Kamagra

Kamagra is a medicine that is used for problems with erection. Contains the active ingredient sildenafil.

Indications of the kamagra

It is recommended to use for men who suffer impotence - are unable to achieve or maintain a penis in a state of erection, in order to successfully enter into sexual contact.

To achieve the effect of using drugs, sexual stimulation is required.

Release form

The release is carried out in tablets, on the first or 4 pieces in a blister. In the pack - 1 blister plate.

Camagra jelly is produced in sachets with a volume of 5 g. Inside the pack - 1 or 50 such sachets.

Pharmacodynamics

Sildenafil is a medicine used inside, helping to get rid of impotence. At the onset of sexual arousal, the Kamagra restores a weakened erection, increasing the flow of blood to the penis area.

The physiological mechanism that causes an erection includes the process of releasing the NO element inside the corpus cavernosum, which develops upon the initiation of a sexual nature. The released NO element activates the enzyme of guanylate cyclase, which stimulates the increase in the cGMP index, and this leads to a relaxation of the smooth muscle tissues in the area of the cavernous body, helping the blood to flow into the penis.

Sildenafil is a potent selective inhibitor of the PDE-5 component (the so-called cGMP-specific phosphodiesterase) acting inside the cavernous body, where this element promotes the disintegration of the cGMP substance. The effect of sildenafil on erectile function is peripheral. The substance does not have a direct relaxing effect on the isolated cavernous body, but it significantly potentiates the relaxing effect of the NO element with respect to this tissue. During the activation of the NO / cGMP pathway that occurs during sexual stimulation, the slowing of the element PDE-5 by sildenafil increases the cGMP indices inside the cavernous body. In this regard, to get the effect of taking sildenafil, it is required that the man was in a state of sexual arousal.

In vitro tests revealed the selectivity of sildenafil effect on the element of PDE-5, which is an active participant in the development of erection. The effect of sildenafil in relation to PDE-5 is much more powerful than with other known elements of PDE. It is 10 times greater in power than the element PDE-6, which is a participant in phototransformation within the retina.

In case of admission in the maximum permissible dosages, the selectivity of sildenafil in relation to PDE-5 exceeds its selectivity for elements from PDE-2 to PDE-4 and from PDE-7 to PDE-11 by 80 times. For example, the selectivity of the action of the component on PDE-5 is above the selective effect on the PDE-3 component (it is the cGMP-specific isoform of the element that is involved in the regulation of the contractile processes of the heart muscle) by 4000 times.

Pharmacokinetics

Absorption.

Sildenafil is rapidly absorbed. Inside the plasma, its peak reaches 0.5-2 hours (median is 1 hour) - with oral fasting. The average level of bioavailability when ingested is 41% (within 25-63%). Within the limits of average permissible dosages (25-100 mg), the values of AUC, and in addition the peak concentration of the drug for oral use, increase in accordance with the size of the dose.

If the drug is consumed with food, the degree of absorption is reduced. The average time to reach the highest indicator is extended to 1 hour, and the peak concentration level itself falls by 29%.

Distribution.

The average equilibrium values of the distribution volume are 105 liters, from which it can be deduced that the drug is distributed inside the tissues. With a 1-time oral administration of LS in a 100 mg dose, the average value of the total peak concentration within the plasma reaches approximately 440 ng / ml (with a variability factor of 40%). Since the protein synthesis of sildenafil, as well as its main N-desmethyl product of decomposition inside the plasma is 96%, the average maximum value of LS inside the plasma reaches 18 ng / ml (or 38 nmol). The level of protein synthesis in plasma does not depend on the total index of the substance.

In the case of male volunteers who once took a drug of 100 mg, after 1.5 hours inside the ejaculate, less than 0.0002% (an average level of 188 ng) of the substance consumed was detected.

Metabolic processes.

The metabolism of the active substance mostly occurs under the influence of microsomal hepatic isoenzymes - the elements CYP3A4 (main path), and also CYP2C9 (second way).

The main circulating metabolic product is formed by the N-demethylation process of the active ingredient.

The selectivity of this drug metabolite with respect to the element of PDE-5 can be compared with the selectivity of sildenafil itself. The activity of the decay product with respect to the element of PDE-5 is approximately 50% of the activity index of the active substance. The metabolite level inside the plasma has approximately 40% of the indices of sildenafil. Further, the N-demethylated degradation product undergoes other metabolic processes, and its half-life is approximately 4 hours.

Excretion.

The total clearance of the drug is 41 l / h, with a half-life lasting for 3-5 hours. The substance is excreted with its metabolites mainly with feces (about 80% of the dose taken inside), and the remainder with urine (about 13%).

