Cenforce 200 mg (Sildenafil citrate 200 mg)

Maximum Potency for Severe ED

Cenforce 200 is the most powerful Sildenafil Citrate tablet available, containing a massive 200mg dose — double the standard strength of Viagra. This product is designed for men with severe erectile dysfunction or those who have built up a tolerance to standard doses.

WARNING: This is a high-potency product. It should only be used by individuals who have experience with Sildenafil and require a higher dosage. We recommend splitting the tablet to assess tolerance.

Key Benefits:

• Double Strength: 200mg of Sildenafil per tablet.
• Unbeatable Value: effectively two doses in one pill.
• Maximum Performance: For the hardest, longest-lasting erections possible.
• Rapid Action: 30-60 minute onset.

Dosage:

• Typical Dose: Start with 1/2 tablet (100mg). Only take a full tablet if absolutely necessary.
• Limit: Never exceed 1 tablet (200mg) per 24 hours.

Chemical Profile

• Proprietary name: Cenforce 200 (marketed formulation commonly containing sildenafil in citrate salt form)
• Active ingredient (chemical): sildenafil citrate (sildenafil, citrate salt). Typical marketed specification: sildenafil equivalent to 200 mg (as sildenafil base) presented as the citrate salt.
• IUPAC (sildenafil base): 1-3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H‑pyrazolo4,3‑dpyrimidin‑5‑yl)-4‑ethoxyphenylsulfonyl-4‑methylpiperazine. The citrate denotes the salt counter-ion (citric acid).
• Molecular formula (sildenafil base): C22H30N6O4S. Approximate molecular weight (sildenafil base): 474.6 g·mol−1. Sildenafil citrate (salt) has a higher formula weight due to the citrate counter‑ion.
• Structural description: sildenafil contains a substituted pyrazolo4,3‑dpyrimidinone core linked via a sulfonyl bridge to a 4‑ethoxyphenyl ring; a N‑methylated piperazine moiety is attached to the sulfonyl group. Functional groups include a heterocyclic lactam-like pyrazolopyrimidinone, a sulfonamide (sulfonyl–piperazine linkage), an ethoxy-substituted aromatic ring and a tertiary amine (methylpiperazine). No stereocenters are present in the sildenafil molecule (achiral).
• Physicochemical properties (representative): sildenafil citrate is a crystalline solid; the citrate salt increases aqueous solubility relative to the free base. Sildenafil is moderately lipophilic and highly protein bound in plasma (~96%). Oral bioavailability is reduced by hepatic first-pass metabolism (see Clinical Pharmacology).
• Terminal elimination half-life: mean terminal plasma half‑life of sildenafil is approximately 3–5 hours (commonly reported ~4 hours) in healthy adults following a single oral dose. The N‑desmethyl metabolite has a similar half‑life and contributes to overall pharmacologic activity to a lesser extent.

Clinical Pharmacology (Mechanism of action)

• Pharmacologic class: Selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).
• Primary mechanism: Sildenafil competitively inhibits PDE5, the enzyme principally responsible for the hydrolysis of cGMP in smooth muscle cells of the corpus cavernosum. Under sexual stimulation, nitric oxide (NO) is released from nerve terminals and endothelial cells, activating guanylate cyclase and increasing intracellular cGMP. Elevated cGMP causes smooth muscle relaxation by reducing intracellular calcium concentrations, leading to increased arterial inflow and veno‑occlusive mechanism engagement in the corpus cavernosum and thereby facilitating erection. By inhibiting PDE5, sildenafil potentiates the effect of endogenous NO/cGMP signaling, enhancing and prolonging erection in response to sexual stimulation.
• Selectivity and off‑target effects: Sildenafil displays high inhibitory potency for PDE5 but also has activity against other PDE isoenzymes at therapeutic or supratherapeutic concentrations—most notably PDE6 (retinal phototransduction) and to a lesser extent PDE1 (cardiac and vascular). Inhibition of PDE6 is associated with transient visual disturbances (e.g., altered color perception). Systemic vasodilatory effects can result from PDE5 inhibition in vascular smooth muscle, manifesting as transient decreases in systemic blood pressure and occasional reflex tachycardia.
• Metabolism and active metabolite: Sildenafil is extensively metabolized in the liver predominantly via cytochrome P450 isoenzyme CYP3A4 (major) and CYP2C9 (minor) to an N‑desmethyl metabolite. The N‑desmethyl metabolite possesses PDE5 inhibitory activity, approximately one‑third to one‑half the potency of parent sildenafil, and contributes to the overall pharmacodynamic effect.
• Pharmacokinetics (summary): Following oral administration, sildenafil is absorbed with median time to peak plasma concentration (Tmax) about 0.5–2 hours (commonly ≈1 hour). Oral bioavailability is reduced (~40%) by first‑pass hepatic extraction. Protein binding is high (~96%). Elimination occurs primarily as metabolites excreted in feces (major route) and urine (minor route).
• Pharmacodynamic consequences: Enhancement of cGMP signaling in target tissues underlies the therapeutic effect for erectile dysfunction. Systemic vasodilation can lower blood pressure, which is clinically relevant with concomitant vasodilators (not discussed here). Pharmacodynamic onset, magnitude and duration correlate with plasma exposure and presence of sexual stimulation.

