What is sildenafil viagra

Do not take sildenafil if you also use nitrates. Talk with your doctor or pharmacist for more details and for information on what to do if you get unusual chest pain. Do not take this medication with any other product that contains sildenafil or other similar medications for erection problems/pulmonary hypertension (such as tadalafil, vardenafil). Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection. Medical tests (such as blood pressure, eye exams) may be performed periodically to monitor your progress or check for side effects. Do not store in the bathroom. Keep all medications away from children and pets.

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day. Since higher plasma levels may increase both the efficacy and incidence of adverse events, a starting dose of 25 mg should be considered in these patients. Over 550 patients were treated for longer than one year. The adverse events were generally transient and mild to moderate in nature.

If any of these effects persist or worsen, notify your doctor or pharmacist promptly. To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. This may or may not be due to sildenafil. Stop taking sildenafil and get medical help right away if this occurs. Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop taking sildenafil and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.



The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor. Sexual dysfunction can be a result of a physical or psychological problem. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, h. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. 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. Stop using sildenafil and call your doctor at once if you have any of these serious side effects: sudden vision loss;.

Limit alcoholic beverages. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of this drug. Your doctor may start you on a lower dose. This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk.

The patient addressed both questions at the final visit for the last 4 weeks of the study. The possible categorical responses to these questions were (0) no attempted intercourse, (1) never or almost never, (2) a few times, (3) sometimes, (4) most times, and (5) almost always or always. Sexual function data were also recorded by patients in a daily diary. In addition, patients were asked a global efficacy question and an optional partner questionnaire was administered. Results with all doses have been pooled, but scores showed greater improvement at the 50 and 100 mg doses than at 25 mg. The pattern of responses was similar for the other principal question, the ability to achieve an erection sufficient for intercourse. The titration studies, in which most patients received 100 mg, showed similar results. At the same time, ontreatment function was better in treated patients who were less impaired at baseline.

Consult your doctor before breastfeeding. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. John's wort, among others. Sildenafil may interact with certain chest pain medications (nitrates such as nitroglycerin, isosorbide) causing a dangerous drop in blood pressure.

In fixeddose studies, the incidence of some adverse events increased with dose. The nature of the adverse events in flexibledose studies, which more closely reflect the recommended dosage regimen, was similar to that for fixeddose studies. In these studies, only one patient discontinued due to abnormal vision. At doses above the recommended dose range, adverse events were similar to those detailed above but generally were reported more frequently. Digestive: vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis. Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis. Nervous: ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hypesthesia. Respiratory: asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased.

Do not substitute one form of this drug for the other. If you have any questions, consult your doctor or pharmacist. To treat erectile dysfunction, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily. A highfat meal may delay how quickly the drug begins to work. Avoid eating grapefruit or drinking grapefruit juice while you are being treated with this medication unless your doctor instructs you otherwise. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur.

Onethird to onehalf of the subjects in these studies reported successful intercourse at least once during a 4week, treatmentfree runin period. In many of the studies, of both fixed dose and titration designs, daily diaries were kept by patients. One randomized, doubleblind, flexibledose, placebocontrolled study included only patients with erectile dysfunction attributed to complications of diabetes mellitus (n=268). One randomized, doubleblind, placebocontrolled, crossover, flexibledose (up to 100 mg) study of patients with erectile dysfunction resulting from spinal cord injury (n=178) was conducted. A review of population subgroups demonstrated efficacy regardless of baseline severity, etiology, race and age. This analysis was performed retrospectively, and was not powered to detect any prespecified difference in adverse reactions. It is not meant to take the place of your doctor's instructions. This medicine can help many men when it is used as prescribed by their doctors.

If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result. No evidence of teratogenicity, embryotoxicity or fetotoxicity was observed in rats and rabbits which received up to 200 mg/kg/day during organogenesis. In the rat preand postnatal development study, the no observed adverse effect dose was 30 mg/kg/day given for 36 days. There are no adequate and wellcontrolled studies of sildenafil in pregnant women. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine. Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely coadministered at this time point. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.

Its pharmacokinetics are doseproportional over the recommended dose range. Both sildenafil and the metabolite have terminal half lives of about 4 hours. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. Protein binding is independent of total drug concentrations. Based upon measurements of sildenafil in semen of healthy volunteers 90 minutes after dosing, less than 0. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the feces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of the administered oral dose). Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.

The mean subject age was 66. No severe adverse events potentially related to blood pressure effects were reported in this group. There were no reports of syncope among these patients. For these four subjects, the placebosubtracted mean maximum decreases from baseline in supine and standing systolic blood pressures were 14. The mean subject age in this study was 63. This patient had been taking minoxidil, a potent vasodilator, during the study. There were no severe adverse events potentially related to blood pressure and no episodes of syncope reported in this study. If a subject did not successfully complete this first dosing period, he was discontinued from the study.

