Viraha 100mg, manufactured by Micro Labs Ltd., is a drug used for the treatment of erectile dysfunction or impotence. Each tablet of Viraha contains 100 mg of sildenafil citrate, known to improve blood flow in the small vessels of the penis resulting in erection . Erectile dysfunction is a highly prevalent disease. It is associated with medical conditions like hypertension, obesity, hyperlipidemia and diabetes mellitus . These conditions affect the blood vessels of the male reproductive system which lead to erectile dysfunction. The drug acts by causing relaxation and vasodilation of the blood vessels. With this, taking Viraha will benefit them the most since the effect of the drug ensures them of having an optimum sexual performance.
Although most men with advancing age may suffer from erectile dysfunction, not all of them can take Viraha. Certain precautions should be considered. It is important that a physician must evaluate a patient. A stratification based on risks factors can be done, and recommendation will be made regarding treatment initiation. Viraha is not indicated for those with the high-risk cardiovascular disease. Patients requiring drugs like nitrates, ketoconazole, and ritonavir, are also advised not to take the Viraha since drug interactions have been noted to cause hypotension .
About Micro Labs Ltd.
Micro Labs Ltd is striving to become one of the leading global pharmaceutical industry. Its humble beginning started in India, and now it operates in some countries in Asia, Europe, America, and Africa. It has state of the art equipment and facilities which ensure all products made are of excellent quality. It has been producing drugs for various applications in the field of cardiology, diabetology, dermatology and neurology. The company also produces many antimicrobials, drugs in ophthalmology and for pain management.
Currently, it has 497 types of drugs listed under the company . As a highly regarded pharmaceutical company, Micro Labs has its API manufacturing facility essential in providing cost effective medicine for everyone.
Ensuring that every medicine made is effective and safe, their products underwent testing for approval by certain regulatory bodies. The Goa plant product of the company which was used for manufacturing oral form of cephalosporin received the UK MHRA approval and also by the USFDA . Its Levocetirizine has also received US FDA approval last September of 2013.
Scientific Studies on Sildenafil
Numerous studies were conducted on sildenafil. It is the first available phosphodiesterase inhibitor type 5 (PDEi5) drug that paved the way in the treatment of erectile dysfunction. Most studies were experimental which states its mechanism of action, interactions when combined with other drugs and side effects as tested on a certain group of subjects. A study conducted by Goldstein, I. in 1998 regarding “Oral sildenafil in the treatment of erectile dysfunction” states the improvement of the sexual function of the subjects using the drug. The study was conducted on 532 men with erectile dysfunction. Subjects were given sildenafil for a 24-week dose-response study. They were given 25 mg, 50 mg, and 100mg of the drug. A 12-week dose-escalation study was made afterward, and another 32-week open-label extension study followed. Using the International Index of Erectile Function (IIEF), the subjects taking sildenafil showed improved erectile function compared to those taking the placebo. The result holds true to subjects from the dose-response study, dose-escalation study, and open-label extension study. Certain side effects were also noted during the duration of the experiment. Most common were a headache, flushing, and dyspepsia. Goldstein concluded that sildenafil is well-tolerated by men suffering from erectile dysfunction .
Another study was made in China by Tang, WH, et al. which used 1922 subjects. It was a broad study initiated by the Chinese Andrological Association in 2011. It covered 53 andrology centers in 15 major cities including Beijing and Shanghai. The age of the subjects ranged from 30 to 72 years old (average age was 40 years old). Some of them (57.2%) have a pre-existing medical condition like hypertension, hyperlipidemia, diabetes millets, benign prostatic hyperplasia, and prostatitis. Some subjects (60%) also have a history of cigarette smoking and alcohol consumption.
After a 4-week treatment of different doses of sildenafil, 40% of the subjects regained a normal level of sexual potency based on the International Index of Erectile Function, and 98.4% said they noted improvement of erectile function.
Tang, WH., et al. concluded that sildenafil showed effects beneficial to Chinese patients with erectile dysfunction. Not only erection was achieved, but subjects also noted to restore sexual function despite existing medical conditions and social habits (e.g., smoking) .
Description and Mechanism of Action of Sildenafil
Sildenafil is an inhibitor of phosphodiesterase type 5(PDE-5). It is a highly selective inhibitor. It acts on the corpus cavernosum of the penis by enhancing the nitrogen oxide-mediated relaxation. Inhibition of phosphodiesterase causes the intracellular concentration of cyclic guanosine 3’ 5’ monophosphate (cGMP) to increase. The endogenous NO-cGMP signaling pathway is amplified. All of these biochemical reactions result to erection .
The drug is also known to slow the aging (apoptosis) of corpus cavernosal. It also improves sperm production (spermatogenesis) since it acts on the endothelial cells and improves blood flow in small vessels (microcirculation).
Viraha Effects for Erectile Dysfunction
Viraha containing 100 mg of sildenafil citrate per tablet will address erectile dysfunction with the same mechanism as mentioned above. It will cause smooth muscle relaxation of the penis by inhibiting PGE-5 and enhancing NO-mediated relaxation. It also promotes the blood flow by increasing levels of cGMP intracellularly.
