Maxigra Go (Sildenafil Citrate)

• Sildenafil citrate, a phosphodiesterase type 5 inhibitor, is used in conditions where enhanced nitric‑oxide mediated vasodilation improves clinical outcomes.
• Erectile dysfunction: improves ability to achieve and maintain an erection during sexual stimulation.
• Pulmonary arterial hypertension: lowers pulmonary arterial pressure and improves exercise capacity.
• Benign prostatic hyperplasia (off‑label): may reduce lower urinary tract symptoms by relaxing smooth muscle in the prostate and bladder neck.

• Sildenafil citrate selectively inhibits the enzyme phosphodiesterase type 5, which degrades cyclic guanosine monophosphate (cGMP) in the corpus cavernosum and pulmonary vasculature. By blocking PDE5, intracellular cGMP concentrations rise, leading to smooth‑muscle relaxation via the nitric‑oxide pathway, increased blood flow, and facilitation of erection or pulmonary vasodilation. The effect is activity‑dependent, occurring primarily when sexual or physiological stimulation triggers nitric‑oxide release.

Sildenafil citrate may be associated with a range of adverse reactions, which are classified by frequency and severity.

Common Side Effects

• Headache
• Flushing
• Dyspepsia
• Nasal congestion

Serious or Rare Side Effects

• Priapism (prolonged erection)
• Sudden loss of vision
• Sudden loss of hearing

Before prescribing sildenafil citrate, consider the following precautions:

• Cardiovascular assessment: avoid use in patients with recent myocardial infarction or unstable angina.
• Nitrate therapy: contraindicated because of risk of severe hypotension.
• Renal impairment: dose adjustment may be required in severe renal dysfunction.
• Alcohol consumption: may increase hypotensive effects and side‑effects.
• Vision disorders: monitor patients with pre‑existing retinal disease.
• Store at ambient temperature: keep in original container, protect from moisture and heat.

Sildenafil citrate can interact with several medicines; interactions are grouped by clinical significance.

Major Interactions (Avoid)

• Nitrates (e.g., nitroglycerin): may cause profound hypotension.
• Guanylate cyclase stimulators (e.g., riociguat): risk of excessive vasodilation.
• Certain alpha‑blockers (e.g., doxazosin): may lead to marked blood pressure drops.

Moderate Interactions (Monitor Closely)

• Strong CYP3A4 inhibitors (e.g., ketoconazole): increase sildenafil exposure.
• CYP3A4 inducers (e.g., rifampin): may reduce efficacy.
• Protease inhibitors (e.g., ritonavir): can elevate plasma levels.