pronounced as (sil den' a fil)
Sildenafil (commonly known as Viagra) is a medication specifically designed to treat erectile dysfunction (impotence, or the inability to achieve or maintain an erection) in adult males. In addition to its use for erectile dysfunction, sildenafil is also marketed under the names Liqrev and Revatio and is employed to enhance exercise capacity in adults, as well as children aged one year and older, who are diagnosed with pulmonary arterial hypertension (PAH). PAH is characterized by high blood pressure in the pulmonary arteries, which can result in symptoms like shortness of breath, weakness, dizziness, and fatigue. Sildenafil belongs to a category of medications referred to as phosphodiesterase type 5 (PDE5) inhibitors. It works by augmenting blood flow to the penis when a male is sexually stimulated, thereby facilitating an erection. In the case of PAH, sildenafil acts by relaxing the vascular smooth muscle in the pulmonary arteries, enabling easier blood flow and reducing the symptoms associated with high pressure within these vessels.
It’s essential to understand that if you are using sildenafil for erectile dysfunction, it will not serve as a cure for the condition nor will it enhance your sexual desire. Furthermore, sildenafil does not provide protection against pregnancy or sexually transmitted infections, including human immunodeficiency virus (HIV).
Sildenafil is available in both tablet and liquid suspension forms intended for oral administration.
When treating erectile dysfunction, it’s critical to adhere to your healthcare provider's instructions meticulously. Sildenafil should be consumed as needed prior to engaging in sexual activity, with an optimal time frame being approximately one hour beforehand. However, it may be taken any time ranging from four hours to thirty minutes prior to sexual engagement. Generally, sildenafil should not be administered more than once within a 24-hour period. Should you have pre-existing health conditions or be on other medications, your doctor may adjust the frequency of your sildenafil intake accordingly. It can be consumed with or without meals, but when taken alongside a high-fat meal, it may delay the onset of its effects.
For those using sildenafil to manage PAH, the typical regimen involves taking the medication three times daily, with or without food. Consistency in timing is important for optimal management.
It’s vital to carefully follow the directions provided on your prescription label. Should any part of the instructions be unclear, do not hesitate to ask your doctor or pharmacist for clarification. Sildenafil must be taken exactly as prescribed — do not alter the dose or frequency without consulting your healthcare provider.
When administering the liquid form of sildenafil, remember to shake the bottle vigorously for about ten seconds prior to measuring out your dose to ensure the medication is mixed adequately. Utilize the oral syringe that is provided to measure your dose accurately. Follow the manufacturer’s instructions for the use and cleaning of this syringe. It is crucial not to mix the liquid with other medications, nor should you add flavorings to it.
If sildenafil is not demonstrating effective results for erectile dysfunction, your doctor may initiate you on a standard dose with the intent to adjust it based on your response to the medication. Communicate openly with your doctor regarding the effectiveness of sildenafil and any side effects you may experience.
For patients taking sildenafil for PAH, it is important to recognize that the medication helps manage PAH symptoms but does not eliminate the condition. Continue your regimen even if you feel well, and consult your physician before discontinuing sildenafil.
For further information, you may request a copy of the manufacturer's patient information guide from your pharmacist or doctor.
This medication may also be prescribed for various other conditions; it is advisable to consult your healthcare provider or pharmacist for more details on those indications.
Before taking sildenafil,
- inform your healthcare provider and pharmacist if you have any allergies to sildenafil or any other drugs, or to any of the ingredients contained in the sildenafil tablet or suspension. Your pharmacist can provide a comprehensive list of components.
- Certain medications can interact adversely with sildenafil. Disclose to your healthcare provider or pharmacist if you are currently taking any nitrates (medications used for treating chest pain), such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), or nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). Ensure a thorough discussion regarding all other medications you are using or intend to use before initiating treatment with sildenafil.
- If you are using recreational drugs that contain nitrates (commonly referred to as 'poppers'), including amyl nitrate, amyl nitrite, or butyl nitrate, inform your doctor as they may advise against the use of sildenafil due to potential interactions.
- Make sure to discuss all prescription and non-prescription medications, as well as vitamins and nutritional supplements you are taking or plan to take, with your healthcare provider. Adjustments to your medication regimen may be necessary, and your doctor will monitor you closely for adverse effects.
- It is important to note that sildenafil is available under the brand names of Liqrev, Revatio, and Viagra; obtaining treatment with more than one brand at the same time is not recommended.
- Be aware that certain non-prescription or herbal products may interact with sildenafil, including cimetidine (Tagamet HB) and St. John’s wort. Always inform your healthcare provider and pharmacist of any such products prior to commencing sildenafil.
- Notify your healthcare provider if you smoke, have undergone heart surgery in the last six months, have ever experienced an erection lasting longer than four hours, or if you have recently become dehydrated due to illness (e.g., fever, diarrhea, vomiting) or excessive sweating. Additionally, inform your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD), stomach ulcers, heart complications, renal or hepatic disorders, histories of heart attacks, heart failure, angina (chest pain), arrhythmias, strokes, hypertension, hypercholesterolemia, bleeding disorders, and blood circulation issues. Discuss any family history of eye diseases like retinitis pigmentosa or prior incidents of sudden severe vision loss.
- If you are a woman prescribed sildenafil for PAH, inform your doctor if you are pregnant, intending to become pregnant, or if you are breastfeeding. Immediately contact your healthcare provider if you become pregnant while taking this medication.
- Prior to any surgical procedures, including dental work, inform your surgeon or dentist that you are currently taking sildenafil.
