Viraha

Viraha is the brand name of the generic drug sildenafil citrate. Its use is in the treatment of erectile dysfunction.

Before you start this medication, there are a few things that you must know, including what this drug is, how it works, possible side effects, and natural alternatives.

What is Viraha?

Viraha is a medication containing sildenafil citrate, a drug used for erectile dysfunction (ED). It contains the same ingredient as another popular ED drug, Viagra.

ED is a condition that makes men unable to get and maintain an erection long enough for sexual intercourse. It is a topic of much embarrassment for some men who are often hesitant to seek treatment. It can happen due to injury, disease, psychological conditions, older age, etc.

Viraha, a phosphodiesterase 5 (PDE5) inhibitor, can increase blood flow into the penis, enabling it to get erect. This makes it an efficient treatment for erectile dysfunction.

Viraha is a product of Micro Labs, a company specializing in pharmaceuticals and based in India.

What’s the Dose of Viraha?

Viraha comes in a dose of 100 per pill and comes in 10 tablets per pack. It is a prescription-only drug in most countries, so you need to be checked by a certified doctor to confirm your diagnosis, and they may prescribe Viraha to you.

The maximum dosage is one pill a day; however, your doctor may adjust your dosage according to how your body reacts. If you overdose on Viraha intentionally or accidentally, you may experience lightheadedness, fainting, and painful and prolonged erections. In this case, immediately contact your doctor and seek medical attention.

How Long Does it Take Viraha To Kick In?

It takes about 30 minutes to 1 hour for Viraha to act. However, the onset time may differ according to the user. Proper sexual stimulation and a relaxed and calm mind can help it to work sooner.

How Long Does Viraha Last?

Viraha lasts for about 3 to 4 hours. It is enough time for completing sexual intercourse. Viraha’s half-life is about 3 to 5 hours.

How Much Does Viraha Cost?

Viraha costs about $0.51 per 100 mg pill. This is less expensive compared to other ED medications.

How Does Viraha Work?

The sildenafil citrate present in Viraha is a phosphodiesterase 5 (PDE5) inhibitor. PDE5 is present in the corpora cavernosum, the vascular smooth muscles, the visceral smooth muscles, and platelets.

During sexual excitement, nerve signals are sent into the pelvis following mental and physical stimulation. It causes a release of nitric oxide (NO) from the nerve terminals and endothelial cells and, in turn, cyclic guanosine monophosphate (cGMP).

The release of cGMP makes muscles relax and encourages blood vessels in the penis to dilate, causing blood to flow fast into those blood vessels. This rapid flow of blood into the penis causes it to enlarge, causing an erection. The tunica albuginea, the membrane around the corpora cavernosum, sustains that erection by trapping the blood in it. Only when the muscles of the penis contract will the erection go down.

PDE5 can prevent the blood vessels in the penis and corpora cavernosum from relaxing. Sometimes the blood vessels themselves don’t function properly, some having narrow lumens while others may have obstructions. This usually happens due to old age or some health conditions.

Viraha can stop the effects of PDE5 in the penis and improve blood flow into it, causing an erection. It also helps to maintain it enough for you to have sex.

However, this medication only works if there is sexual stimulation. It cannot cause an erection by itself.

Viraha is metabolized in the liver by cytochrome P450 enzymes. Any medications that react with these enzymes can cause an increase or decrease of this drug in the body.

History of Viraha

Sildenafil came into production in 1989 as a potential heart treatment. The discovery of its ability to cause erection in patients with ED was accidental, but it changed the whole treatment course for this disease.

Following this discovery, this drug got patented in 1996 and was made and sold by Pfizer as Viagra. It got approved by the FDA in 1998.

In 2019, Sildenafil’s patent expired, and many pharmaceutical companies from all over the world started producing it at a much lower rate. Micro Labs began producing and exporting it as Viraha.

Who Should Take Viraha?

Viraha is for men who are unable to sport an erection long enough to have sexual intercourse. It can also help with pulmonary hypertension.

However, Viraha is not an aphrodisiac and does not increase libido. It simply helps an already sexually excited penis to get erect well enough for penetration.

Is Viraha Safe?

Viraha is generally safe to take in most ED patients. However, it has side effects because it acts on the body as a whole instead of just one system.

Most of these side effects are due to taking the medication irregularly or more than the recommended amount.

Common Side Effects of Viraha

Here are some of the most common side effects of Viraha:

Abnormal vision
Back pain
Blue tinted vision
Dizziness
Headaches
Hot flushes
Muscle pain
Nasal congestion
Nausea
Rash
Sensitivity to light
Stomach upset
Tingling in arms and feet
Vision Loss

Potential Drug Interactions With Viraha

Some medications can interact with Viraha and cause abnormal side effects — inform your doctor if you are taking such medications.

If you are using any of these medications listed below, taking any other ED drug can also be dangerous since they all have a similar mechanism of action.

Some of the medications that can react with Viraha include:

Nitrates

These are used in treating angina and coronary artery disease. Viraha can react with these and lower blood pressure significantly, causing dizziness, rapid heart rate, fainting, etc. These include medications like nitroglycerin (Nitro-Dur, Nitrolingual, Nitrostat), isosorbide (such as Dilatrate, Isordil), nitroprusside (such as Nitropress), amyl nitrite, amyl nitrate, etc.

