Dynamic Long
Dynamic Long: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Dynamico Long
ATX code: G04BE08
Active ingredient: tadalafil (Tadalafil)
Manufacturer: TEVA Pharmaceutical Industries, Ltd. (TEVA Pharmaceutical Industries, Ltd.) (Israel)
Description and photo update: 2019-11-07
Prices in pharmacies: from 320 rubles.
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Dynamiko Long is a drug for the treatment of erectile dysfunction (impotence), an inhibitor of PDE-5 (phosphodiesterase type 5).
Release form and composition
Dynamico Long is available in the form of film-coated tablets:
- tablets with a dosage of 2.5 mg: biconvex, round, from light yellow to brownish yellow, engraved on one side with "2.5" (7 pcs. in blisters, in a cardboard box 2 or 4 blisters; 10 pcs.. in blisters, in a cardboard box 1 blister);
- tablets with a dosage of 5 mg: biconvex, oval, from light yellow to brownish yellow, engraved on one side with "5" (7 pcs. in blisters, in a cardboard box 2 or 4 blisters; 10 pcs. in blisters, in a cardboard box 1 blister);
- tablets with a dosage of 10 mg: biconvex, oval, from light yellow to brownish-yellow in color, with a line, on one side to the left of the risk there is an engraving "1", a certificate of risks - engraving "0" (4 pcs. in blisters, in a cardboard box 1 or 2 blisters; 10 pcs. in blisters, in a cardboard box 1 blister);
- tablets with a dosage of 20 mg: biconvex, oval, from light yellow to brownish yellow, with a line, on one side to the left of the risk there is an engraving "2", a certificate from the risks - engraving "0" (1, 2 or 10 pcs.. in blisters, in a cardboard box 1 blister; 4 pcs. in blisters, in a cardboard box 1 or 2 blisters).
Each pack also contains instructions for the use of Dynamic Long.
Composition for one film-coated tablet:
- active substance: tadalafil - 2.5; 5, 10 or 20 mg;
- auxiliary components of the tablet core: sodium lauryl sulfate, crospovidone, lactose monohydrate, povidone-K12, sodium stearyl fumarate;
- film casing: Opadry II 85F32782 yellow (macrogol-3350, talc, partially hydrolyzed polyvinyl alcohol, titanium dioxide, yellow iron oxide dye).
Pharmacological properties
Pharmacodynamics
Tadalafil is a reversible selective inhibitor of specific PDE-5 cyclic guanosine monophosphate (cGMP). With sexual arousal, a local release of nitric oxide occurs, and due to the inhibition of PDE-5 by the drug, the concentration of cGMP in the corpus cavernosum increases. As a result, the smooth muscles of the arteries relax, and blood flows to the tissues of the penis, which ultimately causes an erection. If there is no sexual arousal, tadalafil does not show its effect.
In vitro studies have revealed that tadalafil selectively inhibits PDE-5, an enzyme present in the smooth muscles of the blood vessels of internal organs, in the smooth muscle fibers of the corpus cavernosum, in skeletal muscles, lungs, kidneys, cerebellum and platelets. The drug is most active against PDE-5 (inhibition of PDE-5 is 10,000 times stronger than the inhibition of other phosphodiesterases - types 1, 2, 3, 4 and 7). This difference is especially important for PDE-3, an enzyme found in blood vessels and the heart and involved in myocardial contraction. Tadalafil is 700 times more active in inhibiting PDE-5 than PDE-6 (phosphodiesterase, which is present in the retina and is responsible for phototransmission). The activity of the drug against phosphodiesterases 8, 9 and 10 types is 9000 times lower than against PDE-5, and the blocking of PDE-11 is 14 times weaker,than PDE-5.
When using Dynamic Long, erection improves and the likelihood of successful intercourse increases.
The drug does not cause significant changes in heart rate (heart rate), as well as diastolic and systolic blood pressure (both in the supine position and in the standing position).
Dynamic Long does not impair the ability to recognize colors (green / blue), as it has a low affinity for PDE-6. It does not affect visual acuity, pupil size, intraocular pressure and retinal electrical potentials.
The studies did not reveal any negative effect of tadalafil on spermatogenesis (morphology and motility of spermatozoa did not change). One study found a decrease in mean sperm concentration due to a higher rate of ejaculation. The drug did not change the average concentration of sex hormones (testosterone, follicle-stimulating hormone, luteinizing hormone).
In the course of clinical studies, Dynamiko Long at doses of 2.5 and 5 mg showed an improvement in erection with impotence of all severity (provided that the drug was taken once a day).
