
Sildenafil Patient Tips
Sildenafil, a PDE-5 inhibitor, helps maintain that erection instead. There are some situations where you should not take sildenafil. You’re taking medications known as nitrates You’re taking medications known as nitrates You’re taking amyl nitrites (also known as “poppers”) You’re taking amyl nitrites (also known as “poppers”) You’re taking medications known as protease inhibitors You’re taking medications known as protease inhibitors You’re taking medications known as alpha-blockers You’re taking medications known as alpha-blockers You’re already taking sildenafil or any other PDE5 inhibitor in another form You’re already taking sildenafil or any other PDE5 inhibitor in another form You have any heart, liver or kidney problems You have any heart, liver or kidney problems You are taking medications for pulmonary arterial hypertension You are taking medications for pulmonary arterial hypertension You’re under the age of 18 You’re under the age of 18 The recommended starting dose is 50 mg. You shouldn’t take this more than once within a 24 hour period. Taking it more than once a day will increase the chance of side effects. If, after taking sildenafil, you feel the effect is too strong or too weak, you should talk to your doctor or pharmacist who may suggest an adjusted dosage for you or an alternative treatment. You should not take sildenafil film-coated tablets in combination with sildenafil oro-dispersible tablets. Take your sildenafil about an hour before you plan to have sex.
- Sildenafil citrate was approved by the FDA in 1998.
- Its discovery revolutionized the treatment of erectile dysfunction.
- The medication requires sexual stimulation to be effective.
- It is not an aphrodisiac; it facilitates natural response.
- Overdose symptoms may include severe hypotension.
- Recreational use of sildenafil without prescription is risky.
- Combining with alcohol can increase side effects.
- It should be stored at room temperature away from moisture.
Swallow the tablet whole with a glass of water.
Frequently asked questions
Most people feel the effect of sildenafil in 45 minutes or so. You’ll need to have sexual stimulation or feel sexually aroused to get an erection. If nothing happens, or if not enough happens, you should inform your doctor. You may experience side effects, and some are more common than others You may experience side effects, and some are more common than others Sildenafil may cause side effects which include dizziness and altered vision. You should be aware of your personal reaction to sildenafil before you drive or operate heavy machinery whilst taking it.
Altitude sickness
Sildenafil may cause side effects which include dizziness and altered vision. you experience any sudden decrease or loss of vision; you experience any sudden decrease or loss of vision; you experience any allergic reaction, such as wheeze, breathing difficulties, or swelling around the eyes or airways; you experience any allergic reaction, such as wheeze, breathing difficulties, or swelling around the eyes or airways; (If you are on nitrate medications for chest pain, do not take them.) (If you are on nitrate medications for chest pain, do not take them.) Severe side effects are rare, but they do happen. If you do experience any of the above severe side effects, you should seek urgent medical attention. Handled correctly, sildenafil citrate is a generally safe and effective way to treat erectile dysfunction. But you should always read the Patient Information Leaflet before taking it.
Pulmonary Arterial Hypertension
To find out more, book a consultation with one of our clinicians. Phosphodiesterase Inhibitors for EDPhosphodiesterase Inhibitors for PAH May be administered without regard to meals. Shake well for at least 10 seconds prior to each administration.Measure dose with an oral dosing syringe or calibrated measuring device.Concentration of the suspension is 10 mg/mL. Oral suspension (e.g., Liqrev)Storage: Store at room temperature of 20 to 25 degrees C (68 to 77 degrees F). Discard any unused portion after 90 days of opening the bottle.Powder for oral suspension (e.g., Revatio or generic equivalents)):Do not mix with any other medication or additional flavoring agent.Prior to reconstitution, tap the bottle to loosen the powder.Reconstitute with a total of 90 mL of water added in 2 portions. You can take it with or without food, but you might find that the effect takes longer to start if you’ve eaten heavily.
