Viagra 50mg #12

You can buy Viagra for men here

Viagra instruction for use

Composition

In the composition of Viagra, sildenafil (Sildenafil) can be in the concentration of 25, 50 or 100 mg.
In addition to sildenafil, the composition contains microcrystalline cellulose, calcium hydrogen phosphate, sodium croscarmellose sodium, magnesium stearate.
For the manufacture of the coating film-coated tablets, Opadry is blue and transparent.
The composition of Viagra does not differ depending on the concentration of the active substance.

Form of issue

The drug form of Viagra is a film-coated tablet.
Tablets slightly biconvex, have a rhomboid shape, their edges are cut and rounded, the color - blue. On one side of the tablet there is the inscription "Pfizer", on the other - "VGR 25/50/100" (depending on the concentration of sildenafil).
In one package can be 1, 2, 4 or 12 tablets.

pharmachologic effect

The drug is aimed at restoring a physiological reaction to sexual arousal.

Pharmacodynamics and pharmacokinetics

The drug Viagra is intended for the treatment of erectile dysfunction.
In the event of sexual arousal, the remedy updates the decreased erectile function by increasing the flow of blood to the penis.
The natural mechanism of erection is associated with the release during sexual stimulation in the cavernous (cavernous) body of the penis NO (nitric oxide), which promotes the activation of the enzyme guanylate cyclase.
The latter, in turn, stimulates an increase in the concentration of cGMP (cyclic guanosine monophosphate). As a result, the smooth musculature of the cavernous body relaxes and the blood flow increases.
Sildenafil is a potent and selective inhibitor of cGMP-specific PDE-5 (phosphodiesterase-5) in the cavernous body, where PDE-5 plays an important role in the process of cGMP decay.
The effect of the substance on the erectile function is peripheral: the drug does not have a direct relaxing effect on the isolated human cavernous body, while powerfully enhancing the relaxing effect of nitric oxide on it.
In order to develop the necessary therapeutic effect under the influence of sildenafil, sexual arousal is required.
TCmax (the time to reach the maximum plasma concentration) with oral fasting sildenafil is 0.5 to 2 hours, the bioavailability is between 25 and 60%.
When taking the drug with fatty foods, the pharmacokinetic index of Cmax decreases by at least 20% (sometimes up to 40%), it takes from 1.5 to 3 hours to achieve it.
Metabolization of sildenafil occurs in the liver under the influence of microsomal isozymes of the cytochrome system.
The half-life of sildenafil in pure form and N-desmethyl metabolite, which is its main metabolite, is from 3 to 5 hours. The drug is excreted as inactive metabolic products. About 80% is eliminated with the contents of the intestine, about 15% is eliminated by the kidneys.

Indications for use: for what tablets Viagra?

The description of the drug states that Viagra is intended for the treatment of erectile dysfunction, which is a consequence of vascular disorders or nervous disorders and is defined as the inability to achieve penile erection and maintain it for the time necessary for successful sexual intercourse.
To ensure the effectiveness of the drug requires sexual stimulation.

Contraindications

Viagra has a number of contraindications. So, it is forbidden to use the drug when:
    hypersensitivity to the constituent components;
    simultaneous application with nitrites and nitrates in any form, as well as with donators of nitric oxide (for example, with amyl nitrite);
    the presence of contraindications to the conduct of sexual activity (for example, if the patient is diagnosed with serious heart disease and vascular disorders - severe form of heart failure or unstable angina);
    loss of vision in one eye, which was triggered by anterior ischemic optic neuropathy (neuropathy of the optic nerve) of non-arterial genesis, regardless of whether this pathology has a connection with previous use of PDE inhibitors of the fifth type;
    severe liver dysfunction.
Also, do not take Viagra for women, children and adolescents under the age of 18. With caution the drug is prescribed:
at anatomic deformations of a sexual member (including, at a fibroplastic inducing of a sexual member, a fibrosis of cavernous bodies, angulation, etc.);
    with diseases that can become a predisposing factor to the development of priapism (leukemia, sickle-cell anemia, thrombocytopenia, multiple myeloma, etc.);
    with diseases that are accompanied by bleeding;
    stomach ulcer or ulcer 12 duodenal ulcer in the stage of exacerbation;
    if the patient has suffered a myocardial infarction or stroke in the past six months;
    if the patient has a hereditary degenerative disease of the retina (for example, retinitis pigmentosa);
    with unstable angina or heart failure;
    with arrhythmia, which may pose a threat to the life of the patient;
    arterial hypotension (in cases when arterial pressure indices do not exceed 90/50 mm Hg) or hypertension (in cases when blood pressure indices do not exceed 170/100 mm Hg)

Side effects

As a rule, the side effects that develop against the background of the use of Viagra, are characterized as light or moderately expressed and have a transient nature. The incidence of unwanted symptoms increases with increasing dosage.

