PENEGRA Tablets – Comprehensive Patient Information Guide

What is PENEGRA?

PENEGRA is a prescription medication containing Sildenafil Citrate, a phosphodiesterase type 5 (PDE5) inhibitor clinically developed to address erectile dysfunction (ED) in adult men. This therapeutic agent works by enhancing blood flow to specific areas of the body, helping men achieve and maintain an erection sufficient for sexual activity when sexually stimulated. PENEGRA represents a cost-effective generic alternative that delivers clinically equivalent results to branded formulations, making essential treatment more accessible to patients worldwide.

Active Ingredient: Sildenafil Citrate
Available Strengths: 25mg, 50mg, 100mg tablets
Dosage Form: Oral tablet (film-coated)
Manufacturer: Zydus Cadila Healthcare Ltd.
Prescription Category: Prescription Required (Rx)

This medication addresses a significant health concern affecting millions of men globally, offering a medically validated solution when lifestyle modifications alone prove insufficient.

---

How Does PENEGRA Work? Understanding the Mechanism

PENEGRA’s active ingredient, Sildenafil Citrate, operates through a targeted biochemical pathway that addresses the physiological basis of erectile dysfunction.

The Science Made Simple:

During sexual arousal, the body naturally releases nitric oxide in the penile tissue. This chemical messenger triggers the production of cyclic guanosine monophosphate (cGMP), a substance that relaxes smooth muscle tissue and dilates blood vessels in the penis, allowing increased blood flow necessary for an erection.

In men with ED, an enzyme called phosphodiesterase type 5 (PDE5) breaks down cGMP too quickly, preventing adequate blood flow. PENEGRA selectively inhibits this PDE5 enzyme, allowing cGMP levels to remain elevated longer. This sustained presence of cGMP promotes:

• Enhanced vasodilation – Blood vessels expand more effectively
• Improved blood circulation – Increased arterial inflow to erectile tissue
• Prolonged smooth muscle relaxation – Maintained rigidity during sexual activity

Important clarification: PENEGRA does not create automatic erections. Sexual stimulation remains necessary to initiate the natural arousal response. The medication simply supports the body’s existing mechanisms when they’re not functioning optimally.

---

Approved Medical Uses and Therapeutic Benefits

PENEGRA has been clinically evaluated and approved for specific medical indications:

Primary Indication:

• Erectile Dysfunction (ED) Treatment – Helps adult men achieve and sustain erections adequate for satisfactory sexual intercourse

Therapeutic Advantages:

• Rapid onset of action – Typically becomes effective within 30-60 minutes after administration • Sustained efficacy window – Remains active in the body for approximately 4-5 hours • Improved sexual confidence – Restores intimacy and relationship quality • Enhanced quality of life – Addresses psychological distress associated with ED • Flexible dosing options – Multiple strengths available for individualized treatment • Well-established safety profile – Decades of clinical use and research validation • Cost-effective therapy – Generic formulation provides affordable access to treatment

Additional Medical Context:

While primarily prescribed for ED, Sildenafil (the active compound) is also used in specific formulations and dosages to treat pulmonary arterial hypertension under different brand names. However, PENEGRA tablets are specifically indicated and dosed for erectile dysfunction management only.

---

Dosage Guidance and Administration Instructions

Critical Advisory: Dosage must be determined exclusively by a qualified healthcare provider based on individual medical assessment, concurrent conditions, and medication interactions.

