Sngra
Generic Name
Sildenafil Citrate
Manufacturer
Generic Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sngra 100 mg tablet | ৳ 37.00 | ৳ 148.00 |
Description
Overview of the medicine
Sngra 100 mg Tablet contains Sildenafil Citrate, a phosphodiesterase-5 (PDE5) inhibitor, primarily used to treat erectile dysfunction (ED) in men. It helps increase blood flow to the penis, enabling an erection when sexually stimulated. It is not intended for use by women or children.
Uses & Indications
Dosage
Adults
For Erectile Dysfunction: The recommended dose is 50 mg taken approximately 1 hour before sexual activity. May be increased to 100 mg or decreased to 25 mg based on efficacy and tolerability. Maximum recommended dosing frequency is once per day.
Elderly
No dosage adjustment is generally required in elderly patients, but individual response should be monitored.
Renal_impairment
For severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg is recommended. For mild to moderate impairment, no adjustment needed.
How to Take
Take orally, with or without food, approximately 30 minutes to 4 hours before sexual activity. For best results, take about 1 hour before. Do not take more than once a day.
Mechanism of Action
Sildenafil inhibits phosphodiesterase type 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 during sexual stimulation, resulting in an erection.
Pharmacokinetics
Onset
Typically 30-60 minutes after administration (with sexual stimulation).
Excretion
Excreted predominantly as metabolites in the feces (approximately 80% of the administered oral dose) and, to a lesser extent, in the urine (approximately 13% of the administered oral dose).
Half life
Approximately 3-5 hours.
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations are reached within 30-120 minutes (median 60 minutes) of oral dosing in the fasted state. Absolute bioavailability is approximately 41%.
Metabolism
Primarily metabolized by CYP3A4 (major route) and CYP2C9 (minor route) in the liver. The major circulating metabolite, N-desmethyl sildenafil, has about 50% of the activity of sildenafil.
Side Effects
Contraindications
- Patients taking nitrates (e.g., nitroglycerin) in any form, as it can cause a severe drop in blood pressure.
- Patients with known hypersensitivity to sildenafil or any component of the tablet.
- Concomitant use with guanylate cyclase stimulators (e.g., riociguat).
- Patients with severe cardiovascular conditions, recent stroke, or heart attack.
- Severe hepatic impairment.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening. Concomitant use is contraindicated.
Riociguat
Potentiation of hypotensive effects, contraindicated.
Alpha-blockers
Increased risk of symptomatic hypotension, especially with doxazosin. Initiate sildenafil at 25 mg if alpha-blockers are used.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Increased plasma levels of sildenafil, requiring lower starting doses of sildenafil.
Storage
Store below 30°C in a dry place, away from light 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 increased in incidence and severity. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not significantly excreted in urine.
Pregnancy & Lactation
Sngra is not indicated for use in women. There are no adequate and well-controlled studies of sildenafil in pregnant or lactating women. For PAH use, it's category B, but typically not used for ED in women.
Side Effects
Contraindications
- Patients taking nitrates (e.g., nitroglycerin) in any form, as it can cause a severe drop in blood pressure.
- Patients with known hypersensitivity to sildenafil or any component of the tablet.
- Concomitant use with guanylate cyclase stimulators (e.g., riociguat).
- Patients with severe cardiovascular conditions, recent stroke, or heart attack.
- Severe hepatic impairment.
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening. Concomitant use is contraindicated.
Riociguat
Potentiation of hypotensive effects, contraindicated.
Alpha-blockers
Increased risk of symptomatic hypotension, especially with doxazosin. Initiate sildenafil at 25 mg if alpha-blockers are used.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, ritonavir)
Increased plasma levels of sildenafil, requiring lower starting doses of sildenafil.
Storage
Store below 30°C in a dry place, away from light 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 increased in incidence and severity. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not significantly excreted in urine.
Pregnancy & Lactation
Sngra is not indicated for use in women. There are no adequate and well-controlled studies of sildenafil in pregnant or lactating women. For PAH use, it's category B, but typically not used for ED in women.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA (USA), DGDA (Bangladesh)
Patent Status
Generic versions available (original patent expired)
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of sildenafil for erectile dysfunction across various patient populations, showing significant improvement in erectile function compared to placebo. Ongoing research explores its potential in other conditions and long-term safety profiles.
Lab Monitoring
- No specific routine lab monitoring required for ED treatment.
- For PAH, liver and kidney function tests may be periodically monitored.
Doctor Notes
- Always assess patient's cardiovascular status before prescribing sildenafil.
- Educate patients on proper usage, potential side effects, and especially contraindications with nitrates.
- Consider starting with a lower dose (25 mg) in elderly patients or those with hepatic/renal impairment, or those on CYP3A4 inhibitors.
Patient Guidelines
- Take Sngra about 1 hour before sexual activity.
- Do not take more than one tablet a day.
- Avoid alcohol as it can impair your ability to get an erection and potentially increase side effects.
- Seek immediate medical attention if you experience an erection lasting more than 4 hours.
- Do not take Sngra if you are also taking nitrate medications for chest pain.
Missed Dose Advice
Sngra is taken as needed, so you are not on a regular dosing schedule. If you use it for Pulmonary Arterial Hypertension (PAH), do not double dose if you miss one. Take the next dose as scheduled.
Driving Precautions
Sngra may cause dizziness and visual disturbances. Patients should be aware of how they react to Sngra before driving or operating machinery.
Lifestyle Advice
- Adopt a healthy lifestyle including regular exercise and a balanced diet to improve overall cardiovascular health.
- Manage stress and anxiety as they can contribute to erectile dysfunction.
- Consult a doctor for underlying health conditions contributing to ED.
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