Jikagra 50mg tablet tablet Gia Nguyen treat erectile dysfunction (1 blister x 4 tablets)

Dosage form Box of 1 blister x 4 tablets
Specifications Sildenafil

Ingredient

Composition information	Content
Sildenafil	50mg

Uses

Indications

Sildenafil is used to treat erectile dysfunction, which is the inability to achieve or maintain enough erection to satisfy sexual activity. Sildenafil only works when there is an accompanying sexual stimulation.

Pharmacology

ATC code: G04be03

Pharmacological group: Phosphodiesterase inhibitors 5.

Sildenafil uses Sildenafil's citrate salt, oral to treat erectile dysfunction. Sildenafil has a selective inhibitory effect on Guanosin Monophosphate Round (CGMP- Cyclic Guuan Monophosphate) Phosphodi-Conease specific tube 5 (PDE5).

Mechanism of action:

The penis physiological mechanism leads to the release of nitric oxid (NO) in the cave in the process of sexual stimulation. After that, NO activated the Ganylat Cyclase enzyme, which increases the concentration of CGMP, thereby relaxing the blood vessel smooth muscle of the cave and allows the blood flow to flow.

Sildenafil has no direct relaxation effect on human isolation, but it increases the effect of NO by inhibiting PDE5, this substance has the effect of decomposing CGMP in the cave. When sexual stimulation creates a NO release on the spot, Sildenafil's PDE5 inhibitors will increase the amount of CGMP in the cave, the result of smooth muscle relaxation and increase blood flow to the cave, at the recommended dose, Sildenafil only works when there is sex stimulation.

The effect of Sildenafil selected on PDE5 is stronger than other known phosphodiesterase (10 times higher for PDE6,> 80 times for PDE1,> 700 times for PDE2, PDE3, PDE4 and PDE7-PDE11).

Selective effect on PDE5 is 4,000 times stronger than PDE3, this is very important because PDE3 is an enamel related to heart contractions.

Dynamic pharmacokinetics

Sildenafil pharmacokinetics corresponding to the dose in the recommended dose range.

Sildenafil is metabolized in the liver (mainly through Cytochrom P450 3A4) and its metabolites have the same activity as the mother (Sildenafil).

absorption

Sildenafil is quickly absorbed after drinking, with absolute bioavailability of about 41% (ranging from 25-63%).

Maximum concentrations achieved in plasma from 30-120 minutes (60 minutes on average) when taking the drug when hungry.

Food with high fat content reduces Sildenafil's absorption capacity, with an average time for TMAX's average reduction of 60 minutes and CMAX decreases an average of 29%, on the contrary, the absorption level does not affect significantly (the area below the curve decreases by 11%).

distribution

Sildenafil's average drug distribution volume is 105 l, focusing on tissues.

Sildenafil and the metabolites in its large circulatory round are N-Desmethyl mounted up to 96% to plasma proteins. The attachment to plasma protein does not depend on its total concentration. Sildenafil's concentration in the semen of healthy volunteers after taking 90 minutes is less than 0.0002% of the dose used (average 188ng).

transformation

Sildenafil is metabolized mainly by CYP3A4 (main roads) and CYP2C9 (sub -line) in the liver.

The metabolites in the main metabolic ring of Sildenafil produced from the n-Desmethyl process and is then further metabolized.

These metabolites have a selective activity for PDE similar to Sildenafil and on the Invitro selective for PDE5 approximately 50% of the mother. In healthy people, the plasma concentration of metabolites is approximately 40% of the mother concentration.

N-Desmethyl metabolites are metabolized again, with a half-life of 4 hours.

Elimination

Sildenafil's total clearance is 41 l/h with the last half phase time of 3-5 hours.

After oral or intravenous use, Sildenafil is excreted mainly in the form of metabolites (about 80% of oral dose) and a small part through urine (about 13% of oral dose).

Before taking Jikagra 50mg tablet tablet Gia Nguyen treat erectile dysfunction (1 blister x 4 tablets)

How to use

Jikagra tablets are used by oral.

Dosage

for adults:

Most patients are recommended to take the dose of 50mg when needed, take before sex about 1 hour. The maximum recommended dose is 100 mg, the maximum number of times is 1 time per day.

For patients with renal failure:

Cases of mild or medium renal failure (Creatinine clearance = 30-80 ml/min), do not need to adjust the dose.

The dose should be 25 mg because Sildenafil's clearance is reduced in these patients (for example, cirrhosis). Inhibiting CYP3A4 (e.g. For example, erythromycin, saquinavir, ketoconazole, iTraconazole), the starting dose should be used as 25 mg. In addition, it is advisable to consider using lower sildenafil doses at the beginning of treatment. 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? Kidney fertilizer does not increase clearance because Sildenafil is strongly attached to plasma proteins and is not eliminated through urine.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

The frequency of some complications increases by dose.

Classification by agency system

and

rare
(≥ 1/10000 and
Fainting Eye disorders blurred vision

Certification of blue eye pain
Fear of light

eye -catching

blinding
eye swelling

eye swelling
The yellow color
see the red color

congestion

Itchy eye
The irregular feeling in the eyelid
eyelid edema The hot burning

Blushing hypotension Disorder digestive system Ban Unwanted erection
Increasing erection

Warnings

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

Contraindicated

Jikagra 50mg drug is contraindicated in the following cases:

Patients allergic to any component of the drug. Therefore, contraindicated use of Sildenafil for patients who are using nitric oxidation suppliers, organic nitrates or organic nitrites in any form, whether they are frequent or interrupted. Such as pigmentitis (a small part of these patients with phosphodiesterase genetic disorders).

Be cautious when using

must exploit the history and clinical examination meticulously to diagnose erectile dysfunction, to determine the potential causes and determine the appropriate treatment direction. Treatment of erectile dysfunction in men is recommended not to be sexually active. For most patients, it has very little or no effect. However, before prescribing, physicians must pay attention to patients with pathological conditions that may be affected by this effect and especially when they have more sexual activity. Patients who hinder the left ventricular flow (e.g. aortic stenosis, obstructive hypertrophy of myocardial disease) or syndrome of multiple system atrophy are patients with hyperactive hyperplasia, manifested by severe decline in the ability to control blood pressure automatically, those who need to consider treatment. Aspirin bleeding time (150 mg).

Drug interaction

The effect of other drugs with Sildenafil:

Sildenafil metabolism takes place mainly by cytochrom P450 (CYP) subgroups form 3a4 (main road) and 2C9 (sub -line). Therefore, all agents that inhibit these subgroups can reduce the clearance of Sildenafil and its agents that stimulate these subgroups that can increase Sildenafil's clearance. Sildenafil.

The influence of Sildenafil on other drugs:

Sildenafil is a weak inhibiting agent of Cytocrom P450 subgroups 1A2, 2C9 2C19, 2D6, 2E1 and 3A4 (IC50> 150 μm). This isoenzym. Therefore, contraindicated use of Sildenafil along with substances for nitric oxyd, organic nitrates or organic nitrite in any form, whether regular or interrupted. Sildenafil (50 mg) with Tolbutamid (250mg) or Warfarin (40 mg) (are substances metabolized by CYP2C9).

Storage

In a dry place, temperatures below 30 ° C.

Other drugs

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