Description

Suhagra (sildenafil)

Suhagra is manufactured by Cipla Ltd in India and contains sildenafil citrate in 25 mg, 50 mg, and 100 mg tablets. Clinical data for sildenafil shows efficacy rates in the range of 60 to 90 percent across the erectile dysfunction patient population — a range that reflects genuine variation between individuals. Men with primarily psychological ED tend to respond well; men with more significant vascular impairment may respond less reliably. That gap between 60 and 90 percent is clinically meaningful.

Dosing

One tablet approximately 60 minutes before sexual activity, swallowed whole with water. Best absorbed on an empty stomach or after a light meal; do not chew or crush. Maximum dose 100 mg per 24-hour period.

Start at 50 mg unless there’s a reason to begin lower. A lower starting point makes sense for older men, men with hepatic or renal impairment, or those on strong CYP3A4 inhibitors — in those cases, 25 mg is the appropriate starting dose. The 100 mg option is for men where 50 mg produces insufficient effect and the side effect profile at 50 mg was manageable.

Duration: 4 to 6 hours. Sexual stimulation is required throughout — the drug works with the physiological arousal response, not in place of it.

Nitrates

Sildenafil is absolutely contraindicated with all nitrates: nitroglycerin, isosorbide preparations, amyl nitrate. Combined use can cause severe, fatal hypotension. There is no safe dose or timing interval for this combination.

Contraindications

All nitrates. Serious cardiovascular disease. Unstable angina. Heart failure. Retinitis pigmentosa. Severe hepatic or renal insufficiency. Uncontrolled blood pressure. Antivirals including ritonavir significantly raise sildenafil blood levels — start at 25 mg with these co-medications and do not exceed that dose without medical guidance. Hypersensitivity to sildenafil.

Side effects

Headache, facial flushing, and color vision disturbances are the most commonly reported effects. The visual side effects — blue tint, increased brightness sensitivity — are a known consequence of PDE6 inhibition in the retina and are dose-dependent. At 50 mg they occur less frequently than at 100 mg.

Sudden vision loss, sudden hearing loss, and chest pain require immediate evaluation and cessation of the drug.

Priapism — erection lasting more than 4 hours — requires emergency treatment. Delay results in permanent damage to erectile tissue.