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Impotence is the heartache of many men, overwork kidney and other reasons can cause sexual dysfunction. The famous Viagra, I believe that most of the male friends all know that Viagra is a drug commonly used to treat impotence.

But friends may not know the right usage, the correct way of taking Viagra, and how long for the Viagra to take effects?

Viagra, also known as sildenafil citrate, Viagra is the treatment of erectile dysfunction (ED) oral medication. It is sildenafil citrate, a kind of cyclic guanosine monophosphate (cGMP) specific phosphodiesterase type 5 (PDE5) selective inhibitors.

Viagra mechanism of action:

The physiological mechanism of penile erection related to during intracavernous nitric oxide (NO) release of sexual stimulation. NO activate guanylate cyclase resulting in cyclic guanosine monophosphate (cGMP) levels increased, so that within the cavernous smooth muscle relaxation and blood filling.

Pharmacodynamics of sildenafil effects on penile erectile response:

Sildenafil (Sildenafil, Viagra) is a highly selective phosphodiesterase 5 (PDE5) inhibitors, PDE5 is highly expressed in the penis, whereas in other tissues (including platelets, vascular and visceral smooth muscle, skeletal muscle), low expression.

Sildenafil by selectively inhibiting PDE5, enhancement of nitric oxide (NO) -cGMP pathway, leading to increased levels of cGMP in corpus cavernosum smooth muscle relaxation,make  erectile dysfunction patients erectile response to sexual stimulation naturally. The reaction is generally increased with erectile sildenafil dose and plasma concentration increased.  

Viagra how long it will take effect? Fasting state when taking 25 ~ 100mg, within about one hour plasma concentration (Cmax) 127 ~ 560ng / ml.

For most patients, the recommended initial dose of 50 mg,taking in about 1 hour before sexual activity ; but any time before sexual activity within 0.5 to 4 hours can be taken. Based on the efficacy and tolerability, the dose can be increased to 100 mg (recommended dose) or decreased to 25 mg. Multiple doses of 1 day is one time.

The following factors is related with plasma levels of sildenafil (AUC) increased : over 65 years of age (40% increase), liver damage (eg cirrhosis of the liver, an increase of 80%), severe renal impairment (creatinine clearance <30ml / min, 100% increase), while taking potent cytochrome P450 3A4 inhibitors (ketoconazole, itraconazole 200% increase), erythromycin increased 182%, saquinavir increase of 210%.

Since higher plasma levels may also increase the efficacy and incidence of adverse events, so the starting dose in these patients: 25mg is appropriate.

Studies have shown that, HIV protease inhibitors Ritonavir can make the sildenafil plasma levels were significantly higher (AUC increased 11-fold). For this reason, we recommend that the patients taking Ritonavir, dose every 48 hours no more than 25mg.

Reminder: Before some friends may have  misunderstanding on the Viagra, that immediately after taking Viagra can roam.

I would like to see: after  reading this article  friends can learn the correct dosage of Viagra, to better improve the symptoms of impotence.

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