Joker oral suspension 25mg/ml bottle 30 ml

1 ml of Joker oral suspension contains 35.1 mg of sildenafil citrate, which is equivalent to 25 mg of pure sildenafil.

One injection of the dosing spray releases 0.5 ml of suspension (12.5 mg of sildenafil).

The composition also includes auxiliary components: sodium benzoate, citric acid, sweeteners (sucralose and acesulfame potassium), hypromellose, xanthan gum, natural and nature-identical flavors, purified water.

Joker is taken orally, shaking the bottle before use.

The standard recommended dose is 2 ml of suspension (4 sprays of the dispenser), which corresponds to 50 mg of sildenafil.

The product is taken approximately 30-60 minutes before intended sexual activity and no more than once a day.

The doctor may reduce the dose to 25 mg (1 ml, two injections) or increase it to 100 mg, based on effectiveness and tolerability.

It is better to take the drug on an empty stomach, as fatty foods delay absorption and reduce the bioavailability of the active ingredient by 20-40%.

Each injection releases 0.5 ml of suspension – it is convenient to dose the required amount.

Before first use, you need to press the dispenser several times to fill the pump, then apply the suspension to your tongue and swallow.

Sexual stimulation is required for the potency drug to work. Sildenafil does not cause an automatic erection; its effect is realized only during arousal.

Do not combine with nitrates, NO donors, riociguat, and other PDE-5 inhibitors. This combination may cause dangerous hypotension.

Use caution when taking alpha-blockers and strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir). Start with a lower dose and monitor blood pressure.

Do not use in case of anatomical deformation of the penis or a tendency to priapism. If an erection lasts more than 4 hours, immediate medical attention is required.

It is not recommended to consume alcohol and grapefruit juice during therapy, as they may increase adverse reactions and increase the level of sildenafil in the blood.

Sildenafil is well tolerated by most patients, but side effects are possible. The most common are headache, flushing, dyspepsia, nasal congestion, dizziness, and transient color vision disturbances. Less commonly, tachycardia, dyspnea, chest pain, or stroke may occur.

Sildenafil enhances the hypotensive effect of nitrates and some antihypertensive drugs, so when taken together, the risk of a sharp decrease in blood pressure increases.

In exceptional cases, priapism (prolonged painful erection), hearing impairment and serious allergic reactions have been reported.

Taking doses above 100 mg does not increase efficacy, but sharply increases the likelihood of adverse reactions. With a single dose of sildenafil up to 800 mg, side effects (headache, hot flashes, dizziness, dyspepsia, nasal congestion and visual disturbances) were much more common, although their profile remained the same.

There is no specific antidote; treatment is symptomatic. Hemodialysis does not accelerate the elimination of the drug, since sildenafil binds to plasma proteins and is only minimally excreted in the urine.

The drug is contraindicated in:

• hypersensitivity to sildenafil or any of the excipients;
• taking nitrates, nitric oxide donors or guanylate cyclase stimulants (e.g. riociguat);
• severe cardiovascular diseases in which sexual activity is not recommended (unstable angina, severe heart failure);
• loss of vision in one eye due to anterior ischemic optic neuropathy (NAION);
• recent myocardial infarction or stroke, severe arterial hypotension (BP < 90/50 mm Hg) or severe hepatic insufficiency;
• hereditary degenerative retinal diseases (e.g. retinitis pigmentosa) and combination with other PDE-5 inhibitors.

The drug is not intended for women and minors. Use is only permitted in adult men as prescribed by a doctor.

Joker suspension should be stored in its original packaging at a temperature not exceeding 30°C, protected from children and direct sunlight.

The shelf life of the sealed bottle is 36 months. After opening the bottle, it is recommended to use the drug within 12 months, observing the tightness of the dosing pump.