Dynamico

Among the analogues of Viagra, which are not inferior to it in quality, but are noticeably more attractive in price, we should highlight Dynamico, as well as its two additional varieties - Forward and Long. With the help of this drug, you can successfully cope with such pathologies as erectile dysfunction, regaining your former self-confidence.

pharmachologic effect

The drug Dynamico is used to treat erectile dysfunction . The active substance inhibits PDE-5. Due to increased blood flow to the penis, the active substance is able to restore impaired erectile function with provided sexual stimulation.

Erection at the physiological level is based on the release of NO - nitric oxide in the cavernous bodies as a result of excitement. NO is able to activate guanylate cyclase, which increases the level of cyclic guanosine monophosphate (cGMP), which relaxes smooth muscle fibers in the blood vessels, which leads to increased blood flow to the cavernous bodies in the penis.

Sildenafil is a selective inhibitor of cGMP (specific PDE-5), under the influence of which cGMP breaks down in the cavernous bodies in the penis. The active substance does not have a direct effect on the relaxation of smooth muscles in the corpora cavernosa, but it is able to increase blood flow to the penis and enhance the ability of NO to relax smooth muscles. During sexual stimulation, activation of the NO-cGMP chain is observed, which inhibits PDE-5, which increases the level of cGMP in the cavernous bodies. The above pharmacological effect is observed only with sexual stimulation .

Sildenophil is more active than all known PDE isoenzymes: it is 10 times more active than PDE-6, 80 times more active than PDE-1, 700 times more active than PDE-2, 4, 7, 11. The active substance is 4 more selective in comparison with PDE-3 thousand times, which is important because PDE-3 is the main enzyme in the regulation of cardiac contractility.

Sildenafil is characterized by a mild hypotensive effect , which has a short-term effect and has virtually no clinical significance when treated with the drug in doses recommended by the manufacturer. The hypotensive effect is due to a vasodilating effect caused by an increased content of cGMP in smooth muscle fibers in the vascular wall.

Reviews from doctors

Eduard Yakovlevich Zh, urologist.

Dynamico is another sildenafil drug, practically no different from its predecessors. The properties of this medicine have been studied for a long time, so it can be prescribed with confidence.

Lev Pavlovich B, doctor – andrologist.

In my practice, I try to move away from sildenafil and drugs based on it, since today there are new generations of PDE5 inhibitors. But in the absence of alternatives, drugs like Dynamico may well be used as a temporary solution to the problem.

Pharmacodynamics and pharmacokinetics

Suction process

Rapidly absorbed after oral administration. When taken on an empty stomach, the maximum level is recorded after 0.5-2 hours. Bioavailability depends on food intake: on an empty stomach - 41%, after eating - 20-40% (reached within 1.5-3 hours).

Distribution

The VSS indicator is 105 liters. Active metabolites and Sildenafil itself are bound to plasma proteins by 90% of the dose taken. The indicator is not dose-dependent.

Metabolism

metabolic pathway is carried out with the participation of the microsomal isoenzyme CYP2C9, and the main one is CYP3A4. The most important active circulating metabolite is the N-demethyl metabolite, which exhibits activity in relation to PDE equal to 50% of the activity of Sildenafil. Its concentration reaches 40% of the level of Sildenafil. The half-life of N-demethyl metabolite is 4 hours.

Removal

The clearance of the active substance is 41 l/h. The half-life is 3-5 hours. Inactive metabolites are excreted 13% through the renal system and 80% through the intestines.

Special group of patients

Compared with patients 18-45 years old, in people over 65 years old, the Cmax is 90% higher, which is explained by the reduced clearance of Sildenafil. The level of active substance not bound to plasma proteins is 40%. With moderate pathology of the renal system, the pharmacokinetics do not change (when taking 50 mg of the drug). With cirrhotic damage to the hepatic system, Cmax and AUC increase by 47 and 84%, respectively.

