Sildenafil (Viagra) has established itself as a crucial therapeutic agent primarily targeted towards the treatment of erectile dysfunction in men, often identified as impotence. This condition is characterized by the inability to attain or maintain an erection sufficient for satisfactory sexual performance. Beyond this primary application, sildenafil is also utilized under the names Liqrev and Revatio to enhance exercise capacity among adults and pediatric patients aged 1 year and older diagnosed with pulmonary arterial hypertension (PAH). This condition is marked by elevated blood pressure within the pulmonary arteries, leading to symptoms such as shortness of breath, dizziness, and fatigue.
As a member of the phosphodiesterase type 5 (PDE5) inhibitors class, sildenafil functions by augmenting blood flow to the penis during sexual stimulation, thereby facilitating an erection. In patients suffering from PAH, sildenafil effectively relaxes the pulmonary blood vessels, thereby improving overall blood flow and oxygenation.
It is vital to emphasize that sildenafil does not serve as a cure for erectile dysfunction nor does it inherently boost sexual desire. Additionally, it does not confer any form of pregnancy prevention or protection against sexually transmitted infections, including the human immunodeficiency virus (HIV).
This medication is available in both tablet and liquid suspension forms for oral intake. Those using sildenafil for erectile dysfunction should rigorously follow their physician's guidance along with the instructions provided herein. Typically, sildenafil is administered on an as-needed basis prior to sexual activity, with the recommendation to take it approximately one hour before the intended engagement. However, it can be ingested any time ranging from 4 hours to 30 minutes before sexual endeavor. In general, patients are advised against taking sildenafil more than once every 24-hour cycle. Depending on individual health conditions or concurrent medications, healthcare providers may recommend a reduced frequency of administration.
Sildenafil can be taken with or without food; nevertheless, it is important to note that high-fat meals may delay its onset of action. For patients utilizing sildenafil for PAH, the standard regimen may involve taking the medication three times daily with or without food, ensuring to maintain consistent timing with each dose.
Adhere to the instructions found on your medication label diligently, and do not hesitate to consult your healthcare provider or pharmacist for clarification regarding any aspect of your treatment plan. It is essential to consume sildenafil precisely as prescribed, avoiding deviations in dosage or frequency as instructed by your healthcare professional.
When using the liquid form, it is critical to shake the suspension well for 10 seconds prior to each dose to guarantee an even mixture. Use the designated oral syringe for accurate measurement and administration, in accordance with the manufacturer's guidelines for usage and cleaning. Do not combine the liquid with other substances or attempt to flavor it.
If sildenafil is administered for erectile dysfunction, the initial prescribed dose is often moderate, allowing for adjustments based on therapeutic response. Patients should inform their healthcare providers if the medication proves ineffective or if they encounter any side effects.
For PAH patients, it is crucial to recognize that while sildenafil may control the condition, it does not constitute a cure. Thus, sustaining treatment is necessary even when symptoms seem well-managed. Cease administration only after consulting your physician.
Ensure to request a copy of the manufacturer's informational material from your pharmacist or doctor.
This medication may sometimes be prescribed for different medical conditions; please consult your healthcare provider or pharmacist for additional details.
Before taking sildenafil,
- Notify your physician and pharmacist if you are allergic to sildenafil, or any other medications, or any components found in the sildenafil tablets or liquid suspension. It is advisable to ask your pharmacist for a comprehensive list of ingredients.
- Certain medications are contraindicated with sildenafil. Inform your healthcare provider if you are currently taking nitrates, such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). Ensure that your healthcare provider and pharmacist are informed about all medications you are currently using or plan to initiate before starting sildenafil.
- Disclose to your healthcare provider if you are using illegal drugs containing nitrates, often termed 'poppers', such as amyl nitrite, nitrite, or butyl nitrate. Your physician will likely advise against sildenafil if you are using such substances.
- Inform your healthcare provider of any prescription and non-prescription medications, vitamins, or dietary supplements you are currently consuming or intend to take. Your doctor might need to modify your medication dosages or conduct close monitoring to mitigate side effects.
- Be aware that sildenafil is marketed under the brand names Liqrev, Revatio, and Viagra. You should only utilize one of these products at any given time.
- Over-the-counter or herbal products such as cimetidine (Tagamet HB) and St. John's wort may interact adversely with sildenafil. Always inform your healthcare provider and pharmacist if you are using these medications before starting sildenafil, and refrain from initiating new medications without consulting your healthcare provider.
- Advise your physician if you smoke, have had cardiac surgery in the last six months, have experienced an erection lasting longer than 4 hours, or have recently become dehydrated due to illness, such as fever, diarrhea, or vomiting, or from excessive sweating without adequate fluid intake. Inform your healthcare provider of any history of pulmonary veno-occlusive disease (PVOD), stomach ulcers, or cardiovascular, renal, or hepatic diseases; heart attack; heart failure; angina; arrhythmias; stroke; significant hypertension or hypotension; hypercholesterolemia; bleeding disorders; circulatory problems; or blood cell disorders such as sickle cell anemia, multiple myeloma, or leukemia. Notify your healthcare provider if you or a family member has a history of retinal diseases, including retinitis pigmentosa, or have ever experienced sudden severe vision loss attributed to reduced blood flow to the optic nerve.
- For women taking sildenafil to treat PAH, disclose to your physician if you are pregnant, plan to conceive, or are breastfeeding. Contact your physician immediately if you become pregnant while on medication.
- If undergoing any surgical procedures, including dental treatments, inform your physician or dentist that you are currently prescribed sildenafil.