The use of Viagra can cause:

    pain in the abdomen, back, muscles or joints;
    asthenia;
    influenza-like syndrome;
    infection (including respiratory tract and urinary system);
    diarrhea;
    nausea;
    increased muscle tone;
    insomnia;
    nasal congestion;
    inflammation of lymphoid tissue and pharyngeal mucosa (pharyngitis);
    inflammation of the paranasal sinuses (sinusitis);
    dysfunction of breathing;
    rashes on the skin;
    violation of color perception of objects (usually this change in vision is expressed in a mild form and has a transient character);
    conjunctivitis;
    impaired prostate function;
During clinical trials, such side effects as blurred vision, increased perception of light, rhinitis, dizziness, vasodilation were also recorded.
When using the drug in high doses, the patient has the same side effects, but they appear an order of magnitude more often than when the prescribed dosage regimen is observed.
In the process of post-marketing Viagra application, in individual patients, in connection with the use of the drug, the following were recorded:
    syncope, arterial hypotension, palpitation, tachycardia;
    vomiting;
    prolonged erection and / or priapism;
    redness of the eyes and pain in them;
    allergic reactions.

Viagra, instructions for use

The instructions for the use of Viagra indicate that the drug should be taken orally. Tablets are recommended to drink before eating, because in this case their action develops more quickly.

Viagra - how to take for men?

The drug is available in three dosages - 25, 50 and 100 mg. Typically, for most patients, the starting dose is 50 mg. Tablets are taken one at about an hour before sexual activity.
Their action begins after 30-60 minutes and remains for the next 4 hours. To make the drug act faster, it is recommended to take it before eating.
Depending on the severity of the effect and taking into account the patient's tolerance of the drug, the dose can be adjusted both in the large and in the lower side.
In some cases, another scheme is followed - the tablets begin to be taken with a minimum dosage, gradually increasing it until a pronounced therapeutic effect.
How to properly take Viagra, the scheme of application and the dose of medicine the doctor determines individually, taking into account the characteristics of the patient's body.
The highest recommended dose is 100 mg. The maximum recommended multiplicity of receptions is 1 time per day.
Older patients do not need to adjust the dosage regimen.

Overdose

In studies that were conducted on healthy volunteers, it was found that a single dose intake of up to 0.8 grams provokes the same side effects that were observed when taking the drug in much lower doses, but the frequency of their occurrence and the degree of severity increased.
The use of sildenafil in a dose equal to 0.2 grams does not lead to an increase in the effectiveness of the remedy, but it provokes an increase in the incidence of side effects. The most frequent are blood rashes, dizziness, headaches, impaired vision, dyspeptic symptoms, nasal congestion.
In case of an overdose, Viagra is prescribed a maintenance treatment that is usual for such situations. Since sildenafil is characterized by a high degree of binding to blood plasma proteins (binding index is 96%) and is not eliminated with urine, acceleration of the clearance of the substance during hemodialysis is considered unlikely.

Interaction

Sildenafil undergoes liver metabolism, mainly under the influence of CYP3A4 isozymes and partly under the influence of CYP2C9, so inhibitors of these isoenzymes decrease, and their inductors, respectively, increase the clearance of sildenafil.
Thus, 0.8 grams of cimetidine, which is a nonspecific inhibitor of CYP3A4, in combination with 0.05 grams of sildenafil causes an increase in plasma concentration of the latter by 56%.
When you take 0.1 grams of sildenafil in combination with erythromycin, which is a specific inhibitor of CYP3A4 (in the case where erythromycin is taken twice a day for 0.5 grams for 5 days), after a constant erythromycin concentration in the blood is reached, AUC sildenafil increases by 182%.
Simultaneous single administration of 0.1 grams of sildenafil with 1.2 grams of saquinavir, which is an inhibitor of CYP3A4 and HIV protease, with a multiplicity of applications of the latter three times per day: with the achievement of a constant plasma concentration of sankvinavir, the AUC of sildenafil increases by 210%, and Cmax - by 140%. However, sildenafil does not change the pharmacokinetics of sancvinavir.
Ketoconazole and itraconazole, which are more potent inhibitors of the CYP3A4 isoenzyme, may have a stronger effect on the pharmacokinetic parameters of sildenafil.
With the simultaneous use of 0.1 grams of sildenafil (once) and ritonavir (0.5 grams twice a day), which is a potent inhibitor of cytochrome P450 isoenzymes and an HIV protease inhibitor, after achieving a constant plasma concentration of ritonavir, sildenafil AUC rises 11-fold (1000%), and Cmax - 4 times (300%).
After 24 hours, the plasma concentration of sildenafil is 200 ng / ml, while after a single application of one sildenafil, this figure is 5 ng / ml.
Patients who take sildenafil in the recommended dosages and in addition receive powerful inhibitors of CYP3A4, are well tolerated by Viagra.
Sildenafil affects the pathways of NO / cGMP metabolism and potentiates the hypotensive effect of nitrates (both in acute and prolonged treatment with these drugs). In this regard, the use of sildenafil with donators of nitric oxide or nitrates is contraindicated.
A single intake of antacid preparations (aluminum hydroxide or magnesium hydroxide) does not affect the bioavailability of the drug.
In some sensitive patients, simultaneous application of sildenafil and α-adrenoblockers may develop symptomatic hypotension.
No significant interaction of the drug with warfarin (0.04 grams) and tolbutamide (0.25 grams) has not been established. Also, the interaction of sildenafil in a dose of 0.1 gram with amlodipine was not established in the use of these drugs in patients with arterial hypertension.

