Niagra
Generic Name
Sildenafil Citrate
Manufacturer
Example Pharmaceutical Co. Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| niagra 50 mg tablet | ৳ 15.00 | ৳ 60.00 |
Description
Overview of the medicine
Niagra 50 mg Tablet contains Sildenafil Citrate, a phosphodiesterase-5 (PDE5) inhibitor, primarily used to treat erectile dysfunction (impotence) in men. It works by increasing blood flow to the penis to help men get and maintain an erection.
Uses & Indications
Dosage
Adults
Recommended initial dose is 50 mg taken approximately 1 hour before sexual activity. Can be increased to 100 mg or decreased to 25 mg based on efficacy and tolerability. Maximum frequency is once daily.
Elderly
Consider a starting dose of 25 mg for patients over 65 years due to reduced clearance.
Renal_impairment
For severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered.
How to Take
Take orally with a glass of water, approximately 30 minutes to 4 hours before sexual activity (preferably 1 hour before). Can be taken with or without food, but a high-fat meal may delay the onset of action.
Mechanism of Action
Sildenafil inhibits phosphodiesterase-5 (PDE5), an enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum. By inhibiting PDE5, sildenafil increases cGMP levels, leading to smooth muscle relaxation and increased blood flow into the penis, resulting in an erection. It requires sexual stimulation for its effect.
Pharmacokinetics
Onset
Typically within 30-60 minutes after oral ingestion.
Excretion
Primarily excreted as metabolites 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
Approximately 3-5 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 30-120 minutes (median 60 minutes) of oral dosing in the fasted state.
Metabolism
Primarily metabolized by cytochrome P450 enzymes (CYP3A4 major, CYP2C9 minor) in the liver. The major circulating metabolite, N-desmethyl sildenafil, has about 50% of the activity of the parent drug.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) in any form (due to potential for severe hypotension).
- Concomitant use with guanylate cyclase stimulators (e.g., Riociguat).
- Hypersensitivity to Sildenafil or any component of the tablet.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening.
Riociguat
Contraindicated due to risk of symptomatic hypotension.
Alpha-blockers
May lead to symptomatic hypotension.
CYP3A4 Inhibitors (e.g., Ketoconazole, Erythromycin, Ritonavir)
Increased sildenafil plasma levels, requiring dose reduction.
Storage
Store in a cool, dry place, below 30°C, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In volunteers who received single doses of up to 800 mg, adverse reactions were similar to those seen at lower doses but generally increased in incidence and severity. In cases of overdose, standard supportive measures should be adopted as required.
Pregnancy & Lactation
Niagra is not indicated for use in women. There are no adequate and well-controlled studies in pregnant or lactating women.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) in any form (due to potential for severe hypotension).
- Concomitant use with guanylate cyclase stimulators (e.g., Riociguat).
- Hypersensitivity to Sildenafil or any component of the tablet.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening.
Riociguat
Contraindicated due to risk of symptomatic hypotension.
Alpha-blockers
May lead to symptomatic hypotension.
CYP3A4 Inhibitors (e.g., Ketoconazole, Erythromycin, Ritonavir)
Increased sildenafil plasma levels, requiring dose reduction.
Storage
Store in a cool, dry place, below 30°C, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In volunteers who received single doses of up to 800 mg, adverse reactions were similar to those seen at lower doses but generally increased in incidence and severity. In cases of overdose, standard supportive measures should be adopted as required.
Pregnancy & Lactation
Niagra is not indicated for use in women. There are no adequate and well-controlled studies in pregnant or lactating women.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies, online pharmacies
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available (original patent expired)
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Sildenafil for erectile dysfunction across various patient populations.
Lab Monitoring
- Generally, no specific lab monitoring is required for routine use in healthy individuals. Blood pressure monitoring may be considered in patients taking alpha-blockers.
Doctor Notes
- Assess cardiovascular status before prescribing.
- Counsel patients on priapism and vision/hearing changes.
- Review concomitant medications, especially nitrates and alpha-blockers.
Patient Guidelines
- Do not take Niagra if you are taking nitrate medicines.
- Seek immediate medical attention if you experience an erection lasting more than 4 hours.
- Do not take more than one dose in 24 hours.
- Consult your doctor if you have heart problems, high or low blood pressure, or liver/kidney disease.
Missed Dose Advice
Niagra is taken on an as-needed basis, so a missed dose is not applicable. Do not take more than one dose per day.
Driving Precautions
May cause dizziness or visual disturbances. Patients should be aware of how they react to Niagra before driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including regular exercise and a balanced diet, to improve overall cardiovascular health.
- Avoid excessive alcohol consumption as it can impair erection and increase side effects.
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