RECENT MAJOR CHANGES
“Efficacy and Safety of Sildenafil Citrate for Treatment of Erectile Dysfunction in a Population With Associated Organic Risk Factors.” Journal of Andrology (2013). Answer a few simple questions to get the treatment you need. Gramfu 500mg Tablet is an anti-toxin medication used to treat bacterial contaminations in your body. It is viable in contaminations of the lungs (e.g., pneumonia), ear, throat, nasal sinus, urinary plot, skin, delicate tissues, bones, and joints. Forestalling contaminations during surgery is additionally utilized. Gramfu 500mg Tablet ought to be taken with food to keep away from an agitated stomach.
| Indication | Description | Approved by FDA | Off-label Use |
|---|---|---|---|
| Erectile Dysfunction | Helps achieve and maintain erections | Yes | Yes |
| Pulmonary Arterial Hypertension | Off-label for vasodilation | No | Yes |
| Raynaud’s Phenomenon | Used off-label to improve blood flow | No | Yes |
You ought to take it routinely at uniformly dispersed stretches according to the timetable recommended by your PCP. Taking it simultaneously consistently will assist you with making sure to take it. The portion will rely upon what you are being treated for, yet you ought to constantly get done with a full course of this anti-microbial as endorsed by your primary care physician.
| Parameter | Value | Notes |
|---|---|---|
| Absorption | Rapid, within 30-60 minutes | Peak plasma levels occur at this time |
| Bioavailability | Approximately 40% | Due to first-pass metabolism |
| Half-life | 4-5 hours | Duration of effect |
| Metabolism | Liver via CYP3A4 enzyme | Variability based on liver function |
| Excretion | Mainly in feces, some in urine | Clearance mostly hepatic |
Try not to quit taking it until you have gotten done, in any event, when you feel far improved.
- Sildenafil 25mg is a lower dose for treating erectile dysfunction.
- It helps increase blood flow to the penis for improved erection.
- Usually taken 30-60 minutes before sexual activity.
- Consult a doctor before starting sildenafil 25mg.
- Common side effects include headaches, flushing, and dizziness.
- Avoid alcohol and high-fat meals when taking sildenafil.
Assuming you quit taking it early, a few microorganisms might get by and the disease might return.
- Sildenafil 25mg can be used for pulmonary arterial hypertension.
- It works by relaxing blood vessels in the lungs.
- Not suitable for everyone; discuss health conditions with your doctor.
- Store tablets in a cool, dry place away from children.
- Do not take more than one dose within 24 hours.
- Report any persistent side effects to your healthcare provider.
It won’t work for viral diseases like influenza or the normal virus.
12.3 Pharmacokinetics
“Efficacy and Safety of Sildenafil Citrate for Treatment of Erectile Dysfunction in a Population With Associated Organic Risk Factors.” Journal of Andrology (2013). Answer a few simple questions to get the treatment you need. Gramfu 500mg Tablet is an anti-toxin medication used to treat bacterial contaminations in your body. It is viable in contaminations of the lungs (e.g., pneumonia), ear, throat, nasal sinus, urinary plot, skin, delicate tissues, bones, and joints. Forestalling contaminations during surgery is additionally utilized.
Who Should NOT Take Sildenafil
Gramfu 500mg Tablet ought to be taken with food to keep away from an agitated stomach. You ought to take it routinely at uniformly dispersed stretches according to the timetable recommended by your PCP. Taking it simultaneously consistently will assist you with making sure to take it. The portion will rely upon what you are being treated for, yet you ought to constantly get done with a full course of this anti-microbial as endorsed by your primary care physician. Try not to quit taking it until you have gotten done, in any event, when you feel far improved.
