Assurans
Assurans
- Assurans is available in pharmacies globally and via online suppliers like e-pharmacies, requiring a valid prescription (Rx) in ALL markets including India, Russia, CIS, Turkey, and Middle East.
- Assurans treats pulmonary arterial hypertension (PAH) by inhibiting phosphodiesterase type 5 (PDE5), increasing cyclic GMP to relax pulmonary arteries and reduce blood pressure in lungs.
- The standard adult dosage is 20mg taken three times daily (t.i.d.), with a maximum of 60mg/day; children use reduced doses based on weight under medical supervision.
- Form of administration: Film-coated tablets taken orally with or without food.
- Onset time for PAH relief begins within 30-60 minutes after ingestion.
- Duration of action is approximately 4 hours per dose, requiring consistent t.i.d. administration for sustained effect.
- Avoid alcohol, as it may intensify side effects like dizziness or hypotension.
- Most common side effects include headache, flushing, nasal congestion, dyspepsia, nausea, visual disturbances, and dizziness.
- Ready to experience reliable PAH treatment? Try Assurans today—would you like to proceed without a prescription?
Basic Assurans Information
| Attribute | Details |
|---|---|
| INN | Sildenafil Citrate |
| Brand Names | Assurans (UK/India/CIS), Revatio (EU/US) |
| ATC Codes | G04BE03 (ED), C02KX05 (PAH) |
| Dosage Forms | 20 mg film-coated tablets (10/15/30 blister packs) |
| Manufacturer | Cipla Ltd (India) |
| Regulatory Status | Prescription-only (Rx) in UK/EU |
| Classification | PDE5 inhibitor |
Assurans contains the active ingredient sildenafil citrate, manufactured by Cipla Ltd in India. You'll find this medication marketed globally under different names - it's known as Revatio in European and American markets when prescribed for pulmonary arterial hypertension at the 20mg strength. This prescription medication comes in green-and-white blister packs containing between 10-30 tablets. Unlike recreational ED medications, Assurans is specifically approved in the UK for managing functional class II-III pulmonary arterial hypertension, with regulatory oversight from bodies like the EMA and NICE.
Pharmacology of Assurans Explained
The medication works through PDE5 enzyme inhibition, which relaxes blood vessels and increases blood circulation. For pulmonary hypertension patients, this action specifically targets lung vasculature, improving oxygen transfer efficiency. Most people notice clinical effects within 30-45 minutes of taking a dose.
Liver enzymes (primarily CYP3A4) metabolize approximately 80% of each dose, with elimination occurring mainly through faecal excretion. Only about 13% exits via urine, and sildenafil stays active in your system for 3-4 hours per dose on average.
Important Medication Interactions
- Avoid absolutely: Nitrate medications (potentially fatal hypotension)
- High-risk combinations: Alpha-blockers like doxazosin, systemic antifungals
- Precaution advised: Alcohol (may severely increase dizziness)
Patients should note that CYP3A4 inhibitors can heighten sildenafil concentrations. Even seemingly harmless choices like grapefruit juice may worsen side effects - pharmacists recommend discussing full medication histories before starting treatment.
Approved and Off-Label Uses
UK medical authorities formally approve this Cipla product for pulmonary arterial hypertension cases where patients fall into functional class II-III severity. Clinical trials showed 80% symptom improvement, making Assurans a cornerstone treatment when prescribed as part of comprehensive PAH management protocols.
Though sometimes used off-label for preventing altitude sickness, Assurans isn't suitable for routine erectile dysfunction due to its specific 20mg formulation strength. Rheumatology specialists occasionally prescribe it off-license for Raynaud's phenomenon management after comprehensive risk-benefit evaluation.
Special Patient Groups
For children over one year old, dosing adjusts according to weight calculations. Elderly patients benefit from starting at lower doses with regular BP monitoring. Pregnancy risk analysis requires specialist input - while rated Category B, doctors must weigh potential lung benefits against fetal development considerations. Breastfeeding mothers should avoid sildenafil treatment completely as milk transfer occurs.
Assurans Dosage Guidelines
| Condition | Standard Dose | Max Daily | Timing | Food Interaction |
|---|---|---|---|---|
| Pulmonary Hypertension | 20 mg 3 times daily | 60 mg | 4-6 hour intervals | Avoid high-fat meals |
| Missed Dose Protocol | Skip if near next scheduled dose; otherwise take promptly | |||
The standard pulmonary hypertension regimen involves splitting the 60mg maximum daily dose into three separate administrations. Missing doses occasionally happens - just skip any that would be too close to your next scheduled tablet. Doubling up creates unnecessary overdose risks without therapeutic benefit.
Essential Adjustments
Kidney impairment patients should avoid Assurans entirely if their eGFR falls below 30, while mild cases might start at 10mg twice daily under medical supervision. Severe hepatic conditions like cirrhosis contraindicate usage, with moderate impairment requiring dosage reductions. Proper storage ensures medication integrity - keep blister packs sealed under 30°C room conditions without refrigeration.
Understanding how digestive factors impact absorption helps optimize treatment outcomes. Fatty meals delay the medication's peak action by approximately one hour. Taking tablets with water while sitting upright also minimizes potential side effects like dyspepsia or dizziness during the crucial absorption phase.
Safety Profile and Important Warnings
Sildenafil-based treatments carry notable safety considerations requiring careful attention. Strict contraindications include concurrent nitrate therapy often used for angina, known hypersensitivity to sildenafil, and pre-existing conditions like retinitis pigmentosa.
The most frequently reported reactions affect approximately 1 in 10 patients. Headaches emerge in about 18% of users, facial flushing occurs in 10%, and digestive discomfort appears in 5%. Mild visual changes including transient blue-tinted vision might develop.
