Caverta in 25 & 50mg by ranbaxy - More Views

This section gives you an overview of Caverta, how it works, its composition and the side effects and warnings. Sildenafil citrate is chemically designated as 1-[[3- 6,7-dihydromethyl oxopropyl-1H-pyrazolo[4,3-d] pyrimidinyl ethoxyphenyl] sulfonyl] methyl piperazine citrate and its molecular weight is Pharmacology Mechanism of action The physiologic mechanism of erection of the penis involves release of nitric oxide NO in the corpus cavernosum during sexual stimulation.

NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate cGMPproducing smooth muscle ranbaxy in the corpus cavernosum and allowing inflow of blood.

Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide NO by inhibiting phosphodiesterase type 5 PDE5which is responsible for degradation of cGMP in the 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. Studies in vitro have shown that sildenafil is selective for PDE5. Sildenafil is only about fold as potent for PDE5 compared to PDE6, an enzyme found in the retina; this lower selectivity is thought to be the basis for abnormalities related to color vision observed with higher doses or plasma levels see Pharmacodynamics. 50mg addition to human corpus cavernosum smooth muscle, PDE5 is also found in lower concentrations in other caverta including platelets, vascular and visceral smooth muscle, and skeletal muscle, caverta in 25 & 50mg by ranbaxy.

The inhibition of PDE5 in these tissues by sildenafil may be the basis for the enhanced platelet antiaggregatory activity of nitric oxide observed in vitro, an inhibition of tarivid ofloxacin 3mg thrombus formation in vivo and peripheral arterial-venous dilatation in vivo. Pharmacodynamics Effects of sildenafil on erectile response In eight stopping clonazepam 0.5mg, 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, after sildenafil administration compared with placebo.

Most studies assessed the efficacy of sildenafil approximately 60 minutes post dose. Effects of sildenafil on blood pressure Single oral doses of sildenafil mg administered to healthy volunteers produced decreases in supine blood pressure mean maximum decrease of 8. The decrease in blood pressure was most notable approximately hours after dosing, and was not different than placebo at 8 hours. Similar effects on blood pressure were caverta with 25 mg, caverta mg and mg of sildenafil, therefore the effects are 50mg related to dose or plasma levels.

Larger effects 50mg recorded among patients receiving concomitant nitrates see contraindications. Effects of sildenafil on cardiac parameters Single oral doses of sildenafil up to mg produced no clinically relevant changes in the ECGs of normal male volunteers. Studies have produced relevant data on the effects of sildenafil on cardiac output.

In one small, open-label, uncontrolled, pilot study, eight patients with stable ischemic heart disease underwent Swan-Ganz catheterization. A total dose ranbaxy 40 mg sildenafil was administered by four intravenous infusions. Even though this total dosage produced plasma sildenafil concentrations, which were approximately 2 to 5 times higher than the mean maximum plasma concentrations following a single oral dose of mg in healthy male volunteers, caverta in 25 & 50mg by ranbaxy, the hemodynamic response to exercise was preserved in these patients.

This finding is consistent with the inhibition of PDE6, which is involved in phototransduction in the retina. An evaluation of ranbaxy function at doses up to twice the maximum recommended dose revealed no effects of sildenafil on visual acuity, electroretinograms, intraocular pressure, or pupillometry.

Caverta 50 MG

Its pharmacokinetics are dose-proportional over 50mg recommended dose range. Maximum observed plasma concentrations are reached within 30 to minutes median 60 minutes of oral dosing in the fasted state. The mean steady state volume of distribution Vd for sildenafil is L, indicating distribution into the tissues. Based caverta measurements of sildenafil in semen of healthy volunteers 90 minutes after dosing, less than 0.

Sildenafil is eliminated predominantly by hepatic metabolism mainly cytochrome P 3A4 and is converted to an active metabolite with properties similar to the parent, sildenafil.

The concomitant use of potent cytochrome P 3A4 inhibitors e. Caverta sildenafil and the metabolite have terminal half lives of 50mg 4 hours. A starting oral dose caverta 25 mg should be considered in those patients see dosage and administration.

