Viera
Generic Name
Sildenafil Citrate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| viera 200 mg tablet | ৳ 130.00 | ৳ 1,040.00 |
Description
Overview of the medicine
Viera 200 mg Tablet contains Sildenafil Citrate, a phosphodiesterase-5 (PDE5) inhibitor. It is primarily used to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. It may also be used in some cases of pulmonary arterial hypertension, though 200mg is a high dose typically reserved for specific conditions under strict medical supervision.
Uses & Indications
Dosage
Adults
For Pulmonary Arterial Hypertension: Typically 20 mg three times daily. Higher doses up to 200 mg three times daily may be used in severe cases under specialist supervision. For Erectile Dysfunction: This strength (200mg) is generally not recommended; maximum recommended dose is 100 mg once daily, 30-60 minutes before sexual activity.
Elderly
No specific dose adjustment recommended for ED in elderly. For PAH, similar to adults, but careful monitoring due to potential for increased plasma concentrations.
Renal_impairment
For mild to moderate renal impairment, no dose adjustment is needed for ED. For severe renal impairment (creatinine clearance <30 mL/min), initial ED dose should be 25 mg. For PAH, lower starting doses and careful titration may be required.
How to Take
Oral administration. Take with or without food. For ED, take approximately 30-60 minutes before sexual activity. For PAH, take at regular intervals as prescribed.
Mechanism of Action
Sildenafil inhibits phosphodiesterase type 5 (PDE5), an enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum. In erectile dysfunction, it enhances the effects of nitric oxide, leading to increased cGMP levels, smooth muscle relaxation, and blood inflow into the penis. In pulmonary hypertension, it causes vasodilation in the pulmonary vascular bed.
Pharmacokinetics
Onset
30-120 minutes (typically 60 minutes)
Excretion
Mainly excreted as metabolites in feces (approximately 80%) and to a lesser extent in urine (approximately 13%).
Half life
Approximately 3-5 hours
Absorption
Rapidly absorbed after oral administration. Bioavailability is approximately 41%.
Metabolism
Primarily metabolized by CYP3A4 (major route) and CYP2C9 (minor route) in the liver. Forms an active metabolite, N-desmethyl sildenafil, which has about 50% of the potency of the parent drug.
Side Effects
Contraindications
- Concurrent use with nitrates (e.g., nitroglycerin) or nitric oxide donors due to risk of severe hypotension.
- Hypersensitivity to sildenafil or any component of the tablet.
- Concurrent use with guanylate cyclase stimulators (e.g., riociguat).
- Severe cardiovascular conditions (e.g., recent myocardial infarction or stroke, uncontrolled hypertension).
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening.
Riociguat
Contraindicated due to risk of symptomatic hypotension.
Alpha-blockers
Increased risk of symptomatic hypotension.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, cimetidine, ritonavir)
Increased plasma levels of sildenafil, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe headache, dizziness, dyspepsia, nasal congestion, and vision disturbances. Management involves standard supportive measures. Dialysis is not expected to accelerate clearance due to high protein binding.
Pregnancy & Lactation
Pregnancy Category B (for ED, not indicated). For PAH, use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether sildenafil is excreted in human milk; use with caution in nursing mothers.
Side Effects
Contraindications
- Concurrent use with nitrates (e.g., nitroglycerin) or nitric oxide donors due to risk of severe hypotension.
- Hypersensitivity to sildenafil or any component of the tablet.
- Concurrent use with guanylate cyclase stimulators (e.g., riociguat).
- Severe cardiovascular conditions (e.g., recent myocardial infarction or stroke, uncontrolled hypertension).
Drug Interactions
Nitrates
Potentiation of hypotensive effects, potentially life-threatening.
Riociguat
Contraindicated due to risk of symptomatic hypotension.
Alpha-blockers
Increased risk of symptomatic hypotension.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, cimetidine, ritonavir)
Increased plasma levels of sildenafil, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include severe headache, dizziness, dyspepsia, nasal congestion, and vision disturbances. Management involves standard supportive measures. Dialysis is not expected to accelerate clearance due to high protein binding.
Pregnancy & Lactation
Pregnancy Category B (for ED, not indicated). For PAH, use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether sildenafil is excreted in human milk; use with caution in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available (original patent expired)
Clinical Trials
Numerous clinical trials have established the efficacy and safety of sildenafil for ED and PAH. Ongoing research explores new indications and formulations.
Lab Monitoring
- Blood pressure monitoring (especially for PAH or concurrent alpha-blocker use).
- Regular assessment of PAH symptoms and functional class if used for PAH.
Doctor Notes
- Emphasize absolute contraindication with nitrates.
- Counsel patients on priapism and seek urgent medical care if it occurs.
- Monitor blood pressure, especially in patients on alpha-blockers or with cardiovascular risk factors.
- Ensure the patient understands the specific dosage regimen for ED vs. PAH.
Patient Guidelines
- Take as directed by your doctor.
- Do not exceed the recommended dose.
- Seek immediate medical attention if you experience an erection lasting longer than 4 hours.
- Be aware of potential visual and hearing side effects.
- Avoid sudden changes in posture to minimize risk of orthostatic hypotension.
Missed Dose Advice
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 resume your regular dosing schedule. Do not take two doses at once to make up for a missed dose.
Driving Precautions
May cause dizziness or visual disturbances. Do not drive or operate machinery if you experience these effects.
Lifestyle Advice
- Maintain a healthy lifestyle, including regular exercise and a balanced diet.
- Limit alcohol consumption, as it can worsen erectile dysfunction and increase the risk of side effects.
- Quit smoking to improve overall cardiovascular health.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Viera Brand
Other medicines available under the same brand name
