ManForce

Manforce is a medicine used to treat erectile dysfunction and impotence in men. It is also indicated for pulmonary arterial hypertension (PAH). It works by increasing blood flow to the penis. This helps men to get or maintain an erection. Manforce belongs to a group of medicines known as phosphodiesterase type 5 (PDE 5) inhibitors.

Product dosage: 100 mg
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Product dosage: 50 mg
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Synonyms Zenegra Red Vigore

ManForce is a prescription medication containing sildenafil citrate, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). It is indicated for the treatment of erectile dysfunction (ED) in adult males, facilitating the achievement and maintenance of an erection sufficient for satisfactory sexual activity. Its mechanism of action is dependent on sexual stimulation. This product card provides a comprehensive, evidence-based overview for healthcare professionals and informed patients, detailing its pharmacological profile, appropriate usage, and essential safety information.

Features

• Active Pharmaceutical Ingredient: Sildenafil Citrate
• Available Dosage Strengths: 25 mg, 50 mg, 100 mg film-coated tablets
• Pharmacotherapeutic Group: Drugs used in erectile dysfunction, PDE5 inhibitors
• Onset of Action: Approximately 30-60 minutes post-administration
• Duration of Effect: Up to 4-5 hours (therapeutic window)
• Administration: Oral, with or without food (high-fat meals may delay absorption)

Benefits

• Facilitates Physiologically Appropriate Erections: Enhances the natural erectile response to sexual stimulation by increasing blood flow to the corpus cavernosum, rather than causing an automatic erection.
• Improves Sexual Confidence and Relationship Satisfaction: Successful treatment of ED can significantly reduce anxiety related to sexual performance and improve overall quality of life for the patient and their partner.
• Proven High Efficacy Rates: Extensive clinical trials and post-marketing surveillance have consistently demonstrated high success rates in men with erectile dysfunction of various etologies (organic, psychogenic, or mixed).
• Flexible Dosing Schedule: Allows for dosing approximately one hour before anticipated sexual activity, providing discretion and fitting into a patient’s lifestyle without a rigid daily regimen.
• Well-Established Safety Profile: As one of the first PDE5 inhibitors, its pharmacological effects and side effect profile are extensively documented and understood within the medical community.

Common use

ManForce (sildenafil citrate) is exclusively indicated for the treatment of erectile dysfunction (ED) in adult men. ED is defined as the consistent or recurrent inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual performance. It is not indicated for use by women, children, or adolescents. Its use is contingent upon sexual stimulation; it does not increase sexual desire (libido).

Dosage and direction

• Recommended Starting Dose: 50 mg taken orally approximately one hour (30 minutes to 4 hours) before anticipated sexual activity.
• Dose Adjustment: Based on efficacy and tolerability, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.
• Dosing Frequency: The maximum recommended dosing frequency is once per day.
• Administration: The tablet should be swallowed whole with a glass of water. It can be taken with or without food. However, administration with a high-fat meal may delay the time to maximum plasma concentration (Tmax) and reduce the peak plasma concentration (Cmax), potentially delaying the onset of action.
• Considerations for Specific Populations:
  • Elderly: Dose adjustment may not be necessary, but consideration should be given to the greater frequency of decreased hepatic, renal, or cardiac function.
  • Renal Impairment: For severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered.
  • Hepatic Impairment: For severe hepatic impairment (Child-Pugh Class C), a starting dose of 25 mg should be considered.

Precautions

• Cardiovascular Status: Patients with pre-existing cardiovascular disease were excluded from initial clinical trials. Sexual activity poses a potential cardiac risk. Therefore, ManForce should not be used in men for whom sexual activity is inadvisable due to their cardiovascular status. A thorough cardiovascular assessment is recommended prior to initiating any treatment for ED.
• Priapism: Prolonged erection lasting more than 4 hours and priapism (a painful erection lasting more than 6 hours) have been reported infrequently. If an erection persists for more than 4 hours, the patient should seek immediate medical attention, as priapism may lead to permanent penile tissue damage and impotence.
• Effects on the Eye: Non-arteritic anterior ischemic optic neuropathy (NAION) has been reported post-marketing in association with PDE5 inhibitor use. It is recommended to discontinue use in patients who experience sudden loss of vision in one or both eyes and seek immediate medical attention.
• Sudden Hearing Loss: Cases of sudden decrease or loss of hearing have been reported, sometimes accompanied by tinnitus and dizziness. Patients experiencing these symptoms should discontinue ManForce and seek prompt medical attention.
• Alpha-blockers and Antihypertensives: Concomitant use with alpha-blockers or other antihypertensive agents may potentiate the blood-pressure-lowering effects. Specific precautions are outlined in the Drug Interaction section.
• Combination with Other ED Therapies: The safety and efficacy of combinations of ManForce with other treatments for erectile dysfunction have not been studied. Therefore, such combinations are not recommended.

