Romento is a tablet having sildenafil as an effective component in the dose of 50 mg to be used for the treatment of impotence or erectile dysfunction (ED). It is a product of Lupin, a company well known for producing world-class generic drugs and being a leader in this field. Romento should not be confused with the oil of the same name but for completely different use and by a different manufacturer.
As already mentioned, Romento contains sildenafil, which is famous as Viagra. It is a pill that can really change the sexual experience of any man. For men suffering from impotence, it is a blessing enabling them to have the experience they have longed for. While many healthy men use it for a recreational purpose to improve their sexual performance and have more fun.
Romento has also proved its worth in the treatment of pulmonary arterial hypertension.
Unwanted effects are few and generally mild and self-limiting. Most commonly people may get headaches, congested nose, reddening of eyes, and maybe a little dizziness.
This drug has good safety track record. But still as with any drugs, one should be careful as one cannot fully exclude the bad effects. In many aged men diseases of heart and blood vessels are quite common; such people should take precaution and better consult their doctor before giving this pill a try.
Truly global pharmaceutical company from India, Lupin was established 5 decades ago. It started with manufacturing of high-quality products against tuberculosis and antibiotics with a special focus on cephalosporin. With time, Lupin successfully diversified its portfolio into cardiology, diabetes, neurology, respiratory medicine, anti-inflammatory drugs.
Though also manufactures raw materials but finished formulations give it more than 90% of turnover. Lupin has more than 7000 employees and in 2016 it had 4.8% of the share of prescriptions in the US market, thus making it 5 largest players in the US market, it is the 3rd largest pharmaceutical company in India, 6th largest generic manufacturer in Japan and holding 4th place in South Africa .
Lupin follows the philosophy of continuous improvement, innovation, teamwork and improving the efficiency of manufacturing units. It has factories for manufacturing drugs in the US, India, Brazil, Japan and Mexico. Its facilities have been accredited by WHO GMP, US FDA, MHRA UK, TGA Australia, MHLW Japan, Brazilian ANVISA and many other accreditation institutions .
The company has one of the best research and development facilities to be ever owned by any Indian company. Lupin has more than 1700 research fellows committed to making sure the company continues to come up with more and better-produced formulations.
Sildenafil in Clinical Studies
Hundreds of clinical trials regarding the use of sildenafil have been done, proving the effectiveness of the drug. But conditions may differ in clinical practice. Hence a large scale study was done in Canada to assess the practical effectiveness of sildenafil. Carrier S et al. named the study “Treatment Satisfaction with Sildenafil in a Canadian Real-Life Setting. A 6-Month Prospective Observational Study of Primary Care Practices”. It was large scale study involving 231 primary care centers across various locations in Canada. The standardized educational program was used to optimize the treatment with sildenafil. Participants were patients who first started using sildenafil after being prescribed in a primary care center. Results of therapy were estimated at 3 and 6 months by using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. 2573 patient were part of the study out of them one-fifth suffered from severe ED, and another one-fifth suffered from moderate ED, while rest of them suffered from mild to moderate ED. Outcomes of the clinical study were quite good, with 89% satisfied with their treatment, satisfaction rate was equally good at 6 months. Considering the fact that sample size of the study was quite large and with more than 40 percent suffering from moderate to severe ED, there is no doubt left that sildenafil is an effective treatment of impotence in practical settings .
Sildenafil dilates blood vessels, and many of its unwanted effects like flushing, headaches are related to it. There are also many reported cases of cardiac failure related to sildenafil use. But most of the cases are not a direct side effect of sildenafil, but rather they happen due to physical exertion during a sexual act in a risk group. Hence American Heart Association came up with certain recommendations. The scientific document was titled “Use of Sildenafil (Viagra) in Patients with Cardiovascular Disease” and prepared by a panel of leading cardiologists of USA. In the document it was noted and strongly cautioned not to take sildenafil if a person is taking nitrates, as dangerous fall in blood pressure with these drugs is well known. Also if a person is on antihypertensive therapy, it is always better to monitor blood pressure closely when initiating the therapy as some people may be unusually sensitive to the hypotensive effect of sildenafil. Also patient must understand that an act of coitus result in hemodynamic changes and is stressful for the heart, therefore sildenafil must be used with caution in a patient with poor exercise tolerance. Also, hemodynamic changes are more with an unfamiliar partner and when alcohol has been consumed .