Sildenafil Tablets for ED
Assuming you quit taking it early, a few microorganisms might get by and the disease might return. It won’t work for viral diseases like influenza or the normal virus. Utilizing any anti-toxin when you needn’t bother with it can make it less powerful for future contaminations. Applies to the following strengths: 10 mg/mL; 10 mg/12.5 mL; 20 mg; 25 mg; 50 mg; 100 mg; 75 mg TABLETS (Viagra) Initial dose: 50 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May increase to 100 mg or decrease to 25 mg once a day, based on efficacy and tolerability. Maximum dose: 100 mg orally once a day Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity. Utilizing any anti-toxin when you needn’t bother with it can make it less powerful for future contaminations. Applies to the following strengths: 10 mg/mL; 10 mg/12.5 mL; 20 mg; 25 mg; 50 mg; 100 mg; 75 mg TABLETS (Viagra) Initial dose: 50 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May increase to 100 mg or decrease to 25 mg once a day, based on efficacy and tolerability. Maximum dose: 100 mg orally once a day Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity. TABLETS (Revatio)/ORAL SUSPENSION (Revatio, Liqrev): Initial dose: 20 mg orally 3 times a day Maintenance dose: May titrate up to 80 mg orally 3 times a day, if required, based on symptoms and tolerability.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 25mg | 90 + 6 Pills | 105.03€ 100.03€ | |
| Kamagra Soft Tabs | 100mg | 60 + 4 Pills | 180.59€ 171.99€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Kamagra | 100mg | 84 + 6 Pills | 264.44€ 251.85€ | |
| Kamagra Soft Tabs | 100mg | 84 + 4 Pills | 233.05€ 221.95€ | |
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ | |
| Viagra Generic | 100mg | 270 + 10 Pills | 270.47€ 257.59€ | |
| Kamagra Polo | 100mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Viagra Generic | 200mg | 60 + 4 Pills | 125.19€ 119.23€ | |
| Viagra Generic | 100mg | 20 Pills | 45.58€ 43.41€ | |
| Kamagra Polo | 100mg | 272 + 12 Pills | 622.94€ 593.28€ | |
| Viagra Generic | 100mg | 10 Pills | 28.91€ 27.53€ | |
| Viagra Generic | 50mg | 120 + 6 Pills | 129.64€ 123.47€ | |
| Kamagra | 100mg | 180 + 6 Pills | 436.79€ 415.99€ | |
| Viagra Generic | 25mg | 20 Pills | 37.74€ 35.94€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ |
Maximum dose: 80 mg orally 3 times a day IV: 10 mg IV bolus 3 times a day Comments: No adjustment for body weight is required for IV dosing. The 10 mg IV bolus dose is predicted to provide an equivalent pharmacological effect to that of 20 mg orally. Doses up to a maximum of 80 mg orally 3 times a day are supported by delayed clinical worsening with long-term use in clinical studies despite a lack of observed dose-response improvement in exercise ability in short-term clinical studies. In adults 65 years or older, use caution with dose selection due to a higher incidence of compromised renal, cardiac, and/or hepatic function, and of concomitant disease or drug therapy. Use: For the treatment of PAH (WHO Group I) to improve exercise ability and delay clinical worsening TABLETS (Viagra) Initial dose: 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May titrate up to 100 mg orally once a day, based on effectiveness and toleration. Maximum dose: 100 mg orally once a day Comments: This drug may be administered anywhere from 30 minutes to 4 hours before sexual activity. A reduced starting dose is recommended in older adults due to higher systemic exposure as compared to younger adults. TABLETS (Revatio)/ORAL SUSPENSION (Revatio) 1 to less than 18 years: Weight 20 kg or less: 10 mg orally 3 times a day Weight greater than 20 kg to 45 kg: 20 mg orally 3 times a day Weight greater than 45 kg: 20 mg orally 3 times a day; dose may be titrated up to a maximum of 40 mg orally 3 times a day, if required, based on symptoms and tolerability Use: For the treatment of pulmonary arterial hypertension (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underlie improvements in exercise ERECTILE DYSFUNCTION: Mild to Moderate Renal Dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended Severe Renal Dysfunction (CrCl less than 30 mL/min): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity Mild, Moderate, or Severe Renal Dysfunction (CrCl 80 to less than 30 mL/min): No adjustment recommended ERECTILE DYSFUNCTION: Mild, Moderate, or Severe Liver Dysfunction (Child-Pugh A, B, or C): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity. Mild or Moderate Liver Dysfunction (Child-Pugh A or B): No adjustment recommended Severe Liver Dysfunction (Child-Pugh C): Data not available in this population. Initiate treatment with 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Patients should be stable on alpha blocker therapy prior initiating treatment with this drug.
