Viagra

Sildenafil citrate

Erectile dysfunction.

50 mg once daily as needed, approx 1 hr before sexual activity. May be taken anywhere from 0.5-4 hr before sexual activity. May be increased to max dose of 100 mg or decreased to 25 mg. Patient >65 yr, hepatic (eg, cirrhosis 80%) or severe renal impairment (CrCl <30 mL/min), &/or concomitant use of potent CYP3A4 inhibitors eg, ketoconazole, itraconazole, erythromycin, saquinavir Starting dose: 25 mg. Patient receiving concomitant therapy w/ ritonavir Do not exceed a max single dose of 25 mg in a 48-hr period. Concomitant use w/ α-blocker 25 mg at any time. Doses of 50 or 100 mg should not be taken w/in 4 hr of α-blocker.

May be taken with or without food.

Hypersensitivity. Patients who are using organic nitrates either regularly &/or intermittently. Co-administration w/ guanylate cyclase stimulators eg, riociguat.

Not to be used in men for whom sexual activity is inadvisable because of underlying CV status. Discontinue use in cases of sudden visual loss or hearing decrease/loss. Serious CV events eg, MI, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage & transient ischaemic attack; non-arteritic anterior ischemic optic neuropathy; prolonged erection >4 hr & priapism >6 hr. Patients w/ left ventricular outflow obstruction (eg, aortic stenosis, idiopathic hypertrophic subaortic stenosis) & severely impaired autonomic BP control; anatomical deformation of penis (eg, angulation, cavernosal fibrosis or Peyronie's disease), predisposition to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia). Patients who have suffered MI, stroke or life-threatening arrhythmia w/in the last 6 mth; resting hypotension (BP <90/50) or HTN (BP >170/110); cardiac failure or CAD causing unstable angina; retinitis pigmentosa; bleeding disorders, active peptic ulceration. Concomitant use w/ ritonavir. Combination w/ PDE₅ inhibitors or other treatments for erectile dysfunction is not recommended. Doses >25 mg should not be taken w/in 4 hr of taking an α-blocker. Offers no protection against STDs. Not to be used in women, childn or newborn. Elderly ≥65 yr.

Headache. Dizziness; blurred vision, visual disturbance, cyanopsia; hot flush, flushing; nasal congestion; nausea, dyspepsia.

CYP3A4/2C9 inhibitors may reduce clearance. CYP3A4/2C9 inducers may increase clearance. Increased plasma conc w/ cimetidine. Increased AUC w/ erythromycin. Increased C_max & AUC w/ saquinavir, ritonavir. Reduced clearance w/ CYP3A4 inhibitors eg, ketoconazole, erythromycin, cimetidine. Decreased AUC and C_max w/ bosentan. Increased bosentan AUC & C_max. Decreased plasma level w/ rifampin. May lead to symptomatic hypotension w/ α-blocker.

Drugs for Erectile Dysfunction & Ejaculatory Disorders

G04BE03 - sildenafil ; Belongs to the class of drugs used in erectile dysfunction.

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