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Alcohol can interfere with your ability to get an erection (we’ve written about it in detail here), so to maximise the benefit of sildenafil, it’s best to give the beer a miss. Grapefruit juice may increase the incidence of unwanted side effects of sildenafil. The effects of sildenafil last approximately four hours, which means your erectile function is improved for four hours. The effects of sildenafil become evident when you are sexually stimulated or aroused. You should not have an erection for four hours - a prolonged and painful erection (priapism) is a surgical emergency, and you should seek urgent medical attention should this happen.
| Parameter | Frequency | Purpose | Notes |
|---|---|---|---|
| Blood Pressure | Before and after dosage | Check for hypotension | Especially in high-risk groups |
| Visual Function | Periodic | Monitor for retinal issues | Baseline and follow-up |
| Liver Function Tests | As needed | Detect hepatotoxicity | For long-term users |
Most people feel the effect of sildenafil in 45 minutes or so. You’ll need to have sexual stimulation or feel sexually aroused to get an erection. If nothing happens, or if not enough happens, you should inform your doctor. You may experience side effects, and some are more common than others You may experience side effects, and some are more common than others Sildenafil may cause side effects which include dizziness and altered vision. You should be aware of your personal reaction to sildenafil before you drive or operate heavy machinery whilst taking it. Sildenafil may cause side effects which include dizziness and altered vision. you experience any sudden decrease or loss of vision; you experience any sudden decrease or loss of vision; you experience any allergic reaction, such as wheeze, breathing difficulties, or swelling around the eyes or airways; you experience any allergic reaction, such as wheeze, breathing difficulties, or swelling around the eyes or airways; (If you are on nitrate medications for chest pain, do not take them.) (If you are on nitrate medications for chest pain, do not take them.) Severe side effects are rare, but they do happen. If you do experience any of the above severe side effects, you should seek urgent medical attention. Handled correctly, sildenafil citrate is a generally safe and effective way to treat erectile dysfunction. But you should always read the Patient Information Leaflet before taking it. To find out more, book a consultation with one of our clinicians.
What is Sildenafil and How Does it Work?
Although dose-response improvement in exercise ability was not observed in short-term clinical trials in adults with pulmonary hypertension, the delay in clinical worsening with long-term use of sildenafil in a clinical trial supports dosing up to a maximum of 80 mg PO 3 times daily. A maximum dose in pediatric patients has not been identified. Based on experience in adults, the dose may be titrated as needed to a maximum of 40 mg PO 3 times daily based on symptoms and tolerability. Avoid higher dosing due to a greater risk of mortality in pediatric patients (age 1 to 17 years) treated with high dose sildenafil monotherapy. 0.5 to 1 mg/kg/dose PO every 8 hours.
Sildenafil side effects
Prior to the release of pediatric pulmonary hypertension guidelines, the generally accepted dose of sildenafil was 0.5 to 2 mg/kg/dose every 6 to 8 hours, with some regimens, particularly those described in earlier reports, administering doses every 4 hours; however, guidelines recommend more conservative dosing based on a greater risk of mortality in pediatric patients (age 1 to 17 years) treated with high dose sildenafil monotherapy, as seen in the STARTS-2 trial. Relevance of this data to the infant population is unclear. 0.22 to 0.5 mg/kg/dose PO as a single dose 1 hour prior to discontinuing iNO or 4 times daily. None of the 15 patients receiving a single sildenafil dose of 0.3 to 0.5 mg/kg/dose PO 1 hour prior to discontinuation of iNO experienced rebound pulmonary hypertension compared to 10 of 14 patients receiving placebo. In 7 patients receiving sildenafil 0.22 to 0.47 mg/kg/dose PO 4 times daily, mean iNO dose was significantly reduced compared to baseline within 24 hours of sildenafil initiation (12.2 vs.
How is sildenafil supplied (dosage forms)?
