Fildena Red Fildena compared to viagra
Mechanism of action. Fildena for women is a drug for oral administration, intended for the treatment of erectile dysfunction. With sexual arousal, the drug restores reduced erectile function by increasing blood flow to the penis.
The physiological mechanism that leads to erection involves the release of nitric oxide (NO) in cavernous bodies during sexual arousal. The released nitric oxide activates the enzyme guanylate cyclase, which stimulates an increase in the level of cyclic guanosine monophosphate (cGMP), which in turn causes relaxation of the smooth muscles of the cavernous bodies, contributing to the flow of blood.
Fildena 100 is a potent and selective inhibitor of cGMP-specific phosphodiesterase 5 (FDE5) in cavernous bodies, where fde5 is responsible for the breakdown of cGMP. The influence of Fildena 100 side effects on the erection is peripheral. Fildena forum does not have a direct relaxing effect on isolated cavernous human body, but powerfully enhances the relaxing effect of NO on this tissue. When activated by the metabolic pathway of NO / cGMP, which occurs during sexual stimulation, inhibition by Fildena 50 FDE5 leads to an increase in the level of cGMP in the cavernous bodies. Thus, in order for Fildena information to cause the necessary pharmacological effect, sexual arousal is necessary.
Fildena Red Fildena fruit chew
Influence on pharmacodynamics. Studies in vitro have shown that Fildena fruit chew reviews is selective for ФДЕ5 that takes an active part in the process of erection. The effect of Fildena forum on FDE5 is stronger than other known phosphodiesterases. This effect is 10 times stronger than the effect on ФДЕ6 what is involved in the processes of transformation associated, in the retina. When using the maximum recommended doses, the selectivity of Fildena for women to ФДЕ5 80 times greater than its selectivity for ФДЕ1, 700 times higher than ФДЕ2, PDAS, ФДЕ4, ФДЕ7, ФДЕ8, ФДЕ9, ФДЕ10 and ФДЕ11. In particular, the selectivity of Fildena safety to FDE5 is 4000 times higher than its selectivity to FDEZ – camp-specific isoform of phosphodiesterase involved in the regulation of cardiac contractility.
Absorption. Fildena super active 100mg is rapidly absorbed. The maximum plasma concentration of the drug is achieved within 30-120 minutes (with a median of 60 minutes) after its oral administration on an empty stomach. The average absolute bioavailability after oral administration is 41 % (with a range of values from 25 to 63 %). In the recommended dose range (from 25 to 100 mg), the AUC and Smax of Fildena ingredients after oral administration increase in proportion to the dose.
Fildena Red Fildena side effects
In the application of Fildena for women during meals extent of absorption is reduced, with an average elongation Tmax of 60 min and an average decrease in Cmax of 29 %.
Distribution. The average equilibrium volume of distribution (Vd) is 105 liters, which indicates the distribution of the drug in the tissues of the body. After a single oral administration of Fildena vs Filagra at a dose of 100 mg, the average maximum total plasma concentration of Fildena tablets is approximately 440 ng / ml (coefficient of variation is 40 %). Since the binding of Fildena instructions and its main n-desmethyl metabolite to plasma proteins reaches 96 %, the average maximum plasma concentration of free Fildena side effects reaches 18 ng/ml (38 nmol). The degree of plasma protein binding is independent of the total Fildena 50 concentrations.
In healthy volunteers who used Fildena 50 reviews once in a dose of 100 mg, after 90 minutes in the ejaculate was determined less than 0. 0002 % (average 188 ng) of the applied dose.
Biotransformation. The metabolism of Fildena information is mainly carried out with the participation of microsomal liver isoenzymes CYP3A4 (main pathway) and CYP2C9 (secondary pathway). The main circulating metabolite is formed by N-demethylation of Fildena viagra. The selectivity of the metabolite relative to ФДЕ5 comparable with Fildena online selectivity and activity of the metabolite relative to ФДЕ5 is approximately 50 % activity of the initial substance. The plasma concentration of this metabolite is approximately 40% of the concentration of Fildena chew in blood plasma. The n-demethylation metabolite is further metabolized, and its half-life is approximately 4 hours.