Tadalafil has a positive effect on the condition of patients with BPH (benign prostatic hyperplasia). This is due to the fact that inhibition of PDE-5, leading to an increase in the concentration of cGMP in the corpus cavernosum, is also observed in the smooth muscles of the bladder, prostate and blood vessels that supply them with blood. As a result of relaxation of vascular smooth muscles, blood perfusion in the listed organs increases and, as a result, the severity of BPH symptoms decreases. Due to the relaxation of the smooth muscles of the bladder and prostate gland, additional enhancement of vascular effects is possible.
Pharmacokinetics
Tadalafil is rapidly absorbed. The average maximum plasma concentration is reached approximately 2 hours after ingestion. The degree and speed of absorption of the active substance does not depend on the time of the meal, therefore, Dynamic Long can be taken before, during or after meals, as well as at any time of the day.
In healthy volunteers, the pharmacokinetics of the drug are linear in relation to dose and time. In the therapeutic dose range of 2.5–20 mg, AUC (area under the concentration-time curve) increases in proportion to the dose. In blood plasma, the equilibrium concentration is achieved during the first 5 days when using tadalafil once a day. In patients with erectile dysfunction, pharmacokinetic parameters are similar to those in healthy patients.
The volume of distribution of tadalafil averages 63 liters, that is, it is distributed in all tissues. About 94% binds to plasma proteins (with impaired renal function, this figure does not change). In the semen of healthy volunteers, less than 0.0005% of the dose taken is found.
It is metabolized with the participation of the isoenzyme CYP3A4 of cytochrome P 450. The main circulating metabolite is methylcatecholglucuronide. Its activity is approximately 13,000 times less than that of tadalafil, that is, the concentration of this metabolite has no clinical significance.
The average drug clearance in healthy volunteers is about 2.5 l / h, and the half-life is about 17.5 hours. Most of the dose taken (more than 61%) is excreted through the intestines, a smaller part (about 36%) - by the kidneys. Tadalafil is excreted mainly in the form of inactive metabolites.
In healthy volunteers over 65 years of age, the oral clearance of the drug is lower than in younger people, which is expressed in an increase of 25% in AUC, but this fact has no clinical significance and does not require a special dose selection.
In renal failure of any severity, as well as in end-stage patients (who are on hemodialysis), the AUC of tadalafil is approximately doubled. In hemodialysis patients, the maximum plasma concentration of the drug is 41% higher than in healthy volunteers. Tadalafil is almost not excreted by hemodialysis.
There is very little data on the safety and efficacy of the drug when used in patients with severe hepatic insufficiency, therefore, when prescribing Dynamico Long to such patients, the ratio of the expected benefit and possible risk should be assessed. Hepatic insufficiency of mild to moderate severity almost does not alter the pharmacokinetics of the drug.
In patients with diabetes mellitus, the AUC is reduced by about 19%, but this has no clinical significance and does not require a special dose selection.
Indications for use
- impotence (erectile dysfunction);
- LUTS (lower urinary tract symptoms) in patients with BPH (for 5 mg tablets);
- impotence in patients with LUTS associated with BPH.
Contraindications
Absolute:
- severe renal failure (creatinine clearance less than 30 ml / min);
- the presence of restrictions on sexual activity in persons with cardiovascular diseases: uncontrolled arterial hypertension, myocardial infarction in the last 90 days, chronic heart failure (class II and higher) or ischemic stroke within the last 6 months, low blood pressure (less than 90/50 mm Hg), unstable angina pectoris (as well as an attack of angina pectoris during intercourse), uncontrolled cardiac arrhythmias;
- loss of vision due to the development of NAPION (non-arteritis anterior ischemic optic neuropathy), even if this condition did not arise due to the previous intake of PDE-5 inhibitors;
- lactose intolerance, lactase enzyme deficiency, glucose-galactose malabsorption syndrome (since the tablets contain lactose);
- taking medications containing organic nitrates;
- concomitant use with other PDE-5 inhibitors, guanylate cyclase stimulants (for example, riociguat), doxazosin and other drugs for the treatment of erectile dysfunction;
- children and adolescents up to 18 years old;
- hypersensitivity to the components of the drug.
Relative (Dynamic Long tablets are used with caution):
- severe liver failure;
- predisposition to priapism (with leukemia, multiple myeloma, or sickle cell disease);
- anatomical deformity of the penis (Peyronie's disease, cavernous fibrosis, or angular curvature);
- simultaneous use with alpha 1 -adrenergic blockers, inhibitors of the isoenzyme CYP3A4 (ketoconazole, ritonavir, itraconazole, saquinavir, erythromycin, clarithromycin, grapefruit juice), 5-alpha reductase inhibitors, antihypertensive drugs.
To diagnose erectile dysfunction, it is necessary to identify its potential root cause, conduct an appropriate examination and determine the tactics of treatment.
Dynamiko Long, instructions for use: method and dosage
Dynamic Long tablets are taken orally.
With erectile dysfunction, patients with frequent sexual activity (2 or more times a week) are recommended to take a dose of Dynamico Long 5 mg once a day (daily, at the same time). Depending on the individual sensitivity to tadalafil, the dose can be reduced to 2.5 mg per day.
With infrequent sexual activity (less than 2 times a week), the recommended dose of Dynamico Long is 10 mg immediately before the intended intercourse. In case of insufficient effectiveness, it is possible to increase the dose to 20 mg. Tadalafil should be taken at least 16 minutes before the start of sexual activity. To establish the optimal response time to therapy, attempts at intercourse can be carried out at any time within 36 hours after taking the pill.
The maximum dose of tadalafil is 20 mg per day, and the recommended frequency of taking Dynamico Long is no more than 1 time per day. The drug in doses of 10 mg and 20 mg should be used immediately before the anticipated sexual activity. These doses are not suitable for daily use.
For BPH or erectile dysfunction in combination with BPH, Dynamic Long is used daily 1 time per day at a dose of 5 mg (preferably at the same time, regardless of the time of sexual activity). The duration of the drug intake is determined by the doctor.
Side effects
The most common side effects of Dynamico Long are dyspepsia, headache, myalgia and back pain.
In the course of clinical studies and post-registration use, undesirable side effects from the following systems and organs were recorded:
- digestive system: often - dyspeptic disorders; infrequently - vomiting, abdominal pain, nausea, diarrhea (in persons over 65), gastroesophageal reflux;
- respiratory system: often - nasal congestion; infrequently - nosebleeds, dyspnea;
- cardiovascular system: often - rush of blood to the skin of the face; infrequently - a feeling of palpitations, a decrease or increase in blood pressure, tachycardia; rarely - ventricular heart rhythm disturbances, myocardial infarction, unstable angina pectoris;
- central and peripheral nervous system: often - headache; infrequently - dizziness; rarely - fainting, migraine, transient amnesia, transient ischemic attacks, stroke (including hemorrhagic stroke), spontaneous seizures;
- sense organs: infrequently - pain in the eyeballs, ringing in the ears, impaired clarity of visual perception; rarely - swelling of the eyelids, occlusion of the retinal arteries, sudden hearing loss, impaired visual fields, NAPION, conjunctival hyperemia;
- musculoskeletal system and connective tissue: often - myalgia, pain in the back and extremities;
- urinary system: infrequently - the presence of red blood cells in the urine in excess of the norm;
- reproductive system: infrequently - prolonged erection; rarely - bleeding from the penis, priapism, blood in the semen;
- skin and subcutaneous fat: infrequently - skin rash; rarely - increased sweating, urticaria, exfoliative dermatitis, Stevens-Johnson syndrome;
- immune system: infrequently - hypersensitivity reactions; rarely - Quincke's edema;
- other reactions: infrequently - peripheral edema, chest pain, fatigue; rarely - facial swelling, SCD (sudden cardiac death).
These side effects are usually mild or moderate and transient.
Overdose
Acceptance of a single dose of Dynamico Long in a daily dose of 500 mg in healthy volunteers and repeated use of daily doses up to 100 mg in impotence patients caused the same side effects as the use of the drug at lower doses.
In case of an overdose of tadalafil, it is recommended to carry out standard symptomatic therapy. Hemodialysis is ineffective.
special instructions
Sexual activity itself is a potential risk for men with diseases of the cardiovascular system, therefore, treatment of erectile dysfunction with tadalafil should not be carried out in patients with heart disease for whom an active sex life is not recommended.
In the event of priapism (an erection lasting 4 hours or more), an urgent need to consult a doctor, because if timely assistance is not provided, the tissues of the penis may be damaged, leading to irreversible impotence.
The combined use of Dynamico Long with other drugs that inhibit PDE-5, as well as other types of therapy for erectile dysfunction, is not recommended, since the effectiveness and safety of such combinations have not been studied.
Tadalafil has a systemic vasodilator effect, which can cause a transient decrease in blood pressure, therefore, before prescribing Dynamico Long, the doctor must decide on the possibility of using the drug by patients with diseases of the cardiovascular system.
