Oral sildenafil in erectile dysfunction

In clinical trials,* long-term side effects, such as vision loss and hearing loss,† occurred at any time during treatment.

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If you have questions about the side effects of your prescribed sildenafil dose, talk with your doctor or pharmacist. * To learn more about the clinical trials of sildenafil, refer to the drug’s prescribing information for erectile dysfunction and pulmonary arterial hypertension (PAH). No, sildenafil isn’t known to cause different side effects in females. * Sildenafil is approved to treat PAH in most adults, including females. If you’re female and concerned about side effects with sildenafil, talk with your doctor. However, the exact reason why these side effects occurred is not fully known.

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If you have any sudden changes in your vision or hearing, talk with your doctor right away.

Implications of the review for practice and research

Clinical safety of oral sildenafil citrate (VIAGRATM) in the treatment of erectile dysfunction. Sildenafil (Revatio, Viagra) is a generic prescription medication used to treat erectile dysfunction and pulmonary arterial hypertension in adults. Sildenafil, which is also called sildenafil citrate, comes as an oral tablet. The drug also comes as an oral liquid suspension and IV infusion. However, this article does not cover these forms.

Less common

It only covers the side effects of sildenafil oral tablets. If you’d like to learn more about these forms, talk with your doctor. As with other drugs, sildenafil can cause side effects (adverse effects). It’s typically taken as a long-term treatment. Read on to learn about potential common, mild, and serious side effects.

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For a general overview of sildenafil, including details about its uses, refer to this article. Your doctor can also tell you more about sildenafil. Sildenafil can cause certain side effects, some of which are more common than others. These side sildenafil spray effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist. Also talk with them if you’re concerned about long-term side effects with sildenafil treatment.

Dose (mg)	Typical Usage Frequency	Time to Onset (minutes)	Duration of Effect (hours)	Notes
50	Once or twice daily	30-60	4-6	Starting dose for most patients
100	Once daily	30-60	4-6	Common for moderate ED
25	As needed	30-60	4-6	For mild ED
10	As needed	30-60	4-6	Lower dose option

* To learn more about the clinical trials of sildenafil, refer to the drug’s prescribing information for erectile dysfunction and pulmonary arterial hypertension. † For more details about these side effects, including their symptoms, see the “Sildenafil: Serious side effects” section above.

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Note: If you’re male, priapism may occur during sildenafil treatment. With priapism, you experience a continued (4 hours or longer) erection that’s often painful. For more information about this side effect, see the “Sildenafil: Side effect specifics” section below. Use of the term “female” and “male” in this article refers to sex assigned at birth. It’s possible to develop long-term side effects from sildenafil treatment. Learn more about some of the side effects that sildenafil may cause.

Dose Adjustments

These are just a few of the more common side effects reported by people who took sildenafil in clinical trials:* * To learn more about the clinical trials of sildenafil, refer to the drug’s prescribing information for erectile dysfunction and pulmonary arterial hypertension. † For more information about this side effect, see “Sildenafil: Side effect specifics” below. Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Mild side effects can occur with sildenafil use.

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This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to sildenafil’s prescribing information for erectile dysfunction (ED) and pulmonary arterial hypertension (PAH). Mild side effects that have been reported with sildenafil include: These side effects may be temporary, lasting a few days to weeks. Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking sildenafil and want to tell the FDA about it, visit MedWatch.

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* For more information about this side effect, see “Sildenafil: Side effect specifics” below. † An allergic reaction is possible after taking sildenafil. However, this side effect was rarely reported in clinical trials of sildenafil for ED and PAH. To learn more, see the “Sildenafil: Side effect specifics” section below. The list below may not include all possible serious side effects of the drug. To find out how often side effects occurred in clinical trials, see the drug’s prescribing information for erectile dysfunction (ED) and pulmonary arterial hypertension (PAH).

What should I do if I forget a dose?

Do you know these 11 amazing facts about Viagra? Is generic Viagra available in the U.S.? Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Sildenafil citrate has been shown to be effective in a wide range of patients with erectile dysfunction and has been approved in the United States for this indication. The overall clinical safety of oral sildenafil, a potent inhibitor of phosphodiesterase type 5, in the treatment of erectile dysfunction was evaluated in more than 3700 patients (with a total of 1631 years of exposure worldwide).

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Safety and tolerability data were analysed from a series of double-blind, placebo-controlled studies and from 10 open-label extension studies of sildenafil in the treatment of erectile dysfunction. A total of 4274 patients (2722 sildenafil, 1552 placebo; age range 19–87 y) received double-blind treatment over a period of up to six months’ duration, and 2199 received long-term, open-label sildenafil for up to 1 y. The most commonly reported adverse events (all causes) were headache (16% sildenafil, 4% placebo), flushing (10% sildenafil, 1% placebo), and dyspepsia (7% sildenafil, 2% placebo) and they were predominantly transient and mild or moderate in nature. These adverse events reflect the pharmacology of sildenafil as a phosphodiesterase type 5 inhibitor. The rate of discontinuation due to adverse events (all causes) was comparable for patients treated with sildenafil (2.5%) and placebo (2.3%).

