Nizagara

Nizagara is the name of the medication containing the generic drug sildenafil citrate. It is used in treating erectile dysfunction in men.

There are a few things you need to know before you use Nizagara, including how to use it, possible side effects, its safety profile, and natural alternatives.

What is Nizagara?

Nizagara is a drug containing the generic form of the drug sildenafil citrate.

It is a product of Unisule Pharma Pvt. Ltd, which now goes by another name, Combitic Global Caplet. It is a large pharmaceutical company based in New Delhi, India.

Erectile dysfunction (ED) is often a topic men are hesitant to talk about and reluctant to seek medical treatment for. But with medical advancements — or ancient wisdom — some medications can help improve ED and bring back the joy in life.

Nizagara falls into the category of PDE5 inhibitors and works by stopping the action of the PDE5 enzyme, allowing enough blood to flow into the penis to get an erection.

What’s the Dosage of Nizagara?

Nizagara comes in dosage of 100 mg. It is available as a blue oval-shaped pill and comes as ten pills in one pack.

How is Nizagara Metabolized?

Nizagara is metabolized in the liver by an enzyme called cytochrome P450 (CYP450). In addition, the hepatic microsomal enzymes CYP450 3A4 (major route) and CYP2C9 (minor route) metabolize it. This means any medication that reacts with these enzymes can affect the metabolization rate of Nizagara in the body.

How Does Nizagara Work?

Nizagara works by increasing the blood flow to a flaccid penis, causing it to get erect. It does this by inhibiting an enzyme called phosphodiesterase type 5 (PDE5), commonly found in corpora cavernosa, vascular smooth muscles, visceral smooth muscles, and platelets.

Generally, in sexual intercourse, after an adequate amount of foreplay, nitric oxide (NO) is released from nerve terminals and endothelial cells. This action releases cyclic guanosine monophosphate (cGMP) too.

The cGMP’s release causes the muscles of corpora cavernosa in the penis to relax and the blood vessels to get dilated. It leads to a rapid entry of blood into those vessels, causing the penis to engorge, grow larger, and get erect.

PDE5 can prevent blood vessels in the penis from relaxing. In most ED patients, the blood vessels in the penis are also affected and cannot relax properly or have some kind of obstruction in them.

Nizagara inhibits PDE5, allowing more blood to flow into the penis, and causes the penis to get erect long enough to have sex.

However, Nizagara needs proper sexual stimulation to do its work. With a relaxed mind and good sexual stimulation, Nizagara will be able to work much better.

The History of Nizagara

Sildenafil, the wonder drug, was accidentally discovered to be useful in causing erections. It was first studied as a blood pressure-lowering medication in heart patients back in 1989. From then on, it started its journey as an ED medication.

After this discovery, this medication got patented in 1996. It was then manufactured and sold by Pfizer as Viagra. Finally, it got approved for use by the FDA in 1998.

Sildenafil’s patent ended in 2019. Following the end of its patent, many pharmaceutical companies worldwide started using the same formulations to make their version of sildenafil. Unisule Pharma Pvt. Ltd started producing this medication under the brand name Nizagara.

Medical Research Involving Nizagara

Nizagara’s base ingredient, sildenafil, has had some research on its use in treating ED [1]. In addition, it has also started to be used to treat pulmonary hypertension [2]. However, there is a limited amount of research that the individual companies do. Once a drug patent expires, other companies can simply follow the same formula as the first developed medication. Hence, there is not much need for companies to conduct research themselves.

Who Should Take Nizagara?

Nizagara is for men who cannot get erections. Commonly called erectile dysfunction, this condition affects many men, especially as they grow older and have some health issues. It can also happen due to psychological factors such as stress, anxiety, depression, PTSD, etc.

Nizagara is not recommended for use in children and women, especially pregnant and breastfeeding mothers. There are no studies or clinical evidence of it being useful for use in women.

How Safe is Nizagara?

Nizagara is safe for use by most men. It is effective even in ED caused by various diseases. However, like most other drugs, it can affect the entirety of the body and not just one system. So strict regulation of taking this drug is needed. If you already suffer from heart conditions and high blood pressure, it is best to let your doctor know beforehand.

