Uses

1.Erectile Dysfunction (ED)

Erectile dysfunction impairs the ability of adult men to produce and/or sustain an erection for a minimum sufficient amount of time. This phenomenon is caused by the overreaction of a certain enzyme involved in controlling the erection. ED can be caused by several factors, which include diseases (cardiovascular, renal, hepatic, neurological, hematological, etc), lifestyle choices, and other underlying conditions. Fildena 100 mg enhances vasodilation (dilation of blood vessels) and promotes smooth muscle relaxation in the penis. Using this medication, individuals can sustain an erection for a sufficient amount of time.

Erectile dysfunction is the only on-label indication approved for Fildena 100 mg. However, based on the patient’s clinical requirements, physicians can recommend these tablets for other off-label indications as well. The main off-label indications of Fildena 100 mg are explained below:

2.Erectile Dysfunction Due To Selective Serotonin Reuptake Inhibitors (SSRI)

SSRIs are a class of antidepressants that are typically used to treat mood and anxiety-related problems. It increases the availability of serotonin in the brain by preventing its reuptake back into the neurons. As the serotonin levels in the central nervous system increase, it inhibits dopamine, which is essential for proper sexual functioning. Hence, as a side effect of these medications, SSRI-dependent ED develops in the individual. Fildena 100 mg consists of sildenafil citrate, which helps improve the duration and quality of the erection by enhancing the nitric oxide-cGMP pathway. It does not interfere with the working of the SSRIs and treats the ED through alternative pathways.

3.Pulmonary Hypertension (PAH)

PAH refers to a progressive disease caused by high blood pressure (over 20 mmHg) in the pulmonary artery. As the artery becomes more and more constricted, the blood pressure increases. However, the overall blood flow carried by the artery is reduced. This results in reduced functioning of the left heart. The pathological changes occurring in PAH are similar to those occurring in erectile dysfunction. It is characterized by decreased nitric oxide production and increased functioning of the PDE-5 enzyme, which promotes vasoconstriction. The sildenafil citrate present in Fildena 100 mg inhibits this PDE-5 enzyme, thus improving the blood flow in the pulmonary artery.

4.Other Indications

• Pulmonary hypertension (different dosing/formulations)
• Raynaud’s phenomenon
• Female sexual arousal disorder
• Benign prostatic hyperplasia–associated lower urinary tract symptoms
• High-altitude–related pulmonary hypertension
• Digital ischemia and ulcers in systemic sclerosis

Dosage Information

1.Erectile Dysfunction (ED)

• Recommended dose: 50 mg orally 30–60 minutes before sexual activity, increased to 100 mg if needed.
• Maximum limit: 100 mg once in 24 hours.
• Important clinical information: This indication requires sexual stimulation. This dosage should not be combined with nitrates.

2.SSRI-Induced Erectile Dysfunction (OFF-LABEL)

• Recommended dose: 25–50 mg before sexual activity, titrated up to 100 mg if response is inadequate.
• Maximum limit: 100 mg once in 24 hours.
• Important clinical information: Initially, low doses are recommended due to preserved baseline vascular function.

3.Psychogenic or Mixed Erectile Dysfunction

• Recommended dose: 25–50 mg before intercourse, increased to 100 mg based on response.
• Maximum limit: 100 mg per day.
• Important clinical information: For this indication, occasional use, on an on-demand basis, is recommended rather than daily use.

4.Erectile Dysfunction Associated with Chronic Diseases (diabetes, hypertension, post-prostate surgery)

• Recommended dose: 50 mg before sexual activity, often requiring escalation to 100 mg.
• Maximum limit: 100 mg once daily.
• Important clinical information: Higher doses may be needed due to reduced vascular responsiveness.

How Fildena 100mg Works

Fildena 100 mg is composed of 100 mg of sildenafil citrate. This drug targets the NO-cGMP pathway involved in the formation of an erection. Sildenafil citrate belongs to the PDE-5 class of inhibitors. The working mechanism of Fildena 100 mg is explained below:

Under normal conditions, after sexual stimulation is sensed by the nervous system, a chain of reactions is activated in the penis. The parasympathetic nerve endings release nitric oxide (NO) in the penis. This NO activates the production of an enzyme called guanylate cyclase. Guanylate cyclase converts the existing GTP molecules in the region to cyclic guanosine monophosphate (cGMP). As more guanylate cyclase is produced, the concentration of cGMPs is also increased. cGMP is a chemical messenger that is central to the process of forming and sustaining an erection.

cGMP causes the relaxation of smooth muscles in the corpus cavernosum (penile erectile tissue). The blood vessels in this region also dilate (vasodilation). This reaction facilitates more and more blood flow to the penile tissue. This process also compresses the penile veins, thus reducing the blood outflow. As the blood is retained in the penis, it leads to the formation of an erection. 

Normally, after a certain amount of time, an enzyme called phosphodiesterase type-5 (PDE-5) is released in the penis. It breaks down the cGMP molecules, thus reducing the physiological effects caused by it. As a result, the blood flow in the penis decreases, and the relaxed smooth muscle tissues get contracted, thus weakening the erection.

