Sildenafil-SZ, 50 mg, film-coated tablets, 20 pcs.

"Sildenafil-SZ" is an effective prescription drug for improving erectile function, produced (hence the abbreviation "SZ" in the name). It is not intended to increase libido - it does not create a desire to enter into an intimate relationship . Due to information illiteracy, approximately 3% of men are disappointed in sildenafil-based products. The drug helps only in the presence of arousal and against the background of sexual stimulation . Without this, an erection can occur solely under the influence of the placebo effect - the brain will generate appropriate impulses without the participation of sildenafil.

Active substance and properties

the drug is sildenafil citrate - the same as in Viagra . Refers to PDE-5 inhibitors - inhibits the activity of the enzyme phosphodiesterase type 5, which interferes with the release of nitric oxide (NO3) from the walls of the cavernous bodies of the penis. Without NO3, the blood vessels will not dilate, blood will not flow, and there will be no erection.

A healthy man without psychological problems usually does not need sildenafil. Stimulation of erection using PDE-5 inhibitors is advisable in the following cases :

1. Metabolic disorders, poor blood circulation . Sexual weakness may be a consequence of slow blood flow in the pelvic area or obesity. In such cases, the erection is very sensitive to the slightest decline in sexual arousal.
2. Psychological problems, a typical one of which is the syndrome of anxious anticipation of sexual failure . The man is excited, but as soon as it comes directly to sex, the erection weakens due to the subconscious fear of failure. Sildenafil will not allow the blood vessels to contract, the blood will remain in the penis, and the erection will not disappear.

Practicing sexologist and psychotherapist Evgeniy Aleksandrovich Kulgavchuk will talk about how to independently diagnose the syndrome of anxious expectation of failure and how to cope with this problem:

1. Premature ejaculation. Sildenafil helps prolong sexual intercourse.
2. Impaired sexual reflexes, for example due to frequent masturbation . An erection is maintained only with manual stimulation, and during friction the usual pressure is not enough, the penis falls. After taking sildenafil for penis hardness, it is enough for a man to be aroused, sexual intercourse will not fail due to a weakened erection.
3. Impaired functioning of the blood vessels of the penis . In such cases, sildenafil is prescribed as a course. It is not addictive.

If a man is completely impotent (not only cannot have sexual intercourse, but also does not want to), then PDE-5 inhibitors will not help him.

How often do you have problems with erection during sexual intercourse?

Operating principle

To understand what kind of Sildenafil-C3 tablets these are, it is enough to know that they are based on a proven phosphodiesterase inhibitor PDE5, which was originally created by pharmacists to improve blood flow to tissues.

Doctors were unable to treat heart disease with sildenafil, but the drug was able to effectively pump blood into the penis in a selective manner (tonicizing blood flow throughout the entire pelvis). To better fill the corpora cavernosa of the penis with blood, the PDE5 inhibitor also relaxes their smooth muscles through the action of nitric oxide.

A curious feature of the pharmacodynamics of Sildenafil-C3 potency tablets is the fact that without the presence of natural sexual arousal, their use will not give a noticeable result. Only by acting in parallel with natural male hormones, the drug allows you to achieve a stable and long-lasting erection, which naturally decreases after sexual intercourse.

According to the instructions for use (annotation), men need to take the drug half an hour or an hour before expected coitus, so that the release of sildenafil reaches its maximum level. Also, you should pay attention to the fact that in case of severe liver and kidney diseases, the effectiveness of stimulation is reduced. Like any other pill for men, Sildenafil-C3 has a less pronounced effect in old age or when consumed simultaneously with alcohol or large amounts of fatty foods that interfere with absorption.

Analogs and price

Sildenafil is the oldest, most studied and cheapest of all PDE5 inhibitors, but is far from the best in terms of effectiveness, side effects and duration of action. Viagra is the only original drug based on it, and therefore costs much more than generics . The latter include: “Sildenafil-SZ”, “Dynamiko”, “Revatio”, “Tornetis”, “Maxigra”. There are quite a lot of drugs based on sildenafil (about 60). This substance is also added by some unscrupulous ones (Alikaps).