- Sildenafil 25mg can be part of a physical and psychological treatment plan.
- Follow your doctor’s guidance on how often to take the medication.
- Do not increase the dose to improve results without approval.
- Store tablets at room temperature, away from direct sunlight.
- Be cautious if you are on medications for blood pressure or prostate issues.
- Always complete your treatment course unless advised otherwise.
Administration with CYP450 3A4 Inhibitors (e.g., ketoconazole, itraconazole, saquinavir) or Erythromycin: Consider a starting dose of 25 orally once a day, as needed, about 1 hour prior to sexual activity. Recommended dose: 25 mg orally, as needed, about 1 hour prior to sexual activity Maximum dose: 25 mg orally within a 48 hour period Known hypersensitivity to either the active component or to any of the ingredients; hypersensitivity reactions have been reported, including rash and urticaria In patients who are using a guanylate cyclase (GC) stimulators, such as riociguat; phosphodiesterase type 5 inhibitors (PDE5), including this drug, may potentiate the hypotensive effects of GC stimulators.
What It Contains
Oral suspension (powder): Reconstitute with water (total 90 mL) in separate additions; shake vigorously after each addition. Do not mix with other medications or flavoring; insert adaptor into bottle neck. Consult the manufacturer product information for detailed instructions. Cardiovascular: Cardiac status/risk factors (prior to initiation); blood pressure (periodically during treatment in patients with PAH on concomitant anti-hypertensive agents) Drug Interactions: For concomitant use of medications that may be contraindicated or for dose adjustment (at baseline and during treatment) Ocular: NAION risk factors (prior to initiation) Read the US FDA-approved patient labeling (Patient Information and/or Instructions for Use). Tell your healthcare provider about all of the medicines you (or your child take).
Clinical monitoring
Regular and/or intermittent use of nitric oxide donors (e.g., organic nitrates or nitrites) in any form Other PDE5 inhibitors or products containing sildenafil Seek immediate medical attention in the event of: Sudden loss of vision in one or both eyes Sudden decrease or loss of hearing; may be accompanied by tinnitus and dizziness An erection that persists longer than 4 hours. It is not recommended to take this drug more than once a day. This medication can cause your blood pressure to unsafely drop suddenly if it is taken with certain other medicines. Stop sexual activity and seek medical attention if you experience symptoms such as chest pain, dizziness, or nausea during sex, or if you have any side effect that bothers you or does not go away. Use protective measures to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV).
How it works
The primary ingredient of Viagra is Sildenafil. It’s a medicine that belongs to a group of drugs known as phosphodiesterase type 5 inhibitors, or PDE5 for short. These medicines, which includes Sildenafil help men who suffer erectile dysfunction get and maintain an erection suitable for sex. They work by opening the blood vessels in the penis, the increased blood flow helps maintain an erection. Viagra is licenced exclusively for the treatment of male erectile dysfunction and can be used in adults over 18 years old. In patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently; this drug has been shown to potentiate the hypotensive effects of nitrates based on its mechanism of action After patients have taken this drug for ED, it is unknown when nitrates, if necessary, can be safely administered. Although plasma levels of this drug at 24 hours post-dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point. Concomitant use of organic nitrates in any form, either regularly or intermittently, because of sildenafil products over the counter the greater risk of hypotension Concomitant use of riociguat, a guanylate cyclase stimulator; PDE5 inhibitors, including this drug, may potentiate the hypotensive effects of riociguat. Known hypersensitivity to either the active component or to any of the ingredients of the tablet, injection, or oral suspension; hypersensitivity reactions have been reported, including anaphylactic reaction, anaphylactic shock, and anaphylactoid reaction Safety and efficacy have not been established in patients with ED younger than 18 years. Safety and efficacy have not been established in patients with PAH younger than 1 year. Due to high plasma protein binding and poor elimination in urine, removal via hemodialysis is unlikely. Tablets: Administer orally with or without food. Reconstitute product before oral administration, and shake well before use. An oral syringe is recommended for dose measurement (and delivery). Use within 60 days after reconstitution; discard any remainder after expiration.
