1 INDICATIONS AND USAGE

In addition, sildenafil significantly improved Vo2max.98 These findings by themselves are very valuable but are also important in the context

• Sildenafil citrate 100mg tablets are prescribed for erectile dysfunction and pulmonary hypertension.
• The medication enhances the effects of nitric oxide for improved blood flow.
• Do not use sildenafil if you are allergic to citrate or other components.
• Commonly prescribed in adult men experiencing erectile difficulty.
• Patients should avoid heavy meals before taking sildenafil to optimize absorption.
• Do not barge to take sildenafil if on certain blood pressure medications.
• Sildenafil may cause skin rashes or allergic reactions in sensitive individuals.
• Inform your doctor if you experience vision impairment or sudden hearing loss.
• Use caution when operating machinery or driving after taking sildenafil.
• This medication has been effective for many men, but results vary.
• Do not combine sildenafil with other ED medications without medical advice.
• Always keep sildenafil out of children's reach to prevent accidental ingestion.

of safety: Sildenafil can be safely used in patients with

heart failure and pulmonary hypertension, in contrast to other pulmonary vasodilators.

How should this medicine be used?

We do not endorse non-Cleveland Clinic products or services. SILDENAFIL (sil DEN a fil) treats erectile dysfunction (ED). It works by increasing blood flow to the penis, which helps to maintain an erection. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. They need to know if you have any of these conditions: History of blood diseases, such as sickle cell anemia or leukemia Stomach ulcers, other stomach or intestine problems An unusual or allergic reaction to sildenafil, other medications, foods, dyes, or preservatives Take this medication by mouth with a glass of water.

How is sildenafil supplied (dosage forms)?

Follow the directions on the prescription label. The dose is usually taken 1 hour before sexual activity. You should not take the dose more than once per day. Do not take your medication more often than directed. Talk to your care team about the use of this medication in children. In contrast, the endothelin antagonist bosentan has been associated with fluid retention and failure

to improve symptoms of heart failure,101 and the prostacyclin analogue epoprostenol has been associated

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Some items may interact with your medicine. Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. Tell your care team right away if you have any change in your eyesight or hearing. This medication may affect your coordination, reaction time, or judgment.

Mechanism of Action

Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects. Contact your care team right away if you have an erection that lasts longer than 4 hours or if it becomes painful. This may be a sign of a serious problem and must be treated right away to prevent permanent damage. with increased mortality, especially in patients with coronary artery disease.102 Researchers in a second trial also evaluated the chronic effect of sildenafil on hemodynamics, as well as exercise dynamics.

Other uses for this medicine

It therefore increases levels of cyclic guanosine monophosphate (cGMP), which leads to the activation of cGMP-dependent protein kinases that mediate vascular smooth muscle relaxation and thus vasodilation.95 Newer data implicate the role of cGMP-dependent protein kinases in the reversal of ventricular hypertrophy by inhibiting downstream hypertrophy signaling96 (Figure 50-6). Sildenafil has been shown to be beneficial in the treatment of patients with pulmonary hypertension by decreasing pulmonary artery pressures without having a significant effect on systemic pressures. The development of pulmonary hypertension in patients with heart failure portends worse outcomes and can be a contraindication to therapies such as cardiac transplantation.97 Sildenafil has been evaluated for the treatment of systolic heart failure in small clinical trials. Lewis and associates98 evaluated the acute effect of sildenafil on invasive cardiac hemodynamics, gas exchange, and first-pass radionuclide ventriculography at rest and during exercise in 13 patients with NYHA class III heart failure. Sildenafil administration was associated with reductions in resting pulmonary arterial pressure, systemic vascular resistance, and pulmonary vascular resistance and with an increase in resting cardiac index, without altering mean arterial pressure, heart rate, or pulmonary capillary wedge pressure.

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During exercise, sildenafil reduced pulmonary arterial pressure and pulmonary vascular resistance. Moreover, peak oxygen consumption (Vo2max) increased, ventilatory response to carbon dioxide output (Ve/Vco2 slope) decreased, and right ventricular ejection fraction increased after sildenafil administration. Thus, the investigators were able to demonstrate that sildenafil has a selective pulmonary vasodilator effect with little effect on systemic blood pressure, heart rate, and pulmonary capillary wedge pressure. The pulmonary vasodilator effect leads to an increase in right ventricular function and, possibly as a result, an increase in cardiac output.98 The increase in cardiac output, together with other mechanisms, may have contributed to improvements in exercise capacity. Of note, the one other selective pulmonary vasodilator, inhaled nitric oxide, has the disadvantage of increasing pulmonary capillary wedge pressure and inducing pulmonary edema in patients with heart failure.99 In another trial, Bussotti and colleagues100 evaluated the acute effects of sildenafil on pulmonary mechanics at rest and with exercise by administering 25-mg and 100-mg doses of sildenafil to 22 male patients with systolic heart failure (NYHA class II or III). Guazzi and coworkers103 randomly assigned 46 male patients with NYHA functional class II or III heart

