Generic Name: sildenafil (oral) (sil DEN a fil). Brand Names: Revatio, Viagra, medically reviewed on October 12, 2017. Sildenafil relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body. Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Do not take Viagra while also taking Revatio, unless your doctor tells you. Important information, do not take sildenafil if you are sildenafil pulmonary hypertension also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, tadalafil vs sildenafil isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil pulmonary hypertension sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Some medicines can cause unwanted or dangerous effects when used with sildenafil. Tell your doctor about all your current medicines, especially riociguat (Adempas). Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis. Stop using sildenafil and get emergency medical help if you have sudden vision loss. Before taking this medicine, you should not use sildenafil if you are allergic to it, or: if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite poppers. To make sure sildenafil is safe for you, tell your doctor if you have ever had: heart disease or heart rhythm problems, coronary artery disease; a heart attack, stroke, or congestive heart failure; high or low blood pressure; liver or kidney disease; a blood cell. Sildenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss. This medicine is not expected to harm an what is sildenafil for unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. Do not give sildenafil to anyone under 18 years old without medical advice. How should I take sildenafil? Take sildenafil exactly as it was prescribed for you Follow all directions on your prescription label. Do not take this medicine in larger what is sildenafil for or smaller amounts or for longer than recommended. Revatio is usually taken three times each day, about 4 to 6 hours apart. Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day. Shake the oral suspension (liquid) dosage for sildenafil well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions. During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil. Store at room temperature away from moisture and heat. See also: Dosage Information (in sildenafil pulmonary hypertension more detail) What happens if I miss a dose? Since Viagra is used as needed, you are not likely to miss a dose. If you miss a dose of Revatio, take the missed dose as soon as you remember. Skip tadalafil vs sildenafil the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose?
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For other sildenafil half life uses, see. Sildenafil, sold as the brand name. Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. 3, its effectiveness for treating sexual dysfunction in women has sildenafil half life not been sildenafil half life demonstrated. 3, common side effects include headaches and heartburn, as well as flushed skin. Caution is advised in those who have cardiovascular disease. Rare but sildenafil half life serious side effects include prolonged erections, which can lead to damage to the penis, and sudden-onset hearing loss. Sildenafil should not be taken by people who take nitrates such as nitroglycerin (glycerin trinitrate as this may result in a severe and potentially fatal drop in blood pressure. 3, sildenafil acts by inhibiting cGMP-specific phosphodiesterase type 5 (phosphodiesterase 5, PDE5 an enzyme that promotes degradation of cGMP, which regulates blood flow in the penis. Pfizer scientists, andrew Bell, David Brown, and Nicholas Terrett originally discovered sildenafil as a treatment for various cardiovascular disorders. 4 5, since becoming available in 1998, sildenafil has been a common treatment for erectile dysfunction; its primary competitors are tadalafil (trade name Cialis) and vardenafil (Levitra). Contents Medical uses 50mg tablets of sildenafil Sexual dysfunction The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete intercourse). Its use is now sildenafil half life one of the standard treatments for erectile dysfunction, including for men with diabetes mellitus. 6 Antidepressant-associated sexual dysfunction Tentative evidence suggests that sildenafil may help men who experience antidepressant -induced erectile dysfunction. 7 Pulmonary hypertension 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 as of 2014. 8 Raynaud's phenomenon 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 10 these drugs have moderate efficacy for reducing the frequency and duration. 9 As of 2016, their role more generally in Raynaud's was not clear. 10 Adverse effects 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. 2 Some sildenafil users have complained of seeing everything tinted blue ( cyanopsia ). 11 Some complained of blurriness and loss of peripheral vision. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases 12 and a number of studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy. 13 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. 2 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. 14 Interactions 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. 2 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. The use of sildenafil and an 1 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. 15 Contraindications Contraindications include: 2 :11 Concomitant use of nitric oxide donors, organic nitrites and nitrates, 16 such as: Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Known hypersensitivity to sildenafil Sildenafil should not be used if sexual activity is inadvisable due. Citation needed Nonmedical use Recreational use Sildenafil's popularity with young adults has increased over the years. 17 Sildenafil's trade name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. 18 The reasons behind such use include the belief that the drug increases libido, improves sexual performance, 18 or permanently increases penis size. 19 Studies on the effects of viagra when used recreationally are limited, but suggest it has little effect when used by those not suffering from erectile dysfunction. In one study, a 25-mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. 20 This study also noted a significant placebo effect in the control group. 20 Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. 21 Sildenafil is sometimes used to counteract the effects of other substances, often illicit. 18 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 or "trail mix". 18 Mixing with amyl nitrite is particularly dangerous and potentially fatal. 18 Jet lag research The 2007 Ig Nobel Prize in Aviation went to Patricia. Plano, and Diego. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that sildenafil helps treat jet lag recovery in hamsters. 22 23 Sports 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. 24 25 Analogs 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. 26 These analogs have not undergone any of the rigorous testing that drugs like sildenafil have passed, and thus have unknown side-effect profiles. 27 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.
