Axcel Sildenafil Dosage/Direction for Use

For oral administration only.
Use in adults: For most patients, the recommended dose is 50mg taken, as needed, approximately 1 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100mg or decreased to 25mg. The maximum recommended daily dose is 100mg. The maximum recommended dosing frequency is once a day.
Use in patients with impaired renal function: Dosage adjustments are not required in patients with mild to moderate renal impairment (creatinine clearance=30-80ml/min). Since sildenafil clearance is reduced in patients with severe renal impairment (creatinine clearance <30ml/min), a 25mg dose should be considered.
Use in patients with impaired hepatic function: Since sildenafil clearance is reduced in patients with hepatic impairment (e.g. cirrhosis), a 25mg dose should be considered.
Use in patients using other medications: Given the extent of the interaction with patients receiving concomitant therapy with ritonavir (see INTERACTIONS), it is recommended not to exceed a maximum single dose of 25mg of sildenafil in a 48-hours period. A starting dose of 25mg should be considered in patients receiving concomitant treatment with CYP 3A4 inhibitors (e.g. erythromycin, saquinavir, ketoconazole and itraconazole) (see INTERACTIONS). In order to minimize the potential for developing postural hypotension, patients should be stable on alpha-blocker therapy prior to initiating sildenafil treatment. In addition, initiation of sildenafil at lower doses should be considered (see PRECAUTIONS and INTERACTIONS).
Use in children: Sildenafil is not indicated for use in children (<18 years old).
Use in elderly men: Dosage adjustments are not required in elderly patients.