General Prescribing Framework:

Standard Starting Dose:

• Most patients begin with 50mg taken approximately one hour before anticipated sexual activity
• May be administered 30 minutes to 4 hours prior to intercourse

Dose Adjustment:

• Based on treatment response and tolerability, physicians may increase to 100mg (maximum recommended dose)
• For patients experiencing side effects or with specific risk factors, dose may be reduced to 25mg

Frequency Limitation:

• Maximum: ONE dose per 24-hour period
• Never exceed prescribed dosage

Administration Best Practices:

✓ Swallow tablet whole with water – do not crush, chew, or split
✓ Can be taken with or without food – though high-fat meals may delay onset
✓ Avoid grapefruit products – may increase medication levels unpredictably
✓ Timing matters – plan intake approximately 1 hour before activity
✓ Sexual stimulation required – medication facilitates but doesn’t initiate erection

Special Population Considerations:

Elderly Patients (65+ years): May require lower starting doses due to altered medication clearance

Hepatic Impairment: Patients with liver dysfunction typically start with 25mg

Renal Impairment: Severe kidney disease may necessitate dose reduction

Concurrent Medications: Alpha-blockers, nitrates, and certain other drugs require dosage modifications or contraindicate use

---

Potential Side Effects: What Patients Should Know

Like all medications, PENEGRA may cause side effects, though not everyone experiences them. Understanding potential reactions helps patients identify normal versus concerning symptoms.

Common Side Effects (Generally Mild and Temporary):

Frequently Reported (affecting 1-10% of users):

• Headache (most common)
• Facial flushing or warmth sensation
• Indigestion or upset stomach
• Nasal congestion
• Dizziness or lightheadedness
• Visual disturbances (blue-tinted vision, increased light sensitivity, blurred vision)
• Back pain or muscle aches

These effects typically diminish as the body adjusts to the medication and usually resolve within a few hours.

Serious Side Effects Requiring Immediate Medical Attention:

Seek emergency care if you experience:

⚠ Priapism – Painful erection lasting more than 4 hours (medical emergency requiring immediate treatment to prevent permanent damage)

⚠ Sudden vision loss – In one or both eyes, potentially indicating non-arteritic anterior ischemic optic neuropathy (NAION)

⚠ Sudden hearing decrease or loss – Sometimes accompanied by ringing in ears (tinnitus) and dizziness

⚠ Cardiovascular symptoms – Chest pain, irregular heartbeat, severe dizziness, shortness of breath

⚠ Severe allergic reactions – Rash, hives, severe itching, swelling of face/lips/tongue/throat, difficulty breathing

Managing Minor Side Effects:

• Headaches: Stay hydrated; over-the-counter pain relief may be appropriate (consult physician)
• Flushing: Usually temporary; cool compresses may provide comfort
• Indigestion: Taking medication after a light meal may help
• Nasal congestion: Typically resolves without intervention

Patient responsibility: Report any persistent, worsening, or concerning symptoms to your healthcare provider promptly.

---

Comparative Analysis: PENEGRA vs. Alternative Options

<div style=”overflow-x:auto;”>

Comparison Factor	PENEGRA (Sildenafil)	Branded Sildenafil	Tadalafil Generics	Vardenafil Generics
Active Ingredient	Sildenafil Citrate	Sildenafil Citrate	Tadalafil	Vardenafil
Onset of Action	30-60 minutes	30-60 minutes	30-45 minutes	25-60 minutes
Duration of Effect	4-5 hours	4-5 hours	Up to 36 hours	4-5 hours
Dosing Frequency	As needed, max 1/day	As needed, max 1/day	As needed or daily low-dose	As needed, max 1/day
Food Interaction	High-fat meals delay onset	High-fat meals delay onset	Minimal food effect	High-fat meals reduce efficacy
Common Strengths	25mg, 50mg, 100mg	25mg, 50mg, 100mg	2.5mg, 5mg, 10mg, 20mg	5mg, 10mg, 20mg
Cost-Effectiveness	★★★★★ Highly affordable	★★☆☆☆ Premium pricing	★★★★☆ Moderate generic pricing	★★★☆☆ Mid-range pricing
Clinical Efficacy	Proven effective in 70-85%	Proven effective in 70-85%	Proven effective in 70-80%	Proven effective in 70-80%
Alcohol Sensitivity	Moderate caution advised	Moderate caution advised	Moderate caution advised	Enhanced caution needed
Manufacturer	Zydus Cadila	Pfizer (original)	Various manufacturers	Various manufacturers

