Visral
Generic Name
Sildenafil Citrate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| visral 50 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Visral 50 mg Tablet contains Sildenafil Citrate, primarily 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.
Uses & Indications
Dosage
Adults
For ED: Usually 50 mg orally, approximately 1 hour before sexual activity. Can be adjusted to 25 mg or 100 mg. Max once daily. For PAH: 20 mg three times daily.
Elderly
Consider starting with 25 mg due to decreased clearance.
Renal_impairment
For severe renal impairment (CrCl < 30 mL/min), consider starting with 25 mg.
How to Take
Administer orally approximately 30-60 minutes before sexual activity. Can be taken with or without food, but a high-fat meal may delay absorption.
Mechanism of Action
Sildenafil inhibits phosphodiesterase-5 (PDE5), an enzyme that degrades 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, causing an erection. In pulmonary hypertension, it relaxes smooth muscle cells in pulmonary arteries.
Pharmacokinetics
Onset
Onset of action within 30-60 minutes.
Excretion
Excreted predominantly in feces (approx 80%) and to a lesser extent in urine (approx 13%).
Half life
Terminal half-life is approximately 3-5 hours.
Absorption
Rapidly absorbed after oral administration, absolute bioavailability is about 41%.
Metabolism
Primarily metabolized in the liver by CYP3A4 and CYP2C9 isoenzymes. Main active metabolite is N-desmethyl sildenafil.
Side Effects
Contraindications
- Concurrent use with nitrates or nitric oxide donors (e.g., nitroglycerin) due to risk of severe hypotension.
- Hypersensitivity to sildenafil or any component.
- Severe cardiovascular events (e.g., recent MI or stroke).
- Severe hepatic impairment.
Drug Interactions
Nitrates (e.g., Nitroglycerin)
Potentiates hypotensive effects, potentially leading to life-threatening drops in blood pressure.
Alpha-blockers (e.g., Tamsulosin)
Increased risk of symptomatic hypotension. Administer sildenafil at least 4 hours after alpha-blocker.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)
Increases sildenafil plasma concentrations, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In cases of overdose, standard supportive measures should be adopted as sildenafil is highly protein bound and not expected to be cleared by renal dialysis. Hypotension may occur.
Pregnancy & Lactation
Generally not indicated for women. For PAH, use during pregnancy only if potential benefit justifies potential risk to fetus. Excretion into breast milk is unknown; caution advised.
Side Effects
Contraindications
- Concurrent use with nitrates or nitric oxide donors (e.g., nitroglycerin) due to risk of severe hypotension.
- Hypersensitivity to sildenafil or any component.
- Severe cardiovascular events (e.g., recent MI or stroke).
- Severe hepatic impairment.
Drug Interactions
Nitrates (e.g., Nitroglycerin)
Potentiates hypotensive effects, potentially leading to life-threatening drops in blood pressure.
Alpha-blockers (e.g., Tamsulosin)
Increased risk of symptomatic hypotension. Administer sildenafil at least 4 hours after alpha-blocker.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)
Increases sildenafil plasma concentrations, requiring dose adjustment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In cases of overdose, standard supportive measures should be adopted as sildenafil is highly protein bound and not expected to be cleared by renal dialysis. Hypotension may occur.
Pregnancy & Lactation
Generally not indicated for women. For PAH, use during pregnancy only if potential benefit justifies potential risk to fetus. Excretion into breast milk is unknown; caution advised.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generic available (original patent expired)
Clinical Trials
Extensive clinical trials have established efficacy and safety for ED and PAH across various patient populations.
Lab Monitoring
- Blood pressure monitoring, especially with alpha-blockers.
Doctor Notes
- Counsel patients on potential drug interactions, especially with nitrates.
- Emphasize that Sildenafil does not protect against STIs.
- Advise patients to report any sudden vision or hearing loss.
Patient Guidelines
- Take about 1 hour before sexual activity.
- Do not take more than once a day.
- Avoid excessive alcohol.
- Seek immediate medical attention if erection lasts longer than 4 hours.
- Do not take if you are taking nitrates.
Missed Dose Advice
As this medicine is taken on an as-needed basis for ED, there is no missed dose. For PAH, take the missed dose as soon as you remember. If it's almost time for the next dose, skip the missed dose.
Driving Precautions
May cause dizziness or visual disturbances; avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain a healthy lifestyle.
- Regular exercise.
- Stress management.
- Quit smoking (if applicable).
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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