- If you are prescribed sildenafil for erectile dysfunction, let your healthcare provider know if you have ever been advised to avoid sexual activity for medical reasons or if you have experienced chest pain during sexual intercourse, as this type of engagement may pose additional risk to your heart health. If you encounter chest pain, dizziness, or nausea during sexual activity, seek medical guidance immediately and refrain from such activity until you receive clearance from your healthcare provider.
- It is important for all of your healthcare providers to be aware that you are taking sildenafil. In the event of a medical emergency involving heart issues, it is crucial that treating personnel know the last time you took sildenafil.
Please discuss with your healthcare provider the implications of consuming grapefruit or grapefruit juice while taking this medication.
For those using sildenafil for erectile dysfunction, missing a dose is unlikely as the medication is typically taken on an as-needed basis rather than at scheduled intervals.
If you are taking sildenafil for PAH and miss a dose, take it as soon as you recall. If it is nearly time for your next scheduled dose, skip the missed dose and continue with your regular dosing plan. Under no circumstances should you double up on doses to compensate for a missed one.
Sildenafil may cause side effects. It is advisable to inform your healthcare provider if any of the following symptoms are severe or persist:
- headache
- heartburn
- diarrhea
- nausea
- flushing (a sensation of warmth)
- nosebleeds
- numbness, burning, or tingling sensations in the arms, hands, feet, or legs
- muscle pain, back pain, or discomfort in the arms or legs
- changes in color perception (difficulty distinguishing between blue and green, or a blue tinge to objects)
- increased sensitivity to light
- nasal congestion
Some side effects may be serious. If you experience any of the following symptoms, contact your healthcare provider immediately:
- sudden loss of vision in one or both eyes (see below for additional information)
- blurred vision
- sudden decrease or loss of hearing
- ringing in the ears
- feelings of dizziness or lightheadedness
- fainting episodes
- chest pain or pressure
- worsening shortness of breath
- erections that are painful or persist for longer than four hours
- any rash, itching, hives, difficulty in breathing or swallowing, or swelling of the eyes, face, throat, tongue, or lips
There have been accounts of patients experiencing sudden vision loss—either partial or total—after administering sildenafil or other related medications. In certain instances, this vision loss has proven to be permanent. The causative relationship between the medication and vision loss remains unclear. Should you experience sudden vision changes while using sildenafil, seek immediate medical help. Do not take additional doses of sildenafil or related medications like tadalafil (Cialis) or vardenafil (Levitra) until you have consulted with your healthcare provider.
Reports have surfaced linking sildenafil usage to heart attacks, strokes, irregular heart rhythms, brain or lung bleeding, elevated blood pressure, and in some cases, sudden death among men taking the medication for erectile dysfunction. It has been noted that most, though not all, of these individuals had pre-existing heart problems. The precise role of sildenafil, sexual activity, and underlying heart disease in these incidents remains to be determined. It would be prudent to discuss the potential risks associated with sildenafil usage with your doctor.
Additionally, some patients have reported sudden hearing loss while on sildenafil or similar medications. The relationship between hearing loss and sildenafil use is not entirely understood. If you notice sudden changes in your hearing, often accompanied by tinnitus or dizziness, during treatment with sildenafil, contact your healthcare provider without delay. If you are using sildenafil (Viagra) for erectile dysfunction, refrain from taking any further doses of sildenafil or similar medications until you have received guidance from your doctor. For those on sildenafil (Liqrev, Revatio) for PAH, do not discontinue the medication without consulting your healthcare provider first.
Other adverse effects from sildenafil usage can occur as well. If you notice any unexpected problems or side effects while taking this medication, make sure to reach out to your doctor for advice.
In the event of a serious side effect, you or your healthcare provider may report it to the FDA's MedWatch Adverse Event Reporting System either online or by calling 1-800-332-1088.
Store this medication in its original container, ensuring it is tightly closed and out of reach of children. Tablets should be maintained at room temperature, away from excess heat and moisture (avoid bathrooms). The suspension can be stored at room temperature or in a refrigerator, but freezing is not permitted. Any unused suspension should be discarded after 60 days.
It is crucial to keep all medications securely stored away from children, as many packaging types (including pill minders and containers for eye drops, creams, patches, and inhalers) are not child-resistant, presenting a risk for young children. Always engage safety caps and promptly place medications in secure locations that are elevated and out of reach from children's sight and access. More information on how to keep medications safe can be found at the designated safety website.
Unused medications should be disposed of in a manner that prevents access by children, pets, or others. However, flushing these medications down the toilet is not advisable. The preferred disposal method is to utilize medication take-back programs. Consult with your pharmacist or reach out to your local waste management agency to learn about community disposal options. Further guidelines regarding safe disposal of medicines can be found on the FDA's website.
If you suspect an overdose, contact the poison control hotline at 1-800-222-1222 or consult their online resources. In cases where the individual has collapsed, experienced a seizure, is having difficulty breathing, or cannot be woken, immediately call emergency services at 911.
It’s important to attend all scheduled appointments with your healthcare provider.
Do not permit anyone else to consume your medication. Should you have any queries regarding prescription refills, reach out to your pharmacist for assistance.
Maintaining an updated written list of all prescription and over-the-counter medications, including any vitamins, minerals, or dietary supplements you are taking, is crucial. Bring this list with you during routine medical visits or in case of hospitalizations, and ensure you have it readily available for emergencies.
- Liqrev®
- Revatio®
- Viagra®