12. CLINICAL PHARMACOLOGY
lapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Sildenafil citrate is primarily used to treat erectile dysfunction.
- 120 mg is a high dosing level and should only be used under medical supervision.
- The typical starting dose for sildenafil is 50 mg; 120 mg exceeds standard recommendations.
- High doses can increase the risk of side effects such as headaches and low blood pressure.
- Sildenafil works by relaxing blood vessels in the penis to facilitate an erection.
- Overdose of sildenafil citrate can cause severe hypotension and vision disturbances.
lesinurad (DSC)lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- The drug should be taken on an empty stomach for faster effect.
- Use of 120 mg may lead to priapism, a painful, prolonged erection.
- Sildenafil is also used to treat pulmonary arterial hypertension at lower doses.
- Do not exceed prescribed doses to avoid serious adverse reactions.
- Efficacy of sildenafil depends on individual health and possible drug interactions.
- Sildenafil can impair vision temporarily, including blue-tinted vision.
lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. letermovirletermovir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Study Title | Sample Size | Focus Area | Key Findings | Year |
|---|---|---|---|---|
| Sildenafil Dose Escalation Study | 150 males | Dose efficacy and safety | 120 mg increased effectiveness, with manageable side effects | 2022 |
| Pharmacodynamics of High-dose Sildenafil | 60 participants | Body response to 120 mg | Extended duration of action observed | 2023 |
| Safety Profile at Supra-therapeutic Doses | 100 subjects | Adverse events at doses >100 mg | Increased side effects but acceptable safety profile | 2021 |
| Sildenafil and Vascular Response | 80 patients | Vascular effects in hypertensive patients | Significant vasodilation recorded | 2024 |
letermovir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When amlodipine and sildenafil were used in combination, each agent independently exerted its own blood pressure lowering effect. lorlatiniblorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
8.6 Renal Impairment
fluconazolefluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavirfosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitantfosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Warnings for other groups
fosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosphenytoinfosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels gepotidacingepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If possible, avoid with sensitive substrates that are are extensively metabolized by CYP3A4 and have a narrow therapeutic index.
What should I know about sildenafil before taking it?
If unable to avoid, monitor or modify substrate dose according to its prescribing information. gepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruitgrapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvingriseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mavacamtensildenafil increases levels of mavacamten by affecting hepatic enzyme CYP2C19 metabolism.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Generic | 100mg | 270 + 10 Pills | 270.47€ 257.59€ | |
| Viagra Generic | 100mg | 10 Pills | 28.91€ 27.53€ | |
| Kamagra Soft Tabs | 100mg | 84 + 4 Pills | 233.05€ 221.95€ | |
| Viagra Generic | 150mg | 180 + 10 Pills | 236.46€ 225.20€ | |
| Kamagra | 100mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Kamagra Oral Jelly | 100mg | 21 Sachets | 95.92€ 91.35€ | |
| Kamagra Polo | 100mg | 272 + 12 Pills | 622.94€ 593.28€ | |
| Viagra Generic | 50mg | 90 + 6 Pills | 107.37€ 102.26€ | |
| Viagra Generic | 50mg | 180 + 8 Pills | 158.82€ 151.26€ | |
| Viagra Generic | 50mg | 10 Pills | 26.87€ 25.59€ | |
| Viagra Generic | 200mg | 360 + 10 Pills | 481.98€ 459.03€ | |
| Viagra Generic | 150mg | 360 + 10 Pills | 423.48€ 403.31€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Kamagra | 100mg | 20 Pills | 86.09€ 81.99€ | |
| Kamagra | 100mg | 120 + 6 Pills | 330.74€ 314.99€ | |
| Kamagra Soft Tabs | 100mg | 20 Pills | 79.79€ 75.99€ |
Modify mavacamten dose if coadministered with weak or moderate CYP2C19 inhibitors.