</div>

Key Insights from Comparison:

PENEGRA’s Advantages:

• Bioequivalent to branded options at significantly reduced cost
• Well-established safety and efficacy profile
• Flexible dosing options for individual needs
• Rapid onset suitable for on-demand use
• Manufactured by reputable pharmaceutical company with quality certifications

Considerations:

• Shorter duration compared to tadalafil (may require better timing)
• Food interactions may affect some users
• Generic alternatives offer similar profiles at comparable prices

Clinical Note: All PDE5 inhibitors have similar efficacy rates. Individual response varies, and what works optimally for one patient may differ for another. Healthcare providers may recommend trying different options to find the best match.

---

Drug Interactions and Medical Warnings

PENEGRA can interact with numerous medications and substances, potentially causing serious complications. Complete disclosure of all medications, supplements, and health conditions to your physician is essential.

Critical Contraindications (NEVER combine with):

🚫 Nitrate Medications (ABSOLUTE CONTRAINDICATION)

• Nitroglycerin (tablets, spray, patches)
• Isosorbide mononitrate or dinitrate
• Recreational nitrites (“poppers” – amyl nitrite, butyl nitrite)

Reason: Combined use causes severe, potentially fatal blood pressure drops

🚫 Riociguat (for pulmonary hypertension)

• Causes dangerous blood pressure reduction

Significant Drug Interactions:

Alpha-Blockers (prostate/blood pressure medications):

• Doxazosin, terazosin, tamsulosin, alfuzosin
• May cause symptomatic hypotension; requires dosage timing adjustment

Antifungal Medications:

• Ketoconazole, itraconazole – increase Sildenafil blood levels

Antibiotics:

• Erythromycin, clarithromycin – affect medication metabolism

HIV Protease Inhibitors:

• Ritonavir, saquinavir, atazanavir – significantly increase Sildenafil levels; major dose reduction required

Other Blood Pressure Medications:

• May enhance hypotensive effects

Additional PDE5 Inhibitors:

• Never combine with other ED medications

Substance Interactions:

Alcohol:

• Moderate to heavy consumption increases risk of side effects (dizziness, headache, rapid heartbeat)
• May impair erectile function independently
• Limit alcohol when using PENEGRA

Grapefruit/Grapefruit Juice:

• Increases Sildenafil levels unpredictably
• Avoid consumption around medication timing

Medical Conditions Requiring Special Consideration:

Inform your healthcare provider if you have:

• Cardiovascular disease: Heart attack, stroke, irregular heartbeat, angina
• Blood pressure abnormalities: Hypertension or hypotension
• Hepatic or renal impairment: Liver or kidney dysfunction
• Retinal disorders: Retinitis pigmentosa or vision problems
• Bleeding disorders: Or active peptic ulceration
• Penile abnormalities: Peyronie’s disease, priapism history
• Blood cell disorders: Sickle cell anemia, multiple myeloma, leukemia

---

Who Should Avoid or Use PENEGRA With Caution?

Absolute Contraindications (Do NOT Use):

❌ Hypersensitivity: Known allergy to Sildenafil or tablet components
❌ Nitrate therapy: Current or intermittent use of any nitrate medication
❌ Recent cardiovascular events: Heart attack or stroke within past 6 months
❌ Severe heart failure: Uncontrolled cardiac conditions
❌ Severe liver impairment: Advanced hepatic disease
❌ Hypotension: Resting blood pressure below 90/50 mmHg
❌ Retinal disorders: Hereditary degenerative retinal conditions
❌ Women: PENEGRA is not indicated for female patients
❌ Pediatric use: Not approved for individuals under 18 years

Use With Extreme Caution (Medical Supervision Required):

⚠ Cardiovascular risk assessment needed – Patients with heart conditions must undergo evaluation to determine if sexual activity is advisable

⚠ Anatomical penile deformation – Increases priapism risk

⚠ Conditions predisposing to priapism – Sickle cell disease, multiple myeloma, leukemia

⚠ Concurrent alpha-blocker therapy – Requires careful dosing protocol

⚠ Moderate hepatic/renal impairment – Necessitates dose adjustment

⚠ Age over 65 years – May require lower initial dosing

⚠ Multiple medication use – Polypharmacy increases interaction risk

Important Patient Counseling Points:

Sexual activity considerations: Sexual activity carries cardiovascular demands. Patients with pre-existing heart conditions should receive medical clearance before using any ED medication.