In addition, sildenafil:

    in a dose of 0.1 gram does not change the pharmacokinetics of HIV protease inhibitors at their constant concentration in the blood;
    in a dose of 0.05 grams with simultaneous intake with 0.15 grams of acetylsalicylic acid does not provoke an additional increase in the duration of bleeding;
    in a dose of 0.05 grams in healthy volunteers does not cause an increase in the hypotensive effect of ethanol at a maximum level of the latter in the blood of about 80 mg / dL;
    does not provoke the occurrence of additional side effects when used simultaneously with antihypertensive agents.

Terms of sale

The drug is not released without a prescription.

Storage conditions

Viagra is included in the list B. Store the drug recommended in a dry, inaccessible place for children. The optimum temperature is not more than 30 degrees Celsius.

Shelf life

5 years.

special instructions

What is Viagra?

Viagra - what is it, what does it do and why? Viagra is the first pharmaceutical drug that demonstrates reliable and pronounced efficacy in most patients suffering from erectile dysfunction. The drug promotes the response of the body when exposed to sexual stimuli.
In Wikipedia about the medicine it is written that initially it was created to improve the blood flow in the heart muscle, the treatment of coronary disease and angina.
However, in the early 90s of the XX century, as a result of clinical studies, it was found that the drug has minimal effect on the cardiac blood flow, but it stimulates blood flow in the pelvic organs and, in particular, in the penis.

How does the drug work?

The mechanism of action of tablets is to increase the amount of blood that enters the penis. The drug has an effect solely on the natural mechanisms of the appearance of an erection and provokes a natural erection.
When the sexual intercourse is completed, there is a natural relaxation of the penis.
The drug does not provoke an increase in sexual desire, and does not belong to the category of increasing libido and "stimulant" drugs, its active substance acts only when a man experiences natural sexual arousal.

Sexual norm - what is it and how to define it?

Healthy is a man who has an erection and persists, allowing him to have sex and successfully complete each sexual intercourse.
If a person thinks he is healthy, but he has an improvement in erection against the background of using Viagra, one can assume that he suffers to some extent from erectile dysfunction.

The principle of the action of Viagra on a healthy man

Often there are questions, whether it is possible to take the drug to healthy men, and what will happen if you take a Viagra pill and whether Viagra is harmful for a healthy man.
Healthy men are not forbidden to take sildenafil preparations, as they contribute to the stabilization of the sexual organs, the appearance of a second erection and the prolongation of the sexual act.
In addition, Viagra has the ability to reduce the influence of factors that interfere with the appearance of an erection or reduce its stability (including in healthy men). Tablets improve the functioning of the reproductive apparatus with malaise, agitation and fatigue.
The agent does not provoke an uncontrolled erection and raises it in those cases when a man is nervous. If there is no excitation, then the drug has no effect.
With regard to the safety of the drug, clinical studies have established that patients taking Viagra and placebo discontinued the use of the drug due to the occurrence of side effects at approximately the same frequency: the discontinuation rate among patients taking Viagra was 2.5%, placebo - 2.3%.
Taking Viagra tablets, you should consider possible drug interactions of this drug. In particular, the interaction with nitrates, which are used to treat heart disease.

Is there a dependence on Viagra?

Cases of physical dependence on the drug are not established. However, if you take the pill every day and for a long time, you can not rule out the possibility of psychological dependence.
That is, with constant use of the medicine, the patient becomes so accustomed to the effect of stabilizing the erection, that after his cancellation an illusion of deterioration of potency may arise.
As a rule, this is expressed in the sense that the erection has become less stable and more exposed to the influence of external factors. But as a whole it is not so, a person simply returns to the usual rhythm of sexual life, in which dependence on fatigue, psycho-emotional state, and general health is traced.

