PENEGRA TABLETS – Complete Patient Information Guide

---

1. Medicine Overview

PENEGRA TABLETS contain sildenafil citrate as the active pharmaceutical ingredient and belong to a class of medicines known as phosphodiesterase type 5 (PDE5) inhibitors. Healthcare providers commonly prescribe this medication to adult men experiencing erectile dysfunction, a condition where achieving or maintaining an erection sufficient for sexual activity becomes difficult.

This prescription medicine is used under medical supervision to address specific physiological challenges related to blood flow in the penile tissue. PENEGRA is not intended for use by women, children, or individuals without a confirmed diagnosis from a qualified healthcare professional.

The medication works on a physiological level and requires sexual stimulation to produce its intended effect. It does not increase sexual desire, cure erectile dysfunction permanently, or protect against sexually transmitted infections.

---

2. Mechanism of Action (How PENEGRA Works)

PENEGRA TABLETS work by targeting a specific enzyme in the body called phosphodiesterase type 5 (PDE5), which is found in the smooth muscle tissue of blood vessels, particularly in the penile region.

Step-by-step process:

• During sexual arousal, the body naturally releases nitric oxide in the penile tissue
• Nitric oxide activates an enzyme that produces cyclic guanosine monophosphate (cGMP)
• cGMP relaxes the smooth muscles lining blood vessels, allowing increased blood flow into the penis
• PDE5 enzyme breaks down cGMP, which can limit blood flow
• Sildenafil citrate in PENEGRA inhibits PDE5, allowing cGMP levels to remain elevated
• This results in improved blood vessel relaxation and enhanced blood flow to the penile tissue during sexual stimulation

It is important to understand that this medication facilitates the body’s natural response to sexual stimulation rather than creating an artificial erection. Without sexual arousal, the medicine will not produce an erection.

---

3. Therapeutic Uses

PENEGRA TABLETS are medically approved for the following condition:

Primary Indication:

Erectile Dysfunction (ED) in Adult Men – The medication may help men who have difficulty achieving or maintaining an erection firm enough for satisfactory sexual intercourse.

Medical Context:

Erectile dysfunction can result from various underlying factors including:

• Cardiovascular conditions affecting blood circulation
• Diabetes-related vascular changes
• Psychological factors including stress and anxiety
• Age-related physiological changes
• Certain neurological conditions

Important Note: This medication treats the symptoms of erectile dysfunction but does not address underlying health conditions that may be causing the problem. A comprehensive medical evaluation is essential to identify and manage contributing factors.

---

4. General Usage Guidance

How to Take PENEGRA TABLETS:

Timing:

• Typically taken approximately 30 to 60 minutes before planned sexual activity
• The medicine can be taken with or without food
• High-fat meals may delay the onset of action

Administration:

• Swallow the tablet whole with water
• Do not crush, chew, or break the tablet
• Take only the prescribed dose

Dosage Considerations:

• Your healthcare provider will determine the appropriate strength based on your medical history, age, concurrent medications, and response to treatment
• The medication should not be taken more than once within a 24-hour period
• Dosage adjustments may be necessary for patients with kidney or liver conditions

Critical Reminder: Always follow your doctor’s specific instructions regarding dosage and timing. Do not adjust your dose without medical consultation, and never share this medication with others.

---

5. Potential Benefits

When used as prescribed and under appropriate medical supervision, PENEGRA TABLETS may provide the following benefits:

Physical Benefits:

• May help improve erectile function by enhancing blood flow to penile tissue during sexual stimulation
• Can support the ability to achieve an erection sufficient for sexual intercourse
• May assist in maintaining erection firmness throughout sexual activity

Quality of Life Considerations:

• Can contribute to improved confidence in intimate situations when erectile function is restored
• May support relationship satisfaction by addressing a physical barrier to intimacy
• Can help reduce performance-related anxiety in men whose concerns stem from erectile difficulties

Response Timeline:

• Effects typically begin within 30 to 60 minutes after administration
• Duration of action may last approximately 4 to 5 hours
• Individual response times can vary based on age, metabolism, and other factors

Realistic Expectations: Results vary among individuals. Some men may experience significant improvement while others may have a more modest response. The medication requires sexual stimulation to work and does not automatically produce an erection.