Guanylate Cyclase (GC) Stimulators

Guanylate Cyclase (GC) Stimulators are used for pulmonary arterial hypertension and to reduce heart failure-related hospitalization. Viraha can react with these and cause a rapid lowering of blood pressure. These include medications like riociguat and vericiguat.

Antihypertensive Medications

These include alpha-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers. Viraha can increase their blood pressure-lowering abilities.

CYP3A4 Inhibitors

Since Viraha is metabolized by CYP3A4 enzymes, the medicines that inhibit this enzyme can interact with Viraha and delay its metabolism. These include clarithromycin, erythromycin, diltiazem, itraconazole, ketoconazole, ritonavir, verapamil, goldenseal, and grapefruit.

Alcohol

Any kind of alcohol can interact with Viraha and worsen its side effects like headaches, flushing, etc.

Antacids

Antacids such as Alternagel, Amphojel, Alka-Seltzer, Tums, Magnesium hydroxide, Gaviscon, Gelusil, Maalox, Mylanta, Rolaids can decrease the uptake of Viraha by the body and lessen its effects.

CYP3A4 Inducers

These drugs work in the opposite direction compared to CYP3A4 inhibitors. These can lead to faster metabolism of Viraha and lessen its effects. These include phenobarbital, phenytoin, rifampicin, St. John’s Wort, and glucocorticoids.

Who Should Avoid Using Viraha

There are people with health conditions where taking Viraha can turn out to be dangerous. They are anyone with the following:

A history of priapism
Certain blood disorders (hemophilia, leukemia, sickle-cell anemia)
Hypersensitivity to Viraha or any other ED medication
NAION or “crowded” optic disc
Retinitis pigmentosa
Severe heart disease or heart valve failure
Severe kidney disease

Medical Research Around Viraha

There is plenty of research concerning the use of sildenafil, Viraha’s active ingredient, and its use in treating ED [1] and pulmonary hypertension [2].

However, there is a lack of research conducted on this drug by individual companies. This is because most companies simply follow the formula and thus, do not have much need to conduct research themselves.

Alternatives for Viraha

Several medications can treat ED. It can be pharmaceutical ones or non-pharmaceutical ones. Most of them work the same as Viraha, while others may have a different ingredient and mechanism of action.

Pharmaceutical Alternatives

Many drugs work the same as Viraha. They may have a wide cost range and differ in ingredients. However, most of them have a similar mechanism of action, so it may be good to look around and choose what is best for you.

Here are some of the pharmaceutical alternatives to Viraha:

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

Non-Pharmaceutical Alternatives

These include various herbs and nutrients that can help treat ED. Many are effective, though research is lacking. They can be a great place to start if you are hesitant to try pharmaceutical medications. If these do not work for you, you can always go back to pharmaceutical drugs.

Here are some natural herbs and nutrients that could help with ED:

Horny goat weed (Epimedium spp.) — The icariin in this herb can act as a PDE5 inhibitor and can build up stamina, increase libido, and treat ED [3].

Korean red ginseng (Panax ginseng)—These have antioxidant properties and can improve libido and stamina and lower ED symptoms [4].

Mondia whitei — This plant can improve sperm movements and raise testosterone levels, and may also relieve symptoms of ED [5].

Maca (Lepidium meyenii)— This herb can relieve stress, increase libido and treat ED [6].

Yohimbe (Pausinystalia johimbe)— This herb can increase blood flow to the penis and make erections last longer [7].

Muira puama (Ptychopetalum olacoides) — These can increase blood flow to the penis and keep an erection for longer [8].

L-Arginine — L-Arginine can help treat ED [9].

Tribulus (Tribulus Terrestris) —These can increase libido, provide energy, and relieve stress [1 0].

Where to Buy Viraha?

You need a prescription from a certified doctor to buy Viraha, as it is a prescription-only drug in most countries. Once you get it, you can buy Viraha from nearby pharmacies or online. The latter may be a better idea as it is easy and inconspicuous. Remember to take it only before you’re about to have sex or as per your doctor’s orders.

If you’re looking for an ED medication that works fast and provides instant results, Viraha may be the best one for you. Or, try a natural alternative first and save yourself a trip to the doctor.

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.
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.
Quasie, O., Martey, O. N. K., Nyarko, A. K., Gbewonyo, W. S. K., & Okine, L. K. N. (2010). Modulation of penile erection in rabbits by Mondia whitei: possible mechanism of action. African Journal of Traditional, Complementary and Alternative Medicines, 7(3).
Shin, B. C., Lee, M. S., Yang, E. J., Lim, H. S., & Ernst, E. (2010). Maca (L. meyenii) for improving sexual function: a systematic review. BMC complementary and alternative medicine, 10(1), 1-6.
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.
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.
Ferrini, M. G., Garcia, E., Abraham, A., Artaza, J. N., Nguyen, S., & Rajfer, J. (2018). Effect of ginger, Paullinia cupana, Muira puama, and l-citrulline, singly or in combination, on modulation of the inducible nitric oxide-NO-cGMP pathway in rats’ penile smooth muscle cells. nitric oxide, 76, 81-86.
Moody, J. A., Vernet, D., Laidlaw, S., Rajfer, J., & Gonzalez-Cadavid, N. F. (1997). Effects of long-term oral administration of L-arginine on the rat erectile response. The journal of urology, 158(3), 942-947.