Comparative analysis

When comparing various PDE5 inhibitors, their effectiveness comes to the fore, as well as a list of contraindications, limitations and side effects. Additionally, you need to take into account the country of production of the tablets and their cost on the domestic medicine market.

Dynamico or Vizarsin: which is better?

Identifying the more preferable drug in a given pair is problematic, since both drugs are almost identical to each other. Being based on the same active ingredient, these two drugs cost approximately the same, so the final choice is based on the actual availability of any of the medications in city pharmacies.

Dynamico or Sildenafil: which is better?

If we consider not the substance, but the brand name Sildenafil, then it is a better choice compared to Dynamico, since in Russia you can buy domestically produced tablets at an attractive price.

As for generics of sildenafil, including American Viagra or, for example, French Revatio, with similar effectiveness, these drugs are much more expensive.

Dynamico or Cialis: which is better?

It is appropriate to compare only Dynamico Long with American Cialis, since both drugs contain tadalafil, a more modern and less harmful analogue of sildenafil. Having a gentler and longer-lasting effect on the body, the Long version is in no way inferior to Cialis, but costs half as much.

Dynamico or Levitra: which is better?

Levitra is a German version of PDE5, whose active ingredient is vardenafil. In terms of effectiveness, it belongs to the same generation as sildenafil, so there is no significant difference between Levitra and Dynamico, except for the price: the drug from Germany is noticeably more expensive.

Contraindications

• taking Ritonavir ;
• individual hypersensitivity;
• patients suffering from loss of vision in one eye due to optical ischemic anterior neuropathy of non-arterial origin (regardless of the influence of a PDE-5 inhibitor);
• age limit – up to 18 years of age;
• female;
• intake of organic nitrates, NO donors;
• severe pathology of the hepatic system;
• degenerative changes in the retina of hereditary origin (for example, retinitis pigmentosa ).

The medication is not prescribed to persons for whom sexual activity is undesirable:

• life-threatening arrhythmias;
• heart failure;
• arterial hypertension;
• arterial hypotension;
• unstable form of angina;
• myocardial infarction;
• cerebrovascular accidents.

Relative contraindications:

• obstructive lesion of the left ventricular outflow tract;
• multiple system atrophy syndrome;
• obstructive hypertrophic cardiomyopathy ;
• aortic stenosis;
• multiple myeloma;
• priapism;
• anatomical deformation of the shape of the penis;
• galactose-glucose malabsorption;
• lactose deficiency;
• lactose intolerance;
• leukemia;
• taking alpha-blockers.

Side effects

Organs of vision:

• disruption of tear flow;
• damage to the conjunctiva;
• color vision impairment;
• disturbance of visual perception;
• transient form of chromatopsia ;
• blurred vision;
• increased perception of light;
• redness of the sclera;
• occlusion of blood vessels in the retina;
• ischemic form of anterior optic neuropathy;
• narrowing of visual fields;
• pain in the eyeballs.

Heart, vascular system:

• atrial fibrillation;
• feeling of rapid heartbeat;
• sudden coronary death;
• unstable form of angina;
• ventricular arrhythmias;
• myocardial infarction;
• instability of blood pressure .

Nervous system:

• transient ischemic attack;
• fainting;
• stroke;
• hypoesthesia;
• seizures (including recurrent ones);
• increased drowsiness;
• dizziness;
• migraine headaches.

Other reactions:

• deafness;
• noise in ears;
• vertigo;
• nosebleeds ; _
• nasal congestion;
• vomit;
• dyspeptic disorders;
• dry mouth;
• fast fatiguability;
• chest pain;
• priapism;
• prolonged erection;
• skin rashes;
• nausea;
• Lyell's syndrome.

Dynamico tablets, instructions for use (Method and dosage)

The medication must be taken 1 hour before the intended sexual activity.

Instructions for use Dynamico 50 mg: 1 tablet per day. The dosage can be reduced to 25 mg or increased to 100 mg, taking into account the tolerability and effectiveness of the drug.

