sildénafil

Sildénafil

Sildénafil

Identification
Nom UICPA citrate de 1-[4-éthoxy-3-(6,7-dihydro-1-méthyl-7-oxo-3-propyl-1H >-pyrazolo[4,3-d]pyrimidin-5-yl) (phénylsulfonyl]-4-méthylpipérazine
No CAS 139755-83-2
171599-83-0 (citrate)
Code ATC G04BE03
DrugBank APRD00556
PubChem 5281023
ChEBI 9139
SMILES CCCC1=NN(C2=C1N=C(N=C2O)C3=C(C=CC(=C3)S(=O)(=O)N4CCN(CC4)C)OCC)C
PubChem, vue 3D
InChI InChI : vue 3D
InChI=1/C22H30N6O4S/c1-5-7-17-19-20(27(4)25-17)22(29)24-21(23-19)16-14-15(8-9-18(16)32-6-2)33(30,31)28-12-10-26(3)11-13-28/h8-9,14H,5-7,10-13H2,1-4H3,(H,23,24,29)/f/h29H
Apparence Solide
Propriétés chimiques
Formule brute C22H30N6O4S  [Isomères]
Masse molaire[1] 474,576 ± 0,027 g/mol
C 55,68 %, H 6,37 %, N 17,71 %, O 13,49 %, S 6,76 %,
Propriétés physiques
T° fusion 189 à 190 °C
Précautions
Directive 67/548/EEC[2]
Citrate de sildénafil en poudre :
Xi
Symboles :
Xi : Irritant

Phrases R :
R36/37/38 : Irritant pour les yeux, les voies respiratoires et la peau.

Phrases S :
S22 : Ne pas respirer les poussières.
S24/25 : Éviter le contact avec la peau et les yeux.

Phrases R : 36/37/38,
Phrases S : 22, 24/25,
Données pharmacocinétiques
Biodisponibilité 40 %
Métabolisme Hépatique CYP3A4 (majeur) et CYP2C9 (mineur)
Demi-vie de distrib.
  • Concentration maximale : 60 min (écart = 30 min à 120 min)
  • Nourriture : repas gras diminuent concentration maximale de 29 %
  • Chez personnes >65 ans : clairance diminuée
  • Insuffisance rénale sévère (ClCR estimée < 30 mL/min) : clairance diminuée
  • Excrétion
  • Fécal : 80 % sous forme de métabolites.
  • Rénal : 13 % sous forme de métabolites.
  • Non dialysable.
  • Considérations thérapeutiques
    Classe thérapeutique voir « Monographie »
    Voie d’administration orale
    Unités du SI et CNTP, sauf indication contraire.

    citrate de sildénafilViagraRevatio

    Histoire[modifier | modifier le code]

    Découverte[modifier | modifier le code]

    Brevet[modifier | modifier le code]

    Autres utilisations[modifier | modifier le code]

    Concurrents[modifier | modifier le code]

    Viagra et environnement[modifier | modifier le code]

    De plus, les résidus de Viagra évacués avec l'urine dans le milieu naturel pourraient poser problème en tant que perturbateur du comportement de certains animaux.

    Monographie du produit[modifier | modifier le code]

    Noms commerciaux[modifier | modifier le code]

    • Viagra - Verventi (Pfizer)

    Classe[modifier | modifier le code]

    • Antihypertenseur, vasodilatateur périphérique
    • Agent pour la dysfonction érectile
    • Inhibiteur de la phosphodiestérase de type 5

    Dose adulte[modifier | modifier le code]

    • Dysfonction érectile
    • 25–100 mg (dose usuelle : 50 mg) per os 1 heure avant la relation sexuelle. Une administration par jour maximum
    • Hypertension pulmonaire
    • 20 mg per os TID q6h

    Dose pédiatrique[modifier | modifier le code]

    • Le sildénafil n'est pas indiqué chez les enfants.

    Ajustements de doses[modifier | modifier le code]

    • Gériatrie (patient >65 ans, dysfonction érectile) : dose initiale 25 mg per os
    • Maladie hépatique (dysfonction érectile) : dose initiale 25 mg per os
    • Maladie hépatique (hypertension pulmonaire) : pas d'ajustements requis (classification Child-Pugh A et B)
    • Insuffisance rénale (dysfonction érectile) : ClCr <30 ml/min, dose initiale 25 mg per os
    • Insuffisance rénale (hypertension pulmonaire) : pas d'ajustements requis
    • Avec ritonavir (dysfonction érectile) : 25 mg per os q48h MAX.

