Dzhenagra

Genagra is the selective inhibitor of cGMP PDE-5. The drug affects the erectile function.

Indications Zhenagry

It is used for therapy in the presence of problems with potency (to increase the ability to develop and retain an erection during sexual contact).

Release form

The release of the substance is realized in tablets with a volume of 25, 50 or 100 mg. Inside the blister pack, 1 or 4 tablets. In the box - 1 pack.

Pharmacodynamics

Sildenafil helps block the activity of the enzyme PDE-5, which causes cumulation of cGMP inside the cavernous bodies of the penis - thus, the drug has an indirect effect without affecting the cavernous bodies directly. The increase in cGMP values causes active relaxation of smooth muscle within the cavernous bodies, and besides it increases the blood flow to the penis, which ensures a firm and persistent erection during the entire sexual act.

The effectiveness of the effect of the drug directly depends on the desire and feelings of arousal of the man. During the excitation process, the release of nitric oxide, which is a participant in the activation of the guanylate cyclase enzyme, occurs. Due to this, cumulation begins and cGMP values increase. Enzyme PDE-5 disrupts the activity of cGMP, but more active production of nitric oxide increases the severity of erection and its duration. A stronger cumulation of NO is observed when sildenafil is affected.

If a man's sexual arousal is absent, the medicine will not be able to have the desired effect, because in such a situation there will not be an initial trigger mechanism that is associated with the secretion of the NO element. The genagra influences orgasm, a little potentizing it, and besides it enhances the sense of satisfaction from sex.

Pharmacokinetics

When you use drugs inside fasting, it is quickly absorbed. The bioavailability values are approximately 41%. Peak blood values of sildenafil are detected after a lapse of 0.5-2 hours. The primary effect is observed on the average by the 60th minute. The rate of absorption of the drug is reduced when it is combined with fatty foods. The degree of synthesis of the substance with albumin is 96%.

The metabolism of the substance occurs inside the liver, using the hemoprotein system P450, where it is transformed into the active product of N-desmethyl sildenafil decomposition. The half-life is 4 hours.

Elimination in the form of metabolic products occurs mainly with feces, about 13% is excreted in urine.

In the elderly, the blood level of sildenafil is higher by 40%.

In individuals with CRF, a significant increase in the level of Sma is observed in the severe stage by 88% (as a result of a decrease in the sildenafil clearance due to the disease). If a moderate or mild degree of disease is observed, no such changes are noted.

In people with liver failure, too, the rate of clearance of sildenafil, resulting in a 47% increase in the level of Smoke drug.

The genagra does not have a negative impact on male fertility.

Dosing and administration

Take the drug must be taken orally, on an empty stomach (because in this case, the development of therapeutic effects occurs faster than when taking drugs along with food). The medication is applied for 1 hour before sexual contact. To achieve the optimal influence of drugs, it is necessary that the man was excited.

The size of the first single dose is 50 mg. If required (for example, if there is no effect), the portion is allowed to be increased to 0.1 g. Also, the dose can be reduced to 25 mg if the 50 mg dosage gives too much effect. Do not take more than 0.1 grams. Between the use of tablets, gaps of at least 24 hours must be observed.

Men with chronic renal failure, having a moderate or mild degree of severity, are prescribed the same dosages as those who are healthy. In case of severe disease or liver failure, a dose of 25 mg is recommended first.

If the patient is taking ritonavir, then Gagarina should be consumed in a dosage of 25 mg at intervals of 48 hours.

When combined sildenafil with itraconazole, ketoconazole, as well as saquinavir and erythromycin, it should be used in the initial portion of not more than 25 mg.

During therapy with drugs that block the activity of α-adrenergic receptors, one must take into account the risk of developing orthostatic collapse, which means that treatment should begin with minimal portions of Genagra.

[2]

Contraindications

Among the contraindications:

• the patient is intolerant of sildenafil or other medicinal components;
• use in combination with nitrates, nitrites of organic type, as well as donators of nitric oxide;
• use for persons with concomitant disease in the CAS region, having severe form (for example, heart failure or unstable angina);
• the presence of an optic form of neuropathy, which is non-arterial in nature and developing in the anterior ischemic region (the loss of vision is also noted on the background of the disease);
• insufficiency of the liver, which has a severe character;
• decreased values of blood pressure;
• use in women, as well as persons under the age of 18 years.

Side effects Zhenagry

Side-effects often develop when using drugs in high dosages. These symptoms are temporary and curable. In the case of receiving Genagra in therapeutic portions, she is transferred without complications.

Sometimes there are moderate-onset headaches, nasal congestion, facial congestion, changes in color perception and dyspepsia. Occasionally, signs of priapism develop.

All of the above manifestations are transient and do not need additional treatment procedures.

In the presence of individual intolerance, allergy symptoms may appear.

[1]

Overdose

With the introduction of dosages up to 0.8 g there are strong enough side effects.

Symptomatic procedures are used to eliminate them. Since the drug is firmly synthesized with albumin, dialysis sessions will be ineffective.

Interactions with other drugs

Substances that slow down the activity of hemoprotein P450, reduce the elimination of sildenafil, which increases the likelihood of the appearance of negative symptoms.

Medications that induce the activity of hemoprotein P450, prolong the half-life of drugs, and also reduce the duration of its therapeutic effect.

Cimetidine, as well as drugs that slow the action of CYP 3A4, reduce the level of clearance of sildenafil, and in addition increase the risk of negative symptoms.

Combination of Genagra with drugs slowing the activity of HIV proteases (such as ritonavir or saquinavir) increases the peak rate of drug absorption inside the blood, respectively by 1000% and 140%.

One-time use of antacids does not lead to a change in the pharmacokinetic properties of drugs.

Sildenafil increases the therapeutic properties of nitrates, which increases the risk of a significant decrease in blood pressure. Because of this, these drugs are not allowed to be combined.

Grapefruit juice affects the metabolic processes of drugs, as a result of which its blood values Smax increase.

Warfarin with tolbutamide does not interact with the drug.

Doxazosin in combination with a medication can lead to the appearance of orthostatic collapse, but without loss of consciousness.

Genagra does not have a negative interaction with antihypertensive drugs.

Sildenafil does not potentiate the effects of alcoholic beverages.

[3], [4]

Storage conditions

The genagra should be kept at temperatures not exceeding 25 ° C.

Shelf life

Genago can be used within 36 months of the release of the therapeutic drug.

Analogues

Analogues of the medicine are medicines Potential, Viagra, and also Penimex and Vekta.