Pills against erectile dysfunction: contradictions and side effects
A man having decided to return to his life full sex with the help of such pills against erectile dysfunction as Viagra, Cialis and Levitra, should choose the right product. There is undoubtedly no one who will help him in this better than doctor. Here we want to give a short list of side effects of the basic drugs against erectile dysfunction, the indications and contraindications to their use.
The most well-known pills against ED is certainly Viagra. The active component of Viagra is sildenafil citrate. In pills it is contained in doses which are equivalent to 50 mg or 100 mg of sildenafil.
Sildenafil is allocated in case of erectile dysfunction, regardless of the reasons which caused it.
Substance sildenafil citrate is contraindicated at:
- hypersensitivity to this substance;
- simultaneous intake of donor nitric oxide or nitrates in any form;
- occurrence of anatomical deformation of the penis, sickle-cell disease, multiple myeloma, leukemia;
- age younger than 18.
Basic side effects of sildenafil citrate, which you can feel: head ache, visual impairment (change in objects colour (blue/green), intensified light perception, disturbance of clear vision), «rushes» of blood to the face, vertigo, dyspepsia, stuffiness in nose.
Interactions of sildenafil citrate
Also, before ordering Viagra, Cialis or Levitra, one should attentively get to know interactions of their active substances with other substances. For example, cimetidine, erythromycin and ketoconazole increase concentration of sildenafil in the blood and reduce clearance. Sildenafil enhances antiplatelet effect of sodium nitroprusside. Sildenafil can be very dangerous with a joint appointment with peroral hypokalemic drugs, with slow calcium channel blockers and beta-blockers. The combination of sildenafil with nitrates may result in fatal an outcome, sildenafil enhances the hypotensive effect of nitrates.
It is obvious that when a person uses the drug correctly and has no contraindications to use sildenafil, this substance can return the person to ability to enjoy full sex life, but ignoring contraindications can be dangerous.
Dosage of sildenafil citrate
Sildenafil should be taken up to 1 hour before sexual activity. An adult dose is 50 mg 1 time per day. With a glance of efficiency and tolerance the dose may be increased to 100 mg or decreased to 25 mg. The maximum single dose is 100 mg. Patients with compromised liver or kidney function and old patients don’t need dose adjustment.
Another widely used substance against ED is vardenafil. Vardenafil is the active substance of a well-known drug Levitra and many other less known drugs.
This substance is also used at erectile dysfunction.
The main contraindications to vardenafil intake:
- hypersensitivity to any component of the drug;
- combination with such inhibitors of HIV proteases as indinavir or ritonavir;
- simultaneous administration with nitrates or drugs which are donors of nitric oxide;
- inherent prolongation of Q-T interval;
- diseases, predisposing to priapism (sickle-cell disease, multiple myeloma, leukemia);
- severe compromised liver function;
- anatomical penis deformation;
- age younger than 18 years old.
Side effects of vardenafil
Vardenafil is renowned for that fact that it rarely causes side effects. Side effects are usually slightly or moderately expressed and are transient. Common side effects of vardenafil include headache, facial blush, dyspepsia, nausea, vertigo, rhinitis. Rare side effects of vardenafil: facial edema, photosensitization, pains in the small of the back, high blood pressure, changes in the functional "liver" tests, increased gamma-glutamyl transpeptidase, increased creatine kinase, myalgia, sleepiness, dyspnea, visual impairment, running eyes, priapism, anaphylactic reactions (including laryngeal edema), stenocardia, low blood pressure, myocardial ischemia, postural hypotension, syncopal state, increased muscle tone, nosebleed, glaucoma.
Now, about the interactions of vardenafil with other substances.
In combinatopn of vardenafil with erythromycin, ketoconazole, itraconazole its dose shouldn’t be exceeded more than 5 mg. At the same time the dose of ketoconazole and itraconazole should not exceed 200 mg. Combination with indinavir and ritonavir is contraindicated. Nitrates, nitric oxide donors: combined appointment of vardenafil and nitrates is contraindicated because of the risk of increasing arterial hypotension. Combined therapy by alpha-blockers and Levitra can be followed by the extension of low blood pressure. Vardenafil should be taken not earlier than in 6 hours after the administration of alpha blockers, and the dose should not exceed 5 mg. However, in combination with the alpha-blocker tamsulosin, drugs intake can be concur with time.
The initial dose is 10 mg. It should be taken 25-60 minutes before sexual intercourse. Effect duration of Vardenafil is 4-5 hours. The maximum recommended frequency of intake is 1 time per day. Depending on the effectiveness and tolerance of treatment the dose may be increased to 20 mg or decreased to 5 mg per day. The maximum recommended dose is 20 mg 1 time per day.
The third well-known substance is tadalafil, active substance of Cialis and many other drugs.
Indications: erectile dysfunction.
- hypersensitization to tadalafil;
- intake of drugs containing any organic nitrates.
- age till 18 years old.
Side effects of tadalafil
The most frequent side effects of Cialis include headache and dyspepsia, low-back pain, myalgia, stuffiness in nose and «rushes» of blood to the face. Rarer side effects include eyelids edema, eyes pain, conjunctiva hypermia and vertigo.
The recommended dose of tadalafil is 20 mg. Tadalafil is taken before anticipated sexual activity, regardless of food intake. The drug should be taken at least 16 minutes before anticipated sexual activity.
Patients may carry out an attempt of sexual intercourse at any time within 36 hours after taking the drug in order to establish the optimal time for drug intake. The maximum recommended frequency of administration is once a day.
Tadalafil is mainly metabolized by the enzyme CYP3A4. Selective inhibitor of CYP3A4, ketoconazole, increases the area under the curve "concentration-time" by 107%, and rifampicin reduces it to 88%.
Despite the fact that the specific interactions have not been studied, we can assume that inhibitors of such proteases such as ritonavir and saquinavir, as well as inhibitors of CYP3A4, such as erythromycin and itraconazole increase activity of tadalafil.
Simultaneous administration of antacid (magnesium hydroxide /aluminium hydroxide) and tadalafil reduces the rate of absorption of tadalafil without altering of the area under pharmacokinetic curve for tadalafil. Enlargement of рН stomach as a result of taking Н2-receptor antagonist nizatidine didn’t exert influence on pharmacokinetics of tadalafil.
If you have decided to order Viagra, Cialis or Levitra online, be sure to get to know the above-mentioned information. Also be sure to consult with your doctor - a survey of professional doctor can detect your organism changes, excluding the possibility of taking the drug.
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Within his training as a Specialist in General Internal Medicine, he trained at the london Hospital in the diagnosis, screening, testing and treatment of all STD and STI. He has carried out and supervised research into medical treatment of Ed, Male and Female Sexual Dysfunction. He has written many legal opinions on sexual health matters, as well as other sexual practices and diseases such as impotence, erectile dysfunction, bizarre sexual practise and auto-eroticism.
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