It is a treatment for erectile dysfunction.
Drug information contained herein may be time sensitive.
Contraindications Consistent with its known effects on the nitric oxide/cGMP pathway (see CLINICAL PHARMACOLOGY), Viagra was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using organic nitrates, either regularly and/or intermittently, in any form is therefore contraindicated.
Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers.
This medicine usually begins to work within 30 minutes after taking it for erectile dysfunction.
Sildenafil was not carcinogenic when administered to mice for 18–21 months at dosages up to the Maximum Tolerated Dose (MTD) of 10 mg/kg/day, approximately 0.
Follow your doctor's instructions.
There is no controlled clinical data on the safety or efficacy of Viagra in the following groups; if prescribed, this should be done with caution.
Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light, or blurred vision.
As in the other titration studies, patients were started on 50 mg and allowed to adjust the dose up to 100 mg or down to 25 mg of Viagra; all patients, however, were receiving 50 mg or 100 mg at the end of the study.
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If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis.
Geriatric Use Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil (see CLINICAL PHARMACOLOGY: Pharmacokinetics in Special Populations).
Talk with your doctor about the best way to take Viagra .
There were no episodes of syncope reported in this study.
If you have questions about side effects, contact your health care provider.
This patient had been taking minoxidil, a potent vasodilator, during the study.
Be sure that any discarded medicine is out of the reach of children.
Effect of Viagra and Placebo on Maintenance of Erection by Baseline Score.
Viagra had no effect on ritonavir pharmacokinetics (see DOSAGE AND ADMINISTRATION).
Talk to your pharmacist if you have questions about this information.
Be sure to tell your doctor if you: have ever had any heart problems (e.
Effects of Viagra on Blood Pressure Single oral doses of sildenafil (100 mg) administered to healthy volunteers produced decreases in sitting blood pressure (mean maximum decrease in systolic/diastolic blood pressure of 8.
The erection goes away.
The pattern of responses was similar for the other principal question, the ability to achieve an erection sufficient for intercourse.
Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra without sexual activity.
If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoconazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient.
Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra without sexual activity.
Viagra is a phosphodiesterase inhibitor.
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Hemic and Lymphatic: anemia and leukopenia.
You will need to discuss the benefits and risks of using Viagra while you are pregnant.
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Keep Viagra in its original container.
You should call a doctor immediately if you ever have an erection that lasts more than 4 hours.
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Read the directions carefully before using the medicine .
Over 550 patients were treated for longer than one year.
Sildenafil is used to treat men who have erectile dysfunction (also called sexual impotence).
If you have questions about side effects, contact your health care provider.
This is consistent with ritonavir's marked effects on a broad range of P450 substrates.
The concomitant administration of the protease inhibitor ritonavir substantially increases serum concentrations of sildenafil (11-fold increase in AUC).
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If you think you need a larger dose of Viagra, check with your doctor.
Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.
Special Senses: diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal vascular disease or bleeding, vitreous detachment/traction, paramacular edema and epistaxis.
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It is not clear whether Viagra is the actual cause of vision loss.
Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely coadministered at this time point.
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.
Viagra should not be used with any other medical treatments that cause erections.
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There were highly statistically significant improvements on the two principal IIEF questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) on Viagra compared to placebo.
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Some conditions and medicines interfere with this natural erection process.
Patients 65 years of age and older who are taking this medicine for erectile dysfunction are started on a low dose, 25 mg, of sildenafil.
Viagra relaxes muscles and increases blood flow to particular areas of the body.
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Overdose symptoms may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.
Alert your doctor to the problem as soon as possible.
Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.
Viagra was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.
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The approximately 4,000-fold selectivity for PDE5 versus PDE3 is important because PDE3 is involved in control of cardiac contractility.
Effects of Viagra on Vision At single oral doses of 100 mg and 200 mg, transient dose-related impairment of color discrimination (blue/green) was detected using the Farnsworth-Munsell 100-hue test, with peak effects near the time of peak plasma levels.
