ADAGRIN 50mg 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	50mg

Uses

indications

ADAGRIN drugs are indicated in the following cases:

Treatment erectile dysfunction .

Pharmacological

The physiological mechanism of erection is associated with the release of nitrogen oxyd (NO) in the cave when there is sexual stimulation. 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 impact of nitrogen oxyd by inhibiting phosphodiesterase type 5 (PDE5), an enzyme that plays the role of a GMP divestment in the cave form.

When sexual stimulation releases saturated on the spot, the inhibition of Sildenafil on PDE5 causes an increase in GMP levels in the cave, leading to blood vessel and bloody dilatation that causes erections, in suggested dose, Sildenafil will not work without sexual stimulation.

Pharmacokinetics

absorption

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.

Distribution

Sildenafil's stable distribution (VSS) is 105 liters, distributed into tissues. Both Sildenafil and its main metabolites are N-Desmethyl 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 semen, healthy volunteers at about 90 minutes after taking the drug, less than 0.001 % of the dose may appear in the patient's epidemic.

Metabolism

Sildenafil is largely metabolized through micro -isoenzyme in the CYP3A4 liver (the main road) and CYP2C9 (secondary road).

Elimination

After oral, Sildenafil excreted mostly in the form of stool exchange (nearly 80% of oral doses) and a less amount was eliminated through urine (accounting for about 13% of oral doses).

Before taking ADAGRIN 50mg Treatment of erectile dysfunction (1 blister x 3 tablets)

How to use

oral medication.

In order for the drug to be effective, there is a sex stimulation, drinking about 1 hour before sexual activity and not more than 1 time a day.

Dosage

Adults: The commonly used dose is 50 mg. Based on the effect and tolerance, 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 renal failure (clearing creatinine less than 30 ml/minute), liver failure: The starting dose is 25 mg. Then, based on the effect and tolerance may increase to 50 mg and 100mg.

Mild kidney failure (clearly 30 - 80 ml/minute creatinine): use the dose like a large person.

People who are taking other drugs: The starting dose shall not exceed 25 mg/day if taking the cytochrom P450 3A4 enzyme inhibitors (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 do

do when using 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 you forget 1 dose?

If you forget to take a dose, drink as soon as possible when remembering. However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

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

Common, ADR> 1/100

Central nerve: headache, dizziness, insomnia, anxiety, dizziness, fever;

cardiovascular: flushed face; digestion: indigestion, diarrhea, vomiting;

eyes: visual disorders like blurred vision, fear of light, blue look, eye stimulation, pain and red eyes;

Respiratory: nosebleeds, stuffy nose.

Rare, ADR

TKTW: Memory loss, depression, migraine, nerve pain, epilepsy, shock, fainting, brain thrombosis, cerebral vascular bleeding, bleeding in the brain, hemorrhage subarachia;

Cardiovascular: angina, atrial - ventricular obstruction, cardiac arrest, myocardial disease, heart failure, hypertension, reducing blood pressure, myocardial ischemia, myocardial infarction, hitting chest drum, posture hypotension, tachycardia, ventricular arrhythmia;

Respiratory: Hen, pulmonary hemorrhage;

digestive: colitis, difficulty swallowing, rectal hemorrhage, stomatitis. Allergic immunity: hypersensitivity reaction, allergic reaction; skin: edema, peeling dermatitis; genital - urinary: cystitis, urinary blood, penis pain, bedwetting;

Endocrine - Metabolism: increased/decreased blood glucose, hyperemia, hyperuricemia;

Neurological - muscle and bone: gout, myasthenia gravis, tendon rupture. Hematology: Anemia, leukemia, sickle cell attacks;

Eye: cataracts, eye bleeding, glaucoma, pupils, optic neuropathy due to ischemic anemia without artery, vascular disease or retinal hemorrhage, loss of field, peeling/stretching of glass body; ears: hearing loss, hearing loss.

ADR has indefinite frequency

Digestive: gastritis;

skin: ban, erythema, hair loss;

Genital - Urology: Urinary tract infections, big breasts;

Neurological - muscle and bones: muscle pain, abnormalities, limbs, back pain;

Respiratory: Difficulty breathing, cough, rhinitis, sinusitis, bronchitis;

Other: Cellitis;

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.

Contraindications:

Contraindications in the following cases:

Too hypersensitivity to any ingredients.

suffer from angina or heart disease 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.

Be cautious when using

Caution should be cautious in patients with severe liver or kidney failure, reducing the dose of Sildenafil may be necessary.

Care is also necessary in patients with anatomical deformation of penis or hematological disorders that affect erections.

In case of long erection (more than 4 hours), patients should seek medical assistance, penis tissue damage and permanent loss may occur.

Patients should also stop using Sildenafil and seek medical advice in case of sudden vision or hearing loss.

Sildenafil should not be used for people who have an eye-loss-loss due to the non-vascular retinal anemia (Naion), regardless of whether it is related to the previous phosphodiesterase type-5 inhibitor.

Patients with dizziness or visual disorders should not drive or operate dangerous machines.

Sildenafil should not be used in patients with severe hepatic impairment, bleeding disorders, progressive stomach ulcers, hypotension, hypertension, a history of myocardial bleeding, recent mutant or life -threatening arrhythmia, unstable angina, heart failure, or retinal disorders such as pigmentitis (only some of them have genetic disorders of glazed glazed rhymes).

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

Not for pregnant women.

Breastfeeding period

Not used for women for nursing women.

Drug interaction

Sildenafil and other phosphodiesterase type-5 inhibitors may increase the hypotension of organic nitrates, and thus contraindicated in patients using this drug.

Sildenafil may also increase the effect of lowering Nicorandil's hypotension, thus avoiding these two drugs.

Symptoms of hypotension can also occur when phosphodiesterase type-5 inhibitors are used with alpha blockers. Patients should be treated stably with alpha blockers before taking phosphodiesterase type-5 inhibitors started at low doses and adjusted to the patient's response.

Cytochrome P450 CYP3A4 inhibitors, such as Cimetidine, Delavirdine, Erythromycin, Itraconazole and Ketoconazole may reduce the clearance of phosphodiesterase type-5 inhibitors, so the dose should be reduced.

The concentration of phosphodiesterase type-5 inhibitors is significantly increased by HIV-Protease inhibitors, especially ritonavir. These combinations should not be used unless they are needed.

Avoid using grapefruit juice with sildenafil or phosphodiesterase type-5 inhibitors as it can increase the concentration of these substances in plasma.

CYP3A4 induction substance, like rifampicin, is capable of reducing plasma concentrations of phosphodiesterase type-5 inhibitors.

Bosentan reduces Sildenafil decomposition.

Storage

Keep a cool dry place (

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