Dosing and Administration

In open-label extension studies, 90% of patients completed long-term sildenafil treatment, with only 2% withdrawing due to adverse events. Sildenafil is a well-tolerated oral treatment for erectile dysfunction. This is a preview of subscription content, access via your institution Receive 12 print issues and online access Instant access to the full article PDF. Prices may be subject to local taxes which are calculated during checkout Morales, A., Gingell, C., Collins, M. et al. However, this side effect was rare in clinical trials. * Sildenafil is a vasodilator, meaning it widens the blood vessels and makes it easier for blood to flow. When this happens, your blood pressure may drop.

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No, there aren’t any reviews from people who’ve taken 50-milligram (mg) or 100-mg sildenafil tablets. However, you may experience mild sildenafil for women or severe side effects from sildenafil with any prescribed dose. In clinical trials,* a similar number of people reported certain side effects with both 50-mg and 100-mg doses. These side effects included mild to moderate headaches, flushing, and back pain. However, people taking the 100-mg dose had an increased risk of upset stomach, vision changes, and runny nose. This is because your heart doesn’t have to work as hard to move blood around your body.

What special dietary instructions should I follow?

If you develop serious side effects while taking sildenafil, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number. Serious side effects that have been reported and their symptoms include: Symptoms can include:tinnitus (ringing in your ear)dizzinessdecrease in hearing Symptoms can include:trouble seeing in either eyeblurry visionseeing eye floaters * To learn more about this side effect, see the “Sildenafil: Side effect specifics” section below. Sildenafil is not approved by the Food and Drug Administration (FDA) for use in children. In clinical trials, children who were given sildenafil long term to treat pulmonary arterial hypertension had an increased risk of fatality.

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However, your child’s doctor may recommend taking sildenafil off-label in some cases. (With off-label use, a doctor prescribes an FDA-approved drug for a purpose other than what it’s approved for.) Talk with your child’s doctor to determine if sildenafil is right for your child. They can help compare the risks and benefits of the drug. Sildenafil oral tablets come in different strengths: 20 milligrams (mg), 25 mg, 50 mg, and 100 mg. The dosage you’re prescribed will depend on what condition you’re taking sildenafil for.

Pulmonary hypertension

It also depends on how the dosage is working for you. You can experience mild or severe side effects from sildenafil with any dosage. However, you may have an increased risk of side effects with higher dosages. If you start to experience side effects that become bothersome or severe while taking sildenafil, talk with your doctor. Here are some frequently asked questions about the drug’s side effects and their answers. Signs and symptoms of low blood pressure include tiredness, lightheadedness, or blurry vision.

• Always consult a healthcare provider before starting sildenafil.
• Do not exceed the prescribed dose to avoid side effects.
• Sildenafil can interact with nitrates, causing dangerous blood pressure drops.

They may also include nausea, dizziness, fainting, and confusion.

Parameter	Description	Typical Value	Notes
Absorption Rate	How quickly sildenafil enters bloodstream	Rapid	Peaks in 30-120 minutes
Bioavailability	Percentage of dose reaching systemic circulation	~40%	Affected by food intake
Half-life	Time for plasma concentration to reduce by half	3-5 hours	Determines dosing frequency
Peak Plasma Concentration	Maximum concentration after dose	1 hour	Influenced by gastric emptying and food intake

Low blood pressure can be mild or severe depending on how much your blood pressure drops.

• Sildenafil is not a cure for erectile dysfunction but helps improve function.
• Use sildenafil only as prescribed to ensure safety and efficacy.
• It is not intended for recreational use and can be harmful.

You may have an increased risk of severe low blood pressure if you: already take drugs to lower your blood pressure have a blood pressure less than 90/50 before taking sildenafil If you take blood pressure drugs during sildenafil treatment, your doctor will recommend monitoring your blood pressure regularly. If you notice any signs or symptoms of low blood pressure while taking sildenafil, talk with your doctor. They’ll review your symptoms and other medications to make sure it’s safe for you to keep taking the drug.

Medication Type	Potential Interaction	Effect	Notes
Nitrates	Severe hypotension	Dangerous drop in blood pressure	Absolute contraindication
Alpha-blockers	Enhanced hypotensive effect	Blood pressure may drop too low	Use with caution, monitor BP
CYP3A4 inhibitors	Increased sildenafil levels	Increased risk of side effects	Dose adjustment may be needed
Rifampin	Reduced sildenafil effectiveness	Lower plasma levels	May require dose increase

* To learn more about the clinical trials of sildenafil, refer to the drug’s prescribing information for ED and PAH.