Common side effects include headaches, heartburn, and flushed skin. Sildenafil acts by blocking phosphodiesterase 5 PDE 5, an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. The primary indication of sildenafil is treatment of erectile dysfunction inability to sustain a satisfactory erection to complete intercourse. Its use is now one of the standard treatments for erectile dysfunction, including for men with diabetes mellitus. Tentative evidence suggests that sildenafil may help men who experience antidepressant -induced erectile dysfunction. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon ; these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. Sildenafil has been studied for high-altitude pulmonary edema, but its use is currently not recommended for that indication.

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Group A : 40 women are given oral estradiol valerate tablets 2mg hourly from the day of the cycle to prepare the endometrium. Group B : 40 women are give sildenafil citrate 25mg vaginally every 6 hours a half of 50 mg tablet is crushed and dissolved in 2cc of distilled water and injected in to vagina starting from day of the cycle, in addition to oral 2mg of estradiol valerat hourly from the day of the menstrual cycle. Estrogen and progesterone prontogest mg pessaries are given 3 days prior to embryo transfer. Sildenafil is discontinued hours prior to the embryo transfe due sildenafil may have some detrimental effects on endometrium in the implantation window. For assessing endometrial vascularity on day 14 of cycle, two dimension power Doppler characteristics as normal quality of color, color gain https://www.ajc.com After 5 days when the endometrial pattern is triple line pattern trilaminar and endometrial thickness is more than 8mm,embryos will be transferred.

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VIAGRA sildenafil citrate, an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate cGMP -specific phosphodiesterase type 5 PDE5. Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3. For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. The maximum recommended dosing https://www.snapus.org frequency is once per day. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of mg or decreased to 25 mg. Consider a starting dose of 25 mg in patients treated with strong CYP3A4 inhibitors e.

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