Лечение эректильной дисфункции, характеризующейся неспособностью к достижению или сохранению эрекции полового члена, достаточной для удовлетворительного полового акта. Препарат эффективен только при сексуальной стимуляции.
Противопоказания
Повышенная чувствительность к активному веществу или любому другому компоненту препарата, применение в сочетании с донаторами оксида азота (например, амилнитрит), нитратами или нитритами в любой форме, совместное применение с другими лекарственными средствами для лечения нарушений эрекции (безопасность и эффективность комбинированной терапии не изучены), ...
Олмакс стронг - средство лечения эректильной дисфункции. Применяется для лечения эректильной дисфункции, восстанавливает в условиях сексуальной стимуляции нарушенную эректильную функцию путем увеличения кровотока в половом члене.
Фармакологические свойства
Силденафил является мощным селективным ингибитором циклического гуанозинмонофосфата (цГМФ) - специфической фосфодиэстеразы типа 5 (ФДЭ5). Реализация физиологического механизма эрекции связана с высвобождением оксида азота (N0) в кавернозном теле во время сексуальной стимуляции. Это, в свою очередь, приводит к увеличению уровня цГМФ, последующему расслаблению гладкомышечной ткани кавернозного тела и увеличению притока крови. Силденафил не оказывает прямого расслабляющего действия на изолированное кавернозное тело у человека, но усиливает эффект N0 посредством ингибирования ФДЭ5, которая ответственна за распад цГМФ. Применение силденафила в рекомендованных дозах неэффективно при отсутствии сексуальной стимуляции. Силденафил селективен в отношении ФДЭ5 in vitro, его активность в отношении ФДЭ5 значительно превосходит активность в отношении других известных изоферментов фосфодиэстеразы.
Показания к применению
Лечение эректильной дисфункции, характеризующейся неспособностью к достижению или сохранению эрекции полового члена, достаточной для удовлетворительного полового акта. Препарат эффективен только при сексуальной стимуляции.
Противопоказания
Повышенная чувствительность к активному веществу или любому другому компоненту препарата, применение в сочетании с донаторами оксида азота (например, амилнитрит), нитратами или нитритами в любой форме, совместное применение с другими лекарственными средствами для лечения нарушений эрекции (безопасность и эффективность комбинированной терапии не изучены), возраст до 18 лет (эффективность и безопасность не установлены), тяжелые нарушения функции печени (стадия С по классификации Чайлд-Пью), совместное применение с ингибитором ВИЧ-1 и ВИЧ-2 протеаз ритонавиром, применение у женщин, пациенты с редкими наследственными заболеваниями непереносимости галактозы, недостаточность лактазы или глюкозо-галактозная мальабсорбция (содержит лактозы моногидрат).
Способ применения и дозы
Препарат принимают внутрь. Рекомендуемая доза для большинства пациентов - 50 мг внутрь примерно за 1 ч до сексуальной активности. С учетом эффективности и переносимости доза может быть увеличена до 100 мг или снижена до 25 мг. Максимальная рекомендуемая доза составляет 100 мг. Максимальная рекомендуемая кратность применения - 1 раз в сутки. Коррекция дозы для пожилых пациентов не требуется.
Побочное действие
Частота НПР, о которых сообщалось в пострегистрационный период, указана как "неизвестно". Нарушения со стороны сердечно-сосудистой системы: часто - вазодилатация ("приливы"), нечасто - ощущение сердцебиения, тахикардия, редко - инфаркт миокарда, фибрилляция предсердий, повышение или снижение артериального давления (АД), неизвестно - желудочковые аритмии, нестабильная стенокардия, внезапная остановка сердца. Нарушения со стороны нервной системы: очень часто - головная боль, часто - головокружение, нечасто - сонливость, гипестезия, редко - инсульт, обморок, неизвестно - транзиторная ишемическая атака, судороги, в т.ч. рецидивирующие. Нарушения со стороны органа зрения: часто - нарушение зрения, нарушение цветовосприятия, нечасто - поражение органа зрения, в т.ч. поражение конъюктивы, нарушение слезотечения, неизвестно - передняя неартериитная ишемическая невропатия зрительного нерва, окклюзия сосудов сетчатки, сужение полей зрения. Нарушения со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго, шум в ушах, редко - глухота (внезапное снижение или потеря слуха). Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: часто - заложенность носа, редко - носовое кровотечение. Нарушения со стороны желудочно-кишечного тракта: часто - диспепсия, нечасто - рвота, тошнота, сухость слизистой оболочки полости рта. Нарушения со стороны кожи и подкожных тканей: нечасто - кожная сыпь. Нарушения со стороны костно-мышечной и соединительной ткани: нечасто - миалгия. Общие расстройства: нечасто - боль в груди, утомляемость. Нарушения со стороны иммунной системы: редко - гиперчувствительность. Нарушения со стороны половых органов: нечасто - гематоспермия и кровотечение из полового члена, неизвестно - приапизм, длительная эрекция.
