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Packaging

4 tablets.

Mechanism of action

Dynamic - a drug for the treatment of erectile dysfunction. Under sexual stimulation, it restores impaired erectile function by increasing blood flow in the penis.

The physiological mechanism of erection involves the release of nitric oxide (NO) in the cavernous body due to sexual arousal. NO activates the enzyme guanylate cyclase, which leads to an increase in the concentration of cGMP. In turn, cGMP causes relaxation of the smooth muscles of blood vessels and, accordingly, blood flow to the cavernous body of the penis.
Dynamically is a selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5), which causes the disintegration of cGMP in the cavernous body of the penis. It does not have a direct relaxing effect on the smooth muscles of the cavernous body, but enhances the relaxing effect of NO and increases blood flow to the penis. When the NO – cGMP chain is observed, which is observed during sexual stimulation, the inhibition of PDE5 leads to an increase in the level of cGMP in the cavernous body. The pharmacological effect is achieved only in the presence of sexual stimulation.
The activity of Sildenafil with respect to PDE5 exceeds the activity with respect to other known phosphodiesterase isoenzymes: PDE6 - by 10 times, PDE1 - by more than 80 times; PDE2 – PDE4, PDE7 – PDE11 - more than 700 times. Sildenafil is 4,000 times more selective for PDE5 compared to PDE3, which is important because PDE3 is one of the key enzymes regulating myocardial contractility.

Dynamo has a light and short-term antihypertensive effect, in most cases without clinical manifestation when taken in recommended doses. The antihypertensive effect is associated with the vasodilating effect of sildenafil due to an increase in the cGMP content in the vascular smooth muscle membrane.

Indications and usage

Treatment of erectile dysfunction, characterized by the inability to achieve or maintain an erection of the penis, sufficient for satisfactory sexual intercourse.
Effective only with sexual stimulation.

Contraindications

- Hypersensitivity to the drug.
- Patients who constantly or intermittently receive donators of nitric oxide, organic nitrates.
- Patients for whom sexual activity is undesirable, including those with severe cardiovascular diseases such as unstable angina, severe heart failure, life-threatening arrhythmias, arterial hypotension (arterial pressure (BP) less than 90/50 mm Hg)., arterial hypertension (BP more than 170/100 mmHg), recently suffered a violation of cerebral circulation or myocardial infarction;
- Patients with vision loss in one eye due to anterior ischemic optic neuropathy of non-arterial genesis (regardless of whether it happened as a result of taking a PDE5 inhibitor or not);
- Hereditary degenerative diseases of the retina, including retinitis pigmentosa (a smaller proportion of these patients have a genetic disease of the retinal PDE);
- Severe liver failure;
- Female;
- Age up to 18 years.

Dosage and administration

Inside, about 1 hour before planned sexual activity.

Based on the effect and tolerability of the drug Dynamic daily dose can be from 25 mg to 100 mg.
It is recommended to take the drug no more than 1 time per day.

Adverse Effects

From the nervous system: very often - a headache; often - dizziness; infrequently - drowsiness, hypesthesia; rarely - stroke, fainting; frequency is unknown - transient ischemic attack, convulsions, including recurrent.
Since the cardiovascular system: often - "tides"; infrequently - palpitations, tachycardia; rarely - increase or decrease in blood pressure, myocardial infarction, atrial fibrillation; frequency is unknown - ventricular arrhythmia, unstable stenocardia, sudden death.
On the part of the organ of vision: often - impaired vision, violation of color perception; infrequently - defeat of the conjunctiva, disturbed tearing, enhanced perception of light, impaired visual clarity, transient chromatopsia; rarely - redness of the sclera, pain in the eyeballs; frequency unknown - anterior ischemic optic neuropathy, retinal vascular occlusion, narrowing of the visual fields.
On the part of the organ of hearing: infrequently - vertigo, tinnitus; rarely - deafness.
On the part of the respiratory system: often - nasal congestion; rarely - nosebleeds.
From the gastrointestinal tract: often - dyspepsia; infrequently - vomiting, nausea, dryness of the oral mucosa.
Allergic reactions: rarely - skin rash; frequency is unknown - Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).
On the part of the genitals: the frequency is unknown - priapism, prolonged erection.
Other: rarely - chest pain, fatigue.

Special notes

Before using the drug Dynamic should conduct a thorough examination of the patient in order to diagnose erectile dysfunction and determine its causes. It is necessary to assess the risk of serious adverse reactions due to sexual activity in patients with cardiovascular diseases, as well as concomitant medication. Sildenafil causes a mild decrease in blood pressure. Particularly susceptible to the hypotensive effect of sildenafil patients with left ventricular obstruction or with a rare syndrome of multiple atrophy. Before using sildenafil in these patients, it is necessary to eliminate the risk of adverse effects of low blood pressure during sexual activity. Most adverse reactions of the cardiovascular system develop immediately after intercourse or shortly thereafter, in rare cases, adverse reactions may develop before sexual intercourse.

The simultaneous use of several different medicines for the treatment of erectile dysfunction is not recommended.
Dynamic should be used with caution in patients with anatomical deformities of the penis (angulation, cavernous fibrosis or Peyronie's disease), as well as in patients with diseases that predispose to priapism (sickle cell anemia, myeloma, leukemia).

If a visual impairment occurs, consult a doctor immediately.
Doses of more than 200 mg do not increase efficacy, but they increase the frequency and severity of dose-dependent side effects.
Influence on ability to drive motor transport and control mechanisms

In the event of the development of adverse reactions from the nervous system and sensory organs, patients are advised to refrain from driving a car and controlling mechanisms, and also to be careful when engaging in activities that require attention concentration and psychomotor speed.

Keep out of the reach of children, at a temperature not exceeding 25 ° C.

Dynamic