Sildenafil

Description

Sildenafil is a medicine used to treat erectile dysfunction and pulmonary artery hypertension. Sildenafil comes in oral (tablet and capsule) and injection forms. Sildenafil oral form is better known as the blue pill. It is used in the treatment of erectile dysfunction (ED) in men. Erectile dysfunction is a condition where a man is unable to achieve and/or maintain an erection adequate for sexual intercourse. This happens because of decreased blood flow due to physical injuries and certain medical conditions, or due to some psychological conditions such as anxiety, stress, depression, etc. This medicine relaxes the blood vessels and helps in increasing the flow of blood to the penis. Sildenafil injection is used in the treatment of pulmonary artery hypertension (high blood pressure in the arteries of the lungs) in men and women. Sildenafil may cause side effects such as flushing (redness and feeling of warmth), headache, upset stomach, dizziness, blurred vision, etc. Usually, these side effects get resolved on their own. Consult your doctor if these side effects worsen or persist for a long time. Sildenafil oral form can be taken with or without food, as prescribed by your doctor. It is recommended that you take the tablet 30-60 minutes before having sex. However, you can also take it up to 4 hours prior to sex. This medicine will help you get/maintain the erection only if you are sexually stimulated. Do not take extra pills for quick results. As Sildenafil oral form is used in the treatment of erectile dysfunction, this medicine is intended only for men. It is not recommended for use in women and children. Sildenafil injection is administered by a healthcare professional in a hospital or clinical setting. Your doctor will decide the dose and duration based on your medical condition. Sildenafil is not recommended if you are allergic to it or have heart problems. Avoid taking this medicine if you have a recent history of stroke or angina (chest pain and discomfort). Inform your doctor if you have liver or kidney problems. Avoid or limit drinking alcohol during the treatment as it makes you feel dizzy. Do not drive or operate machines while you are under treatment with Sildenafil.

Side effects

Major & minor side effects for Sildenafil

  • Headache
  • Nosebleed
  • Indigestion
  • Trouble sleeping
  • Diarrhoea
  • Dizziness
  • Bloody and cloudy urine
  • Burning, numbness, tingling in the arms and feet
  • Visual disturbances
  • Sensitivity to light
  • Prolonged and painful erection
  • Painful urination
  • Excessive tearing of the eye
  • Ringing or buzzing in the ears
  • Deafness
  • Nasal congestion
  • Nausea
  • Increased heartbeat

Uses of Sildenafil

What is it prescribed for?

  • Erectile Dysfunction
  • Pulmonary arterial hypertension
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Concerns

Commonly asked questions

  • Onset of action
    The effect of Sildenafil can be observed within 30 to 120 minutes of administration of the dose in oral form. Sildenafil injection may start to work immediately after administration.
  • Duration of effect
    Sildenafil oral form may remain in your body for 24 hours.
  • Safe with alcohol?
    Avoid consumption of alcohol while taking Sildenafil as it lowers blood pressure. Side effects such as dizziness, fainting, flushing, persistent headaches, changes in heart rate, etc. may occur.
  • Is it habit forming?
    No habit forming tendency has been reported for Sildenafil.
  • Usage in pregnancy?
    Due to lack of sufficient human data, Sildenafil is not recommended for use in pregnancy. Consult your doctor if you are pregnant.
  • Usage while breast-feeding?
    Due to lack of sufficient data, Sildenafil is not recommended for use while breastfeeding. Consult your doctor if you are breastfeeding.

Allergy

Avoid taking Sildenafil if you have a history of allergy to it. Seek immediate medical attention if you notice any symptoms such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulty, etc.

Nitrate containing medicines

If you have been prescribed any medicine that contains nitrates such as Nitroglycerin, Isosorbide, etc, avoid taking Sildenafil as it lowers blood pressure and leads to cardiovascular collapse (a dangerous drop in the blood pressure that can be fatal). The risk of other side effects such as dizziness, lightheadedness, fainting, headache, flushing, heart palpitations, and priapism (prolonged and painful erection unrelated to sexual activity) may also increase.

Riociguat

Riociguat is a medicine that is used to treat pulmonary arterial hypertension (PAH; high blood pressure in the vessels that carry blood to the lungs). Sildenafil is not recommended for use if you are on treatment with Riociguat as it may significantly lower your blood pressure, which can be dangerous. You may also experience other side effects such as dizziness, lightheadedness, fainting, flushing, headache, and nasal congestion.

Cardiac insufficiency

Cardiac insufficiency (heart failure), is when the heart muscle is not able to pump blood as well as it should. People having severe unstable angina (chest pain) or severe cardiac failure should not take Sildenafil. Sexual activity is also not recommended in such cases due to the potential risk of a heart attack. This medicine affects the blood vessels of the heart also and could lead to other heart problems.
Warnings for special population

Pregnancy

Due to lack of sufficient human data, Sildenafil is not recommended for use in pregnancy. Consult your doctor if you are pregnant.

Breast-feeding

Due to lack of sufficient data, Sildenafil is not recommended for use while breastfeeding. Consult your doctor if you are breastfeeding.
General warnings

Hypotension

Sildenafil can cause mild and short-lasting hypotension (decreased blood pressure levels) as it relaxes the blood vessels. Be careful if you are taking this medicine along with any medication for lowering high blood pressure levels.

