Sildenafil
Sildenafil, a potent phosphodiesterase type 5 (PDE5) inhibitor, is marketed under the trade name Viagra. This medication is primarily recognized for its effectiveness in enhancing sexual health.
Mechanism of Action
- Sildenafil effectively inhibits the enzyme phosphodiesterase type 5 (PDE5), which is responsible for degrading cyclic guanosine monophosphate (cGMP). During sexual arousal, the release of nitric oxide (NO) elevates cGMP levels, leading to relaxation of penile smooth muscles and increased blood flow, facilitating an erection.
- This mechanism allows for the achievement and maintenance of an erection.
Indications
- Sildenafil is primarily indicated for the treatment of erectile dysfunction in men.
- It is also prescribed for managing pulmonary arterial hypertension under the brand name Revatio.
Onset of Action
- Typically, sildenafil begins to work within 30 minutes of ingestion; however, some individuals may experience effects after up to 1 hour.
Duration of Action
- The effects of sildenafil generally last for 4 to 5 hours, providing ample time for satisfactory sexual activity.
Dosage
- The recommended initial dose of sildenafil is 50 mg, which can be adjusted based on patient response and requirements.
- For optimal results, it should be taken approximately 30 to 60 minutes before anticipated sexual activity.
Side Effects
- Common side effects include headache, facial flushing, gastrointestinal discomfort (nausea, diarrhea), visual disturbances (blurred vision, color perception changes), elevated blood pressure, and, in rare cases, hearing loss or alterations in hearing.
Contraindications
- Sildenafil must not be combined with nitrates (e.g., nitroglycerin) due to the risk of a severe drop in blood pressure.
- It is not suitable for patients with significant cardiovascular conditions, recent heart attack, or stroke.
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