8.1 Pregnancy
TABLETS (Revatio)/ORAL SUSPENSION (Revatio, Liqrev): Initial dose: 20 mg orally 3 times a day Maintenance dose: May titrate up to 80 mg orally 3 times a day, if required, based on symptoms and tolerability. Maximum dose: 80 mg orally 3 times a day IV: 10 mg IV bolus 3 times a day Comments: No adjustment for body weight is required for IV dosing. The 10 mg IV bolus dose is predicted to provide an equivalent pharmacological effect to that of 20 mg orally. Doses up to a maximum of 80 mg orally 3 times a day are supported by delayed clinical worsening with long-term use in clinical studies despite a lack of observed dose-response improvement in exercise ability in short-term clinical studies. In adults 65 years or older, use caution with dose selection due to a higher incidence of compromised renal, cardiac, and/or hepatic function, and of concomitant disease or drug therapy.
Does sildenafil interact with other medicines (drug interactions)?
Use: For the treatment of PAH (WHO Group I) to improve exercise ability and delay clinical worsening TABLETS (Viagra) Initial dose: 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May titrate up to 100 mg orally once a day, based on effectiveness and toleration. Maximum dose: 100 mg orally once a day Comments: This drug may be administered anywhere from 30 minutes to 4 hours before sexual activity. A reduced starting dose is recommended in older adults due to higher systemic exposure as compared to younger adults. TABLETS (Revatio)/ORAL SUSPENSION (Revatio) 1 to less than 18 years: Weight 20 kg or less: 10 mg orally 3 times a day Weight greater than 20 kg to 45 kg: 20 mg orally 3 times a day Weight greater than 45 kg: 20 mg orally 3 times a day; dose may be titrated up to a maximum of 40 mg orally 3 times a day, if required, based on symptoms and tolerability Use: For the treatment of pulmonary arterial hypertension (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underlie improvements in exercise ERECTILE DYSFUNCTION: Mild to Moderate Renal Dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended Severe Renal Dysfunction (CrCl less than 30 mL/min): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity Mild, Moderate, or Severe Renal Dysfunction (CrCl 80 to less than 30 mL/min): No adjustment recommended ERECTILE DYSFUNCTION: Mild, Moderate, or Severe Liver Dysfunction (Child-Pugh A, B, or C): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity. Mild or Moderate Liver Dysfunction (Child-Pugh A or B): No adjustment recommended Severe Liver Dysfunction (Child-Pugh C): Data not available in this population.
Mechanism of Action
Initiate treatment with 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Patients should be stable on alpha blocker therapy prior initiating treatment with this drug. Administration with CYP450 3A4 Inhibitors (e.g., ketoconazole, itraconazole, saquinavir) or Erythromycin: Consider a starting dose of 25 orally once a day, as needed, about 1 hour prior to sexual activity. Recommended dose: 25 mg orally, as needed, about 1 hour prior to sexual activity Maximum dose: 25 mg orally within a 48 hour period Known hypersensitivity to either the active component or to any of the ingredients; hypersensitivity reactions have been reported, including rash and urticaria In patients who are using a guanylate cyclase (GC) stimulators, such as riociguat; phosphodiesterase type 5 inhibitors (PDE5), including this drug, may potentiate the hypotensive effects of GC stimulators. In patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently; this drug has been shown to potentiate the hypotensive effects of nitrates based on its mechanism of action After patients have taken this drug for ED, it is unknown when nitrates, if necessary, can be safely administered. Although plasma levels of this drug at 24 hours post-dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point. The liquid suspension is premixed and may contain flavoring. Shake well before oral administration and use a calibrated measuring device for accurate dosing. IV: Administer as an IV bolus injection; the supplied product is ready for use. Tablets/IV solution: Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (liquid): Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (powder): Store below 30C (86F) in the original package in order to protect from moisture.
