pronounced as (sil den' a fil)
Sildenafil (Viagra) plays a crucial role in the treatment of erectile dysfunction, commonly known as impotence or the inability to obtain or maintain an erection in men. Additionally, sildenafil, under the brand names Liqrev and Revatio, is beneficial for improving the capacity to exercise in both adults and children aged 1 year and older who are diagnosed with pulmonary arterial hypertension (PAH), a condition characterized by elevated blood pressure within the vessels that transport blood to the lungs. This high blood pressure can lead to symptoms such as shortness of breath, dizziness, and extreme fatigue. As a member of the phosphodiesterase (PDE) inhibitors class, sildenafil effectively enhances erections by augmenting blood flow to the penis during sexual stimulation. Conversely, in the treatment of PAH, sildenafil functions by relaxing the pulmonary blood vessels, thus facilitating a smoother flow of blood, which aids in relieving the symptoms associated with this condition.
It is imperative to understand that while sildenafil can significantly alleviate the symptoms of erectile dysfunction, it does not provide a cure for this condition nor does it enhance sexual desire. Furthermore, sildenafil should not be viewed as a preventive measure against pregnancy or the transmission of sexually transmitted infections, including human immunodeficiency virus (HIV).
Sildenafil is available in two forms: as a tablet and as a liquid suspension that is administered orally.
When prescribed sildenafil for erectile dysfunction, adhering to your doctor’s instructions is essential. The typical recommendation is to take sildenafil as needed before engaging in sexual activity. The optimal timing for consumption is approximately 1 hour prior to sexual activity; however, it can be taken anywhere from 4 hours to as short as 30 minutes before. It is advised against taking sildenafil more than once in a 24-hour period. In cases where individuals have certain health issues or are on specific medications, doctors may prescribe a reduced frequency of use. Sildenafil can be ingested with or without food, but it’s important to note that consuming it alongside a high-fat meal may delay its onset of action.
For those using sildenafil to manage PAH, the typical regimen involves taking it three times daily, with or without food, and on a consistent schedule to maintain steady levels of the medication in the body.
Carefully follow the guidelines provided on your prescription label. If there is anything unclear about your medication or dosage, do not hesitate to consult your doctor or pharmacist. Dosage adjustments may be made based on your response. It is vital not to exceed prescribed amounts or alter the frequency without guidance from a healthcare provider.
If using the liquid form of sildenafil, make sure to shake it well for 10 seconds prior to each use to guarantee an even distribution of the medication. Employ the provided oral syringe for accurate measurement of your dosage and adhere to the manufacturer’s instructions for both usage and cleaning. Avoid diluting or flavoring the liquid with other substances.
When treating erectile dysfunction, your healthcare provider will typically start you on a standard dose, with adjustments made according to your experience with the medication. Should you find that sildenafil is ineffective or if side effects arise, it is crucial to communicate this with your doctor.
In the event that you are prescribed sildenafil for PAH, it’s essential to recognize that while the medication can effectively control PAH, it is not a cure. Therefore, even if you feel better, you must continue your prescribed regimen. Always consult your doctor before discontinuing use.
Patients are encouraged to discuss medication guides provided by the manufacturer to better understand their treatment.
This medication may also be prescribed for various other conditions; reach out to your healthcare provider or pharmacist for more details.
Before taking sildenafil,
- Inform your doctor and pharmacist about any allergies you may have to sildenafil or any other medications, including any ingredients present in the sildenafil tablets or suspensions. Request a detailed list of ingredients from your pharmacist.
- Certain medications interact negatively with sildenafil. Notify your healthcare provider if you are currently taking nitrates (medications for chest pain), such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Nitromist, Nitro-Dur, Nitrostat). It is vital to have a comprehensive discussion about any medications you are taking or considering before commencing treatment with sildenafil.
- If you are using recreational drugs that contain nitrates (known colloquially as 'poppers'), such as amyl nitrate or amyl nitrite, advise your doctor immediately, as sildenafil should not be taken concurrently with these substances.
- Disclose all prescription and nonprescription medications, vitamins, and nutritional supplements you are using or intend to use to your healthcare provider. This information is crucial, as it may impact the dose required or necessitate close monitoring for potential side effects.
- It is important to know that sildenafil can be obtained under the brand names Liqrev, Revatio, and Viagra, but you should only utilize one of these products at a given time.
- Some nonprescription or herbal remedies may have negative interactions with sildenafil, such as cimetidine (Tagamet HB) and St. John's wort. Make sure to inform your doctor and pharmacist if you are using these products prior to starting sildenafil therapy.
- Inform your doctor if you smoke, have undergone heart surgery in the past six months, have ever experienced an erection lasting over four hours, or if you have suffered from dehydration due to fever, vomiting, or diarrhea. This can increase the risks associated with sildenafil. Additionally, notify your physician of any prior medical history of conditions such as pulmonary veno-occlusive disease (PVOD), stomach ulcers, heart or kidney disease, heart attack, chest pain, irregular heartbeat, or any history of stroke. Disclose any family history of eye diseases, particularly retinitis pigmentosa, or if you have had sudden vision loss.
