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Sildenafil 150 mg: Cenforce 150 Mg | Overview | Benefits | Uses

What is Cenforce 150 mg? What are the benefits and uses of Cenforce 150 mg? How does it work? What are the dosage instructions and storage guidelines?

Overview of Cenforce 150 mg

Cenforce 150 mg is a medication used to treat erectile dysfunction (ED) in men. It contains the active ingredient sildenafil citrate, which belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. Sildenafil works by increasing blood flow to the penis, which helps men achieve and maintain an erection during sexual activity.

Benefits of Cenforce 150 mg

The primary benefit of Cenforce 150 mg is its ability to treat erectile dysfunction. By increasing blood flow to the penis, it helps men who struggle with achieving or maintaining an erection. This can improve sexual performance and satisfaction for both the patient and their partner.

Uses of Cenforce 150 mg

Cenforce 150 mg is used to treat erectile dysfunction in adult men. It is not intended for use in women or children. The medication should be taken approximately one hour before engaging in sexual activity, as it requires sexual stimulation to work effectively.

How Cenforce 150 mg Works

Sildenafil citrate, the active ingredient in Cenforce 150 mg, works by inhibiting the action of phosphodiesterase type 5 (PDE5), an enzyme that can cause the blood vessels in the penis to constrict. By inhibiting PDE5, sildenafil allows the blood vessels to relax and expand, increasing blood flow to the penis and enabling an erection.

Dosage and Administration

The recommended dose of Cenforce 150 mg is one tablet taken approximately one hour before sexual activity. Patients may be started on a lower dose, such as 25 mg or 50 mg, and the dose can be increased if needed. Cenforce 150 mg should not be taken more than once per day.

Storage and Handling

Cenforce 150 mg should be stored at room temperature, away from moisture, heat, and direct light. The medication should be kept out of the reach of children. Expired medications should not be used.

Interactions and Precautions

Cenforce 150 mg can interact with certain medications, such as nitrates, alpha-blockers, and certain antifungal drugs. Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs and supplements. Cenforce 150 mg should not be used in patients with certain health conditions, such as severe heart or liver problems, or in those who have recently had a stroke or heart attack.

Does Cenforce 150 mg have any contraindications?. Yes, Cenforce 150 mg should not be used in patients with significant heart or liver problems, recent stroke or heart attack, or hypotension (low blood pressure). It is also contraindicated in patients taking nitrate-based medications for chest pain or angina.

Can Cenforce 150 mg be used by women?. No, Cenforce 150 mg is only approved for use in adult men and should not be used by women. The safety and efficacy of the medication have not been established in female patients.

How long does it take for Cenforce 150 mg to start working?. Cenforce 150 mg typically takes effect within 30 minutes to 4 hours after administration. However, the medication requires sexual stimulation to work effectively, so it may not produce an immediate erection without such stimulation.

Can Cenforce 150 mg be taken with alcohol?. It is generally recommended to avoid or limit alcohol consumption while taking Cenforce 150 mg, as alcohol can increase the risk of side effects and reduce the effectiveness of the medication.

What are the potential side effects of Cenforce 150 mg?. Common side effects of Cenforce 150 mg may include headache, flushing, indigestion, nasal congestion, and visual disturbances. Patients should consult their healthcare provider if they experience any persistent or concerning side effects.

In summary, Cenforce 150 mg is a medication used to treat erectile dysfunction in adult men. It works by increasing blood flow to the penis, which can help men achieve and maintain an erection during sexual activity. Patients should follow the dosage instructions provided by their healthcare provider and be aware of potential interactions and contraindications. By understanding the benefits, uses, and proper administration of Cenforce 150 mg, patients can make informed decisions about their treatment options for erectile dysfunction.

Cenforce 150 Mg | Overview | Benefits | Uses

SKUCMS508
US Brand NameSildenafil Tablets
Strength150mg
Generic Name

Sildenafil Citrate

ManufactureCenturion Laboratories,India

Cenforce 150 mg treats impotence (erectile dysfunction) in men. It works by spiking the blood flow to the penile area of the body. This helps men gain and maintain an erection. It belongs to the phosphodiesterase type 5 (PDE 5) inhibitors family of medicines. While investigating the possible use of PDE 5 inhibitors for hypertension and angina, researchers unintentionally found its capacity to treat erectile dysfunction in males.

