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Sildenafil


What is Sildenafil?

If you have not heard of Sildenafil, perhaps it is better for us to use the name Viagra as this is the brand name. Sildenafil is used to treat erectile dysfunction and is a solid choice in these matters. After all, more than 20 million men worldwide can’t be wrong. This will assist you getting, and more important, keeping an erection. Sildenafil will act by relaxing the blood vessels in your penis, allowing for more blood to flow. This medicine contains the same active ingredient as Viagra.

Dosage

Sildenafil pills are available in dosages of 25mg, 50mg and 100mg.

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Buy Sildenafil With an Online Prescription

An online doctor consultation means filling out a medical questionnaire. A registered EU doctor assesses your medical questionnaire and analize whether generic Sildenafil is suitable and safe for you to buy. After approval, a prescription is issued and send to the registered EU pharmacy. You will receive your discretely shipped Sildenafil pills within 3 business days.

Based on the results of the Massachusetts study on the study of male aging, it can be assumed that in 1995 there were more than 152 million men suffering from erectile dysfunction (ED) worldwide. According to expert forecasts, by 2025 their number will increase by 170 million people and amount to 322 million. A significant increase in patients with ED will occur in developing countries. In Europe, such patients by this time will be approximately 11.9 million, in North America - 9.1 million, in Africa - 19.3 million, in Asia - 113 million.

Erectile function is a key indicator of the quality of life for many men. Erectile dysfunction is a problem that can affect up to 52% of men aged 40 to 70 years. This causes serious concern due to the negative impact of ED on self-esteem, quality of life and interpersonal relationships in society. Of 52% of men with ED 17.2% have a mild, 25.2% moderate and 9.6% have a severe degree of erectile dysfunction. According to statistics, the incidence of ED correlates with age, but it should be remembered that it is not an inevitable consequence of aging, and old age does not exclude sexual desire in men. Nevertheless, with an increase in life expectancy, the prevalence of ED will inevitably increase. The presence of ED in a man has a negative effect on his partner, causing her secondary sexual dysfunction.

Studies have shown that ED is associated with metabolic syndrome and cardiovascular disease and is currently considered their marker. A diagnosis of ED can be used for early detection of the risk of cardiovascular disease.

The discoveries of the last two decades in the field of neurophysiology and molecular biology have led to significant progress in the treatment of patients with ED and its associated diseases. A fundamentally new tool has been developed in the treatment of this disease - sildenafil (Viagra), which meets all modern requirements for ED therapy. This drug is a highly effective and reliable oral medication, has few side effects. According to the mechanism of action, it refers to type 5 phosphodiesterase inhibitors (PDE-5). Selective inhibition of PDE-5 improves tolerance to ischemia and hypoxia, therefore, exposure to this enzyme opens up new possibilities for pharmacological correction through NO-dependent mechanisms.

In their work “PDE-5 Inhibitors in the Treatment of Erectile Dysfunction: The Right Drug for the Right Patient,” Italian researchers G. Corona and N. Mondaini emphasized that ED is a common disorder that affects men around the world. PDE-5 inhibitors are effective, are well tolerated and are first-line drugs for the treatment of ED. This is currently the “gold standard” in the treatment of ED, and the intracavernous drugs that were widely used before have now become second-line drugs. This is primarily due to the high effectiveness of new drugs, and most importantly - with oral administration and ease of use.

The efficacy and safety of sildenafil have been confirmed in patients with ED of various etiologies. By 2003, more than 20 million people worldwide were taking sildenafil with excellent results. Despite the fact that ED was caused by such severe and poorly treatable diseases as radical prostatectomy in patients with prostate cancer, severe diabetes mellitus, and spinal cord injury, sildenafil has also been shown to be effective in such patients. The incidence of adverse cardiovascular effects in patients taking sildenafil did not differ from those in the population. A study of the pharmacological effects of sildenafil on ischemic myocardium also confirms the safety of this drug. Sildenafil has proven to be safe and effective in patients taking various medications,

Taking alcohol in moderate doses does not have any effect on the pharmacokinetics of sildenafil when taken together. Studies have shown that the use of Viagra with alcohol does not lead to a change in cardiac output, heart rate, blood pressure, and peripheral vascular resistance. Sildenafil does not enhance the hypotensive effect of alcohol when its concentration in the blood is 0.08%, or 80 mg/dl.

