(Generic Viagra) [sildenafil citrate], manufactured by Ajanta Pharma, Ltd, this drug is the first cyclic guanosine monophosphate [cGMP] specific phosphodiesterase type 5enzyme inhibitor. This enzyme helps in regulating the blood circulation inthe penile tissue. This leads to better penile erection.
(Generic Viagra) is primarily indicated in the treatment of impotence [erectiledysfunction]
Thecompound sildenafil was synthesized in Pfizer's research lab in Kent, England. Believe it or not, sildenafilwas actually being studied for the treatment of hypertension and anginapectoris. Angina pectoris, or chest pain, caused by an insufficient supply ofoxygen and decreased blood flow to the heart muscle. Angina is frequently thefirst sign of ischemic heart disease. However, during the phase 1 clinicaltrials, it was found that instead of having a remarkable action on angina, thisdrug was very effective in inducing penile erections, the main pathology behinderectile dysfunction.
The drug was patented in 1996, approved for use inerectile dysfunction by the Food and Drug Administration on March 27, 1998,becoming the first oral treatment approved to treat erectile dysfunction in theUnited States
Needlessto say, this drug has become a household hit.
Erectile dysfunction:
Erectiledysfunction (ED) is defined as the inability of a man to achieve or maintain anerection sufficient for his sexual needs or the needs of his partner
Erection of the penis during coitus or otherwise is aresult of increase in the blood flow of the arteries of the penis andsimultaneous relaxation of the smooth muscle of corpora cavernosum. This wholeprocess is due to the release of nitric oxide (NO) from nerve terminals andendothelial cells, which stimulates the synthesis of cGMP in smooth musclecells. Cyclic GMP in turn, relaxes smooth muscle and resulting in an increasein the blood flow to the corpus cavernosum.
In erectile dysfunction, enough blood does not flow in thearteries of the penis to cause a sufficient erection.
.An organic cause can be found out in about50% of the cases of erectile dysfunction; the rest are either psychogenic inorigin or are due to a psychiatric illness such as depression which requiresappropriate drug treatment. Systemic diseases like chronic liver or kidneydiseases and drug addiction are important causes and should be looked for. Incase of any psychogenic problem, even the partner should be actively involvedin the counseling therapy
The physiologic mechanism oferection of the penis involves release of nitric oxide (NO) in the corpuscavernosum of the penile tissue during sexual stimulation. Nitric oxide thenactivates the enzyme guanylate cyclase,which results in increased levels of cyclicguanosine monophosphate (cGMP), producing smooth muscle relaxation in thecorpus cavernosum and allowing inflow of blood. Kamagra (Generic Viagra)[sildenafil citrate] has no direct relaxant effect on isolated human corpuscavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), whichis responsible for degradation of cGMP in the corpus cavernosum. When sexualstimulation causes local release of nitric oxide, inhibition of PDE5 bysildenafil causes increased levels of cGMP in the corpus cavernosum, resultingin smooth muscle relaxation and inflow of blood to the corpus cavernosum.Sildenafil at recommended doses has no effect in the absence of sexualstimulation.
There are many types of PDE, eachhaving varied function. The plus point of (Generic Viagra) [sildenafil citrate] is that it is PDE 5selective, though it can also act on the other types of PDE. In fact higherdoses or plasma levels of the drug is thought to be associated with defects incolor vision due to its action on PDE 6.
Kamagra (Generic Viagra)[sildenafil citrate] has a 4,000-fold selectivity for PDE5 versus PDE3, whichis concerned with cardiac contractility.
Indications:
-Erectiledysfunction. This is the main indication whereas for the indications givenbelow, sildenafil is not in the first line treatment regimen.
-pulmonaryarterial hypertension
-preventionof high altitude pulmonary edema associated with altitude sickness
-treatment of benign prostatic hypertrophy [BPH]-associated lowerurinary tract symptoms [LUTS]
Indications underinvestigation:
-Relievingfemale sexual dysfunction. Several studies have indicated the drug may beeffective in improving libido and arousal in women taking selective serotoninuptake inhibitors (SSRIs)
-Treatmentof infertility. Women who have had repeated failures with in vitrofertilization (IVF) due to poor development of the endometrium [tissue thatlines the uterus] may benefit from treatment with vaginal suppositoriescontaining sildenafil.
-Esophagealmotility dysfunction (achalasia), since it can enhance nitric oxide production.
Contraindications:
- patients on nitric oxide drugs sincesildenafil potentiatethe hypotensive effects of nitrates, andits administration to patients who are using organic nitrates, either regularlyand/or intermittently, in any form is therefore contraindicated.
- There is a degree of cardiacrisk associated with sexual activity, especially in elderly people above theage of 60 years. There is increase incidence of mortality and morbidity with KAMAGRA(GENERIC VIAGRA) [sildenafil]
- Severe hepatic impairment (decreased liverfunction)
- Severe impairment in renal function
- Hypotension (low blood pressure)
- History of stroke or heart attack
- Hereditary degenerative retinal disorders(including genetic disorders of retinal phosphodiesterases)
Side effects:
The most commonly reported sideeffects of KAMAGRA (GENERIC VIAGRA) are headache, flushing of the face, upsetstomach, and nasal congestion.
Other less common side effectsinclude, but are not limited to:
vision problems, including sensitivity to light, blurred vision, and a color tinge to vision
urinary tract infection
diarrhea
dizziness
rash
Dosage:
Administered in the dose of 50 mgone hour before the intended sexual activity. Based on effectiveness andtoleration, it can be increased to 100 mg or decreased to 25 mg.
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