Brand(s): Fildena® Extra Power
Manufacturer: Fortune Health Care
Generic name: Sildenafil Citrate
Pharmacologic Classifications: Type 5 Inhibitor
Fildena 150 is used to treat moderate to severe erectile dysfunction (ED) in cases when lower doses have failed to produce the desired results. Fildena Extra Power, containing 150mg of Sildenafil Citrate, is a generic version of a popular brand Viagra. It comes in a strip of 10 tablets; each tablet is film coated and red in color.
Erectile Dysfunction (ED) increases in severity with age or as the chronic illnesses progress. Many patients fail to get the desired result at the most common prescribed dose of 50mg or 100mg. As per Mayo clinic website, ED is often caused by chronic disease conditions like diabetes, heart disease, multiple sclerosis, metabolic syndrome, Parkinson’s disease, sleep disorders, falling levels of testosterone, alcoholism or drug addiction, stroke, radiation therapy.
There are several clinical trials to support the use of a higher dose of sildenafil citrate (up to 200mg in a single dose/day). Patients who have earlier taken sildenafil citrate up to 100mg and still failed to get the satisfactory erectile function can switch to Fildena 150. With the increase in strength of sildenafil citrate, the incidence of adverse effects also increases, though most of these adverse effects are transient and tolerable, although in a few cases person may need to discontinue the therapy.
Fortune Healthcare is a generic drug manufacturer based in India, which has a wide portfolio of generic drugs. On its website, the company claims that its manufacturing facilities are US FDA approved, which is an indicator of the high manufacturing standards being followed by the company.
Fortune Healthcare aims to produce generic drugs which are at par with innovators in quality but still considered much more affordable when it comes to pricing. It manufactures products which are not only cheaper in price as compared to the brands but also less priced in comparison to other branded generics. The company keeps the price affordable without compromising on the quality. It is continually investing in state of art machinery and is also well aware of the training needs of its staff. Products are well tested and inspected before they reach the patients.
Fortune Healthcare specializes in the manufacturing of branded generics of high quality and follows the patent rules and regulations; it only manufactures the drugs for which the patent has expired. The company believes in green technology and, hence, ensures that there are minimum liquid or gas emissions released into the environment from its factory. Fortune Healthcare also makes sure that most of the waste products are recycled. The company understands its responsibility towards the environment and keeps the surrounding green by planting trees.
Erection in men is a complex process involving emotions, blood vessels, hormones, and nerves. Failure or decreased activity of any of these may lead to ED.
During early days of discovery of Sildenafil molecule lots of research was done regarding efficacy and safety in ED for doses within the range of 100 mg. Many patients suffering from ED did not respond to this dosage. There were several reasons for it, advancing age to severe organic diseases (diabetes, hypertension, spinal cord injury, prostatectomy). Hence, the need to carry out clinical trials for Sildenafil at doses higher than 100 mg became evident. To evaluate the efficacy and safety of high-dose Sildenafil, McMahon CG carried out the clinical study “High-dose Sildenafil Citrate as a Salvage Therapy for Severe Erectile Dysfunction”. In the study, those patients, who had earlier failed to respond to 100 mg Sildenafil, were given 150 mg or 200 mg of Sildenafil. The etiology of ED in participants of the clinical trial was psychogenic, arteriogenic, cavernosal veno-occlusive dysfunction (CVOD), MVED and post radical prostatectomy. Most of the patients enrolled in the study have been suffering from ED for quite a long time. The duration of ED was 16.6 months (range of 4 – 32). Most of the patients had comorbidities like diabetes mellitus, hypertension, dyslipidemia. After 4 weeks of treatment, most of the patients reported improvement in erectile function, though, high doses also lead to higher incidence of adverse effects and treatment discontinuation rate. Most common adverse effects reported were facial flushing, headache, dyspepsia, nasal congestion, visual disturbances, and dizziness.
Selective serotonin reuptake inhibitors are commonly used to treat depression often leading to the ejaculatory delay. Sildenafil has been found effective and more or less safe treatment at doses up to 200 mg. In a study by Seidman SN “High-dose Sildenafil Citrate for Selective Serotonin Reuptake Inhibitor-Associated Ejaculatory Delay: Open Clinical Trial” patients were treated with Sildenafil for the ejaculatory delay caused due to the antidepressant drug therapy to patients suffering from depression. Patients involved in the clinical trial were instructed to use 25 mg of Sildenafil before the sexual activity. If not effective, then progressively increase the dose up to 200 mg. At the dose of 150 mg or 200 mg, most patients reported significant clinical improvement in ejaculatory latency.
