Erectile dysfunction

Erectile dysfunctionPreparations for the treatment of erectile dysfunction – a pharmacological agents designed to correct disorders in men’s ability to achieve increased their penis, its hardening and straightening long enough for satisfactory sexual intercourse, orgasm control. Failure to quality erection at its core has at least a dozen reasons, only some of them overcome with the help of medicines.

Modern drug therapy of erectile dysfunction has made substantial progress in 1983, when British physiologist Giles Brindley PhD, dropped his trousers and demonstrated phentolamine-induced erection your penis shocked American Urological Association audience. One drug that Brindley injected himself into the penis, was not specific vasodilator an alpha-blocker, which the mechanism of action was clearly due to the relaxation of smooth muscle in the body member.Effect, outdoors Brindley, set the foundation for the later development of specific, safe, orally-effective drug treatments.

Sildenafil

Sildenafil sulfonyl] piperazine citrate) – a drug to increase potency.

History of creation

Initially, the drug was synthesized in order to improve blood flow in the myocardium and treatment of angina and coronary heart disease, but in 1992, in clinical trials it was found that its effect on heart blood flow is minimal, but it has a pronounced effect on blood flow in the pelvic organs ( in the penis as well).

The mechanism of action of sildenafil: a drug increases the amount of blood flowing into the penis. It also helps man to call a natural erection. Sildenafil works only when a man feels a natural sexual arousal, and when sexual intercourse is completed, the penis naturally returns to the relaxed state. In other words, Viagra works only on natural mechanisms of erection.

Clinical efficacy

Numerous clinical trials have shown that sildenafil is effective for erectile dysfunction, which are based on the vascular component, in other cases, its efficiency is low.

Contraindications

Hypersensitivity; simultaneous reception donators of nitric oxide or nitrates in any form. C care: heart disease, anatomical deformations of the penis, sickle cell anemia, multiple myeloma, leukemia, childhood.

Interaction

Cimetidine, ketoconazole, erythromycin decrease clearance and increase in the blood concentration of sildenafil. It enhances the antiplatelet effect of sodium nitroprusside. Enhances the hypotensive effect of nitrates (a combination of sildenafil with nitrates can lead to death), a potentially life-threatening joint appointment with the BCCI, beta-blockers and oral hypoglycemic drugs.

Tadalafil

Cialis (Tadalafil is lat.) – A medicine for the treatment of erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).

Synonym: Cialis.

Tadalafil improves erection and the possibility of successful sexual intercourse. The drug acts during 36 hours. The effect is already apparent 16 minutes after taking the drug in the presence of sexual arousal. After oral administration of tadalafil is rapidly absorbed. The average maximum concentration (Cmax) in plasma reached a median of 2 hours after ingestion. The rate and extent of absorption of tadalafil are not dependent on food intake, so it can be taken without regard to meals. Hours (morning or evening) had no clinically significant effect on the rate and extent of absorption.

Contraindications

  • Installed hypersensitivity to tadalafil or to any of the substances in the preparation.
  • In the case of taking the drugs containing any organic nitrates.
  • The use of persons under 18 years of age.

The pharmacokinetics of tadalafil in patients with erectile dysfunction is similar to pharmacokinetics in subjects without erectile dysfunction.

Elderly patients

Healthy elderly (65 and over) had a lower clearance of tadalafil when taken orally, which was reflected in an increase in the area under the concentration-time curve by 25% compared with healthy people aged 19 to 45 years. This difference is not clinically significant and does not require adjustment of the dosage.

Patients with renal failure

In individuals with mild (creatinine clearance 51 – 80 ml / min) or moderate (creatinine clearance of 31-50 ml / min) of renal insufficiency area under the concentration-time curve was higher than in healthy individuals. In patients with severe renal impairment (creatinine clearance 30 mL / min) Tadalafil has not been studied (see. Section Special warnings and precautions for use).

Patients with hepatic insufficiency

The pharmacokinetics of tadalafil in patients with mild to moderate hepatic impairment is comparable with that in healthy individuals. In such patients, dose selection is required.

Patients with diabetes mellitus

In patients with diabetes during treatment with tadalafil area under the concentration-time curve is less than about 19% than that of healthy individuals. This difference does not require dose adjustment.

Side effects

The most commonly reported adverse events were headache and dyspepsia (11 and 7%, respectively). Adverse events associated with taking Cialis were generally mild or moderate in severity, transient and diminished with continued use of the drug. Other common adverse effects include back pain, myalgia, nasal congestion and flushing. During the day, nagging muscle pain in the legs. Rarely – edema of the eyelids, eye pain, hyperemia of the conjunctiva and dizziness.

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