Drug Interactions with Sildenafil Citrate

Note that this list is not all-inclusive and includes only common medications that may interact with sildenafil. You should refer to the prescribing information for sildenafil for a complete list of interactions. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use sildenafil only for the indication prescribed. Sildenafil Citrate is a medication that has gained significant attention in the medical community for its versatile applications.

• Sildenafil binds to phosphodiesterase type 5 enzymes in tissues.
• It was initially developed by Pfizer.
• The drug’s patent expired in many countries, increasing generic availability.
• It can improve quality of life for men with ED and pulmonary hypertension.
• Discuss potential interactions and health conditions with your doctor.
• Usage guidelines differ for ED and pulmonary hypertension treatment.
• Follow the prescribed dose and avoid exceeding recommended limits.

It is known by several brand names, including Revatio and Viagra[2].

Drug Interactions

[1][2][4][5][7][8][10][24][27][33][41][56][57][67][91][131] Brand Name: Vybrique, ViagraClasses: Phosphodiesterase Type 5 Inhibitors (24:08.12), Phosphodiesterase type 5 inhibitors (48:48.24) Sildenafil citrate (Viagra® and generic equivalents) is used orally for the treatment of erectile dysfunction (ED, impotence). [1][4][6][7][8][9][10][25][33][34][67][81][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][142][143][144][189] A thorough medical, sexual and psychosocial history, physical examination, and selective laboratory testing should be undertaken to diagnose ED, determine potential underlying sildenafil products over the counter causes, exclude potentially reversible or treatable causes (e.g., hypogonadism with inadequate testosterone replacement, hyperprolactinemia, drug-induced dysfunction, dyslipidemias, alcoholism, other substance abuse, hypertension, thyroid disease, cardiovascular or cerebrovascular disease, neurologic disease, adrenal dysfunction, psychologic dysfunction, marital discord, smoking), and identify appropriate treatment in conjunction with or prior to initiating vasoactive therapy (e.g., PDE 5 type inhibitor). [12][28][30][31][57][65][66][70][78][83][94][144][145][160][161][189][601][602][603] A review of the patient's current drug regimens should be conducted to detect possible drug-induced ED (e.g., certain antihypertensive, antidepressant, antipsychotic, or antiarrhythmic agents); it may be possible to substitute alternative drug(s) that lessen the risk of such dysfunction. [12][28][70][81][118][144][161][602][603] In instances where substitution therapy is not feasible, concomitant vasoactive therapy with a PDE 5 type inhibitor may promote patient compliance by counteracting ED as an adverse effect. [12][28][70][81][118][144][161][602][603] Efficacy of sildenafil is variable in patients with ED, in part depending on the underlying etiology, severity, and dose employed, but the drug generally appears to be effective in restoring sexual function to an acceptable level in the majority of treated men.

Clinical monitoring

[1][7][8][9][10][25][33][34][65][76][81][101][104][105][126][127][131][142][143][144] The erectile response generally increases with increasing sildenafil dose and plasma drug concentration, with response becoming greater at 50- and 100-mg doses than at 25 mg.[1][8][9][33][126][130][131][155] Analyses of subgroups of patients with ED indicate that efficacy of sildenafil is not affected by race or age, duration of ED, or duration of select underlying disease states (e.g., diabetes mellitus), and the drug has been effective in a broad range of patients with ED, including those with a history of coronary artery disease (e.g., coronary artery bypass graft [CABG]), hypertension, other cardiac disease (including ischemic heart disease), peripheral vascular disease, type 1 or 2 diabetes mellitus, depression, radical prostatectomy, prostate brachytherapy, transurethral resection of the prostate (TURP), spina bifida, spinal cord injury, and in patients taking antidepressants, antipsychotics, diuretics, and antihypertensive agents. [1][25][30][33][34][93][101][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][144] Pooled data from numerous fixed-dose and flexible-dose studies in men with ED secondary to a broad spectrum of organic and psychogenic causes showed increases in mean rates of successful intercourse (total successes divided by total attempts) to about 66-69% in those receiving sildenafil compared with about 20-22% for placebo. Erectile response to sildenafil is better in patients whose erectile function is less impaired at treatment initiation (e.g., those with some spontaneous successful intercourse, with partial erections, with erections during sleep, or with psychogenic causes). [1][33][105][145] In one flexible-dose study (dosage titration and maintenance up to 100 mg), mean scores for number of successful penetrations returned to normal in a subgroup of patients with psychogenic causes of ED; however, mean scores for maintenance of erections during intercourse in these men were lower than in untreated healthy men. [33][34] In a study in men with ED secondary to radical prostatectomy receiving fixed-dose sildenafil (100 mg), response to therapy was greatest in those who had undergone bilateral-nerve-sparing surgery than in those who had undergone unilateral or non-nerve-sparing procedures.