In Russia, an online survey was conducted with 304 men and 306 women, in which heterosexual men and women took part. The study evaluated many parameters: the place of sex in the list of life priorities, satisfaction depending on the age and degree of hardness of an erection, the relationship between sex and main life priorities, the frequency of sexual intercourse, and the degree of satisfaction with sex. The hardness of an erection was put at the forefront. The study showed that sex plays a very important role in the lives of 67% of men and 55% of women. However, 58% of men and 64% of women are not completely satisfied with their sex life. 30% of men noted that their hardness of erection is not optimal (3rd degree on the scale of hardness of erection or lower), and 50% see this as a problem.

It has been proven that sildenafil provides 20 times higher penetration ability than placebo (for comparison: vardenafil - 7.5 times, and tadalafil - 1.4 times).

The clinical benefits of sildenafil therapy in countries with high levels of heart disease, in particular, heart failure, have been demonstrated by scientists from the Montreal Heart Institute by conducting a retrospective review of medical records of 16 patients admitted to the heart transplant center due to progressive heart failure. In patients, systolic and mean pulmonary pressure, transpulmonary pressure gradient, cardiac output, and cardiac index were determined. The functional class of heart failure was assessed according to the criteria of the New York Heart Association (NYHA) at baseline and after 6 months of sildenafil therapy. Patients received Viagra therapy for 4166 patient days at an average dose of 102.5 ± 54.0 mg/day. None of the patients dropped out of the study due to side effects of the drug. After 6 months of treatment, an improvement in the cardiac index (p = 0.014), pressure in the pulmonary artery (p = 0.049) was noted without any significant change in other hemodynamic parameters. In 10 patients (62.5%) there was an improvement in the functional class of heart failure according to NYHA, 8 later underwent a heart transplant (50%), and in 2 the improvement reached such a degree that this operation was avoided (12.5%). The authors concluded that sildenafil therapy in patients with heart failure is well tolerated and significantly improves cardiac functionality 5%) there was an improvement in the functional class of heart failure according to NYHA, 8 later underwent a heart transplant (50%), and in 2 the improvement reached such a degree that this operation was avoided (12.5%). The authors concluded that sildenafil therapy in patients with heart failure is well tolerated and significantly improves cardiac functionality. 5%) there was an improvement in the functional class of heart failure according to NYHA, 8 later underwent a heart transplant (50%), and in 2 the improvement reached such a degree that this operation was avoided (12.5%). The authors concluded that sildenafil therapy in patients with heart failure is well tolerated and significantly improves cardiac functionality.

In recent years, there has been significant interest in the use of sildenafil as the target method in the treatment of pulmonary arterial hypertension. Its use significantly improved such an indicator as patient survival, which in the past did not exceed 2.5 years. A combination of sildenafil and endothelin receptor antagonists is recognized as an effective treatment method. Different mechanisms of action of each class of drugs provide a synergy of their effects. Sildenafil suppresses PDE-5 in the vasculature of the lungs, which causes the expansion of blood vessels and reduces pulmonary vascular pressure. In addition, when used in combination with prostaglandin inhibitors, PDE-5 inhibitors cause relaxation of smooth muscles in the walls of the pulmonary vessels and, therefore, reduce both pulmonary pressure and total vascular resistance.

Short-term sildenafil therapy is safe and effective in patients with pulmonary arterial hypertension. However, data on the effect of sildenafil on the survival of patients with idiopathic pulmonary arterial hypertension are still scarce. A study at Peking University examined the effects of sildenafil therapy in 77 patients with newly diagnosed idiopathic pulmonary hypertension between 2005 and 2009. Patients were divided into 2 groups: sildenafil and conventional therapy. The baseline characteristics of patients receiving sildenafil were similar to the comparison group. Catheterization of the right heart was performed initially and after 3 months for patients from the sildenafil group. After 3 months of treatment with sildenafil, a significant improvement was noted during the test with a 6-minute walk, Myocardial oxygen consumption increased significantly (p <0.05). One-, two-, and three-year survival rates for those receiving sildenafil were 88, 72, and 68%, respectively, compared with 61, 36, and 27% in the control group (p <0.001). A low body mass index and a decrease in oxygen saturation of the myocardium without sildenafil were independent predictors of fatal outcomes. The use of sildenafil as a pathogenetic therapy is associated with improved survival of patients with idiopathic pulmonary arterial hypertension. A low body mass index and a decrease in oxygen saturation of the myocardium without sildenafil were independent predictors of fatal outcomes. The use of sildenafil as a pathogenetic therapy is associated with improved survival of patients with idiopathic pulmonary arterial hypertension. A low body mass index and a decrease in oxygen saturation of the myocardium without sildenafil were independent predictors of fatal outcomes. The use of sildenafil as a pathogenetic therapy is associated with improved survival of patients with idiopathic pulmonary arterial hypertension.