You can take this medicine on an empty stomach or with food. You must take this medicine exactly as directed by your doctor. Take it about an hour before engaging in any sexual activity. This medicine will help you get an erection once you’ve been sexually aroused. On the other hand, this drug will not work without sexual stimulation. 

You should not take it more than once a day. If you are using erectile dysfunction drugs for the first time, start with a lower dose, such as 25 mg, 50 mg, or 100 mg, and gradually increase your dose if and when required.  

Females are not supposed to use Cenforce 150. It might be risky to take it with nitrate-based medications (often given for chest pain or angina). Don’t take this medicine if you have significant heart or liver problems, recently had a stroke or heart attack, or hypotension (low blood pressure). 

Avoid drinking alcohol while taking this medication since it increases the chance of side effects.  You should not drive after taking this medication since it might make you dizzy.

How does Cenforce 150 mg work?

Sildenafil Citrate is the primary compound of this medicine. Sildenafil works by suppressing the action of phosphodiesterase type-5, a chemical found naturally in the penis.

Sildenafil Citrate aids in the widening (relaxation) of blood vessels while sexual activity is taking place. The volume of blood circulating through the penile region of the body increases. This mechanism helps men develop and keep a firm erection.

What is the use of Cenforce 150 mg?

Cenforce is a medication that helps men with erectile dysfunction. Erectile dysfunction is a sexual disorder in which men cannot achieve a hard enough erection for sexual intercourse.

Because this drug is a PDE 5 inhibitor, it inhibits the enzymes that induce flaccidity in the penis. It increases blood flow to the penile muscles by relaxing blood vessels.

Dosage

The dose of this drug will vary based on the patient. Follow your doctor’s orders or the directions label. The following information includes the average dosages of this medicine. If your dose varies, don’t change it until your doctor says it.

For oral administration (tablets):

  • Adults up to 65 years of age- Consume this medicine once a day, 1 hour before sexual intercourse, as a single dosage. The drug can also be administered 30 minutes to 4 hours before sexual activity. If necessary, your doctor may change your dosage by increasing or decreasing the strength of the drug.
  • Adults above 65 years of age- Usually, a smaller dose is given to patients above 65 once a day, an hour before sexual intercourse. Based on your health, your doctor may advise you to take Cenforce 150 mg or a weaker strength of this medication, like 120 mg or 130 mg. However, if you need a more potent version of the drug, you can consider taking Cenforce 200. The drug can also be administered 30 minutes to 4 hours before sexual activity. If necessary, your doctor may alter your dosage.

Children and teens should avoid using it.

Storage:

Keep Cenforce away from moisture, heat, and direct light in a closed container at room temperature. 

Keep out of children’s reach. Do not store expired medications.

Interactions

Drugs, food, and diseases can interact with this drug. All the interactions are mentioned below:

Major drug interactions:

  • Adderall (amphetamine / dextroamphetamine)
  • Aspir 81 (aspirin)
  • Aspirin Low Strength (aspirin)
  • Cialis (tadalafil)
  • CoQ10 (ubiquinone)
  • Crestor (rosuvastatin)
  • Cymbalta (duloxetine)
  • Eliquis (apixaban)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Flonase (fluticasone nasal)
  • Lipitor (atorvastatin)
  • Lyrica (pregabalin)
  • Metoprolol Succinate ER (metoprolol)
  • Metoprolol Tartrate (metoprolol)
  • Tylenol (acetaminophen)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zyrtec (cetirizine)

Disease interactions:

  • Renal dysfunction
  • Pulmonary disease
  • Priapism
  • Alcoholism
  • Hearing loss
  • Liver disease
  • Retinitis pigmentosa
  • Seizure disorders

Food and beverage interactions:

  • Alcohol – This drug can reduce blood pressure, which can be enhanced by alcohol. Taking alcohol while taking Sildenafil might cause problems and increase adverse effects. As a result, avoid alcohol at all costs when taking Cenforce.
  • Grapefruit – If you’re taking Sildenafil, don’t consume or consume too many grapefruits or grapefruit juice regularly. Grapefruit may cause your body’s levels of sildenafil citrate to rise, making the drug take longer to take effect. 

Side effects of Cenforce 150 mg:

Common side effects may include:

  • Flushing (warmth, redness, or tingly feeling)
  • Headache or dizziness
  • Heartburn or nausea
  • Abnormal (blurred) vision
  • Runny or stuffy nose
  • Sleep problems (insomnia)
  • Muscle pain or back pain

This is not a comprehensive list of probable side effects; more may emerge. Contact your doctor for medical advice about side effects.

