12 August

Viagra - instructions for use , indications, dosage

Viagra - a means for the treatment of erectile dysfunction.

release form and composition

tablets in blue film coated, biconvex diamond shape with cut rounded edges and Pfizer engraved on one side (in carton packs with the control of the first opening: 1 or 2 blisters of 1 or 2 tablets or 1 .;3 blisters of 4 tablets .; blister 1 - Table 12)..

The main active substance of Viagra - sildenafil (in the form of citrate), its content corresponds to the engraving on the second side of the tablets and tablets with the inscription:

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

Excipients: microcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate.

The film coating composition comprises: hypromellose, lactose, triacetin, titanium dioxide (E171), aluminum lake of indigo-based (E132), vanillin, biotin.

Indications

therapy of erectile dysfunction, which is characterized by the inability to achieve or retain an erection of the penis, you need to compl

ete the act of copulation.

Contraindications

  • Combined treatment with other drugs intended for the treatment of erectile dysfunction;
  • regularly or occasionally receive donor of nitric oxide, organic nitrites or nitrates in any form as sildenafil enhances the hypotensive effect of nitrates;
  • female sex;
  • the age of 18;
  • Hypersensitivity to sildenafil or excipients of the drug.

With care prescribe Viagra to patients in the presence of the following pathologies:

  • anatomical deformation of the penis, including angulation, cavernous fibrosis or Peyronie's disease;
  • Sickle-cell anemia, multiple myeloma, anemia, leukemia, and other diseases that can cause the development of priapism;
  • diseases, accompanied by bleeding, including in the case of aggravation of gastric ulcer and duodenal ulcer;
  • Hereditary retinitis pigmentosa.

recommended for use under medical supervision means within the first 6 months after myocardial infarction or stroke, as well as in patients with heart disease, as heart failure, severe arrhythmia, hypertension and / or hypotension, unstable angina.

Dosage and Administration

tablets are taken orally one hour before sexual intercourse.

initial dose of Viagra is 50 mg.Depending on individual tolerance and efficacy allowed its adjustment to increase or decrease.

The maximum daily dose should not exceed 100 mg, and the frequency of administration 1 times.

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

For elderly patients dose adjustment is required.

If necessary, simultaneous treatment of other drugs, Viagra should be taken 25 mg: with ritonavir - not more than 1 time in 48 hours;erythromycin, ketoconazole, saquinavir, itraconazole - 1 time per day.

Patients receiving α-blockers, to minimize the risk of postural hypotension, the drug should be started only after the hemodynamic stabilization.It should also consider reducing the starting dose of sildenafil

Side effects

degree of side effects depends on the individual tolerability of sildenafil, undesirable effects are transient in nature:

  • the part of the central nervous system: most frequently - headache;often - dizziness;in some cases - seizures;
  • Since the cardiovascular system: the most common - flushing;often - increased heart rate;in some cases - tachycardia, decreased blood pressure, nosebleeds, fainting;
  • From a sight organ: often - a violation sensitivity, blurred vision, transient hromatopsiya;in some cases - eye pain, tearing, redness of the eye;
  • From the digestive system: often - indigestion, sometimes - vomiting;
  • part of the respiratory system: often - rhinitis;
  • part of the reproductive system: prolonged erection, priapism;
  • Allergic reactions: skin rash, cough, runny nose.

Exceeding the recommended dosage is similar side effects, but much more often.

Cautions

Viagra appointed by the attending physician on the basis of a complete medical history and physical examination to determine the causes of erectile dysfunction.

Sexual activity carries risks for men with heart disease, so treatments to restore erection should take into account the recommendations of a cardiologist.

Taking medication for hypotension should be borne in mind that Viagra has systemic vasodilatory effects, which leads to a transient decrease in blood pressure.For most patients, it is not clinically significant and does not lead to serious consequences.Nevertheless, it is important that the physician to carefully assess the possible risk of adverse events vasodilating action of the drug for each individual man, especially against sexual activity.Increased susceptibility to vasodilators exposed to patients with obstruction of the left ventricular outflow tract (obstructive hypertrophic cardiomyopathy, aortic stenosis), multiple system atrophy syndrome.

the appointment of Viagra, the physician should warn the patient of a significant risk of developing nearteriitnoy anterior ischemic optic neuropathy, if this state of a man already mentioned.

Precautions recommended to use Viagra in patients with anatomical deformation of the penis.

combined use of sildenafil and alpha-blockers may lead to symptomatic hypotension.Patients receiving alpha-blockers, Viagra is recommended to start the application only after hemodynamic stabilization, using the minimum dose.The physician should inform the patient about what action should be taken, in the case of the onset of symptoms of postural hypotension.

In case of decrease or loss of hearing loss during therapy, discontinue the drug and consult a doctor.

Since the safety and efficacy of Viagra in conjunction with other agents for the treatment of erectile dysfunction has not been studied, it is not recommended to use such a combination.

Viagra should not be used in patients for whom sexual activity is undesirable.

At the beginning of treatment or when dosage adjustment is necessary to be attentive to the well-being and to use caution when driving.

Drug Interactions

In the case of simultaneous use of Viagra with other drugs should take into account their possible interaction.

Sildenafil metabolism occurs in the liver, so sildenafil clearance is directly dependent on drugs affecting isozymes CYP3A4 and CYP2C9.

Simultaneous administration of ketoconazole, cimetidine, erythromycin and other CYP3A4 inhibitors, reduced the clearance of sildenafil.

Viagra was well tolerated with strong CYP3A4 inhibitors, provided that reception is performed at the recommended doses.

on the pharmacokinetics of sildenafil does not affect: tolbutamide, warfarin, and other inhibitors of CYP2C9 isoenzymes;ACE inhibitors;tricyclic antidepressants;selective serotonin reuptake inhibitor;thiazides and thiazide diuretics;calcium channel blockers;azithromycin;combination antacid.

Sildenafil 50 mg causes an additional increase of bleeding time when taking aspirin at a dose of 150 mg.

Do not take Viagra along with nitrates or nitric oxide donators, as sildenafil enhances their hypotensive effect.

Concomitant use with antihypertensive drugs Viagra does not cause side effects.

The recommended dose (50 mg), sildenafil does not increase the hypotensive effect of ethanol.

Terms and conditions of storage

Store in a dry place at a temperature no higher than 30 ° C.Keep away from children.

Shelf life - 5 years.

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