29.8 ppm, p = 0.024). Guidelines recommend sildenafil use to prevent rebound pulmonary hypertension and facilitate iNO weaning in patients with evidence of increased pulmonary artery pressure upon iNO withdrawal; however, they do not provide specific dosing. Recommended maintenance dosing for pulmonary hypertension is 0.5 to 1 mg/kg/dose PO 3 times daily in persons younger than 1 year, 10 mg PO 3 times daily in persons weighing 20 kg or less, and 20 mg PO 3 times daily in persons weighing more than 20 kg. A double-blind, placebo-controlled, crossover study evaluated sildenafil for symptomatic secondary Raynaud's phenomenon resistant to vasodilatory therapy. Patients (n = 18, 15 were female) were randomly assigned to receive placebo or sildenafil 50 mg PO twice daily for 4 weeks; a washout period of 1 week was used before crossover. Phosphodiesterase Inhibitors for EDPhosphodiesterase Inhibitors for PAH May be administered without regard to meals. Shake well for at least 10 seconds prior to each administration.Measure dose with an oral dosing syringe or calibrated measuring device.Concentration of the suspension is 10 mg/mL. Oral suspension (e.g., Liqrev)Storage: Store at room temperature of 20 to 25 degrees C (68 to 77 degrees F). Discard any unused portion after 90 days of opening the bottle.Powder for oral suspension (e.g., Revatio or generic equivalents)):Do not mix with any other medication or additional flavoring agent.Prior to reconstitution, tap the bottle to loosen the powder.Reconstitute with a total of 90 mL of water added in 2 portions. Initially, add 60 mL of water to the bottle and shake vigorously for at least 30 seconds. Add the remaining 30 mL of water and shake vigorously for at least 30 seconds.Remove the cap and press the adaptor for the oral syringe into the neck of the bottle; replace cap.Write an expiration date of 60 days from the date of reconstitution on the bottle label.Storage: Store below 30 degrees C (86 degrees F) or in refrigerator at 2 to 8 degrees C (36 to 46 degrees F).
What to avoid
Initially, add 60 mL of water to the bottle and shake vigorously for at least 30 seconds. Add the remaining 30 mL of water and shake vigorously for at least 30 seconds.Remove the cap and press the adaptor for the oral syringe into the neck of the bottle; replace cap.Write an expiration date of 60 days from the date of reconstitution on the bottle label.Storage: Store below 30 degrees C (86 degrees F) or in refrigerator at 2 to 8 degrees C (36 to 46 degrees F). Discard any unused portion after 60 days. Extemporaneous 2.5 mg/mL sildenafil oral suspension:NOTE: Extemporaneously prepared sildenafil oral suspension is not approved by the FDA; an FDA-approved powder for pfizer sildenafil 50 oral suspension is now commercially available.With a mortar and pestle, grind thirty 25-mg sildenafil citrate tablets to a fine powder.In a separate container, mix 1 of the following: 1) 150 mL of Ora-Sweet with 150 mL of Ora-Plus; or 2) 150 mL of Simple Syrup, NF with 150 mL of methylcellulose 1%.Add a small amount of the mixture to the fine powder and mix into a uniform paste. Add geometric amounts of the vehicle to the almost desired volume while mixing.
Erectile dysfunction
Transfer to a graduated cylinder and adjust to volume while mixing.Place in amber plastic bottles. Shake well before each use.Storage: This suspension is stable for 91 days when stored at 4 and 25 degrees C. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Sildenafil injection is available as a ready to use solution; further dilution is not required.Administer as an IV bolus injection. May decrease the dose to 25 mg or increase the dose to 100 mg PO as needed approximately 1 hour before sexual activity.
Statistical Analysis
The dose may be taken from 30 minutes to 4 hours before sexual activity. Coadministration of certain drugs may need to be avoided or dosage adjustments may be necessary; review drug interactions. 25 mg PO as needed approximately 1 hour before anticipated sexual activity. May increase the dose up to 100 mg PO as needed approximately 1 hour before sexual activity. Dose may be titrated as needed based on symptoms and tolerability to a maximum of 80 mg PO 3 times daily. Discard any unused portion after 60 days.
- Sildenafil works by inhibiting phosphodiesterase type 5 enzyme.
- This inhibition increases cGMP levels in the body.
- Elevated cGMP leads to smooth muscle relaxation.
- It promotes vasodilation in the corpus cavernosum.
- This process facilitates an erection during sexual activity.
- The drug’s pharmacokinetics allow for rapid absorption.
- Food intake can influence absorption rate.
- It is effective in men of various ages.