This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. In combination with sexual stimulation, sildenafil works by helping the blood flow into the penis to achieve and maintain an erection. Practice "safe sex" such as using latex condoms. Consult your doctor or pharmacist for more details. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Sildenafil is also available in other strengths for treating high blood pressure in the lungs (pulmonary arterial hypertension).

Therefore, age 65, hepatic impairment and severe renal impairment are associated with increased plasma levels of sildenafil. The time course of effect was examined in one study, showing an effect for up to 4 hours but the response was diminished compared to 2 hours. The decrease in sitting blood pressure was most notable approximately 12 hours after dosing, and was not different than placebo at 8 hours. A total dose of 40 mg sildenafil was administered by four intravenous infusions. Even though this total dosage produced plasma sildenafil concentrations which were approximately 2 to 5 times higher than the mean maximum plasma concentrations following a single oral dose of 100 mg in healthy male volunteers, the hemodynamic response to exercise was preserved in these patients. The primary endpoint was time to limiting angina in the evaluable cohort. The mean times (adjusted for baseline) to onset of limiting angina were 423. The studies that established benefit demonstrated improvements in success rates for sexual intercourse compared with placebo.

You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours. Some conditions and medicines interfere with this natural erection process. The penis cannot fill with enough blood. The man cannot have an erection. This is called erectile dysfunction if it becomes a frequent problem. During sex, your heart works harder. Therefore sexual activity may not be advisable for people who have heart problems. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

Visual disturbances occurred more commonly at higher levels of sildenafil exposure. Decreased blood pressure, syncope, and prolonged erection were reported in some healthy volunteers exposed to high doses of sildenafil (200800 mg). When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. Viagra (sildenafil citrate) has systemic vasodilatory properties and may augment the blood pressure lowering effect of other antihypertensive medications. Therefore, the use of such combinations is not recommended. In vitro studies with human platelets indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside (a nitric oxide donor). Physicians should discuss with patients the potential cardiac risk of sexual activity in patients with preexisting cardiovascular risk factors. Patients who experience symptoms (e.

It is intended for use only by men who have a condition called erectile dysfunction. This includes nitroglycerin. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated). You will not get an erection just by taking this medicine. The penis then expands and hardens. This is called an erection. After the man is done having sex, this extra blood flows out of the penis back into the body. The erection goes away.

Treatment with doxazosin continued for at least 7 days after dose period 1. The mean subject age in this study was 66. Twentyfive subjects were screened. There were no episodes of syncope reported in this study. Sildenafil at steady state (80 mg t. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result. Data from subjects exposed to high systemic levels of sildenafil are limited.



Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. See additional information.

In the unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away or permanent problems could occur. Rarely, sildenafil may cause sudden hearing problems (such as decrease/loss of hearing in one or both ears, ringing in the ears). Stop taking sildenafil and get medical help right away if these effects occur. A very serious allergic reaction to this drug is rare. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.

Some of these side effects are more likely to occur with higher doses. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. In rare instances, men have reported an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours. Most, but not all, of these men had heart problems before taking this medicine. If you want more information or develop any side effects or symptoms you are concerned about, call your doctor. Only your doctor can decide if it is right for you. This sheet is only a summary.



Do not start or stop taking any medicines before checking with your doctor or pharmacist. If you are taking medicines called alphablockers for the treatment of high blood pressure or prostate problems, your blood pressure could suddenly drop. You could get dizzy or faint. These treatments include pills, medicines that are injected or inserted into the penis, implants or vacuum pumps. If you do not get the results you expect, talk with your doctor. You and your doctor can determine the dose that works best for you. You will not get an erection just by taking the pill. These effects are usually mild to moderate and usually don't last longer than a few hours.

If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem. After sex is over, the erection goes away. You could get dizzy, faint, or even have a heart attack or stroke. If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist. It is a treatment for erectile dysfunction. Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex. Be sure to tell your doctor if you: have ever had any heart problems (e. Tell your doctor about any medicines you are taking.

Urogenital: cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia. Most, but not all, of these patients had preexisting cardiovascular risk factors. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical followup information was limited. Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance. Although the interaction between other protease inhibitors and sildenafil has not been studied, their concomitant use is expected to increase sildenafil levels. In a study of healthy male volunteers, coadministration of sildenafil at steady state (80 mg t. These effects on the metabolite are not expected to be of clinical consequence.