Sildenafil
Sildenafil, known commercially as Viagra, is a renowned treatment in the phosphodiesterase type 5 (PDE5) inhibitors category.
Mechanism of Action
- Sildenafil inhibits the enzyme PDE5, preventing the breakdown of cyclic guanosine monophosphate (cGMP). During sexual arousal, nitric oxide (NO) release elevates cGMP, facilitating vascular smooth muscle relaxation and enhancing blood flow to the penis.
- This mechanism enables individuals to achieve and sustain an erection.
Indications
- Sildenafil is primarily indicated for erectile dysfunction in men.
- Additionally, it is marketed under the name Revatio for treating pulmonary arterial hypertension.
Onset of Action
- Patients can expect sildenafil to take effect within approximately 30 minutes, although some may require up to 1 hour.
Duration of Action
- The effects of sildenafil persist for around 4 to 5 hours, facilitating the achievement and maintenance of an erection during that period.
Dosage
- The standard starting dose for sildenafil is 50 mg, which can be adjusted based on individual response.
- For optimal results, it should be consumed about 30 minutes to 1 hour prior to sexual activity.
Side Effects
- Common adverse effects include headaches, facial flushing, indigestion (nausea, diarrhea), visual disturbances (blurred vision, alterations in color perception), elevated blood pressure, and in rare instances, hearing loss.
Contraindications
- Avoid using sildenafil concurrently with nitrates (such as nitroglycerin) to prevent significant blood pressure drops. It is also contraindicated in individuals with severe cardiac conditions, recent myocardial infarction, or stroke.
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