For mild/moderate pathology of the renal system, no adjustment of the dosage regimen is required. In case of severe renal pathology, treatment begins with taking 25 mg of Sildenafil with a gradual increase to 50 or 100 mg if well tolerated. The first dose for older men is 25 mg, with gradual increases as needed and well tolerated.

Treatment also begins with 25 mg for mild/compensated pathology of the hepatic system, gradually increasing the dose to 50-100 mg as needed. A similar regimen should be followed for patients taking drugs from the alpha-blocker group.

Release form and composition

Dynamico is produced in the form of film-coated tablets: blue, biconvex, at a dose of 25 mg and 50 mg - round, at a dose of 100 mg - oval and with a separating line on both sides (1 or 4 pieces in blisters, in a cardboard pack 1 blister).

1 film-coated tablet contains:

• active ingredient: sildenafil citrate – 35.12 mg, 70.24 mg or 140.48 mg, this corresponds to the content of 25 mg, 50 mg or 100 mg of sildenafil;
• auxiliary components: microcrystalline cellulose, croscarmellose sodium, hyprolose, colloidal anhydrous silicon dioxide, magnesium stearate;
• film shell composition: indigo carmine (E132), opadry II 31F58914 white – macrogol 4000, lactose monohydrate, hypromellose, sodium citrate, titanium dioxide (E171).

Interaction

The concentration of Sildenafil in the blood increases when treated with inhibitors of the isoenzymes CYP2C9 and CYP3A4:

• Erythromycin;
• Ketoconazole;
• Cimetidine.

Such patients are recommended to take 25 mg of Sildenafil.

The maximum concentration of Sildenafin increases by 300% and the AUC by 1000% with simultaneous use of Ritonavir. These indicators also increase during treatment with Saquinavir. Dynamico does not affect the pharmacokinetics of Saquinavir and Ritonavir. Sildenafil is able to enhance the antiplatelet effect of Nitroprusside Na. It is possible to develop severe arterial hypotension when taking Nicorandil , which contains a nitrate component. There is a mutual increase in effects (possible death) when taking nitrates and other NO donors. The drug Dynamic may enhance the hypotensive effect of ACE inhibitors, beta blockers and medications of the CCB group. There is an increase in the activity of hypoglycemic drugs . It is possible to develop orthostatic hypotension and a pronounced drop in blood pressure when taking the alpha-blocker Doxazosin . The concentration of the active substance Sildenafil increases if you take the tablets with grapefruit juice.

Drug interactions

Inhibitors of cytochrome CYP3A4 reduce the clearance of sildenafil - this is true for drugs such as Erythromycin, Cimetidine, Clarithromycin and Ketoconazole. The active substance is not characterized by an effect on the pharmacokinetics of substances such as Saquinavir, Antacid, Azithromycin and acetylsalicylic acid, Warfarin and Tolbutamide.

There is a decrease in blood pressure with simultaneous administration of alpha-blockers. Drinking alcohol-containing beverages does not enhance the hypotensive effect of sildenafil in healthy patients, so Dynamic and alcohol can be compatible with each other.

special instructions

A thorough examination is required to determine the true causes of erectile dysfunction. Patients taking other medications, as well as those suffering from serious diseases of the heart and vascular system, are advised to assess the risk of developing negative reactions associated with sexual activity. Sildenafil is able to gradually lower blood pressure. In patients with rare multiple atrophy syndrome and obstructive lesions of the left ventricle, the hypotensive effect is more pronounced. Most negative reactions from the heart and vascular system develop immediately after sexual intercourse or a certain time after it. It is extremely rare that adverse reactions occur before sexual intercourse. Concomitant use of other medications prescribed for erectile dysfunction .

The medication is used with caution by persons suffering from various diseases that predispose to the development of priapism:

• multiple myeloma;
• sickle cell anemia;
• leukemia (bone marrow disease).