ED is a condition which affects not only men, but it also has an adverse effect on their female partners. Thus timely therapy with PDE 5 inhibitor like sildenafil will improve the sexual life of both the partners. In a clinical study titled “Sexual Experience of Female Partners of Men with Erectile Dysfunction: The Female Experience of Men’s Attitudes to Life Events and Sexuality (FEMALES) Study” by Fisher WA et al. it was found that female partner of men reported more satisfying sexual experience after the use of PDE 5 inhibitor for the treatment of ED .
Sildenafil Action Explained
Erectile dysfunction affects a large part of the male population, and in most cases, impaired relaxation of the smooth muscle cells in the corpus cavernosum and the penile arteries is a factor. Sildenafil, a specific vasodilator of the penile blood circulation, has drastically changed the treatment of impotence. It helps to increase NO-cGMP levels in corpus cavernosal and penile arteries, thus leading to better blood flow and it also helps these arteries to stay in relaxed and dilated state for longer. Thus, the final effect of sildenafil is nice erection on sexual stimulation which also stays for a longer period.
Pulmonary arteries also have some sensitivity to sildenafil, thus is also beneficial in pulmonary arterial hypertension.
Romento Benefits for Erectile Dysfunction
With the possible exception of ED due to radical prostatectomy, sildenafil improves sexual power and performance regardless of the cause of impotence. In the men with impotence, it greatly improves the score on International Index of Erectile Function (IIEF). After therapy with sildenafil even most aged men are able to match their sexual performance to young healthy males.
Length of Therapy and Doses
The therapeutic dose range for sildenafil is 25 to 100 mg . With most, a well-accepted starting dose of 50 mg once a day, when and as needed, an hour before the planned coitus is enough. The further dose can either be increased or decreased depending on the outcome. Romento comes in the dose which is ideal starting dose for most men.
Sildenafil has been demonstrated to be safe in long term, and still continue to maintain its effectiveness. There is no limit to how long this drug can be taken. Mostly, it is discontinued either due to adverse effects or in few cases it stops helping.
Alerts and Adverse Reactions
Sildenafil acts by relaxing smooth muscles in penile tissues. But this action is not 100 percent selective, which means that it relax smooth muscles of blood vessels in other parts of the body, which is responsible for most of its side effects, like headaches, flushing of the face, redness of eyes, dizziness, and blurring of vision .
With the power comes responsibility. Sildenafil improves sexual power and it must be responsibly practiced in men with weak hearts. Over exertion can be dangerous in men suffering from an ischemic cardiac disease or who had suffered a stroke earlier in life.
There are two mechanisms involved in drug interactions of sildenafil. First is its effect of relaxation of smooth muscles in blood vessels. Thus, it can potentiate the effect of certain drugs. Notable in this group are nitrates for ischaemic cardiac disease, where this relaxation and dilation of blood vessels can result in dangerous fall in blood pressure and is thus classified as an absolute contraindication. Similarly, precaution should be taken and may require dose correction if a person is already taking some drugs for the treatment of hypertension.
The second pathway of drug interactions is disturbances in the metabolism of sildenafil by other drugs. Sildenafil is metabolized by certain enzymes in the liver, and drug like erythromycin, protease inhibitors, cimetidine tend to disturb this metabolism. If the person taking the drugs using same metabolic pathway than precaution and dose correction may be needed .
Romento is still not an established brand for the treatment of sildenafil. It is poorly available outside India. Its online sales are really very limited. Thus, there are no customer reviews online to know more about the product. Though it is a product of the good manufacturer, for those who want to know more about this molecule, it is recommended to search online for brands like Viagra or Kamagra. Romento has similar content and will act is a similar way.
Forms, Pricing, and Suitable Dosage
As already mentioned, this brand of Lupin pharma has limited availability outside India. In India, it is really well priced at less than one and a half US dollars for 4 tablets of 50 mg. This makes it quite cheap, especially considering the fact that it is manufactured by one of the global leaders of generics.
It is only available in the dose of 50 mg. This dose will be fine for starting the therapy in around 70 percent of men. But some may find the effect of this dose insufficient.
Conclusion with Rating
What goes strongly in favor of Romento, is the fact that it is being made by one of the leaders in generics world. Considering a large number of accreditations of factories, one can be sure that this drug is no different at all from Viagra, it will surely be helpful and safe.
With all that said, one thing goes against Romento and that is a non-availability of other dose forms. Though 50 mg will help most men, still, many will need a higher dose of 100 mg, either from the very first dose or may need to increase that dose after some time.
Thus, I would give Romento 4 stars out 5: it is a really good product to start with, but doesn’t provide other dose options