Most of the clinical studies done on the usage of Sildenafil above 100 mg have shown that the patients who failed to respond to lower doses may report improved erectile function at higher doses, but there were also reports of higher incidences of adverse effects.
There was one incidence reported in Indian Journal of Psychiatry by Sathyanarayana Rao TS and titled “Prolonged, Longstanding, Ultra-High-Dose Abuse of Sildenafil”. In the reported case, a 40-year-old man has been taking Sildenafil for more than 10 years. During the last 2 years, he has been taking 1300 mg (far exceeding the maximum dose of 200 mg) per occasion at the frequency of 2-3 times a week, and the only adverse effect that patient reported was a transient blurring of vision . This report demonstrates abuse potential of Sildenafil and low toxicity in some individuals even if taken for a long time.
In males, Nitric Oxide (NO) is released in reaction to sexual arousal. NO relaxes penile smooth muscles, which increases the blood flow to penile tissues and results in an erection. Sildenafil enhances and prolongs the effect of NO on penile smooth muscle, thus making an improved erectile function and sexual satisfaction possible.
Sildenafil is classified as Phosphodiesterase Type 5 inhibitor. By inhibiting Phosphodiesterase Type 5 Sildenafil prolongs the action of NO on penile smooth muscles.
Sildenafil is used for the treatment of primary or secondary erectile dysfunction of various etiologies, It has also been recommended as the treatment of pulmonary hypertension.
Fildena Extra Power contains 150 mg of Sildenafil. This dose form is especially effective in the treatment of moderate to severe erectile dysfunction, whether psychogenic or due to organic diseases.
Fildena Extra Power contains 150 mg which is considered as a high dose form. Therapy for ED with this formulation is recommended only after doses up to 100 mg daily have failed to improve the erectile function.
Fildena Extra Power should be taken 1 hour before planned sexual activity. In the case of no adverse effects or tolerable adverse effects (most side effects with Sildenafil are transient in nature), one can continue the therapy for the long term.
Side effects like face flushing, headache, nasal congestion, loss of appetite, short-term blurring of vision are expected to be experienced, especially if a patient is consuming more than a 100 mg dose.
As per drugs.com, contraindications for sildenafil are concomitant therapy with Nitrates, hypersensitivity reactions and using Guanylate cyclase (GC) stimulators.
Sildenafil lacks sufficient clinical data supporting use in patients, who have suffered a myocardial infarction, heart failure, severe arrhythmias in last 6 months and people having resting hypotension, unstable angina.
Great caution should be taken when using Sildenafil with antihypertensive therapy or alpha-blockers, as Sildenafil may potentiate their blood pressure lowering effect and may lead to an undesired hypotension.
High precaution should be taken when using with Ritonavir and other CYP3A4 inhibitors (like Ketoconazole, Itraconazole) as these products may increase the plasma level of Sildenafil. Usually, if a person is taking any of these drugs, the maximum recommended dose is 25 mg once in 48 hours.
From customers comments, one can say that they have a very positive opinion about Fildena 150 mg. Most customers seem to have bought it because it is an affordable generic variation of Sildenafil, or were recommended due to a severe impotence. The customer also liked that the effect of tablet lasts longer which is explained by higher dose form as compared to standard Sildenafil tabs. Many customers have made the repeat order of the product.
One of the customers, Gary, appreciated the quality and value of the product and said, “Cheap it is here! Delivery was really good. Medicine is as good as branded ED blue pill.”
Fildena Extra Power is priced at 39.99 US dollars for the strip of 10 tablets, each tablet containing 150 mg of Sildenafil citrate; it’s a generic form of Viagra.
The product can be shipped to the USA, Australia, and Canada, the delivery price of 10$ is added if the product is supplied by non-trackable airmail service and 30$ if supplied by trackable courier service.
Clinical effectiveness of Sildenafil citrate in treating erectile dysfunction has been established without any doubt by numerous clinical trials. ED is often found along with other chronic diseases and can be severe, especially when associated with hemodynamic disorders, diabetes or metabolic syndrome. When ED is moderate to severe, not all patients get satisfactory results from 100 mg of Sildenafil. In such cases, higher doses of Sildenafil are needed.
Fildena Extra Power, having 150 mg Sildenafil as an active ingredient, comes in red colored film-coated tablets. It is effective and safe for most people suffering from moderate to severe ED. Fildena Extra Power is manufactured by the company having US FDA approved plants, ensuring that quality and safety profile of the product are comparable to the innovator. Fildena Extra Power is sold by several websites. Most of the people, who have used the product, have a positive opinion and ordered the product more than once. As the product comes in a high dosage, it should not be taken without the proper advice by a specialist or a general physician. Considering all of these above, I can rate Fildena Extra Power 4 out of 5.