Sildenafil (commonly known as Viagra) is a medication designed primarily for the treatment of erectile dysfunction (ED) in men. This condition is defined as the difficulty in achieving or maintaining an erection suitable for sexual intercourse. Beyond its application in treating ED, sildenafil is also utilized under the trade names Liqrev and Revatio for patients of all ages above one year suffering from pulmonary arterial hypertension (PAH). PAH involves elevated pressure in the lung arteries, causing symptoms such as shortness of breath, lightheadedness, and extreme fatigue, significantly affecting the quality of life.
As a part of the phosphodiesterase type 5 (PDE5) inhibitors class of medications, sildenafil operates effectively for erectile dysfunction by enhancing blood flow to the penis during sexual arousal, which often results in an erection. In patients with PAH, sildenafil aids in relaxing the pulmonary blood vessels, which enables smoother blood circulation.
It is critical to note that sildenafil is not a cure for erectile dysfunction, nor does it stimulate sexual desire. Additionally, it does not offer any protection against pregnancy or the transmission of sexually transmitted infections, including HIV.
Sildenafil is available in various forms, primarily as tablets and in oral suspension format (liquid) intended for ingestion. When prescribed sildenafil for erectile dysfunction, adhere strictly to your physician’s instructions and the guidelines outlined in this section.
The prescribed medication should generally be taken as necessary, ideally about one hour prior to engaging in sexual activity. However, it can be consumed anytime within a window of 4 hours to 30 minutes before sexual intercourse. Typically, sildenafil should not be consumed more than once within a 24-hour period. Depending on your medical conditions or concurrent medications, your healthcare provider may adjust the recommended frequency of dosage based on your individual needs.
You may take sildenafil either with or without food; however, meals high in fat might delay the onset of its effectiveness.
If you are prescribed sildenafil for PAH, the usual regimen involves taking the medication three times a day, irrespective of meals, and at roughly the same times each day. It is vital to follow the dosage guidelines provided by your healthcare professional diligently and refrain from exceeding or underdosing beyond what has been prescribed.
For liquid formulations of sildenafil, ensure to shake the bottle well before each use to guarantee even distribution of the medication. Utilize the measuring syringe supplied with the medication to ensure an accurate dose. Avoid mixing sildenafil liquid with other medications or any flavoring agents.
When treating erectile dysfunction, your healthcare provider might initiate treatment with a moderate dosage of sildenafil, adjusting it as deemed necessary based on your response to the therapy. Should you find that the medication fails to work, it is imperative to inform your healthcare provider.
If using sildenafil for PAH, recognize that while it aids in managing the condition, it does not provide a definitive cure. Continue your sildenafil treatment even if you feel well, and consult your physician before making any changes to your medication regimen.
There are circumstances under which sildenafil may be prescribed for conditions other than those outlined previously. For further details, please consult your healthcare provider or pharmacist.
Before starting sildenafil, consider the following:
- Notify your doctor and pharmacist if you have any allergies to sildenafil, other medications, or specific ingredients found in sildenafil tablets or liquid forms. Do not hesitate to ask your pharmacist for a comprehensive list of these ingredients.
- Certain medications must not be taken alongside sildenafil. Ensure your healthcare provider is fully aware of all medications you are currently taking, including those used for chest pain such as nitrates (e.g., isosorbide dinitrate, nitroglycerin).
- Inform your physician if you are using illegal drugs with nitrate content (commonly referred to as "poppers"), as these can interact negatively with sildenafil.
- Provide a complete inventory of all prescription medications, over-the-counter drugs, vitamins, and dietary supplements you are either taking or plan to start.
- Sildenafil is marketed under the brand names Liqrev, Revatio, and Viagra; using more than one of these medications at the same time is discouraged.
- Be aware that some over-the-counter products or herbal remedies, such as St. John's Wort, can interact adversely with sildenafil. Always consult your physician or pharmacist prior to initiating any new medications while on sildenafil.
- Inform your doctor if you smoke, have recently undergone heart surgery, or have any underlying conditions that may complicate the use of sildenafil.
- If you experience chest pain during sexual activity, or if a healthcare provider has advised you to refrain from sexual activity due to medical reasons, contact your doctor immediately.
Discuss with your healthcare provider the implications of consuming grapefruit or grapefruit juice while undergoing treatment with sildenafil.
It is uncommon for you to forget a dose of sildenafil when used for erectile dysfunction, as it is taken as needed. If you’re using it for PAH and miss a dose, take it as soon as you remember. If it is nearly time for your next scheduled dose, skip the missed dose and do not double the dose.
Sildenafil may cause side effects. It is essential to notify your doctor if you experience any severe or persistent symptoms:
- Headache
- Heartburn
- Diarrhea
- Nausea
- Flushing (a feeling of warmth)
- Nasal congestion
- Muscle pain
- Visual disturbances (e.g., blue tint to vision or difficulty distinguishing between blue and green)
Some side effects may be serious. Seek immediate medical attention if you experience:
- Sudden loss of vision
- Loss of hearing or a sudden decrease in hearing ability
- Chest pain
- Prolonged or painful erection lasting more than 4 hours
Serious cardiovascular events, including heart attacks or strokes, have been reported in men taking sildenafil. The exact relationship between these events and the medication remains unclear; thus, discussing potential risks with your healthcare provider is crucial.
Store sildenafil in its original packaging, keeping it tightly closed and out of reach of children. Tablets should be stored at room temperature, away from excessive heat and humidity. If you possess a liquid formulation, it should be stored at room temperature or in the refrigerator, but do not freeze it. Discard any unused liquid after 60 days.
Ensure that all medications are kept out of sight and reach of children. Employ safety caps and store medications in a secured manner. Dispose of any unused medications appropriately and do not flush them down the toilet.
If an overdose is suspected, contact the Poison Control Center at 1-800-222-1222. If the person is unresponsive, having seizures, or experiencing difficulty breathing, summon emergency services immediately.
It is essential to attend all follow-up appointments with your healthcare provider while taking sildenafil.
Maintain an updated list of all medications you are taking, including both prescription and over-the-counter drugs, and provide this information during medical consultations or emergencies.
- Liqrev®
- Revatio®
- Viagra®