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This is called an erection.
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Sildenafil is not indicated for use in women for erectile dysfunction.
Contraindications Consistent with its known effects on the nitric oxide/cGMP pathway (see CLINICAL PHARMACOLOGY), Viagra was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using organic nitrates, either regularly and/or intermittently, in any form is therefore contraindicated.
Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse.
Visual disturbances occurred more commonly at higher levels of sildenafil exposure.
Therefore, age >65, hepatic impairment and severe renal impairment are associated with increased plasma levels of sildenafil.
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However, Viagra is not for everyone.
The effectiveness of Viagra was evaluated in most studies using several assessment instruments.
Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse.
In the second study, a single oral dose of Viagra 50 mg or matching placebo was administered in a 2-period crossover design to 20 generally healthy males with BPH.
Special Senses: diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal vascular disease or bleeding, vitreous detachment/traction, paramacular edema and epistaxis.
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5 mmHg), (see CLINICAL PHARMACOLOGY: Pharmacodynamics).
Check the label on the medicine for exact dosing instructions.
This medicine is available only with your doctor's prescription, in the following dosage In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do.
If needed, your doctor may increase your daily dose.
The dose may be increased by a doctor as needed and tolerated.
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These effects are usually mild to moderate and usually don't last longer than a few hours.
The mean subject age in this study was 66.
Nitrates, such as nitroglycerin (e.
Its effect is more potent on PDE5 than on other known phosphodiesterases (10-fold for PDE6, >80-fold for PDE1, >700-fold for PDE2, PDE3, PDE4, PDE7, PDE8, PDE9, PDE10, and PDE11).
If you take Viagra with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level.
It is not possible to determine whether these reported events are related directly to the use of Viagra, to the patient’s underlying risk factors for hearing loss, a combination of these factors, or to other factors (see PRECAUTIONS, Information for Patients).
No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by CYP2C9.
Taking Viagra approximately 1 hour before sexual activity works best for most men.
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Therefore, treatments for erectile dysfunction, including Viagra, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status.
It is intended for use only by men who have a condition called erectile dysfunction.
Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect.
If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely coadministered at this time point.
Patients 65 years of age and older who are taking this medicine for erectile dysfunction are started on a low dose, 25 mg, of sildenafil.
Single doses of antacid (magnesium hydroxide/aluminum hydroxide) did not affect the bioavailability of Viagra.
Keep Viagra in its original container.
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Viagra helps a man with erectile dysfunction get an erection only when he is sexually excited.
Subjects who had successfully completed the previous doxazosin interaction study (using Viagra 50 mg), including no significant hemodynamic adverse events, were allowed to skip dose period 1.
It is especially important to check with your doctor before combining Viagra with the following: Viagra should not be used by women.
Studies have produced relevant data on the effects of Viagra on cardiac output.
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The results from this pilot study are shown in Table 1; the mean resting systolic and diastolic blood pressures decreased by 7% and 10% compared to baseline in these patients.
Sildenafil is also used to treat the symptoms of pulmonary arterial hypertension.
When Viagra is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating Viagra treatment and Viagra should be initiated at the lowest dose (see Drug Interactions).
Viagra (50 mg) did not potentiate the hypotensive effect of alcohol in healthy volunteers with mean maximum blood alcohol levels of 0.
Viagra was effective in a broad range of ED patients, including those with a history of coronary artery disease, hypertension, other cardiac disease, peripheral vascular disease, diabetes mellitus, depression, coronary artery bypass graft (CABG), radical prostatectomy, transurethral resection of the prostate (TURP) and spinal cord injury, and in patients taking antidepressants/antipsychotics and antihypertensives/diuretics.
Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers").
Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers.
Ask your doctor or pharmacist if you do not understand any of this information or if you want to know more about Viagra.
The effectiveness of Viagra was evaluated in most studies using several assessment instruments.