When to call your doctor

[104][127] Pooled data from various clinical trials indicate that sildenafil improved the erections of 43% of patients with ED secondary to radical prostatectomy compared with 15% of those receiving placebo. [1][104] A pooled analysis of 10 placebo-controlled studies of men with severe ED (organic etiology in 60%, psychogenic in 15%, and mixed in 25% of patients) treated with sildenafil (50-100 mg in fixed- or flexible-dose studies) indicated that 48% of the patients usually had erections sufficient for intercourse (score of 4, with 0 being unsuccessful and 5 being almost always successful) after treatment with sildenafil, compared with 8% of those receiving placebo. [76][127] In several randomized, double-blind, placebo-controlled studies in patients receiving sildenafil (flexible doses up to 100 mg or fixed doses ranging from 10-100 mg for 12 weeks) for the treatment of ED attributed to complications of diabetes mellitus, complications of spinal cord injury, or psychogenic causes, 48, 59, or 70% of all attempts at intercourse were successful, respectively, compared with 12, 13, or 29% of all attempts in those receiving placebo. [1][7][8][9][10][25][33][93] In these studies, sildenafil improved several aspects of sexual function including frequency, firmness, and maintenance of erection; frequency of orgasm; satisfaction and enjoyment of intercourse; and overall relationship satisfaction. [1][8][9][33][94][107][130][131][142] Pooled data from fixed- and flexible-dose studies indicate that sildenafil (50 or 100 mg) has no effect on sexual desire (i.e., rates of attempted intercourse, which averaged about 2 per week), but the rate of success increased to an average of 1.3 events per patient per week from 0.4 events per week with placebo. This drug belongs to a class of medications called phosphodiesterase type 5 (PDE5) inhibitors, which work by affecting specific enzymes in the body[3]. Sildenafil Citrate is primarily used to treat two main conditions: Pulmonary Arterial Hypertension (PAH): This is a serious condition where there is high blood pressure in the arteries that supply the lungs. Sildenafil helps to improve exercise capacity and slow down the worsening of this condition[1]. Erectile Dysfunction (ED): While not the focus of most clinical trials presented, Sildenafil is well-known for its use in treating erectile dysfunction in men[4]. This action leads to the relaxation of blood vessels, which improves blood flow in specific areas of the body.

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	100mg	270 + 10 Pills	270.47€ 257.59€	Buy
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Kamagra Polo	100mg	60 + 4 Pills	189.39€ 180.37€	Buy
Viagra Generic	150mg	10 Pills	36.73€ 34.98€	Buy
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Kamagra	100mg	20 Pills	86.09€ 81.99€	Buy
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In the case of PAH, it helps to reduce blood pressure in the lungs, while for ED, it increases blood flow to the penis[3]. Sildenafil Citrate comes in various forms and dosages: Tablets: Available in different strengths, commonly 20 mg for PAH and 50 mg or 100 mg for ED[5]. Oral Suspension: A liquid form of the medication, typically at a concentration of 10 mg/mL[6]. Orally Disintegrating Film (ODF): A newer form that dissolves in the mouth[2].

Patient Group	Starting Dose	Maximum Dose	Frequency	Notes
Adult Men with ED	50 mg	100 mg	Once per day, 1 hour before sex	Adjust based on efficacy and side effects
Patients with Liver Impairment	25 mg	50 mg	Once daily	Lower doses recommended
Elderly Patients	25-50 mg	100 mg	As needed	Monitor for side effects

The dosage and frequency of administration depend on the condition being treated and the individual patient’s needs.

