T h e r a p e u t i c I n d e x 252 Special Precautions Patients on antihypertensive or antianginal drugs. Presentation Box of 10 blister-pack strips of 10 capsules each. Pharmacological Actions of Principal Ingredients 1. Androgenic action: Protodioscin from Tribulus terrestris improves sexual desire and enhances erection. It gets converted to dehydroepiandrosterone (DHEA) and improves flow-mediated dilation of the penile arteries. This results in vascular smooth muscle relaxation in erectile tissue, and thus, enhanced erection. Curculigo orchioides has androgenic actions that renormalize sexual dysfunction. This includes improvement in sex drive, performance, and spermatogenesis. Piper betle has vasorelaxant activity mediated by inhibition of NO synthase (NOS) inhibitor, and provides androgenic action. Asteracantha longifolia helps in the release of NO from the endothelium and nitrergic nerve endings. Also, it contains active principles having pro-erectile activity. 2. Aphrodisiac action: Prunus amygdalus, an aphrodisiac, significantly increases sperm motility and sperm contents without producing any spermatotoxic effect. Blepharis edulis, an aphrodisiac, treats male sexual weakness, premature ejaculation, and spermatorrhea. Crocus sativus, used as an aphrodisiac, and in premature ejaculation, contributes to satisfactory sexual performance. 3. Antidepressant and anxiolytic actions: ED is associated with diabetes and hypertension. It is more prevalent in aging men. Psychological distress such as anxiety and depression also contribute to higher levels of premature ejaculation and ED rates. Crocus sativus has potent antidepressant action. Prunus amygdalus is a nervine tonic and improves psychotropic function. 4. Antioxidant action: ED demonstrates decreased intracavernous blood flow, loss of smooth muscle relaxation, decreased endothelial NOS and neuronal NOS, increased inducible NOS expression, diffused cavernous fibrosis, and increased cavernous levels of the oxidative product 8-epi-prostaglandin F2 alpha, an F2-isoprostane. Long-term use of antioxidants increases intracavernous blood flow and improves smooth muscle relaxation and erectile response in ED. Crocus sativus and Prunus amygdalus are potent antioxidant agents, which reduce lipid peroxidation with a concomitant increase in enzymatic activity of superoxide dismutase, catalase, and glutathione peroxidase. Asteracantha longifolia, Curculigo orchioides, and Piper betle have potent antioxidant activity. Tentex Royal® (capsule)
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