin.

Indications to use

Therapy of erectile dysfunction of which inability to achievement or preservation of an erection of a penis necessary for the full act of a coition is characteristic.

Contraindications

• The combined treatment with other drugs intended for therapy of disturbances of erectile function;
• Constant or incidental reception of donators of nitrogen oxide, organic nitrites or nitrates in any forms as sildenafit strengthens hypotensive effect of nitrates;
• Female;
• Age up to 18 years;
• Hypersensitivity to a sildenafil or excipients of drug.

With care appoint Viagra sick in the presence of the following pathologies:

• Anatomic deformation of a penis, including an angulation, cavernous fibrosis or Peyroni's disease;
• The sickemia, multiple myeloma, thrombocytopenia, leukosis and other diseases capable to cause development of a priapism;
• The diseases which are followed by bleedings including in case of an aggravation of a peptic ulcer of a stomach and a duodenum;
• Hereditary pigmental retinitis.

It is recommended to apply means under observation of the doctor within the first 6 months after the had myocardial infarction or a stroke, and also to patients with such heart diseases as: heart failure, severe form of arrhythmia, arterial hypertension and/or hypotension, unstable stenocardia.

Route of administration and dosage

Pill is taken inside in one hour prior to sexual intercourse.

The initial dose of Viagra makes 50 mg. Depending on efficiency and individual portability its correction towards increase or decrease is allowed.

In days the maximum dose of drug should not exceed 100 mg, and the frequency of reception of 1 times.

For patients with a severe form of a renal failure or cirrhosis the recommended dose no more than 25 mg.

For patients of advanced age dose adjustment is not required.

In case of need simultaneous treatment by other medicines, it is necessary to accept Viagra on 25 mg: with ritonaviry – is not more often than 1 time at 48 o'clock; with erythromycin, ketokonazoly, sakvinaviry, itrakonazoly – 1 time a day.

To the patients accepting α-adrenoblockers, for minimizing of risk of development of postural hypotension, it is necessary to begin administration of drug only after achievement of stabilization of a hemodynamics. It is also necessary to consider expediency of reduction of an initial dose of a sildenafil

Side effects

Degree of side effects depends on individual portability of a sildenafil, the undesirable phenomena have passing character:

• From the central nervous system: most often – a headache; often – dizziness; in some cases – spasms;
• From cardiovascular system: most often – rushes of blood to the person; often – a cardiopalmus; in some cases – tachycardia, a lowering of arterial pressure, nasal bleeding, faints;
• From an organ of sight: often – disturbance of a photosensitivity, a sight zatumanennost, a passing chromatopsia; in some cases – eye pain, lachrymation, reddening of eyes;
• From the alimentary system: often – dyspepsia, sometimes – vomiting;
• From respiratory system: often – rhinitis;
• From a reproductive system: long erection, priapism;
• Allergic reactions: skin rash, cough, cold.

Exceeding of the recommended dosing causes similar side effects, only much more often.

Special instructions

Viagra is appointed by the attending physician on the basis of the full medical anamnesis and physical inspection regarding definition of the reasons causing disturbance of an erection.

Sexual activity is accompanied by risk for men with cardiac pathologies therefore treatment on recovery of an erection has to take place taking into account recommendations of the cardiologist.

Accepting drug at hypotension it is necessary to consider that Viagra has systemic vazodilatiruyushchy action which leads to a passing lowering of arterial pressure. For most of patients it is not clinically significant and does not lead to serious effects. Nevertheless it is important that the doctor carefully estimated possible risk of undesirable manifestations of vazodilatiruyushchy effect of drug individually for each man, especially against the background of sexual activity. Patients with obstruction of an output path of a left ventricle (a hypertrophic subaortic stenosis, an aorta stenosis), a syndrome of a multiple system atrophy are subject to the raised susceptibility to vazodilatator.

At purpose of Viagra, the doctor has to warn the patient about great risk of development of a front nearteriitny ischemic neuropathy of an optic nerve if this state at the man was already noted.

With care patients are recommended to use Viagra with anatomic deformation of a penis.

Combined use of a sildenafil and alpha adrenoblockers can lead to symptomatic hypotension. The patients accepting alpha adrenoblockers are recommended to begin Viagra use only after stabilization of a hemodynamics, using the minimum dose. The doctor has to inform the patient on what actions should be taken, in case of symptoms of postural hypotension.

In case of decrease or a hearing loss during therapy, it is necessary to stop administration of drug and to consult with the doctor.

As safety and efficiency of use of Viagra together with other means for treatment of disturbances of an erection is not studied, it is not recommended to apply similar combinations.

Patients to whom sexual activity is undesirable should not appoint viagra.

In an initiation of treatment or in case of correction of dosing it is necessary to show consideration for health and to be careful at control of vehicles.

Medicinal interaction

In case of simultaneous use of Viagra with other drugs it is necessary to consider their possible interference.

Metabolism of a sildenafil occur in a liver therefore the clearance of a sildenafil is in direct dependence on the drugs influencing isoenzymes of CYP3A4 and CYP2C9.

The concomitant use of a ketokonazol, Cimetidinum, erythromycin and other CYP3A4 inhibitors reduces clearance of a sildenafil.

Viagra is well transferred with strong CYP3A4 inhibitors under a condition if reception is made in the recommended doses.

Do not exert impact on pharmacokinetics of a sildenafil: Tolbutamidum, warfarin and other inhibitors of an isoenzyme CYP2C9; inhibitors of an angiotensin-converting enzyme; tricyclic antidepressants; selective serotonin reuptake inhibitors; tiazida and tiazidopodobny diuretics; antagonists of calcium; azithromycin; the combined antiacid means.

Sildenafil in a dose of 50 mg does not cause additional increase in a bleeding time at reception of acetylsalicylic acid in a dose of 150 mg.

It is impossible to accept Viagra along with nitrates or donators of nitrogen oxide as sildenafit strengthens their hypotensive action.

Simultaneous use of Viagra with anti-hypertensive drugs does not cause side effects.

In the recommended dose (50 mg) sildenafit does not strengthen hypotensive effect of ethanol.

Terms and storage conditions

To store in the dry place, at a temperature not above 30 °C. To protect from children.

Period of validity – 5 years.