Brand Intagra

1.  General Information 

Trade (unpatented) denomination of the preparation: VIAGRA.  International (unpatented) denomination:  Cildenaphil (in the form of Cildenaphil Citrate).   

Pharmacotherapeutic group. 

VIAGRA is the first representative of a new group of medications which are called inhibitors of phosphodiesterasa of the 5th type. The preparation broadens blood vessels of the penis in sexual excitation. It results in blood reflux in the penis, which promotes a normal erection. 

Active substance. 

Cildenaphil is the active substance of VIAGRA. One tablet of the preparation contains 25 mg., 50 mg or 100 mg of Cyldenaphil (in the form of Cildenaphil Citrate).   

Non-active components.

VIAGRA also contains the following non-active components:

microcrystal cellulose, hydrogenphosfate of calcium (anhydrous), natrium crosscarmellosa, magnesium stearate, hypromellosa, dioxide of titanium (Y 171), lactose, tryacetine, indigo carmine, aluminium varnish (Е132). 

2. Indications for application 

VIAGRA is intended for the treatment of men with erection disorders, which is also called impotency. In this state a man have no erection needed for a sex intercourse. VIAGRA acts only in response to sexual excitement. VIAGRA does not affect reproductive function. 

3. Counter indications 

DO NOT take VIAGRA if:

In the past you had allergic reaction on VIAGRA or any other component of the preparation. Allergic reaction may be manifested with rash, itching, oedema of the face and lips, short breath. If you have had such symptoms, inform your doctor.

If you take medications containing nitrates or donators of oxide of nitrogen for the treatment of stenocardia, VIAGRA may provoke an undesired intensification of the actions of such medications. If you take such medications, inform your doctor or pharmacist. 

4. Warnings 

If you suffer from any of the below mentioned diseases, inform you doctor before you take VIAGRA:

crescent cell anemia (change of red blood cells),

leukemia (cancer of blood cells),

multiple myeloma (cancer of marrow)

disease or deformation of the penis.

During the treatment by the medications which influence erection disorders, special precautions may be needed for men with such diseases:

rare eye disease called pigment retinitis,

ulcer of stomach and diseases, accompanied with bleedings (for instance hemophilia). With such diseases VIAGRA may give undesired effects. 

VIAGRA should not be applied in combination with other medications intended for erection disorders treatment 

Use in children.

VIAGRA should not be given to children.  

Use in elderly people and in people with kidney and liver diseases.

There are no special recommendations on the treatment of elderly people or patients with kidney or liver diseases. No need of precautions in driving or mechanisms operating 

Interaction with other medications.

You should inform your doctor about all the medications which you take. VIAGRA may interact with some other medicines. VIAGRA may provoke undesired intensification of the action of other medications which are called nitrogen oxide donators or nitrates (they are used in the treatment of stenocardia). If you take such medications it is PROHIBITED TO TAKE VIAGRA! 

Overdose.

Do not take a tablet of more dosage than you doctor have recommended. Do not take more than one tablet a day.  If you have taken more tablets than recommended, call your doctor immediately. 

5.  Directions for use and doses. 

It is up to your doctor to decide which dose is applicable for you to take VIAGRA. For most men the dose is 50 mg., but depending on efficiency and tolerance of the medication, the dose may be increased to 100 mg., or reduced to 25 mg.    

VIAGRA should be taken about 30 minutes – 1 hour before a sexual intercourse. Swallow a whole tablet and drink a small amount of water. VIAGRA should be taken not more than once a day. VIAGRA favors erection ONLY with sexual excitement. It does not provoke spontaneous erection without erotic stimulation. The action of VIAGRA starts in various time frames in various people, but usually it is from 30 minutes to 1 hour after intake and continues 4-6 hours. After abundant meals the action of VIAGRA may start later. Drinking alcohol may result in a temporary erection disturbance, that is why in order to get maximal effect alcohol is not recommended to drink in bigger quantities.  

If intake of VIAGRA does not favor erection or remains not long enough for finishing a sexual intercourse, talk to your doctor. 

6.  Side effects. 

As many other medicines VIAGRA may provoke some undesired reactions. Usually they are lightly or moderately shown and do not persist. The most frequent side effects are headache and flash. Less frequent are digestion disturbances, faintness, stuffiness in nose and change in vision (discoloration, high-light or blur in vision). 

MALE STERILIZATION OR VASECTOMY
Sterilization in men is less complicated than in women. The procedure, called a vasectomy, is usually done on an outpatient basis, using a local anesthetic. The surgeon (generally an urologist) makes an incision on each side of the scrotum. The vas deferens on each side is then located, and a piece is removed from each. The ends are usually tied or sewn shut.
The man usually experiences some discomfort, local pain, swelling, and discoloration for about a week. In a small percentage of cases, more serious complications occur: formation of a blood clot in the scrotum (which usually disappears without medical treatment), infection, and inflammatory reactions. Because sperm are stored in other areas of the reproductive system besides the vasa deferentia, couples must use alternative methods of birth control for at least one month after the vasectomy. The man must check with his physician (who will do a semen analysis) to determine when unprotected intercourse can take place. The pregnancy rate in women whose partners have had vasectomies is about 15 in 10,000.
Many men are reluctant to consider sterilization because they fear the operation will affect their sexual performance. Such fears are unfounded (although not abnormal) and can be alleviated by talking to men who have already been vasectomized.
A vasectomy in no way affects sexual response. Because sperm constitute only a small percentage of the semen, the amount of ejaculate is not changed significantly. The testes continue to produce sperm, but the sperm are prevented from entering the ejaculatory duct because of the surgery. After a time, sperm production may diminish. Any sperm that are manufactured disintegrate and are absorbed into the lymphatic system.
Although a vasectomy should be considered a permanent procedure, surgical reversal is sometimes successful in restoring fertility. Recent improvements in microsurgery techniques have resulted in annual pregnancy rates of between 40 and 60 percent for women whose partners have had reversals. The two major factors influencing the success rate of reversal are the doctor's expertise and the time elapsed since the vasectomy.
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MEN’S HEALTH

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