Zilden Dosage/Direction for Use

Adults: The recommended dose is 50 mg taken, as needed, approximately 1 hr before sexual activity. Based on clinical effects, the dose may be increased to a maximum of 100 mg or decreased to 25 mg. The maximum recommended daily dose is 100 mg and the maximum recommended dosing frequency is once per day (OD). Dosage adjustments are not required in elderly patients.
Adults with Impaired Renal Function: Dosage adjustments are not required in patients with mild to moderate renal impairment (creatinine clearance 30-80 ml/min). Since Sildenafil clearance is reduced in patients with severe renal impairment (creatinine clearance <30 ml/min), a 25-mg dose should be considered.
Patients with Impaired Hepatic Function: Since Sildenafil clearance is reduced in patients with hepatic impairment (e.g. cirrhosis,) a 25-mg dose should be considered.
Patients Using Other Drugs: Given the extent of the interactions with patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum single dose of 25 mg Sildenafil in a 48-hour period. A starting dose of 25 mg should be given in patients receiving concomitant treatment with CYP3A4 inhibitors (e.g. erythromycin, saquinavir, ketoconazole, itraconazole). In addition, patients should be stable on α-blocker therapy prior to initiating Sildenafil treatment and initiation of Sildenafil at lower doses should be considered in order to minimize the potential for developing postural hypertension.