- For men utilizing sildenafil for erectile dysfunction, notify your healthcare provider if a medical professional has ever advised you against sexual activity for health reasons, or if you have ever encountered chest pain while engaging in sexual activity. Sexual interaction can impose stress on your cardiovascular system, especially if you have a pre-existing heart condition. If you experience chest pain, dizziness, or nausea during sexual activities, seek immediate medical attention and abstain from further sexual engagement until cleared by your healthcare provider.
- Ensure that all your healthcare providers are aware that you are taking sildenafil. In the event of an emergency regarding your heart condition, it is vital for healthcare personnel to know your last dose of sildenafil.
Consult with your doctor about the consumption of grapefruit and grapefruit juice during sildenafil treatment.
For patients taking sildenafil for erectile dysfunction, it is unlikely to forget a dose, as the medication is taken on an as-needed basis rather than a fixed schedule.
If taking sildenafil for PAH, take the missed dose as soon as you recall it. However, if it is nearly time for your next scheduled dose, skip the missed dose and continue with your regular dosing regimen. Do not double up on doses to compensate for a missed one.
Sildenafil may cause side effects. Please inform your healthcare provider if any of the following symptoms become severe or persistent:
- headache
- upset stomach
- diarrhea
- nausea
- flushing (sensation of warmth)
- nosebleeds
- numbness, tingling, or burning sensations in the extremities
- muscle, back, arm, or leg pain
- altered color vision (including a blue tint to objects or difficulties in distinguishing blue from green)
- light sensitivity
- nasal congestion
Some side effects may be serious. If you experience any of the following symptoms, contact your physician immediately:
- acute and significant vision loss (details are provided below)
- blurred vision
- sudden auditory changes or loss of hearing
- tinnitus (ringing in the ears)
- dizziness or lightheadedness
- fainting spells
- chest pain
- aggravation of shortness of breath
- prolonged erection lasting beyond 4 hours
- rash; itching; hives; difficulty breathing or swallowing; swelling of the eyes, face, throat, tongue, or lips
Cases of sudden partial or total vision loss have been documented following the administration of sildenafil or similar medications. Some instances of vision loss were permanent, although it remains uncertain if these occurrences were directly attributed to the medication. If you encounter sudden vision impairment while using sildenafil, reach out to your healthcare provider without delay. Refrain from taking additional doses of sildenafil or analogous medications, such as tadalafil (Cialis) or vardenafil (Levitra), until you have consulted your physician.
Furthermore, there have been reports linking sildenafil to occurrences of heart attack, stroke, arrhythmias, cerebral or pulmonary hemorrhages, high blood pressure, and sudden death amongst men using the medication for erectile dysfunction. While most patients who experienced these events had pre-existing cardiovascular issues, the relationship between these incidents and sildenafil, sexual activity, cardiovascular disease, or a combination of various factors remains uncertain. It is critical to engage in discussions regarding the risks associated with sildenafil use with your healthcare provider.
Some patients have reported experiencing sudden auditory loss following the use of sildenafil or comparable medications. The precise relationship between the medication and auditory impairment is not well-defined. If you notice any sudden loss of hearing, sometimes accompanied by tinnitus or dizziness, while on sildenafil, please contact your physician promptly. If sildenafil (Viagra) is being used for erectile dysfunction, refrain from taking any additional doses or similar medications until you have consulted your healthcare provider. If you are taking sildenafil (Liqrev, Revatio) for PAH, do not discontinue use without first discussing it with your doctor.
Sildenafil may produce other side effects. Contact your healthcare provider if you experience any unusual issues while using this medication.
In case of developing significant side effects, either you or your physician may file a report with the FDA’s MedWatch adverse event reporting system. For more information visit https://www.fda.gov/Safety/MedWatch or call 1-800-332-1088.
Store this medication within its original packaging, securely closed, and out of reach of children. Keep tablets stored at room temperature and shielded from excessive heat and humidity (do not store in the bathroom). The liquid suspension should be stored at room temperature or in the refrigerator, but avoid freezing it. Discard any unused suspension after 60 days of opening.
It is vital to safeguard all medications from the reach and sight of children, as numerous containers (including weekly pill organizers and those containing eye drops, creams, patches, and inhalers) are not childproof, and children can easily access them. To avert potential poisoning, always utilize safety closures and store medications in a secured location, well out of children's sight and reach. For further guidance, visit https://www.upandaway.org/es/.
Unnecessary medications must be disposed of properly to prevent accidental consumption by children, pets, and others. However, do not flush these medications down the toilet. The best method of disposal is through a drug take-back program. Consult your pharmacist or local waste/recycling department for information on drug take-back initiatives available in your community. To learn more about safe medication disposal, visit the FDA’s website at https://goo.gl/xRXbPn.
If an overdose is suspected, contact the Poison Control Center at 1-800-222-1222. Additional information is available online at https://www.poisonhelp.org/help. Should the person collapse, experience seizures, show signs of difficulty breathing, or be unresponsive, call emergency services at 911 immediately.
Ensure to attend all scheduled appointments with your healthcare provider.
Never allow anyone else to use your medication. If you have any queries regarding the refilling of your prescription, consult your pharmacist.
It is crucial to maintain a written record of all medications you are currently taking, inclusive of prescriptions, over-the-counter products, vitamins, and dietary supplements. This list should accompany you during every visit to your healthcare provider or any hospital admissions. Such information is also essential in emergency situations.
- Liqrev ®
- Revatio ®
- Viagra ®