Stop taking Sildenafil and get medical assistance if you have:

  • Heart attack symptoms – chest pain, pain spreading to your shoulder or jaw, nausea, sweating
  • The erection lasts longer than 4 hours 
  • Vision changes or sudden vision loss
  • Irregular heartbeat
  • Ringing in your ears
  • Swelling in your hands, ankles, or feet
  • Shortness of breath
  • Seizure (convulsions)

Manufacturer

Centurion Laboratories, which was founded in 2006, produces Cenforce 150. It has gained recognition as a trustworthy pharmaceutical drug manufacturer and supplier.

Centurion Laboratories manufactures drugs that meet industry standards and contain high-quality components. 

Frequently Asked Questions

How long does Cenforce 150 mg last?

The half-life of Cenforce 150 is around 4 hours. This means Sildenafil will be reduced by half in your bloodstream every four hours.

How to take Cenforce 150 red pills?

You should consult with your doctor before taking Cenforce 150 pills. Keep in mind that you should not take more than one pill in 24 hours. Also, if you’re taking Sildenafil Citrate for the first time, start with a smaller dose of the medicine and gradually increase the dose.

Is Cenforce 150 mg safe?

Like every other medicine available for erectile dysfunction, Cenforce 150 also has minor side effects. However, it is FDA-approved and is safe to use.  

Should I buy Cenforce 150 online?

You can buy Cenforce 150 mg online through a trusted online pharmacy like CheapMedicineShop.

Sildenafil Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. Consult your doctor or pharmacist for more details.

How to use Sildenafil Tablet

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve.

Side Effects

Dizziness, headache, flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.

Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, dehydration, penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION).

This drug may make you dizzy or cause vision problems. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, sildenafil should be used only when clearly needed. Since high blood pressure in the lungs is a serious condition that can harm both a pregnant woman and her unborn baby, do not stop this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, talk to your doctor about the benefits and risks of using sildenafil.

This medication passes into breast milk in small amounts. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: riociguat, vericiguat.

Sildenafil can cause a serious drop in your blood pressure when used with nitrates. A serious drop in blood pressure can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl nitrate, amyl nitrite, or butyl nitrite.

If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.

Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as saquinavir), mifepristone, rifampin, ritonavir, among others.

Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

Does Sildenafil Tablet interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

Do not share this medication with others.

Not applicable.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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Sildenafil 150 mg

Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction | Popova A.Yu., Ovchinnikov R.I., Gamidov S.I.

Currently, there are a fairly large number of effective methods of drug treatment of erectile dysfunction (ED). The choice of treatment method is determined by its invasiveness. In case of insufficient effectiveness of a less invasive technique, they switch to a more invasive one. Thus, most clinicians begin treatment with oral phosphodiesterase type 5 (PDE-5) inhibitors, which fail with intracavernous injections or vacuum devices. Combination treatment is also possible. With the ineffectiveness of such methods, it is possible to carry out surgical intervention (falloprosthesis).

Sildenafil – the first PDE5 inhibitor

PDE-5 inhibitors are highly effective and safe oral drugs for the treatment of ED and are recommended as first-line therapy [1]. The number of patients taking these drugs continues to increase in parallel with the increase in the prevalence of ED.

Sildenafil was approved for clinical use in 1998. This moment was not just a starting point for the existence of another drug on the pharmacological market. It turned out to be the beginning of a new era in the field of sexual medicine, marked by a real breakthrough in the fundamental and clinical fields, as well as in the public perception of sexual pathology.

Sildenafil became the first effective and safe oral treatment for ED. The history of the discovery of sildenafil was preceded by the accumulation of knowledge about the role of nitric oxide in ensuring the normal functional state of the cardiovascular system, which was initiated by R.R Furchgott and J.V. Zawadski [2]. Nevertheless, today’s use of the drug as a therapy for ED is an example of how an accidental observation can have a huge impact on the course of scientific progress. In the course of clinical trials of the antianginal properties of sildenafil, researchers noted that although taking the drug is not accompanied by a significant clinical improvement in the course of angina pectoris, in many patients it leads to the development of a kind of “side effect” that consists in improving erectile function. This observation was the reason for further study of the possibility of using this substance in the treatment of ED.