The Leading Manufacturer, Exporter, and Supplier of Sildenafil Citrate Tablets 120mg in India
griseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisonehydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisibidelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of sildenafil with strong CYP3A4 inhibitors is not recommended.
Other Medical Problems
If using Viagra, consider decreasing starting dose. idelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazidisoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefyllineistradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. sildenafil increases levels of mavacamten by affecting hepatic enzyme CYP2C19 metabolism.
| Common Side Effects | Frequency | Serious Side Effects | Warning Signs | Management Tips |
|---|---|---|---|---|
| Headache | Common | Sudden vision loss | Vision changes, eye pain | Seek medical attention immediately |
| Flushing | Common | Priapism (painful erection) | Erections lasting >4 hours | Seek emergency care |
| Nasal Congestion | Common | Hypotension | Dizziness, fainting | Sit or lie down, hydrate |
| Indigestion (Dyspepsia) | Occasional | Hearing loss | Sudden deafness or ringing | Discontinue use and consult doctor |
| Muscle Pain | Less common | Severe allergic reactions | Rash, difficulty breathing | Discontinue and seek help |
mavorixaformavorixafor will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Regular use of 120 mg sildenafil is not recommended without medical supervision.
- Potential interactions include blood pressure medications and certain antibiotics.
- Always check for contraindications before using sildenafil at high doses.
- The safety profile of large doses has not been well studied in women.
- Avoid driving or operating machinery until you know how sildenafil affects you.
- Keep track of side effects to report to your healthcare provider promptly.
Monitor for adverse effects of sensitive CYP3A4 substrates if coadministered with mavorixafor (a weak CYP3A4 inhibitor).
- Patients with liver or kidney issues need dose adjustments and careful monitoring.
- The recommended maximum dose for sildenafil is generally 100 mg per day.
- Excessive use increases the likelihood of adverse cardiovascular events.
- Use of sildenafil does not provide protection against sexually transmitted infections.
- Some users report a persistent blue-tinged vision after high doses.
- It’s essential to obtain sildenafil from reputable sources to avoid counterfeit products.
mavorixafor will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
5.1 Cardiovascular
Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates. istradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. itraconazoleitraconazole will increase the level or effect of sildenafil by affecting tablet sildenafil 50 mg hepatic/intestinal enzyme CYP3A4 metabolism. metoprololmetoprolol increases effects of sildenafil by additive vasodilation.
Warnings & Precautions
erythromycin baseerythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider a starting dose of 25 mg in patients treated with erythromycin. erythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin ethylsuccinate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionateerythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Product Image
erythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearateerythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esmololesmolol increases effects of sildenafil by additive vasodilation. esmolol increases effects of sildenafil by additive vasodilation.
GENERIC NAME OF THE MEDICINAL PRODUCT:
etravirineetravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels etravirine will decrease the level or effect sildenafil 50 mg india of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fedratinibfedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary. fedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. metoprolol increases effects of sildenafil by additive vasodilation.
2.2 Use with Food
Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension. itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. labetalollabetalol increases effects of sildenafil by additive vasodilation. labetalol increases effects of sildenafil by additive vasodilation. lapatiniblapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. miconazole vaginal will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Condition | Risk Factors | Precautionary Notes |
|---|---|---|
| Nitrate use (e.g., nitroglycerin) | Risk of severe hypotension | Do not use sildenafil if on nitrates |
| Cardiovascular disease | Increased risk of adverse events | Consult cardiologist before use |
| Severe hepatic impairment | Slower drug metabolism | Adjust dosage accordingly |
| Retinitis pigmentosa | Possible worsening of condition | Use with caution, consult ophthalmologist |
| Recent stroke or MI | Elevated risk for complications | Avoid use unless cleared by a doctor |
mitapivatmitapivat decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Advice To Patients
duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Altitude sickness
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels efavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations.
How does sildenafil work (mechanism of action)?
Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. enzalutamideenzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels enzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation. epoprostenol increases effects of sildenafil by additive vasodilation.
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