1. Name of the restorative item
VIAGRA 25 mg film-covered tablets
VIAGRA 50 mg film-covered tablets
VIAGRA 100 mg film-covered tablets
2. Subjective and quantitative structure
Every tablet contains sildenafil citrate proportionate to 25, 50 or 100 mg of sildenafil.
Excipient with known impact:
Every tablet contains 0.834 mg lactose (as monohydrate).
Every tablet contains 1.667 mg lactose (as monohydrate).
Every tablet contains 3.334 mg lactose (as monohydrate).
For the full rundown of excipients, see area 6.1.
3. Pharmaceutical structure
Film-covered tablet.
VIAGRA 25 mg film-covered tablets
VIAGRA 50 mg film-covered tablets
Blue adjusted precious stone formed tablets, stamped "PFIZER" on one side and "VGR 50" on the other.
VIAGRA 100 mg film-covered tablets
Blue adjusted precious stone formed tablets, stamped "PFIZER" on one side and "VGR 100" on the other.
4. Clinical points of interest
4.1 Therapeutic signs
VIAGRA Tablets in Pakistan is demonstrated in grown-up men with erectile brokenness, which is the powerlessness to accomplish or keep up a penile erection adequate for acceptable sexual execution.
With the end goal for VIAGRA to be compelling, sexual incitement is required.
4.2 Posology and strategy for organization
Posology
Use in grown-ups
The prescribed portion is 50 mg taken as required roughly one hour before sexual action. In view of viability and passableness, the portion might be expanded to 100 mg or diminished to 25 mg. The most extreme suggested portion is 100 mg. The most extreme prescribed dosing recurrence is once every day. On the off chance that VIAGRA is taken with nourishment, the beginning of action might be postponed contrasted with the fasted state (see area 5.2).
Unique populaces
Older
Measurement modifications are not required in old patients (≥ 65 years of age).
Renal debilitation
The dosing suggestions portrayed in "Use in grown-ups" apply to patients with mellow to direct renal disability (creatinine leeway = 30-80 mL/min).
Since sildenafil leeway is decreased in patients with serious renal weakness (creatinine freedom < 30 mL/min) a 25 mg portion ought to be considered. In view of adequacy and fairness, the portion might be expanded advance insightful to 50 mg up to 100 mg as essential.
Hepatic weakness
Since sildenafil leeway is decreased in patients with hepatic impedance (for example cirrhosis) a 25 mg portion ought to be considered. In view of adequacy and bearableness, the portion might be expanded advance savvy to 50 mg up to 100 mg as fundamental.
Pediatric populace
VIAGRA isn't shown for people beneath 18 years old.
Use in patients taking other therapeutic items
Except for ritonavir for which co-organization with sildenafil isn't prompted (see Section
4.4) a beginning portion of 25 mg ought to be considered in patients getting attendant treatment with CYP3A4 inhibitors (see segment
4.5).
Viagra Tablets in Pakistan
So as to limit the capability of creating postural hypotension in patients accepting alpha-blocker treatment patients ought to be settled on alpha-blocker treatment before starting sildenafil treatment. What's more, inception of sildenafil at a portion of 25 mg ought to be considered (see areas 4.4 and 4.5).
Strategy for organization
For oral use.
4.3 Contraindications
Excessive touchiness to the dynamic substance or to any of the excipients recorded in area 6.1.
Predictable with its known impacts on the nitric oxide/cyclic guanosine monophosphate (cGMP) pathway (see segment 5.1), sildenafil was appeared to potentiate the hypotensive impacts of nitrates, and its co-organization with nitric oxide givers, (for example, amyl nitrite) or nitrates in any structure is in this way contraindicated.
The co-organization of PDE5 inhibitors, including sildenafil, with guanylate cyclase triggers, for example, riociguat, is contraindicated as it might possibly prompt symptomatic hypotension (see area 4.5).
Specialists for the treatment of erectile brokenness, including sildenafil, ought not be utilized in men for whom sexual action is unwise (for example patients with extreme cardiovascular issue, for example, unsteady angina or serious heart disappointment).
VIAGRA Tablets in Pakistan is contraindicated in patients who have loss of vision in one eye as a result of non-arteritic front ischaemic optic neuropathy (NAION), paying little heed to whether this scene was in association or not with past PDE5 inhibitor introduction (see area 4.4).
The wellbeing of sildenafil has not been concentrated in the accompanying sub-gatherings of patients and its utilization is subsequently contraindicated: extreme hepatic impedance, hypotension (pulse < 90/50 mmHg), ongoing history of stroke or myocardial dead tissue and referred to innate degenerative retinal issue, for example, retinitis pigmentosa (a minority of these patients have hereditary issue of retinal phosphodiesterases).
