Kamagra 100mg


Pharmacological properties.

Pharmacodynamics. Kamagra is oral medication, used to treat erectile dysfunction. Restores impaired ability to erect and provides a natural response to sexual stimulation. Physiological mechanism of penile erection is the release of nitric oxide (NO) in the cavernous body during sexual stimulation. Nitric oxide activates the enzyme, resulting in increased GMP, smooth muscle relaxation of the cavernous body and increase blood flow to the penis.

Sildenafil is a potent and selective inhibitor of GMP-specific type 5 (PDE), which provides the collapse of GMP in the cavernous body. Sildenafil does not direct action on isolated cavernous, but enhances the relaxing action of NO in the cavernous tissue of the body. When activated, the way NO / GMP that occurs during sexual arousal, inhibition of PDE 5 under the influence of sildenafil resulting in increased GMP in the cavernous body. Therefore, to achieve a favorable pharmacological effect Kamagra need adequate sexual stimulation.

At one time receiving Kamagra internally in doses of 100 mg in healthy volunteers the drug did not cause clinically significant EKG changes. Maximum decrease in systolic blood pressure in the patient lying in the application of the drug internally in a dose of 100 mg was on average 8.4 mmHg The corresponding decrease in diastolic blood pressure in the prone position was 5.5 mmHg BP decrease effect of sildenafil, probably by increasing GMP in vascular smooth muscles.

In vitro activity of sildenafil on PDE 5 in the 10 – 10000 times higher than its activity compared with other forms (PDE by types 1, 2, 3, 4 and 6). In particular, the activity of sildenafil on PDE 5 in 4000 times higher than its activity on PDE 3 – AMP-specific, which regulates the contractile activity of myocardium. In some patients within 1 h after taking the drug at a dose of 100 mg were found easily, passing violation (blue / green) by a test Fransworth-Munsell 100; in 2 hours after taking the drug it passed. Admitting that the mechanism of this impairment is depression PDE 6, which is involved in the transmission of light in the retina. The results in vitro suggest that the effect of sildenafil on PDE 6 in 100 times its inferior activity of PDE 5. Kamagra no effect on visual acuity and contrast perception.

Pharmacokinetics. The drug is rapidly absorbed after administration internally. The concentration of drug in plasma after oral administration of glucose reaches a maximum for 30 – 120 min. (Approximately 60 min.). Absolute bioavailability of receiving internally averages 41% (25 – 63%). Pharmacokinetics Kamagra internally when receiving the recommended doses (25 – 100 mg) is linear. Taking Kamagra with fat food, place the following processes: absorption rate decreases, the period of maximum concentration increases by 60 min. And the maximum concentration in plasma is reduced on average by 29%. Volume of distribution of sildenafil in an equilibrium state at an average of 105 liters / kg. Sildenafil and its primary circulating metabolite approximately 96% bound to plasma proteins. Binding proteins is not dependent on the concentration of the drug. In healthy volunteers who received single Kamagra 100 mg, less than 0.0002% (average 188 ng) dose detected in semen after 90 minutes. after admission. Acute administration Kamagra internally at a dose of 100 mg is not accompanied by changes in sperm motility or morphology.

By selective action on PDE metabolite can be compared with sildenafil, and its activity on PDE 5 is approximately 50% of the activity of the preparation. Metabolite concentration in plasma is about 40% of sildenafil in this.

In healthy volunteers aged 65 and older sildenafil clearance is reduced and the concentration of free drug into the blood plasma of approximately 40% higher than its level in healthy young volunteers (18 – 45 years). However, analysis of safety data showed that age does not affect the frequency of adverse side effects.

Indications for use. Erectile Dysfunction.

Dosage and Administration. Take internally. Prescribe 50 mg 1 hour before sexual intercourse. Given the efficacy and tolerability the dose can be increased to 100 mg. The maximum recommended dose is 100 mg 1 per day.

In the elderly and patients with severe degree of renal insufficiency (creatinine clearance less than 30 ml / min) or with impaired liver function starting dose is 25 mg. Given the efficacy and tolerability the dose can be increased to 50 – 100 mg.

Drug. Hypersensitivity to the drug, the simultaneous application of NO donors or nitrates in any form, child age of 18.

Overdose. In studies in healthy volunteers receiving the drug after single doses of up to 800 mg adverse effects were similar to those at the reception in lower doses Kamagra, but met more often (heat sensation, dizziness, headache, blurred vision, hypotension, dyspepsia). In case of overdose transmitting standard symptomatic treatment. Application of dialysis, probably does not increase the clearance of sildenafil, as the latter actively binds to plasma proteins and not derived from urine.

Features application. A diagnosis of erectile dysfunction, determine their possible causes and the adequate treatment is necessary to collect a complete medical history and perform a thorough physical examination the patient. Sexual activity is a risk if cardiovascular system. Therefore, before beginning treatment for erectile dysfunction patients required cardio logical examination. After a broad introduction to the practice of medicine has received reports of serious violations of the cardiovascular system, which included angina, myocardial infarction, sudden coronary death, ventricular arrhythmia, hemorrhagic stroke, avoiding ischemia, arterial hyper-or hypotension, which developed the application of the drug patients with cardiovascular diseases. These cases mainly developed during or immediately after sexual activity. In most patients, but not all were present risk factors for cardiovascular system. Cautious use with an acute gastric ulcer and duodenum 12.

Information about the safety of a peptic ulcer at Kamagra and bleeding diathesis exists, because of the drug to patients with these pathologies is prescribed with caution.

Drugs designed to treat erectile dysfunction, should not appoint men for whom sexual activity is not desirable.

Since during clinical trials of sildenafil observed dizziness and blurred vision, you should not manage transport and handle potentially dangerous machinery to determine the individual response to medication.

Interaction with other drugs. Safety and efficacy of the drug in combination with other drugs intended to treat erectile dysfunction, were not investigated because such a combination use is not recommended.

Cimetidine at a dose of 800 mg, which is a nonspecific inhibitor of CYP3A4, while acceptance of Kamagra, to cause the increase of concentration of sildenafil in plasma by 56% in healthy volunteers. Population pharmacokinetic analysis of clinical trial results showed decrease sildenafil clearance while applying inhibitors of CYP3A4, but the incidence of adverse effects in these patients is not increased.

Acute administration antacids (Magnesium / aluminum hydroxide) did not influence the bioavailability Kamagra.

Kamagra (50 mg) is bolstered by hypotensive effects of alcohol in healthy volunteers at a maximum level of alcohol in an average of 80 mg / dL. In patients with arterial hypertension signs of interaction Kamagra (100 mg) of amlodipine was not revealed. The mean additional reduction in blood pressure in supine (systolic – 8 mm Hg, diastolic – 7 mm Hg) approached the reception to such a Kamagra in healthy volunteers. Data on the safety of a lack of evidence of differences in the nature of side effects in patients who received Kamagra with antihypertensive drugs and without them.

Terms and conditions. Store in dry, light and reach of children, at a temperature 15 – 25 ° C. Shelf life – 3 years