Vizarsin Q-tab 50mg #1

Vizarsin Q-tab instruction for use

Reed more and buy Vizarsin Q-tab here

Release form

Tablets dispersed in the mouth: slightly biconvex, round, almost white or white, with a mint odor, may be dark patches

Composition

Ingredients 1 tablet:
active ingredient: sildenafil - 100 mg;
additional components: aspartame, neohesperidin dihydrochalcon (E959), calcium silicate FM1000, crospovidone type A, mannitol, giproloza, mint flavor, magnesium stearate, peppermint flavor (field mint oil, acacia gum, water, levomentol, sorbitol, malt, malt, sorbitol, malt, gin, water, levomentol, sorbitol, malt, mortar, field oil
Packaging - 1 PC.

pharmachologic effect

Selective inhibitor cycloguanosine monophosphate (cGMP) -specific PDE5. PDE5, which is responsible for the decay of cGMP, is contained not only in the cavernous body of the penis, but also in the vessels of the lungs.
Restores impaired erectile function and provides a natural response to sexual arousal.
Sildenafil has no direct relaxing effect on the corpus cavernosum, but actively enhances the relaxing effect of nitric oxide on this tissue. During sexual arousal, the local release of NO under the influence of sildenafil leads to the inhibition of PDE5 and an increase in the level of cGMP in the cavernous body, resulting in the relaxation of smooth muscles and an increase in blood flow in the cavernous body.
Being an inhibitor of PDE5, sildenafil increases the cGMP content in the smooth muscle cells of the pulmonary vessels and causes them to relax. In patients with pulmonary hypertension, administration of sildenafil leads to dilation of the pulmonary vessels and, to a lesser extent, other vessels.
Sildenafil is selective for in vitro PDE5. Its activity in relation to PDE5 exceeds the activity in relation to other known PDE isoenzymes: PDE6, which participates in the transmission of a light signal in the retina, 10 times; PDE1 - 80 times; PDE2, PDE4, PDE7-PDE11 - more than 700 times. The activity of sildenafil in relation to PDE5 is more than 4000 times greater than its activity in relation to PDE3, a cAMP-specific PDE involved in the contraction of the heart.
Sildenafil can cause a mild and transient disturbance in color (blue / green). A supposed mechanism of color vision impairment is the inhibition of PDE6, which is involved in the process of transmitting light in the retina. In vitro studies have shown that the effect of sildenafil on PDE6 is 10 times less than its activity on PDE5.

Vizarsin Q-tab, indications for use

According to the instructions, Vizarsin Q-tab is recommended for use for the treatment of erectile dysfunction, which is characterized by the inability to achieve or maintain penile erection, necessary for satisfactory sexual intercourse. For the manifestation of the effect of Vizarsin Q-tab requires sexual arousal.