Since Viraha has a higher concentration of sildenafil, it is expected to be more potent which is useful for patients who are less sensitive to the drug
Recommended Doses and Duration of Therapy
Viraha is taken orally, and it reaches a peak concentration in the plasma within an hour of administration. The half-life is between four to five hours. Patients with erectile dysfunction are instructed to take the drug one hour prior to sexual activity. A maximum dose of 100mg is to be taken once daily. Like all drugs with sildenafil, sexual stimulation must be initiated for a penile erection to be achieved. It may happen before an hour, as early as 14 minutes and may last between four to five hours which is same as the half-life of the drug. A 12-hour drug efficacy has also been noted in some cases.
Consumption of fatty meal has shown to decrease the drug level and reduced its absorption. Alcohol consumption, however, has not been proven to have an effect on the drug.
Side Effects and Warnings
The common side effects of the drug include a headache and facial flushing. Others may experience dyspepsia, dizziness, nasal congestion, abnormal vision, and palpitation. Less common drug side effects include back pain, nausea, and vomiting, rash, diarrhea, cardiac arrhythmia, and hypersensitivity. It is noted that most side effects are dose-related. They are however self-limiting and mild in nature if used continuously. It is very important for men with erectile dysfunction to consult a physician before taking the drug.
Patients should be warned if they have a cardiovascular disorder together with erectile dysfunction. This includes uncontrolled hypertension, angina, and history of coronary revascularization, history of myocardial infarction, valvular disease, and congestive heart failure. Princeton Consensus Recommendation provides instructions to physicians for patients being managed with cardiovascular disease and erectile dysfunction at the same time. The most important question “Is it safe to take PDEI-5 and engage in sexual activity?” is usually asked. It is important to check their cardiac function since there is a risk involved once they engage in sexual activity.
Patients experiencing the difficulty of breathing and fainting are encouraged to get medical help right away .
Viraha can have an adverse effect if taken together with other drugs like alpha blockers. Their drug interaction is known to cause orthostatic hypotension. Patients on alpha blockers must be stabilized on a certain alpha-blocker first before initiating sildenafil.
Nitrates have also been found to have a drug interaction with sildenafil. Since organic nitrates and sildenafil have the same effect on the smooth muscle relaxation by increasing cGMP levels, the use of both drugs can give a significantly lower systolic blood pressure .
Ritonavir, an anti-viral drug used for patients with HIV also increases the blood levels of sildenafil. Use of sildenafil should be limited to a maximum dose of 25 mg in a 48-hour duration is recommended if the said anti-viral drug is taken concomitantly.
Customer reviews for Viraha 100mg/tablet are unavailable as of the moment. However, other drugs with the same sildenafil citrate component have proven to be very beneficial to patients with erectile dysfunction. Reviews from patients using 100mg versions of sildenafil are limited too. Most patients are using 25mg-50mg tablets. Patients aged 60 years old and above are satisfied with the drug. Most men with advancing age from different parts of the world taking the drug have been satisfied with the results. Although some patients complain about the side effects (a headache and flushing), they still keep on taking medicine because it worked well for them.
Viraha is manufactured by Micro Labs Ltd, a company that is producing drugs that are US FDA and UK MHRA approved, so the efficiency and safety of the drug can be guaranteed.
Price, Available Forms, and Dosage
Viraha is available as a 100mg tablet. It costs $8.35 (USD) for 10 tablets. The drug is available online for shipping to countries like USA, Australia, and Canada. For products delivered within one to two weeks, an additional fee of $60 (USD) and for products shipped within four weeks, a fee of $30 is added to the total amount of the product ordered. If bulk orders are made, you can save money since the shipping cost remains the same.
For the dosage, Viraha 100mg/tablet should be taken at least an hour before sexual activity and once a day only. Avoid overdosing on the drug to prevent unnecessary side effects. It may be taken with or without food.
The drug is also available in 25 mg tablet and 50 mg tablet.
Conclusion and Rating
Erectile dysfunction remains to be a growing concern among men with advancing age. This, however, can be addressed by taking Viraha 100 tablet once daily. Its active ingredient sildenafil has been proven to deliver results. The dose can be ideal especially for those patients who are less responsive to lower dosages. Viraha has the same mechanism of action and effects in the body. This will not only improve one’s sexual function but at the same time, it can boost their self-esteem and confidence.
As a drug manufactured by Micro Labs Ltd., it is safe, and drug efficiency is guaranteed. Although patient reviews of the 100mg preparation are unavailable, the product is very promising and can produce better if not the same results if compared to other brands.
Since the dose is at maximum (100mg/tablet), I would like to recommend future users to have a medical consult first, especially those with cardiovascular disorders. This is also to avoid unnecessary complications shortly.
For the rating, I am giving Viraha 100 a 4 out 5. If only reviews can be found at this time, Viraha would deserve a perfect score.
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