Viagra

Erectile dysfunction.

Adult 50 mg taken, as needed, approx 1 hr before sexual activity. May be increased to max 100 mg or decreased to 25 mg. Max dose frequency: Once daily. Patient w/ hepatic & severe renal (CrCl <30 mL/min) impairment 25 mg. Patient receiving concomitant therapy w/ ritonavir Do not exceed max single dose of 25 mg in a 48-hr period, concomitant treatment w/ CYP3A4 inhibitor eg, erythromycin, saquinavir, ketoconazole, itraconazole Starting dose: 25 mg.

May be taken with or without food.

Hypersensitivity. Concurrent use of nitric oxide donors, organic nitrates or nitrites in any form regularly or intermittently. Co-administration w/ guanylate cyclase stimulators eg, riociguat.

Discontinue use in case of sudden decrease or loss of hearing. Not to be used in men for whom sexual activity is inadvisable. Consider CV status prior to initiating therapy. Post-marketing reports of serious CV events, including MI, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage & transient ischemic attack; non-arteritic anterior ischemic optic neuropathy (rare). Patients w/ increased susceptibility to vasodilators including those w/ left ventricular outflow obstruction (eg, aortic stenosis, hypertrophic obstructive cardiomyopathy), or those w/ the rare syndrome of multiple system atrophy manifesting as severely impaired autonomic control of BP. Caution in patients w/ retinitis pigmentosa; bleeding disorders or active peptic ulceration; anatomical penis deformation (eg, angulation, cavernosal fibrosis or Peyronie's disease) or conditions predisposing to priapism (eg, sickle cell anemia, multiple myeloma or leukemia). Seek immediate medical assistance in the event of an erection that persists >4 hr. Concomitant use w/ α-blocker. Not recommended in combination w/ other PDE5 inhibitors or other pulmonary arterial HTN treatments. Reports of dizziness & altered vision; caution when driving or operating machinery. Not indicated in women & childn <18 yr.

Headache & flushing.

Reduced clearance w/ inhibitors of CYP3A4 (eg, ketoconazole, erythromycin, cimetidine) & CYP2C9. Increased plasma conc w/ cimetidine. Increased systemic exposure (AUC) w/ erythromycin. Increased AUC & C_max w/ saquinavir & ritonavir (HIV PI). Decreased AUC & C_max of sildenafil & increased AUC & C_max of bosentan (endothelin antagonist) when co-administered. Decreased plasma conc w/ strong CYP3A4 inducers eg, rifampin. Potentiated hypotensive effects of acute & chronic nitrates. Symptomatic hypotension w/ α-blockers eg, doxazosin.

Drugs for Erectile Dysfunction & Ejaculatory Disorders

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

Rx