Sildera Overdosage

In studies of healthy volunteers with single dose up to 800 mg, adverse events were similar to those seen at lower doses, but incidence rates were increased.
Management of sildenafil overdose includes standard supportive and therapies as required.
For severe hypotensive episodes, consideration can be given to placing the patient in the Trendelenburg position, initiating fluid resuscitation, providing judicious use of an IV α-adrenergicagonist (e.g., phenylephrine), providing a combined α- and β-adrenergicagonist (norepinephrine) for blood pressure support (although exacerbation or development of an acute ischemic syndrome could occur), and/or providing intra­-aortic balloon counterpulsation as indicated. Hypotensive episodes resulting from inadvertent use of sildenafil and a nitrate/nitrite should be managed in similar fashion.
Renal dialysis is not expected to enhance clearance of drug, since sildenafil and its active metabolite are highly bound to plasma proteins, and renal clearance does not constitute a major elimination pathway.