This process is essential as the body must revert to its normal resting state after serving the necessary functions. Without the effects of PDE-5, there is a risk of priapism, i.e., prolonged erection over four hours.

In individuals suffering from erectile dysfunction, the PDE-5 enzyme is either overexpressed or is activated prematurely. As a result, the cGMP molecules are destroyed before their physiological purposes are fulfilled. Hence, the individual cannot sustain an erection, even for the minimum required amount of time. 

Sildenafil citrate in Fildena 100 mg selectively inhibits the PDE-5 enzyme. It allows the cGMP to work for a sufficient amount of time. This leads to improved vasodilation and blood flow to the penile erectile tissue, and the erection is sustained for a longer period of time.

It must be noted that Fildena 100 mg cannot spontaneously trigger an erection after its consumption. For the medication to work, sexual stimulation is required. Fildena 100 mg enhances the body’s natural reaction to this sexual stimulation.

Possible Side Effects

1.Common Side Effects

(most frequently reported; dose-related)

• Headache
• Facial flushing
• Nasal congestion
• Dizziness
• Dyspepsia (indigestion)
• Nausea
• Mild visual blurring
• Feeling of warmth

2.Less Common Side Effects

(occur in a smaller proportion of patients)

• Palpitations
• Tachycardia
• Orthostatic hypotension
• Dry mouth
• Vomiting
• Diarrhea
• Fatigue
• Muscle aches
• Back pain

3.Visual Side Effects

(due to partial PDE-6 inhibition in retina)

• Blue-tinged vision (cyanopsia)
• Increased light sensitivity
• Blurred vision
• Difficulty distinguishing blue and green colors

4.Auditory Side Effects

(rare but clinically important)

• Sudden decrease in hearing
• Hearing loss
• Tinnitus
• Ear fullness

5.Cardiovascular Side Effects

(more likely in high doses or predisposed patients)

• Hypotension
• Syncope
• Chest pain
• Arrhythmias
• Myocardial ischemia (rare)

6.Gastrointestinal Side Effects

• Acid reflux
• Epigastric discomfort
• Gastritis
• Abdominal pain

7.Dermatological Side Effects

• Rash
• Flushing
• Pruritus
• Photosensitivity
• Urticaria

8.Genitourinary Side Effects

• Prolonged erection
• Painful erection
• Ejaculatory discomfort

9.Serious / Rare Adverse Effects

(require immediate medical attention)

• Priapism (erection lasting over 4 hours)
• Non-arteritic anterior ischemic optic neuropathy (NAION)
• Severe hypotension (especially with nitrates)
• Seizures (rare)
• Anaphylaxis/angioedema

Precautions and Considerations

• Fildena 100 mg must be consumed only after being prescribed by a licensed healthcare provider. 
• Individuals must not change the dosing amount and schedule by themselves.
• For ED, Fildena 100 mg is intended for on-demand use only. It must not be consumed daily.
• Avoid fat-rich meals before consuming Fildena 100 mg, as it might delay the onset of its effect.
• Individuals must report any side effects to their healthcare providers. Serious side effects, such as priapism, require immediate medical intervention.
• Fildena 100 mg must be prescribed cautiously in patients suffering from cardiovascular diseases. They are at risk of cardiovascular events and hypotension as a side effect of Fildena 100 mg. These patients must be regularly monitored for any cardiovascular signs while on Fildena 100 mg therapy.
• Apart from these, this medication must be administered cautiously in patients suffering from ophthalmic, hepatic, renal, hematological, and neurological conditions.
• Fildena 100 mg is contraindicated in several medications, such as nitrates, alpha-blockers, CYP3A4 inhibitors, and other PDE-5 inhibitors.
• This drug is not approved for use in women and children.
• In elderly patients, initially, a low concentration dose must be administered. Based on the level of tolerance and requirements, the dosage can be increased gradually. 
• While consuming Fildena 100 mg, certain items like grapefruit and alcohol must be avoided.

Other Information

Frequently Asked Questions

1.Can Fildena 100 mg be used for performance boosting?

Fildena 100 mg can only be consumed for diagnosed erectile dysfunction (ED). The dosage must be decided by a licensed healthcare professional.

2.How long will the effects of Fildena 100 mg last?

Typically, the effects of Fildena 100 mg will last for 4-6 hours after consumption.

3.What is the process of consumption of Fildena 100 mg?

Fildena 100 mg must be consumed whole along with water. Individuals must avoid chewing, crushing, or dissolving the tablets in water before consumption.

4.Does Fildena 100 mg cause dependence?

Fildena 100 mg acts on the pathophysiological pathways involved in the formation of erections. It does not affect the reward system of the brain, which is involved in developing dependence.

5.Can diabetic and high blood pressure patients consume Fildena 100 mg safely?

Yes. Diabetic and high blood pressure patients can consume Fildena 100 mg safely. However, regular monitoring of blood pressure and blood sugar is required.