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The active ingredient in Viagrax-DS is Sildenafil Citrate. Sildenafil is used a treatment for men experiencing erectile dysfunction (difficulty maintaining an erection). Sildenafil's mission is to work on enzymes of the body called phosphodiesterases and to improve a man's response to sexual stimulation. These enzymes work mainly in the penis, so the action of sildenafil citrate is primarily limited to the penis.

Sildenafil works to control the enzyme, and by doing so regulates the blood flow out of the penis and thereby helping the patient maintain an erection.

Sildenafil citrate improves the erection of most men, regardless of how long they have had ED. So the time spent with one's partner can be sexually active and arousing.

Composition: Each film-coated tablet contains Sildenafil Citrate equivalent to Sildenafil-100mg.

Viagrax-DS contains the active ingredient sildenafil citrate.

Store below 25 degree Celsius, protected from moisture.

Keep out of reach of children and it is meant for personal usage by your own doctor prescription only.

Sildenafil citrate, an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Sildenafil citrate is chemically designated as 1-[[3-(6,7-dihydro-1-methyl-7- oxo-3-propyl-1H-pyrazolo[4,3-d] pyrimidin-5-yl)-4-ethoxyphenyl] sulfonyl] -4-methyl piperazine citrate and its molecular weight is 666.7.

Experts believe impotence affects between 10 and 15 million American men. In 1985, the National Ambulatory Medical Care Survey counted 525,000 doctor-office visits for erectile dysfunction. Impotence usually has a physical cause : such as disease, injury or drug side effects. Any disorder that impairs blood flow in the penis has the potential to cause impotence. Incidence rises with age: about 5 percent of men at the age of 40 and between 15 and 25 percent of men at the age of 65 experience impotence. However, it is not an inevitable part of aging.

Impotence is treatable in all age groups and awareness of this fact has been growing. More men have been seeking help and returning to near-normal sexual activity because of improved, successful treatments for impotence. Urologists, who specialize in problems of the urinary tract, have traditionally treated impotence - especially complications of impotence.

Your Physician will want to know some information about your past and current health. Some of the key areas they will be concerned about are:

• Heart Problems, and Arrhythmias
• High or Low Blood Pressure
• History of Strokes
• HIV Positive Treatment
• Severe Liver or Kidney disorders
• Retinitis Pigmentosis
• Bleeding problems or Blood Conditions

For men that are HIV positive, your healthcare advisor will consult you on the use of Sildenafil with the other medications that you may be using. It is recommended a maximum single dose of 25mg sildenafil citrate in a 48 hour period for men taking sildenafil citrate in conjunction with HIV protease inhibitors (Agenerase, Norvir, Crixivan, Viracept, Invirase, Fortovase).

It is important that your physician or our consulting physician know exactly what medications you are taking.

Contraindications Nitrates

It is urgent that you inform your healthcare advisor if you are taking any form of Nitrate including amyl nitrate (poppers) or nitroglycerin. The combination of Sildenafil and nitrates may reduce the blood pressure to dangerous and perhaps even fatal levels and must never be mixed.

List of Nitrates Not to be Used with Sildenafil Citrate

Protease inhibitors have been shown to substantially increase the effects of sildenafil citrate when taken together. Interaction studies of sildenafil citrate in conjunction with protease inhibitors indicated that these drugs may enhance the negative side-effects of sildenafil citrate, and because protease inhibitor drugs typically inhibit the p450 enzyme system, they may affect the metabolism of sildenafil citrate. It is recommended that a maximum single dose of 25mg sildenafil citrate in a 48 hour period for men taking sildenafil citrate in conjunction with HIV protease inhibitors (Agenerase, Norvir, Crixivan, Viracept, Invirase, Fortovase).

Other medications that may affect sildenafil citrate metabolism and your doctor will need to know about are:

• Cimetidine
• Erythomycin
• Itraconazole
• Ketaconazole
• Mibefradil

Please be thorough in completing your medical questionnaire or in consulting with your physician.

Your sildenafil citrate prescription is exclusively for you. It is not to be shared and should only be used as directed by your physician. Although it can improve sexual performance and sexual responsiveness, sildenafil citrate is not a recreational drug. Used irresponsibly, Sildenafil citrate can have severe consequences. Concurrent use of sildenafil citrate and "poppers" can have potentially dangerous and perhaps deadly consequences. Sildenafil citrate is prescribed to treat erectile dysfunction, and if you have had problems maintaining an erection, then Sildenafil citrate may be for you.

If your physician prescribes sildenafil citrate for your condition, they will inform you of the appropriate dose for you . For many men the prescribed dose is 50mgs, one hour before a sexual encounter It is also recommended that you take no more than one dose per day.

Sildenafil citrate takes between 30 minutes and one hour to take effect and lasts for 4 - 6 hours.

Like all medicines, sildenafil citrate can cause some side effects. These effects are usually mild to moderate and usually don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses.

The most common side effects of sildenafil citrate are headache, flushing of the face and upset stomach. Less common side effects that may occur are temporary changes in colour vision (such as trouble telling the difference between blue and green objects or having a blue colour tinge to them), eyes being more sensitive to light or blurred vision. In rare instances, men have reported an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours. If not treated right away, permanent damage to your penis could occur.

Heart attack, stroke, irregular heartbeats and death have been reported rarely in men taking sildenafil citrate. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to sildenafil citrate. Sildenafil citrate may cause other side effects besides those listed on this sheet. If you want more information or develop any side effect or symptom you are concerned about, call your doctor.

Only your doctor can decide if Sildenafil Citrate is right for you. Sildenafil citrate can cause mild, temporary lowering of your blood pressure. You will need to have a thorough medical exam to diagnose your erectile dysfunction and to find out if you can safely take sildenafil citrate alone or with your other medicines.

Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex. Be sure to tell your doctor if you have had:

• Any heart problems (e.g., angina, chest pain, heart failure, irregular heart beats, or heart attack), have ever had a stroke.
• Low or high blood pressure.
• A rare inherited eye disease called retinitis pigmentosa.
• Any kidney problems or any liver problems.
• Any blood problems, including sickle cell anemia or leukemia.
• Allergies to sildenafil or any of the other ingredients of sildenafil citrate pills.
• A deformed penis, Peyronie's disease, or ever had an erection that lasted more than 4 hours.
• Stomach ulcers or any types of bleeding problems or, if you are taking any other medicines.

If you do not get the results you expect, talk with your doctor. You and your doctor can determine the dose that works best for you. Do not take more sildenafil citrate than your doctor prescribes.

Sildenafil citrate should not be taken more than once a day. If you are older than 65 years, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg) of sildenafil citrate. If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25mg of sildenafil citrate in a 48-hour period.

Sildenafil Citrate side effects generally range from mild to moderate. The most common side effects sometimes associated with sildenafil citrate use are :

• Headache
• Facial Flushing
• Nasal Congestion
• Upset Stomach
• Visual Changes and increased sensitivity to light

If you experience more troublesome or more severe side-effects stop taking Sildenafil citrate and consult your physician.