Extemporaneous 2.5 mg/mL sildenafil oral suspension:NOTE: Extemporaneously prepared sildenafil oral suspension is not approved by the FDA; an FDA-approved powder for pfizer sildenafil 50 oral suspension is now commercially available.With a mortar and pestle, grind thirty 25-mg sildenafil citrate tablets to a fine powder.In a separate container, mix 1 of the following: 1) 150 mL of Ora-Sweet with 150 mL of Ora-Plus; or 2) 150 mL of Simple Syrup, NF with 150 mL of methylcellulose 1%.Add a small amount of the mixture to the fine powder and mix into a uniform paste. Add geometric amounts of the vehicle to the almost desired volume while mixing. Transfer to a graduated cylinder and adjust to volume while mixing.Place in amber plastic bottles. Shake well before each use.Storage: This suspension is stable for 91 days when stored at 4 and 25 degrees C. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Sildenafil injection is available as a ready to use solution; further dilution is not required.Administer as an IV bolus injection. May decrease the dose to 25 mg or increase the dose to 100 mg PO as needed approximately 1 hour before sexual activity.
Before taking this medicine
The results showed that sildenafil significantly improved microcirculation and symptoms associated with Raynaud's. In patients with chronic digital ulcerations, sildenafil treatment resulted in healing of trophic lesions which reappeared or progressed when sildenafil was stopped. Ulcerations did not heal while receiving placebo. Sildenafil therapy may be an alternative therapy in patients with Raynaud's resistant to vasodilatory therapy. 50 mg PO every 8 hours starting the day before ascent and continuing for 5 days after reaching the target altitude or until descent is initiated as an alternative to nifedipine. The dose may be taken from 30 minutes to 4 hours before sexual activity. Coadministration of certain drugs may need to be avoided or dosage adjustments may be necessary; review drug interactions. 25 mg PO as needed approximately 1 hour before anticipated sexual activity. May increase the dose up to 100 mg PO as needed approximately 1 hour before sexual activity.
Route of administration
Sildenafil, a PDE-5 inhibitor, helps maintain that erection instead. There are some situations where you should not take sildenafil. You’re taking medications known as nitrates You’re taking medications known as nitrates You’re taking amyl nitrites (also known as “poppers”) You’re taking amyl nitrites (also known as “poppers”) You’re taking medications known as protease inhibitors You’re taking medications known as protease inhibitors You’re taking medications known as alpha-blockers You’re taking medications known as alpha-blockers You’re already taking sildenafil or any other PDE5 inhibitor in another form You’re already taking sildenafil or any other PDE5 inhibitor in another form You have any heart, liver or kidney problems You have any heart, liver or kidney problems You are taking medications for pulmonary arterial hypertension You are taking medications for pulmonary arterial hypertension You’re under the age of 18 You’re under the age of 18 The recommended starting dose is 50 mg. You shouldn’t take this more than once within a 24 hour period. Taking it more than once a day will increase the chance of side effects.
Postmarketing Reports
If, after taking sildenafil, you feel the effect is too strong or too weak, you should talk to your doctor or pharmacist who may suggest an adjusted dosage for you or an alternative treatment. You should not take sildenafil film-coated tablets in combination with sildenafil oro-dispersible tablets. Take your sildenafil about an hour before you plan to have sex. Swallow the tablet whole with a glass of water. You can take it with or without food, but you might find that the effect takes longer to start if you’ve eaten heavily.
Professional resources
Alcohol can interfere with your ability to get an erection (we’ve written about it in detail here), so to maximise the benefit of sildenafil, it’s best to give the beer a miss. Grapefruit juice may increase the incidence of unwanted side effects of sildenafil. The effects of sildenafil last approximately four hours, which means your erectile function is improved for four hours. The effects of sildenafil become evident when you are sexually stimulated or aroused. You should not have an erection for four hours - a prolonged and painful erection (priapism) is a surgical emergency, and you should seek urgent medical attention should this happen. Dose may be titrated as needed based on symptoms and tolerability to a maximum of 80 mg PO 3 times daily. Although dose-response improvement in exercise ability was not observed in short-term clinical trials in adults with pulmonary hypertension, the delay in clinical worsening with long-term use of sildenafil in a clinical trial supports dosing up to a maximum of 80 mg PO 3 times daily. A maximum dose in pediatric patients has not been identified. Based on experience in adults, the dose may be titrated as needed to a maximum of 40 mg PO 3 times daily based on symptoms and tolerability. Avoid higher dosing due to a greater risk of mortality in pediatric patients (age 1 to 17 years) treated with high dose sildenafil monotherapy. 0.5 to 1 mg/kg/dose PO every 8 hours. Prior to the release of pediatric pulmonary hypertension guidelines, the generally accepted dose of sildenafil was 0.5 to 2 mg/kg/dose every 6 to 8 hours, with some regimens, particularly those described in earlier reports, administering doses every 4 hours; however, guidelines recommend more conservative dosing based on a greater risk of mortality in pediatric patients (age 1 to 17 years) treated with high dose sildenafil monotherapy, as seen in the STARTS-2 trial. Relevance of this data to the infant population is unclear. 0.22 to 0.5 mg/kg/dose PO as a single dose 1 hour prior to discontinuing iNO or 4 times daily. None of the 15 patients receiving a single sildenafil dose of 0.3 to 0.5 mg/kg/dose PO 1 hour prior to discontinuation of iNO experienced rebound pulmonary hypertension compared to 10 of 14 patients receiving placebo. In 7 patients receiving sildenafil 0.22 to 0.47 mg/kg/dose PO 4 times daily, mean iNO dose was significantly reduced compared to baseline within 24 hours of sildenafil initiation (12.2 vs.
