The internet market for Erectile Dysfunction (ED) drugs containing Sildenafil is continuously expanding as more patients suffering from ED prefer acquiring their ED (Sildenafil) medications online, as reflected by the study conducted in 2001 by Miles Jones with a title “Internet-based Prescription of Sildenafil: A 2104-Patient Series” .
One of the most common product lines in internet-based pharmacies is the Kamagra series, the generic Sildenafil drugs manufactured by India’s Ajanta Pharma. Kamagra products include various forms of Sildenafil delivery, and some products are beyond the conventional hard-pill type, like the Kamagra-100 Soft Tablets.
This may be a strategic marketing ploy by the manufacturer, as it is unlike the conventional 100 mg Sildenafil carrier, as the product is flavored (makes it more tolerable to take), may be chewed or placed under the tongue, and may be taken along with fatty foods , unlike the regular pills which have their effectiveness delayed by the fatty food intake. Aside from the chewable tablets’ peculiar characteristic (for intake), they are also said to work faster than the regular pills .
Ajanta Pharma Information
The company responsible for the Kamagra medication line and many other generics and branded generic medications, Ajanta Pharma Limited is one of the many drug manufacturers located in India. Although it is mainly in India, Ajanta is a global brand and is one the recognized companies in the field of Branded Generic Products in the country (India). But it is starting to gain popularity in the US market by its generic products .
Ajanta has a number of concentrations in manufacturing, depending on its operation in a particular country. For instance, in India, the prime concern of the company is for dermatology, pain, cardiology, and ophthalmology. Its US arm is focused in ANDAs and has several of these approved by the USFDA and several are pending for US FDA approval . In other countries (Africa, Asia, CIS, and the Middle East), the company is concerned primarily with the areas of meds like gastro, antibiotics, dermatology, pain, cardiology, anti-malarial, and many others .
As for the company’s facilities, it has several, and its main facility in India has already attained US FDA, WHO (GMP), UNICEF, and other FDA’s approval . Even if it already has manufactured countless medications, the company still continues in research and development to further advances in the pharmaceutical field.
Sildenafil Citrate—Scientific Studies
Sildenafil is the first effective and FDA-approved orally-taken treatment for ED, according to the review done by McCullough in 2002, “Four-Year Review of Sildenafil Citrate, which discussed in detail Sildenafil’s effects on various ED conditions, the public’s general reception of the drug, and which also explored other aspects of Sildenafil treatment . It was mentioned in the review that Sildenafil was quite well-received even just in its first few months on the market. Upon its US FDA approval, 5.3 M prescriptions were already given by practitioners for the ED patients . According to the study, Sildenafil’s safety is already established as reflected by a number of studies, and with even the dosage about 8x the recommended Sildenafil dose . Contrary to the initial assumption, Sildenafil is not the agent for the rare case myocardial infarction, as the condition is actually caused by the act of intercourse rather than the drug . The effectiveness of Sildenafil also was noted even in patients with underlying diseases causing ED, for instance, those with Parkinson’s disease, spinal cord injury (both complete and incomplete), diabetes, and even in those under medication for hypertension . Side effects of the drug common to patients included only headache and flushing, which also managed easily . Sildenafil has come a long way since its accidental discovery for ED, as it was really intended for angina and other cardiovascular diseases; it was found ineffective as an antianginal drug but was then developed as a potent ED treatment due to its erectogenic adverse effect .
Sildenafil Citrate (SC) is not only helping patients with ED treat the dysfunction itself, but it also helps improve the quality of their sexual lives, as indicated by the results of the study, “Effect of sildenafil on erectile dysfunction and improvement in the quality of sexual life in China: a multi-center study” by Wen-Hao Tang in 2015 . Evidence gathered by the researchers suggests that SC treatment indeed improved the quality of the patients’ sexual lives and not only treat the ED symptoms . It seemed that treating ED also had a positive psychosocial impact on the patients too.
According to the research by Hosny et.al., “Soy polysaccharide as a novel super disintegrant in sildenafil citrate sublingual tablets: preparation, characterization, and in vivo evaluation” made on 2015, although Sildenafil Citrate (SC) is effective in treating ED, its tablet form causes concern . The tablet form only has 40% bioavailability due to its extensive first-pass metabolism, it hurts the GI by causing dyspepsia and burning sensation, and it has a delayed onset of action due to its lack of water solubility . The researchers were able to prepare SC sublingual tablets using soy polysaccharide super disintegrant to fix the concerns mentioned for the hard pills. The results showed promise for SC sublingual tablets as they were able to be dissolved faster, had a rapid onset of action, and had a higher systemic bioavailability than the hard pills .
