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What is sildenafil?

  • Sildenafil relaxes muscles and increases blood flow to particular areas of the body.
  • Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.
  • Sildenafil may also be used for purposes other than those listed here.

What should I discuss with my doctor before taking sildenafil?

  • Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
  • A small number of patients have had a sudden loss of eyesight after taking sildenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether sildenafil is the actual cause of such vision loss. Sudden vision loss with sildenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
  • Before taking sildenafil, tell your doctor if you have:
    • heart disease or heart rhythm problems;
    • a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder;
    • congestive heart failure;
    • high or low blood pressure;
    • coronary artery disease;
    • liver disease;
    • kidney disease;
    • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
    • a bleeding disorder such as hemophilia;
    • a stomach ulcer;
    • retinitis pigmentosa (an inherited condition of the eye);
    • a physical deformity of the penis (such as Peyronie's disease); or
    • if you have been told you should not have sexual intercourse for health reasons.
  • If you have any of these conditions, you may not be able to use sildenafil or you may need a dosage adjustment or special tests during treatment.
  • FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use sildenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
  • It is not known if sildenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take sildenafil?

  • Take each dose with a full glass of water.
  • Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
  • Sildenafil is usually taken only when needed, 30 - 90 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
  • Do not take sildenafil more than once a day. Allow 24 hours to pass between doses.
  • Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

  • Viagra is used as needed, so you are not likely to miss a dose.
  • If you miss a dose of Revatio, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

  • Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a sildenafil overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

What should I avoid while taking sildenafil?

  • Avoid drinking alcohol, which can increase some of the side effects of sildenafil.
  • Avoid using other medicines to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.

What are the possible side effects of sildenafil?

  • If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of sildenafil.
  • Stop using sildenafil and get emergency medical help if you have sudden vision loss.
  • Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
  • Stop using sildenafil and call your doctor at once if you have any of these serious side effects:
    • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
    • irregular heartbeat;
    • swelling in your hands, ankles, or feet;
    • shortness of breath;
    • vision changes;
    • feeling light-headed, fainting; or
    • penis erection that is painful or lasts 4 hours or longer.
  • Continue taking sildenafil and talk with your doctor if you have any of these less serious side effects:
    • warmth or redness in your face, neck, or chest;
    • stuffy nose;
    • headache;
    • upset stomach; or
    • back pain.
  • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What drug(s) may interact with ?

Do not take sildenafil if you are taking the following medications:

  • nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally

Sildenafil may also interact with the following medications:

  • alpha blockers, used for high blood pressure or an enlarged prostate. NOTE: Do not take doses of sildenafil higher than 25 mg within 4 hours of taking alpha blockers, such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), or terazosin (Hytrin®).
  • bosentan
  • certain drugs used for seizures such as carbamazepine, phenytoin, and phenobarbital
  • certain drugs used for fungal or yeast infections, such as fluconazole, ketoconazole, and voriconazole
  • certain drugs for the treatment of HIV infection or AIDS
  • cimetidine
  • cisapride
  • clarithromycin
  • diltiazem
  • erythromycin
  • grapefruit juice
  • mibefradil
  • nitroprusside
  • rifabutin
  • rifampin
  • quinidine
  • some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone)
  • verapamil

What is the shelf life of the pills?

  • The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.
 

 

Sildenafil (Viagra) Frequently Asked Questions.

Frequently Asked Questions About Sildenafil - Viagra

 

More than 20 million men around the world use it regularly. In the U.S., one out of every five men over 40 has tried it. An average of nine Viagra pills are dispensed every second.

What more could anyone possibly need to know about Viagra?

Plenty. Because for all its ubiquity, Viagra is surprisingly misunderstood. We all know what it does -- and what it helps men do -- but beyond that, how much does anyone really know about the Viagra experience?

"It has the name recognition of Coke and Nike," says Harin Padma-Nathan, clinical professor of urology at the University of Southern California Keck School of Medicine. "But when you ask people about it beyond the name, they really don't understand it."

Men -- and women -- who use it rarely talk about it openly. But in the U.S., an estimated 34% of all men ages 40 to 70 -- about 20 million men -- suffer from some significant level of erectile dysfunction. Most of them, about 80%, never seek treatment.

 

1. What is Sildenafil for?
Sildenafil is approved for the treatment of men who have difficulty having and maintaining an erection (impotence).

2. How much does Sildenafil cost?
The FDA has no input into or legal control over the pricing of any drug product. Some companies sell Sildenafil far above what most others charge.

The more you buy, the less the cost per does will be. If you have tried Sildenafil and know it works for you, buying in larger quantities is recommended. If you have never used Sildenafil, you should get a smaller quantity to see if it works for you.

