Impaza enhances endothelial NO synthase activity, restores production of nitric oxide (NO) by the endothelium during sexual stimulation, increases the levels of cyclic guanosine monophosphate (cGMP) in smooth muscles, and facilitates their relaxation, which leads to increased blood filling of the cavernous bodies. These effects ensure erection of sufficient strength and duration. The main peripheral mechanism of Impaza action has been confirmed by experimental findings: it implies increased enzymatic activity of endothelial NO-synthase, a key enzyme supporting penis erection. Changes in certain parameters associated with its action suggest the existence of central effects mediating its action on the mechanisms of erection.
Impaza increases libido (sexual desire) and intercourse satisfaction. Impaza administration in patients with somatic diseases based on endothelial dysfunction leads to normalization of NO production level and prevents the development of erectile dysfunction. In addition, Impaza therapy is associated with increased libido and a trend towards increased testosterone level (in patients with initially lower level of testosterone). Higher efficacy of prolonged courses of Impaza therapy unconditionally proves its therapeutic effect.
Impaza therapy not only affects the mechanisms of erection and improves male sexual functions, but also effectively prevents the development of erectile dysfunction in men with comorbid conditions and age-related hormonal deficit. Courses of Impaza therapy in patients with metabolic syndrome and traumatic urethra injury diminish the frequency and severity of erectile dysfunction.
Impaza is the only drug that can be used for the correction of male climacteric syndrome (andropause) presenting as flushes, weakness, fatigue, low physical activity, and decreased libido.
Different mechanisms of action of FDE-5 inhibitors and Impaza suggest their combined use in patients with advanced ED and inadequate efficacy of monotherapy. This combination provides higher efficacy and lower rate of adverse effects of FDE-5 inhibitors, since their doses can be significantly reduced while retaining therapeutic efficacy of treatment at the same level.
Impaza administration at a dose of one tablet per day for 12 weeks provides for the restoration of erectile function; this effect is long-lasting. Tablet is to be held in the mouth until its complete dissolution; it should not be taken with food. In patients with advanced symptoms of erectile dysfunction, optimal effect is achieved with twice daily administration, in the morning and before sleep. If necessary, therapy may be repeated after 6 months.
Preventive nature of Impaza action has been noted in patients with diabetes mellitus and cardiovascular diseases. The duration of preventive Impaza therapy should be at least 12 weeks (1 tablet every other day).
Impaza may be used with nitrates in patients with coronaty heart disease and is a drug of choice and alternative to FDE-5 inhibitors in these patients. Combination of Impaza with beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and calcium antagonists demonstrated good tolerability and lead to beneficial changes in cardiologic parameters.
Advantages of Impaza treatment include its efficacy and a possibility to combine it with therapy of comorbid conditions, including CHD, hypertension, etc., virtually complete absence of adverse reactions or adverse systemic effects. In very rare cases, individual hypersensitivity reactions may occur to any formulation ingredient (lactose, microcrystalline cellulose, magnesium stearate). No adverse effects or overdosage have been reported in patients receiving prolonged Impaza therapy courses, so it is categorized as an over-the-counter drug.