pronounced as (sil den' a fil)
Sildenafil (commonly known by its brand name Viagra) is primarily indicated for the treatment of erectile dysfunction, which is characterized by the inability of a man to achieve or maintain an erection adequate for sexual performance. Additionally, sildenafil is available under the brand names Liqrev and Revatio, which are utilized to enhance pulmonary arterial hypertension (PAH) in both adults and pediatric patients aged one year and older. PAH is a serious condition that involves elevated blood pressure in the pulmonary arteries, leading to symptoms such as breathlessness, fatigue, and dizziness. The medication belongs to a pharmacological class known as phosphodiesterase type 5 (PDE5) inhibitors. It operates by facilitating increased blood flow to the penis during sexual stimulation, ultimately leading to an erection. For PAH, sildenafil works by relaxing pulmonary blood vessels, thus promoting easier blood flow through the lungs.
It is important to understand that while sildenafil may effectively alleviate the symptoms of erectile dysfunction, it does not serve as a cure nor does it amplify sexual desire. Furthermore, sildenafil is not effective as a contraceptive agent, nor does it provide protection against sexually transmitted infections, including human immunodeficiency virus (HIV).
Sildenafil is available in both tablet and liquid suspension forms intended for oral administration.
When prescribed for erectile dysfunction, it is crucial to follow your healthcare provider's instructions regarding dosage and timing. The recommended approach is to take sildenafil approximately one hour prior to engaging in sexual activity, although it is permissible to take the medication anywhere from 4 hours to 30 minutes before intercourse. It is essential that sildenafil is not ingested more than once within a 24-hour period. In certain cases, your healthcare provider may recommend a less frequent dosing schedule based on your individual health considerations or concurrent medications. Sildenafil can be taken with or without food, but it is vital to note that consumption alongside a high-fat meal may delay its onset of action.
For those using sildenafil to treat PAH, a typical regimen includes three doses per day, again, with or without food and ideally taken around the same time each day.
Always adhere closely to the instructions provided on your prescription label, and do not hesitate to ask your doctor or pharmacist for clarification on any aspect you find unclear. Taking sildenafil precisely as directed is imperative, and you should avoid altering the dosage or frequency without explicit guidance from your healthcare provider.
For the liquid formulation, it is necessary to shake the vial thoroughly for about 10 seconds before administering each dose to ensure proper mixing of the medication. Utilize the oral syringe provided for accurate measurement and dosing, and adhere to the manufacturer's directions for the proper usage and cleaning of the syringe. You should never attempt to combine the liquid medication with other substances or flavorings.
If sildenafil is prescribed for erectile dysfunction, your physician will likely start you on a standard initial dose, adjusting it as necessary based on your response and any side effects you report. It’s crucial to communicate openly with your healthcare provider regarding the efficacy of the treatment and any unwanted reactions you might experience.
In the case of PAH, it’s important to recognize that although sildenafil can manage symptoms effectively, it does not provide a cure. Continue taking the medication as prescribed, and do not discontinue use without prior consultation with your healthcare provider.
For comprehensive understanding, request a copy of the patient information provided by the manufacturer from your doctor or pharmacist.
This medication may also be prescribed off-label for other medical conditions; discuss these possibilities with your healthcare provider or pharmacist for further information.
Before taking sildenafil,
- inform your doctor and pharmacist if you have a known allergy to sildenafil, any other medications, or any of the constituent ingredients found in sildenafil tablets or liquid. Your pharmacist can provide a detailed ingredient list for your reference.
- It is critical to avoid certain medications when taking sildenafil. Notify your doctor or pharmacist if you are currently on nitrates (commonly prescribed for chest discomfort), such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). Ensure you disclose all medications you are taking prior to starting sildenafil, and before making any changes to your medication regimen, seek advice from your healthcare provider.
- If you are using recreational drugs containing nitrates such as amyl nitrate or butyl nitrate, inform your doctor, as sildenafil should not be taken concurrently with these substances.
- Disclose to your doctor and pharmacist all prescription and nonprescription medications, vitamins, and dietary supplements you are consuming or plan to start. Your doctor might need to adjust dosages or monitor for potential side effects of your concomitant therapy.
- Be aware that sildenafil is marketed under various brand names, including Liqrev, Revatio, and Viagra, and you should use only one of these products at any given time to avoid overdose.
- Caution should be exercised with certain nonprescription or herbal products that may interact with sildenafil; these include cimetidine (Tagamet HB) and St. John’s Wort. Always disclose any such products to your healthcare provider before initiating sildenafil therapy.
- Let your doctor know if you smoke, have undergone heart surgery within the past six months, have had a prolonged erection lasting more than four hours at any time in the past, or have lost significant fluid levels due to illness (e.g., fever, vomiting, diarrhea). Conditions may arise from heavy sweating or inadequate fluid intake. It is also vital to inform your physician of any history of pulmonary veno-occlusive disease (PVOD), stomach ulcers, cardiovascular ailments, kidney or liver dysfunction, heart attacks, angina, irregular heart rhythms, strokes, and any other significant medical histories that could influence treatment outcomes.
- If you are a woman prescribed sildenafil for PAH, consult your physician regarding pregnancy, plans for pregnancy, or breastfeeding. If you become pregnant while receiving treatment, contact your doctor immediately.
