pronounced as (sil den' a fil)
Sildenafil, commonly known by its brand name Viagra, is primarily utilized for the treatment of erectile dysfunction, which is characterized by the inability to achieve or maintain an erection sufficient for sexual activity in men. Additionally, sildenafil is marketed under the brand names Liqrev and Revatio for the treatment of pulmonary arterial hypertension (PAH). This condition is marked by elevated blood pressure in the arteries that supply blood to the lungs, leading to symptoms such as shortness of breath, dizziness, and general fatigue. Sildenafil is classified within a category of medications known as phosphodiesterase (PDE) inhibitors. For erectile dysfunction, sildenafil works by enhancing blood flow to the penis upon sexual arousal, facilitating an erection. In the case of PAH, it functions by relaxing the blood vessels in the pulmonary region, thereby promoting better blood circulation.
It is essential to understand that while sildenafil can effectively treat erectile dysfunction, it does not provide a cure for the condition or amplify sexual desire. Moreover, sildenafil does not serve as a preventive measure against pregnancy or sexually transmitted infections, including HIV.
Sildenafil is available in both tablet and liquid suspension forms, intended for oral administration.
When prescribed for erectile dysfunction, it is critical to adhere to your healthcare provider's instructions. Sildenafil should be consumed as needed prior to sexual engagement. The optimal time for consumption is approximately one hour before anticipated sexual activity, although it may also be taken between 4 hours to 30 minutes before the act. Typically, sildenafil should not be ingested more than once within a 24-hour period. Depending on individual health factors or concurrent medication use, your healthcare provider may advise reduced frequency in dosage. You may take sildenafil with or without food; however, be cautious as consuming it alongside a high-fat meal may delay its efficacy.
For those taking sildenafil for PAH, the recommended frequency is generally three doses per day, which can be consumed with or without food. Consistency is key; hence, it is advisable to take the medication at roughly the same times every day.
Always carefully follow the instructions provided on your prescription label, and do not hesitate to consult your doctor or pharmacist for clarification on any points you find confusing. It is vital to administer sildenafil precisely as directed; avoid altering the dosage or frequency without approval from your healthcare provider.
For the liquid form, ensure thorough mixing by shaking the bottle for at least 10 seconds before each use. Utilize the oral syringe provided to accurately measure your dose and adhere to the guidelines for cleaning and using the syringe as instructed by the manufacturer. Do not combine the suspension with other medications or attempt to modify its flavor.
Your healthcare provider will likely start you on a standard dose of sildenafil for erectile dysfunction, adjusting the dosage based on your therapeutic response. Make sure to communicate with your provider if you find that sildenafil is insufficient or if you are encountering adverse reactions.
When prescribed for PAH, it's important to note that while sildenafil helps control the condition, it does not cure it. Thus, continue regular use even if you feel well. Eliminate the use of sildenafil only upon your healthcare provider's advice.
Request your pharmacist or doctor for a copy of the patient information leaflets provided by the manufacturer.
This medication might also be indicated for various other conditions; consult your healthcare provider or pharmacist for further insights.
Before taking sildenafil,
- disclose any allergies you have to sildenafil, alternative medications, or components found within sildenafil tablets or liquid suspension. Ask your pharmacist for a comprehensive list of ingredients.
- some medications are contraindicated when taken with sildenafil. Inform your healthcare provider if you are currently on nitrates (used for chest pain), such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), or nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). It is crucial to have discussed all medications you are presently taking or plan to start before beginning sildenafil with your doctor and pharmacist. Always seek guidance from your healthcare professional prior to initiating, halting, or altering any treatments while on sildenafil.
- disclose any use of recreational drugs containing nitrates (known as "poppers"), such as amyl nitrate or amyl nitrite, while on sildenafil, as your physician may advise against the use of sildenafil in such cases.
- inform your healthcare team of all prescription and over-the-counter medications, as well as any vitamins and dietary supplements you are currently taking or considering. Your doctor may need to adjust medication doses or monitor you closely for potential side effects.
- keep in mind that sildenafil is marketed under brand names such as Liqrev, Revatio, and Viagra, and you should only receive treatment from one of these brands at any given time.
- be aware that certain nonprescription or herbal remedies, like cimetidine (Tagamet HB) and St. John’s wort, may interact with sildenafil. Make sure to notify your healthcare team if you are using these products before starting treatment with sildenafil. Initiating these medications without prior consultation is not advisable.
- inform your doctor if you smoke, if you have undergone heart surgery within the past six months, if you’ve experienced an erection lasting beyond four hours, or if you have recently experienced significant fluid loss due to illness (fever, vomiting, or diarrhea). Such conditions can impact your response to treatment.
- provide your medical history related to pulmonary veno-occlusive disease (PVOD), ulcers, heart conditions, kidney or liver disorders, previous heart attacks, angina, irregular heartbeats, strokes, and other significant health issues. Disclose whether you or your family have a history of eye diseases, including retinitis pigmentosa or any sudden vision loss incidents.
- if you are a woman considering sildenafil for PAH, make sure to inform your healthcare provider if you're pregnant, planning to become pregnant, or are currently breastfeeding. In the event that pregnancy occurs during treatment, reach out to your doctor promptly.
