12-24 Hours
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Nirvana 20
Healthcare Pharmaceuticals Ltd.
Generic: Tadalafil
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Nirvana 20.
SAFE IF PRESCRIBED
Nirvana 20 is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.
CONSULT YOUR DOCTOR
Information regarding the use of Nirvana 20 during breastfeeding is not available. Please consult your doctor.
UNSAFE
Nirvana 20 may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Nirvana 20 should be used with caution in patients with kidney disease. Dose adjustment of Nirvana 20 may be needed. Please consult your doctor.
CAUTION
Nirvana 20 should be used with caution in patients with liver disease. Dose adjustment of Nirvana 20 may be needed. Please consult your doctor.
Use of Nirvana 20 is not recommended in patients with severe liver disease.
Medicine Overview of Nirvana 20mg Tablet
Introduction
Nirvana 20 is used to treat erectile dysfunction in men. It increases blood flow to the penis to help men get an erection. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. Nirvana 20 may be taken on an empty stomach or with a meal. It should be strictly taken as advised by your doctor. The medicine will only help you to get an erection if you are sexually stimulated. You should take it about one hour before you plan to have sex. The amount...
... Show moreUses of Nirvana 20
- Erectile dysfunction
Side effects of Nirvana 20
Common
- Headache
- Blurred vision
- Muscle pain
- Nasal congestion (stuffy nose)
- Flushing (sense of warmth in the face, ears, neck and trunk)
- Nosebleeds
How to use Nirvana 20
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nirvana 20 may be taken with or without food, but it is better to take it at a fixed time.
How Nirvana 20 works
Nirvana 20 is a phosphodiesterase (PDE-5) inhibitor. It works in erectile dysfunction by increasing blood flow to the penis by relaxing the muscles in penile blood vessels.
What if you forget to take Nirvana 20?
If you miss a dose of Nirvana 20, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- You have been prescribed Nirvana 20 for the treatment of erectile dysfunction.
- It is best to take it an hour before sexual intercourse. But, you can take it anytime between 30 minutes and 4 hours before sexual activity.
- Do not take it more than once a day.
- It may also be used for treating the urinary symptoms of an enlarged prostate gland (benign prostatic hyperplasia).
- It may cause dizziness or blurred vision. Do not drive or do anything requiring concentration until you know how it affects you.
- Avoid drinking alcohol as it can reduce your ability to get an erection and can make dizziness worse.
- Seek medical attention if the erection persists for more than 4 hours after sexual intercourse.
- Do not use Nirvana 20 if you have recently taken nitrates (medicines used in angina or chest pain), if you have had a heart attack in the past 3 months, or stroke or heart failure in the past 6 months.
Brief Description
Indication
Erectile dysfunction, signs and symptoms of benign prostatic hyperplasia (BPH)
Administration
May be taken with or without food.
In order for Tadalafil to be effective, sexual stimulation is required.
It can be taken from 30 minutes to 12 hours prior to sexual activity. Efficacy of Tadalafil may persist up to 24 hours post-dose.
Adult Dose
Oral Erectile dysfunction Adult: For Use as Needed The recommended starting dose of Tadalafil for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients. For Once Daily Use The recommended starting dose of Tadalafil for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. The IntimateTM dose for once daily use...
... Show moreRenal Dose
Renal impairment (erectile dysfunction)
Mild (CrCl >51 mL/min): No dosage adjustment needed
Moderate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hr
Severe (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr
Renal impairment (pulmonary arterial hypertension)
Mild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerability
Severe (CrCl <30 mL/min and on hemodialysis): Avoid use
Contraindication
Concurrent use of organic nitrates, nitrates and nitric oxide donors. Men with cardiac disease for whom sexual activity is inadvisable. Recent MI (within 90 days) or stroke (within last 6 mth), hypotension (<90/50 mm Hg), unstable angina, heart failure, uncontrolled arrhythmias or hypertension.
Mode of Action
Tadalafil is a phosphodiesterase type-5 inhibitor.
Precaution
Use caution in patients with anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, myocardial infarction in preceding 90 days, unstable angina, angina occurring during sexual intercourse, NYHA class 2 or greater heart failure in preceding 6 months, uncontrolled arrhythmias, hypotension, uncontrolled hypertension, cerebrovascular accident in preceding 6 months, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors
Hepatic or renal impairment; CV diseases; anatomical penile deformation; predisposition to priapism; child 4 hr.
Side Effect
>10%
Headache (11-42%),Myalgia (1-14%),Respiratory tract infection (3-13%),Nasopharyngitis (2-13%),Dyspepsia (1-13%),Flushing (1-13%),Back pain (2-12%),Nausea (10-11%)
1-10%
Nasal congestion (<9%),Gastroesophageal reflux disease (1-3%),Hypertension (1-3%),Bronchitis (<2%),Genitourinary tract infection (<2%)
<1%
Amnesia,Angina pectoris,Arthralgia,Change in color vision,Conjunctival hyperemia,Dyspnea,Epistaxis
Potentially Fatal: Stevens-Johnson syndrome, exfoliative dermatitis, severe cardiovascular events e.g. MI, stroke, sudden cardiac death;
Interaction
Concurrent use increased risk of hypotension with beta-blockers; increased risk of priapism with other drugs for erectile dysfunction, e.g. alprostadil; increased heart rate with theophylline; decreased tadalafil serum concentration with CYP 3A4 inducers e.g. rifampicin, efavirenz, carbamazepine, nevirapine, barbiturates, phenobarbital, phenytoin, ribabutin; increased tadalafil serum concentration with CYP3A4 inhibitors e.g. azole antifungals, protease inhibitors, cimetidine, macrolides.
Potentially Fatal: Enhanced hypotensive effect with nitrates and nicorandil.
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