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Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE 2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility.

• When considering magnesium citrate as part of your workout regimen, you need to bear in mind what your body needs and the demands of your training.
• Grapefruit juice is a weak inhibitor of CYP3A4 gut wall metabolism and may give rise to modest increases in plasma levels of sildenafil.
• In the event of an erection that persists for longer than 4 hours, the patient should seek immediate medical assistance.
• Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.
• Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP.

In order to minimise the potential for developing postural hypotension, patients should be hemodynamically stable on alpha-blocker therapy prior to initiating sildenafil treatment. Initiation of sildenafil at a dose of 25 mg should be considered (see Section 4.2). In addition, physicians should advise patients what to do in the event of postural hypotensive symptoms. Since sildenafil clearance is reduced in patients with hepatic impairment (e.g. cirrhosis) a 25mg dose should be considered.

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There are no data on the interaction of sildenafil and non-specific phosphodiesterase inhibitors such as theophylline or dipyridamole. Grapefruit juice is a weak inhibitor of CYP3A4 gut https://ysfc.or.kr/?p=139384 wall metabolism and may give rise to modest increases in plasma levels of sildenafil. Potassium-based food supplement chelated with citric acid, which favors its absorption by the body.

Potassium Citrate 99mg Solaray 60 Vegetable Capsules

Stronger CYP3A4 inhibitors such as ketoconazole and itraconazole would be expected to have greater effects. Most, but not all, of these patients had pre-existing cardiovascular risk factors. Many events were reported to occur during or shortly after sexual intercourse and a few were reported to occur shortly after the use of Sildenafil without sexual activity. It is not possible to determine whether these events are related directly to these factors or to other factors. The recommended dose is 50mg taken as needed approximately one hour before sexual activity.

Single oral doses of sildenafil up to 100mg in healthy volunteers produced no clinically relevant effects on ECG. In a specific interaction study, where sildenafil (100mg) was co-administered with amlodipine in hypertensive patients, there was an additional reduction on supine systolic blood pressure of 8 mmHg. The corresponding additional reduction in supine diastolic blood pressure was 7 mmHg. These additional blood pressure reductions were of a similar magnitude to those seen when sildenafil was administered alone to healthy volunteers (see Section 5.1).