It’s not only in ED that SC is studied for, as there is a number of other research exploring its significance on other diseases. The “Effect of topically applied sildenafil citrate on wound healing: experimental study”, a study made by Koray Gürsoy et.al. (2014), studied the effect of SC on wound healing when topically applied . The study showed that 1% and 5% SC in gel formulation showed significance in wound healing in the aspects of inflammation, granulation tissue formation and maturation, and vascularity . The researchers recommended further clinical trials to support the initial results, though the results for SC as a topically applied agent in wound healing seem promising.
Sildenafil Citrate Mechanism
SC works as a specific inhibitor of Phosphodiesterase type 5 (PDE5), one of the 11 PDEs found in the body. This PDE5 is found specifically in the corpus cavernosum of the penis, pulmonary vascularity, platelets, skeletal muscle and vascular/visceral muscle . Erection occurs when NO (Nitric Oxide – a neurotransmitter is released during any form of sexual stimulation) increases cGMP (cyclic guanosine monophosphate), which in turn causes vasodilation in the penile tissue by relaxing the smooth muscle cells of the cavernosa . Since SC inhibits PDE5 which breaks down cGMP, erection potentiated in patients with ED and the erection is maintained .
Effects of Sildenafil Citrate
As mentioned in the discussion of SC’s mechanism, it can be expected that SC can cause ED patients to have erections when sexually stimulated and maintain them for long hours. The study “Sildenafil: from the bench to the bedside” by Michelakis et.al in 2000 mentioned that although SC is known to treat ED, it does not cause spontaneous erections or priapism on its own (without the patients being sexually stimulated) . SC is an effective and proven treatment for ED patients, although there are some considerations when it comes to patients having ED with other underlying diseases. ED may be effective in those patients too, but the dosage has to be adjusted for patients with other clinical considerations than ED .
Kamagra Soft Tablets contain 100 mg SC, which is an effective dose of the active ingredient, so it is expected that it can indeed treat ED in patients. The manufacturer and vendors claim that Kamagra in chewable form is released faster than the regular pill  and that is actually plausible as one of the mentioned studies  mentioned that sublingual pills (or easily dissolved pills) are delivered easier into the bloodstream  compared with the hard pills which need to be digested in the GI first.
Recommended Doses and Duration of Therapy
According to a recent study , the recommended therapeutic dose of SC is between 25 to 100 mg a day. But, it is the GP’s discretion which doses to assign to his patients especially the ones affected by other medical considerations aside from ED. Doses for those with liver cirrhosis and renal failures should be decreased, since SC is metabolized in the liver plus it’s processed by the kidney for excretion . There is no recommended daily intake for SC as it is to be used as needed only, but the limit is only one dose in a day.
Kamagra Soft (chewable) tablets are also limited to an as-needed use, and it is recommended to be taken at least 30 minutes to an hour before sexual activity . It is also limited to one dose within a 24-hour period .
Side effects and Warnings
As for the side effects of SC, so far, according to the review by McCullough  is the result of the PDE5 inhibiting property of SC (vasodilation and gastroesophageal sphincter relaxation). The review also mentioned that side effects vary from one patient to another and may also be dose-related . The commonly observed side effects are headaches and facial flushing, which accounts for 16% (headache) and 10% (flushing) of the tested population. Also, dyspepsia was observed in 7% of the patients treated with SC .
SC is known to interact with a large number of medications, especially nitrates, so patients should always heed the advice of their GPs when taking the medication. There are a number of listed contraindicated drugs for SC and these are only some of them: Erythromycin Imdur (Isosorbide mononitrate), Amyl Nitrate Cardilate (Erythrityl tetranitrate), Nitroglyn (Nitroglycerin), Nitrol Ointment (Nitroglycerin), Iso-D (Isosorbide dinitrate), Nizoral (Ketoconazole), Sorbitrate & Sorbitrate SR (isosorbide dinitrate), and many more .
Since Sildenafil Citrate is reviewed as an effective treatment for ED, it is expected that the patients taking Soft Kamagra (chewable) tablets will also benefit from the drug, since Kamagra Soft also contains SC. Users attest to its effectivity as shown by the reviews posted on Alldaychemist.com, where users rated the drug 5/5 due to its effectiveness. Some of the patients also noted how fast Kamagra Soft worked for them (some in 45 mins) and also noted that the drug is no different than the regular pills as the soft ones are also as effective.
Reviewers from Pharmacy2home.com also exclaimed the same things, as they also praised the Soft Kamagra tabs for their effectiveness in helping them with ED. Users with comments found on the same site showed how pleased they were with the effect and even recommended Kamagra Soft Tablets to others.
Since the effectiveness of SC in ED is established and since the Soft Kamagra tablets contain 100 mg SC, it is indeed recommendable for patients with ED to take them as other users were positive about their effectiveness too.
