GENERIC CIALIS

How Sildenafil works?

• Sildenafil action involves relaxation of unstriped muscles in arteries for enhancement of the blood flow to special parts of the body.
• Sildenafil, the medication which may be purchased under commercial name Viagra, is used in men for erectile dysfunction (impotence) treatment. One more sildenafil’s brand name is Revatio. Revatio is used for improvement of exercise capacity and for pulmonary arterial hypertension treatment in both men and women.
• Sildenafil is used for erectile dysfunction treatment.
• Sildenafil can be used for other purposes then ones written about in this medicine guide.

What have I ask my doctor before starting treatment with Sildenafil?

• Do not take Sildenafil if you are getting treatment with nitrate containing drugs for heart problems, unless your doctor checked the possibility of such combination and specified your dosage. Mentioned above group of drugs consists of nitroglycerin (GTN spray, Nitrolingual, Angispan, Minitran, Angised, Nitrostat, Deponit, Nitro – Bid, Nitrol, Nitro – Dur, Transderm – Nitro), isosorbide mononitrate (Oral, Angicor, Monoket, Monotrate, Ismo, Vasotrate, Imdur), isosorbide dinitrate (Sorbitrate, Isordil, Dilatrate-SR), and amylnitrite. Associated use of the Sildenafil and nitrate containing drugs can produce an abrupt decrease of the arterial pressure which makes the danger of stroke, sheer heart attack or fainting. So called poppers – recreational drugs, used to prolong, to enlarge and to enhance sexual activity related sensations – also include amyl combined nitrite or nitrate.
• Sometimes after taking Sildenafil a small number of patients may have temporal vision changes such as increased sensitivity to light, blurred vision. Impaired blue/green color discrimination may also occur. These kinds of vision distortions are caused with changes in the blood supply of the optic nerves in the eye. It is impossible to call Sildenafil the actual cause of mentioned above vision problems. These distortions usually occur in patients with diabetes, high cholesterol levels, heart diseases, high blood pressure, existing eye diseases, and in the elderly persons. If these problems continue or get bothersome, check with your doctor.
• Before start treatment with Sildenafil, inform your doctor about listed below diseases and conditions:
• heart beat problems or other heart diseases;
• the history of the heart attack within the past half of the year;
• the history of the heart failure with congestion within the past half of the year;
• stroke within the past half of the year;
• coronary disease (angina);
• unstable blood pressure (arterial hypertension or hypotension);
• terminal stages of kidney diseases. Slight kidney dysfunctions are not the cause to reduce the dose of Sildenafil.
• kidney diseases, including dialysis demanding conditions;
• heavy liver dysfunctions. Most of the slight liver dysfunctions are not the reasons to deny the treatment with Sildenafil. In such cases Sildenafil’s starting dose shall be reduced up to 5 mg, further treatment have to be performed with adjusted dose of Sildenafil.
• stomach or duodenal ulcers;
• high sensibility to any ingredient of Sildenafil tablet;
• aorta stenosis;
• inherited diseases of retina, such as retinitis pigmentosa;
• inclinations to hemorrhage;
• penis anatomic deformities (such as Peyronie’s disease);
• diseases, which may cause priapism (sickle cells anemia, myelomathosis, leukemia).
• if you are told to withhold from sexual intercourse to prevent health problems;
• In case if you have any of listed above diseases or conditions your dose may need an adjustment. Sometimes, during the treatment with Sildenafil, there may appear a need for special tests.
• FDA pregnancy category B: Though Sildenafil is not designed to be used in women, this drug is not supposed to be dangerous for fetus. If you are or going to be pregnant and intend to take Sildenafil, tell your doctor about it beforehand.
• Though Sildenafil is not designed to be used in women, there are no data about its penetration into breast milk or its harmful influence on a nursing baby. Anyhow, before take Sildenafil, tell your doctor you feed baby with your breast milk.
• You Sildenafil dose possibly needs to be reduced if you are over 65. Ask your doctor about it.

How Sildenafil is to be taken?

• Each dose has to be followed with a full glass of water.
• High fat food may delay absorption of the Sildenafil from the stomach and cause delay of the drug activity.
• Usually Sildenafil is taken as needed, 60 – 30 minutes before having sexual activity. Drug’s erection enhancing activity develops under the sexual stimulation. Medication itself does not produce an erection.
• Take Sildenafil once a day only. Next dose may be taken after 24 hours.
• This drug has to be stored at the room temperature in a dry place, away from heat sources.

What to do if dose is missed?

• As far as Sildenafil is to be used as needed, there may not be any case of the dose missed.
• If a dose of Revatio is missed it has to be taken as soon as possible. Skip Revatio’s missed dose if the time is close to take next dose, then take the drug as it is scheduled.

What to do in case of the overdose?

• If you suppose you took too much Sildenafil you have to get urgent medical attention.
• Sildenafil overdose symptoms are fainting, nausea, and
chest pain, irregular heart rhythm, light – headed feeling, severe dizziness, and long lasting erection and vision problems.

What should I withhold during the treatment with Sildenafil?

• Alcohol consumption should be restricted because it can provoke or strengthen some side effects of the Sildenafil.
• Do not combine Sildenafil with any other medication for erectile dysfunctions treatment, such as yohimbine (Yodoxin, Youcon, etc.), or alprostadil (Muse, Caverject, Edex), if your doctor did not prescribed such combination.

What possible side effects Sildenafil may induce?

• Side effects of Sildenafil occur not often and are mild as a rule. But sometimes it may be so serious that treatment with Sildenafil has to be stopped and immediate medical help is needed. Such cases are:
• acute dizziness;
• numbness;
• continuous tingling in the ears;
• pain in the chest, neck and left shoulder;
• heart rhythm disorder;
• swelling of the feet;
• sudden loss of the vision;
• allergic reaction such as difficult breathing, swelling of the face or tongue, hives;
• painful and long lasting erection;
• fainting and light – headedness;
• In case of appearance of any listed above condition stop having sex and call for medical help.
• If side effect is mild, the treatment with Sildenafil may be continued with doctor permission. Such conditions are listed below:
• redness or feeling of the heat in the face, neck, and upper chest;
• vision changes;
• stuffy nose;
• nausea;
• upset stomach;
• headache;
• back pain;
• There may appear side effects other than listed above. Inform your doctor about anything that seems unusual.
• Some medication may interact with Sildenafil, reducing, amplifying, or distorting its action. Do not take Sildenafil if you are treated with any of listed below medications:
• any nitrate or nitrite containing drug used for treatment of angina, such as nitroglycerin, isosorbid mono or dinitrate, amyl nitrite or amyl nitrate.

Sildenafil also interacts with following drugs:

• antibiotics such as troleandomycin, erythromycin, clarithromycin;
• alpha blockers, such as terazosin (Hytrin®), alfuzosin (UroXatral®), doxazosin (Cardura®), or prazosin (Minipress®) used for high blood pressure treatment and prostate enlargement treatment;
• cimetidine;
• bosentan;
• diltiazem;
• cizapride;
• carbamazepine;
• phenobarbital;
• phenitoin;
• fluconazole;
• itraconazole;
• ketoconazole;
• voriconazole;
• mibefradil;
• nicardipine;
• verapamil;
• rifapentine;
• rifampin;
• rifabutin;
• fluvoxamine;
• fluoxetine;
• nefazodone;
• quinidine;
• some drugs for HIV treatment, such as delavirdine or ritonavir and saquinavir.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.