Передозировка
При однократном приеме препарата в дозе до 800 мг нежелательные реакции были такими же, как и в случае более низких доз, но встречались чаще. В случае передозировки при необходимости следует проводить стандартные поддерживающие мероприятия. Лечение симптоматическое. Диализ не ускоряет клиренс, поскольку силденафил в значительной степени связан с белками плазмы и не выводится почками.
Особые указания
Перед началом любого лечения нарушения эрекции врач должен определить сердечнососудистый статус пациента, поскольку существует определённая степень риска, связанная с сексуальной активностью. Препараты, предназначенные для лечения нарушений эрекции, не следует назначать мужчинам, для которых сексуальная активность нежелательна. Силденафил обладает сосудорасширяющими свойствами, приводящими к незначительным транзиторным снижениям АД. Однако повышенная восприимчивость к вазодилататорам наблюдается у пациентов с обструкцией выходного тракта левого желудочка (например, аортальный стеноз, гипертрофическая обструктивная кардиомиопатия), или у пациентов с редким синдромом множественной системной атрофии, проявляющимся тяжёлым нарушением регуляции давления крови со стороны вегетативной нервной системы. В пострегистрационный период сообщались о серьёзных сердечно-сосудистых явлениях, включавших инфаркт миокарда, нестабильную стенокардию, внезапную сердечную смерть, желудочковые аритмии, цереброваскулярные кровотечения, транзиторную ишемическую атаку, повышение или снижение АД, которые находились во временной связи с применением силденафила. У большинства из этих пациентов существовали сердечно-сосудистые факторы риска. Сообщалось, что многие явления возникали во время или вскоре после полового акта, и только небольшое количество возникало вскоре после приёма силденафила без сексуальной активности, поэтому невозможно определить, связаны ли эти явления непосредственно с этими или другими факторами. Поскольку совместное применение силденафила и альфа-адреноблокаторов может привести к симптоматической гипотензии у отдельных чувствительных пациентов, силденафил следует с осторожностью назначать пациентам, принимающим альфа- адреноблокаторы. Чтобы свести к минимуму риск развития постуральной гипотензии у пациентов, принимающих альфа-адреноблокаторы, начинать прием силденафила следует только после того, как будет достигнута стабилизация гемодинамики у этих пациентов. Следует рассмотреть целесообразность снижения начальной дозы силденафила. Кроме того, врач должен проинфомировать пациентов о том, какие действия следует предпринять в случае появления симптомов постуральной гипотензии. Силденафил усиливает антиагрегантный эффект натрия нитропруссида (донатора оксида азота) на тромбоциты человека in vitro. Сведения о безопасности применения препарата у пациентов с внутренними кровотечениями или активной пептической язвой желудка отсутствуют, поэтому в таких случаях препарат следует применять с осторожностью. У небольшого числа пациентов с наследственным пигментным ретинитом имеются наследственные нарушения фосфодиэстераз сетчатки и, поскольку сведений о безопасности применения силденафила нет, препарат следует применять с осторожностью. Врач должен проинформировать пациента о повышении риска развития передней ишемической оптической невропатии неартериального генеза, если ранее это состояние у него уже отмечалось. Были отмечены редкие случаи развития передней ишемической оптической невропатии неартериального генеза как причина ухудшения или потери зрения на фоне применения всех ингибиторов ФДЭ5, включая силденафил. Большинство этих пациентов имели факторы риска, такие как экскавация (углубление) головки зрительного нерва, возраст старше 50 лет, сахарный диабет, артериальная гипертензия, ИБС, гиперлипидемия, курение. Причинно-следственной связи между приемом ингибиторов ФДЭ5 и передней ишемической оптической невропатией неартериального генеза не выявлено. В некоторых постмаркетинговых и клинических исследованиях с использованием всех ингибиторов ФДЭ5, включая силденафил, сообщалось о внезапном снижении или потере слуха у пациентов. Однако в большинстве случаев у этих пациентов имелись факторы риска развития данной патологии, и не было выявлено никакой корреляции между применением ингибиторов ФДЭ5 и внезапным снижением или потерей слуха. Пациента следует предупредить о том, что в случае внезапного снижения или потери слуха необходимо прекратить терапию силденафилом и немедленно проконсультироваться с врачом.