The discovery of sildenafil, a selective PDE-5 inhibitor, led to numerous fundamental studies that showed that this particular type of enzyme dominates in the cavernous tissue, which ensures the selectivity of the drug. It should be noted that these studies also made it possible to elucidate the mechanisms of action of other drugs that have been used in clinical practice for a long time, in particular papaverine and prostaglandin E1 [3], and to significantly expand knowledge about the mechanism of erection and its disturbances leading to ED.

The appearance of sildenafil also had a great influence on clinical research in the field of sexual medicine. In recent years, the terminology has been clarified, new definitions of various forms of sexual disorders have been developed. Clinical trials of sildenafil have stimulated the creation of new diaries and questionnaires to assess the state of male sexual function. Analysis of the demographics of participants in large-scale clinical trials revealed risk factors for ED, which, in turn, contributed to understanding its pathogenesis.

The appearance of sildenafil had a huge public outcry. A large number of patients with ED, who had not previously consulted a doctor, received hope for the restoration of sexual function, and so far, millions of men around the world have returned to a normal sexual life thanks to the use of this drug.

The dose of the drug is selected by titration, starting with 50 mg, followed by a dose change (either a decrease to 25 mg or an increase to 100 mg), depending on the effect and tolerability. Sildenafil is taken 1 p./day, 1 hour before the intended sexual intercourse. The action of the drug begins 40-60 minutes after administration and lasts for 3-5 hours [3]. It is important to note that taking the drug does not in itself lead to an erection and sexual stimulation is necessary for its action to begin.

Sildenafil is contraindicated in patients taking nitrates, patients with hypotension, severe hepatic insufficiency (the drug is metabolized by hepatic cytochrome P450 3A4) and retinopathy pigmentosa [20].

The clinical efficacy of sildenafil has been evaluated in numerous studies conducted around the world. S.S. Carson et al. pooled data from 11 double-blind, placebo-controlled studies that included a total of nearly 3,000 patients with ED. After 12 weeks after the start of taking the drug, an improvement in erection was noted by 76% of men who received sildenafil and 22% of those who received placebo, while the percentage of successful attempts to have sexual intercourse was 66 and 26% in the 1st and 2nd groups, respectively. The effectiveness of various doses of sildenafil was 65% for 25 mg, 74% for 50 mg, 82% for 100 mg High efficiency of sildenafil was noted in different age groups. Thus, among patients aged younger and older than 65 years, the effectiveness of sildenafil was 77. 6 and 69.2% respectively. Significantly higher efficacy of sildenafil compared with that of placebo also occurred in patients with ED of varying severity and etiology [4].

The use of sildenafil in special categories of patients with ED

Arterial hypertension (AH) is known to be one of the risk factors for ED. Although sildenafil has some antihypertensive effect, this drug is safe in patients with hypertension, both receiving and not receiving antihypertensive drugs [5, 6]. The effectiveness of sildenafil in patients with ED suffering from hypertension is high. Among patients with hypertension of various origins, taking placebo and sildenafil was accompanied by an improvement in erection in 18 and 70% of patients, respectively. Among men who took 2 or more antihypertensive drugs, these figures were 17.6 and 71% [6].

Another well-known risk factor for ED is smoking. The effectiveness of sildenafil among smokers was not inferior to that among non-smokers (80 and 74%, respectively) [4].

Many epidemiological studies have shown that depression is the second most common cause of ED after cardiovascular risk factors. In addition, the presence of ED exacerbates depressive symptoms. Treatment with sildenafil was not only highly effective in patients with depression in terms of improving erectile function, but was also accompanied by a decrease in the severity of depressive symptoms [7].

Various neurological diseases, as mentioned above, can also be the cause of ED. According to studies, the effectiveness of sildenafil among patients with parkinsonism, multiple sclerosis and spinal cord injuries exceeds 80%, which corresponds to the data obtained in the general population of patients with ED [8].

Special groups of patients with ED, difficult to treat, are patients with diabetes mellitus (DM) and patients who underwent radical prostatectomy (RP).

In patients with diabetes, the effectiveness of sildenafil depends on the severity of the underlying disease and the presence of its complications. So, in the study of S.S. Carson et al. among patients with diabetes without complications, improvement in erection was noted by 8% of patients who received placebo, and 69% who received sildenafil. In the presence of 1 complication, these figures were 12 and 43%, and 2 – 10 and 43%, respectively. In all groups, the efficacy of sildenafil was significantly higher compared to that of placebo [4].

The effectiveness of treating ED after RP is determined by a number of factors. According to R. Raina et al., sildenafil treatment was effective in 71.7% of patients after bilateral nerve-sparing RP, in 50% after unilateral nerve-sparing RP, and only in 15% of patients with ED after non-nerve-sparing surgery [9].