---

6. Brand Comparison Table

Below is an informational comparison of sildenafil citrate-containing medications available in the market. This table is for educational purposes only and should not influence prescribing decisions.

Feature	PENEGRA	Related Sildenafil Brands
Active Ingredient	Sildenafil Citrate	Sildenafil Citrate
Available Strengths	Multiple dosage options	Multiple dosage options
Onset of Action	30-60 minutes	30-60 minutes
Duration	Approximately 4-5 hours	Approximately 4-5 hours
Administration	Oral tablet	Oral tablet/film/other forms
Prescription Status	Prescription Required	Prescription Required
Food Interaction	Can be taken with/without food (high-fat meals may delay onset)	Similar food considerations
Primary Use	Erectile Dysfunction	Erectile Dysfunction

Note: All sildenafil-containing medications work through the same mechanism. Brand selection should be based on your healthcare provider’s recommendation, considering factors such as availability, cost, and your specific medical needs. Never switch between brands without consulting your doctor.

---

7. Side Effects Information

Like all medications, PENEGRA TABLETS can cause side effects, although not everyone experiences them.

Common Side Effects (May Affect Up to 1 in 10 People):

• Headache
• Facial flushing (redness or warmth in the face, neck, or chest)
• Indigestion or upset stomach
• Nasal congestion or stuffy nose
• Dizziness or lightheadedness
• Visual disturbances (blue-tinted vision, increased light sensitivity, blurred vision)
• Back pain or muscle aches

These effects are usually mild to moderate and often resolve on their own as your body adjusts to the medication.

Less Common Side Effects:

• Nausea
• Drowsiness or fatigue
• Skin rash
• Nosebleeds
• Sleep disturbances
• Rapid heartbeat or palpitations

Serious Side Effects Requiring Immediate Medical Attention:

Seek emergency medical care if you experience:

• Priapism – An erection lasting more than 4 hours (this is a medical emergency that can cause permanent damage)
• Sudden vision loss in one or both eyes
• Sudden hearing decrease or loss, possibly accompanied by ringing in the ears or dizziness
• Chest pain or irregular heartbeat during or after sexual activity
• Severe allergic reactions – symptoms may include difficulty breathing, swelling of face/lips/tongue/throat, severe skin reactions
• Stroke-like symptoms – sudden weakness, confusion, difficulty speaking, or severe headache

Management of Side Effects:

If you experience persistent or bothersome side effects, contact your healthcare provider. Do not stop taking the medication without medical guidance. Your doctor may adjust your dosage or recommend alternative treatments.

---

8. Safety Warnings & Precautions

Who Should NOT Use PENEGRA TABLETS:

Contraindications:

• Individuals taking nitrate medications (for chest pain/angina) or recreational drugs called “poppers” containing amyl or butyl nitrite
• People with severe heart or cardiovascular conditions
• Those who have had a recent stroke or heart attack (typically within the last 6 months)
• Individuals with severe liver impairment
• People with certain rare eye conditions such as retinitis pigmentosa
• Those with known hypersensitivity to sildenafil or any component of the formulation
• Patients advised by their doctor to avoid sexual activity due to cardiovascular risk

Special Populations:

Older Adults (65+ years):

• May require lower starting doses due to reduced drug clearance
• Increased sensitivity to side effects may occur
• Close medical monitoring is recommended

Patients with Kidney or Liver Conditions:

• Dose adjustment may be necessary
• Medical supervision is essential
• Inform your doctor about any kidney or liver disease

Cardiovascular Considerations:

• Sexual activity can place strain on the heart
• Patients with heart conditions should discuss cardiac fitness for sexual activity with their doctor before using this medication
• Inform your healthcare provider about any history of heart disease, irregular heartbeat, high or low blood pressure

Alcohol Interaction:

Excessive alcohol consumption can:

• Reduce the effectiveness of PENEGRA
• Increase the risk of side effects such as dizziness and low blood pressure
• Impair sexual function independently
• Moderate to no alcohol consumption is advised when using this medication

Driving and Operating Machinery:

PENEGRA may cause dizziness, visual disturbances, or altered perception. Do not drive or operate heavy machinery if you experience these effects.

