pronounced as (sil den' a fil)
Sildenafil (commonly known as Viagra) is primarily prescribed to treat erectile dysfunction, which is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance in men. The medication promotes increased blood flow to the penis, which is essential for achieving an erection, particularly during sexual stimulation. In addition to its use for erectile dysfunction, sildenafil is also utilized under the brand names Liqrev and Revatio to enhance exercise capacity in adults and children aged one year and older suffering from pulmonary arterial hypertension (PAH). PAH is characterized by high blood pressure in the blood vessels that deliver blood to the lungs, which can result in symptoms like dizziness, shortness of breath, and fatigue. By relaxing the blood vessels in the lungs, sildenafil helps improve blood flow and reduces these associated symptoms.
It is essential to understand that while sildenafil can effectively alleviate the symptoms of erectile dysfunction and PAH, it does not cure these conditions. Furthermore, sildenafil does not enhance sexual desire, nor does it provide protection against sexually transmitted infections, including HIV.
Sildenafil is available as a tablet and in liquid suspension form, designed to be taken orally.
For those taking sildenafil to address erectile dysfunction, adherence to your doctor's specific instructions is crucial. The medication should be taken as needed and is most effective when consumed approximately one hour before sexual activity. However, it can be taken anywhere from four hours to thirty minutes prior to engaging in sexual activity. In general, sildenafil should not be taken more than once within a 24-hour period. Individuals with specific health concerns or those on certain medications may be instructed by their healthcare provider to limit their usage. The medication can be consumed with or without food, though it is advisable to avoid high-fat meals as they can delay the onset of action.
For patients using sildenafil to treat PAH, the typical regimen involves taking the medication three times a day, also with or without food, while aiming to maintain a consistent schedule for each dose.
It is essential to carefully follow the instructions on your prescription label and to consult your doctor or pharmacist if you have any uncertainties. Always take sildenafil precisely as directed, avoiding the temptation to adjust your dosage without professional guidance.
With liquid formulations, shake the bottle well for a minimum of ten seconds before each use to ensure proper mixing of the medication. Utilize the oral syringe provided to measure your dosage accurately, following the manufacturer's instructions for both use and cleaning of the syringe. Never mix the liquid with other medications or attempt to alter its flavor.
When taken for erectile dysfunction, your healthcare provider will likely start you on a standard dose of sildenafil, monitoring your response to the treatment to verify if adjustments are necessary. Should the medication fail to deliver the desired results or if you experience side effects, it is imperative to communicate these issues to your doctor.
When using sildenafil for PAH, remember that while it can help manage the condition, it is not a cure. Continue taking sildenafil even if you feel fine and consult your healthcare provider prior to discontinuing use.
Do not hesitate to ask your pharmacist or doctor for the manufacturer’s patient information flyer, which can provide additional insights and recommendations.
This medication may also be prescribed for various off-label uses, so do consult your healthcare provider or pharmacist for further information on any additional indications.
Before taking sildenafil,
- Inform your doctor and pharmacist if you have a known allergy to sildenafil or any other medications, as well as to any components present in your specific formulation of sildenafil. Ask your pharmacist for a comprehensive list of ingredients.
- Certain medications may pose contraindications when taken alongside sildenafil. Disclose any current medications to your healthcare provider, specifically if you are being treated with nitrates for chest pain, such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), or nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). Ensure that your doctor and pharmacist are fully informed of your complete medication history before initiating sildenafil treatment.
- Be open about using recreational substances containing nitrates, commonly referred to as 'poppers,' including amyl nitrate or amyl nitrite. If you are engaged in such usage while prescribed sildenafil, your healthcare provider will likely advise against the combination.
- Inform your doctor and pharmacist about all prescription and nonprescription medicines, vitamins, and supplements you are taking or intend to start. Adjustments in medication dosages or enhanced monitoring may be necessary.
- Sildenafil is marketed under various brand names, including Liqrev, Revatio, and Viagra. You should only use one brand at a time to mitigate the risk of interactions.
- Be aware that certain nonprescription or herbal products, including cimetidine (Tagamet HB) and St. John’s wort, may interact with sildenafil. Always inform your healthcare provider of these products before commencing sildenafil treatment and avoid initiating them without prior discussion.
- Inform your doctor if you smoke or have had recent heart surgery, have experienced prolonged erections exceeding four hours in the past, or have lost a significant volume of bodily fluids (dehydration) due to illness, diarrhea, or excessive sweating. Additionally, disclose if you have been diagnosed with pulmonary veno-occlusive disease, stomach ulcers, or a history of significant cardiovascular conditions, kidney or liver diseases, strokes, or bleeding disorders, among others.
- Women taking sildenafil for PAH should inform their healthcare provider if they are pregnant, planning to become pregnant, or breastfeeding. If pregnancy occurs during treatment, consult your doctor immediately.