Kamagra Soft Tablets Price, Available Forms and Dosage
Newhealthyman.com sells soft Kamagra tablets for $60 for 28 pieces of the pills. Other internet pharmacies sell them for either more or less (Reliablecanadianpharmacy.com offers them for $1.69 each/$54.08 for 30 and 247worldstorerxe.com has them for $131.72 for 30) depending on their discretion.
There is no actual regulation in the pricing of these ED drugs on the web, so vendors have the discretion in allotting the price for the products.
Concerning the shipping fees, internet pharmacies are also allotting the prices based on their prerogative; but some are able to make the shipping free for the buyers. Also, the shipping rates are courier-preference-based and not based on the location of the buyer.
Conclusion and Rating
There is no question regarding the effectiveness of Sildenafil Citrate (SC) in patients as it is really an effective and proven treatment for those affected with Erectile Dysfunction. SC was first formulated as an antianginal drug but it proved to be ineffective for the condition and was found out to have an erectile effect to those taking it. The drug was then developed into an actual cure for ED, and the rest is history.
Aside from being a known cure for ED, SC is also studied for other implications, like for instance, as a topical wound-healing agent. Results have been promising and there is a possibility for SC to become a topical wound cure in the future. There is more research dedicated to the development of ED for other uses aside from ED and so far, most of the results were plausible towards SC’s use for ED.
Kamagra Soft (chewable) Tablets are only one of the many generic SC for ED products in the market. The product is manufactured by Ajanta Pharma, which is an established entity when it comes to pharmaceutical product manufacturing. The company has an impressive portfolio and its presence in the US market is a testament to its high-quality manufacturing. As for the soft pills’ effectiveness, users were positively commenting on the results, and they were generally well-pleased. There was even a mention of the product being fast-acting, which may actually be true as the study by Hosny et.al. proved that sublingual/soft pills are really faster-acting than the regular ones.
Kamagra Soft (chewable, 100 mg) Tablets deserve 4 out of 5 for its effectiveness as an SC-containing product for ED treatment. I highly recommend it due to its reviews from users who were able to try out the drug. But the product should be taken only under the strict supervision of a doctor, as there are many considerations to be taken before using the drug as an ED treatment, as is the protocol for all SC-containing meds. I left out a point because I have not really seen mentions of USFDA approval for this product; but otherwise, it is a good generic choice for ED.
Kamagra Chewable Tablets Wiki Facts
- Brand: Kamagra Chewable Tablets
- Active Ingredient: Sildenafil
- Treatment: Erectile Dysfunction
- Manufacturer: Ajanta
- Country of Manufacture: India
- Availability: UK, USA, EU, New Zealand, ++
- Jones MJ. Internet-based Prescription of Sildenafil: A 2104-Patient Series. J Med Internet Res. 2001 Jan-Mar; 3(1): e2. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761892/ [Accessed 29th November 2016].
- Kamagra Stock. Kamagra – Generic Viagra from Ajanta Pharma. Available from: https://server8.kproxy.com/servlet/redirect.srv/sruj/stmzffogwrete/p1/ [Accessed 29th November 2016].
- Ajanta Pharma Ltd. Available from: https://www.linkedin.com/company/ajanta-pharma-ltd [Accessed 29th November 2016].
- McCullough AR. Four-Year Review of Sildenafil Citrate. Rev Urol. 2002; 4(Suppl 3): S26–S38. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476025/ [Accessed 29th November 2016].
- Tang WH, Zhuang XJ, Ma LL, Hong K, Zhao LM, Liu DF, et.al. Effect of sildenafil on erectile dysfunction and improvement in the quality of sexual life in China: a multi-center study, Int J Clin Exp Med. 2015; 8(7): 11539–11543. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565360/ [Accessed 29th November 2016].
- Hosny KM, Mosli HA, Hassan AH. Soy polysaccharide as a novel superdisintegrant in sildenafil citrate sublingual tablets: preparation, characterization, and in vivo evaluation. Drug Des Devel Ther. 2015; 9: 465–472. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296913/ [Accessed 29th November 2016].
- Gürsoy K, Oruç M, Kankaya Y, Ulusoy MG, Koçer U, Kankaya D, et. al. Effect of topically applied sildenafil citrate on wound healing: experimental study. Bosn J Basic Med Sci. 2014 Aug; 14(3): 125–131. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333992/ [Accessed 29th November 2016].
- Michelakis E, Tymchak W, Archer A. Sildenafil: from the bench to the bedside. CMAJ. 2000 Oct 31; 163(9): 1171–1175. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80254/ [Accessed 29th November 2016].
- Kamagra Chewable Tablets 100mg (Generic Viagra). Available from: http://www.reliablecanadianpharmacy.com/product-details/kamagra-chewable-tablets-100mg-generic-viagra/275.html [Accessed 29th November 2016].