Sildenafil analogues:

• Vardenafil (Levitra). The nature of action is closest to sildenafil;
• Udenafil (Zidena). Efficiency does not depend on food intake, lasts 24 hours;
• Avanafil (Stendra). There are no particular advantages over other PDE-5 inhibitors, but they are much more expensive. Not sold in pharmacies;
• Tadalafil (Cialis). The action lasts 36 hours.

Average prices for Sildenafil-SZ in pharmacies:

1. 550 rub. for 10 tablets of 100 mg;
2. 753 rub. for 20 tablets of 100 mg;
3. 420 rub. for 20 tablets of 25 mg;
4. 670 rub. for 20 tablets of 50 mg;
5. 375 rub. for 10 tablets of 50 mg.

There is also a packing option of 4 pcs. 50 mg each at a price of 209 rubles. and 4 tablets of 100 mg for 330 rubles.

Comparative analysis

Taking into account how sildenafil works, drugs based on it never contain additional active components that stimulate erection, therefore all analogues and generics differ from each other in a minimal way. In fact, you can easily replace one drug with another, depending on your preferences, since the differences relate only to the auxiliary components and the appearance of the drug:

• Sildenafil Ozone and Sildenafil Vertex: like the product from North Star, these tablets are blue and biconvex, and the drug from Ozone is completely identical in composition, and Sildenafil Vertex additionally contains hyprolose instead of primellose, as well as silicon dioxide;
• Vizarsin: Slovenian drug for. White tablets include, in addition to the standard set of substances, calcium dihydrogen phosphate. The Ku-Tab version is considered separately - these are lozenges intended for patients who have difficulty swallowing;
• Viagra: the ancestor of PDE5 inhibitors, whose name has become a household name. The American medicine looks the same as Sildenafil-C3, but contains calcium;
• Dynamic: a drug completely identical to Sildenafil-C3, including composition and appearance. Produced in Croatia.

How and for how long does the tablet work?

Sildenafil begins to act within 30-120 minutes . This period is individual for everyone and depends on the speed of metabolic processes, age, food eaten and drinks drunk. Mistakes that make men disappointed in the effectiveness of sildenafil:

• Take the tablet after a heavy meal or fatty food. The maximum concentration of the active substance in the blood after administration on an empty stomach is reached in about an hour. Fatty foods slow down the absorption process by an average of 30 minutes.
• Start sexual intercourse early. Some people simply do not wait for the maximum effect (no earlier than an hour) and start having sex when the drug has not yet begun to work in full force.

The half-life is 4 hours. After this time, the effectiveness of the drug will decrease by half. Sildenafil will act for approximately this amount of time after administration - maximum 5 hours . The product is most effective during the first two hours after reaching the maximum concentration, then its activity will gradually decline.

Sildenafil-sz tablet p/o film 25mg 20 pcs

Pharmacological group:

A treatment for erectile dysfunction is a PDE5 inhibitor.
Pharmacodynamics:
Sildenafil is a powerful selective inhibitor of cycloguanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

Mechanism of action. The physiological mechanism of erection is associated with the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. This, in turn, leads to an increase in cGMP levels, subsequent relaxation of the smooth muscle tissue of the corpus cavernosum and increased blood flow. Sildenafil does not have a direct relaxant effect on the isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting PDE5, which is responsible for the breakdown of cGMP. Sildenafil is selective for PDE5 in vitro, its activity against PDE5 exceeds that of other known phosphodiesterase isoenzymes: PDE6 – 10 times; PDE1 – more than 80 times; PDE2, PDE4, PDE7-PDE11 – more than 700 times. Sildenafil is 4000 times more selective for PDE5 compared to PDE3, which is of utmost importance since PDE3 is one of the key enzymes in the regulation of myocardial contractility.

A prerequisite for the effectiveness of sildenafil is sexual stimulation.

Clinical data.

Cardiac research.