How to take the drug and how long does it work?

Viagra takes one tablet approximately one hour before sexual intercourse. The effect of using sildenafil develops 30-60 minutes after ingestion.
By the time the action lasts for 4 hours.

How does Viagra work on women and girls?

According to statistics, about 40% of women suffer from various kinds of violations of sexual function, which are both a consequence of somatic diseases and psychological reasons.
In this regard, as well as taking into account the popularity and effectiveness of the male Viagra, the question "Does the Viagra work for women?" Began to appear.
Experts respond that the effect of sildenafil for women is similar to how Viagra works for men. For girls, it is manifested in increased blood supply to the genital organs and their somatic stimulation. In addition, women are increasing the amount of releasing natural lubricant, increasing sensitivity and excitability and, as a result, the chances of achieving orgasm.
Nevertheless, it is much more difficult to accurately determine the effectiveness of the remedy for women than for men.
In addition, doctors believe that the data on the safety of Viagra for women is not enough, so they would not recommend taking it to healthy women. However, for women who entered the menopause early (up to 50 years) with all the unpleasant symptoms, and for women who underwent a serious gynecological operation (for example, hysterectomy), taking such pills can become practically the only chance to lead a normal sexual life.
It should be remembered that for a person Viagra acts properly only if there is sexual stimulation.
Viagra, which is produced by American company Pfizer, is still intended exclusively for men, and for women, pharmaceutical companies develop other drugs.
Viagra tablets for women in pharmacies are sold under the name "Female Viagra" (Female Viagra). Dosage of sildenafil in one tablet is 100 mg (100 mg).
As an alternative to Viagra, such remedies as the Gold Drop Girl, Silver Fox, Span.Fliege Minitablet, Lokmanzade syrup (a Turkish drug in jars that can be used as an aphrodisiac by both men and women), etc., can be recommended.

How to make Viagra at home?

Popular recipes of Viagra are very popular. First, most of them passed the test of time. Secondly, to make Viagra, use only natural ingredients. Consequently, the probability of side effects from such a tool will be practically zero.
The most simple and effective means are tincture of garlic, a mixture of crushed nuts (walnuts or any other) with natural honey and tincture of ginseng (a ready-made pharmaceutical product sold in a pharmacy).
To make garlic tincture, a kilogram of peeled and chopped garlic is poured into three liters of boiled water and left to infuse for 30 days. Take the drug daily on a teaspoon, until the whole pot is spent.
Ginseng tincture is taken twice or thrice a day for about half an hour before meals for 25-30 drops (no later than 4 hours before bedtime).

Analogues of Viagra

Preparations, close to Viagra by the mechanism of action
Analogues of Viagra tablets are  Verona, Impaza.

Viagra and alcohol

Viagra with alcohol - compatible or not? There is no categorical ban on taking these products in combination, from the chemical point of view they do not interact with each other.
However, if sildenafil enters the stomach with alcohol, its absorption and, therefore, the speed of action slows down. In addition, with the simultaneous use of the drug with alcohol, the load on the body as a whole and, in particular, the heart muscle increases substantially (which should be taken into account for people suffering from hypertension or heart disease).
Thus, despite the fact that Viagra and alcohol are not mutually exclusive, they should be combined as little as possible and in the minimum dose.
The scientists concluded (and the responses of men who took Viagra, confirm this), that for normal health when using the drug in combination with alcohol should drink no more than 100 grams of vodka, 700 grams of beer or 450 grams of wine.

Reviews about Viagra

Reviews of the Viagra tablets for men, like those about Viagra for women, are quite individual. This is due to the fact that both women's pills and preparations for men, for each organism act in their own way, and their effectiveness depends on a large number of factors.
Nevertheless, many people are looking at the forums for reviews of women and men who have experienced the effects of medication.
According to patients who, due to their age, psycho-emotional overload, health problems or fatigue, have experienced erectile dysfunction, it can be concluded that the medicine has earned worldwide recognition not in vain.
As stated in the instructions, it acts quickly and reliably. And, given that the tablets are produced with different concentrations of active substance (25 mg, 50 mg and 100 mg), it is quite easy for a patient to choose the optimal dosage regimen.
Moreover, generics and analogues of the original Viagra (for example, Viagra Soft, Vectra-100 and Boss Royal Viagra) are not inferior in performance to the product of Pfizer Inc.
Healthy men who do not have problems with potency, note that for them, Viagra is a remedy that allows you to experience new emotions for yourself.
And yet, doctors in the reviews of the drug do not get tired of repeating that Viagra is primarily a medicine, before using which you should always consult a doctor. At least in order to exclude heart problems and diseases of the vascular system. Otherwise, the drug can not only not be of use, but also cause serious harm to the body.