In case of anatomical deformation of the penis (against the background of cavernous fibrosis , angulation , Peyron's disease ), Dynamic is prescribed with caution. If visual perception disorders develop, immediate consultation with your doctor is required. Taking more than 200 mg of the active substance does not affect the effectiveness, but increases the severity and frequency of dose-dependent negative reactions. It is recommended to refrain from driving a vehicle.

Analogues of Dynamico

Level 4 ATX code matches:
Tornetis

Olmax Strong

Taxier

Revatio

Caverject

Levitra

Cialis

Tentex Forte

Rileys

Viagra

Sildenafil

Yohimbine hydrochloride

Zidena

Papazole

Structural analogues:

• Wildegra;
• Viagra;
• Silaphil;
• Rijump;
• Maxigra;
• Vizarsin;
• Olmax Strong;
• Vigrande;
• Erexesil;
• Taxier;
• Revatio;
• Tornetis.

Vizarsin or Dynamico - which is better?

The composition of the drugs is absolutely identical, both contain Sildenafil. Both medications are generics - substitutes for the original Viagra . Vizarsin costs much less (90-280 rubles).

Reviews about Dynamiko

The drug has established itself as a good analogue of Viagra, used for erectile dysfunction.

Reviews of the drug Dynamico (100 mg, 4 tablets)

The medication does not provoke an erection on its own; the mechanism of action is aimed at increasing arousal and blood flow. According to statistics, potency returned to normal in 89% of patients. Patients note that if you take Dynamico before a meal, its effectiveness will appear within 30-40 minutes, and if after a meal, the effect may last for 3-4 hours.

Dynamico tablets, reviews from men

On thematic forums, males leave mostly positive reviews about the drug, confirming its effectiveness in treating potency disorders. Most often, patients write that the drug reduces the severity of shortness of breath during sexual intercourse, which is due to the effect of enzymes on the vessels of the respiratory tract and on the pulmonary artery ( vasodilating effect ). After the drug stops working, this effect is lost. The duration of action of the medication varies individually and ranges from 5-9 hours.

Dynamico price, where to buy

The price of Dynamico in pharmacies depends on the region, the dosage of the active substance and the number of tablets. For example, the price of Dynamico 100 mg 4 tablets is 1000 rubles. The medicine in the smallest dosage of 25 mg can be bought in Moscow for 300 rubles.

• Online pharmacies in RussiaRussia

ZdravCity

• Dynamico Long tablets p.p.o.
  5mg 14 pcs. Teva Pharmaceutical Enterprises Ltd. RUR 1,975 order
• Dynamic tablets p.p.o. 100 mg 1 pc. Pliva Hrvatska d.o.o.

  RUB 495 order

• Dynamico Long tablets p.p.o. 20mg 2 pcs. Teva Pharmaceutical Enterprises Ltd.

  RUB 1,288 order

• Dynamic tablets p.p.o. 100 mg 4 pcs. Pliva Hrvatska d.o.o.

  RUB 854 order

• Dynamic tablets p.p.o. 50 mg 1 pc. Pliva Hrvatska d.o.o.

  RUB 447 order

Analogues and prices

Cheap analogues of Dynamico should be considered other generics (synonyms) of sildenafil produced in Europe or Asia, while American drugs based on this PDE5 inhibitor are distinguished by a higher cost.

Today you can buy the following structural substitutes at the pharmacy:

• Sildenafil-SZ;
• Viagra;
• Vizarsin;
• Revatio;
• Tornetis;
• Vivaira;
• Erexesil;
• Maxigra;
• Viatile;
• Wildegra;
• Silden;
• Invida UDP;
• Taxier;
• Kamasteel.

There are also drugs of the PDE5 inhibitor class (including Russian ones), based on tadalafil, udenafil, vardenafil and avanafil. Plus, without a prescription at the pharmacy you can buy various dietary supplements and homeopathy preparations with a claimed effect against erectile dysfunction.

To purchase medical supplies you will need a prescription; the average price is shown in the table: