Dynamically tablets are coated. 100 mg 4 pcs. (Sildenafil)

Release Form Coated Tablets

Packaging

In the package 4 pcs.

Pharmacological action

Dynamically - a drug for the treatment of erectile dysfunction. Under the conditions of sexual stimulation, it restores impaired erectile function by increasing blood flow in the penis.

The physiological mechanism of erection involves the release of nitric oxide (NO) in the cavernous body due to sexual arousal. NO activates the enzyme guanylate cyclase, which leads to an increase in the concentration of cGMP. In turn, cGMP causes relaxation of the smooth muscles of blood vessels and, accordingly, the flow of blood into the cavernous body of the penis.

Dynamically is a selective inhibitor of cGMP-specific type 5 phosphodiesterase (PDE5), which causes the breakdown of cGMP in the cavernous body of the penis. It does not have a direct relaxing effect on the smooth muscles of the cavernous body, but enhances the relaxing effect of NO and increases blood flow in the penis. Upon activation of the NO – cGMP chain, observed with sexual stimulation, inhibition of PDE5 leads to an increase in the level of cGMP in the cavernous body. The pharmacological effect is achieved only in the presence of sexual stimulation.

The activity of sildenafil in relation to PDE5 is superior to activity against other known phosphodiesterase isoenzymes: PDE6 - 10 times, PDE1 - more than 80 times PDE2 – PDE4, PDE7 – PDE11 - more than 700 times. Sildenafil is 4,000 times more selective for PDE5 compared to PDE3, which is of great importance, since PDE3 is one of the key enzymes in the regulation of myocardial contractility.

Dynamically has a mild and short-term hypotensive effect, in most cases without clinical manifestations when taken in recommended doses. The antihypertensive effect is associated with the vasodilating effect of sildenafil due to an increase in the content of cGMP in the smooth muscle membrane of blood vessels.

Indications

Treatment of erectile dysfunction characterized by an inability to achieve or maintain an erection of the penis sufficient for satisfactory intercourse.

Effective only with sexual stimulation.

Contraindications

- Hypersensitivity to the components of the drug Dynamically.

- Patients who are continuously or intermittently receiving nitric oxide donors, organic nitrates.

- For patients for whom sexual activity is undesirable, including with severe cardiovascular diseases such as unstable angina, severe heart failure, life-threatening arrhythmias, arterial hypotension (blood pressure (BP) less than 90/50 mm Hg. ), arterial hypertension (blood pressure greater than 170/100 mm Hg), recent cerebrovascular accident or myocardial infarction

- Patients with loss of vision in one eye due to anterior ischemic optic neuropathy of non-arterial eneza (regardless of whether it was due to PDE5 inhibitor reception or not)

- Inherited retinal degenerative diseases, including retinitis pigmentosa (a smaller proportion of these patients have a genetic disease of PDE of the retina)

- Severe liver failure

- Female gender

- Age under 18 years.

Special instructions

Before using the drug Dynamically, a thorough examination of the patient should be carried out in order to diagnose erectile dysfunction and determine the causes of its occurrence. It is necessary to assess the risk of developing serious adverse reactions due to sexual activity in patients with cardiovascular diseases, as well as concomitant medications. Sildenafil causes a mild decrease in blood pressure. Patients with left ventricular obstruction or with rare multiple atrophy syndrome are especially susceptible to the hypotensive effect of sildenafil. Before using sildenafil in such patients, it is necessary to exclude the risk of the adverse effects of low blood pressure during sexual activity. Most adverse reactions from the cardiovascular system develop immediately after sexual intercourse or shortly after it, in rare cases, adverse reactions can develop before sexual intercourse.

The simultaneous use of several different drugs for the treatment of erectile dysfunction is not recommended.

Dynamically should be used with caution in patients with anatomical deformities of the penis (angulation, cavernous fibrosis or Peyronie's disease), as well as in patients with diseases predisposing to priapism (sickle cell anemia, myeloma, leukemia).

If a visual impairment occurs, consult a doctor immediately.

Doses of more than 200 mg do not increase effectiveness, but increase the frequency and severity of dose-dependent side effects.

Influence on the ability to drive vehicles and control mechanisms

In case of adverse reactions from the nervous system and sensory organs, patients are advised to refrain from driving and controlling mechanisms, as well as to exercise caution when engaging in activities that require concentration and speed of psychomotor reactions.

Dosage and administration of

Inside, about 1 hour before the planned sexual activity.

Based on the effect and tolerability of the drug, the dynamic daily dosage may be from 25 mg to 100 mg.

It is recommended to take the drug no more than 1 time per day.

Side effects of the

From the nervous system: very often - headache often - dizziness infrequently - drowsiness, hypesthesia rarely - stroke, fainting frequency is unknown - transient ischemic attack, convulsions, including relapses.

From the cardiovascular system: often - “hot flashes” infrequently - palpitations, tachycardia rarely — increase or decrease in blood pressure, myocardial infarction, atrial fibrillation, frequency unknown - ventricular arrhythmia, unstable angina, sudden death.

From the side of the organ of vision: often - impaired vision, impaired color perception infrequently - conjunctival damage, violation of lacrimation, increased perception of light, impaired vision, transient chromatopsia rarely - redness of the sclera, pain in the eyeballs frequency unknown - anterior ischemic optic neuropathy, occlusion of the retinal vessels, narrowing of the fields of vision.

On the part of the hearing organ: infrequently - vertigo, tinnitus rarely - deafness.

On the part of the respiratory system: often - nasal congestion rarely - nosebleeds.

From the gastrointestinal tract: often - dyspepsia infrequently - vomiting, nausea, dry oral mucosa.

Allergic reactions: infrequently - skin rash frequency is unknown - Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).

From the genital organs: frequency is unknown - priapism, prolonged erection.

Other: rarely - chest pain, fatigue.

Storage conditions

Keep out of the reach of children, at a temperature not exceeding 25 ° C.

Expiration

3 years.

Deystvuyuschee substances

Sildenafil

Form of Treatment

tablets

Pliva Hrvatska doo, Croatia



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