Vision/hearing concerns: Rare reports of sudden sensory loss require immediate discontinuation and medical evaluation.

Priapism awareness: Any erection lasting beyond 4 hours constitutes a medical emergency requiring immediate hospital presentation.

---

Proper Storage and Handling Instructions

Correct storage maintains medication stability, potency, and safety.

Standard Storage Requirements:

📦 Temperature: Store at controlled room temperature between 20°C to 25°C (68°F to 77°F)

📦 Humidity: Keep in original container; protect from excessive moisture

📦 Light protection: Store away from direct sunlight and bright artificial light

📦 Container: Keep tablets in original blister packaging until use

Safety Precautions:

🔒 Child safety: Store in a secure location inaccessible to children and adolescents

🔒 Pet safety: Keep away from animals

🔒 Separate storage: Do not store with household chemicals or food items

🔒 Bathroom storage: Avoid storing in bathrooms due to humidity fluctuations

Medication Integrity:

✓ Expiration date: Never use beyond printed expiry date; potency cannot be guaranteed

✓ Physical inspection: Check tablets before use – discard if discolored, cracked, or degraded

✓ Damaged packaging: Do not use if blister pack is compromised

Disposal Guidelines:

When medication is expired or no longer needed:

• Do NOT flush down toilets or drains (environmental contamination)
• Do NOT throw in household trash where children/pets might access
• Recommended: Return to pharmacy take-back programs
• Alternative: Mix with undesirable substance (coffee grounds, dirt) in sealed bag before disposal

---

Frequently Asked Questions About PENEGRA

1. How quickly does PENEGRA start working, and how long do effects last?

PENEGRA typically begins working within 30-60 minutes after ingestion, with peak effectiveness occurring around 1 hour post-dose. The medication remains active in your system for approximately 4-5 hours, though this doesn’t mean you’ll have a continuous erection. Rather, you’ll be able to achieve erections when sexually stimulated during this window. Individual response varies based on metabolism, age, food intake, and overall health status. Taking PENEGRA after a high-fat meal may delay onset by 30-60 minutes.

2. Can I take PENEGRA daily, or is it only for occasional use?

PENEGRA is designed as an “on-demand” medication, taken only when you plan sexual activity—not as a daily supplement. The maximum safe frequency is once per 24-hour period. Unlike some ED medications that offer daily low-dose options, PENEGRA’s formulation and dosing strategy focus on situational use. Taking it more frequently than prescribed increases risk of side effects without enhancing effectiveness. If you find yourself needing ED medication very frequently, discuss treatment alternatives with your physician, as other options might better suit your needs.

3. What should I do if PENEGRA doesn’t work the first time I try it?

Several factors can influence initial response. The medication requires sexual stimulation to work—it won’t produce automatic erections. Anxiety, stress, or performance pressure can interfere with effectiveness. Additionally, the first dose may not represent optimal efficacy as your body adjusts. Healthcare providers typically recommend trying the medication on 4-8 separate occasions before concluding it’s ineffective. Ensure you’re taking it correctly (proper timing, avoiding heavy meals, limiting alcohol). If repeated attempts fail, consult your physician about dosage adjustment or alternative treatments rather than increasing the dose yourself.

4. Is it safe to drink alcohol while taking PENEGRA?

Small amounts of alcohol (1-2 standard drinks) generally don’t pose serious interaction risks with PENEGRA. However, both alcohol and Sildenafil lower blood pressure and relax blood vessels, so combining them increases likelihood of dizziness, headaches, rapid heartbeat, and low blood pressure. More significantly, excessive alcohol consumption independently impairs erectile function, potentially counteracting PENEGRA’s benefits. For optimal results and safety, limit alcohol intake when planning to use this medication. If you experience significant dizziness or lightheadedness after combining alcohol with PENEGRA, avoid driving and lie down until symptoms resolve.

