Sngra
Generic Name
Sildenafil
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sngra 50 mg tablet | ৳ 20.00 | ৳ 80.00 |
Description
Overview of the medicine
Sngra 50 mg Tablet contains Sildenafil, which is used to treat erectile dysfunction (impotence) in men. It works by increasing blood flow to the penis during sexual stimulation. It can also be used to treat pulmonary arterial hypertension (PAH).
Uses & Indications
Dosage
Adults
For ED: 50 mg as needed, approximately 1 hour before sexual activity. May be taken anywhere from 30 minutes to 4 hours before. Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. Maximum frequency is once per day. For PAH: 20 mg three times daily.
Elderly
No dosage adjustment is required for elderly patients. However, a starting dose of 25 mg should be considered due to decreased clearance in this population.
Renal_impairment
For patients with severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered. No dose adjustment is needed for mild to moderate impairment.
How to Take
Oral administration. Take with or without food. However, a high-fat meal may delay the onset of action.
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. Inhibition of PDE5 leads to increased cGMP levels, resulting in smooth muscle relaxation and inflow of blood into the penis, causing an erection. In PAH, it relaxes pulmonary blood vessels.
Pharmacokinetics
Onset
Onset of action is typically 30-60 minutes for erectile dysfunction.
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
The mean terminal half-life of Sildenafil and its active N-desmethyl metabolite is about 3-5 hours.
Absorption
Rapidly absorbed after oral administration. Mean absolute bioavailability is about 41%. Peak plasma concentrations (Tmax) are reached within 30 to 120 minutes (median 60 minutes).
Metabolism
Primarily metabolized in the liver by cytochrome P450 enzymes, mainly CYP3A4 (major route) and CYP2C9 (minor route). The major metabolite, N-desmethylsildenafil, is also active.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) due to potentiation of hypotensive effects.
- Concomitant use with Riociguat.
- Patients with known hypersensitivity to Sildenafil or any component of the tablet.
- Patients with severe cardiovascular disease, recent myocardial infarction, or stroke.
- Severe hepatic impairment.
- Known hereditary degenerative retinal disorders, such as retinitis pigmentosa.
Drug Interactions
Nitrates
Contraindicated. Potentiates hypotensive effects, potentially leading to a severe and life-threatening drop in blood pressure.
Riociguat
Contraindicated. Concomitant use with PDE5 inhibitors like Sildenafil can cause a significant decrease in blood pressure.
Alpha-blockers
Concomitant use may lead to symptomatic hypotension (dizziness, lightheadedness). Advise patients to be stable on alpha-blocker therapy before initiating Sildenafil.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir, Erythromycin)
These drugs can increase Sildenafil plasma concentrations, leading to increased risk of side effects. A lower starting dose of Sildenafil should be considered.
Storage
Store below 30°C in a cool, dry place. Protect 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 incidence rates were increased. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance.
Pregnancy & Lactation
Sildenafil is not indicated for use in women. For PAH: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if Sildenafil is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin, isosorbide dinitrate) due to potentiation of hypotensive effects.
- Concomitant use with Riociguat.
- Patients with known hypersensitivity to Sildenafil or any component of the tablet.
- Patients with severe cardiovascular disease, recent myocardial infarction, or stroke.
- Severe hepatic impairment.
- Known hereditary degenerative retinal disorders, such as retinitis pigmentosa.
Drug Interactions
Nitrates
Contraindicated. Potentiates hypotensive effects, potentially leading to a severe and life-threatening drop in blood pressure.
Riociguat
Contraindicated. Concomitant use with PDE5 inhibitors like Sildenafil can cause a significant decrease in blood pressure.
Alpha-blockers
Concomitant use may lead to symptomatic hypotension (dizziness, lightheadedness). Advise patients to be stable on alpha-blocker therapy before initiating Sildenafil.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir, Erythromycin)
These drugs can increase Sildenafil plasma concentrations, leading to increased risk of side effects. A lower starting dose of Sildenafil should be considered.
Storage
Store below 30°C in a cool, dry place. Protect 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 incidence rates were increased. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance.
Pregnancy & Lactation
Sildenafil is not indicated for use in women. For PAH: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if Sildenafil is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from the date of manufacture, specific to batch.
Availability
Pharmacies, hospitals
Approval Status
Approved (FDA, DGDA)
Patent Status
Patent expired, generic versions available
Clinical Trials
Sildenafil has undergone extensive clinical trials demonstrating its efficacy and safety for erectile dysfunction and pulmonary arterial hypertension in various patient populations.
Lab Monitoring
- Generally, no routine laboratory monitoring is required for patients taking Sildenafil for erectile dysfunction.
- For pulmonary arterial hypertension, regular monitoring of pulmonary arterial pressure and functional capacity may be performed.
Doctor Notes
- Thoroughly assess patient's cardiovascular status before prescribing Sildenafil, especially for patients with pre-existing heart conditions.
- Emphasize the absolute contraindication with nitrate-containing medications and advise patients about the risks.
- Counsel patients on potential visual and auditory side effects and the importance of seeking immediate medical attention for priapism or sudden sensory loss.
Patient Guidelines
- Take Sngra 50 mg tablet exactly as prescribed by your doctor.
- Do not take more than one dose per day.
- Do not take Sngra if you are also taking nitrate medications (e.g., for chest pain), as this can cause a dangerous drop in blood pressure.
- Seek immediate medical attention if you experience an erection lasting more than 4 hours (priapism).
- Report any sudden decrease or loss of vision or hearing to your doctor immediately.
Missed Dose Advice
For erectile dysfunction, this medicine is taken as needed, so you are unlikely to miss a dose. For pulmonary arterial hypertension, if you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Sildenafil may cause dizziness or visual disturbances (e.g., blurred vision). 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.
- Limit alcohol intake, as excessive alcohol can impair erectile function and increase the risk of side effects.
- Discuss any underlying cardiovascular conditions with your doctor before starting Sildenafil.
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