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Dosing and administration

The medicine needs to be taken inside. To achieve the desired effect of its reception, a state of sexual arousal is required.

The standard adult portion of the drug is 50 mg. The drug should be consumed approximately 60 minutes before the alleged sexual contact. In this case, taking into account the patient's tolerance and the effectiveness of the drug itself, the dosage can be increased to 100 mg or reduced to 25 mg. Do not take more than 100 mg of the drug.

The maximum permissible dosage of drugs can be taken no more often than 1 time per day. If you take Camagra with food, its effect can begin a little later than when using the tablet on an empty stomach.

Persons with kidney failure.

People who experience this pathology in moderate or mild form (at a QC level within 30-80 ml / minute), you can take the drug in a standard adult dosage.

Persons with severe disease (with QC values that do not reach 30 ml / minute) should take 25 mg of the drug, because the level of clearance of sildenafil in this case will be reduced.

Taking into account the patient's tolerability, as well as the effect of the drug effect, if necessary, it is permitted to gradually increase the dosage to 50 or 100 mg.

People with liver failure.

Due to the fact that people with this disease (for example, with cirrhosis) have a decrease in the clearance rate of drugs, they can take a maximum of 25 mg of the drug. Increase the dose in 2 or 4 times is required gradually, taking into account the effectiveness of the drug, and at the same time, its tolerance to the patient.

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Contraindications

The main contraindications:

• the presence of hypersensitivity to the active component or other elements of the drug;
• combined with NO donors (eg, amyl nitrite) or nitrate substances of various forms. This use is prohibited, because there is evidence to show that sildenafil has a marked effect on the metabolic pathways of NO / cGMP, and also significantly potentiates the antihypertensive parameters of nitrates;
• states during which sexual activity is banned (for example, in severe cardiomyopathy, with unstable angina or with a severe heart failure stage);
• loss of vision due to one eye due to AION non-arterial type, without taking into account the presence / absence of communication of the disease with the previous intake of inhibitor medications of the PDE-5 component;
• presence of the following pathologies: severe discomfort in the liver, low blood pressure (less than 90/50 mm Hg), a recent myocardial infarction or stroke, and with it diagnosed diseases of the retina in a degenerative form, having a hereditary nature (for example, retinitis pigmentosa, rarely in patients noted genetic lesions of PDE in the eye retina). This is due to the fact that these subcategories of the treated did not investigate the safety of taking the medication.

Kamagra is also not used in persons under the age of 18 and women.

Side effects of the kamagra

Taking medication can cause the development of certain side effects:

• symptoms from the NA and sensory organs: dizziness with severe headaches, flush of blood to the skin of the face, increased sensitivity to light, a violation of color perception and a blurred vision;
• lesions of respiratory organs: nasal congestion;
• disorders of the function of the digestive tract: displays of dyspepsia and diarrhea;
• skin disorders: the appearance of rash;
• Other: pain in the back, infections inside the respiratory system, arthralgia and the flu-like syndrome.

All the above negative reactions are usually expressed rather weakly and quickly pass.

Overdose

As a result of taking a 1-fold dose of LS to 800 mg, there are negative effects similar to those observed with the use of the drug at lower dosages, although they occur more often and have a higher severity. Using Kamagra in the amount of 200 mg did not increase the effectiveness of the drug, but led to an increase in the occurrence of side effects (such as hot flushes with headaches, dyspeptic manifestations, nasal congestion, severe dizziness and problems with the visual organs).

With the development of intoxication, standard support procedures are required. Hemodialysis, most likely, can not accelerate the clearance of the drug, because the substance in large quantities is subjected to protein synthesis inside the plasma, and also because sildenafil is not eliminated with urine.

Interactions with other drugs

It is forbidden to prescribe medication together with other drugs that increase potency, because this can lead to the development of intoxication.

You can not also combine drugs with a number of drugs that affect cardiac function.

Do not take the drug and along with alcoholic beverages, because alcohol in large doses itself has a negative effect on erectile function. When combined with alcohol, there may be a weakening of the properties of Kamagra.

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Storage conditions

The Kamagra is kept in a place that is closed from the access of small children. The temperature maximum at storage - 30 ° С.

Special instructions

Reviews

Kamagra is an analog of Viagra. Judging by the reviews, the drug is quite effective, with a long time of action, rarely causing adverse reactions. Among the shortcomings noted quite high cost.

Shelf life

Kamagra in tablets can be used in the period of 3 years from the date of release of the medicine, and in the form of gel / jelly - maximum for 2 years.