In addition, a feature of the course of ED in such patients is the possibility of a progressive improvement in erection for up to 4 years after surgery, and therefore one can finally judge the ineffectiveness of a particular treatment method only a few years after surgery. This is confirmed by the data of a survey of 316 patients with ED after RP, in 95% of cases had a bilateral nerve-sparing character. The effectiveness of sildenafil was 26% during the first 6 months, 36% – in the period from 6 to 12 months, 50% – from 12 to 18 months, 60% – from 18 to 24 months. after surgery [10].

Efficacy and tolerability analysis of sildenafil

Despite the high efficacy of sildenafil, there is a certain number of patients in whom taking this drug does not lead to an improvement in erection. In many cases, this is due to improper medication [11]. Patients, especially at the beginning of treatment, should be advised to take sildenafil on an empty stomach at least 30 minutes before sexual activity [21]. It is also important to explain to patients that the effect of the drug develops only against the background of adequate sexual arousal and largely depends on it. In many cases, treatment should be started with 100 mg, which will allow a maximum response already at the beginning of treatment and inspire patients with confidence in its success [21-23]. In addition, studies have shown that in some patients the maximum effect of sildenafil is achieved by 6-8 doses, and therefore in many patients the final assessment of the effectiveness of the drug should be carried out after several attempts to use it [24, 37, 38].

Noteworthy is the work of A. Eisenhardt et al., who found that the clinical efficacy of sildenafil depends on genetic factors. When analyzing the relationship between the polymorphism of the GNB3 C825T and ACE I / D genes, it was found that in the group of carriers of the GNB3 825C allele, sildenafil was effective only in 50% of men, while this figure exceeded 90% among the owners of the TT genotype. Similar results were obtained with respect to the ACE I/D polymorphism – among carriers of the ACE D allele, the effectiveness of sildenafil did not exceed 50%, while in men with genotype II it was 75% [12].

The long-term efficacy of sildenafil was also studied by Montorsi et al., who interviewed 2618 patients who took the drug for 3 years. In general, 96% of these patients were satisfied with the treatment, and only 1.6% discontinued it due to low efficiency [25]. The remaining 2.4% of patients discontinued the drug for other reasons. Laboratory studies have not confirmed the existence of the effect of tachyphylaxis when taking sildenafil [13].

An important characteristic of any pharmacological drug is its side effects. The most common side effects when taking sildenafil are headache (7%), facial flushing (7%), dizziness (2%), dyspepsia (1.8%), nasal congestion (1.4%) and visual disturbances. , usually in the form of blue staining of objects (1.2%) [26].

It should also be noted that the frequency of side effects decreases as the drug is taken. So, in the study of S.S. Carson, the frequency of all side effects, except for visual impairment and dyspeptic disorders, decreased during the period of taking the drug. Headaches at the beginning of the study were noted by 7% of patients with ED, and after 16 weeks. – less than 1%, the frequency of dizziness also decreased from 7% to less than 1%, and nasal congestion – from 1.4% to less than 0.5% [14]. An important circumstance is also the fact that 2/3 of the patients in the course of this study increased the dose of sildenafil. Thus, with long-term use, the frequency of most side effects of sildenafil does not exceed that of placebo.

There is growing interest in the possibility of using sildenafil for various diseases, in addition to ED. In a study by K. Sairam et al. evaluated the effect of sildenafil on the severity of urination disorders in patients with ED. After 1 and 3 months. after the start of treatment, a significant decrease in the severity of symptoms of lower urinary tract dysfunction was noted, which was accompanied by an improvement in erectile function [15].

The intake of sildenafil leads to an improvement in the condition of patients with primary and secondary pulmonary hypertension [27, 28]. Another possible direction for future research on sildenafil is the use of this drug in the treatment of endothelial dysfunction [29]. -31].