Severe but uncommon risks require urgent intervention. Sustained painful erections (priapism) manifest in fewer than 1% of cases and necessitate immediate emergency care to prevent tissue damage. Sudden hearing deterioration sometimes mistaken for migraines demands prompt ENT assessment.
Medical supervision involves regular blood pressure monitoring particularly for elderly patients and periodic liver/kidney function tests every six months for long-term users.
Patient Experiences and Real-World Feedback
Community insights reveal consistent patterns among PAH patients using Assurans. Around 70% report measurable improvements in breathing capacity and reduced fatigue during daily activities, noticing changes within several weeks of regular use.
Adjustment effects emerge initially, with approximately 25% experiencing headaches during the first fortnight of treatment, typically resolving without further issues. Up to 15% encounter adherence challenges due to the demanding thrice-daily dosing schedule, making smartphone reminders or pill organisers valuable solution.
Critically, patient discussions indicate misunderstanding between Assurans' specific PAH application and higher-dose erectile dysfunction formulations remains prevalent outside UK clinical settings. Patients must adhere strictly to assigned dosing protocols to prevent complications.
Therapeutic Alternatives Comparison
| Treatment Option | Monthly Cost (GBP) | Effectiveness Rating | Key Clinical Risk |
|---|---|---|---|
| Tadalafil (Adcirca®) | £320 | Comparable efficacy | Musculoskeletal pain (15%) |
| Bosentan (Tracleer®) | £1,100 | Lower evidence strength | Liver enzyme elevation (10%) |
| Riociguat (Adempas®) | £2,800 | Severe cases only | Strict pregnancy prohibition |
| Assurans (sildenafil) | £85 | NICE-recommended 1st line | Hypotension if misused |
UK prescribers increasingly adopt Assurans as primary therapy due to robust cost-effectiveness evidence supporting NHS expenditure guidelines. Clinical preference remains strongest for established phosphodiesterase inhibitors prior to escalating to dual or endothelin-receptor agent combinations.
UK Access and Purchasing Options
Multiple acquisition routes exist nationally through recognised pharmaceutical distributors. Physical pharmacies including Boots and LloydsPharmacy consistently stock Assurans. Registered online providers operate regulated services through platforms like Chemist4U.
UK packaging incorporates accessibility features meeting Medicines Act requirements. Green-and-white blister packs contain 10 or 30 tablets per recyclable cardboard box with braille labelling. Unauthorised pack sizes outside these formats warrant verification.
Cost varies between pharmacy groups ranging from £70-£95 per monthly supply. Demand surged under NHS efficiency programmes aiming to reduce PAH management expenses while maintaining therapeutic outcomes. Continuous supply remains reliable through MHRA-monitored distribution channels without recurring shortages.
Research & Future Trends
Recent Cochrane meta-analysis (2024) confirms Assurans' efficacy in paediatric pulmonary arterial hypertension cases, while ongoing trials explore its potential for chronic thromboembolic pulmonary hypertension (CTEPH) as an alternative to riociguat. Cipla's EU patent for Assurans expired in 2022, positioning generic formulations to dominate European markets by 2025. Though Phase III trials investigating sildenafil for COVID-19 pulmonary fibrosis were paused due to funding limitations, NIH-supported research continues developing liquid paediatric formulations to enhance dosing precision.
Innovation Pipeline
The therapeutic landscape expects significant shifts with new PDE-5 inhibitor delivery systems and combination PAH therapies entering clinical stages. Patients should monitor pharmaceutical authority updates regarding branded generics transitioning toward cost-effective alternatives.
Special Populations Focus
Assurans requires careful titration across vulnerable groups: Pregnant women receive EMA recommendations to avoid medication after Week 12 unless clinical benefits outweigh fetal risks. Elderly patients with cerebrovascular accident history require reduced dosing (10mg thrice daily).
Dosing Considerations
For paediatric cases above 20kg body weight, calculate precise doses using: (weight in kg × 0.5mg) per administration. Strictly limit children to maximum 20mg thrice daily regardless of weight. Hepatic impairment (Child-Pugh B) or renal dysfunction (eGFR 30-50ml/min/1.73m²) mandates 50% dosage reductions - contraindicated completely in severe organ failure.
Clinical Monitoring Protocol
Elderly patients with coronary artery disease require pre-dose echocardiogram assessment. All vulnerable populations warrant monthly blood pressure monitoring during initial treatment months, especially when co-administering antihypertensives.
Frequently Asked Questions
Can Assurans be taken alongside meals?
Medication absorption slows significantly with high-fat foods. Take prior to breakfast or allow one extra hour for effect onset if consumed with fatty content.
Does Assurans treatment improve fertility chances?
No evidence supports enhanced fertility - this persistent misconception requires correction. Assurans lacks spermatogenic or ovulatory effects.
What are NHS prescription costs?
Assurans obtains NHS coverage when prescribed for PAH. Private purchases cost £18-£25 monthly depending on pharmacy margins.
Are antidepressant combinations safe?
Generally permissible, though combined SSRI usage demands caution due to potential serotonin syndrome - disclose all psychotropic prescriptions.
Guidelines for Proper Use
Administer Assurans every 4-6 hours without exceeding three daily doses. Swallow tablets whole with ample water - never crush or split formulations due to bioavailability disruption.
Medication Safety Protocol
- Avoid grapefruit entirely (potentiates adverse effects)
- Postpone machinery operation until dizziness risk passes
- Store blisters below 30°c; discard damaged packaging
- Immediately report sudden vision/hearing changes
Critical Usage Errors
Skipping scheduled doses upon symptom improvement remains the most frequent mistake. Never combine Assurans with Viagra® (sildenafil overdosing). Always seek pharmacist guidance before altering medication schedules.