Contraindications

Absolute:
    myocardial infarction or cerebrovascular accident (stroke) suffered in the last 6 months;
    hypotension (blood pressure below 90/50 mm Hg. Art.);
    severe heart failure, unstable angina and other severe forms of cardiovascular lesions, in the presence of which sexual activity is not recommended for men;
    severe functional disorders of the liver;
    congenital fructose intolerance (since sorbitol is included in the Q-tab Vizarsin);
    Phenylketonuria (as. Aspartame contained in the product is a source of phenylalanine);
    loss of vision in one eye, due to the non-arteritic form of the anterior ischemic neuropathy of the optic nerve (non-arteritic AION), regardless of whether this pathology is associated or not with the previous use of PDE-5 inhibitors;
    hereditary degenerative diseases of the retina (hereditary retinal dystrophies), such as retinitis pigmentosa (with the possible presence of genetic disorders of retinal PDE), because the safety profile of sildenafil in these patients has not been studied;
    simultaneous use with NO donators (including amyl nitrite) or nitrates in any form due to the fact that sildenafil can enhance the antihypertensive effect of nitrates (indirectly through NO / cGMP);
    combined use with other drugs for the treatment of erectile dysfunction, because the efficacy and safety of Vizarsin Q-tab in this combination has not been studied;
    age up to 18 years;
    combination with ritonavir;
    hypersensitivity to any of the components of the drug.
Vizarsin Q-tab is not intended for use in women.
Relative contraindications (Sildenafil is required to be used with extreme caution in the presence of the following conditions / diseases):
    arrhythmias of a life-threatening character;
    syndrome of multiple systemic atrophy or obstruction of the outflow tract of the left ventricle of the heart [hypertrophic obstructive cardiomyopathy (GOKMP), aortic stenosis];
    blood pressure readings above 170/100 mm Hg. v .;
    conditions predisposing to the occurrence of priapism (leukemia, multiple myeloma, sickle cell anemia);
    anatomical deformity of the penis (cavernous fibrosis, angulation, or Peyronie’s disease);
    the period of acute gastric ulcer or duodenal ulcer, diseases associated with bleeding (due to the lack of information about the safety of use);
    indications of a history of episodes of non-arteritic AION;
    taking alpha blockers.

Dosage and administration

Vizarsin Q-tab take inside. Tablets dispersed in the oral cavity can be used as an alternative form for patients who have difficulty in swallowing Vizarsin film-coated tablets. Since the tablets dispersed in the oral cavity are fragile and easily broken, they are not recommended to be squeezed through the packaging foil. Do not take a tablet with wet hands due to the fact that it may begin to dissolve. Before taking you need to take a blister with Vizarsin Q-tab and bend it along the line of the gap. To open the blister, gently pull the edge of the foil and carefully remove the pill by shaking it into the palm of your hand. After that, the pill must be immediately put on the tongue, and in order to facilitate swallowing, keep for several seconds in the mouth until completely dissolved. Then Vizarsin Q-tab can be washed down with liquid. Do not mix dispersible tablets in the mouth with food. When using the drug with fatty foods, its effect can be observed later than when taken on an empty stomach. For most adult males, the recommended dose is 50 mg, which, if necessary, should be taken approximately 1 hour before sexual activity. The dose of Vizarsin Q-tab, taking into account its tolerability and effectiveness, can be increased to 100 mg or reduced to 25 mg. The maximum permissible dose should not exceed 100 mg, taken no more than 1 time per day.

Side effects of Vizarsin Q-tab

    nervous system: very often - headache; often - dizziness; infrequently - hypoesthesia, drowsiness; seldom - a faint, violation of cerebral circulation; with an unknown frequency - convulsions, transient ischemic attack, relapse of convulsions;
    gastrointestinal tract: often - dyspepsia; infrequently - nausea, dry mouth, vomiting;
    musculoskeletal and connective tissue: infrequently - myalgia;
    mammary gland and genitals: infrequently - bleeding from the penis, hematospermia; with unknown frequency - prolonged erection, priapism;
    urinary system: infrequently - hematuria;
    skin and subcutaneous tissue: infrequently - skin rash; with unknown frequency - toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome;
    cardiovascular system (CCC): often - a feeling of hot flashes; infrequently - tachycardia, palpitations; rarely - atrial fibrillation, increased / decreased blood pressure, myocardial infarction; with an unknown frequency - unstable stenocardia, ventricular arrhythmia, sudden cardiac death;
    labyrinth disorders and organ of hearing: often - tinnitus, vertigo; rarely - deafness;
    organ of vision: often - visual impairment, chromatopsia (violation of color perception); infrequently - a violation of tearing, defeat of the conjunctiva; with unknown frequency - visual field defect, retinal vascular occlusion, non-arteritic AION;
    organs of the chest and mediastinum, respiratory system: often - nasal congestion; rarely - nosebleeds;
    immune system: rarely - hypersensitivity reactions;
    laboratory and instrumental data: infrequently - increased heart rate;
    other disorders: infrequently - increased fatigue, chest pain.