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моногидрат лактозы, микрокристаллическая целлюлоза, повидон-К29-32, кроскармеллоза натрия, стеарат магния."}}]},{"id":2,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Олмакс стронг - средство лечения эректильной дисфункции. Применяется для лечения эректильной дисфункции, восстанавливает в условиях сексуальной стимуляции нарушенную эректильную функцию путем увеличения кровотока в половом члене."}}]},{"id":3,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Силденафил является мощным селективным ингибитором циклического гуанозинмонофосфата (цГМФ) - специфической фосфодиэстеразы типа 5 (ФДЭ5). Реализация физиологического механизма эрекции связана с высвобождением оксида азота (N0) в кавернозном теле во время сексуальной стимуляции. Это, в свою очередь, приводит к увеличению уровня цГМФ, последующему расслаблению гладкомышечной ткани кавернозного тела и увеличению притока крови. Силденафил не оказывает прямого расслабляющего действия на изолированное кавернозное тело у человека, но усиливает эффект N0 посредством ингибирования ФДЭ5, которая ответственна за распад цГМФ. Применение силденафила в рекомендованных дозах неэффективно при отсутствии сексуальной стимуляции. Силденафил селективен в отношении ФДЭ5 in vitro, его активность в отношении ФДЭ5 значительно превосходит активность в отношении других известных изоферментов фосфодиэстеразы."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Лечение эректильной дисфункции, характеризующейся неспособностью к достижению или сохранению эрекции полового члена, достаточной для удовлетворительного полового акта. Препарат эффективен только при сексуальной стимуляции."}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к активному веществу или любому другому компоненту препарата, применение в сочетании с донаторами оксида азота (например, амилнитрит), нитратами или нитритами в любой форме, совместное применение с другими лекарственными средствами для лечения нарушений эрекции (безопасность и эффективность комбинированной терапии не изучены), возраст до 18 лет (эффективность и безопасность не установлены), тяжелые нарушения функции печени (стадия С по классификации Чайлд-Пью), совместное применение с ингибитором ВИЧ-1 и ВИЧ-2 протеаз ритонавиром, применение у женщин, пациенты с редкими наследственными заболеваниями непереносимости галактозы, недостаточность лактазы или глюкозо-галактозная мальабсорбция (содержит лактозы моногидрат)."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат принимают внутрь. Рекомендуемая доза для большинства пациентов - 50 мг внутрь примерно за 1 ч до сексуальной активности. С учетом эффективности и переносимости доза может быть увеличена до 100 мг или снижена до 25 мг. Максимальная рекомендуемая доза составляет 100 мг. Максимальная рекомендуемая кратность применения - 1 раз в сутки. Коррекция дозы для пожилых пациентов не требуется."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Частота НПР, о которых сообщалось в пострегистрационный период, указана как \"неизвестно\". Нарушения со стороны сердечно-сосудистой системы: часто - вазодилатация (\"приливы\"), нечасто - ощущение сердцебиения, тахикардия, редко - инфаркт миокарда, фибрилляция предсердий, повышение или снижение артериального давления (АД), неизвестно - желудочковые аритмии, нестабильная стенокардия, внезапная остановка сердца. Нарушения со стороны нервной системы: очень часто - головная боль, часто - головокружение, нечасто - сонливость, гипестезия, редко - инсульт, обморок, неизвестно - транзиторная ишемическая атака, судороги, в т.ч. рецидивирующие. Нарушения со стороны органа зрения: часто - нарушение зрения, нарушение цветовосприятия, нечасто - поражение органа зрения, в т.ч. поражение конъюктивы, нарушение слезотечения, неизвестно - передняя неартериитная ишемическая невропатия зрительного нерва, окклюзия сосудов сетчатки, сужение полей зрения. Нарушения со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго, шум в ушах, редко - глухота (внезапное снижение или потеря слуха). Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: часто - заложенность носа, редко - носовое кровотечение. Нарушения со стороны желудочно-кишечного тракта: часто - диспепсия, нечасто - рвота, тошнота, сухость слизистой оболочки полости рта. Нарушения со стороны кожи и подкожных тканей: нечасто - кожная сыпь. Нарушения со стороны костно-мышечной и соединительной ткани: нечасто - миалгия. Общие расстройства: нечасто - боль в груди, утомляемость. Нарушения со стороны иммунной системы: редко - гиперчувствительность. Нарушения со стороны половых органов: нечасто - гематоспермия и кровотечение из полового члена, неизвестно - приапизм, длительная эрекция."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При однократном приеме препарата в дозе до 800 мг нежелательные реакции были такими же, как и в случае более низких доз, но встречались чаще. В случае передозировки при необходимости следует проводить стандартные поддерживающие мероприятия. Лечение симптоматическое. Диализ не ускоряет клиренс, поскольку силденафил в значительной степени связан с белками плазмы и не выводится почками."