The use of sildenafil in doses up to 100 mg did not lead to clinically significant ECG changes in healthy volunteers. The maximum decrease in systolic pressure in the supine position after taking sildenafil at a dose of 100 mg was 8.3 mmHg. Art., and diastolic pressure – 5.3 mm Hg. Art. A more pronounced, but also transient effect on blood pressure (BP) was observed in patients taking nitrates (see sections “Contraindications” and “Interaction with other drugs”). In a study of the hemodynamic effect of sildenafil at a single dose of 100 mg in 14 patients with severe coronary artery disease (CAD) (more than 70% of patients had stenosis of at least one coronary artery), resting systolic and diastolic blood pressure decreased by 7 % and 6%, respectively, and pulmonary systolic pressure decreased by 9%. Sildenafil did not affect cardiac output or impair blood flow in stenotic coronary arteries, and also resulted in an increase (by approximately 13%) in adenosine-induced coronary flow in both stenotic and intact coronary arteries. In a double-blind, placebo-controlled study, 144 patients with erectile dysfunction and stable angina taking antianginal drugs (except nitrates) exercised until their angina symptoms improved. The duration of the exercise was significantly longer (19.9 seconds; 0.9 - 38.9 seconds) in patients taking sildenafil in a single dose of 100 mg compared to patients receiving placebo. A randomized, double-blind, placebo-controlled study examined the effect of varying the dose of sildenafil (up to 100 mg) in men (n = 568) with erectile dysfunction and hypertension taking more than two antihypertensive medications. Sildenafil improved erections in 71% of men compared to 18% in the placebo group. The incidence of adverse effects was comparable to that in other patient groups, as well as in individuals taking more than three antihypertensive drugs.

Studies of visual impairments.

In some patients, 1 hour after taking sildenafil at a dose of 100 mg, the Farnsworth-Munsell 100 test revealed a mild and transient impairment in the ability to distinguish shades of color (blue/green). 2 hours after taking the drug, these changes were absent. Color vision impairment is thought to be caused by inhibition of PDE6, which is involved in light transmission in the retina. Sildenafil had no effect on visual acuity, contrast perception, electroretinogram, intraocular pressure, or pupil diameter. In a placebo-controlled crossover study of patients with proven early-onset macular degeneration (n = 9), sildenafil in a single dose of 100 mg was well tolerated. There were no clinically significant changes in vision assessed by specific visual tests (visual acuity, Amsler grating, color perception, color transmission simulation, Humphrey perimeter, and photostress).

Efficiency.

The efficacy and safety of sildenafil was assessed in 21 randomized, double-blind, placebo-controlled studies lasting up to 6 months in 3,000 patients aged 19 to 87 with erectile dysfunction of various etiologies (organic, psychogenic or mixed). The effectiveness of the drug was assessed globally using an erection diary, the International Index of Erectile Function (a validated questionnaire about the state of sexual function) and a partner interview. The effectiveness of sildenafil, defined as the ability to achieve and maintain an erection sufficient for satisfactory sexual intercourse, has been demonstrated in all studies conducted and was confirmed in long-term studies lasting 1 year. In fixed-dose studies, the proportion of patients reporting that therapy improved their erections was: 62% (25 mg sildenafil dose), 74% (50 mg sildenafil dose), and 82% (100 mg sildenafil dose) compared with 25%. in the placebo group. Analysis of the International Index of Erectile Function showed that in addition to improving erections, treatment with sildenafil also increased the quality of orgasm, achieved satisfaction from sexual intercourse and overall satisfaction.

According to the pooled data, among patients who reported improved erections with sildenafil treatment, 59% of patients with diabetes, 43% of patients who had undergone radical prostatectomy and 83% of patients with spinal cord injury (versus 16%, 15% and 12% in the placebo group, respectively) ).

Pharmacokinetics:

The pharmacokinetics of sildenafil in the recommended dose range is linear.