If you overdose on Nizagara, you may suffer from symptoms like severe headaches, dizziness, prolonged and painful erections, etc. You must contact your doctor immediately or get to the nearest ER as soon as this happens.

Nizagara also has a list of side effects. Most of them occur due to overdosing on this medication. They can range from simple headaches to some more dangerous ones.

Side Effects of Nizagara

Here are some common side effects reported by the men who use Nizagara.

Abdominal pain
Abnormal vision
Back pain
Bluish tinted vision
Headaches
Hot flushes
Loss of vision
Muscle pain
Nasal blockage
Nausea
Prolonged and painful erection
Rash
Sensitivity to light
Tingling sensation in the limbs and extremities

Medications That Could React With Nizagara

Nizagara should not be used in certain conditions. These include patients who have some illnesses, or health conditions, or those who are on some particular medications.

Some medications could react with Nizagara and cause abnormal reactions. If you are on any of these medications, inform your doctor first. As these medications can interact with Nizagara, chances are they’ll do the same for every other ED medication as all of them have a similar mechanism of action.

Here are some of the medications that could react with Nizagara and cause reactions.

Nitrates

Nitrates are used in treating angina and coronary artery disease. Nizagara could heighten their blood vessel relaxing and blood pressure-lowering ability. However, they can also cause the user to faint, have a rapid heart rate, etc.

Guanylate Cyclase (GC) Stimulators

These medications treat pulmonary artery hypertension and heart failure. These consist of riociguat and vericiguat. Nizagara can interact with these and cause a rapid decline in blood pressure.

Medications That Lower Blood Pressure

These contain alpha-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers. Nizagara can react with them and cause a severe drop in blood pressure.

Antacids

These include medications such as Alternagel, Amphojel, Alka-Seltzer, Tums, Magnesium hydroxide, Gaviscon, Gelusil, Maalox, Mylanta, and Rolaids. These can decrease the uptake of Nizagara in the body.

CYP3A4 Inhibitors

These medications can inhibit the action of CYP3A4 enzymes and slow down the removal of Nizagara from the body, increasing the risk of adverse effects. These include drugs such as ritonavir, ketoconazole, itraconazole, erythromycin, and grapefruit juice.

CYP3A4 Inducers

Opposite to CYP3A4 inhibitors, some medications can lead to hyperactivity of the CYP3A4 enzymes making Nizagara be metabolized faster than it should be. This causes a shorter period for the drug to work and produces less pronounced effects. These include rifampin, carbamazepine, phenytoin, and phenobarbital.

Contraindications With Nizagara

Nizagra is contraindicated in some people with:

A history of priapism
Allergy to Nizagara
Certain blood disorders (hemophilia, leukemia, sickle-cell anemia)
Diagnosed with retinitis pigmentosa
Severe heart disease or heart failure
Severe kidney disease or renal failure

Nizagara’s Alternatives

There are plenty of pharmaceutical and non-pharmaceutical ways to treat ED. Most of them work the same as Nizagara and may have similar ingredients. Below, we will talk about some of these alternative treatment techniques.

Pharmaceutical Alternatives

Many drugs can help treat ED. Most of these have the same mechanism of action as Nizagara.

Here are some of the pharmaceutical alternatives to Nizagara

Avanafil (Avaforce, Stendra, Avana)
Mirodenafil (Mvix)
Sildenafil (Viagra, Cenforce, Kamagra, Fildena, P-Force, Vygex, Revatio, etc.)
Tadalafil (Cialis, Adcirca, Vidalista, Tadacip, Forzest, & more)
Udenafil (Zydena, Zudena, Udzire)
Vardenafil (Levitra, Staxyn, Vilitra, Zhewitra, Savitra, & more)

Non-Pharmaceutical Alternatives

There are quite a few non-pharmaceutical techniques and herbs that can help treat ED [7]. These are good alternatives if you are hesitant to start pharmaceutical medications. But most of these have no research to back their role in ED treatment. However, if they do not work, you can always try out the pharmaceutical versions.