- Prior to any surgical procedure, including dental operations, inform your surgeon or dentist that you are on sildenafil.
- For those utilizing sildenafil for erectile dysfunction, consult your doctor immediately if you have ever been advised to avoid sexual activity due to medical conditions, or if you have experienced chest pain during sexual encounters, as sexual activity can impose additional strain on the heart, especially in individuals with pre-existing heart conditions. Should you experience chest pain, dizziness, or nausea during sexual activity, seek medical attention right away.
- Ensure all healthcare providers are aware of your sildenafil regimen. It is crucial to inform medical personnel about your sildenafil usage in case you require emergency treatment for cardiovascular issues.
Consult with your healthcare provider regarding the consumption of grapefruit or grapefruit juice while using this medication, as they may affect how your body processes sildenafil.
For those taking sildenafil for erectile dysfunction, it is improbable that you will miss a dose since this medication is utilized on an as-needed basis rather than following a strict regimen.
However, if you're taking sildenafil to manage PAH and you forget a dose, take it as soon as you remember. In cases where the next scheduled dose is imminent, skip the missed dose and return to your regular dosing schedule, refraining from doubling up on doses.
Like all medications, sildenafil may induce side effects. Notify your doctor 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 limbs
- Muscle, back, arm, or leg discomfort
- Changes in color perception (e.g., seeing a bluish tint to objects or difficulty distinguishing between blue and green)
- Heightened sensitivity to light
- Nasal congestion
Some side effects may be serious. Seek immediate medical attention if you experience:
- Sudden or severe visual impairment (refer to additional information below)
- Blurred vision
- Sudden hearing loss or decrease
- Tinnitus (ringing in ears)
- Dizziness or feelings of lightheadedness
- Fainting
- Chest pain
- Increased shortness of breath
- Painful erection lasting more than four hours
- Rash or allergic symptoms, such as itching, hives, or difficulty breathing or swallowing, along with swelling of facial features such as eyes, face, throat, tongue, or lips
There have been cases of sudden vision loss, either partial or complete, reported in patients who have used sildenafil or similar medications. In some instances, this vision loss was permanent. The relationship between the medication and the vision loss is not fully understood. If you experience sudden vision loss while using sildenafil, contact your healthcare provider immediately. Do not take further doses of sildenafil or similar treatments until you have consulted with your doctor.
Reports have also surfaced regarding serious cardiovascular events, such as heart attacks, strokes, irregular heartbeats, brain or lung hemorrhaging, elevated blood pressure, and even fatalities in men using sildenafil for erectile dysfunction. While many of these individuals had pre-existing heart conditions, it remains unclear whether sildenafil, sexual activity, heart disease, or a combination of factors were responsible for these events. Discuss any potential risks associated with sildenafil with your doctor.
Instances of sudden hearing loss have been noted in patients using sildenafil or comparable medications. Should you experience abrupt hearing impairment, perhaps accompanied by tinnitus or dizziness, reach out to your healthcare provider without delay. If you're on sildenafil for erectile dysfunction, refrain from taking more doses until you have consulted with your doctor. If using sildenafil for PAH, avoid discontinuing the medication until you've spoken to your healthcare provider.
Other side effects may occur while on sildenafil. Report any unusual or bothersome symptoms to your healthcare provider.
In the event of significant side effects, you or your doctor can report these to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program either online or by telephone.
Store this medication in its original container, tightly sealed, and away from children's reach. Maintain the tablets at room temperature, safeguarding them from excessive heat and moisture (avoid storing them in the bathroom). Keep the liquid suspension at room temperature or in a refrigerator, but do not allow it to freeze. Discard any suspension that remains after 60 days.
Always keep medications out of children's sight and reach, as many containers (including weekly pill organizers or containers for creams, drops, patches, and inhalers) are not child-resistant, and small children can easily open them. To prevent accidental poisoning, lock safety caps and ensure that all medications are stored securely out of children's view and reach.
Unused medications should be disposed of through proper channels to prevent accidental ingestion by pets, children, or others. Avoid flushing medicines down the toilet. The best disposal method involves utilizing take-back programs. Inquire with your pharmacist or local waste management service about available drug take-back initiatives in your area for safe disposal options.
If an overdose occurs, contact the poison control helpline. Should the individual collapse, experience seizures, have difficulty breathing, or remain unresponsive, call emergency services immediately.
Maintain all scheduled appointments with your healthcare provider.
Do not share your medication with others. For any questions about prescription refills, consult your pharmacist.
Keeping an updated list of all medications, whether prescription or over-the-counter, along with any supplements, is imperative. Carry this list each time you visit a healthcare provider or if hospitalization is necessary. This information is also vital in emergencies.
- Liqrev®
- Revatio®
- Viagra®