Suction. After oral administration, sildenafil is rapidly absorbed. Absolute bioavailability averages about 40% (from 25% to 63%). In vitro, sildenafil at a concentration of about 1.7 ng/ml (3.5 nM) inhibits human PDE5 activity by 50%. After a single dose of sildenafil 100 mg, the average maximum concentration of free sildenafil in blood plasma (Cmax) in men is about 18 ng/ml (38 nM). Cmax when taking sildenafil orally on an empty stomach is achieved on average within 60 minutes (from 30 minutes to 120 minutes). When taken in combination with fatty foods, the rate of absorption decreases: Cmax decreases by an average of 29%, and the time to reach maximum concentration (Tmax) increases by 60 minutes, but the degree of absorption does not significantly change (the area under the concentration-time pharmacokinetic curve (AUC) decreases by 11%).

Distribution. The volume of distribution of sildenafil at steady state averages 105 liters. The binding of sildenafil and its main circulating N-demethyl metabolite to plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the sildenafil dose (average 188 ng) was found in semen 90 minutes after dosing.

Metabolism. Sildenafil is metabolized mainly in the liver under the influence of the cytochrome CYP3A4 isoenzyme (major pathway) and the cytochrome CYP2C9 isoenzyme (minor pathway). The main circulating active metabolite, resulting from N-demethylation of sildenafil, undergoes further metabolism. The selectivity of this metabolite for PDE is comparable to that of sildenafil, and its activity against PDE5 in vitro is about 50% of the activity of sildenafil. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of sildenafil. The N-demethyl metabolite undergoes further metabolism; its half-life (T1/2) is about 4 hours

Excretion. The total clearance of sildenafil is 41 l/hour, and the final T1/2 is 3-5 hours. After oral administration, as after intravenous administration, sildenafil is excreted in the form of metabolites, mainly by the intestines (about 80% of the oral dose) and, to a lesser extent, by the kidneys (about 13% of the oral dose).

Pharmacokinetics in special groups of patients.

Elderly patients. In healthy elderly patients (over 65 years of age), the clearance of sildenafil is reduced, and the concentration of free sildenafil in the blood plasma is approximately 40% higher than in young patients (18-45 years of age). Age does not have a clinically significant effect on the incidence of side effects

Renal dysfunction. With mild (creatinine clearance (CL) 50-80 ml/min) and moderate (CL 30-49 ml/min) degrees of renal failure, the pharmacokinetics of sildenafil after a single oral dose of 50 mg does not change. In severe renal failure (creatinine clearance less than 30 ml/min), the clearance of sildenafil is reduced, which leads to an approximately twofold increase in AUC (100%) and Cmax (88%) compared to those with normal renal function in patients of the same age group.

Liver dysfunction. In patients with liver cirrhosis (stages A and B according to the Child-Pugh classification), the clearance of sildenafil is reduced, which leads to an increase in AUC (84%) and Cmax (47%) compared with those with normal liver function in patients of the same age groups. The pharmacokinetics of sildenafil in patients with severe liver dysfunction (Child-Pugh stage C) has not been studied.

Reception mode, compatibility

The standard dosage is 50 mg one hour before sex and preferably on an empty stomach . Since most of the drug passes through the kidneys and liver, in the presence of pathologies of these organs, the dosage is reduced to 25 mg. Sildenafil can be taken only once a day . For elderly patients without serious illnesses, no dose adjustment is required.

More information about the indications and side effects of sildenafil:

Compatibility with medications (features of taking sildenafil):

1. Ritonavir: no more than 25 mg no more often than once every 48 hours.
2. Cytochrome CYP3A4 isoenzyme inhibitors (ketoconazole, erythromycin): no more than 25 mg at the first dose.
3. Alpha blockers: low doses only after stabilization of blood flow (hemodynamics).
4. Incompatible with other nitrogen excretion stimulants and nitrates.

Sildenafil should not be taken with alcohol, as the side effects will increase significantly. The maximum that can be allowed is a glass of wine or a glass of beer (not a 0.5 l mug).

Contraindications and side effects

List of contraindications:

• Leukemia;
• Individual intolerance to sildenafil;
• The use of other nitrogen or nitrate donors (the pressure will drop too much);
• Deformation of the penis (intense filling with blood can cause severe pain and tissue ruptures);
• Damage to the optic nerve, retinal pathologies;
• Low pressure;
• Stomach ulcer;
• A recent history of stroke or heart attack (six months);
• Severe heart, kidney or liver failure.

