ADAGRIN 100MG Treatment of erectile dysfunction (1 blister x 3 tablets)

Dosage form Box of 1 blister x 3 tablets
Specifications Sildenafil
Ingredient Impotence, erectile dysfunction, physiological weakness, premature ejaculation

Ingredient

Composition information	Content
Sildenafil	100mg

Uses

Indications

ADAGRIN 100mg drug is indicated in the following cases:

Treatment of erectile dysfunction.

Improve sex life, improve the quality of life. NO then activated the enzyme Ganylat Cyclase, increasing the concentration of guanosin monophosphate (GMP ring), resulting in a cave smooth muscle relaxation, causing blood to flood into the cave.

Sildenafil does not have an independent effect on direct muscle relaxation in the cave in humans, but increases the effects of nitrogen oxyd by inhibiting phosphodiesterase enzymes type 5 (PDE5), an enzyme that plays a racing GMP in the cave form. When the sexual stimulation releases saturated on the spot, the inhibition of Sildenafil on PDE5 causes an increase in GMP levels in the cave, resulting in blood vessel and blood dilation into the cave, causing erections.

In the recommended dose, Sildenafil will not work without sexual stimulation. Sildenafil has a selective and effective inhibition on PDE5. The impact of Sildenafil on PDE5 is much stronger than the known phosphodiesterase (80 times over 80 times compared to PDE1, over 1000 times compared to PDE2, PDE3 and PDE4).

Sildenafil's selective effect on PDE5 is about 4,000 times stronger than the impact on PDE3, this is very important because PDE3 is associated with the control of heart contractions.

The impact of Sildenafil on PDE5 is only 10 times stronger than the impact on PDE6 - an enzyme in the retina, the less selected nature on PDE6 is thought to be the basis of abnormalities related to the visual sensation recorded when tested at high doses or when the Sildenafil concentration in plasma is higher.

pharmacokinetic pharmacokinetics

absorption and distribution

Sildenafil was quickly absorbed immediately after oral, absolutely biological comfort at about 40%. The peak concentration of serum is reached from 30 -120 minutes (an average of 60 minutes), after taking the drug when hungry.

Using drugs when foods rich in fat, the absorption level of the drug is reduced with an average delay in TMAX by 60 minutes and the average decrease in CMAX is 29%. The stable distribution volume (VSS) of Sildenafil is 105 liters, distributed to tissues.

both Sildenafil and its main metabolites are N-Desmethyl are associated with serum protein approximately 96%. The cohesion with protein does not depend on the total concentration of the drug. On the basis of estimating Sildenafil in the semen of healthy volunteers at about 90 minutes after taking the drug, less than 0.001% of the dose may appear in the patient's semen.

Metabolism and elimination

Sildenafil is largely metabolized through micro -isoenzyme in CYP3A4 liver (main road) and CYP2C9 (secondary path). Inhibiting these isenzymes can limit the level of Sildenafil clearance.

The data obtained from patients in clinical trials has shown that it can reduce Sildenafil's clearance when using drugs with CYP3A4 inhibitors (such as ketoconazol, erythromycin, cimetidine).

It is possible to hope that the use of CYP3A4 catalysts like Rifampicin will reduce Sildenafil concentration in serum. Dynamic data from clinical studies shows that CYP2C9 inhibitors do not affect the pharmacokinetics of Sildenafil (such as Tolbutamid, Warfarin).

After drinking, Sildenafil is eliminated mostly in the form of metabolism (nearly 80% of oral doses) and a less amount is eliminated through urine (about 13% of oral doses). Similar figures are collected from ordinary people volunteering to experiment as well as from patients by exploration research.

Before taking ADAGRIN 100MG Treatment of erectile dysfunction (1 blister x 3 tablets)

How to use

In order for the drug to have the effectiveness, it is necessary to have sex stimulation, take about 1 hour before sexual activity and do not use more than once a day.

Dosage

Adults

The commonly used dose is 50 mg. Based on the effect and the use of loading, the dose may increase to 100 mg or decrease to 25 mg. The maximum dose is 100 mg daily.

People over 65 years old, medium and severe kidney failure (clearing creatinine less than 30 ml/minute), people with liver failure

The starting dose is 25 mg. Then, based on the effect and tolerance can increase to 50 mg and 100 mg.

Mild kidney failure (Tearing Creatinin 30 - 80 ml/minute)

Dosage like normal adults.

The person who is taking other drugs, the starting dose must not exceed 25 mg/day if the enzyme inhibitor is taking Cytochrom P450 3A4 (Ketoconazole, Itraconazole, Erythromycin, Saquinavir); Do not use more than 25 mg Sildenafil for about 48 hours when used with ritonavir; The starting dose of 25 mg should be considered when used with Alpha blockers. Do not use higher doses within 4 hours of alpha blockers due to the risk of hypotension.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

In case of overdose, flexibly applies to standard supportive treatments. Bloody decentralization cannot be tied to Sildenafil strongly connected to plasma proteins and not eliminated by urinary tract.

What to do when forgetting 1 dose?

Not recorded.

Side Effects

When using adagrin, you may experience unwanted effects (ADR).

The most common: headache, flushing, stomach pain, mild and temporary visual changes (changing the awareness of color, changing awareness of light, unknown vision), indigestion, nasal congestion, diarrhea.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

ADAGRIN drug contraindicated in the following cases:

Hypersensitivity to any ingredients of the drug.

suffer from angina or heart diseases being treated with organic nitrate, cardiovascular problems that affect physiological activity, heart attack or stroke within six months.

Severe liver failure, too high blood pressure or too low. Eye disease such as retinal pigments.

Contraindications for babies, children and women.

Precautions when using

need to consider the patient's cardiovascular condition before conducting treatment. The use of Sildenafil does not protect patients from sexually transmitted diseases.

Be cautious in patients with anatomical deformed genitalia (angular, fibrosis or Peyronie disease), patients with diseases can lead to an erection (sickle cell disease, bone marrow tumor, leukemia).

In some rare cases, patients taking PDE5 inhibitors (drugs to treat erectile dysfunction for oral oral dysfunction, including sildenafil), lost vision in one or both eyes. Although it is not yet possible to conclude drugs to treat erectile dysfunction PDE5 is the cause of vision loss or other agents such as high blood pressure, diabetes or the combination of all of the above problems, if suddenly reduced or loss of vision, patients have to stop taking the drug and report immediately to the doctor.

The ability to drive and operate machinery

If using drugs to change vision or dizziness, do not drive or operate machinery during the use of the drug.

Pregnancy

Women's contraindications.

Breastfeeding period

Drug interaction

Because Sildenafil metabolizes mainly through CYP3A4, the use of CYP3A4 inhibitors such as cimetidin, erythromycin, ketoconazole, iTraconazole, ritonavir, saquavir will reduce Sildenafil Surgery, which leads to drug increase in blood levels in blood levels in blood concentrations Thanh.

In contrast, Sildenafil concentration in serum decreases when used with CYP3A4 catalysts such as rifampicin, carbamazepine, phenytoin, phenobarbital.

Sildenafil itself is a vasodilators, so when used in combination with other vasodilators will cause severe hypotension.

Storage

Keep a cool dry place (

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