Sildenafil: MedlinePlus Drug Information

pronounced as (sil den' a fil)

Sildenafil, commonly known by its brand name Viagra, is primarily utilized for the effective 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 also prescribed under the names Liqrev and Revatio for treating pulmonary arterial hypertension (PAH). This condition is marked by elevated blood pressure in the pulmonary arteries, which can lead to symptoms such as severe shortness of breath, dizziness, and persistent fatigue. The medication functions as a phosphodiesterase type 5 (PDE5) inhibitor, enabling increased blood flow to the penis during sexual arousal, thereby facilitating an erection. Moreover, in the case of PAH, sildenafil acts by relaxing the blood vessels in the lungs, promoting better blood circulation and easing the symptoms associated with this condition.

It is important to note that while sildenafil can significantly improve erectile function, it does not provide a cure for erectile dysfunction itself nor does it enhance sexual desire. Furthermore, sildenafil is not a contraceptive; it does not prevent pregnancy nor does it offer protection against sexually transmitted infections, including HIV.

Sildenafil is available in multiple forms, including oral tablets and a liquid suspension, which are both intended for ingestion by mouth.

When prescribed for erectile dysfunction, it is crucial to adhere strictly to your healthcare provider's instructions regarding sildenafil usage. For optimal effectiveness, it is recommended to take the medication approximately one hour prior to engaging in sexual activity. However, sildenafil can be taken anywhere from four hours to thirty minutes before the act. It is advisable not to exceed one dose within a 24-hour period unless your healthcare professional has directed otherwise, particularly if you have other underlying health conditions or are on certain medications. The drug can be taken either with or without food; however, high-fat meals may delay its onset of action.

For the treatment of pulmonary arterial hypertension, sildenafil is typically taken three times a day, regardless of food intake, and it’s best to strive for consistency by dosing at similar times each day.

It is vital to follow the prescribed instructions on the medication label meticulously and seek clarification from your healthcare provider or pharmacist regarding any aspects that are unclear. Ensure that sildenafil is taken exactly as prescribed, refraining from altering the dosage or frequency unless specifically instructed by your doctor.

When using the liquid formulation, it is important to shake the bottle well for about ten seconds before each utilization to ensure the medication is properly mixed. Always utilize the oral syringe provided to measure your dose accurately, following the manufacturer’s guidelines on its proper use and cleaning procedures. Avoid mixing the suspension with other medicines or introducing flavoring agents.

Should you be using sildenafil for erectile dysfunction, your healthcare provider will likely initiate treatment with a standard dose, adjusting it upwards or downwards based on your individual response to the treatment. If you find that the medication is not effective or you experience adverse effects, it is essential to inform your healthcare practitioner.

In cases where sildenafil is administered for PAH, it is crucial to understand that while the medication helps control the condition, it does not provide a cure. Continue taking sildenafil regularly, even if symptoms seem to improve, and consult with your doctor before discontinuing the medication.

Request a copy of the manufacturer’s patient information guide from your pharmacist or doctor for additional details.

This medication may sometimes be prescribed for additional conditions not explicitly mentioned here; consult your healthcare provider or pharmacist for further clarification on such uses.

Before taking sildenafil,

• Inform your doctor and pharmacist regarding any history of allergies to sildenafil, or any other medications, or ingredients found in the sildenafil tablets or suspension. It may be helpful to request a list of these ingredients from your pharmacist.
• Certain medications could potentially interact negatively with sildenafil. Notify your doctor or pharmacist if you are taking nitrates (often prescribed for chest pain), including isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (available in various forms). Be sure to discuss all medications you are currently taking or plan to take, particularly before initiating treatment with sildenafil.
• Be open about any recreational drugs you may be using that contain nitrates (commonly referred to as 'poppers'), such as amyl nitrate or butyl nitrate, as sildenafil should not be taken concurrently with these.
• Share with your doctor and pharmacist a complete list of prescription and over-the-counter medications, vitamins, and dietary supplements that you are currently taking or intend to use. Your healthcare provider may need to adjust your medication dosages or monitor you more closely for potential side effects.
• Be aware that sildenafil can be found under the trade names Liqrev, Revatio, and Viagra, and it is recommended to avoid using more than one of these products simultaneously.
• Certain nonprescription or herbal supplements may interact with sildenafil, including cimetidine (Tagamet HB) and St. John’s wort. Always inform your healthcare provider of any such products you are using prior to starting sildenafil, and avoid introducing new such products without prior discussion.
• Disclose your smoking status and any recent heart surgeries conducted within the last six months. Report any experience of prolonged erections lasting more than four hours or significant fluid loss due to factors such as illness with fever, prolonged vomiting, or diarrhea, as well as excessive sweating or inadequate fluid intake. Additionally, inform your doctor of any history of pulmonary veno-occlusive disease, stomach ulcers, or any cardiovascular, renal, or hepatic conditions. Also, share details regarding any past events of heart attack, stroke, angina, and complications related to blood circulation or blood cell disorders. It is also important to mention any conditions affecting penis shape or diabetes. Furthermore, disclose if you or any family members have experienced eye diseases or sudden vision loss correlating with blood flow issues.
• If you are a woman using sildenafil for PAH, notify your healthcare provider if you are pregnant, planning to conceive, or breastfeeding. Should you become pregnant while on sildenafil, contact your doctor immediately.
• Before undergoing any surgical procedures, including dental work, inform your healthcare provider about your sildenafil use.
• If you are using sildenafil for erectile dysfunction, communicate with your doctor if a healthcare professional has ever advised you to avoid sexual activity due to underlying health issues or if you have experienced chest pain during sexual activity. Understand that sexual activity may impose additional strain on your heart, especially if you have pre-existing heart disease. If you find yourself experiencing chest pain, dizziness, or nausea during sexual activity, seek immediate medical advice and refrain from further sexual activity until cleared by a healthcare professional.
• Ensure all your healthcare providers are informed about your sildenafil use. In case of a medical emergency, it is vital for healthcare professionals to know when you last took sildenafil.

