Method of administration and dosage of sildenafil

   About Viagra

Uses sildenafil: Inside, you can take it with or without water. When taking the drug, you should put a tablet dispersed in the oral cavity on the tongue, after which it will quickly dissolve and it can be swallowed. The tablet should be taken immediately after opening the blister. Patients who are recommended a dose of sildenafil 100 mg, the second tablet of sildenafil 50 mg should be taken after the first tablet is completely dissolved.

The recommended dose for most adult patients is 50 mg approximately 1 hour before sexual activity. Taking into account the effectiveness and tolerability, the dose can be increased to 100 mg or reduced to 25 mg (only film-coated tablets of the appropriate dosage should be taken). The maximum recommended dose is 100 mg. Patients who are recommended a dose of sildenafil 100 mg should take 2 tablets dispersed in the oral cavity, a dosage of 50 mg sequentially one after the other. The maximum recommended frequency of use is 1 time per day. It should be borne in mind that the absorption of viagra is significantly slowed down when it is used in combination with fatty foods.

Uses sildenafil: Special groups of patients

Impaired renal function. In mild to moderate renal insufficiency, dose adjustment is not required, in severe renal insufficiency (creatinine Cl <30 ml / min), the dose of sildenafil should be reduced to 25 mg.

Liver function disorders. Since the elimination of sildenafil is impaired in patients with liver damage (in particular, with cirrhosis), the dose of Viagra should be reduced to 25 mg.

Joint use with other drugs. Joint use with ritonavir is not recommended. In any case, the maximum dose of Viagra should not exceed 25 mg under any circumstances, and the frequency of use is 1 time in 48 hours.

When used in combination with inhibitors of the CYP3A4 isoenzyme (erythromycin, saquinavir, ketoconazole, itraconazole), the initial dose of Viagra should be 25 mg.

To minimize the risk of postural hypotension in patients taking alpha-blockers, Viagra should be started only after the hemodynamic stabilization in these patients has been achieved. The feasibility of reducing the initial dose of sildenafil should also be considered.

Old age. Adjustment of the dose of Viagra is not required.

Special instructions

To diagnose erectile dysfunction, determine their possible causes and choose an adequate treatment, it is necessary to collect a complete medical history and conduct a thorough physical examination. The treatment of erectile dysfunction should be used with caution in patients with anatomical deformity of the penis (angulation, cavernous fibrosis, Peyronie’s disease) or risk factors for the development of priapism (SKA, multiple myeloma, leukemia).

During post-marketing studies, cases of long-term erection and priapism have been reported. If an erection persists for more than 4 hours, you should immediately seek medical help. If priapism therapy was not carried out immediately, it can lead to damage to the tissues of the penis and irreversible loss of potency.

Drugs intended for the treatment of erectile dysfunction should not be prescribed to men for whom sexual activity is undesirable.

The method of uses sildenafil

Sexual activity poses a certain risk in the presence of heart diseases, therefore, before starting any therapy for erectile dysfunction, the doctor should refer the patient to a CCC examination. Sexual activity is undesirable in patients with heart failure, unstable angina, myocardial infarction or stroke suffered in the last 6 months, life-threatening arrhythmias, hypertension (blood pressure >170/100 mm Hg) or hypotension (blood pressure <90/50 mm Hg). Uses sildenafil in such patients is contraindicated. Clinical studies have shown no differences in the frequency of myocardial infarction (1.1 per 100 people per year) or the frequency of mortality from cardiovascular diseases (0.3 per 100 people per year) in patients receiving Viagra compared with patients receiving placebo.

Uses sildenafil: Cardiovascular complications

During the post-marketing use of sildenafil for the treatment of erectile dysfunction, adverse events such as severe cardiovascular complications (including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, hemorrhagic stroke, transient ischemic attack, hypertension and hypotension) were reported, which had a temporary connection with the use of sildenafil. Most of these patients, but not all of them, had risk factors for cardiovascular complications. Many of these adverse events were observed shortly after sexual activity, and some of them were observed after taking sildenafil without subsequent sexual activity. It is not possible to establish the existence of a direct link between the observed adverse events and these or other factors.

Hypotension

Sildenafil has a systemic vasodilating effect, leading to a transient decrease in blood pressure, which is not a clinically significant phenomenon and does not lead to any consequences in most patients. Nevertheless, before prescribing Viagra, the doctor should carefully assess the risk of possible undesirable manifestations of vasodilating action in patients with relevant diseases, especially against the background of sexual activity. Increased susceptibility to vasodilators is observed in patients with obstruction of the output tract of the left ventricle (aortic stenosis, GOCMP), as well as with a rare syndrome of multiple systemic atrophy, manifested by a severe violation of the regulation of blood pressure from the autonomic nervous system.

Since the combined use of sildenafil and alpha-blockers can lead to symptomatic hypotension in some sensitive patients, Viagra should be prescribed with caution to patients taking alpha-blockers . To minimize the risk of developing postural hypotension in patients taking alpha-blockers, Viagra should be started only after the stabilization of hemodynamic parameters in these patients has been achieved. The feasibility of reducing the initial dose of Viagra should also be considered. The doctor should inform patients about what actions should be taken in case of symptoms of postural hypotension.

Uses sildenafil: Hearing disorders

Some post-marketing and clinical studies have reported cases of sudden hearing impairment or loss associated with the use of all PDE-5 inhibitors, including sildenafil. Most of these patients had risk factors for sudden deterioration or hearing loss. There is no causal relationship between the use of PDE-5 inhibitors and sudden hearing impairment or hearing loss. In case of sudden hearing impairment or hearing loss while taking sildenafil, you should immediately consult a doctor.

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