Safety of sexual activity in patients with cardiovascular diseases

Sexual intercourse in most cases is accompanied by physical activity. This makes some people, especially men suffering from cardiovascular diseases and their partners, worry about the possibility of developing various complications due to sexual activity, which can lead to a restriction or complete rejection of it. These fears are reinforced by stories of famous people whose death allegedly took place during sexual intercourse. At the same time, research data show that the risk of cardiovascular complications in patients suffering from cardiac pathology during and immediately after sexual activity, although it exists, is relatively low. For example, the risk of developing a myocardial infarction in a healthy 50-year-old man within 1 year is 1%. As a result of sexual activity, this risk increases to 1.01% in a healthy man and to 1.1% in a man with a confirmed diagnosis of coronary heart disease (CHD) [16]. According to these data, the absolute risk of developing cardiovascular complications for a healthy man is 1 chance in 1 million. This figure increases to 2 chances in 1 million within 2 hours after intercourse for a healthy man and up to 20 chances in 1 million for a man. suffering from coronary artery disease [33].

During intercourse, on average, the maximum heart rate of a man reaches 120-130 beats / min, while systolic blood pressure rises to 150-180 mm Hg. Art. [34]. These indicators take place within only 3-5 minutes with an average duration of sexual intercourse from 5 to 15 minutes. The level of stress on the heart is usually expressed in metabolic equivalents (MET). One MET corresponds to an energy requirement expressed as resting oxygen consumption, which is 3.5 ml of oxygen / 1 kg of body weight per minute. In most cases, during sexual activity with a habitual partner, the load is 2-3 METs (with a maximum value of 5-6 METs), depending on the intensity and posture. This corresponds to walking 1.5 km in 20 minutes or climbing 20 steps in 10 seconds. All of the above indicates that sexual activity in habitual conditions and with a familiar partner does not represent a greater danger for both a healthy man and a patient with coronary artery disease than various forms of everyday physical activity.

In order to standardize the assessment of cardiac risk in men with coronary artery disease who resume sexual activity, several recommendations have been created, the most widely known of which are the Princeton recommendations [16]. In accordance with these recommendations, all patients are divided into 3 risk groups depending on the number of CHD risk factors they have and/or the severity of cardiovascular pathology. Most patients belong to the low-risk group and do not need additional cardiac examination before resuming sexual activity, which poses no danger to them. Patients in the intermediate risk group require additional cardiac examination, after which they are referred to the low or high risk group. Patients from the high-risk group have severe cardiovascular pathology, accompanied by severe heart failure. These patients need specialized treatment, after which the question of the degree of danger for them of sexual activity is again considered [16].

Changes in cavernous electrical activity and hemodynamics of the penis during treatment with sildenafil

To assess the effect of sildenafil on the cavernous electrical activity and hemodynamics of the penis, we conducted our own study [17, 35, 36]. 291 patients with ED of various etiologies aged 21-73 years (mean 59.1±14.7 years) after an examination that included a questionnaire for assessing male sexual health (International Index of Erectile Function (IIEF)), pharmacodopplerography (FDG) and electromyography (EMG) of the penis were divided into groups comparable in age, severity, presumed etiology and pathogenesis of ED [17]. The sildenafil group included 81 patients who took 25-100 mg of sildenafil 1 hour before sexual intercourse for 6 months. The control examination, which was carried out on a monthly basis, included a survey of IIEF, FDG and EMG of the penis.

The indicator “erectile function” IIEF in the treatment with sildenafil increased by 61.7% (p

Thus, according to the results of FDG, sildenafil has an effect on both arterial and venous blood flow in the penis, which makes it indicated in the first place for vasculogenic ED. With EMG, an improvement in cavernous electrical activity was observed with sildenafil treatment, apparently due to improved hemodynamics of the penis and oxygenation of the cavernous tissue. In addition, according to the results of the ICEF survey, sildenafil gives a fast, stable rehabilitation effect.

New preparations of sildenafil

The pharmaceutical market is represented not only by the original sildenafil, but also by the so-called generics, one of which is the drug Dynamico.

Patients’ preferences when choosing drugs are influenced by many factors, including efficiency, quality of erections, persistence of improvement, speed of onset and duration of drug action, as well as a range of side effects [18]. Efficacy and safety are the most important factors determining patient preferences. The research results show that the clinical efficacy of Dynamico is comparable to that of the original drug. In addition, the frequency of side effects (headache, skin flushing) was even lower than that of other sildenafil preparations [17]. This is very important for those patients who have experienced adverse events during therapy. The drug Dynamico provides a quality erection with a minimum of side effects and does not cause addiction or dependence [17, 19].

The appearance on the market of new effective and safe drugs that can improve the quality of life of patients with ED makes the therapeutic arsenal of the urologist-andrologist more diverse and allows increasing the number of patients satisfied with such treatment.

Conclusion

The clinical efficacy of sildenafil has been evaluated in a large number of studies conducted in many countries around the world.