- This dose is often prescribed for sensitive individuals or beginners.
- Sildenafil 25mg may start working within 30 minutes of ingestion.
- It’s important to follow prescribed dosage instructions carefully.
- Sildenafil can interact with medications like nitrates.
- Avoid grapefruit juice, as it can increase drug levels.
- The pill should be swallowed whole with water.
After reconstitution, store below 30C (86F) or in refrigerator at 2C to 8C (36F to 46F); do not freeze. Oral suspension (powder): Reconstitute with water (total 90 mL) in separate additions; shake vigorously after each addition.
When to See a Doctor
Concomitant use of organic nitrates in any form, either regularly or intermittently, because of sildenafil products over the counter the greater risk of hypotension Concomitant use of riociguat, a guanylate cyclase stimulator; PDE5 inhibitors, including this drug, may potentiate the hypotensive effects of riociguat. Known hypersensitivity to either the active component or to any of the ingredients of the tablet, injection, or oral suspension; hypersensitivity reactions have been reported, including anaphylactic reaction, anaphylactic shock, and anaphylactoid reaction Safety and efficacy have not been established in patients with ED younger than 18 years. Safety and efficacy have not been established in patients with PAH younger than 1 year. Due to high plasma protein binding and poor elimination in urine, removal via hemodialysis is unlikely. Tablets: Administer orally with or without food.
Dangerous Interactions
Reconstitute product before oral administration, and shake well before use. An oral syringe is recommended for dose measurement (and delivery). Use within 60 days after reconstitution; discard any remainder after expiration. The liquid suspension is premixed and may contain flavoring. Shake well before oral administration and use a calibrated measuring device for accurate dosing.
What should I tell my healthcare provider before taking sildenafil?
IV: Administer as an IV bolus injection; the supplied product is ready for use. Tablets/IV solution: Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (liquid): Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (powder): Store below 30C (86F) in the original package in order to protect from moisture. After reconstitution, store below 30C (86F) or in refrigerator at 2C to 8C (36F to 46F); do not freeze. Do not mix with other medications or flavoring; insert adaptor into bottle neck. Consult the manufacturer product information for detailed instructions. Cardiovascular: Cardiac status/risk factors (prior to initiation); blood pressure (periodically during treatment in patients with PAH on concomitant anti-hypertensive agents) Drug Interactions: For concomitant use of medications that may be contraindicated or for dose adjustment (at baseline and during treatment) Ocular: NAION risk factors (prior to initiation) Read the US FDA-approved patient labeling (Patient Information and/or Instructions for Use).
Detection in biological fluids
Tell your healthcare provider about all of the medicines you (or your child take). Regular and/or intermittent use of nitric oxide donors (e.g., organic nitrates or nitrites) in any form Other PDE5 inhibitors or products containing sildenafil Seek immediate medical attention in the event of: Sudden loss of vision in one or both eyes Sudden decrease or loss of hearing; may be accompanied by tinnitus and dizziness An erection that persists longer than 4 hours. It is not recommended to take this drug more than once a day. This medication can cause your blood pressure to unsafely drop suddenly if it is taken with certain other medicines. Stop sexual activity and seek medical attention if you experience symptoms such as chest pain, dizziness, or nausea during sex, or if you have any side effect that bothers you or does not go away.
Sildenafil Pricing in India
This product should not be used by women. Use protective measures to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV). The primary ingredient of Viagra is Sildenafil. It’s a medicine that belongs to a group of drugs known as phosphodiesterase type 5 inhibitors, or PDE5 for short. These medicines, which includes Sildenafil help men who suffer erectile dysfunction get and maintain an erection suitable for sex. They work by opening the blood vessels in the penis, the increased blood flow helps maintain an erection. Viagra is licenced exclusively for the treatment of male erectile dysfunction and can be used in adults over 18 years old. This product should not be used by women.