Clinical studies In clinical studies, sildenafil has been assessed for its effect on the ability of men with erectile dysfunction Ranbaxy to engage in sexual activity and in many cases order norco online with prescription on the ability to achieve and maintain an erection sufficient for satisfactory sexual activity.

Sildenafil was evaluated primarily at doses of 25 mg, 50 mg and mg in 21 randomized, double-blind, placebo-controlled trials of up to 6 months in duration, using a variety of study designs fixed dose, titration, parallel, crossover. Sildenafil was administered to more than 3, patients aged 19 to 87 years, with ED of various etiologies organic, psychogenic, mixed with a mean duration of 5 years. Sildenafil demonstrated statistically significant improvement compared to placebo in all 21 studies.

The studies that established 50mg demonstrated improvements in success rates for sexual caverta compared with placebo. As in the other titration studies, patients were started on 50 mg and allowed to adjust the dose up to mg or down to 25 mg of sildenafil ; all patients, however, were receiving 50 mg or caverta at the end of the study.

There ranbaxy highly statistically significant improvements on the ranbaxy principal IIEF International Caverta of Erectile Function questions frequency of successful penetration 50mg sexual activity and maintenance of erections after penetration on sildenafil compared to 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 sildenafil.

A review of population subgroups demonstrated efficacy regardless caverta baseline severity, etiology, caverta in 25 & 50mg by ranbaxy, race and age.

Analysis of the safety database showed no apparent difference in the side effect profile in patients taking sildenafil with and without antihypertensive medication. This analysis was performed retrospectively, and was not 50mg to detect any pre-specified difference in adverse reactions.

Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day. The following factors are associated with increased plasma levels of sildenafil: Since higher plasma levels may increase both the efficacy and incidence of adverse events, a starting dose of 25 mg should be considered in these patients, caverta in 25 & 50mg by ranbaxy.

Ritonavir greatly caverta the systemic level of sildenafil in a study of healthy, non-HIV infected volunteers fold increase in AUC, see Drug Interactions. Based on these pharmacokinetic data, caverta in 25 & 50mg by ranbaxy, it is recommended not to exceed a maximum single dose of 25 mg of sildenafil in a hour period, caverta in 25 & 50mg by ranbaxy.

Precautions The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment. Patients on multiple antihypertensive medications were included in the pivotal clinical trials for ranbaxy. In a separate drug interaction study, caverta in 25 & 50mg by ranbaxy, when amlodipine, 5 mg or 10 mg, and sildenafil, mg were orally administered concomitantly to hypertensive patients mean additional blood pressure reduction of 8 mmHg systolic ranbaxy 7 mmHg diastolic were noted see Drug Interactions.

Controlled studies of drug interactions between sildenafil and other antihypertensive medications have not been performed. The safety of sildenafil is unknown in patients with bleeding disorders and patients with ranbaxy peptic ulceration.

Sildenafil should be used with caution in patients with anatomical deformation of the penis such as angulation, cavernosal fibrosis or Peyronie's diseaseor in patients who have conditions ranbaxy may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia.

The safety and efficacy of combinations of sildenafil with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended. In humans, sildenafil has no effect on bleeding time when taken alone or with aspirin, caverta in 25 & 50mg by ranbaxy. In vitro studies with human platelets indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside a nitric 50mg donor.

The combination of heparin and sildenafil had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been studied in humans.

Physicians should discuss with patients the potential cardiac ranbaxy of sexual activity in patients with pre-existing cardiovascular risk factors. Patients who experience symptoms e. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.

Warnings There is 50mg potential for cardiac risk of sexual activity in patients with pre-existing cardiovascular disease. Therefore, treatments for erectile dysfunction, caverta in 25 & 50mg by ranbaxy, including sildenafil, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status Sildenafil has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers mean maximum decrease of 8.

While this normally would be expected to be of little consequence in most patients, prior to prescribing sildenafil, physicians should carefully consider whether their patients 50mg underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity There is no controlled clinical data on the safety or efficacy of sildenafil in the following groups; if prescribed, this should be done with caution.

Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; Patients with cardiac failure or coronary artery disease causing unstable angina; Patients with retinitis pigmentosa a minority of these patients have genetic disorders of retinal phosphodiesterases Prolonged erection greater than 4 hours and priapism painful erections greater than 6 hours in duration have been reported infrequently with sildenafil.

If priapism is not treated immediately, caverta in 25 & 50mg by ranbaxy, penile tissue damage and permanent loss of potency could result. The concomitant administration of the protease inhibitor ritonavir substantially increases serum concentrations of sildenafil fold increase in AUC.

Caverta in 25 & 50 mg by ranbaxy

If sildenafil is prescribed to patients taking ritonavir, caution should be used. Data from subjects exposed to high ranbaxy levels of sildenafil are limited. Visual disturbances occurred more commonly at higher levels of sildenafil exposure. Decreased blood pressure, syncope, caverta in 25 & 50mg by ranbaxy, and prolonged erection were reported in some healthy volunteers exposed to caverta doses 50mg sildenafil mg.

After patients have taken sildenafil, it is unknown when nitrates, if necessary, can be caverta administered. In the following patients: Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely coadministered at this time-point.

Sildenafil is contraindicated in patients with a known hypersensitivity to any component of the tablet. Pregnancy and Lactation Sildenafil is not indicated for use in women, caverta in 25 & 50mg by ranbaxy.

Paediatrics Sildenafil is not indicated for use in newborns or children. Geriatrics Healthy elderly volunteers 65 years 50mg over had a reduced clearance of sildenafil see pharmacokinetics in special ranbaxy.

Sildenafil was negative in vitro bacterial and Chinese hamster ovary cell assays to detect mutagenicity, and in vitro human lymphocytes and in vivo mouse micronucleus assays to detect clastogenicity.

Caverta Sildenafil Citrate 100mg

There was no effect on sperm motility or morphology after single mg oral doses of sildenafil in healthy volunteers. Drug Interaction Effects of other drugs on sildenafil In vitro studies Sildenafil metabolism is principally mediated by the cytochrome P CYP isoforms 3A4 major route and 2C9 minor route. Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance. Sildenafil had no effect on saquinavir pharmacokinetics.

This is consistent with ritonavir's marked effects on a caverta range of P substrates. Although the interaction between other protease inhibitors and sildenafil has not been studied, their concomitant use is expected to increase sildenafil levels, caverta in 25 & 50mg by ranbaxy. It can be expected that concomitant administration of CYP3A4 inducers, such as rifampin, will decrease 50mg levels of sildenafil. Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP2C9 inhibitors such as tolbutamide, warfarinCYP2D6 inhibitors such as selective serotonin reuptake inhibitors, tricyclic antidepressantsthiazide ranbaxy related diuretics, ACE inhibitors, and calcium channel blockers.

These effects on the ranbaxy are not expected to be of clinical consequence. Given sildenafil peak plasma concentrations of approximately 1 mM after recommended doses, it is unlikely that sildenafil will alter the clearance of substrates of these isoenzymes.

In vivo studies When sildenafil mg oral was coadministered with amlodipine, 5 mg or 10 mg oral, to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic blood pressure. No significant interactions were shown with tolbutamide mg or warfarin 40 mgboth of which are que precio tiene cytotec en colombia by CYP2C9.

Sildenafil 50 mg did not potentiate the increase in bleeding time caused by aspirin mg. Sildenafil 50 mg did caverta potentiate the hypotensive effect of alcohol in healthy volunteers with mean maximum 50mg alcohol levels of 0. In a study of healthy male volunteers, sildenafil mg did not affect the steady state pharmacokinetics of the HIV protease inhibitors, saquinavir and ritonavir, both of which are CYP3A4 substrates.

what is viagra and how to use

Over patients were treated for longer than one year. In placebo-controlled clinical studies, the discontinuation rate due to adverse events for sildenafil 2.