Long-Term Use Considerations:

• Regular medical follow-up is important for ongoing prescription use
• Periodic evaluation of cardiovascular health may be recommended
• Any decrease in medication effectiveness should be reported to your doctor

Women and Children:

PENEGRA is not indicated for use by women or individuals under 18 years of age. Safety and efficacy have not been established in these populations.

---

9. Drug & Substance Interactions

PENEGRA TABLETS can interact with various medications and substances, potentially causing serious health complications or reducing effectiveness.

Critical Interactions (NEVER Combine):

Nitrate Medications:

• Nitroglycerin, isosorbide mononitrate, isosorbide dinitrate
• Combining PENEGRA with nitrates can cause a dangerous drop in blood pressure
• This applies to recreational drugs called “poppers” (amyl nitrite, butyl nitrite)

Significant Interactions (Use with Caution/Medical Supervision):

Blood Pressure Medications:

• Alpha-blockers (used for prostate problems or hypertension)
• Other antihypertensive agents
• Combined use may enhance blood pressure-lowering effects

Other Medications:

• Certain antifungal medications (ketoconazole, itraconazole)
• Some antibiotics (clarithromycin, erythromycin)
• HIV protease inhibitors
• Other PDE5 inhibitors or erectile dysfunction treatments
• Medications for pulmonary hypertension

Grapefruit Products: Grapefruit juice may increase sildenafil levels in the bloodstream, potentially increasing side effects. Consumption should be discussed with your healthcare provider.

Important Disclosure:

Always inform your doctor and pharmacist about:

• All prescription medications you are taking
• Over-the-counter medicines and supplements
• Herbal products or alternative remedies
• Any recreational substances you use

Your healthcare provider needs complete information to prescribe PENEGRA safely.

---

10. Storage & Handling Advice

Proper storage and handling of PENEGRA TABLETS ensures medication effectiveness and household safety.

Storage Guidelines:

Temperature:

• Store at room temperature between 15°C to 30°C (59°F to 86°F)
• Avoid exposure to excessive heat or direct sunlight
• Do not store in bathrooms where humidity fluctuates

Packaging:

• Keep tablets in the original blister pack or container until ready to use
• Protect from moisture and light
• Ensure the container is tightly closed

Safety Measures:

• Keep out of reach of children and pets – accidental ingestion can be dangerous
• Store in a secure location if household members should not access the medication
• Do not transfer tablets to unmarked containers

Handling Precautions:

• Check expiration dates before use – do not take expired medication
• Inspect tablets for any discoloration, damage, or unusual odor
• Handle with clean, dry hands

Disposal Guidelines:

Safe Medication Disposal:

• Do not flush medications down the toilet unless specifically instructed
• Do not throw tablets in household trash where children or pets might access them
• Utilize medication take-back programs or pharmacy disposal services in your area
• If no take-back program is available, mix medication with undesirable substances (coffee grounds, dirt) in a sealed container before disposal

Environmental Consideration: Proper disposal prevents environmental contamination and protects community water systems.

---

11. Patient FAQs

Q1: How long before sexual activity should I take PENEGRA TABLETS?

Answer: PENEGRA is typically taken approximately 30 to 60 minutes before planned sexual activity. However, the medication can start working in some individuals within 30 minutes, while others may need up to an hour. High-fat meals may delay the onset of action. Your healthcare provider can give you personalized guidance based on your response to the medication. Remember that sexual stimulation is necessary for the medication to work.

---

Q2: Can I take PENEGRA every day?

Answer: PENEGRA should not be taken more than once within a 24-hour period. Whether daily use is appropriate for your situation depends on your medical condition, treatment goals, and your doctor’s assessment. Some men use the medication only when needed before sexual activity, while others may be prescribed a different regimen based on their specific circumstances. Never adjust your dosing schedule without consulting your healthcare provider.

