Composition:
Each tablet contains:
Sildenafil (as citrate) ………................… 100 mg

Properties:
Stimu-Max is an oral therapy for erectile dysfunction. Is a selective competitive inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).
The physiological mechanism of erection of the penis involves the release of nitric oxide in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase; which results in increased cGMP levels, producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.
Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but he enhances the effect of nitric oxide by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for the degradation of cGMP in the corpus cavernosum.

When sexual stimulation causes local release of nitric oxide, inhibition of PDE5 by Sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum.
Sildenafil at recommended doses has no effect in the absence of sexual stimulation.
Stimu-Max is rapidly absorbed, with absolute bioavailability of about 40%.Its pharmacokinetics are dose-proportional over the recommended dose range.
Its eliminated predominantly by hepatic metabolism and is converted to an active metabolite with properties similar to the parent Sildenafil.
Both Sildenafil and the metabolite have terminal half life of about 4 hours.

Indications:
Impotence (Erectile dysfunction).

Contraindications:
Sildenafil is contraindicated with organic nitrates as it may potentiate their hypotensive effects.

Precautions:
Caution is required in patients with hepatic or renal impairment.

Warning:
The drug shouldn't be used in patients with pre-exiting cardiovascular diseases as there is potential for cardiac risk of sexual activity.
The drug should be dispensed only by a medical prescription and under strict medical supervision.

Dosage & route of administration & duration:
For most patients the recommended dose is 50 mg taken as needed approximately 1 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.
The maximum recommended dosing frequency is once per day.

interaction:
Concomitant administration of Sildenafil with drugs that inhibits cytochrome P450 isoenzyme CYP3A4 as Cimentidine, Erythromycin, Itraconazole, Ketoconazole and HIV protease inhibitors may reduce Sildenafil clearance which may need a reduction in its dose.

Side effects:
Stim-Max was well tolerated with recommended doses.
Dyspepsia, headache, flushing, dizziness, visual disturbances, nasal congestion or priapism are rare but occasionally reported.

Storage:
Keep out of the reach of children.
Keep medicine at temperature not exceeding 30°C.

Presentation:
Box of 4 tablets (100 mg).