Ernafil 50mg/100mg Sildenafil is an affordably priced generic version of Viagra made by one of the well-known global manufacturers of pharmaceuticals. Like Viagra, it is a drug based on sildenafil as its main acting component and is recommended for the treatment of impotence or erectile dysfunction (ED). Sildenafil helps men to get an erection and have normal sexual life, though it cannot treat the underlining cause of ED.
ED is quite common in men of middle ages and above. Most common causes of ED are endocrinological diseases like diabetes or hypercholesterolemia, neurological disorders like parkinsonism, Alzheimer’s disease, epilepsy or stroke, sometimes it may be caused by certain medications. Other common causes being cardiovascular diseases and psychological factors .
Ernafil is available as blue-colored, film-coated tablets in the dose of 25 mg, 50 mg, and 100 mg. It is recommended to take 50 mg tablet one hour before sexual activity. Depending on the response, the dose may be decreased or increased. But no more than one tablet a day should be taken. If taken with food it may take a longer time to act as compared to empty stomach .
Actavis pharmaceutical was founded in 1983 as a small manufacturing company in the US. After 20 years of operation in the global market, it took a lead in manufacturing generic drugs.
In 2012, it was acquired by pharmaceutical company Watson, later by Forrest Laboratories and further by Allergan. In 2016, Actavis became a part of Israel-based pharmaceutical giant Teva Pharmaceutical Industries Ltd. Presently, Teva is the number one generics company in the world and one of the top 15 pharmaceutical companies in the world.
Teva, being a pharmaceutical giant, is present in all the continents and in most of the countries. Teva has manufacturing facilities in Americas and Europe. Its facilities are accredited by USFDA, UK MHRA and most of the leading European bodies. It has more than 100 products in its profile and product range is fast expanding.
Teva has a special focus on CNS, covering pain, movement disorders, neurodegenerative diseases, has a strong presence in the respiratory segment, with products to treat asthma, allergic disorders, chronic obstructive pulmonary disease. Other areas of its focus being oncology and women’s health .
Being a global leader in generics Teva understands the need of continual investment in research and development. It has more than 20 molecules in the pipeline, with many of them in final stages of approval.
Scientific Research on Sildenafil
ED is an underdiagnosed disease. Most men find it uncomfortable to discuss this topic, hence often remain undiagnosed, more ever many men suffering from it are not fully aware of their problem or not ready to accept it. It is also well-known fact that ED commonly coexists along with certain disease conditions. Shabsigh R et al. studied the effectiveness of sildenafil in such undiagnosed cases in a clinical trial titled “A Multicenter, Double-Blind, Placebo-Controlled Trial to Assess the Efficacy of Sildenafil Citrate in Men with Unrecognized Erectile Dysfunction”. In the clinical trial, those men were taken who either refused to accept that they have ED or were unsure, but were diagnosed with ED based on International Index of Erectile Function-Erectile Function domain (IIEF-EF) scores. Most of them had risk factors like hypertension, hypercholesterolemia, smoking, and obesity. Most of the men reported marked improvement in both physiological and psychological condition after the treatment with sildenafil, adverse effects were mild in most cases. Hence trial concluded that ED to be suspected, assessed and treated in men having the risk factors .
For most men, 50 mg is considered to be a right dose to start with, and later it must be either increased to 100 mg or decreased to 25 mg. But clinical trials and practice have shown that most of the men go on to increase the dose to 100 mg. In a clinical study, Ströberg P et al. studied this tendency and the study was named “Hardness, Function, Emotional Well-Being, Satisfaction and the Overall Sexual Experience in Men Using 100-Mg Fixed-Dose or Flexible-Dose Sildenafil Citrate.” The author in the analysis of two clinical trials noted that 100 mg was equally well tolerated, with similar or better clinical outcomes. It was also noted in the study that more than 90% of men opt to increase the dose to 100 mg after starting with 50 mg initial dose. Hence author recommends starting the therapy directly with 100 mg unless there are specific reasons to give the lower dose, as this will result in better outcomes and fewer cases of discontinuation of therapy .
Compliance is a major challenge with any treatment therapy, it can be improved with better patient education and monitoring. In the clinical practice, it has been noted that one-third of the patient do not take sildenafil when and as needed resulting in poor outcomes and discontinuation of the therapy. This is much higher as compared to under 10% discontinuation rate in clinical trials. In the study titled “Early Sildenafil Dose Optimization and Personalized Instruction Improve the Frequency, Flexibility, And Success of Sexual Intercourse in Men with Erectile Dysfunction.” Steidle CP et al. studied the subject of improving compliance and hence treatment satisfaction. The study noted and concluded that patient should be regularly educated about the therapy. Dose correction should be done as early as possible in order to improve the satisfaction from therapy. It was also noted that 100 mg results in better sexual frequency, satisfaction, and thus leading to better compliance .
Sildenafil Mode of Action
On sexual stimulation nitric oxide (NO) is released in penile tissues, which usually results in increased availability of cyclic guanosine monophosphate (cGMP). cGMP is a chemical which dilates blood vessels in penis resulting in increased blood flow to the penis, and hence erection. This cGMP doesn’t last long and is broken down by an enzyme, phosphodiesterase 5 (PDE 5). This degradation of cGMP makes penis soft again. In men suffering from ED nitric oxide is not released in enough quantity and therefore there is a deficit of cGMP. Sildenafil is an inhibitor of PDE 5, by inhibiting this enzyme it helps to increase the quantity of cGMP in penile tissues, which results in harder and long lasting erection.