Continuing Education Activity

[1][8][33][131] In part, the absence of an effect on sexual desire may be attributed to the fact that men enrolling in ED studies generally have a near-normal level of sexual desire upon study entry. [33][107][130][131] Improvement in erectile function sufficient for successful intercourse can be achieved with sildenafil in a substantial percentage of patients with ED, and the strength and duration of erection achieved with the drug in such patients approached those achieved in untreated healthy men. Sildenafil also has been effective in a limited number of men with temporary ED associated with the stress of providing a sperm sample (e.g., for intrauterine insemination or in vitro fertilization during assisted reproduction).

Professional resources

For PAH, a common dosage is 20 mg three times a day[1].

Condition	Description	Recommended Dosage	Notes
Erectile Dysfunction (ED)	Difficulty achieving or maintaining an erection	50 mg before activity	Can be adjusted based on response
Pulmonary Arterial Hypertension	High blood pressure in lungs	20 mg three times daily	Prescribed under medical supervision
Off-label uses	Other potential uses	Varies	Use under healthcare provider guidance

Clinical trials have shown that Sildenafil is effective in treating PAH. It can improve exercise capacity, as measured by the 6-minute walk distance test (6MWD). This test measures how far a patient can walk in 6 minutes, which is an important indicator of the severity of PAH[5]. For erectile dysfunction, Sildenafil has been shown to significantly improve erectile function and is often used as part of penile rehabilitation programs after prostate surgery[4]. Like all medications, Sildenafil can sildenafil price ireland cause side effects. More serious side effects are rare but can occur. These may include changes in vision or hearing, or prolonged erections in men. It’s important to discuss any side effects with your healthcare provider[2]. Research on Sildenafil continues to explore its potential benefits in various medical conditions. Combination therapy with other medications for PAH[3].

• Sildenafil’s development marked a breakthrough in ED treatment.
• It has revolutionized sexual health for many men globally.
• The drug’s mechanism enhances nitric oxide effects.
• Many patients report improved confidence with sildenafil use.
• Research continues on new formulations and delivery methods.
• Public health campaigns promote safe and effective usage.
• Awareness of contraindications reduces health risks.

Long-term effects and safety in PAH treatment[1]. Use in penile rehabilitation after prostate surgery[4]. Development of new formulations, such as orally disintegrating films, for easier administration[2]. These ongoing studies aim to further improve the effectiveness and safety of Sildenafil, potentially expanding its use in treating various medical conditions. [1][2][4][5][7][8][10][24][27][33][41][56][57][67][91][131] Brand Name: Vybrique, ViagraClasses: Phosphodiesterase Type 5 Inhibitors (24:08.12), Phosphodiesterase type 5 inhibitors (48:48.24) Sildenafil citrate (Viagra® and generic equivalents) is used orally for the treatment of erectile dysfunction (ED, impotence).

• Sildenafil citrate is manufactured by several pharmaceutical companies.
• Its chemical formula is C22H30N6O4S.
• It has a half-life of approximately 4 hours in the body.
• The drug enhances nitric oxide activity in the corpus cavernosum.
• It’s important to follow prescribed dosing to avoid adverse effects.
• It is classified as a phosphodiesterase type 5 inhibitor.
• Sildenafil was initially researched for angina before ED use.

[1][4][6][7][8][9][10][25][33][34][67][81][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][142][143][144][189] A thorough medical, sexual and psychosocial history, physical examination, and selective laboratory testing should be undertaken to diagnose ED, determine potential underlying sildenafil products over the counter causes, exclude potentially reversible or treatable causes (e.g., hypogonadism with inadequate testosterone replacement, hyperprolactinemia, drug-induced dysfunction, dyslipidemias, alcoholism, other substance abuse, hypertension, thyroid disease, cardiovascular or cerebrovascular disease, neurologic disease, adrenal dysfunction, psychologic dysfunction, marital discord, smoking), and identify appropriate treatment in conjunction with or prior to initiating vasoactive therapy (e.g., PDE 5 type inhibitor). [12][28][30][31][57][65][66][70][78][83][94][144][145][160][161][189][601][602][603] A review of the patient's current drug regimens should be conducted to detect possible drug-induced ED (e.g., certain antihypertensive, antidepressant, antipsychotic, or antiarrhythmic agents); it may be possible to substitute alternative drug(s) that lessen the risk of such dysfunction.