special instructions

Before starting drug therapy in order to diagnose erectile dysfunction and determine the possible causes of their development, it is necessary to study the patient’s history and conduct a thorough clinical examination. Since there is a certain risk on the part of the CAS due to sexual activity, it is required to evaluate the patient's condition before starting any course of treatment for erectile dysfunction. Mortality rates from cardiovascular diseases and the incidence of myocardial infarction when using sildenafil did not differ from those in comparison with patients from the placebo group. During post-marketing use of sildenafil, there were reports of serious cardiovascular complications (related in time to the reception of the funds) including sudden cardiac death, myocardial infarction, ventricular arrhythmia, unstable angina, transient ischemic attack, cerebrovascular hemorrhage, hypertension / hypotension. The majority of patients in this group noted the presence of cardiovascular risk factors. Many of these cases occurred during or immediately after sexual activity, and a small number over a short period after taking sildenafil without sexual activity. It is impossible to establish a direct link between the development of these pathologies and any factors. Due to the fact that Vizarsin Q-tab has a vasodilating effect, leading to a temporary and slight decrease in blood pressure, before starting to take it, it is necessary to carefully evaluate the possible threat of these undesirable manifestations against certain associated diseases, especially during sexual activity. Increased susceptibility to the vasodilating action is observed in patients with GOKMP, aortic stenosis or with a rare syndrome of multiple systemic atrophy, accompanied by a severe violation of the autonomous regulation of blood pressure. Since alpha-blockers are vasodilators, their combination with PDE-5 inhibitors exacerbates the threat of an excessive decrease in blood pressure. Patients receiving alpha-adrenergic blockers should take Vizarsin Q-tab with caution, because with an individual predisposition this can cause symptomatic arterial hypotension, usually observed within 4 hours after taking sildenafil. To minimize the likelihood of developing this complication, it is necessary to start taking Vizarsin Q-tab during treatment with alpha-blockers only after stabilization of hemodynamic parameters is achieved. Also in this case, it is recommended to reduce the initial dose of sildenafil to 25 mg. Patients already receiving sildenafil when prescribing therapy with alpha-blockers, the use of the latter, it is advisable to start with a low dose. A subsequent decrease in blood pressure in this combination may be caused by a gradual increase in the dose of alpha-blockers. The patient should be informed about how he should act in case of signs of orthostatic hypotension. During treatment with all PDE-5 inhibitors (including Sildenafil), there were rare reports of the occurrence of non-arteritic AION, occurring with deterioration or loss of vision. The development of this pathology was noted in patients, most of whom had such risk factors as hyperlipidemia, diabetes mellitus, age over 50 years, deepening (excavation) of the optic nerve head, coronary heart disease (CHD), arterial hypertension. The causal relationship between the development of this complication and the use of PDE-5 inhibitors could not be determined. In case of sudden loss of vision, you should stop taking Vizarsin Q-tab and immediately consult with a specialist. During therapy with PDE-5 inhibitors, including sildenafil, cases of loss or sudden hearing loss were recorded, mainly in patients who had risk factors for developing these adverse reactions. It is impossible to determine whether the loss or sudden impairment of hearing is related to the intake of sildenafil. With the development of these disorders it is required to refuse to take Vizarsin Q-tab and immediately seek medical help.