- before undergoing any surgical procedures, including dental work, inform your surgeon or dentist about your sildenafil use.
- if using sildenafil for erectile dysfunction, communicate with your physician if you've been advised to avoid sexual activity for any medical reasons, or if you experience chest pain during sexual intercourse. Such activities may pose risks to your heart and should be discussed and monitored accordingly.
- always inform all healthcare professionals that you are taking sildenafil. In case of any emergency medical situations involving your heart, it is crucial for emergency personnel to understand the timing of your last sildenafil dosage.
Discuss with your physician the implications of consuming grapefruit or grapefruit juice while undergoing treatment with this medication.
If you are prescribed sildenafil for erectile dysfunction, it is unlikely that you will miss a dose since it is taken as necessary rather than on a fixed schedule.
If sildenafil is being used for PAH and you miss a dose, take it as soon as you remember. However, if the time is nearing your next scheduled dose, skip the missed dose to maintain your regular dosing plan. Do not double your intake to compensate for a missed dose.
Sildenafil may lead to side effects. Notify your healthcare provider if any of these symptoms become severe or persist:
- headache
- heartburn
- diarrhea
- nausea
- flushing (the sensation of warmth)
- nosebleeds
- tingling, burning, or numbness in the extremities
- muscular pain in the back, arms, or legs
- alterations in color perception (such as a blue tint to vision or difficulties distinguishing between blue and green)
- heightened sensitivity to light
- nasal congestion
Certain side effects can be serious. Seek immediate medical attention if you experience any of the following
- sudden severe vision loss (see below for more information)
- blurred vision
- sudden decrease or loss of hearing
- tinnitus (ringing in ears)
- lightheadedness or dizziness
- fainting spells
- chest pain
- worsening difficulty breathing
- an erection that is painful or endures longer than 4 hours
- skin rash; itching; hives; difficulty in breathing or swallowing; swelling of facial features.
Some patients have reported a sudden loss of partial or complete vision after using sildenafil or similar drugs. In certain cases, such vision loss was permanent. The exact cause remains unclear. If you encounter sudden vision loss during sildenafil treatment, inform your healthcare provider immediately. Refrain from taking additional doses of sildenafil or related medications such as tadalafil (Cialis) or vardenafil (Levitra) until you consult your physician.
There have also been documented cases of heart attack, stroke, irregular heartbeats, brain or lung bleeding, elevated blood pressure, and even sudden death among men taking sildenafil for erectile dysfunction. Although many of these individuals had preexisting heart conditions, the precise relationship between these occurrences and sildenafil usage, sexual activity, heart disease, or a combination of related factors is still under investigation. Discuss the risks associated with sildenafil with your healthcare provider thoroughly.
Similarly, some individuals have experienced sudden hearing loss after taking sildenafil or related medications. The causal connection has not been definitively established. If you experience sudden hearing loss, often accompanied by ear ringing or dizziness, reach out to your physician without delay. If you are utilizing sildenafil (Viagra) for erectile dysfunction, hold off on taking more doses until you have consulted with your healthcare provider. In the case of sildenafil (Liqrev, Revatio) for PAH, do not cease your medication without your physician’s input.
Other side effects may also arise while using sildenafil. Contact your doctor if you encounter any atypical issues throughout your treatment.
Should you experience a significant adverse reaction, you or your doctor might consider reporting it to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program. This can be done online or via phone (1-800-332-1088).
Store this medication in its original container, keeping it tightly sealed and away from the reach of children. Maintain tablets at room temperature, away from excessive heat and moisture; they should not be kept in the bathroom. The medication in liquid form should also be kept at room temperature or refrigerated but must not be frozen. Any unused liquid should be disposed of after 60 days from opening.
It is crucial to keep all medications securely stored and out of the sight of children, as various containers (like pillboxes or those for creams, drops, or inhalers) are not child-resistant. To prevent accidental poisoning, ensure safety caps are locked, and place medications in an inaccessible location that is high and out of children's view and reach.
Unneeded medications should be disposed of according to specific guidelines to prevent consumption by children, pets, or others. Do not flush this medication down the toilet. The optimal method for disposing of medication is by participating in a medicine take-back initiative. Speak with your pharmacist or contact local waste/recycling services to learn about available take-back programs nearby. For further details, visit the FDA's Safe Disposal of Medicines website.
In the event of an overdose, contact the poison control helpline at 1-800-222-1222, or seek additional information online. If the individual collapses, has a seizure, experiences difficulty breathing, or cannot be awakened, call emergency services immediately.
Ensure to keep all scheduled appointments with your healthcare provider.
Never allow anyone else to use your medication. Should you have any queries regarding the refilling of your prescription, do not hesitate to reach out to your pharmacist.
Maintain a comprehensive written list of all prescription and nonprescription medications you are currently taking, which should include vitamins, minerals, and dietary supplements. Bring this list with you each time you visit a healthcare provider or if you are hospitalized. It is also advisable to carry this information in case of medical emergencies.
- Liqrev®
- Revatio®
- Viagra®