Sildenafil is the active ingredient some of the medicine to treat erectile dysfunction and pulmonary arterial hypertension such as Viagra, Rivatio, Sildenafil and other. This active ingredient helps relax blood vessels and improves blood flow to the penis to allow for a harder and longer-lasting erection.
Nowadays many products are using this ingredient for benefit of making penis harder and longer-lasting erection in a different way that causes many health problems among the user of those products, sometimes it leads to dead by cardiac arrest while having intercourse and other.
So we have to know about this ingredient clearly before buying or using it and strictly follow your doctor’s advice.
Side effect of Sildenafil
The safety profile of sildenafil is based on 9570 patients from 74 double-blind, placebo-controlled clinical trials. The most commonly reported adverse events in clinical trials in patients treated with sildenafil were a headache, flushing, dyspepsia, nasal congestion, dizziness, nausea, hot flash, visual disturbance, cyanopsia, and blurred vision.
Organ system class affected and frequency reported during the study :
1. Very common (≥ 1/10)
- Nervous system: a headache
2. Common (≥ 1/100 and 1/1000)
- Nervous system : dizziness
- Eyes: alteration of color vision, visual disturbance, blurred vision
- Blood vessels: congestive flushes, hot flashes
- Gastro-intestinal: nausea, dyspepsia
- Respiratory: nasal congestion
3. Uncommon (≥1 / 1000 and 10 000)
- Infection and infestation : rhinitis
- Immune system: hypersensitivity
- Nervous system: somnolence, hypoesthesia
- Eyes: psoriasis, eye pain, photophobia, photopsia, ocular hyperemia, visual brilliance, conjunctivitis
- Ear and labyrinth: dizziness, tinnitus
- Heart: tachycardia, palpitation
- Blood vessel: hypertension, hypotension
- Respiratory: epistaxis, sinusale congestion
- Gastro-intestinal: gastroesophageal reflux disease, vomiting, upper abdominal pain, dry mouth
- Skin and subcutaneous tissue: rash
- Musculoskeletal and systemic: myalgia, extremities pains
- Urinary system: hematuria
- General: chest pain, fatigue, the sensation of heat
- Investigations: acceleration of heartbeat
4. Rare (≥ 1/10 000 and 1/100 000)
- Nervous system : stroke, transient ischemic attack, seizure, seizure recurrence, syncope
- Eyes: nonarteritic anterior ischemic optic neuropathy (NAION), retinal vascular occlusion, retinal hemorrhage, retinopathy of arteriosclerotic origin, retinal disorder, glaucoma, alteration of the visual field, diplopia, decrease of visual acuity, myopia, asthenopia, floating bodies glaucoma, iris abnormality, mydriasis, halos vision, eye edema, eye swelling, eye disorders, conjunctival hyperemia, eye irritation, abnormal eye sensation, eyelid edema, scleral discolouration - Ear and labyrinth: deafness
- Heart: sudden cardiac death, myocardial infarction, ventricular arrhythmia, atrial fibrillation, unstable angina
- Respiratory: pharyngeal constriction sensation, nasal edema, nasal dryness
- Gastro-intestinal: oral hypoaesthesia
- Skin and subcutaneous tissue: Stevens-Johnson syndrome (SJS), Lyell syndrome
- Reproduction organ and breast: penile hemorrhage, priapism, hematospermia, increased erection
- General: irritability
Mechanism of action of Sildenafil
Sildenafil is an oral treatment for erectile dysfunction. In natural conditions, that is, with sexual stimulation, it restores poor erectile function by increasing blood flow to the penis.
The physiological mechanism responsible for the erection of the penis involves the release of nitric oxide (NO) into the cavernous body during sexual stimulation. Nitric oxide activates the enzyme guanylate cyclase, resulting in increased concentrations of cyclic guanosine monophosphate (cGMP) inducing relaxation of the smooth muscles of the cavernous body and promoting blood flow.
Sildenafil is a potent and selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5) in cavernous bodies; this is where PDE5 is responsible for the degradation of cGMP. Sildenafil has a peripheral action site on erections. Sildenafil has no direct relaxant effect on human cavernous body tissue alone, but it significantly accentuates the relaxing effects of NO on this tissue. When the NO / cGMP pathway is activated, such as during sexual stimulation, the inhibition of PDE5 by sildenafil results in an increase in cGMP concentrations in cavernous bodies. However, to produce its beneficial pharmacological effects, the sexual stimilation is needed.
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