Vida-Plus
Generic Name
Sildenafil Citrate
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vida plus 50 mg tablet | ৳ 22.00 | ৳ 66.00 |
Description
Overview of the medicine
Sildenafil is a phosphodiesterase-5 (PDE5) inhibitor used to treat erectile dysfunction (ED) in men and pulmonary arterial hypertension (PAH). It helps to increase blood flow to the penis during sexual stimulation, leading to an erection.
Uses & Indications
Dosage
Adults
For Erectile Dysfunction: Initial dose of 50 mg taken orally approximately 1 hour before sexual activity. Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. Maximum recommended dosing frequency is once per day.
Elderly
No dosage adjustment is required for elderly patients (≥65 years) unless there is severe renal or hepatic impairment.
Renal_impairment
For severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered. For mild to moderate impairment, no adjustment is needed.
How to Take
Take Vida-Plus 50 mg orally, with or without food, approximately 30-60 minutes before anticipated sexual activity. High-fat meals may delay the absorption and 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. This inhibition leads to increased cGMP levels, resulting in smooth muscle relaxation and increased blood flow into the penis, facilitating an erection in response to sexual stimulation.
Pharmacokinetics
Onset
Onset of action typically occurs within 30-60 minutes after administration.
Excretion
Excreted predominantly in the feces (approximately 80% of administered oral dose as metabolites) and to a lesser extent in the urine (approximately 13% of administered oral dose as metabolites).
Half life
The mean terminal half-life of Sildenafil is approximately 3-5 hours. The active metabolite, N-desmethyl sildenafil, has a terminal half-life of approximately 4 hours.
Absorption
Rapidly absorbed. Peak plasma concentrations (Tmax) are reached within 30-120 minutes (median 60 min) after oral dosing in the fasted state. Absolute bioavailability is approximately 41%.
Metabolism
Primarily metabolized by hepatic microsomal isoenzymes CYP3A4 (major route) and CYP2C9 (minor route).
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin) due to the risk of severe hypotension.
- Hypersensitivity to Sildenafil or any component of the tablet.
- Concomitant use with guanylate cyclase stimulators (e.g., riociguat).
- Patients with severe cardiovascular disease for whom sexual activity is inadvisable.
Drug Interactions
Nitrates
Contraindicated due to the risk of severe and potentially fatal hypotension.
Riociguat
Contraindicated, concomitant use may cause symptomatic hypotension.
Alpha-blockers
May lead to symptomatic hypotension. Use with caution, initiate at lowest dose of sildenafil.
CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir, erythromycin)
May increase sildenafil plasma concentrations, consider a lower starting dose of sildenafil.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
In studies of healthy volunteers, single doses up to 800 mg caused adverse events similar to those seen at lower doses, but with increased incidence and severity. Symptoms may include severe dizziness, fainting, and vision changes. Treatment should be supportive and symptomatic. Dialysis is not expected to accelerate Sildenafil clearance as it is highly protein bound.
Pregnancy & Lactation
Vida-Plus (Sildenafil) is not indicated for use in women. For conditions like PAH where sildenafil might be used, consult a physician. There are limited data on the presence of sildenafil in human milk; use with caution if prescribed for other indications.
Side Effects
Contraindications
- Concomitant use with nitrates (e.g., nitroglycerin) due to the risk of severe hypotension.
- Hypersensitivity to Sildenafil or any component of the tablet.
- Concomitant use with guanylate cyclase stimulators (e.g., riociguat).
- Patients with severe cardiovascular disease for whom sexual activity is inadvisable.
Drug Interactions
Nitrates
Contraindicated due to the risk of severe and potentially fatal hypotension.
Riociguat
Contraindicated, concomitant use may cause symptomatic hypotension.
Alpha-blockers
May lead to symptomatic hypotension. Use with caution, initiate at lowest dose of sildenafil.
CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir, erythromycin)
May increase sildenafil plasma concentrations, consider a lower starting dose of sildenafil.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
In studies of healthy volunteers, single doses up to 800 mg caused adverse events similar to those seen at lower doses, but with increased incidence and severity. Symptoms may include severe dizziness, fainting, and vision changes. Treatment should be supportive and symptomatic. Dialysis is not expected to accelerate Sildenafil clearance as it is highly protein bound.
Pregnancy & Lactation
Vida-Plus (Sildenafil) is not indicated for use in women. For conditions like PAH where sildenafil might be used, consult a physician. There are limited data on the presence of sildenafil in human milk; use with caution if prescribed for other indications.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies and licensed drug stores
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic versions available, patent expired in many regions
Clinical Trials
Sildenafil has undergone extensive clinical trials demonstrating its efficacy and safety for the treatment of erectile dysfunction across various patient populations, as well as for pulmonary arterial hypertension.
Lab Monitoring
- No routine lab monitoring is generally required for patients taking Sildenafil for erectile dysfunction. For patients with pulmonary arterial hypertension, monitoring of blood pressure and disease progression (e.g., 6-minute walk test, echocardiogram) may be performed.
Doctor Notes
- Prior to prescribing, thoroughly assess cardiovascular risk factors and evaluate for any contraindications, especially concomitant nitrate use.
- Counsel patients on the proper administration, expected onset of action, and potential side effects, including priapism and sudden vision/hearing loss.
- Advise patients that Sildenafil does not protect against sexually transmitted diseases.
Patient Guidelines
- Take Vida-Plus exactly as prescribed by your doctor.
- Do not take more than one dose in a 24-hour period.
- Avoid taking with nitrate medications, as this can cause a dangerous drop in blood pressure.
- Seek immediate medical attention if an erection lasts longer than 4 hours (priapism).
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
For Erectile Dysfunction, Vida-Plus is taken on an as-needed basis, so a missed dose is not applicable. For Pulmonary Arterial Hypertension, take the missed dose as soon as you remember, unless it is almost time for your next scheduled dose. Do not double dose.
Driving Precautions
Sildenafil may cause dizziness, blurred vision, or changes in color perception. Do not drive or operate machinery if you experience these effects.
Lifestyle Advice
- Maintain a healthy lifestyle with regular exercise and a balanced diet.
- Limit alcohol consumption, as it can worsen erectile dysfunction and increase the risk of side effects.
- Quit smoking, as it contributes to cardiovascular disease and ED.
- Manage underlying health conditions like diabetes, high blood pressure, and heart disease.
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