Generic Name: Sildenafil Citrate

Kobra works by increasing the effects of nitric oxide (NO), a substance that serves many key functions in biological processes throughout the body. One of the most well known and important functions of NO is the dilation of blood vessels. This allows greater blood flow to the muscles, which of course can be valuable to an athlete during competition.

What is more interesting to me is the role of NO on muscles during resistance training. JE Anderson found that NO appears to be a vital signal in the activation of muscle satellite cells in response to damage. Satellite cell activation is the key first step in the repair and hypertrophy of muscle cells after heavy training. It may therefore enhance the hypertrophy response to exercise, working at the most basic and primary level of the process.

In addition to this, there is evidence that suggests that Viagra may work to amplify the "pump" response during training. The pump is thought to happen when contracting muscle fibers signal local vascular relaxation (increasing the blood flow to the working muscles). According to KS Lau and coworkers, NO generated by neuronal NO synthase in contracting skeletal muscle fibers may regulate vascular relaxation via a cGMP-mediated pathway. Since the mechanism of action for Viagra is amplification of the cGMP pathway, there is ample reason to believe that the drug may indeed affect the blood flow and pump to the muscle, and therefore indirectly aid in the hypertrophy response.

Common uses and directions for Sildenafil Citrate

Normally nerves or blood vessels in men with male erectile dysfunction do not work properly, which prevents them from achieving an erection. It works to restore the blood flow to the penis making it easier to achieve and sustain longer erections.
  It increases the blood flow to the penis by helping the arteries in the penis relax and expand. As the arteries in the penis expand and harden, veins that normally carry away blood flow to the penis are compressed resulting in an erection.
  It takes at least 30 minutes before it starts to work, and remains active for up to 4 hours. The erection goes away after intercourse.
Men who are currently using medicines that contain nitrates, such as nitroglycerin should not use it because taken together they can lower the blood pressure too much. Kobra should not be used by women or children.

Sildenafil Citrate additional information:

Common uses
  is used to treat erection difficulties, such as erectile dysfunction (ED).

Directions
  comes as a tablet containing 150 mg. sildenafil citrate, to take by mouth.
For most men, the recommended dose is 50 mg. taken, as needed, approximately 1 hour before sexual activity. However, sildenafil citrate may be taken anywhere from 4 hours to 0.5 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.

Precautions
A starting dose of 25 mg. should be considered individuals of the age 65+ and in individuals with hepatic impairment or severe renal impairment.
Given the extent of the interaction with patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum single dose of 25 mg. of Viagra in any 48 hour period.
Sildenafil citrate potentiates the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.
Treatments for erectile dysfunction, including Kobra/Viagra, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status.
Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months, patients with resting hypotension or hypertension, patients with cardiac failure or coronary artery disease and patients with retinitis pigmentosa should use Kobra/Viagra with great caution.
The safety of Viagra is unknown in patients with bleeding disorders and patients with active peptic ulceration.
Kobra/Viagra should be used with caution by individuals with anatomical deformation of the penis and by individuals who have conditions which may predispose them to priapism.
The safety and efficacy of combinations of Viagra with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended.

Possible side effects
The most frequently observed side effects of Kobra/Viagra includes headache, flushing, dyspepsia and nasal congestion.
Less frequent side effects include erections that will not go away and vision changes. In the event that an erection persists longer than 4 hours, seek immediate medical assistance. Other less frequent side effects include urinary tract infection, abnormal vision, diarrhea, dizziness and rash.
If you notice other effects not listed above, contact your doctor.

Overdose
If overdose of Kobra/Viagra is suspected, contact your local poison control center or emergency room immediately.

Additional information
Keep Viagra/Kobra in a tightly closed container and out of reach of children. Store  at room temperature and away from excess heat and moisture (not in the bathroom).

Note
The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, or other healthcare professional. It should not be construed to indicate that use of Viagra is safe, appropriate, or effective for you. Consult your healthcare professional before using Viagra