T h e r a p e u t i c I n d e x 249 Adverse Effects No adverse effects have been reported. Contraindications Tentex forte is contraindicated in patients with chronic renal disease and cardiac failure. Presentation Box of 10 blister-pack strips of 10 tablets each. Pharmacological Actions of Principal Ingredients 1. Androgenic action: Inadequate circulating testosterone levels result in male sexual dysfunction. Mucuna pruriens increases testosterone level in blood, and thus has a beneficial action in male sexual disorders. Protodioscin, a precursor of testosterone from Tribulus terrestris, gets converted to dehydroepiandrosterone (DHEA), and thus improves flow-mediated vasodilation of the penile arteries. Vasodilation is a function dependent on the endothelium-derived nitric oxide (NO), as NO is the principal mediator of vascular smooth muscle relaxation in erectile tissue and penile arteries. Argyreia speciosa has androgen-like activity, useful in male sexual disorders. 2. Aphrodisiac action: Hibiscus abelmoschus, Mucuna pruriens, Withania somnifera, and Tribulus terrestris possess aphrodisiac property that enhances sexual desire and drive and sexual performance. Withania somnifera and Argyreia speciosa have aphrodisiac and tonic properties. The roots of Anacyclus pyrethrum are used in impotency. They are specifically used in sexual debility due to nervous debility. Also, the root paste is mixed in formulations used for local application in male sexual debility. Trivanga bhasma is an effective aphrodisiac. Bombax malabaricum possesses aphrodisiac effect. The root powder of Bombax malabaricum is used as a tonic to treat impotency. Strychnos nux vomica inhibits the hydrolyzing action of phosphodiesterase type-5 (PDE-5) enzyme to facilitate accumulation of active cGMP (cyclic guanosine monophosphate). The cGMP in turn causes “undisturbed” and prolonged erection through increased blood flow. 3. Antioxidant action: Oxidative stress mediated through superoxide radicals and other reactive oxygen species (ROS) is central to impaired cavernosal function in male sexual dysfunction. Also, endothelial dysfunction due to other comorbid conditions like diabetes and cardiovascular disease is associated with male sexual dysfunction. Withania somnifera, Mucuna pruriens, Crocus sativus, Sida cordifolia, Piper nigrum, Ipomoea digitata, Tinospora cordifolia, and Asparagus racemosus have potent antioxidant activity and help alleviate male sexual dysfunction. Piper betle has vasorelaxant activity mediated by inhibition of NO synthase inhibitor. Tentex® forte (tablet)
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