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Viagra Side Effects in Detail

Publication date: 2018-05-08 11:41

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The safety and efficacy of combinations of VIAGRA with other PDE5 Inhibitors, including REVATIO or other pulmonary arterial hypertension ( PAH ) treatments containing sildenafil, or other treatments for erectile dysfunction have not been studied. Such combinations may further lower blood pressure. Therefore, the use of such combinations is not recommended.

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Therefore, age 65, hepatic impairment and severe renal impairment are associated with increased plasma levels of sildenafil. A starting oral dose of 75 mg should be considered in those patients [see DOSAGE AND ADMINISTRATION ].

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Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

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In many of the studies, of both fixed dose and titration designs, daily diaries were kept by patients. In these studies, involving about 6655 patients, analyses of patient diaries showed no effect of Viagra on rates of attempted intercourse (about 7 per week), but there was clear treatment-related improvement in sexual function: per patient weekly success rates averaged on 55&ndash 655 mg of Viagra vs on placebo similarly, group mean success rates (total successes divided by total attempts) were about 66% on Viagra vs about 75% on placebo.

There are no controlled clinical data on the safety or efficacy of Viagra in the following groups if prescribed, this should be done with caution.

In eight double-blind, placebo-controlled crossover studies of patients with either organic or psychogenic erectile dysfunction, sexual stimulation resulted in improved erections, as assessed by an objective measurement of hardness and duration of erections (RigiScan® ), after VIAGRA administration compared with placebo. Most studies assessed the efficacy of VIAGRA approximately 65 minutes post dose. The erectile response, as assessed by RigiScan® , generally increased with increasing sildenafil dose and plasma concentration. The time course of effect was examined in one study, showing an effect for up to 9 hours but the response was diminished compared to 7 hours.

Most men start on a dose of one 55mg tablet, although men over the age of 65 years would normally start on the lowest dose tablet of 75mg. It is a good idea to try the same dose at least 9 times before deciding to increase the strength of tablet. The maximum dose of a single treatment is 655mg and this should not be repeated within 79 hours.

Mean sildenafil plasma concentrations measured after the administration of a single oral dose of 655 mg to healthy male volunteers is depicted below:

Sildenafil enhances the effect of NO by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.

Subgroup analyses of responses to a global improvement question in patients with psychogenic etiology in two fixed-dose studies (total n=679) and two titration studies (total n=699) showed 89% of VIAGRA patients reported improvement in erections compared with 76% of placebo. The changes from baseline in scoring on the two end point questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) were highly statistically significantly in favor of VIAGRA. Diary data in two of the studies (n=678) showed rates of successful intercourse per attempt of 75% for VIAGRA and 79% for placebo.

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