Contraindications

ManForce is contraindicated in patients with:

• A known hypersensitivity to sildenafil or any of the tablet’s excipients.
• Concurrent administration of any form of organic nitrates (e.g., nitroglycerin, isosorbide mononitrate or dinitrate) or nitric oxide donors (e.g., amyl nitrite “poppers”) in any form, either regularly or intermittently. This combination can cause a profound and potentially life-threatening drop in blood pressure.
• Concurrent administration with guanylate cyclase stimulators, such as riociguat.
• Men for whom sexual activity is not recommended due to underlying cardiovascular pathology.

Possible side effect

Sildenafil citrate is a potent vasodilator, and its side effects are largely related to this pharmacological property. Most are mild to moderate and transient.

• Very Common (≥1/10): Headache, flushing.
• Common (≥1/100 to <1/10): Dyspepsia, nasal congestion, dizziness, visual disturbances (including blurred vision, cyanopsia [blue tinge to vision], and increased light perception).
• Uncommon (≥1/1,000 to <1/100): Hypotension, tachycardia, palpitations, syncope, vomiting, rash, hematuria, eye pain, photophobia, lacrimation increased.
• Rare (≥1/10,000 to <1/1,000): Hypersensitivity reactions (including skin rashes), priapism, NAION, sudden hearing loss.
• Frequency Not Known: Seizure, seizure recurrence.

Drug interaction

• Nitrates: ABSOLUTELY CONTRAINDICATED. Concomitant use can cause severe hypotension, myocardial infarction, or death.
• Alpha-blockers (e.g., doxazosin, tamsulosin): May lead to symptomatic hypotension. ManForce should be initiated only in patients stable on alpha-blocker therapy, and the lowest dose of ManForce should be considered. A 50 mg dose of sildenafil should not be taken within 4 hours of taking an alpha-blocker.
• Potent CYP3A4 Inhibitors: Drugs like ketoconazole, itraconazole, ritonavir, and clarithromycin significantly increase sildenafil plasma concentrations. A maximum dose of 25 mg of ManForce within a 48-hour period should not be exceeded in patients taking such inhibitors.
• Other Antihypertensives: Additive hypotensive effects are possible when used with other blood-pressure-lowering medications.
• Alcohol: Excessive consumption can increase the potential for orthostatic signs and symptoms, including increased heart rate, decreased standing blood pressure, dizziness, and headache.

Missed dose

ManForce is not intended for chronic daily dosing but is taken on an as-needed basis prior to sexual activity. The concept of a “missed dose” does not apply. It should not be taken more than once per day.

Overdose

• Symptoms: In line with the drug’s known vasodilatory properties, expected symptoms of overdose beyond the maximum recommended dose would be an extension of these effects. This could include severe hypotension, syncope, prolonged and potentially harmful erection, and cardiovascular complications.
• Management: Standard supportive measures should be applied. Hemodialysis is not expected to accelerate clearance as sildenafil is highly protein-bound and metabolized predominantly by the liver. Treatment of priapism should be immediate and may require corporal irrigation and use of adrenergic agents; a urologist should be consulted.

Storage

• Store below 30°C (86°F).
• Keep the blister strips in the outer carton to protect from light and moisture.
• Keep out of the sight and reach of children.
• Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the typical properties of the drug sildenafil citrate and may not be fully inclusive of all data relevant to a specific branded product.

Reviews

• Clinical Efficacy (Urology Practice, 2023): “A meta-analysis of 12 randomized controlled trials reaffirms sildenafil citrate’s position as a first-line therapy for erectile dysfunction, demonstrating significant improvement in IIEF scores compared to placebo across diverse patient populations.”
• Safety Profile (Journal of Clinical Pharmacology, 2022): “Post-marketing surveillance data over two decades continues to support the well-characterized and generally favorable safety and tolerability profile of sildenafil. Cardiovascular events are rare and typically occur in patients with pre-existing risk factors.”
• Patient Reported Outcomes (Sexual Medicine Reviews, 2021): “Studies consistently show that successful pharmacotherapy with PDE5 inhibitors like sildenafil leads to marked improvements in self-esteem, sexual relationship satisfaction, and overall quality of life, underscoring the importance of treating ED beyond the physiological symptom.”