Zudena

Zudena is an oral drug that contains udenafil as an active compound.

Udenafil is a new addition to the PDE5 inhibitor group of drugs that are used to treat erectile dysfunction in men of any organic cause.

The following article focuses on providing important information that you need to know, like the mechanism of action, dose, duration, side effects, contraindications, potential drug interactions, and other alternatives.

What Is Zudena?

Zudena is a brand name for udenafil that is manufactured by Sunrise Remedies Pvt. Ltd. in India and exported to other countries.

The active ingredient in Zudena is udenafil, a drug classified as a PDE5 inhibitor. It is used to treat erectile dysfunction and acts by inhibiting the enzyme PDE5 in the corpus cavernosum of the penis. This causes relaxation of the smooth muscles of the blood vessels and the spongy tissue of the penis leading to increased blood flow and erection.

The most commonly prescribed drug in this category for ED is sildenafil. Udenafil is similar to sildenafil in terms of both molecular structure and PDE5 receptor selectivity. Udenafil i is unique to other PDE5 inhibitors because it has a longer duration of action, making it suitable for once-daily dosing.

What Is the Dose of Zudena?

Zudena is available as an oral tablet in doses of 100 mg and 200 mg.

Zudena is a long-acting PDE5 inhibitor and has a duration of action of 12 hours, so it can be taken once daily [1, 2]. This helps men achieve a spontaneous erection at any time of the day, unlike on-demand medications, where there’s pressure to indulge in sexual activities within a certain timeframe [3].

Zudena must always be started with the lowest dose; it can then be adjusted according to response and tolerability.

If you take the drug on-demand basis, do not repeat the dose within 24 hours.

Always take the drug according to the doctor’s prescription.

How Long Does It Take for Zudena to Kick In?

Zudena takes 30 to 60 minutes to kick in.

Sexual stimulation is required for the drug to cause an erection.

If the drug is taken on-demand, it is recommended to take it an hour before indulging in sexual intercourse.

How Long Does Zudena Last?

Zudena lasts for about 10 to 13 hours.

How Much Does Zudena Cost?

Zudena costs $6.18 to $7.10 per pill.

It is available as a strip of 4 tablets.

History of Zudena

Zudena is a brand name for the drug udenafil. It is manufactured in India by Sunrise Remedies Pvt. Ltd.

Udenafil was developed in 2005 in Korea by Dong-A Pharmaceuticals under the trade name Zydena. It is approved for treating ED in Korea and 14 other countries (Brazil, Algeria, Belarus, Turkey, Ukraine, Jordan, Azerbaijan, Uzbekistan, Russia, Kyrgyzstan, Mongolia, Philippines, Malaysia, and India).

It has not yet been approved by the FDA in the US.

Zudena treats ED from any cause. It is currently under phase II/III clinical trial for its use in pulmonary arterial hypertension. As of March 2021, it has also been accepted to be reviewed by the FDA for its use to improve the physiology of patients with single ventricle heart disease who have had Fontan operation [4].

Who Should Take Zudena?

Zudena is to be taken by men aged 18 years and above suffering from erectile dysfunction.

Is Zudena Safe?

Yes, Zudena is safe. There are many clinical trials conducted in a diverse group of men with ED to prove the efficacy and safety of udenafil [5, 6, 7].

Some common side effects include:

Dizziness
Dyspepsia
Flushing
Headache
Hearing loss
Nasal congestion
Nasal hemorrhage
Palpitation
Prolonged erection
Rash
Redness in eye
Shortness of breath
Spontaneous penile erection
Visual disturbance

Zudena does not cause muscle pain or back pain.

The above-mentioned side effects are usually mild to moderate and self-limiting.

Potential Drug Interactions With Zudena

Be aware that Zudena interacts with certain types of medications. Always tell your doctor about any drugs you’re using to avoid potentially dangerous adverse reactions.

Nitrates

Nitrates are a group of vasodilators and arterial dilators used for angina. Using these with Zudena or any other PDE5 inhibitor is contraindicated as this combination can cause a life-threatening drop in blood pressure.

Antihypertensives

Zudena produces no significant hemodynamic changes with most hypertensives [8]. However, it can interact with alpha-blockers, so avoid this combination.

Guanylyl Cyclase (GC) Stimulators

Do not use PDE5 inhibitors with GC stimulators, as they can interact and cause a rapid drop in blood pressure. However, there are no individual studies about the interaction between udenafil and GC stimulators.