Liver Dose Adjustments

If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after taking this medication, you should refrain from further activity and call your care team as soon as possible. Using this medication does not protect you or your partner against HIV or other sexually transmitted infections (STIs). Side effects that you should report to your care team as soon as possible: Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing Low sildenafil citrate tablets for female blood pressure—dizziness, feeling faint or lightheaded, blurry vision Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision Sudden vision loss in one or both eyes Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): This list may not describe all possible side effects. Keep out of reach of children and pets. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F).

Can women take Viagra?

Throw away any unused medication after the expiration date. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals. failure (the presence of pulmonary hypertension was not necessary for inclusion) to receive sildenafil or placebo.

In case of emergency/overdose

This medication is not used in children for this condition. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others. Do not take this medication with any of the following: Nitrates, such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin This medication may also interact with the following: Other medications may affect the way this medication works.

Viagra and other medications

Talk with your care team about all of the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended. This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink canadian sildenafil citrate alcohol, or use illegal drugs. At 3 and 6 months, the sildenafil-treated patients demonstrated a reduction in systolic pulmonary artery pressure, a reduction in

Brand names

Sildenafil administration was associated with enhancements in pulmonary perfusion, gas diffusion, and lung mechanics. Subsequent studies have been performed to examine the chronic efficacy of sildenafil in patients with heart failure. Lewis and associates98 randomly assigned 34 patients with NYHA functional class II or III heart failure (LVEF < 40%) and pulmonary hypertension (mean pulmonary arterial pressure > 25 mm Hg) to receive 12 weeks of treatment with sildenafil or placebo. Sildenafil-treated patients demonstrated a significantly greater increase in Vo2max and significantly lower resting pulmonary vascular resistance. The remaining resting hemodynamic parameters did not differ significantly between sildenafil- and sildenafil 20 mg prescription placebo-treated patients.

Can you take Viagra if you have high blood pressure?

With exercise, sildenafil-treated patients exhibited a significant decrease in pulmonary vascular resistance and increases in stroke volume and cardiac output in comparison to placebo recipients. Moreover, sildenafil-treated patients demonstrated a significant increase in right ventricular ejection fraction at rest and with exercise but no change in LV size or LVEF. With regard to symptoms, the Minnesota Living with Heart Failure score and the NYHA functional class improved significantly in the sildenafil-treated patients. Rates of adverse events were similar in the two groups except for headaches, which were more frequent in sildenafil-treated patients. Lewis and associates concluded that in patients with systolic heart failure with pulmonary hypertension, prolonged administration of sildenafil safely decreased pulmonary vascular resistance, improved right ventricular function, and, possibly as a result of these occurrences, led to an increase in stroke volume and cardiac output. ergoreflex effect on ventilation, an improvement in Vco2 production slope

• Sildenafil citrate 100mg tablets can be part of erectile dysfunction treatment plans.
• The medication should be taken approximately 30 minutes to 1 hour before sexual activity.
• Sildenafil does not increase sexual desire but facilitates erection during arousal.
• Patients with heart conditions should seek medical advice before use.
• The medication can cause low blood pressure in some users.
• S sildenafil is not intended for recreational use.
• Do not use sildenafil if you are taking medications for high blood pressure without consulting a doctor.
• The effects depend on individual health and other medications taken concurrently.
• Sildenafil is contraindicated in patients taking certain alpha-blockers.
• Regular follow-up with a healthcare provider is recommended during treatment.
• Alcohol consumption may reduce the effectiveness of sildenafil.
• Read all warnings and instructions provided with the medication.

and Vo2max, and improvements in breathlessness score and flow-mediated vasodilation.

• Sildenafil citrate 100mg tablets are used to treat erectile dysfunction in men.
• The usual recommended dose is 100mg taken about an hour before activity.
• Sildenafil works by increasing blood flow to the penis during arousal.
• This medication should not be used with nitrate drugs due to risk of dangerous interactions.
• Common side effects include headache, flushing, upset stomach, and nasal congestion.
• Do not take sildenafil more than once in a 24-hour period.
• Sildenafil can cause hypotension, especially when combined with certain medications.
• It is available by prescription and should be used under medical supervision.
• Patients with heart problems should consult their doctor before use.
• Sildenafil should be stored at room temperature, away from moisture and heat.
• Alcohol can increase the risk of side effects when taking sildenafil.
• Sildenafil may cause vision changes such as blue tinge or increased sensitivity to light.