ED is highly dependent on the release of nitric oxide (NO) in endothelial cells. Insulin resistance is the cause of endothelial dysfunction, which is characterized by a decrease in the synthesis and release of NO. A prospective, randomized, placebo-controlled, double-blind study in 30 men with ED, insulin resistance and a lack of response to sildenafil showed that to level this effect, it is enough to reduce insulin resistance. In the studied patients, the HOMA insulin resistance index (homeostatic model for assessing insulin resistance) was measured (its level ≥ 3 was considered to be significantly high). Patients were divided into 2 groups: those receiving metformin (n = 17) or placebo (n = 13). After treatment with metformin, patients showed a significant improvement in erectile function in accordance with the International Index of Erectile Function (ICEF-5) and a significant decrease in the HOMA index from the second month of treatment (ICEF-5 index was 17.0 ± 6.0 versus 14.3 ± 3.9 (p = 0.01) and HOMA - 3.9 ± 1.6 versus 5.5 ± 2.4 (p = 0.01)) to the fourth (ICEF-5 - 19.8 ± 3.8 versus 14.3 ± 3.9 (p = 0.005) and HOMA - 4.5 ± 1.9 versus 5.5 ± 2.4 (p = 0.04)), without changing these parameters in patients with ED who received placebo. The data from this study indicate the need to take into account the biochemical mechanisms of endothelial dysfunction and apply complex exposure methods. 9 (p = 0.01) and HOMA - 3.9 ± 1.6 against 5.5 ± 2.4 (p = 0.01)) to the fourth (ICEF-5 - 19.8 ± 3.8 against 14 , 3 ± 3.9 (p = 0.005) and HOMA - 4.5 ± 1.9 versus 5.5 ± 2.4 (p = 0.04)), without changing these parameters in patients with ED who received placebo. The data from this study indicate the need to take into account the biochemical mechanisms of endothelial dysfunction and apply complex exposure methods. 9 (p = 0.01) and HOMA - 3.9 ± 1.6 against 5.5 ± 2.4 (p = 0.01)) to the fourth (ICEF-5 - 19.8 ± 3.8 against 14 , 3 ± 3.9 (p = 0.005) and HOMA - 4.5 ± 1.9 versus 5.5 ± 2.4 (p = 0.04)), without changing these parameters in patients with ED who received placebo. The data from this study indicate the need to take into account the biochemical mechanisms of endothelial dysfunction and apply complex exposure methods.

ED in patients with diabetes is associated with a high risk of cardiovascular events. Endothelial dysfunction, vascular changes and the development of fibrosis are changed characteristic of patients with both diabetes mellitus and ED. ED in patients with diabetes mellitus is most refractory to treatment with FDA-5 inhibitors, but prolonged use of sildenafil improves endothelial function, relaxes the smooth muscles of blood vessels and reduces the degree of fibrosis in such patients. Ultimately, this gives a double effect - it reduces the risk of cardiovascular pathology and improves erectile function in diabetics.

Patients with ED often have depressive disorders. PDE-5 inhibitors are effective in men with ED and depression, in which ED may be secondary due to the use of antidepressants. A multicenter, double-blind, placebo-controlled study of men with untreated mild depression, conducted in Canada, showed that patients with ED are significantly more likely to experience depression than patients without ED (p = 0.0226), and ED itself is a predictor of depression. The study participants (n = 202) were divided into 2 groups: 104 received sildenafil treatment, 98 received placebo. The initial dose of the drug was 50 mg with the possibility of titration from 25 to 100 mg. The degree of depression was evaluated on a Beck scale. After 6 weeks, reliable results were obtained (p <0.001), indicating that

In practice, in patients with Parkinson's disease, the symptoms of ED are quite rare, although they play an important role in worsening the quality of life of such patients. Dissatisfaction with sexual life occurs in both sexes, while men have hypersexuality and simultaneously ED and problems with ejaculation. It has been proven that the combined use of dopamine and sildenafil agonists is effective in patients with Parkinson's disease, and ED and sexual disorders should be actively detected by neurologists with their subsequent correction.

