Therefore sexual activity may not be advisable for people who have heart problems.
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During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away.
Use protective measures and ask your doctor if you have any questions about this.
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Physicians should also discuss with patients the increased risk of NAION in individuals who have already experienced NAION in one eye, including whether such individuals could be adversely affected by use of vasodilators, such as PDE5 inhibitors (see POST-MARKETING EXPERIENCE/Special Senses).
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Metabolism and Excretion Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes.
Viagra can help you have an erection when sexual stimulation occurs.
Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time).
Both of these subjects were protocol violators, one due to a low baseline standing SBP, and the other due to baseline orthostatic hypotension.
Precautions General The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.
Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men.
It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient's underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors (see PRECAUTIONS/Information for Patients).
The safety of Viagra is unknown in patients with bleeding disorders and patients with active peptic ulceration.
Two were discontinued after study period 1: one failed to meet pre-dose screening qualifications and the other experienced symptomatic hypotension as a moderately severe adverse event 30 minutes after dosing with open-label Viagra 50 mg.
Do not take it in larger doses or for longer than recommended by your doctor.
In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance.
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Why should Viagra not be prescribed?
POST-MARKETING EXPERIENCE Cardiovascular and cerebrovascular Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage have been reported post-marketing in temporal association with the use of Viagra.
Subgroup analyses of responses to a global improvement question in patients with psychogenic etiology in two fixed-dose studies (total n=179) and two titration studies (total n=149) showed 84% of Viagra patients reported improvement in erections compared with 26% of placebo.
If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis.
Due to age-differences in plasma protein binding, the corresponding increase in the AUC of free (unbound) sildenafil and its active N-desmethyl metabolite were 45% and 57%, respectively.
Discuss any possible risks to your baby.
In a study of healthy male volunteers, sildenafil (100 mg) did not affect the steady state pharmacokinetics of the HIV protease inhibitors, saquinavir and ritonavir, both of which are CYP3A4 substrates.
In some patients, concomitant use of these two drug classes can lower blood pressure significantly (see Drug Interactions) leading to symptomatic hypotension (e.
You may take it up to 4 hours before sexual activity.
Sildenafil has not been studied in pregnant women.
Over 550 patients were treated for longer than one year.
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In vivo studies Cimetidine (800 mg), a nonspecific CYP inhibitor, caused a 56% increase in plasma sildenafil concentrations when coadministered with Viagra (50 mg) to healthy volunteers.
5, 3, 4, 6 and 8 hours after Viagra or matching placebo.
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Do not use more of it and do not use it more often than your doctor ordered.
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Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.
Metabolism and Excretion Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes.
Contact your doctor or seek medical attention right away if you experience these symptoms.
Erectile dysfunction was attributed to organic (58%; generally not characterized, but including diabetes and excluding spinal cord injury), psychogenic (17%), or mixed (24%) etiologies.
Before taking Viagra, tell your doctor if you are allergic to any drugs, or if you have If you have any of these conditions, you may need a dose adjustment or special tests to safely take Viagra.
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Its safety under these circumstances has not yet been studied.
Mean resting values for right atrial pressure, pulmonary artery pressure, pulmonary artery occluded pressure and cardiac output decreased by 28%, 28%, 20% and 7% respectively.
It is not known if sildenafil passes into breast milk or if it could harm a nursing baby.
The decrease in sitting blood pressure was most notable approximately 1–2 hours after dosing, and was not different than placebo at 8 hours.
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Viagra must be used only under a doctor's supervision.
Patients who are taking this medicine for pulmonary arterial hypertension may also need to be started at a lower dose.
The safety of Viagra is unknown in patients with bleeding disorders and patients with active peptic ulceration.
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For these four subjects, the placebo-subtracted mean maximum decreases from baseline in supine and standing systolic blood pressures were 14.
Viagra can help you get an erection when you are sexually excited.
Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.
Only your doctor can determine if it is safe for you to continue taking Viagra.
Also use cautiously if you have a genital problem or deformity such as Peyronie's disease.
Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.
It does not contain all information about Viagra .
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When Viagra is taken with a high fat meal, the rate of absorption is reduced, with a mean delay in Tmax of 60 minutes and a mean reduction in Cmax of 29%.
Sildenafil has not been studied in pregnant women.
If an erection lasts more than 4 hours, seek treatment immediately.
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Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis.
Use Viagra with caution in the ELDERLY; they may be more sensitive to its effects.
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Without physical action to the penis, such as that occurring during sexual intercourse, sildenafil will not work to cause an erection.
If Viagra gives you an allergic reaction, do not use it again.
Viagra may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects.