Niagra
Generic Name
Sildenafil Citrate
Manufacturer
Generic Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| niagra 100 mg tablet | ৳ 20.00 | ৳ 80.00 |
Description
Overview of the medicine
Niagra 100 mg tablet contains Sildenafil Citrate, a phosphodiesterase type 5 (PDE5) inhibitor. It is primarily used to treat erectile dysfunction (ED) in men by increasing blood flow to the penis during sexual stimulation, allowing for a firmer and longer-lasting erection.
Uses & Indications
Dosage
Adults
For most patients, the recommended dose is 50 mg taken approximately 1 hour before sexual activity. The dose may be increased to 100 mg or decreased to 25 mg based on efficacy and tolerability. The maximum recommended dosing frequency is once per day.
Elderly
For patients over 65 years, a starting dose of 25 mg should be considered due to age-related decrease in clearance.
Renal_impairment
For patients with severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered. Based on efficacy and tolerability, the dose may be increased to a maximum of 100 mg.
How to Take
Take Niagra 100 mg tablet orally, with or without food, approximately 30-60 minutes before sexual activity. Sexual stimulation is necessary for the medicine to work.
Mechanism of Action
Sildenafil inhibits phosphodiesterase type 5 (PDE5), an enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum of the penis. When sexual stimulation causes local release of nitric oxide, PDE5 inhibition by sildenafil increases cGMP levels, leading to smooth muscle relaxation and inflow of blood into the penis, resulting in an erection.
Pharmacokinetics
Onset
Approximately 30-60 minutes.
Excretion
Sildenafil is excreted as metabolites predominantly in the feces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).
Half life
The mean terminal half-life of sildenafil and its major circulating N-desmethyl metabolite is approximately 3-5 hours and 4 hours, respectively.
Absorption
Rapidly absorbed after oral administration, with absolute bioavailability of about 41%. Peak plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state.
Metabolism
Primarily metabolized by cytochrome P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route) in the liver. The major metabolite, N-desmethyl sildenafil, is about 50% as potent as sildenafil.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) in any form, due to the risk of severe hypotension.
- Hypersensitivity to Sildenafil or any component of the tablet.
- Patients with severe cardiovascular disease, unstable angina, or recent myocardial infarction or stroke.
- Known hereditary degenerative retinal disorders, such as retinitis pigmentosa.
- Non-arteritic anterior ischemic optic neuropathy (NAION), regardless of previous PDE5 inhibitor exposure.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, resulting in a dangerous drop in blood pressure.
Riociguat
Concomitant use is contraindicated due to increased risk of hypotension.
Other ED treatments
Co-administration with other treatments for ED is not recommended.
Alpha-blockers (e.g., doxazosin)
Increased risk of symptomatic hypotension.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Increased plasma concentrations of Sildenafil, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In studies with healthy volunteers of single doses up to 800 mg, adverse events were similar to those seen at lower doses but generally more frequent and severe. In cases of overdose, standard supportive measures should be adopted. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins.
Pregnancy & Lactation
Sildenafil is not indicated for use in women.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) in any form, due to the risk of severe hypotension.
- Hypersensitivity to Sildenafil or any component of the tablet.
- Patients with severe cardiovascular disease, unstable angina, or recent myocardial infarction or stroke.
- Known hereditary degenerative retinal disorders, such as retinitis pigmentosa.
- Non-arteritic anterior ischemic optic neuropathy (NAION), regardless of previous PDE5 inhibitor exposure.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, resulting in a dangerous drop in blood pressure.
Riociguat
Concomitant use is contraindicated due to increased risk of hypotension.
Other ED treatments
Co-administration with other treatments for ED is not recommended.
Alpha-blockers (e.g., doxazosin)
Increased risk of symptomatic hypotension.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Increased plasma concentrations of Sildenafil, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In studies with healthy volunteers of single doses up to 800 mg, adverse events were similar to those seen at lower doses but generally more frequent and severe. In cases of overdose, standard supportive measures should be adopted. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins.
Pregnancy & Lactation
Sildenafil is not indicated for use in women.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture, specific expiry date is printed on the packaging.
Availability
Pharmacies
Approval Status
Approved
Patent Status
Expired
Clinical Trials
Sildenafil has undergone extensive clinical trials demonstrating its efficacy and safety for treating erectile dysfunction across various patient populations.
Lab Monitoring
- No specific routine lab monitoring is required for Sildenafil use in erectile dysfunction.
Doctor Notes
- Thorough cardiovascular assessment is crucial before prescribing Sildenafil, especially in patients with pre-existing heart conditions.
- Counsel patients on proper administration, the importance of sexual stimulation, and potential drug interactions, particularly with nitrates and alpha-blockers.
- Emphasize prompt medical attention for priapism or sudden vision/hearing loss.
Patient Guidelines
- Take Niagra 100 mg tablet as prescribed by your doctor, usually 1 hour before sexual activity.
- Do not take more than one tablet in a 24-hour period.
- If you experience an erection lasting more than 4 hours, seek immediate medical attention (priapism).
- Avoid taking Niagra with nitrates, as this can cause a severe drop in blood pressure.
- Inform your doctor about all other medications you are taking, especially if you have heart problems or blood pressure issues.
Missed Dose Advice
Niagra is taken on an as-needed basis for erectile dysfunction. Therefore, a missed dose is not applicable. Do not take more than the recommended dose in a 24-hour period.
Driving Precautions
Niagra can cause dizziness and visual disturbances (e.g., blurred vision). Patients should be aware of how they react to Niagra before driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, which can contribute to overall sexual health.
- Limit or avoid excessive alcohol consumption, as it can worsen side effects and impair the drug's effectiveness.
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