3. Does insurance cover the cost of Sildenafil?
The FDA has no input into or legal control over whether an insurance company does or does not cover the cost of drugs. Some insurance plans do cover Sildenafil, others don't. Please call you insurance company if you have questions about whether your particular insurance provider will cover the cost of this product for you.

4. How does Sildenafil work?
An erection is the result of an increase in blood flow into certain internal areas of the penis. Sildenafil works by enhancing the effects of one of the chemicals the body normally releases into the penis during sexual arousal. This allows an increase of blood flow into the penis.

5. How do I take Sildenafil?
Sildenafil is taken orally (maximum once per twenty-four hour period) about one hour before sexual activity. For more detailed information consult with your health care provider.

6. How long does it take for Sildenafil to be effective?
When consumed orally on an empty stomach, maximum observed plasma concentrations are reached within 30 to 120 minutes (60 minutes is average for the maximum level to be seen in the blood stream).
The effects of Sildenafil can last up to 4 hours, but the response at 4 hours is less than it was 2 hours after consumption. When Sildenafil is taken with a high fat meal, the rate of effectiveness is reduced.

7. How is Sildenafil supplied?
Sildenafil is available as oral tablets in 25mg, 50mg and 100mg strengths. 50mg is the recommended dose size. If you are paying for medication yourself, you should always buy the 100mg size and split the pill into 50mg doses. This is because 50mg and 100mg pills usually cost about the same amount of money.

Some people don't like splitting pills because they worry that the Sildenafil might not be evenly distributed in both halves. Splitting pills has not been a known problem, but you may choose to buy 50 milligram pills if splitting pills is not what you want to do.

Be aware that buying 50mg pills will almost twice as expensive as buying 100mg pills and splitting them yourself. Sildenafil, a film-coated tablet, should be stored in a cool, dry place. There are reports of people leaving Sildenafil in their vehicles, only to return to find the tablets melted together.


8. Are there any side effects with Sildenafil?
As with any drug products, there are side effects of the product in some people. The most commonly reported side effects in patients treated with Sildenafil are: headache, flushing, stomach ache, urinary tract infection, diarrhea, dizziness, rash, and mild and temporary visual changes (color perception changes, light perception changes, and blurred vision). Stomach ache and abnormal vision were more common at 100 mg than at lower doses.

9. Is it true that 69 Americans taking the impotence pill Sildenafil died?
From the marketing of sildenafil citrate (Sildenafil) in late March through July 1998, during which more than 3.6 million outpatient prescriptions were dispensed, the FDA received reports of 123 patients who died after having been prescribed this drug. Twelve deaths concerned foreign patients and 30 concerned patients with unverifiable information (from hearsay, rumor, the media, or unidentifiable reporters).

In addition, reporters stated that they did not know if the drug had been used for 12, leaving 69 U.S. patients who died after having taken Sildenafil. Of these, cause of death was unmentioned or unknown for 21, two patients had strokes, and 46 had cardiovascular events (21 with definite or suspected myocardial infarction, 17 with cardiac arrest, 4 with cardiac symptoms, 3 with coronary artery disease, and one with severe hypotension leading to cardiac arrest).

10. Can Sildenafil be used with other treatment for impotence?
The safety and effectiveness of Sildenafil when used with other treatment for impotence has not been studied. The use of such treatments in combination with Sildenafil is not recommended at present.

11. What types of psychoactive drugs are safe to use in combination with Sildenafil?
This list is by no means complete, but here are some chemicals that have shown no negative side effects when consumed with Sildenafil.

Barbiturates (sleeping pills)
Benzodiazepines (tranquilizers)
Calamus (Acorus calamus)
Catnip (Nepeta cataria)
Chloral Hydrate
Hashish (and hashish oil)
Hops (Humulus lupulus)
Kava (Piper methysticum)
Kratom (Mitragyna speciosa)
Mescaline
PCP
Quaalude
Salvia (Salvia divinorum)
Wormwood (Artemisia absinthium)

Books

The Virility Solution:
Everything You Need to Know
About the Medically Proven Potency Pill
That Can Restore and Enhance Male Sexuality

Very readable, educational, eye-opening book. Not just about Sildenafil and vasomax but how the medication changes a man's definition of his own sexuality and the effects it has on his partner.

The book tells of the surprising discovery of the medication and the history of the treatment of male sexual disorders. The authors use case studies and interviews to show the varieties of problems men and their partners experienced pre-Sildenafil and the uncomfortable and awkward solutions that were available, which included self-injection and surgical implants.

However, the book is not just a public relations vehicle for the drugs. The authors discuss the potential side effects (headaches, muscle pain) and insist that patients treat the cause of their problems (physical or mental). They also discuss overall health programs involving diet and exercise.

 

What Happens When a Man First Takes a Viagra Pill?

Does Viagra Work for Everyone?

What Happens If a Woman Takes Viagra?