The recommended dose is 50 mg taken as needed approximately one hour before sexual activity. Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. The maximum recommended dose is 100 mg.
Ivan IV, Ivan the Fourth, also known as Ivan the Terrible, was the first ruler of Russia to give himself the title tsar. This happened in 1547. The first czar of Russia was Ivan IV (Grozny) Before that sovereigns of Russia used title The Great Knyaz. Ivan Grozny was the first Russia's sovereign, who officially used the Czar in title. Both part were used together - Czar and the Great Knyaz.
The Tsardom of Russia (ÑÑÑÑÐºÐ¾Ðµ ÑÐ°ÑÑÑÐ²Ð¾,[2][3] Russkoye tsarstvo or ÑÐ¾ÑÑÐ¸Ð¹ÑÐºÐ¾Ðµ ÑÐ°ÑÑÑÐ²Ð¾,[4][5] Rossisyskoye tsarstvo), also known as the Tsardom of Muscovy,[6][7] was the name of the centralized Russian state from assumption of the title of Tsar by Ivan IV in 1547 until the foundation of the Russian Empire by Peter the Great in 1721.