- Prior to any surgical procedures, including dental work, inform your doctor or dentist that you are taking sildenafil.
- For those taking sildenafil for erectile dysfunction, make sure to inform your healthcare provider if you have ever been advised to refrain from sexual activity for health reasons or if you have experienced chest pain during sexual activities in the past, as sexual exertion may pose risks, particularly for those with heart disease. If you experience any discomfort such as chest pain, dizziness, or nausea during sexual activity, cease activity and seek medical advice immediately.
- Communicate to all healthcare providers about your sildenafil usage. Should you require emergency medical attention for cardiac-related issues, it is vital for providers to know the timing of your last sildenafil dose.
Consult with your healthcare provider about the consumption of grapefruit and grapefruit juice while taking this medication, as these can affect how your body processes sildenafil.
Since sildenafil for erectile dysfunction is taken as needed, it is unlikely that you will skip a dose. However, if you are on a schedule for PAH treatment, take the missed dose as soon as you remember. If the next scheduled dose is approaching, skip the missed dose and stick to your regular dosing regimen. Do not double up on doses with the intention of correcting a missed one.
Sildenafil may produce side effects. Notify your healthcare provider if any of these symptoms are severe or persistent:
- headache
- heartburn
- diarrhea
- nausea
- flushing (a sensation of warmth)
- nosebleeds
- numbness, tingling, or burning sensations in extremities such as the arms, hands, legs, or feet
- muscle, back, arm, or leg pain
- visual disturbances such as changes in color perception (e.g., seeing a blue tint to objects or difficulty differentiating between blue and green)
- sensitivity to light
- nasal congestion
Some side effects may be serious. If you experience any of the following, contact your doctor immediately:
- sudden severe loss of vision
- blurred vision
- sudden decrease or loss of hearing capability
- ringing in the ears
- lightheadedness or dizziness
- fainting episodes
- chest pain
- worsening shortness of breath
- prolonged or painful erections lasting longer than four hours
- severe rash; itching; hives; difficulty in breathing or swallowing; swelling of the eyes, face, throat, tongue, or lips
There have been cases of sudden vision loss in some patients after taking sildenafil or similar medications. Some incidents have resulted in permanent vision impairment, though it remains unclear whether the medication was the direct cause of such outcomes. If you notice sudden vision changes while taking sildenafil, seek medical help immediately and refrain from taking any further doses of sildenafil or other similar medications until you have consulted with your physician.
Reports have also indicated occurrences of heart attacks, strokes, arrhythmias, cerebral or pulmonary bleeding, elevated blood pressure, and even unexpected mortality in some men administrating sildenafil for erectile dysfunction. Most, but not all, patients who experienced these events had existing heart conditions prior to sildenafil use. The exact relationship between these incidents, sildenafil use, sexual activity, and pre-existing heart disease remains undetermined. Engage in a thorough discussion with your doctor regarding these potential risks before starting treatment.
Additionally, some individuals have reported sudden hearing loss following the use of sildenafil or analogs. The causative relation of these occurrences to the medication is still unclear. If you experience sudden hearing loss, possibly accompanied by tinnitus or vertigo, contact your healthcare provider at once. If you are using sildenafil (Viagra) for erectile dysfunction, postpone any subsequent doses of sildenafil or similar medications until you discuss the situation with your physician. For those using sildenafil (Liqrev, Revatio) for PAH, maintain your medication regimen until you have spoken to your doctor.
Other side effects may occur as well. Should you experience any unusual problems while using sildenafil, consult your healthcare provider.
If you experience a serious side effect, you or your healthcare provider may report it to the FDA's (Food and Drug Administration) MedWatch Adverse Event Reporting program either online (https://www.fda.gov/Safety/MedWatch) or by calling 1-800-332-1088.
Store this medication in its original container at room temperature, securely closed, and out of reach of children. Tablets should be protected from excessive heat and moisture (do not store in bathrooms), while the liquid suspension can be kept at room temperature or refrigerated but must not be frozen. Dispose of any remaining suspension after 60 days.
It is imperative to keep all medications out of the sight and reach of children, as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant, making them accessible to young ones. To safeguard against accidental poisoning, always ensure safety caps are locked and place medications in secure locations – ideally high up, away from children's reach and sight.
Unused medications should be discarded through special disposal methods to prevent accidental ingestion by children, pets, or others. Do not flush this medication down the toilet. The optimal means of medication disposal is through a medicine take-back program. Consult your pharmacist or local waste management services to discover take-back options available in your area. For further information regarding safe disposal, refer to the FDA’s Safe Disposal of Medicines website (https://goo.gl/c4Rm4p).
In the event of an overdose, contact the poison control center at 1-800-222-1222. More information is also accessible online at https://www.poisonhelp.org/help. If the individual is unresponsive, experiencing seizures, having difficulty breathing, or unable to be awakened, immediately call emergency services by dialing 911.
Maintain regular appointments with your healthcare provider to monitor your treatment’s progress.
Never allow anyone else to use your prescribed medication. Always address any questions regarding prescription refills with your pharmacist.
Keeping an updated list of all medications (both prescription and over-the-counter), vitamins, minerals, and dietary supplements you are taking is crucial. Bring this list with you to each medical visit or hospitalization. It can also be vital information to have in case of emergencies.
- Liqrev®
- Revatio®
- Viagra®