Effectiveness of Sildenafil

[12][28][70][81][118][144][161][602][603] In instances where substitution therapy is not feasible, concomitant vasoactive therapy with a PDE 5 type inhibitor may promote patient compliance by counteracting ED as an adverse effect. [12][28][70][81][118][144][161][602][603] Efficacy of sildenafil is variable in patients with ED, in part depending on the underlying etiology, severity, and dose employed, but the drug generally appears to be effective in restoring sexual function to an acceptable level in the majority of treated men.

3. Downsides

Note that this list is not all-inclusive and includes only common medications that may interact with sildenafil. You should refer to the prescribing information for sildenafil for a complete list of interactions. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use sildenafil only for the indication prescribed. Sildenafil Citrate is a medication that has gained significant attention in the medical community for its versatile applications. It is known by several brand names, including Revatio and Viagra[2].

Dosage for pulmonary arterial hypertension (PAH)

This drug belongs to a class of medications called phosphodiesterase type 5 (PDE5) inhibitors, which work by affecting specific enzymes in the body[3]. Sildenafil Citrate is primarily used to treat two main conditions: Pulmonary Arterial Hypertension (PAH): This is a serious condition where there is high blood pressure in the arteries that supply the lungs. Sildenafil helps to improve exercise capacity and slow down the worsening of this condition[1]. Erectile Dysfunction (ED): While not the focus of most clinical trials presented, Sildenafil is well-known for its use in treating erectile dysfunction in men[4]. This action leads to the relaxation of blood vessels, which improves blood flow in specific areas of the body.

What are the side effects of sildenafil?

In the case of PAH, it helps to reduce blood pressure in the lungs, while for ED, it increases blood flow to the penis[3]. Sildenafil Citrate comes in various forms and dosages: Tablets: Available in different strengths, commonly 20 mg for PAH and 50 mg or 100 mg for ED[5]. Oral Suspension: A liquid form of the medication, typically at a concentration of 10 mg/mL[6]. Orally Disintegrating Film (ODF): A newer form that dissolves in the mouth[2]. The dosage and frequency of administration depend on the condition being treated and the individual patient’s needs. [1][7][8][9][10][25][33][34][65][76][81][101][104][105][126][127][131][142][143][144] The erectile response generally increases with increasing sildenafil dose and plasma drug concentration, with response becoming greater at 50- and 100-mg doses than at 25 mg.[1][8][9][33][126][130][131][155] Analyses of subgroups of patients with ED indicate that efficacy of sildenafil is not affected by race or age, duration of ED, or duration of select underlying disease states (e.g., diabetes mellitus), and the drug has been effective in a broad range of patients with ED, including those with a history of coronary artery disease (e.g., coronary artery bypass graft [CABG]), hypertension, other cardiac disease (including ischemic heart disease), peripheral vascular disease, type 1 or 2 diabetes mellitus, depression, radical prostatectomy, prostate brachytherapy, transurethral resection of the prostate (TURP), spina bifida, spinal cord injury, and in patients taking antidepressants, antipsychotics, diuretics, and antihypertensive agents. [1][25][30][33][34][93][101][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][144] Pooled data from numerous fixed-dose and flexible-dose studies in men with ED secondary to a broad spectrum of organic and psychogenic causes showed increases in mean rates of successful intercourse (total successes divided by total attempts) to about 66-69% in those receiving sildenafil compared with about 20-22% for placebo. Erectile response to sildenafil is better in patients whose erectile function is less impaired at treatment initiation (e.g., those with some spontaneous successful intercourse, with partial erections, with erections during sleep, or with psychogenic causes). [1][33][105][145] In one flexible-dose study (dosage titration and maintenance up to 100 mg), mean scores for number of successful penetrations returned to normal in a subgroup of patients with psychogenic causes of ED; however, mean scores for maintenance of erections during intercourse in these men were lower than in untreated healthy men. [33][34] In a study in men with ED secondary to radical prostatectomy receiving fixed-dose sildenafil (100 mg), response to therapy was greatest in those who had undergone bilateral-nerve-sparing surgery than in those who had undergone unilateral or non-nerve-sparing procedures.

