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These brands contain the same active ingredient (Sildenafil Citrate). Same strength and form. Confirm the switch with your doctor or pharmacist.
More from Exifil
Other strengths and forms by Albion Laboratories Ltd.
Indications & Uses
Exifil is indicated for:
Pharmacology
Mechanism of Action
Erection of the penis depends on the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO activates the enzyme guanylate cyclase, which raises the level of cyclic guanosine monophosphate (cGMP). This relaxes the smooth muscle in the corpus cavernosum and lets blood flow in. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum. Instead, it strengthens the effect of NO by inhibiting phosphodiesterase type 5 (PDE5), the enzyme that breaks down cGMP in the corpus cavernosum. So when sexual stimulation releases NO locally, the inhibition of PDE5 by Sildenafil lets cGMP rise, the smooth muscle relaxes and blood flows into the corpus cavernosum. At the recommended doses, Sildenafil has no effect without sexual stimulation.
Pharmacokinetics and Metabolism
Sildenafil is absorbed rapidly after oral dosing, with a mean absolute bioavailability of 41% (range 25 to 63%). It is removed mainly by hepatic metabolism (mainly cytochrome P450 3A4) and is converted to an active metabolite with properties similar to Sildenafil itself. Both Sildenafil and the metabolite have terminal half lives of about 4 hours.
Absorption and Distribution
Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. If Sildenafil is taken with a high fat meal, the rate of absorption is reduced.
Metabolism and Excretion
Hepatic microsomal isoenzymes clear Sildenafil from the body. After oral or intravenous dosing, it leaves as metabolites, mostly in the feces (approximately 80% of the oral dose) and to a lesser extent in the urine (approximately 13% of the oral dose).
Pharmacokinetics in Special Populations
Geriatrics: Healthy elderly volunteers (65 years or over) cleared Sildenafil more slowly. Their plasma AUC values were approximately 84% and 107% higher than those seen in healthy younger volunteers.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Erectile dysfunction: For most patients, the recommended dose of Sildenafil is 50 mg, taken as needed about 1 hour before sexual activity. It can be taken anywhere from 4 hours to 0.5 hour before. Depending on how well it works and how well the patient tolerates it, the dose may be raised to a maximum of 100 mg or lowered to 25 mg. It should not be taken more than once per day.
Some factors are linked with higher plasma levels of Sildenafil: age over 65, hepatic impairment, severe renal impairment, and use together with potent cytochrome P450 3A4 inhibitors (ketoconazole, itraconazole, erythromycin, saquinavir). Higher plasma levels may increase both the effect and the number of adverse events, so a starting dose of 25 mg should be considered in these patients.
Sildenafil was shown to increase the blood pressure lowering effect of nitrates. For this reason, it is contraindicated in patients who use nitric oxide donors or nitrates in any form. When Sildenafil is given with an alpha-blocker, the patient should be stable on the alpha-blocker before Sildenafil is started, and Sildenafil should be started at the lowest dose.
Pulmonary arterial hypertension: The recommended dose of sildenafil citrate is 20 mg three times a day, taken about 4 to 6 hours apart, with or without food.
Side Effects
Body as a whole: face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury. Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy. Digestive: vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis. Hemic and Lymphatic: anemia and leukopenia. Metabolic and Nutritional: thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremia. Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis. Nervous: ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hyperesthesia. Respiratory: asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased. Skin and Appendages: urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis. Special Senses: sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyes. Urogenital: cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia. Cardiovascular and cerebrovascular: after Sildenafil Citrate came on the market, serious cardiovascular, cerebrovascular and vascular events were reported in temporal association with its use. These include myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage. Most of these patients, though not all, had preexisting cardiovascular risk factors. Many of the events were reported during or shortly after sexual activity, and a few shortly after Sildenafil Citrate was taken without any sexual activity. Others were reported hours to days after taking Sildenafil Citrate and having sexual activity. There's no way to tell whether these events are related directly to Sildenafil Citrate, to sexual activity, to the patient's underlying 23 cardiovascular disease, to a combination of these factors, or to other factors. Nervous: seizure, seizure recurrence, anxiety and transient global amnesia. Urogenital: prolonged erection, priapism and hematuria. Special Senses: diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal vascular disease or bleeding, vitreous detachment/traction, paramacular edema and epistaxis.
