Viamax

Introduction
Viamax is a prescription medicine used to treat erectile dysfunction (impotence) in men. It works by increasing blood flow to the penis. This helps men to get or maintain an erection. It belongs to a group of medicines known as phosphodiesterase type 5 (PDE 5) inhibitors. Viamax may be taken on an empty stomach or with a meal. It should be strictly taken as advised by your doctor. You should take it about 1 hour before you plan to have sex. The amount of time it takes to work varies from person to person, but it normally takes between 30 minutes and 1 hour. This medicine will only help you to get an erection if you are sexually stimulated. However, you should not take this medicine if you do not have erectile dysfunction. It should not be taken more than once a day. The most common side effects of this medicine are flushing (sense of warmth), headache, dizziness, blurred vision, muscle pain, stomach upset, and rash. Talk to your doctor if any of the side effects bother you or do not go away. This medicine is not intended for use by women and men should avoid using any other medicines to treat impotence without talking to a doctor first. It can be dangerous to take it along with medicines called nitrates (often given for chest pain or angina). Do not take this medicine if you have severe heart or liver problems, have recently had a stroke or heart attack or if you have low blood pressure. Let your doctor know if you suffer from these or any other health problems before taking it. You should not drive if this medicine makes you feel dizzy. Avoid drinking alcohol while taking this medicine as it increases the chances of side effects.

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Uses of Viamax
Erectile dysfunction
Side effects of Viamax
Common
Flushing (sense of warmth in the face, ears, neck and trunk)
Headache
Blurred vision
Muscle pain
Upset stomach
Altered vision
Rash
How to use Viamax
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Viamax may be taken with or without food, but it is better to take it at a fixed time.
How Viamax works
Viamax is a phosphodiesterase-5 (PDE-5) inhibitor. It works by relaxing the blood vessels in your penis, thereby increasing blood flow into the penis on sexual stimulation. This helps you achieve and maintain a hard, erect penis suitable for sexual activity.
What if you forget to take Viamax?
If you miss a dose of Viamax, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
You have been prescribed Viamax for the treatment of erectile dysfunction.
It is best to take it an hour before sexual intercourse. But, you can take it anytime between 30 minutes and 4 hours before sexual activity.
Do not take it more than once a day.
Seek medical attention if the erection persists for more than 4 hours after sexual intercourse.
Do not use Viamax if you have recently taken nitrates (medicines used in angina or chest pain).
Do not take it if you have had a heart attack in the past 3 months, or stroke or heart failure in the past 6 months.
Brief Description
Indication
Erectile dysfunction, Pulmonary arterial hypertension
Administration
May be taken with or without food.
Adult Dose
Oral Erectile dysfunction Adult: 50 mg about 1 hr before sexual intercourse. May adjust dose depending on penile response. Max: 100 mg/dose and not to be taken > once in 24 hr. Elderly: >65 yr: Lower initial dose at 25 mg. Hepatic impairment: Initially, 25 mg. Pulmonary Arterial Hypertension 20 mg 3 times daily, administered 4-6 hours apart

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Renal Dose
Renal impairment: CrCl (ml/min) Dosage Recommendation <30 Initially, 25 mg. _ Contraindication Hypersensitivity. Patients concurrently or intermittently using organic nitrates in any form. Mode of Action Sildenafil inhibits phosphodiesterase type-5 (PDE5) which is responsible for cGMP degradation in the corpus cavernosum. Inhibition of PDE5 increases cGMP levels in the corpus cavernosum which results in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Precaution Caution when used in patients with anatomical deformation of penis or conditions that may predispose them to priapism (e.g. sickle cell anaemia, myeloma, or leukaemia). Mild, transient, dose-related impairment of colour discrimination (blue/green) may occur. Hepatic or severe renal impairment, bleeding disorders, active peptic ulceration, hypotension, recent history of stroke, MI, arrhythmias, unstable angina, heart failure or retinal disorders. May cause sudden loss or decrease in hearing. Side Effect >10% Headache (7-16%) 1-10% Flushing (4-10%),Epistaxis (8%),Dyspepsia (4-8%),Insomnia (6%),Erythema (5%),Diarrhea (4%),Dizziness (2%),Skin rash (2%)

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Interaction
Inhibitors of CYP3A4 such as cimetidine and erythromycin are likely to reduce sildenafil clearance. CYP3A4 inducers such as rifampicin may decrease the plasma concentrations of sildenafil. Symptomatic hypotension when used with beta-blockers. Plasma concentrations are increased by ritonavir. Potentially Fatal: May potentiate hypotensive effects of of organic nitrates and nicorandil.

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