The credit master of heroism in sexual performance, VIAGRA® (by Pfizer) hails from its serendipitous discovery in 1989, meant to manage Hypertension and Angina pectoris. Treading in the marks left by the wheels of the great discovery, the drug later came to profess some fascinating intrigues of being able to compensate for sexual performance deficits which is an inevitable part of the aging process.
How does the Magic Happen?
When taken, the drug has been shown to block an enzyme in the body known as phosphodiesterase 5 (PDE5). PDE5 catalyzes the breakdown of a secondary messenger, cGMP forming GMP, which leads to more influx of calcium ions into the smooth muscle cells in the penis and thus increased vasoconstriction, meaning reduced erection (Yiu et al., 2019). Therefore, blockage of PDE5 would lead to an increase in the levels of cGMP and hence decreased influx of calcium into the smooth muscles, leading to vasodilation, meaning a sustained erection.
Who then Should Use Sildenafil?
This drug is indicated for the management of erectile dysfunction, apart from the fact that it can be used to effectively manage pulmonary arterial hypertension (men 18 years and above for ED and children 1 year and above and adults for pulmonary hypertension). According to Pfizer, for most patients, it is recommended that one takes 50mg an hour before one engages in a sexual activity. However, it can still be taken 30 minutes to 4 hours before the sexual activity. The maximum dose that should be taken is 100mg once daily.
Who should not Use Sildenafil?
· Those who have an allergic reaction to Sildenafil
· Those on medications known as nitrates for chest pains (angina)
· Those with heart and liver conditions
· Those who have recently suffered heart attack or stroke
· Those with hypotension (low blood pressure).
· Those with eye conditions like Retinitis pigmentosa.
Can Sildenafil Kill You?
In the current era, which I have witnessed in my daily practice within the pharmacy retail environment, it is unfortunate that many men perpetually use sildenafil despite not having erectile dysfunction with the hope of delivering a beastly impression in the “bedminton” gymnastics. Recreational use of sildenafil means one does not know the right dose for them and may be tempted to take more.
The long term implications of continued use is occurrence of adverse effects like chronic headaches, nasal congestion, impaired vision, backaches and chronic stomachaches. In presence of cardiovascular conditions, there is an increased risk of death. On the other hand, an overdose of sildenafil would lead to nose bleeding, facial flushing, hypotension, arrhythmia and tachycardia. An overdose of sildenafil has been shown to have arrhythmogenic potential (abnormal heart rhythm), therefore death (Tracqui et al., 2002).
DR. JUMA THEOPHILUS- PHARMACIST.
jumatheofilo@gmail.com