Sildenafil citrate 100 mg starting dose in men with erectile dysfunction in an international, double-blind, placebo-controlled study: effect on the sexual experience and reducing feelings of anxiety about the next intercourse attempt
[34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction.
5.9 Counseling Patients About Sexually Transmitted Diseases
Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension at room temperature or in a refrigerator, but do not freeze it. Dispose of any unused suspension after 60 days. Keep all medication out of sight and reach of children as many containers are not child-resistant. Place the medication in a safe location – one that is up and away and out of their sight and reach.
Azole Antifungals
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website for more information. In case of overdose, call the poison control helpline at 1-800-222-1222. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time.
- Sildenafil citrate 100 mg is available by prescription only in many countries.
- Do not use sildenafil if you are taking nitrate medications for chest pain.
- Alcohol can increase the risk of side effects when combined with sildenafil.
[35] This study also noted a significant placebo effect in the control group.
- Common side effects include headache, flushing, nasal congestion, and dizziness.
- Serious side effects like vision loss or prolonged erections require immediate medical attention.
- Always consult a healthcare provider before starting sildenafil 100 mg.
Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. [36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 150mg | 360 + 10 Pills | 423.48€ 403.31€ | |
| Kamagra Soft Tabs | 100mg | 120 + 6 Pills | 311.78€ 296.93€ | |
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ | |
| Viagra Generic | 200mg | 10 Pills | 40.96€ 39.01€ | |
| Kamagra | 100mg | 360 + 6 Pills | 839.95€ 799.95€ | |
| Kamagra | 100mg | 32 Pills | 121.24€ 115.47€ | |
| Viagra Generic | 50mg | 270 + 8 Pills | 198.48€ 189.03€ | |
| Viagra Generic | 50mg | 180 + 8 Pills | 158.82€ 151.26€ | |
| Viagra Generic | 200mg | 90 + 6 Pills | 170.79€ 162.66€ | |
| Viagra Generic | 25mg | 10 Pills | 25.19€ 23.99€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ |
[33] Some users mix it with methylenedioxymethamphetamine (MDMA, ecstasy), other stimulants, or opiates in an attempt to compensate for the common side effect of erectile dysfunction, a combination known as "sextasy", "rockin' and rollin'", "hammerheading", or "trail mix".
Society and culture
However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for sildenafil chewable tablets PDE6, which is the phosphodiesterase found in the retina.
Mechanism of Action
Patients thus taking the drug may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. [33] Mixing it with amyl nitrite, another vasodilator, is particularly dangerous and potentially fatal. The 2007 Ig Nobel Prize in aviation went to Patricia V.
What is sildenafil?
[8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure.
Drugs you should not use with sildenafil
Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. Agostino, Santiago A.
- Sildenafil 100 mg can be used for pulmonary arterial hypertension in some cases.
- It is not intended for use in women or children.
- Regular use of sildenafil does not cure erectile dysfunction but manages symptoms.
Plano, and Diego A.
6.2 Postmarketing Experience
[4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours. [4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.
Raynaud's phenomenon
The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors. Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that sildenafil helps treat jet lag recovery in hamsters.
| Monitoring Aspect | Purpose | Key Metrics |
|---|---|---|
| Adverse Event Reporting | Track side effects and adverse reactions | Unexpected or severe reactions |
| Cardiac Function Monitoring | Patients with cardiovascular risk | ECG or other assessments |
| Liver and Kidney Function Tests | Patients on long-term therapy | Ensure no organ damage |
| Patient Education | Inform about common side effects and interaction risks | Enhance safe usage |
Professional athletes have been documented using sildenafil, believing the opening of their blood vessels will enrich their muscles. In turn, they believe it will enhance their performances.
| Country/Region | Approved Use | Regulatory Body | Notes |
|---|---|---|---|
| USA | Prescribed for ED and PAH | FDA | Prescription only |
| European Union | Authorized for ED and PAH | EMA | Prescription required |
| Australia | Approved for ED and PAH | TGA | Schedule 4 medication |
| Other Countries | Varies; often prescription required | Local authorities | Check local regulations |
Acetildenafil and other synthetic structural analogs of sildenafil which are PDE5 inhibitors have been found as adulterants in a number of "herbal" aphrodisiac products sold over-the-counter.
| Contraindication | Reason | Alternatives |
|---|---|---|
| Concurrent Nitrate Use | Risk of severe hypotension | Use other ED treatments |
| Cardiovascular Instability | May exacerbate underlying conditions | Consult cardiologist |
| Hypersensitivity Reactions | Allergic response | Discontinue use |
| Severe Liver Impairment | Altered drug metabolism | Lower dose or avoid |
[41] These analogs have not undergone any of the rigorous testing that drugs like sildenafil have passed, and thus have unknown side-effect profiles.
Pregnancy & Lactation
Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital.
Revatio Injection
You should carry the list with you in case of emergencies. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [42] Some attempts have been made to ban these drugs, but progress has been slow so far, as, even in those jurisdictions that have laws targeting designer drugs, the laws are drafted to ban analogs of illegal drugs of abuse, rather than analogs of prescription medicines.
Usual Adult Dose for Pulmonary Hypertension
[5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus.
Sildenafil Tablets or Oral Suspension for PAH
Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, at least one court case has resulted in a product being taken off the market. The US Food and Drug Administration (FDA) has banned numerous products claiming to be Eurycoma longifolia that, in fact, contain only analogs of sildenafil.