Sildenafil Citrate two decades of benefits or risks

An overview of Erectile Dysfunction

Erectile dysfunction (ED) is also known as male impotence. Erectile dysfunction is the persistent inability to achieve or maintain firm and strong erection for sufficiently longer period of time. This leaves both the partners sexually dissatisfied. Active sex life has positive effect on overall health of an individual.

Causes of Erectile Dysfunction

The cause of erectile dysfunction can be physical or psychological. The most common causes include:

• Diseases such as diabetes, heart diseases, hypertension
• Addictions such as Smoking,  drinking alcohol , drug abuse
• Certain medications that cause ED as a side effect.
• Penile injury
• Obesity
• Surgery
• Relationship conflicts with partner
• Psychological causes include stress, depression, performance anxiety, and frustration.

Treatment includes

• Medicines belonging to class of drugs known as phosphodiesterase type 5 (PDE-5) inhibitors like Sildenafil citrate, Tadalafil, Vardenafil. Alprostadil penile injections are also available for treating ED.
• Penile pumps
• Penile implants or penile prosthesis
• Surgery
• Lifestyle changes like no smoking, no alcohol consumption, no drug abuse and exercising regularly and eating the right food.
•  Counselling sessions

Sildenafil citrate

Sildenafil citrate was the first effective oral drug approved for the use for treating ED in the year 1998 by the Food and Drug Administration (FDA).  Within the period of six month post its approval by FDA, millions of prescriptions were written for sildenafil citrate. It belongs to class of drugs known as phosphodiesterase type 5 (PDE-5) inhibitors.   Sildenafil citrate is a prescription based drug.  Sildenafil Citrate is not a habit forming drug. It is sold under the brand name Viagra. Generic version (Generic Viagra) of the brand Viagra is also available at low cost.

Mechanism of Action   

The enzyme PDE-5 is present large amount inside penis. The sildenafil citrate increases the amount of the enzyme cGMP by inhibiting its degradation by phosphodiesterase type 5 enzyme. The enzyme cGMP causes relaxation of smooth muscles inside penis and widens the blood vessels inside the penis. These blood vessels increase the blood flow to the penis. This increased blood flow to the penis results in a firm and strong erection of the penis. The increased blood flow also maintains the erection for longer duration of time sufficient enough for satisfactory sexual intercourse. 

Onset of action and Duration of effect   

The action of this medicine can be seen within 30 to 120 minutes after administration. The onset of action varies from patient to patient. The effect of this medicine lasts for an average duration of 4 hours.

 Dosing Instructions

 The usual recommended dose of Sildenafil citrate is 100mg once a day. Take this medicine with a glass of water approximately 45 to 60 minutes before sexual intercourse.  Take this medicine as advised by the doctor. Do not consume larger or smaller doses of this medicine. Also take it for the duration as recommended by the doctor.  This medicine can be taken with or without food. 

Precautions and Warnings 

Before starting this medicine tell your complete medical history to your doctor.  Sildenafil citrate should not be taken by the patients with a history of allergy to Sildenafil Citrate or any other PDE-5 inhibitor.  This medicine has shown severe interaction with nitrates and other blood pressure lowering medicines. So avoid taking these medicines together.  Avoid any activity that involves high degree of mental alertness as this medicine causes mild dizziness   Alcohol, grapefruit juice and fatty meal should be avoided while taking Sildenafil citrate.  Use of Sildenafil citrate should be avoided in pregnant women and nursing mothers. 

Common Side effects 

Common side-effects of Sildenafil citrate ( Generic Viagra 100mg ) which stop after discontinuing the medicine include, pain in head, back and muscle pain, vision disturbances, diarrhea, flushing, nasal congestion, nausea dizziness, skin rash 

Steps to be followed in case of missed dose- 

Take the missed dose as soon as you remember. Skip the missed dose if it’s almost the time for next scheduled dose.  Do not take two doses together or an extra dose to compensate for a missed dose.   

Steps to be followed in case of overdose- 

Seek immediate medical attention if you experience the following overdose symptoms:  chest pain, sudden hearing loss, and sudden vision, loss difficulty in breathing irregular heartbeats, swelling of face, lips and tongue, prolonged and painful erection for more than four hours.

After two decades of the wide use of sildenafil citrate as a drug of choice for the treatment of ED  and  after the numerous studies and clinical trials undertaken during this time period  it can be concluded that   the benefits of sildenafil citrate  outweigh the risks and they improve the sexual life of the men with ED

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