Immense 50 | 1 Strip

✔️ Side Effects of Immense 50

Common: headache, flushing, dyspepsia, nasal congestion, dizziness, visual disturbances.
Serious (rare):

Cardiovascular: myocardial infarction, arrhythmias, stroke, hypotension.

Prolonged erections (>4 hours), priapism.

Visual/hearing disturbances, sudden vision loss.

Severe hypotension with concomitant alpha-blockers or antihypertensives.

Caution in patients with preexisting cardiovascular disease.

✔️ Dosage & Administration | Immense 50

Erectile Dysfunction:

• Typical starting dose: 50 mg, 0.5–4 hours before sexual activity.
• Dose adjustment: 25–100 mg based on efficacy and tolerability.
• Maximum: Once daily.

Special considerations:

• Reduced starting dose (25 mg) in patients >65, with hepatic/renal impairment, or on strong CYP3A4 inhibitors.
• Contraindicated with nitrates due to the risk of severe hypotension.
• Caution when combined with alpha-blockers; ensure hemodynamic stability and start at the lowest dose.

Pulmonary Arterial Hypertension:

• 20 mg three times daily, 4–6 hours apart, with or without food.

Use only as directed by a registered physician.

✔️ Interaction

CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) increase Immense plasma levels significantly.

CYP3A4 inducers (rifampin, bosentan) may reduce plasma levels.

No significant effect with CYP2C9, CYP2D6 inhibitors, antacids, ACE inhibitors, calcium channel blockers, or thiazide diuretics.

✔️ Contraindications

Hypersensitivity to Sildenafil.

Concomitant use with organic nitrates (regular or intermittent).

✔️ Pregnancy & Lactation

Category B; not indicated for women.

Animal studies show no teratogenicity.

✔️ Precautions & Warnings

Evaluate underlying causes of ED before prescribing.

• Use caution in:
• Anatomical penile deformities (Peyronie’s disease, cavernosal fibrosis)
• Conditions predisposing to priapism (sickle cell anemia, leukemia, multiple myeloma)
• Patients with cardiovascular instability, recent MI/stroke, uncontrolled hypertension or hypotension
• Seek immediate medical attention for erections >4 hours.
• Dose adjustment required with ritonavir due to high systemic exposure.

✔️ Storage:

Store in a dry place, protected from light and heat.

Keep out of reach of children.