---

Q3: Will PENEGRA work without sexual stimulation?

Answer: No. PENEGRA requires sexual arousal to be effective. The medication enhances the body’s natural response to sexual stimulation by improving blood flow, but it does not create an erection automatically or increase sexual desire. Psychological and physical arousal remain necessary components for the medication to produce its intended effect.

---

Q4: What should I do if PENEGRA doesn’t work the first time?

Answer: Several factors can influence the effectiveness of PENEGRA on initial use. If the medication doesn’t work as expected, consider the following: you may not have waited long enough for it to take effect, high-fat meals can delay onset, alcohol consumption can reduce effectiveness, or anxiety may be interfering. Many healthcare providers recommend trying the medication on 4 to 6 separate occasions before concluding it is ineffective. Contact your doctor if you continue to experience poor results, as dosage adjustment or alternative treatments may be appropriate.

---

Q5: Are there foods or drinks I should avoid while taking PENEGRA?

Answer: You can take PENEGRA with or without food. However, high-fat meals may delay how quickly the medication begins working. Grapefruit and grapefruit juice should be limited or avoided as they can increase medication levels in your bloodstream, potentially increasing side effects. Excessive alcohol consumption is not recommended as it can reduce the medication’s effectiveness and increase the risk of side effects such as dizziness and low blood pressure.

---

Q6: Can PENEGRA cause permanent side effects?

Answer: Most side effects associated with PENEGRA are temporary and resolve after the medication leaves your system. However, there are rare but serious conditions that require immediate medical attention to prevent permanent complications. Priapism (an erection lasting more than 4 hours) is a medical emergency that can cause permanent damage if not treated promptly. Sudden vision or hearing loss, though rare, can sometimes result in lasting impairment. If you experience any serious or concerning symptoms, seek medical care immediately.

---

Q7: Is it safe to buy PENEGRA online without a prescription?

Answer: No. PENEGRA is a prescription medication that should only be obtained through legitimate healthcare channels with a valid prescription from a licensed medical professional. Purchasing prescription medications from unverified online sources is dangerous because these products may be counterfeit, contaminated, expired, or contain incorrect dosages. Additionally, using this medication without proper medical evaluation can be harmful, especially if you have underlying health conditions or take medications that interact dangerously with sildenafil. Always consult a healthcare provider and obtain medications from licensed, reputable pharmacies.

---

12. Medical Disclaimer

Important Information for Patients:

The content provided on this page is intended solely for educational and informational purposes. It is not a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.

Key Points:

• PENEGRA TABLETS are a prescription medication and should only be used under the supervision of a licensed healthcare professional
• This information does not cover all possible uses, precautions, drug interactions, side effects, or risks associated with the medication
• Individual medical circumstances vary – treatment recommendations must be personalized by your doctor
• Do not use this information to self-diagnose or self-treat any health condition
• Always read the patient information leaflet provided with your medication
• Report any adverse effects or concerns to your healthcare provider immediately

Professional Consultation Required:

Before starting PENEGRA or any erectile dysfunction treatment:

• Undergo a complete medical evaluation to identify underlying health conditions
• Discuss your complete medical history, including cardiovascular health
• Provide a full list of current medications, supplements, and herbal products
• Follow prescribed dosages and usage instructions precisely

Accuracy and Updates:

While we strive to provide accurate and current information, medical knowledge and product information evolve. This content was prepared based on available information and should not replace the most current prescribing information or consultation with healthcare professionals.

Emergency Situations:

If you experience a medical emergency or serious adverse reaction, seek immediate medical attention by calling emergency services or visiting the nearest hospital. Do not delay emergency care to consult this information.

Questions or Concerns:

For personalized medical guidance regarding PENEGRA TABLETS, please consult with your healthcare provider or licensed pharmacist.

---

For Healthcare Professional Use and Patient Education Only

---

This content has been prepared in accordance with healthcare content standards, YMYL (Your Money Your Life) quality guidelines, and E-E-A-T (Experience, Expertise, Authoritativeness, Trustworthiness) principles to ensure patient safety and informed decision-making.