Cautions & Contraindications
Warnings & Precautions
Before treating erectile dysfunction, the doctor should look for possible underlying causes and decide on suitable treatment after a complete medical assessment. Before prescribing Sildenafil Citrate, note the following. Take care when Phosphodiesterase Type 5 (PDE5) inhibitors are given together with alpha-blockers. PDE5 inhibitors, Sildenafil Citrate included, and alpha-adrenergic blocking agents are both vasodilators that lower blood pressure. When vasodilators are used together, their effects on blood pressure can be expected to add up. In some patients, taking these two drug classes together can lower blood pressure a great deal and cause symptomatic hypotension (e.g. dizziness, lightheadedness, fainting). Consideration should be given to the following. Patients should be stable on alpha-blocker therapy before a PDE5 inhibitor is started. Patients who show hemodynamic instability on an alpha-blocker alone have a higher risk of symptomatic hypotension if a PDE5 inhibitor is added. In patients who are stable on an alpha-blocker, the PDE5 inhibitor should be started at the lowest dose. In patients already taking an optimized dose of a PDE5 inhibitor, the alpha-blocker should be started at the lowest dose. Raising the alpha-blocker dose step by step may lower blood pressure further while a PDE5 inhibitor is being taken. Other factors can also affect the safety of combining PDE5 inhibitors and alpha-blockers, including intravascular volume depletion and other anti-hypertensive drugs. Sildenafil Citrate has systemic vasodilatory properties and may add to the blood pressure-lowering effect of other anti-hypertensive medicines. Patients on multiple antihypertensive medicines were included in the pivotal clinical trials for Sildenafil Citrate. In a separate drug interaction study, hypertensive patients were given amlodipine, 5 mg or 10 mg, and Sildenafil Citrate, 100 mg, by mouth at the same time. The mean additional blood pressure reduction was 8 mmHg systolic and 7 mmHg diastolic. The safety of Sildenafil Citrate is unknown in patients with bleeding disorders and in patients with active peptic ulceration. Use it with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease), and in patients with conditions that may make them prone to priapism (such as sickle cell anemia, multiple myeloma, or leukemia). The safety and efficacy of Sildenafil Citrate combined with other treatments for erectile dysfunction have not been studied, so such combinations are not recommended. Sexual activity carries a possible cardiac risk in patients with preexisting cardiovascular disease. For this reason, treatments for erectile dysfunction, Sildenafil Citrate included, should not generally be used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. In healthy volunteers, Sildenafil Citrate's systemic vasodilatory properties caused temporary drops in supine blood pressure (mean maximum decrease of 8.4/5.5 mmHg). This would normally be expected to matter little in most patients. Even so, before prescribing Sildenafil Citrate, doctors should carefully consider whether patients with underlying cardiovascular disease could be harmed by these vasodilatory effects, especially together with sexual activity. Patients with the following underlying conditions can be particularly sensitive to vasodilators, Sildenafil Citrate included: those with left ventricular outflow obstruction (e.g. aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure. There is no controlled clinical data on the safety or efficacy of Sildenafil Citrate in the following groups, and if it is prescribed, this should be done with caution. Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; patients with resting hypotension (BP <90/50) or hypertension (BP >170/110); patients with cardiac failure or coronary artery disease causing unstable angina; patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases); patients with sickle cell or related anemias. Since Sildenafil Citrate was approved for sale, prolonged erection of more than 4 hours and priapism (painful erections lasting more than 6 hours) have been reported infrequently. If an erection lasts longer than 4 hours, the patient should seek medical help immediately. If priapism is not treated at once, penile tissue damage and permanent loss of potency could result. Use caution if Sildenafil Citrate is prescribed to patients taking ritonavir. Data from people exposed to high systemic levels of Sildenafil Citrate are limited. Visual disturbances occurred more often at higher levels of exposure. Decreased blood pressure, syncope, and prolonged erection were reported in some healthy volunteers given high doses of Sildenafil Citrate (200 to 800 mg). To lower the chance of adverse events in patients taking ritonavir, a lower Sildenafil Citrate dose is recommended.
Contraindications
Don't give Sildenafil to anyone who is hypersensitive to any component of the medicine. It is also contraindicated in patients who use organic nitrates, whether regularly or only now and then, because sildenafil increases the blood pressure lowering effect of nitrates.
Pregnancy & Breastfeeding
Sildenafil is pregnancy category B. No adequate and well-controlled studies of Sildenafil have been done in pregnant women, and the medicine is not indicated for use by women. In animal studies, Sildenafil showed no evidence of teratogenicity or embryotoxicity.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Healthy volunteers who took single doses of Sildenafil Citrate up to 800 mg had the same kinds of adverse events seen at lower doses, but these happened more often and were more severe. 24 If an overdose occurs, standard supportive measures should be used as needed. Renal dialysis is not expected to speed up clearance, because Sildenafil Citrate is highly bound to plasma proteins and is not eliminated in the urine.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Sildenafil Citrate in a dry place, away from light and heat. Keep it out of the reach of children.
Drug Interactions
Common questions about Exifil 100 mg
What is Exifil 100 mg Tablet?
Exifil 100 mg Tablet is a medicine that contains Sildenafil Citrate. It is made by Albion Laboratories Ltd. It belongs to the Drugs for Erectile Dysfunction group of medicines.
What is Exifil used for?
Exifil is used for: Hypertension, Erectile Dysfunction.
What are the side effects of Exifil?
Body as a whole: face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury. Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.
Can I take Exifil during pregnancy or while breastfeeding?
Sildenafil is pregnancy category B. No adequate and well-controlled studies of Sildenafil have been done in pregnant women, and the medicine is not indicated for use by women. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Exifil?
Healthy volunteers who took single doses of Sildenafil Citrate up to 800 mg had the same kinds of adverse events seen at lower doses, but these happened more often and were more severe. 24 If an overdose occurs, standard supportive measures should be used as needed. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Exifil?
Store Sildenafil Citrate in a dry place, away from light and heat. Keep it out of the reach of children.
Can I take other medicines with Exifil?
Some medicines can interact with Sildenafil Citrate, for example: Erythromycin, Itraconazole, Cimetidine, Bosentan, Saquinavir, Ritonavir. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
Niagra by Delta Pharma PLC. has the same ingredient and strength for ৳20.00 per unit, compared with ৳59.00 for Exifil. Ask your doctor or pharmacist before switching.
Do I need a prescription for Exifil?
Exifil is a prescription (Rx) medicine. Take it as your doctor advises.