Erectile dysfunction and urinary disorders have many common risk factors and are common in older men. PDE-5 inhibitors can lead to the relaxation of the smooth muscles of the urinary tract, so they can be used as pathogenetic therapy in patients with benign prostatic hyperplasia and lower urinary tract symptoms. A search of reviews and articles in Medline allowed us to evaluate six 12-week clinical trials that examined the use of alpha-blockers in combination with sildenafil in patients with benign prostatic hyperplasia. Three uncontrolled studies (total number of participants - 168) were devoted to the study of the effect of sildenafil dosage on lower urinary tract symptoms. Two major studies have shown that a decrease in ED directly correlates with a decrease in the severity of symptoms from the lower urinary tract. In one prospective placebo-controlled study (n = 369), sildenafil at a dose of 100 mg per day in men with ED and lower urinary tract symptoms significantly improved urine flow rate, while the best results were obtained with the largest initial outflow disturbance. An open comparative study involved men (n = 62) who received sildenafil at a dose of 25 mg, alfuzosin 10 mg or sildenafil at a dose of 25 mg in combination with 10 mg of alfuzosin. Combination therapy has shown the highest efficiency, expressed in the improvement of erectile function and symptoms of the lower urinary tract. According to the authors of the study, sildenafil can have a positive,

Viagra goes well with cardiovascular drugs. Thiazide diuretics, loop, and potassium-sparing diuretics, angiotensin-converting enzyme inhibitors, calcium antagonists, beta-blockers, warfarin, aspirin do not affect the pharmacokinetics of sildenafil. The drug is well tolerated. Among the main side effects of sildenafil, a transient is distinguished, they occur when applying a dosage of 100 mg and are characterized by slight or moderate severity (headache, redness of the face and neck, nasal congestion, dyspepsia). Very rarely, the side effects of sildenafil cause discontinuation of treatment. The only contraindication to the use of sildenafil is nitrate therapy because of the risk of hypotension.

Several experimental studies of sildenafil are devoted to various aspects of its effect on organs and tissues. Sildenafil, in particular, can help restore a bone defect. In a study conducted by scientists, they studied the effect of sildenafil on bone healing processes. Of 42 male rats, half received sildenafil at a dose of 10 mg/kg body weight per day for 30 days and a half made up the control group. A small surgical defect in the lower leg bones was inflicted on the rats, and subsequently, histological, densitometric and MRI studies of the bone tissue were performed against the background of therapy. At the stages of recovery and healing, statistically significant differences between the groups were obtained, indicating that sildenafil accelerates the process of bone repair. The authors suggest that conducting research,

The researchers attempted to evaluate the effect of sildenafil on inflammation and apoptosis in rats with experimentally induced colitis. Within 7 days, rats with chemical-induced colitis received sildenafil at a dose of 25 mg/kg/ day, the second group of animals studied was the control. Then, colon morphology was studied, and the levels of tumor necrosis factor-alpha and interleukin 10 were evaluated. Macro- and micromorphological evaluation after treatment showed that sildenafil therapy had a statistically significant effect on apoptosis, an increase in nitric oxide synthesis and a decrease in the level of pro-inflammatory cytokines. In this regard, it seems appropriate to conduct clinical studies on the effects of sildenafil in patients with inflammatory diseases of the large intestine.

The literature also describes the clinical case of the successful use of sildenafil for the treatment of hypersensitivity of the esophagus.

Phosphodiesterase of the 5th type plays an important role in the pathophysiology of migraine, cerebral vasospasm, and in the recovery period of stroke. In experiments, the use of supraphysiological doses of sildenafil caused dilatation of the middle cerebral artery (tadalafil did not give a similar effect). At a dose of 1-3 mg/kg, sildenafil significantly dilated the vessels of the brain, while lowering blood pressure (tadalafil did not have such an effect). The authors concluded that FDA-5 inhibitors have different activity with respect to vasodilation, and sildenafil should be included in clinical studies devoted to the study of its effects on cerebral vessels.

Thus, sildenafil is successfully used in the treatment of ED in patients with a wide variety of pathologies as both mono-and combination therapy. The possibility of its use in patients with various somatic diseases is of interest, and the results of clinical trials open up new prospects for its use.