- If you are a woman taking sildenafil for PAH, discuss your pregnancy status or breastfeeding with your doctor. Should you become pregnant while on this medication, you should reach out to your healthcare provider.
- Prior to undergoing any surgical procedures, including dental work, make sure your surgeon or dentist is aware of your sildenafil usage.
- If you’re prescribed sildenafil for erectile dysfunction, inform your doctor if you have been advised against sexual activity for health reasons in the past, or if you have ever experienced chest pain during sexual activity, as this may impose additional risks. If such symptoms occur during sexual activity, seek medical assistance immediately and refrain from engaging in sexual activity until cleared by your doctor.
- Always inform all healthcare providers you encounter that you are taking sildenafil, especially if emergency treatment for a heart-related condition is necessary, as they need to know your recent medication history.
Consult your healthcare professional regarding the consumption of grapefruit or grapefruit juice while you are on this medication, as it may affect the efficacy and safety of sildenafil.
If using sildenafil for erectile dysfunction, it is unlikely that you will miss a dose since this medication is taken as needed, not on a fixed schedule.
In the treatment of PAH, if you miss a dose, take it as soon as you remember. However, if the next dose is approaching, skip the missed dose to maintain your regular schedule. Never take two doses at once to make up for a forgotten one.
Sildenafil may produce side effects. Contact your doctor if any of the following symptoms are severe or persistent:
- frequent headaches
- heartburn or indigestion
- diarrhea or gastrointestinal discomfort
- nausea
- flushing or warmth
- nosebleeds
- feelings of numbness, burning, or tingling sensations in the extremities
- muscle, back, arm, or leg pain
- alterations in color perception, particularly a blue tinge
- heightened sensitivity to light
- nasal congestion
Some side effects can be serious. If you experience any of the following symptoms, seek immediate medical attention:
- sudden severe vision loss (further information is provided below)
- blurry or unclear vision
- unexpected decrease or loss of hearing
- ringing in the ears
- dizziness or sensations of lightheadedness
- fainting spells
- chest discomfort or pain
- worsening levels of shortness of breath
- painful erection or one lasting longer than four hours
- skin rash; itching; hives; difficulty with breathing or swallowing; swelling in facial areas such as the eyes, mouth, or throat
Some individuals have reported a sudden loss of some or all vision following the use of sildenafil or similar medications. In certain cases, this vision loss was permanent. The causal relationship between the medication and vision loss remains undetermined. If you notice sudden changes in your vision while using sildenafil, reach out to your healthcare provider immediately and refrain from taking any further doses until instructed by a medical professional.
Additionally, instances of heart attack, stroke, irregular heartbeat, cerebrovascular hemorrhage, heightened blood pressure, and sudden death have been documented in men taking sildenafil for erectile dysfunction, especially among those with pre-existing heart conditions. The connection between these events and sildenafil remains unclear, and factors such as heart disease or sexual activity may contribute. Discuss these risks thoroughly with your healthcare provider.
A subset of patients have experienced sudden hearing loss while on sildenafil or comparable medications. The causality of the hearing loss is currently unknown. If you notice sudden hearing changes accompanied by tinnitus or dizziness, consult your doctor without delay. If you are using sildenafil for erectile dysfunction, do not initiate any further doses until you have had a discussion with your healthcare provider. If your usage is for PAH, do not discontinue the medication without professional guidance.
Sildenafil may also lead to other unforeseen side effects. Contact your healthcare provider if you encounter any unusual problems while on this medication.
For severe side effects, you or a healthcare provider can report to the FDA's MedWatch Adverse Event Reporting program either online or via phone.
Store sildenafil in its original container, ensuring it is tightly closed and out of reach of children. Tablets should be kept at room temperature, away from excess humidity and heat, ideally not in a bathroom setting. The liquid formulation can be stored at room temperature or in a refrigerator, but it must not be frozen. Unused liquid should be discarded after 60 days.
It is essential to safeguard all medications by keeping them hidden from children, as many medicine containers are not child-proof and can be easily opened. To avoid accidental poisoning, always secure medications with childproof caps and place them in a secure location out of children’s sight and reach.
For disposal of unused medications, always seek safe ways that prevent accidental consumption by pets, children, or anyone else. Flushing medication down the toilet is not recommended. The preferred method is engaging in a medicine take-back program. Consult your pharmacist or check with your local waste management for available take-back services. For more disposal guidelines, refer to the FDA’s Safe Disposal of Medicines page.
In the event of a suspected overdose, urgently contact your local poison control center. If symptoms include fainting, seizures, respiratory distress, or unresponsiveness, immediately call for emergency services.
Regularly attend all scheduled appointments with your healthcare provider.
Refrain from allowing anyone else to use your medication. If you have questions about medication refills, address them to your pharmacist.
It is beneficial to maintain an updated list of all medications, including prescription and over-the-counter (OTC), as well as any supplements you are taking. Bring this list to all doctor visits or hospital admissions, and keep it accessible for emergencies.
- Liqrev®
- Revatio®
- Viagra®