Dzhenagra is preparation apply in case of erection violations at men. Dzhenagra is tablets accept inside. For the majority of patients the recommended dose makes 50 mg which accept if necessary approximately in 1 hour prior to sexual activity. The preparation can be accepted in limits from 4 h. to 0,5 h. before sexual activity. Taking into account efficiency and portability the dosage can be increased to the maximum recommended dose of 100 mg or is reduced to 25 mg. The maximum recommended dose makes 100 mg. It is recommended to apply not more often than once a day. Factors which promote increase in concentration Sildenafil in blood plasma: the age is higher than 65 years (for 40 % concentration in plasma owing to road clearance lowering), hepatic insufficiency (cirrhosis - 80 % raises), nephritic insufficiency (road clearance 30 ml / mines - 100 %), simultaneous application with P450 cytochrome 3?4 inhibitors (erythromycin - 182 %, 210 %). The increase in concentration in plasma can strengthen efficiency and thus increase cases of collateral action. It is necessary to apply an initial dose of 25 mg to such patients.
In case of sexual activity there is an expressed risk violations for patients who had earlier cardiovascular diseases. Treatment of erektilny dysfunction by Dzhenagra preparation isn't carried out at men for whom sexual activity is inexpedient because of a status of their cardiovascular system. Dzhenagra has system vasodilating properties which led to temporal lowering of arterial pressure at healthy volunteers (average maximum lowering of 8,4/5,5 mm of Hg). Though it isn't the considerable consequence of reception of a preparation for the majority of patients, doctors should weigh carefully favor / risk in case of Dzhenagra assignment, whether their patients with cardiovascular diseases can be treated to unfavorable action of a preparation, especially during sexual activity. Dzhenagr's preparation should be assigned with caution to patients who suffered a myocardial infarction, an attack or life-threatening arrhythmia within the last 6 months; to patients with residual hypotension (joint stock company 90/50) or hypertensia (joint stock 170/110); to patients with warm insufficiency or diseases of coronary arteries which cause unstable stenocardia as there are no controlled clinical researches on safety of a preparation.
Long-time erections more than 4 h. and a priapizm (painful erections more than the 6th hour) were marked infrequently. In case of an erection more than 4 h. it is necessary to address for medical care immediately. If not to begin priapizm treatment directly, it can lead to injury of a penis and long-time loss of a potentiality. At patients with a peptic ulcer in a phase of peaking safety of application of Dzhenagra isn't set. Safety and efficiency of a combination of a preparation with other types of therapy of erection dysfunction wasn't studied.