Storage & Stability

• Dosage form considerations: Tablets (film‑coated) containing sildenafil citrate are formulated to provide chemical and physical stability in standard oral solid dosage form presentation.
• Recommended storage conditions (typical for sildenafil citrate tablets): store at controlled room temperature—commonly 20–25 °C with permissible excursions (for example to 15–30 °C depending on local regulatory labeling). Protect from excessive heat, moisture and direct light. Maintain in original blister/prescription container until use to minimize moisture exposure.
• Stability profile: sildenafil citrate tablets are chemically stable under recommended storage conditions for the labeled shelf life when stored in intact primary packaging. Degradation may be accelerated by exposure to high temperatures, high humidity or oxidizing conditions. Solutions of sildenafil (aqueous) are subject to hydrolytic and oxidative degradation and are therefore less stable than the solid form; photodegradation can occur under strong UV light. Consult product‑specific stability data for validated shelf‑life and reconstitution/handling parameters.
• Storage after opening: maintain tablets in original blister or tight container; avoid prolonged exposure to humid environments (bathrooms, open air).
• Disposal: follow institutional or regional guidelines for pharmaceutical waste disposal; do not maintain beyond labeled expiry date.

General Information (Common medical uses)

• Primary therapeutic indication: treatment of erectile dysfunction (ED) in adult males—used to facilitate achievement and maintenance of an erection sufficient for satisfactory sexual activity when sexual stimulation is present. The pharmacologic effect is contingent on sexual stimulation due to the mechanism of potentiating endogenous NO/cGMP signaling.
• Other clinically recognized uses of sildenafil (different formulations/dosing under separate regulatory approvals): pulmonary arterial hypertension (PAH) is an approved indication for sildenafil in formulations and dosages distinct from ED preparations; in PAH, PDE5 inhibition in pulmonary vascular smooth muscle reduces pulmonary vascular resistance and improves exercise capacity. Use in PAH is product‑ and dose‑specific and should not be extrapolated to ED formulations without reference to regulatory labeling.
• Clinical considerations (biochemical focus): therapeutic activity arises from selective potentiation of cGMP signaling in target smooth muscle; off‑target PDE interactions (e.g., PDE6 in retina) underlie certain adverse effects (visual disturbances). Hepatic metabolism (CYP3A4/CYP2C9) and protein binding affect exposure and interaction potential with concomitant medications that alter CYP3A4 activity or hemodynamic status.
• Regulatory and formulation note: Cenforce 200 denotes a marketed tablet strength commonly containing sildenafil at a high single‑tablet sildenafil equivalent (200 mg as sildenafil base). Regulatory approvals, recommended dosing regimens, and labeled indications vary by jurisdiction and by specific product; clinical use should follow applicable regulatory labeling and specialist guidance.

(References and numerical values in this monograph reflect commonly reported pharmacokinetic and pharmacodynamic parameters for sildenafil citrate formulations in the published literature and product labeling; exact specifications should be confirmed from product‑specific regulatory documents and manufacturer data sheets.)