Consult your healthcare practitioner regarding the safety of consuming grapefruit or drinking grapefruit juice while undergoing treatment with this medication, as it may affect how sildenafil works.

Given that sildenafil for erectile dysfunction is typically taken on an as-needed basis, chances of missing a scheduled dose are minimal.

For those taking sildenafil for PAH, if a dose is missed, take it as soon as possible. However, if the timing is close to the next dosage, skip the missed dose entirely and proceed with your regular dosing regimen. Do not double up on doses to compensate for a missed one.

Sildenafil may lead to several side effects. If any of the following symptoms become severe or persist, please inform your healthcare provider:

• headache
• heartburn
• diarrhea
• nausea
• flushing (a warm sensation)
• nosebleeds
• tingling, numbness, or burning sensations in the extremities
• muscle, back, arm, or leg pain
• color vision alterations (e.g., seeing a blue tint on objects or struggling to differentiate between blue and green)
• increased sensitivity to light
• nasal congestion

Serious side effects may also occur. Contact your physician immediately if you encounter any of the following symptoms:

• sudden severe vision loss
• blurry vision
• sudden hearing decrease or loss
• tinnitus (ringing in ears)
• dizziness or lightheaded feelings
• fainting episodes
• chest pain
• increased shortness of breath
• painful erection lasting longer than four hours
• skin rash, itching, hives, breathing difficulties, or swelling of the face, throat, or mouth

Reports have indicated that some patients experienced sudden vision loss following sildenafil or similar medications. In certain instances, this loss was irreversible. The precise correlation between the medication and the vision loss is unclear. Should you experience sudden vision loss while taking sildenafil, contact your physician immediately and refrain from taking any further doses of sildenafil or similar PDE5 inhibitors until you've consulted with your healthcare provider.

There have also been instances of serious cardiovascular events, such as heart attack, stroke, abnormal heart rhythms, cerebral or pulmonary hemorrhage, increased blood pressure, and untimely death among men using sildenafil for erectile dysfunction. While many of these patients had underlying heart conditions, it remains uncertain whether these events were direct consequences of sildenafil, sexual activity, pre-existing heart issues, or a combination thereof. Discuss the potential risks associated with sildenafil use with your doctor.

Some users also reported sudden hearing impairment after taking sildenafil or related drug formulations. The exact cause of such hearing loss remains undetermined. If you notice a sudden decline in hearing, accompanied by symptoms such as tinnitus or dizziness, get in touch with your physician at once. If you're using sildenafil for erectile dysfunction, do not take additional dosing of sildenafil or any related medications until discussing the situation with your doctor. Similarly, if you are using sildenafil for PAH, do not discontinue your treatment without previous consultation with your healthcare provider.

Other side effects may arise as well. For any unusual occurrences while on this medication, reach out to your healthcare provider.

In case of a significant side effect, either you or your doctor can file a report with the Food and Drug Administration’s (FDA) MedWatch program online or by phone to ensure that adverse effects are documented and addressed promptly.

Store this medication in its original container, secured tightly, and kept away from children. Tablets should be maintained at room temperature, away from excessive moisture and heat, which means avoiding places like the bathroom. The liquid formulation may be stored at room temperature or within a refrigerator, but must not be frozen. Any unused liquid should be discarded after 60 days to ensure safety and efficacy.

Ensuring that all medications remain out of reach and sight of children is crucial, as many types of containers are not designed to be child-resistant, which presents potential risks. Use safety caps diligently and always place medications in secure and inaccessible locations for children to prevent unintentional poisoning.

Any unneeded medications should be disposed of in a manner that prevents consumption by pets, children, or others. This includes not flushing them down the toilet. The optimal method for disposal involves utilizing take-back programs for medications. Consult your pharmacist or local waste management organization for information about available take-back options in your area. The FDA provides additional guidance on safe disposal practices for medications.

If an overdose is suspected, contact the poison control center at 1-800-222-1222 immediately. Further information is accessible online. Should the individual exhibit severe symptoms, such as loss of consciousness, seizures, breathing difficulties, or an inability to awaken, call emergency services right away.

Ensure you maintain all scheduled appointments with your healthcare provider for ongoing care and monitoring.

Under no circumstances should anyone else use your medication. For any inquiries you have regarding prescription refills, do not hesitate to reach out to your pharmacist.

Keeping an updated written record of all prescription and over-the-counter medications, along with vitamins and supplements you are taking, is essential. Bring this list with you to each healthcare visit and in emergencies, as this information is vital for safe medical management.

• Liqrev^®
• Revatio^®
• Viagra^®