Interaction

Possible effects of other drugs / agents on the pharmacokinetic parameters of sildenafil:
    cytochrome P450 isoenzymes (according to in vitro studies): a decrease in clearance may be observed;
    CYP3A4 isoenzyme inhibitors (including cimetidine, erythromycin, ketoconazole): a reduction in drug clearance is noted, but the frequency of adverse reactions does not increase (sildenafil should be started with a dose of 25 mg);
    ritonavir (a powerful inhibitor of cytochrome P450), HIV protease inhibitor (2 times / day at a dose of 500 mg): AUC and Cmax in the blood plasma increases 11 and 4 times, respectively, after 24 hours, the level of sildenafil in plasma is about 200 ng / ml (when taking one sildenafil - 5 ng / ml; the combination is contraindicated);
    Saquinavir (CYP3A4 isoenzyme inhibitor), HIV protease inhibitor (3 times / day at a dose of 1200 mg): Sildenafil AUC and Cmax (100 times per day at a dose of 100 mg) are increased by 210 and 140%, respectively;
    Itraconazole and ketoconazole (potent inhibitors of the CYP3A4 isoenzyme): a pronounced effect on the pharmacokinetics of the drug is possible;
    Erythromycin (5 days, 2 times / day at a dose of 500 mg): AUC increases by 182%; azithromycin (3 days, 500 mg per day): AUC, Tmax, Cmax, T½ of sildenafil or its main metabolite remain unchanged;
    cimetidine (800 mg): the plasma concentration of sildenafil (50 mg) is increased by 56%;
    aluminum / magnesium hydroxide: once taken, the bioavailability of Vizarsin Q-tab does not change;
    Nicorandil (a hybrid of nitrate and activator of potassium channels): there is a possibility of a serious interaction of these funds;
    thiazides and diuretics (ACE), beta-blockers: changes in the pharmacokinetic parameters of the tool have not been identified;
    grapefruit juice: a slight increase in the level of the active substance in the blood plasma is possible.
Possible effects of Vizarsin Q-tab on the pharmacokinetics of other drugs / agents:
    cytochrome P450 isoenzymes 2C9, 1A2, 2C19, 2E1, 2D6, and 3A4 [concentration of semi-maximal inhibition (IC50) ≥150 µmol]: according to in vitro studies, the effect of the drug on the substrates of these isoenzymes is unlikely;
    doxazosin (alpha adrenergic blocking agent) in doses of 4/8 mg: in patients with benign prostatic hyperplasia and stable hemodynamics achieved with the use of doxazosin, rare cases of symptomatic orthostatic hypotension occur, manifested by dizziness, but without fainting;
    warfarin (40 mg), tolbutamide (250 mg): no interaction with sildenafil (50 mg) was detected;
    acetylsalicylic acid (150 mg): additional lengthening of bleeding time when combined with Vizarsin Q-tab (50 mg) is not installed;
    ethanol: when combined with sildenafil (50 mg) in healthy volunteers, the hypotensive effect of ethanol does not increase (Cmax of ethanol in the blood serum is about 80 mg / dL);
    alpha adrenergic blockers, slow calcium channel blockers, adrenergic neuron blockers, centrally acting drugs, vasodilators, angiotensin II receptor antagonists, ACE inhibitors, beta adrenoblockers, diuretics and other antihypertensive drugs: differences in side effects given combinations of effects from patients treated with placenta not noted;
    amlodipine: against the background of arterial hypertension, an additional reduction in blood pressure was established, which is comparable to that when using only sildenafil;
    saquinavir and ritonavir (HIV protease inhibitors): no changes in the pharmacokinetic parameters of these agents were noted.

Overdose

With a single dose of Vizarsin Q-tab in doses of less than 800 mg, the side effects were similar to those with the use of sildenafil in lower doses, but the frequency and severity of these disorders increased. The use of the drug at a dose of 200 mg did not lead to an increase in its action, however, it caused an increase in the frequency of undesirable reactions, such as nasal congestion, dyspepsia, headache, dizziness, flushing, and disorders of the organ of vision. In case of overdose, symptomatic treatment is carried out. Hemodialysis is ineffective because sildenafil has a strong bond with plasma proteins and is not excreted by the kidneys.
Shelf life - 2 years.

Storage conditions

Store in the original packaging out of the reach of children, at a temperature not exceeding 25 ° C.

Terms of sell

You can buy Vizarsin Q-tab without a prescription.