Ernafil Benefits for Erectile Dysfunction
Ernafil contains chemical sildenafil. It was initially approved for use in ED, later due to vasodilating effect, it was also found to be beneficial in pulmonary arterial hypertension. Ernafil is mainly used to treat ED, it helps in increasing the frequency and duration of the sexual act, thus improving the quality of life of men and having the positive effect on men psychology.
It also results in better satisfaction of sexual partner, so indirectly having a positive effect on the partner too.
It has been shown to be effective in ED, whatever be the cause of such pathology.
Suitable Doses and Therapy Extent
Most commonly recommended a starting dose of sildenafil is 50 mg dayly, an hour before sexual activity. It should not be taken more than once in 24 hours and is more effective if taken on an empty stomach as if taken with food its action may be delayed. It is not taken daily, but rather when and as needed. So if a person has sex twice a week, then it should be consumed only twice a week.
If a person fails to get the desired result, then the dose may be increased further to 100 mg an hour before sexual activity.
Adverse Reactions and Warnings
The commonly used dose of 50 mg and 100 mg is well tolerated with flushing, headaches, dizziness, congestion of nose being the most common complaints.
In seldom cases, a patient may feel the change in cardiac rhythm, visual changes or noise in ears.
It should not be used without consulting a doctor if a person has suffered from cardiovascular events like a heart attack or a stroke.
PDE 5 inhibitors relax the blood vessels, and thus they may decrease blood pressure a bit in some people, though they are considered to be safe when used along with antihypertensive therapy, but precautions must be ensured.
Sildenafil should not be taken with nitrates (prescribed in certain cardiac diseases). As it has been found to abnormally lower the blood pressure. If used along with nitrates it can be life threatening.
Sildenafil is removed from a patient’s body by metabolism. There are some drugs which use the same metabolic pathway for clearance too. Hence if sildenafil is used along with these drugs, it may need dose correction. Some of these drugs are HIV protease inhibitors, erythromycin, clarithromycin, ketoconazole and itraconazole .
If you are taking some other medicine it is always advisable to consult your physician.
No customer reviews have been found regarding Ernafil. In these cases, it is always better to read a customer reviews about similar drugs like Viagra. There is no doubt that customer reviews are important and help us to decide whether to go for certain drug therapy or not.
Lack of customer reviews of Ernafil doesn’t necessarily mean that product cannot be trusted. It simply means that it has limited online sales, and brand isn’t very famous. Since it is manufactured by the world’s leading generics manufacturer, hence there is little room left for doubts about the quality.
Price, Forms, and Available Dosage
Ernafil is presently not available online. There could be several reasons for it. It is not very old and known brand. Many countries do not allow online sales of drugs, therefore the manufacturer may have taken the decision not to focus on the online sales.
If this product is not available online, the user has no other option but to go for another similar drug.
Conclusion and Rating
Millions of men and their sexual partners have benefited from Sildenafil powerful action. What is good about Sildenafil, is that sildenafil is effective in all the causes of ED. Whether ED is simply psychological or secondary to certain disease conditions, sildenafil can help most of the men.
Many men are hesitant to accept that they have the problem of ED. In such cases, it is always better to consult a doctor, and not to delay the needed treatment. It is also important to understand that sildenafil will help you to get the strong and lasting erection, but will not treat the cause of ED.
I would like to give Ernafil 5 stars out of 5 possible as it comes from the highly trusted manufacturer, but due to the unavailability of this product on online pharmacies and the lack of customer reviews, I would give Ernafil a 3-star rating. It is wiser to look for confirmed alternative brands, as presently it is not possible to buy Ernafil online.
- 5 Common Causes of Impotence. Accessible at: http://www.healthline.com/health/erectile-dysfunction/common-causes-impotence#Overview1
- Ernafil. Product summary. Accessible at: http://www.actavis.com.hk/NR/rdonlyres/B7375909-21DF-42DD-A1C7-ACD9CA18C566/13796/ernafil_spc.pdf
- Teva. Specialty products. Accessible at: http://www.tevapharm.com/our_products/specialty_products/
- Shabsigh R, Magee M, Kaufman J, Creanga D, Budhwani M, Russell D. A multicenter, double-blind, placebo-controlled trial to assess the efficacy of sildenafil citrate in men with unrecognized erectile dysfunction. Urology. 2010 Aug 31;76(2):373-9. Accessible at: http://www.goldjournal.net/article/S0090-4295(10)00352-3/abstract
- Ströberg P, Kaminetsky JC, Park NC, Goldfischer ER, Creanga DL, Stecher VJ. Hardness, function, emotional well-being, satisfaction and the overall sexual experience in men using 100-mg fixed-dose or flexible-dose sildenafil citrate. International journal of impotence research. 2010 Jul 1;22(4):284-9. Accessible at: https://www.ncbi.nlm.nih.gov/pubmed/20596083
- Steidle CP, McCullough AR, Kaminetsky JC, Crowley AR, Siegel RL, Tseng LJ. Early sildenafil dose optimization and personalized instruction improve the frequency, flexibility, and success of sexual intercourse in men with erectile dysfunction. International journal of impotence research. 2007 Mar 1;19(2):154-60. http://www.nature.com/ijir/journal/v19/n2/full/3901498a.html
- What is Viagra? How to take. Accessible at: http://www.drugsdb.com/rx/viagra/
- Schwartz BG, Kloner RA. Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension. Circulation. 2010 Jul 6;122(1):88-95. Accessible at: http://circ.ahajournals.org/content/122/1/88