5. Can PENEGRA cause permanent damage or dependency?

PENEGRA does not cause physical addiction or dependency. Your body doesn’t develop a “need” for the medication, and you can discontinue use without withdrawal symptoms. However, some men experience psychological reliance, feeling anxious about sexual performance without the medication. Regarding permanent damage, when used appropriately, PENEGRA is safe. The critical exception is priapism (erection lasting over 4 hours), which requires emergency treatment to prevent permanent erectile tissue damage. This complication is rare but serious. Following prescribed dosages and seeking immediate care for prolonged erections prevents permanent complications.

6. Will PENEGRA work if my ED is caused by psychological factors rather than physical issues?

Yes, PENEGRA can be effective regardless of whether ED stems from physical, psychological, or combined causes. Erectile dysfunction typically involves both physical and mental components—even “psychological ED” has physiological manifestations. The medication addresses the physical mechanism of achieving erection, which can break the anxiety-performance failure cycle common in psychologically-based ED. Many men find that successful experiences with medication support rebuild confidence, sometimes reducing future medication need. However, addressing underlying psychological factors through counseling or therapy often provides more comprehensive, lasting results. The most effective approach frequently combines medication with appropriate psychological support.

---

Medical Disclaimer and Prescription Requirements

Professional Healthcare Guidance:

This information is educational only and does NOT replace professional medical advice, diagnosis, or treatment.

PENEGRA is a prescription medication that requires evaluation by a qualified healthcare provider. Self-diagnosis and self-medication carry significant health risks. Erectile dysfunction can indicate underlying health conditions (cardiovascular disease, diabetes, hormonal imbalances) requiring comprehensive medical assessment.

Important Clarifications:

✓ Diagnosis required: Appropriate ED diagnosis must precede treatment
✓ Individual assessment: Suitability determined by medical history, current health, medications
✓ Ongoing monitoring: Regular follow-up ensures safety and treatment optimization
✓ Not for everyone: Contraindications and risk factors may preclude use
✓ Prescription compliance: Always follow prescribed dosage and instructions

When to Consult Healthcare Providers:

• Before starting PENEGRA for the first time
• If you experience inadequate response or side effects
• When starting new medications or supplements
• If health status changes (new medical conditions, surgeries)
• For questions about treatment continuation or modification

Emergency Medical Attention Required For:

• Erections lasting more than 4 hours
• Sudden vision or hearing loss
• Chest pain or cardiovascular symptoms during sexual activity
• Severe allergic reactions
• Any symptoms causing significant concern

Your physician is your partner in achieving optimal health outcomes. Open, honest communication about sexual health concerns ensures safe, effective treatment.

---

Secure Your Health: Order Authentic Generic Medicines from GenericMedsKart

When it comes to prescription medications, authenticity, quality, and discretion matter profoundly. GenericMedsKart stands as a trusted source for genuine generic medications, providing patients worldwide with:

✅ Verified pharmaceutical products from licensed manufacturers
✅ Stringent quality assurance meeting international standards
✅ Secure, tamper-evident packaging ensuring medication integrity
✅ Completely discreet delivery respecting your privacy
✅ Competitive pricing making essential treatments accessible
✅ Professional customer support addressing your concerns
✅ Convenient online ordering with secure payment processing

Order authentic PENEGRA and other generic medicines online from GenericMedsKart, ensuring secure packaging and discreet delivery.

Your health deserves the highest standard of care. Choose authenticity. Choose quality. Choose GenericMedsKart.

---

Final Reminder: Always consult qualified healthcare professionals before starting, stopping, or modifying any medication regimen. This content provides general information and cannot substitute for personalized medical advice tailored to your unique health circumstances.