Fildena Red Fildena forum
Elimination. The total clearance of Fildena viagra is 41 l / h, causing the period of its half-life lasting 3-5 hours. Both after oral and after intravenous administration, the excretion of Fildena forum in the form of metabolites is carried out mainly with feces (approximately 80% of the administered oral dose) and to a lesser extent with urine (approximately 13% of the administered oral dose).
Pharmacokinetics in special groups of patients.
Elderly patients. In healthy elderly volunteers (over 65 years), there was a decrease in the clearance of Fildena online, which led to an increase in plasma concentrations of Fildena safety and its active n-demethyl metabolite by approximately 90% compared to the corresponding concentrations in healthy younger volunteers (18-45 years). Due to age differences in plasma protein binding, the corresponding increase in the plasma concentration of free Fildena vs viagra was approximately 40 %.
Renal failure. In volunteers with impaired renal function of mild to moderate (creatinine clearance 30-80 ml/min), the pharmacokinetics of Fildena extra power 150 remained unchanged after its single oral administration at a dose of 50 mg. Average AUC and Cmax Of n-demethylated metabolite increased by a maximum of 126% and a maximum of 73%, respectively, compared to such indicators in volunteers of the same age without impaired renal function. However, due to high individual variability, these differences were not statistically significant. In volunteers with severe renal impairment (creatinine clearance below 30 ml / min), Fildena tablets clearance decreased, resulting in an average increase of 100% and 88% respectively in AUC and Cmax compared to volunteers of the same age without renal impairment. In addition, the values of AUC and Cmax of N-demethylated metabolite significantly increased by 200% and 79%, respectively.
Fildena Red Fildena chew
Liver failure. In volunteers with mild to moderate cirrhosis (classes a and B according to the classification of child – Pugh), Fildena sildenafil citrate tablets clearance decreased, which led to an increase in AUC (84 %) and Cmax (47 %) compared with the corresponding indicators in volunteers of the same age without liver dysfunction. The pharmacokinetics of Fildena instructions in patients with severe liver dysfunction has not been studied.
Fildena XXX ® is recommended for men with erectile dysfunction, which is defined as the inability to achieve or maintain the erection of the penis necessary for successful sexual intercourse.
For the effective action of the drug Fildena online® requires sexual arousal.
Fildena Red Fildena pills
Hypersensitivity to the active substance or any of the excipients of the drug.
Coadministration with nitric oxide donors (such as amylnitrite) or nitrates in any form is contraindicated, since it is known that Fildena safety affects the metabolism pathways of nitric oxide/cyclic guanosine monophosphate (cGMP) and potentiates the hypotensive effect of nitrates.
Coadministration of PDE5 inhibitors (including Fildena 50 reviews) with guanylate cyclase stimulants such as riociguate is contraindicated, as may lead to symptomatic hypotension (see paras. Section “Interaction with other medicinal products and other forms of interaction”).
Conditions in which sexual activity is not recommended (for example, severe cardiovascular disorders such as unstable angina or severe heart failure).
Loss of vision in one eye due to non-arterial anterior ischemic optic neuropathy, regardless of whether this pathology is associated with previous use of PDE5 inhibitors or not.
The presence of diseases such as severe liver dysfunction, hypotension (blood pressure below 90/50 mm Hg. Recent stroke or myocardial infarction, and known hereditary degenerative retinal diseases such as pigment retinitis (a small number of such patients have genetic disorders of retinal phosphodiesterases), because the safety of Fildena sildenafil citrate tablets has been studied in such subgroups of patients.
Fildena Red Fildena vs viagra
Interaction with other drugs and other types of interactions
The effect of other drugs on Fildena safety.
Fildena Red Fildena 100 side effects
In vitro studies. Metabolism of Fildena viagra occurs mainly with the participation of the ZA4 isoforms (major route) and 2C9 isoforms (minor route) cytochrome P450 (CYP). Therefore, inhibitors of these isoenzymes may reduce Fildena reviews clearance and inducers of these isoenzymes may increase Fildena 25 clearance.
In vivo studies. Population pharmacokinetic analysis of clinical studies data showed a decrease in the clearance of Fildena 100 while using with CYP3A4 inhibitors (such as ketoconazole, erythromycin, cimetidine). Although the simultaneous use of Fildena side effects and CYP3A4 inhibitors increase in the frequency of side effects was not observed, it should be considered the possibility of using an initial dose of Fildena compared to viagra 25 mg.