4.4 Special alerts and safeguards for use
A medicinal history and physical examination ought to be embraced to analyze erectile brokenness and decide potential fundamental causes, before pharmacological treatment is considered.
Cardiovascular hazard factors
Before starting any treatment for erectile brokenness, doctors ought to think about the cardiovascular status of their patients, since there is a level of heart hazard related with sexual action. Sildenafil has vasodilator properties, bringing about gentle and transient abatements in pulse (see area 5.1). Before recommending sildenafil, doctors ought to painstakingly think about whether their patients with certain basic conditions could be antagonistically influenced by such vasodilatory impacts, particularly in mix with sexual action. Patients with expanded powerlessness to vasodilators incorporate those with left ventricular outpouring obstacle (e.g., aortic stenosis, hypertrophic obstructive cardiomyopathy), or those with the uncommon disorder of various framework decay showing as seriously weakened autonomic control of circulatory strain.
VIAGRA potentiates the hypotensive impact of nitrates (see segment 4.3).
Genuine cardiovascular occasions, including myocardial dead tissue, insecure angina, unexpected heart passing, ventricular arrhythmia, cerebrovascular drain, transient ischaemic assault, hypertension and hypotension have been accounted for post-promoting in worldly relationship with the utilization of VIAGRA. Most, however not all, of these patients had previous cardiovascular hazard factors. Numerous occasions were accounted for to happen during or not long after sex and a couple were accounted for to happen soon after the utilization of
VIAGRA Tablets in Pakistan without sexual movement. It is beyond the realm of imagination to expect to decide if these occasions are connected legitimately to these components or to different elements.
Priapism
Operators for the treatment of erectile brokenness, including sildenafil, ought to be utilized with alert in patients with anatomical disfigurement of the penis, (for example, angulation, cavernosal fibrosis or Peyronie's ailment), or in patients who have conditions which may incline them to priapism, (for example, sickle cell sickliness, different myeloma or leukemia).
Delayed erections and priapism have been accounted for with sildenafil in post-promoting background. In case of an erection that endures for longer than 4 hours, the patient should look for prompt therapeutic help. On the off chance that priapism isn't dealt with promptly, penile tissue harm and perpetual loss of intensity could result.
Attendant use with other PDE5 inhibitors or different medications for erectile brokenness
The security and adequacy of blends of sildenafil with other PDE5 inhibitors, or other pneumonic blood vessel hypertension (PAH) medicines containing sildenafil (REVATIO), or different medications for erectile brokenness have not been examined. Consequently the utilization of such blends isn't prescribed.
Impacts on vision
Instances of visual imperfections have been accounted for precipitously regarding the admission of sildenafil and other PDE5 inhibitors (see segment 4.8). Instances of non-arteritic foremost ischaemic optic neuropathy, an uncommon condition, have been accounted for immediately and in an observational examination regarding the admission of sildenafil and other PDE5 inhibitors (see area 4.8). Patients ought to be educated that in the occasion with respect to any unexpected visual imperfection, they should quit taking VIAGRA and counsel a doctor promptly (see area 4.3).
Corresponding use with ritonavir
Co-organization of sildenafil with ritonavir isn't prompted (see segment 4.5).
Accompanying use with alpha-blockers
Alert is exhorted when sildenafil is managed to patients taking an alpha-blocker, as the co-organization may prompt symptomatic hypotension in a couple of helpless people (see area 4.5). This is well on the way to happen inside 4 hours post sildenafil dosing. So as to limit the potential for creating postural hypotension, patients should be hemodynamically steady on alpha-blocker treatment preceding starting sildenafil treatment. Commencement of sildenafil at a portion of 25 mg ought to be considered (see area 4.2). Likewise, doctors ought to encourage patients what to do in case of postural hypotensive side effects.
Viagra Tablets in Pakistan
Impact on dying
Concentrates with human platelets demonstrate that sildenafil potentiates the antiaggregatory impact of sodium nitroprusside in vitro. There is no wellbeing data on the organization of sildenafil to patients with draining issue or dynamic peptic ulceration. In this manner sildenafil ought to be regulated to these patients simply after cautious advantage chance appraisal.
The film covering of the tablet contains lactose. VIAGRA ought not be controlled to men with uncommon inherited issues of galactose bigotry, Lapp lactase lack or glucose-galactose malabsorption.
Ladies
VIAGRA isn't demonstrated for use by wome