It is not advisable to take Sildenafil-SZ for varicose veins of the small pelvis.

Main side effects : heaviness in the head, redness of the face, runny nose. Less common are blurred vision, headaches, nausea, allergies, and swelling. You may experience tinnitus, dizziness, and increased heart rate. The most dangerous side effect is pressure surges and myocardial infarction. This can be fatal.

The above side effects rarely occur if you follow the dosage and do not take the drug without a doctor’s prescription. An overdose of sildenafil will lead to increased negative reactions, and the norm is different for everyone. For some men, half a 25 mg tablet is enough, while for others, the effect occurs only with a maximum dose of 100 mg and side effects are not pronounced.

Directions for use and doses

Taking into account the release form of Sildenafil-C3, strictly oral use of tablets is assumed, regardless of food intake. The product must be taken whole, without chewing and with a small amount of water, which will ensure that the substance begins to act in approximately 30 - 45 minutes. On average, the duration of action of the stimulant lasts about 4 – 6 hours, however, after the end of PA, it does not continue to maintain an erection, ceasing to act on the patient.

The dosage of the drug is determined taking into account the amount of active substance in the tablet and the individual characteristics of the man, but experts recommend starting with one 25 mg tablet. If the required result is not achieved, the dosage can be increased, but 100 mg once is the maximum permissible limit.

The composition of Sildenafil-C3 and its pharmaceutical description allow us to conclude that this drug does not require long-term use, therefore the treatment regimen is based on the symptomatic use of tablets to achieve an immediate result.

Reviews from doctors

Doctors speak differently about Sildenafil-SZ. Some praise it and consider it a very worthy domestic replacement for the expensive Viagra, while others do not recommend it due to the manufacturer’s dishonesty (the dosage may not correspond to the declared one or the drug may not work). Generic drugs all over the world have worse quality control than original drugs, which is the reason for non-compliance with technology.

In general, expert reviews of sildenafil as a means of correcting erectile dysfunction are positive. Serious side effects are reported infrequently; the effect is present in most men.

Indications for use

An analysis of the instructions for use of Sildenafil-C3 for men shows that the drug is highly specific, and the scope of its use includes, first of all, any difficulties in achieving or maintaining a stable erection (necessary for sexual intercourse).

It should be noted that the effectiveness of using the product directly depends on natural sexual arousal, otherwise the mechanism of sildenafil will not be activated.

As for the etiology of erectile dysfunction, it is not of critical importance - the medicine will help with both organic and psycho-emotional causes of impotence. It remains to add that Sildenafil-C3 will be extremely ineffective for women; in addition, it should not be prescribed for prostatitis and prostate adenoma, since it is not able to alleviate their symptom complex.

Reviews from men

Vitaly, 44 years old: I take Sildenafil-C3 no more than three times a week. There is an effect - when aroused, the erection is confident and after ejaculation is easily caused again. The downside is that after about 20-30 minutes my head starts pounding and my nose gets stuffy.”

Sergey, 33 years old: “From 50 mg of sildenafil from Severnaya Zvezda, all the symptoms of an overdose arose: only side effects without an erection. I reduced the dosage to 25 mg - all the negativity disappeared, the erection is stable.”

Evgeniy, 37 years old: “The side effects and effects of Sildenafil-SZ and Viagra are the same. Only our product makes me sleepy the next day after a night of intercourse and I can’t work.”

Video review of the male drug “Sildenafil SZ”:

Composition and release form

Sildenafil-C3 is a tablet containing 25, 50 or 100 mg of active ingredient; sildenafil citrate is the biologically active component. This PDE5 inhibitor is supplemented with minor stabilizers and ingredients, which include cellulose, milk sugar, primellose, polyvinylpyrrolidone and magnesium stearate. Additionally, a number of components (dyes and stabilizers) include the film shell.

As for the appearance of the pills from North Star, they are biconvex and colored blue, like their world-famous progenitor - the Viagra potency enhancing pills. The medicine is sold in the form of contour cellular packaging or plastic jars (bottles) with a capacity of 2, 4, 10, 14 or 20 pcs.