    Administration[modifier | modifier le code]

    • Avec l'utilisation concomitante d'inhibiteurs du cytochrome P450 3A4 (exemples : érythromycine, clarithromycine, kétoconazole, itraconazole) et chez les patients VIH+ sous médication, si et seulement si cette médication n'est pas la combinaison connue sous le nom HAART (thérapie antirétrovirale hautement active), la dose initiale est de 25 mg par jour.
    • Lorsque utilisé pour la dysfonction érectile, les ajustements de doses seront nécessaires si une tachyphylaxie s'installe.

    Suivi[modifier | modifier le code]

    • Dysfonction érectile : fréquences et qualité de l'érection
    • Hypertension pulmonaire : amélioration des exercices
    • Hypertension pulmonaire : signes d'œdème pulmonaire
    • Dysfonction érectile
    • Hypertension pulmonaire

    Mécanisme d'action[modifier | modifier le code]

    Pharmacocinétique[modifier | modifier le code]

    Voir description du médicament.

    Contre-indications[modifier | modifier le code]

    • Utilisation concomitante de nitrates (exemple : nitroglycérine)
    • Hypersensibilité au sildénafil

    Précautions[modifier | modifier le code]

    • Déformation anatomique du pénis
    • Historique de saignements ou ulcère peptique actif
    • Maladie cardiovasculaire (ischémie cardiaque, insuffisance cardiaque congestive)
    • Utilisation concomitante d'inhibiteurs du cytochrome P450 3A4 (exemples : cimétidine, érythromycine, kétoconazole, itraconazole, inhibiteurs des protéases)
    • Prédispositions au priapisme (exemples : anémie falciforme, myélome multiple, leucémie)
    • Maladie hépatique
    • Polypharmacie antihypertensive
    • Insuffisance rénale
    • Retinitis pigmentosa ou autres anomalies rétiniennes

    Effets indésirables[modifier | modifier le code]

    • Communs
    • Dermatologique : flushing (4-10 %), rash (2 %)
    • Gastro-intestinal : diarrhée (4 %), dyspepsie (4-8 %)
    • Neurologique : étourdissements (2 %), céphalée (11-16 %)
    • Ophtalmique : vision anormale
    • Respiratoire : congestion nasale
    • Sévères
    • Cardiovasculaire : infarctus du myocarde (rare)
    • Ophtalmique : neuropathie ischémique optique non-artérielle
    • ORL : troubles ou pertes de l'audition, dans les 3 jours suivants la dernière prise, réversible 1 fois sur 3 dans les deux semaines[14]
    • Reproduction : priapisme (rare)

    Interaction médicamenteuse[modifier | modifier le code]

    • Contre-indications absolues : prise concomitante de dérivé nitré (nitroglycérine, tétranitrate de pentaérythrytol, nitroprussiate de potassium, nitrites d'alkyle, tétranitrate d'érythrityle, dinitrate d'isosorbitol, mononitrate d'isosorbitol, molsidomine)
    • Majeure
    • Atazanavir (théorique)
    • Cannabis (théorique)
    • Dihydrocodéine (probable)
    • Ritonavir (établi)
    • Mineure
    • Alfuzosine (probable)
    • Amprenavir (probable)
    • Bunazosine (probable)
    • Delavirdine (probable)
    • Doxazosine (probable)
    • Érythromycine (probable)
    • Fosamprenavir (probable)
    • Indinavir (probable)
    • Itraconazole (probable)
    • Kétoconazole (probable)
    • Moxisylyte (probable)
    • Nelfinavir (probable)
    • Prazosine (probable)
    • Rifapentine (probable)
    • Saquinavir (établi)
    • Tamsulosine (probable)
    • Térazosine (probable)
    • Trimazosine (probable)

    Utilisation dans l'hypertension artérielle pulmonaire[modifier | modifier le code]

    Notes et références[modifier | modifier le code]

    Voir aussi[modifier | modifier le code]

    Articles connexes[modifier | modifier le code]

    • Médicaments de la même classe thérapeutique : tadalafil (Cialis), chlorhydrate d'apomorphine (Uprima), vardénafil (Levitra) et sulfoaildénafil ; on peut aussi, dans une moindre mesure, citer la yohimbine.
    • Flibansérine ou « Viagra pour femmes »