Natural Alternatives

Yohimbe (Pausinystalia johimbe) — An herb native to Africa, Yohimbe is said to raise the blood flow to the penis and stabilize it long enough for an erection to occur [3].

Horny goat weed (Epimedium spp.) — This herb has long been used in Chinese medicine to treat ED, fatigue, and decreased libido [4].

Ginseng (Panax ginseng) — This herb with antioxidant properties can improve libido, stamina, and ED [5].

Catuaba (Trichilia catigua or Erythroxylum catuaba) — These can decrease the effects of ED and increase libido [6].

Healthy Habits & Lifestyle Changes

Exercise — A proper exercise routine can keep the body healthy and help with ED symptoms [8].

Sleep — A good night’s sleep goes a long way in keeping a person healthy and decreasing the possibility of developing ED [9].

Psychological Counseling — Mental stress and psychological problems can also cause ED. It is best to get professional psychological counseling if your ED does not respond to medications [1 0].

Diet —A well-proportioned and nutrient-rich diet can help improve ED symptoms in men [1 1].

Quit smoking — Smokers have been found to have a higher incidence of ED, so you might want to quit smoking if you have it [1 2].

Where to Buy Nizagara

Nizagara is a prescription-only medication in most countries. Once you get your hands on the prescription from a certified doctor, you can get Nizagara from the local pharmacy or online. The latter is a better idea because it is discreet.

However, there are many natural ways you can try to resolve ED before resorting to prescription medications. It’s worth trying some of these other options and fixing what you can first. If you’re on other medications, talk to your doctor before adding any new supplements since some can cause interactions.

References

Hatzimouratidis, K. (2006). Sildenafil in the treatment of erectile dysfunction: an overview of the clinical evidence. Clinical interventions in aging, 1(4), 403.
Barnett, C. F., & Machado, R. F. (2006). Sildenafil in the treatment of pulmonary hypertension. Vascular health and risk management, 2(4), 411.
Carey, M. P., & Johnson, B. T. (1996). Effectiveness of yohimbine in the treatment of erectile disorder: Four meta-analytic integrations. Archives of sexual behavior, 25(4), 341-360.
Liu, W. J., Xin, Z. C., Xin, H., Yuan, Y. M., Tian, L., & Guo, Y. L. (2005). Effects of icariin on erectile function and expression of nitric oxide synthase isoforms in castrated rats. Asian journal of andrology, 7(4), 381-388.
De Andrade, E., De Mesquita, A. A., de Almeida Claro, J., De Andrade, P. M., Ortiz, V., Paranhos, M., … & Erdogrun, T. (2007). Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian journal of andrology, 9(2), 241-244.
Martins, N. O., de Brito, I. M., Araújo, S. S. O., Negri, G., de Araújo Carlini, E., & Mendes, F. R. (2018). Antioxidant, anticholinesterase and antifatigue effects of Trichilia catigua (catuaba). BMC complementary and alternative medicine, 18(1), 1-13.
Malviya, N., Jain, S., Gupta, V. B., & Vyas, S. (2011). Recent studies on aphrodisiac herbs for the management of male sexual dysfunction-a review. Acta Pol Pharm, 68(1), 3-8.
Gerbild, H., Larsen, C. M., Graugaard, C., & Josefsson, K. A. (2018). Physical activity to improve erectile function: a systematic review of intervention studies. Sexual medicine, 6(2), 75-89.
Pastuszak, A. W., Moon, Y. M., Scovell, J., Badal, J., Lamb, D. J., Link, R. E., & Lipshultz, L. I. (2017). Poor sleep quality predicts hypogonadal symptoms and sexual dysfunction in male nonstandard shift workers. Urology, 102, 121-125.
Nordin, R. B., Soni, T., Kaur, A., Loh, K. P., & Miranda, S. (2019). Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia. Singapore medical journal, 60(1), 40.
La, J., Roberts, N. H., & Yafi, F. A. (2018). Diet and men’s sexual health. Sexual medicine reviews, 6(1), 54-68.
Verze, P., Margreiter, M., Esposito, K., Montorsi, P., & Mulhall, J. (2015). The link between cigarette smoking and erectile dysfunction: a systematic review. European urology focus, 1(1), 39-46.