Priapism

Priapism, a painful erection lasting for more than 4 hours. Sildenafil may cause priapism in some people. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. Use Sildenafil with caution in such conditions. If an erection persists longer than 4 hours, you should seek immediate medical assistance.

Loss of hearing

Sildenafil has been associated with a sudden decrease or loss of hearing. It may be accompanied by tinnitus (ringing of ears) or dizziness as the increased blood flow to the ears may cause damage. This medicine is not recommended for people having hearing problems. Seek prompt medical attention if you experience any hearing loss after taking this medicine.

Surgery

Sildenafil can cause a severe drop in your blood pressure when combined with the effects of anaesthesia and other drugs used during surgery. If you are taking this medicine in oral form, inform your doctor before undergoing any surgery.

Use in children

Sildenafil is not recommended for use in children less than 18 years of age as the safety and efficacy data of this medicine are not clinically established.

Counselling

The underlying cause of erectile dysfunction may be physical, psychological, or both. It is important to determine the underlying cause of erectile dysfunction to devise an appropriate plan of treatment. Counselling and therapy can increase the effectiveness of Sildenafil.

Effect on vision

Cases of visual defect have been reported with Sildenafil especially if used together with other PDE5 inhibitor (group of medicines used in the treatment of erectile dysfunction). If you experience any sudden loss of vision, stop taking the medicine and contact your doctor immediately.

Effect on bleeding

Sildenafil has to be used with caution if you have gastrointestinal bleeding or active ulcer as no safety information is available.

Ability to drive or operate machines

Sildenafil may not severely affect your ability to drive or operate machines. It is important that you become aware of how the medicine affects your body.

Missed Dose

Oral: For erectile dysfunction, Sildenafil is used as and when required, so the chances of missing a dose are less likely. However, when used for the treatment of pulmonary arterial hypertension, in case of a missed dose, take the missed dose as soon as you remember. The dose can be skipped if it is almost time for the next scheduled dose. Do not double your dose to make up for the missed one. Injection: Since Sildenafil is usually administered by a qualified healthcare professional, the likelihood of missing a dose is very low.

Overdose

Oral: Never take more than the prescribed dose. If you have intentionally or accidentally consumed more than the prescribed amount of Sildenafil, contact your doctor immediately for further guidance. Injection: Since Sildenafil is administered in the hospital setting by a qualified healthcare professional, the likelihood of an overdose is very low. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Avoid consumption of alcohol while taking Sildenafil as it lowers blood pressure. Side effects such as dizziness, fainting, flushing, persistent headaches, changes in heart rate, etc. may occur.
Interaction with Medicine

Carbamazepine

Clarithromycin

Dexamethasone

Ketoconazole

Nitroglycerin

Isoniazid

Warfarin

Disease interactions

Kidney Disease

Sildenafil is excreted through the kidneys. If you have pre-existing kidney problems, using this medicine will cause further damage to your kidneys. Sildenafil is not recommended in people with severe kidney problems or on dialysis.

Disease of the retina

Sildenafil is not recommended for use if you have medical conditions related to the retina (part of your eye that is responsible for vision) where colour discrimination is impaired. This medicine may worsen the condition.

Cardiovascular disease

Sildenafil is not recommended in people with heart problems. This medicine affects the blood vessels of the heart also and could increase the risk of heart problems.
Food interactions
Information not available.
Lab interactions
Information not available.
Oral form: Take Sildenafil with or without food but if you have taken a heavy meal, it may take longer to work. Do not crush, break or chew the tablet. Avoid taking it more than once a day. It is not recommended to give your medicine to other people even if their condition appears to be the same as yours. It is advisable to take Sildenafil tablet an hour before sexual intercourse. But, you can take it anytime between 30 minutes and 4 hours before sexual activity. Seek medical attention if the erection persists for more than 4 hours after sexual intercourse. It is important to note that this medicine will not work without sexual stimulation. This medicine does not cure erectile dysfunction. Factors such as obesity, smoking, drinking, etc., could also contribute to erectile dysfunction. Follow major lifestyle modifications like quitting smoking and drinking, weight management, eating a healthy diet, and exercising along with Sildenafil. Remember that Sildenafil does not offer any protection against sexually transmitted diseases (STDs) such as syphilis, gonorrhoea, HIV, etc. hence, adequate safety measures should be taken while having sexual intercourse. Injection: Sildenafil is administered by a qualified healthcare professional in a clinical or hospital setting.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

Does not cause sleepiness

How it works
Sildenafil works by relaxing the smooth muscles in the penis and increases blood flow. This helps the penis to harden and leads to an erection. Sildenafil also reduces the increased blood pressure in the lungs by relaxing the blood vessels.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Drugs for erectile dysfunction and ejaculatory disorder, Agents for pulmonary hypertension, Phosphodiesterase-5 inhibitors

Schedule

Schedule H

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Medicines.org.uk. 2021. Revatio 0.8mg/ml solution for injection - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 13 September 2021].

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Information on this page was last updated on 13 Sep 2021

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