1. How it works

For PAH, a common dosage is 20 mg three times a day[1]. Clinical trials have shown that Sildenafil is effective in treating PAH. It can improve exercise capacity, as measured by the 6-minute walk distance test (6MWD). This test measures how far a patient can walk in 6 minutes, which is an important indicator of the severity of PAH[5]. For erectile dysfunction, Sildenafil has been shown to significantly improve erectile function and is often used as part of penile rehabilitation programs after prostate surgery[4].

Common Adverse Effects

Like all medications, Sildenafil can sildenafil price ireland cause side effects. More serious side effects are rare but can occur. These may include changes in vision or hearing, or prolonged erections in men. It’s important to discuss any side effects with your healthcare provider[2]. Research on Sildenafil continues to explore its potential benefits in various medical conditions.

Pregnancy Precautions

Combination therapy with other medications for PAH[3]. Long-term effects and safety in PAH treatment[1]. Use in penile rehabilitation after prostate surgery[4]. Development of new formulations, such as orally disintegrating films, for easier administration[2]. These ongoing studies aim to further improve the effectiveness and safety of Sildenafil, potentially expanding its use in treating various medical conditions. [104][127] Pooled data from various clinical trials indicate that sildenafil improved the erections of 43% of patients with ED secondary to radical prostatectomy compared with 15% of those receiving placebo. [1][104] A pooled analysis of 10 placebo-controlled studies of men with severe ED (organic etiology in 60%, psychogenic in 15%, and mixed in 25% of patients) treated with sildenafil (50-100 mg in fixed- or flexible-dose studies) indicated that 48% of the patients usually had erections sufficient for intercourse (score of 4, with 0 being unsuccessful and 5 being almost always successful) after treatment with sildenafil, compared with 8% of those receiving placebo. [76][127] In several randomized, double-blind, placebo-controlled studies in patients receiving sildenafil (flexible doses up to 100 mg or fixed doses ranging from 10-100 mg for 12 weeks) for the treatment of ED attributed to complications of diabetes mellitus, complications of spinal cord injury, or psychogenic causes, 48, 59, or 70% of all attempts at intercourse were successful, respectively, compared with 12, 13, or 29% of all attempts in those receiving placebo.

• Contraindications include use with nitrates and recent heart attack.
• Patients with contraindications should avoid sildenafil entirely.
• Visual disturbances including blue-tinted vision may occur.
• Use caution in patients with liver or kidney impairment.
• Sildenafil can interact with certain antibiotics and antifungals.
• Always inform your doctor about other medications you're taking.
• It does not protect against sexually transmitted infections.

[1][7][8][9][10][25][33][93] In these studies, sildenafil improved several aspects of sexual function including frequency, firmness, and maintenance of erection; frequency of orgasm; satisfaction and enjoyment of intercourse; and overall relationship satisfaction. [1][8][9][33][94][107][130][131][142] Pooled data from fixed- and flexible-dose studies indicate that sildenafil (50 or 100 mg) has no effect on sexual desire (i.e., rates of attempted intercourse, which averaged about 2 per week), but the rate of success increased to an average of 1.3 events per patient per week from 0.4 events per week with placebo. [1][8][33][131] In part, the absence of an effect on sexual desire may be attributed to the fact that men enrolling in ED studies generally have a near-normal level of sexual desire upon study entry. [33][107][130][131] Improvement in erectile function sufficient for successful intercourse can be achieved with sildenafil in a substantial percentage of patients with ED, and the strength and duration of erection achieved with the drug in such patients approached those achieved in untreated healthy men. Sildenafil also has been effective in a limited number of men with temporary ED associated with the stress of providing a sperm sample (e.g., for intrauterine insemination or in vitro fertilization during assisted reproduction).