| Property | Description | Value | Notes |
|---|---|---|---|
| Molecular Formula | - | C22H30N6O4S | Chemical composition |
| Molecular Weight | - | 474.6 g/mol | Molar mass |
| Melting Point | - | 195-198°C | Crystalline form |
| Solubility in Water | - | Slightly soluble | At room temperature |
| pH of Aqueous Solution | - | 3.5 - 4.0 | Depends on concentration |
29.8 ppm, p = 0.024). Guidelines recommend sildenafil use to prevent rebound pulmonary hypertension and facilitate iNO weaning in patients with evidence of increased pulmonary artery pressure upon iNO withdrawal; however, they do not provide specific dosing. Recommended maintenance dosing for pulmonary hypertension is 0.5 to 1 mg/kg/dose PO 3 times daily in persons younger than 1 year, 10 mg PO 3 times daily in persons weighing 20 kg or less, and 20 mg PO 3 times daily in persons weighing more than 20 kg. A double-blind, placebo-controlled, crossover study evaluated sildenafil for symptomatic secondary Raynaud's phenomenon resistant to vasodilatory therapy. Patients (n = 18, 15 were female) were randomly assigned to receive placebo or sildenafil 50 mg PO twice daily for 4 weeks; a washout period of 1 week was used before crossover. The results showed that sildenafil significantly improved microcirculation and symptoms associated with Raynaud's.
| Indication | Patient Group | Dosage Recommendation | Additional Notes |
|---|---|---|---|
| Erectile Dysfunction | Men aged 18-65 | 50 mg30-1 hour before activity | Adjust based on efficacy and tolerability |
| Pulmonary Hypertension | Adults with PAH | 20 mg three times daily | Extended release available |
| Raynaud's Phenomenon | People with secondary Raynaud's | Off-label use, consult physician | Limited clinical evidence |
In patients with chronic digital ulcerations, sildenafil treatment resulted in healing of trophic lesions which reappeared or progressed when sildenafil was stopped.
Voir aussi
Prophylactic medications should only be considered for individuals with a prior history of high altitude pulmonary edema. Ulcerations did not heal while receiving placebo.
- Sildenafil citrate can be combined with lifestyle changes.
- Exercise and weight management improve erectile function.
- Quitting smoking enhances medication effectiveness.
- Reducing alcohol intake minimizes side effects.
- Psychological therapy may support ED treatment.
- Counseling can address underlying emotional issues.
- Regular medical check-ups are recommended.
- Patient education improves safe and effective use.
Sildenafil therapy may be an alternative therapy in patients with Raynaud's resistant to vasodilatory therapy.
- Sildenafil citrate’s patent expiration increased market competition.
- Generics help reduce treatment costs globally.
- Pharmaceutical companies conduct clinical trials regularly.
- Safety monitoring continues post-marketing.
- Adverse event reporting is essential for drug safety.
- Patients should only use approved formulations.
- Counterfeit sildenafil products are a concern.
- Purchase from reputable sources is advised.
50 mg PO every 8 hours starting the day before ascent and continuing for 5 days after reaching the target altitude or until descent is initiated as an alternative to nifedipine. Prophylactic medications should only be considered for individuals with a prior history of high altitude pulmonary edema.
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