Sildenafil 50mg Babiophar medicine for erectile dysfunction (4 tablets)

Dosage form Box of 1 blister x 4 tablets
Specifications Sildenafil

Ingredient

Composition information	Content
Sildenafil	50mg

Uses

Indications

Sildenafil 50mg drug is indicated in the following cases:

Treatment of erectile dysfunction, which is the inability to achieve or maintain an erection enough to satisfy sexual activity. Sildenafil only works when there is an accompanying sexual stimulation. Sildenafil has the effect of selecting CGMP (Cyclic guanosin monophosphate) - Phosphodiesteras specific tube 5 (PDE5).

Mechanism of action

The penis physiological mechanism leads to the release of nitric oxid (NO) in the cave during the sexual stimulation process.

Then NO activated Ganylat Cyclas, which increases the concentration of CGMP (Cyclic guanosin monophosphate) thereby reducing the cave's blood vessel smooth muscle relaxation and allowing 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 stimulating sex, creating the release of Sildenafil's PDE5 inhibitors will increase the amount of CGMP in the cave, resulting in smooth muscle relaxation and increasing blood flow to the cave.

In the recommended dose, Sildenafil only works when there is an accompanying sexual stimulation.

In vitro studies show that Sildenafil selectively inhibits PDE5. The effect of Sildenafil selected on PDE5 is stronger than the other known phosphorus phosphorus (> 10 times 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 enzyme associated with heart contraction.

pharmacokinetic

absorption

Sildenafil is quickly absorbed by oral, about 40%. Achieve peak in plasma in about 30 to 120 minutes. The absorption speed decreases when Sildenafil is used with food.

Distribution

Sildenafil is widely distributed to tissues with about 96% attached to plasma proteins.

Metabolism

Sildenafil is metabolized in the liver mainly by Cytocrom P450 Isoenzym CYP3A4 (main road) and CYP2C9. Main metabolites N - Desmethylsildenafil (UK -103320) also have a part of activity. Sildenafil and N - Desmethyl's sale time is about 4 hours.

Elimination

Sildenafil is discharged from the body in the form of metabolites. Mainly through feces and partially through the urine. The elimination capacity of the drug may be limited in the elderly, people with liver disease or severe kidney failure.

Before taking Sildenafil 50mg Babiophar medicine for erectile dysfunction (4 tablets)

How to use

Sildenafil film tablets are used by oral.

Dosage

for adults

Most patients are recommended to take the dose of 50mg, oral before sex about 1 hour.

Based on the tolerance and the effect of the dose drug can increase to a maximum of 100mg or decrease to 25mg. The maximum dose is 100mg, the maximum number of use is 1 time daily.

For patients with renal failure

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

Cases of severe renal failure (Creatinine clearance

For patients with liver failure

The dose to be used is 25mg because of Sildenafil's clearance is reduced in these patients (for example, liver disease).

For patients who are taking other drugs

Patients who are taking Ritonavir do not exceed 1 single dose of 25mg of Sildenafil within 48 hours (see more interaction with other drugs and other types of interactions).

Patients who are taking drugs inhibit CYP 3A4 (for example, erythromycin, saquinavir, ketoconazole, itroconazol), the starting dose should be 25mg (see more interactive parts with other drugs and other types of interactions).

For children

Not for children under 18 years old.

For the elderly

No need to adjust the dose.

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 using overdose?

In case of overdose, requires standard support measures.

Kidney fertilizer does not increase the clearance because Sildenafil is 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

When using Sildenafil 50mg, you may experience unwanted effects (ADR).

In general, unwanted effects are just transient, light or medium.

The most commonly notified effects are headaches and flushing.

Some other side effects:

Immune system disorders: reaction through hypersensitivity (including skin rash).

Cardiovascular disorders: Serious cardiovascular disorders include myocardial infarction, angina syndrome, heart mutation, ventricular arrhythmia, cerebral vascular accident, transient anemia, hypertension, hypotension, fainting, fast vessels, chest drums and nosebleeds.

Gastrointestinal disorders: vomiting.

Eye disorders: eye pain, red eye or eye with bleeding.

Reproductive disorders: A long penis erection or penis pain.

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

Sildenafil 50mg contraindications in the following cases:

Patients with hypotension, unstable angina, myocardial infarction, new stroke, genetic retinal degeneration disorders.

Do not use Sildenafil for patients allergic to any ingredients of the drug.

Sildenafil increases the hypotension effect of acute and chronic nitrates. So contraindicated use of Sildenafil for patients who are using nitric oxid suppliers, organic nitrates (see more interaction with other drugs and other types of interactions).

Precautions when using

must exploit the history and clinical examination meticulously to diagnose erectile dysfunction, to identify the potential causes and determine the appropriate treatment.

Because there may be some cardiovascular risks associated with sexual activity may occur, the physician must pay attention to the patient's cardiovascular condition before the treatment of erectile dysfunction.

Through some clinical trials, Sildenafil has a systemic vasodilation property that causes transient hypotension. 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) or suffer from system of multiplomy atrophy are patients with hyperactive hyperplasia, manifested by a serious decline in the ability to control blood pressure automatically, those who need to be very considerate when treated.

Be careful when prescribing erectile dysfunction agents for patients with deformations of penis anatomy (such as an angle folding penis, cave fibrosis, or Peyroni disease), patients with pathological diseases that cause penis pain (such as sickle cell anemia, multiple myeloma, leukemia).

Also careful when prescribing erectile dysfunction agents for patients with diseases that are not suitable for sexual activity (for example, patients with severe cardiovascular disorders such as unstable angina, severe heart failure).

Safety and effectiveness of Sildenafil coordination with other erectile dysfunction drugs are not studied, so do not coordinate the treatment of these drugs.

In vitro studies on human platelets show that Sildenafil has an influence on platelet condenser resistance of sodium nitroprussid (nitric oxid). There is currently no safety information about the use of Sildenafil in patients with acute blood clotting or digestive ulcers, so be cautious in these patients. A few patients with hammock inflammation wear pigments with phosphodiesteras gene disorders in the retina, need to be cautious when treating Sildenafil in these patients because there is no safety evidence.

The ability to drive and operate machines

There is no recommendation of the influence of the drug on driving and operating machinery.

Pregnancy

Do not take medicine for women.

Research on mice and rabbits after using oral Sildenafil, not seeing evidence of monster birth, reducing fertility, or adverse effects for embryo and fetal development.

There are no complete and appropriate studies on pregnant women.

Breastfeeding period

There are no adequate and appropriate studies on breastfeeding women.

Medicinal interaction

sympathetic alpha blockers: recommended not to be used with sympathetic alpha blockers that can cause hypotension.

Nitrate: Do not use with nitrate (such as nitroglycerin chest pain) due to causing hypotension when used together.

Antibiotics: drugs such as cimetidin, delavirdin, erythromycin, iTraconazole and ketoconazole due to Cytochrom P450 ISOenzyme CYP3A4 inhibitors can reduce Sildenafil elimination from the body.

Protease inhibitors: Do not use with protease inhibitors such as protease inhibitors used in HIV treatment. Must consult your doctor before use.

Rifampicin: CYP3A4 induction drugs like rifampicin may increase the concentration of drugs in plasma.

Bosentan: The drug contains Bosentan reduces the dispersion of Sildenafil leading to a reduction in the effect of the drug.

Anti -viral drugs: Saquinavir or Ritonavir inhibits intermediate metabolism by cytochrom P450 ISOENZYM CYP3 A4, resulting in an increase in the effect of the drug.

Not used with other erection drugs.

Storage

in a dry place, avoiding light. Temperature below 30 ° C.

Other drugs

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