In case of sudden loss of vision, tadalafil should be discontinued and a doctor should be consulted. The likelihood of re-emergence of NAPION in patients who have previously had this disease increases.
If BPH is suspected, the patient should undergo a complete examination to rule out prostate cancer.
There are no data on the effectiveness of tadalafil in patients who have undergone surgery to completely remove the prostate or other surgical intervention on the pelvic organs without preserving the neurovascular bundles.
Influence on the ability to drive vehicles and complex mechanisms
During treatment with Dynamiko Long, it is recommended to be careful when driving vehicles and working with other potentially dangerous mechanisms, since one of the side effects of the drug is dizziness.
Application during pregnancy and lactation
Tadalafil is not intended for use in women.
Pediatric use
Dynamiko Long should not be prescribed to patients under the age of 18 years.
With impaired renal function
Dynamic Long is contraindicated in men with severe renal impairment (if creatinine clearance is less than 30 ml / min).
For violations of liver function
In severe hepatic insufficiency, the drug is used with caution.
Drug interactions
Possible drug interactions due to the effect of other drugs and substances on tadalafil:
- inhibitors of the CYP3A4 isoenzyme (ketoconazole, itraconazole, clarithromycin, erythromycin, grapefruit juice) and HIV protease inhibitors (ritonavir, saquinavir): an increase in plasma concentration and AUC of tadalafil is possible;
- inducers of the isoenzyme CYP3A4 (phenobarbital, carbamazepine, rifampicin, phenytoin): a decrease in the concentration of tadalafil in plasma is possible;
- antacids (aluminum hydroxide or magnesium hydroxide): the rate of absorption of the drug decreases without changing the AUC value;
- blockers of H 2 -histamine receptors of nizatidine, which increase the pH of the stomach: the pharmacokinetics of tadalafil does not change significantly.
Drug interactions due to the effect of tadalafil on other substances and drugs:
- nitrates: the hypotensive effect of nitrates is enhanced (this combination is contraindicated);
- antihypertensive drugs: it is possible to increase the antihypertensive effect of these drugs;
- doxazosin, riociguat: their hypotensive properties are enhanced (combined use with tadalafil is contraindicated);
- ethinyl estradiol and terbutaline: increases the bioavailability of the listed funds;
- ethanol: no significant change in plasma concentrations of both ethanol and tadalafil is observed; when taking high doses of ethanol, postural dizziness and orthostatic hypotension may occur.
No clinically significant interactions of Dynamico Long with other substances and drugs have been registered.
Analogs
Dynamiko Long analogs are: Cialis, Tedallis, Tadalafil Bakter, Tadalafil-Teva, Tadalafil-SZ, Cupid 36, etc.
Terms and conditions of storage
Store out of the reach of children at a temperature not exceeding 25 ° C.
The shelf life of the drug is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Dynamic Long
There are not many reviews about Dynamo Long, but they are very good. Men who have taken the drug for the treatment of erectile dysfunction note its high efficacy, long-lasting effect and a low incidence of adverse reactions. Despite the fact that the cost of tablets is quite high, it is several times lower than some similar products.
Some patients note that as a result of taking Dynamic Long, there is a reddening of the face, a feeling of heat, a stuffy nose, pressure rises, and there is also a slight clouding of consciousness, but these side effects are weak and go away on their own.
Price for Dynamic Long in pharmacies
In the form of film-coated tablets, Dynamiko Long 5 mg, 14 pcs. in a package you can buy an average of 2170 rubles., 28 pcs. in the package - for 3220 rubles.
The price of Dynamico Long in the form of film-coated tablets with a dosage of 20 mg (2 pcs. In a package) is about 1170 rubles.
Dynamico Long: prices in online pharmacies
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Drug name Price Pharmacy |
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Dynamiko Long 20 mg film-coated tablets 1 pc. 320 RUB Buy |
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Dinamiko Long tablets p.p. 20mg 1 pc. 658 r Buy |
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Dinamiko Long 20 mg film-coated tablets 2 pcs. 800 RUB Buy |
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Dynamico Long 5 mg film-coated tablets 14 pcs. RUB 900 Buy |
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Dynamiko Long tablets p.p. 20mg 2 pcs. 1160 RUB Buy |
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Dinamiko Long 5 mg film-coated tablets 28 pcs. 1581 RUB Buy |
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Dynamiko Long tablets p.p. 5mg 14 pcs. 1834 RUB Buy |
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Dynamiko Long tablets p.p. 5mg 28 pcs. 3334 RUB Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