    Liens externes[modifier | modifier le code]

    • Compendium suisse des médicaments : spécialités contenant Sildénafil
    • (en) European Medicines Agency, Rapport Européen Public D’Évaluation
    • Portail de la médecine
    • Portail de la chimie
    • Portail de la pharmacie

    Source: https://www.wikipedia.org/search-redirect.php?family=wikipedia&search=Viagra&language=fr&go=++%E2%86%92++&go=Go



    Смотреть видео про sildénafil

    Citrate de sildénafil Viagra

    Le Sildenafil Citrate est le composant principal de nombreux médicaments qui sont utilisés pour le traitement de la dysfonction érectile. Les médicaments qui contiennent ce composant sont fabriqués sous diverses formes. Ce composant, par exemple, fait partie du Revatio, du Viagra et des préparations génériques. Également, le Sildenafil fait partie du Kamagra, produit par la compagnie pharmaceutique indienne Ajanta Pharma. Le Sildenafil est le composant principal du Silagra, Edegra, Penegra et Zenegra, produits par d'autres compagnies pharmaceutiques principales de l'Inde. Le Sildenafil générique est une alternative efficace et bon marché du Viagra qui est cher. Plusieurs clients qui n'ont pas assez d'argent, préfèrent cette solution.

    Le Sildenafil est efficace pour les patients qui ont acquis l'impuissance pour des raisons médicales. Certains traitements peuvent provoquer l'impuissance.

    Du point de vue de la pharmacologie, ce composant appartient aux inhibiteurs de la phosphodiestérase. Il traite la dysfonction érectile à l'aide de la PDE-5 (phosphodiestérase), qui détend les muscles. Le Sildenafil aide à stimuler la circulation sanguine vers les organes génitaux. C'est très important pour avoir l'érection.

    Les hommes ne doivent pas retarder avec le traitement, si la dysfonction érectile apparaît soudainement. Il vaut mieux de résoudre le problème à l'aide du médecin, et ensuite d'acheter le Sildenafil en ligne. Bien qu'il est possible d'acheter le Sildenafil sans ordonnance, nous vous conseillons de vous servir d'une telle alternative, uniquement lorsqu'il est nécessaire de compléter le stock du médicament. Seul votre médecin peut déterminer un bon médicament et une bonne dose. Pour certains patients, une petite dose est suffisante, alors que dans les cas complexes, que les comprimés du Sildenafil 100 mg peuvent être efficaces.

    • éclipse visuelle, la cophose;
    • bourdonnement d'oreille;
    • douleur dans la poitrine, les bras, les épaules, le dos;
    • transpiration;
    • malaise général;
    • gonflement des chevilles , des mains et des pieds;
    • essoufflement;
    • distraction;
    • problèmes de mémoire;
    • problèmes d'estomac.

    Ce n'est pas la liste complète des effets secondaires possibles du Sildenafil, et probablement, ce médicament peut produire des autres effets.

    Avant d'acheter le Sildenafil, vous devez être sûrs que ce médicament est bon pour vous. Certaines personnes peuvent avoir une réaction allergique à ce produit.

    Il n'est pas recommandé d'utiliser les nitrates, quand vous prenez le Sildenafil.

    Il y a quelques états quand le traitement du Sildenafil est dangereux. Par exemple, le priapisme. Cet état de l'érection douloureuse se produit rarement, comme l'effet secondaire, mais vous devez prendre les mesures immédiatement – sinon, il peut amener à l'impuissance irréversible. Si vous avez déjà eu cela, il vaut mieux de vous retenir du Sildenafil.

    Les patients avec les maladies des reins et du foie doivent être prudents, parce que le Sildenafil peut les influencer gravement. La même chose existe par rapport aux personnes qui ont l'ulcère, les problèmes cardiaques, les troubles des vaisseaux sanguins etc.

    Il est important d'analyser la liste des médicaments que le patient prend à l'heure actuel, afin d'éviter la possibilité des interactions négatives. Si vous prenez le Viagra, les médicaments contenant le Sildenafil ou d'autres inhibiteurs de la phosphodiestérase, vous ne devez pas prendre d'autres médicaments de ce type. Dans le cas contraire, le traitement se retournera contre vous!

    Source: http://www.sildenafil-medecine.com/



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