KAMAGRA PINEAPPLE 100MG/5G JELLY

Indications

• Erectile dysfunction
• Pulmonary arterial hypertension

Dosage

Children: Sildenafil is not typically indicated for use in paediatric populations; refer to the BNF for Children for any specific cases.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Sildenafil selectively inhibits the phosphodiesterase type 5 enzyme, which is responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum. This leads to increased levels of cGMP, resulting in prolonged smooth muscle relaxation and vasodilation, ultimately facilitating penile erection upon sexual stimulation.

Pharmacodynamics

The primary pharmacodynamic effect of sildenafil is the relaxation of smooth muscle in the corpus cavernosum, which enhances blood flow to the penis, facilitating erection. Additionally, it decreases pulmonary vascular resistance, aiding patients with pulmonary arterial hypertension. The onset of action typically occurs within 30 to 60 minutes, with effects lasting for up to four hours, although this can vary between individuals.

Pharmacokinetics

Sildenafil is well absorbed after oral administration, with peak plasma concentrations occurring approximately 1 hour after ingestion. Its bioavailability is about 40%, and it is extensively metabolized in the liver, primarily by the CYP3A4 enzyme. The elimination half-life is approximately 3 to 5 hours, and it is excreted predominantly in the feces and urine as metabolites. Factors such as age, liver function, and concomitant medications can affect its pharmacokinetics.

Contra-indications

• Hypersensitivity to sildenafil or any of its components
• Severe cardiovascular disorders, including unstable angina or recent myocardial infarction
• Concurrent use of nitrates or nitric oxide donors due to the risk of hypotension
• Severe hepatic impairment
• Severe renal impairment requiring dialysis

Adverse effects

• Headache
• Flushing
• Dyspepsia
• Nasal congestion
• Visual disturbances, including changes in color perception
• Priapism
• Sudden hearing loss

Interactions

• Nitrates, which can lead to significant hypotension
• Alpha-blockers, which may increase the risk of hypotension
• CYP3A4 inhibitors, such as ketoconazole and erythromycin, which may increase sildenafil levels
• CYP3A4 inducers, such as rifampicin and St. John's Wort, which may decrease sildenafil levels

Precautions

• Use with caution in patients with a history of cardiovascular disease
• Consider potential visual or hearing problems before prescribing
• Patients should be advised to seek medical attention if they experience symptoms of priapism or sudden loss of vision or hearing

Pregnancy

Sildenafil is not indicated for use in women and should not be used during pregnancy due to lack of safety data.

Breast-feeding

It is not known whether sildenafil is excreted in human milk; caution is advised.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Tablets
• Oral suspension