CYP3A4 Inhibitors

Zudena undergoes metabolism in the liver mainly via cytochrome P450 (CYP3A4). Using CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, erythromycin, and grapefruit) with udenafil increases the half-life of the latter.

CYP3A4 Inducers

These medications induce the liver CYP3A4 enzyme, which is responsible for the metabolism of Zudena. Their use together leads to faster metabolism of Zudena and decreased drug effect.

Some common CYP3A4 inducers include rifampin, carbamazepine, phenytoin, and phenobarbitone.

Alcohol

The use of alcohol with PDE5 inhibitors is not advised as it can increase the severity of adverse effects like chest discomfort and dizziness [9].

Food

Taking Zudena with food affects only the rate of absorption of Zudena, not the bioavailability [10].

Antacids

Antacids should be taken separately if taken together with Zudena as it can slow the absorption of the latter.

Who Should Avoid Using Udenafil?

Always consult your physician before taking Zudena to avoid any potential risks.

Here are some conditions when you should avoid Zudena:

A history of NAION or “crowded” optic disc
A history of priapism
Known hypersensitivity to any PDE5 inhibitors
Retinitis pigmentosa
Severe heart disease
Severe liver disease

How Does Zudena Work?

Zudena contains udenafil as an active ingredient.

Udenafil is a phosphodiesterase5 (PDE5) inhibitor drug. It inhibits the enzyme phosphodiesterase type 5 in the smooth muscles of the corpus cavernosum, which is responsible for the degradation of cGMP. cGMP plays an important role in increasing the blood flow to the penis, facilitating an erection.

Zudena has no direct effect on the corpus cavernosum but potently enhances the relaxant effect of NO on this tissue, which is released only after sexual stimulation. Zudena cannot work without sexual stimulation.

Sexual stimulation causes nitric oxide (NO) production by the endothelial cells and neuronal endings of the penis. NO then travels to the smooth muscle cells and binds to guanylate cyclase receptors, leading to the activation of guanylate cyclase (GC). The GC then produces cGMP from GTP.

The cGMP formed activates cGMP-dependent protein kinase, which, in turn, activates certain proteins resulting in decreased intracellular calcium. Major effects are vascular and smooth muscle relaxation, which increases blood flow to the spongy corpus cavernosum and ultimately causing an erection. This erection is maintained until sexual stimulation is withdrawn.

It’s best to take the drug 1 hour before sexual intercourse.

Medical Research Involving Udenafil

Zudena is a generic version of udenafil. There isn’t any research available done specifically with Zudena. The original developers of udenafil have performed much research with a diverse group of men with ED to prove its efficacy and safety.

Alternatives To Zudena

There are quite a few options for anyone dealing with ED. Here are the most common pharmaceutical and natural alternatives to Zudena.

Pharmaceutical Alternatives

There are many ED medications, some using the same active ingredients, others with separate ingredients that share the same mechanism of action.

Zudena is a generic medication. Many other companies manufacture similar drugs — some are cheaper, and some are expensive, but all contain the same compound and dose.

Here is a list of similar medications:

Avanafil (Avaforce, Stendra, Avana)
Mirodenafil (Mvix)
Sildenafil (Viagra, Fildena, P-Force, Vygex)
Tadalafil (Cialis, Tadagra, Tadovas, Tadact,Tadacip, Tadalip)

Natural Alternatives to Udenafil

It is always best to make lifestyle changes to reduce stress levels that might be causing ED. This includes diet modifications, meditation, supplements, and exercise to keep the body and mind healthy.

Some herbs and nutrients can also help facilitate erection. These herbal compounds are effective but also have side effects.

Ginseng (Panax ginseng)

Various studies have been conducted to show the benefit of Korean red ginseng for ED [11, 12]. It induces the release of NO and relaxes the smooth muscles of the corpus cavernosum.

L-arginine

L- arginine is an essential amino acid that is a substrate for the synthesis of nitric oxide by the enzyme NO synthase. It can be used as a supplement to facilitate NO production. NO is released during sexual stimulation and plays an important role in penile erection [1 3].

Horny Goat Weed (Epimedium spp.)

The main compound in horny goat weed is called icariin, which acts similarly to the PDE5 inhibitor drugs, increases nitric oxide synthesis, and shows androgen mimetic activity.

Muira Puama (Ptychopetalum olacoides)

It is an herb that is used for libido and penile erections. It is rich in sterols that activate the body’s receptors for testosterone to increase libido and enhance sexual performance. Also, the presence of volatile oils like camphor helps to restore sex drive.