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Class: Phosphodiesterase Type 5 Inhibitors, vA Class: GU900, chemical Name: molecular Formula: C22H30N6O4SC6H8O7. CAS Number:, brands: Revatio, Viagra, vasodilating agent; a selective phosphodiesterase (PDE) type 5 inhibitor. To facilitate attainment of a sexually functional erection in males with erectile dysfunction (ED, impotence). Most experts currently recommend that selective PDE type 5 inhibitors be offered as first-line therapy for ED unless contraindicated.189 Insufficient evidence to support the superiority of one selective PDE type 5 inhibitor over another.189. Has been used for the management of sexual dysfunction in women ; however, additional study needed to establish role, if any, of such therapy. Although sildenafil may improve physiologic response (e.g., increased blood flow to sexual organs 224 such changes have sildenafil heart not been associated with overall improvement in sexual dysfunction in women. Also has been used in women with sexual dysfunction induced by ssri antidepressants and in women with neurogenic sexual dysfunction (e.g., due to spinal cord injury or multiple sclerosis however, data limited.227228. Symptomatic management of PAH (WHO group 1 pulmonary hypertension) to improve exercise capacity and delay clinical worsening. Parenteral preparation used for continued treatment in patients sildenafil heart with PAH who are temporarily unable to take oral medication.203. Efficacy established principally in patients with nyha/WHO functional class iiiii PAH (idiopathic or associated with connective tissue diseases).203208235. Recommended as one of several treatment options for initial management of PAH in patients with nyha/WHO functional class II, III, or IV symptoms who are not candidates for calcium-channel blocker therapy or in whom such therapy has failed.242 Individualize choice of therapy; sildenafil heart consider factors such. In patients with inadequate response to initial monotherapy, sildenafil heart may consider combination therapy with a prostanoid or endothelin-receptor antagonist (added sequentially).242 By targeting different pathophysiologic pathways of the disease, such combination therapy may provide additive and/or synergistic benefits.243244246. Because increased mortality has been observed in children receiving sildenafil heart higher (more effective) dosages of sildenafil, FDA currently does not recommend use of the drug in patients 18 years of age.203233 (See Pediatric Use under Cautions.) Whether long-term sildenafil therapy has a beneficial effect on mortality. Administer orally about 1 hour (range: 4 hours to 30 minutes) before sexual activity. If a dose is missed, take missed dose as soon as it is remembered, then resume regular dosing schedule; do not double dose to replace missed dose.229. To reconstitute powder for oral suspension, tap bottle to release the powder.203 Add 60 mL of water to the bottle; recap and shake vigorously for at least 30 seconds.203 Add another 30 mL to bottle, recap and shake for at least 30 seconds; add. Use provided bottle adapter to fill 2-mL oral syringe (with.5- and 2-mL dose markings) with the reconstituted suspension.203. May administer by direct IV injection in patients who temporarily cannot take oral medication.203. Initially, 50 mg as a single dose no more than once daily. Depending on effectiveness and tolerance, increase dosage to a maximum of 100 mg once daily or decrease to 25 mg once daily. Dosages up to 80 mg 3 times daily not more effective than recommended dosage of 20 mg 3 times daily. Mild to moderate hepatic impairment (Child-Pugh class A or B No dosage adjustments necessary.203. No dosage adjustment needed, even with severe impairment (Clcr 30 mL/minute).203. Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.203. Serious, potentially fatal cardiovascular effects reported rarely. Use with caution in the treatment of ED in patients with a recent (within 6 months) MI, stroke, or life-threatening arrhythmia; in patients with resting hypotension (BP 90/50 mm Hg) or hypertension (BP 170/110 mm Hg or in patients with cardiac failure or CAD causing. Assess cardiovascular and cerebrovascular status (including use of organic nitrates and nitrites) sildenafil heart prior to initiating therapy. Symptomatic hypotension may occur in patients receiving concomitant13167 -adrenergic blocking agents; hypotension may be severe or fatal in patients receiving an organic nitrate or nitrite concomitantly. (See Specific Drugs under Interactions.). Consider whether patients with underlying cardiovascular disease (e.g., severe left ventricular outflow obstruction, autonomic dysfunction, resting hypotension BP 90/50 mm Hg, fluid depletion) could be adversely affected by sildenafils vasodilatory activity,203 especially in combination with sexual activity.167154. Use not recommended in patients with pulmonary veno-occlusive disease.203 Clinical data on use in this population are not available, and pulmonary vasodilators may worsen cardiovascular status of such patients.203 If pulmonary edema occurs during sildenafil therapy, consider the possibility of pulmonary veno-occlusive disease.203. Vaso-occlusive crisis requiring hospitalization reported in patients with pulmonary hypertension secondary to sickle cell disease who received sildenafil.1203 Efficacy and safety of sildenafil in patients with sickle cell anemia not established.1203. Nonarteritic anterior ischemic optic neuropathy (naion) reported rarely in patients receiving PDE type 5 inhibitors for the treatment. Potential increased risk of naion in the second eye in patients who already have had naion in one eye. Possible visual disturbances (e.g., blue/green vision, changes in light sensitivity particularly at high doses. Possible persistent and/or serious retinal changes in older patients or with long-term use. Use with caution in patients with retinitis pigmentosa. Periodically monitor retinal function in patients with ocular manifestations suggestive of retinal effects and in those at risk.88115. Sudden decrease or loss of hearing reported with all PDE type 5 inhibitors, including sildenafil. Adverse otic effects (e.g., deafness, otic pain, tinnitus) observed in a few patients in controlled clinical trials.1217 In at least 1 case, permanent, bilateral sensorineural deafness occurred.217218. Although not clear whether such effects are directly related to PDE type 5 inhibitors or to other factors (e.g., patients underlying medical condition, concomitant use of other ototoxic drugs a strong temporal relationship has been observed. Possible prolonged ( 4 hours) erections and priapism (painful erection 6 hours). May result in penile tissue damage and permanent loss of potency if priapism is not treated immediately.131 Use with caution in patients with conditions predisposing to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia). Concomitant use with potent CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, ritonavir) substantially increases serum sildenafil concentrations.1203 Depending on the particular use of sildenafil (e.g., ED, PAH) and the specific CYP3A4 inhibitor, concomitant use may not be recommended or precautions (e.g., dosage adjustments) may be required.1203 (See. Thorough medical history and physical examination recommended to diagnose ED, determine potential underlying causes, exclude potentially reversible or treatable causes, and identify appropriate treatment. Review of patients current drug regimens recommended to detect possible drug-induced. Possible hypotensive reaction in patients receiving concomitant antihypertensive therapy, in patients with CHF and a borderline low blood volume and low BP status, and in patients with left-ventricular outflow obstruction.283167 (See Specific Drugs under Interactions.) Monitor BP during initiation of therapy in these patients.2867159 Use. Incidence of epistaxis in sildenafil-treated patients is higher in those with PAH secondary to connective tissue disease (13) than in those with primary pulmonary hypertension (3).203 Use with caution in patients with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, Peyronies disease).
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