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Перед началом любого лечения нарушения эрекции врач должен определить сердечнососудистый статус пациента, поскольку существует определённая степень риска, связанная с сексуальной активностью. Препараты, предназначенные для лечения нарушений эрекции, не следует назначать мужчинам, для которых сексуальная активность нежелательна. Силденафил обладает сосудорасширяющими свойствами, приводящими к незначительным транзиторным снижениям АД. Однако повышенная восприимчивость к вазодилататорам наблюдается у пациентов с обструкцией выходного тракта левого желудочка (например, аортальный стеноз, гипертрофическая обструктивная кардиомиопатия), или у пациентов с редким синдромом множественной системной атрофии, проявляющимся тяжёлым нарушением регуляции давления крови со стороны вегетативной нервной системы. В пострегистрационный период сообщались о серьёзных сердечно-сосудистых явлениях, включавших инфаркт миокарда, нестабильную стенокардию, внезапную сердечную смерть, желудочковые аритмии, цереброваскулярные кровотечения, транзиторную ишемическую атаку, повышение или снижение АД, которые находились во временной связи с применением силденафила. У большинства из этих пациентов существовали сердечно-сосудистые факторы риска. Сообщалось, что многие явления возникали во время или вскоре после полового акта, и только небольшое количество возникало вскоре после приёма силденафила без сексуальной активности, поэтому невозможно определить, связаны ли эти явления непосредственно с этими или другими факторами. Поскольку совместное применение силденафила и альфа-адреноблокаторов может привести к симптоматической гипотензии у отдельных чувствительных пациентов, силденафил следует с осторожностью назначать пациентам, принимающим альфа- адреноблокаторы. Чтобы свести к минимуму риск развития постуральной гипотензии у пациентов, принимающих альфа-адреноблокаторы, начинать прием силденафила следует только после того, как будет достигнута стабилизация гемодинамики у этих пациентов. Следует рассмотреть целесообразность снижения начальной дозы силденафила. Кроме того, врач должен проинфомировать пациентов о том, какие действия следует предпринять в случае появления симптомов постуральной гипотензии. Силденафил усиливает антиагрегантный эффект натрия нитропруссида (донатора оксида азота) на тромбоциты человека in vitro. Сведения о безопасности применения препарата у пациентов с внутренними кровотечениями или активной пептической язвой желудка отсутствуют, поэтому в таких случаях препарат следует применять с осторожностью. У небольшого числа пациентов с наследственным пигментным ретинитом имеются наследственные нарушения фосфодиэстераз сетчатки и, поскольку сведений о безопасности применения силденафила нет, препарат следует применять с осторожностью. Врач должен проинформировать пациента о повышении риска развития передней ишемической оптической невропатии неартериального генеза, если ранее это состояние у него уже отмечалось. Были отмечены редкие случаи развития передней ишемической оптической невропатии неартериального генеза как причина ухудшения или потери зрения на фоне применения всех ингибиторов ФДЭ5, включая силденафил. Большинство этих пациентов имели факторы риска, такие как экскавация (углубление) головки зрительного нерва, возраст старше 50 лет, сахарный диабет, артериальная гипертензия, ИБС, гиперлипидемия, курение. Причинно-следственной связи между приемом ингибиторов ФДЭ5 и передней ишемической оптической невропатией неартериального генеза не выявлено. В некоторых постмаркетинговых и клинических исследованиях с использованием всех ингибиторов ФДЭ5, включая силденафил, сообщалось о внезапном снижении или потере слуха у пациентов. Однако в большинстве случаев у этих пациентов имелись факторы риска развития данной патологии, и не было выявлено никакой корреляции между применением ингибиторов ФДЭ5 и внезапным снижением или потерей слуха. Пациента следует предупредить о том, что в случае внезапного снижения или потери слуха необходимо прекратить терапию силденафилом и немедленно проконсультироваться с врачом."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Силденафил является мощным селективным ингибитором циклического гуанозинмонофосфата (цГМФ) - специфической фосфодиэстеразы типа 5 (ФДЭ5). Реализация физиологического механизма эрекции связана с высвобождением оксида азота (N0) в кавернозном теле во время сексуальной стимуляции. Это, в свою очередь, приводит к увеличению уровня цГМФ, последующему расслаблению гладкомышечной ткани кавернозного тела и увеличению притока крови. Силденафил не оказывает прямого расслабляющего действия на изолированное кавернозное тело у человека, но усиливает эффект N0 посредством ингибирования ФДЭ5, которая ответственна за распад цГМФ. Применение силденафила в рекомендованных дозах неэффективно при отсутствии сексуальной стимуляции. 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