Catuaba (Erythroxylum catuaba)

Catuaba extract is a central nervous system stimulant. It’s often used as a remedy for sexual weakness and low libido.

Yohimbe (Pausinystalia johimbe)

Yohimbe blocks alpha-2 activity allowing vasodilation. It acts as a monoamine oxidase inhibitor, increasing serotonin in the brain, and acts as an aphrodisiac. However, it can cause nervousness, palpitations, headache, nausea, and mild hypertension, among other things.

Tribulus (Tribulus terrestris)

This increases testosterone and NO synthesis, improving the symptoms of ED.

Where to Buy Zudena?

Zudena is available with a doctor’s prescription. You can buy Zudena from any authorized pharmacy or online.

Most patients prefer to order their medications online, as they can compare prices and have easy access to information and reference sources. It is a discrete method of having your medications delivered to your doorstep without ever leaving the comfort of your own home.

References

Moon, K. H., Ko, Y. H., Kim, S. W., Moon, D. G., Kim, J. J., Park, N. C., … & Park, K. (2015). Efficacy of Once‐Daily Administration of Udenafil for 24 Weeks on Erectile Dysfunction: Results from a Randomized Multicenter Placebo‐Controlled Clinical Trial. The journal of sexual medicine, 12(5), 1194-1201.
Zhao, C., Kim, S. W., Yang, D. Y., Kim, J. J., Park, N. C., Lee, S. W., … & Park, J. K. (2011). Efficacy and safety of once-daily dosing of udenafil in the treatment of erectile dysfunction: results of a multicenter, randomized, double-blind, placebo-controlled trial. European urology, 60(2), 380-387.
Kang, S. G., & Kim, J. J. (2013). Udenafil: efficacy and tolerability in the management of erectile dysfunction. Therapeutic advances in urology, 5(2), 101-110.
Goldberg, D. J., Zak, V., Goldstein, B. H., Schumacher, K. R., Rhodes, J., Penny, D. J., … & Pediatric Heart Network Investigators. (2020). Results of the FUEL trial. Circulation, 141(8), 641-651.
Ortaç, M., Çayan, S., Çalışkan, M. K., Yaman, M. Ö., Okutucu, T. M., Semerci, M. B., … & Kadıoğlu, A. (2013). Efficacy and tolerability of udenafil in Turkish men with erectile dysfunction of psychogenic and organic aetiology: a randomized, double‐blind, placebo‐controlled study. Andrology, 1(4), 549-555.
Zhao, C., Kim, S. W., Yang, D. Y., Kim, J. J., Park, N. C., Lee, S. W., … & Park, J. K. (2011). Efficacy and safety of once-daily dosing of udenafil in the treatment of erectile dysfunction: results of a multicenter, randomized, double-blind, placebo-controlled trial. European urology, 60(2), 380-387.
Moon, K. H., Ko, Y. H., Kim, S. W., Moon, D. G., Kim, J. J., Park, N. C., … & Park, K. (2015). Efficacy of Once‐Daily Administration of Udenafil for 24 Weeks on Erectile Dysfunction: Results from a Randomized Multicenter Placebo‐Controlled Clinical Trial. The journal of sexual medicine, 12(5), 1194-1201.
Park, S. Y., Choi, G. S., Park, J. S., Kim, H. J., Park, J. A., & Choi, J. I. (2015). Efficacy and safety of udenafil for the treatment of erectile dysfunction after total mesorectal excision of rectal cancer: a randomized, double-blind, placebo-controlled trial. Surgery, 157(1), 64-71.
Kim, J. N., Oh, J. J., Park, D. S., Hong, Y. K., & Yu, Y. D. (2019). Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle-to Old-Aged Men: A Comparative Study of Adverse Events. Sexual medicine, 7(4), 425-432.
Kim, T. E., Kim, B. H., Kim, J. R., Lim, K. S., Hong, J. H., Kim, K. P., … & Yu, K. S. (2009). Effect of food on the pharmacokinetics of the oral phosphodiesterase 5 inhibitor udenafil for the treatment of erectile dysfunction. British journal of clinical pharmacology, 68(1), 43-46.
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.
Hong, B., Ji, Y. H., Hong, J. H., Nam, K. Y., & Ahn, T. Y. (2002). A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. The Journal of urology, 168(5), 2070-2073.