11 DESCRIPTION

If you experience any headaches, vision problems, dizziness, or low blood pressure, then you may need to lower your dosage.

• Alcohol can interact with sildenafil, reducing its effectiveness and increasing side effects.
• Avoid alcohol consumption when planning to use sildenafil.
• Always inform your doctor about alcohol use prior to prescription.

Erections that last more than 4 hours is known as priapism, and is a serious medical condition for which you should seek immediate medical attention including visiting an emergency or urgent care facility. Your doctor should monitor how you react to your initially prescribed dosage. If the the starting dosage for example is 50mg, and is effective, no changes are necessary. However, keep track of any notable differences or side effects that might occur, just in case. One study concluded that through counselling and dose customization, many men found improved satisfaction rates when being treated for the first time with PDE-5 inhibitors such as sildenafil.

6.2 Postmarketing Experience

(5) This recommended dosage was arrived at when studying different dosages in 532 different men with ED over a 24-week period with doctors escalating the dosage in 329 men to study the tolerance and efficacy of the drug. (6) The results showed that doctors can start at 50mg and then if a patient finds that the 50mg pill is not effective enough, they can double the dosage. If side effects occur with the 50mg dosage, patients can have their prescription cut in half to 25mg or another medication such as tadalafil (Cialis) may be prescribed. Adjusting your dosage can be important for both maximizing the intended effects and avoiding side effects. If your erections are weak or inconsistent, then speak to your doctor about possibly increasing the dose. 25mg is not a normally the initially prescribed dosage of sildenafil, but if your doctor prescribes the low dose for any reason, achieving an erection is still possible.

Doctors have found during a study that at an even lower dosage of 20mg sildenafil taken under the tongue (sublingual), 65% of men were able to have satisfactory results.

What other information should I know?

Tell your doctor about all other medications you use for erectile dysfunction. Ask your healthcare provider or pharmacist for a list of these medicines if you are not sure. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Common Side Effects

Store sildenafil tablets and oral film at room temperature, between 20°C and 25°C (68°F and 77°F). Store sildenafil reconstituted oral suspension below 30°C (86°F) or in a refrigerator between 2°C to 8°C (36°F to 46°F). Throw away the reconstituted oral suspension after 60 days. Active ingredient: sildenafil citrateInactive ingredients: dextrose and water for injection. Contains no ingredients made from gluten-containing grain (eg, wheat, barley, or rye). (7) However, the efficacy of sildenafil generally increases with dosage, with 82% of men having great results at 100mg.

• Sildenafil 20 mg is contraindicated with nitrate medications due to risk of severe hypotension.
• Patients with heart problems should consult their doctor before use.
• It’s important to disclose all medications to your healthcare provider.

Most studies focus on 25-100mg dosages, but if your doctor thinks a lower dosage is the best option for you based on your medical profile, there sildenafil citrate 100mg tablets is still a chance you can get the results you want. The maximum FDA approved dosage for sildenafil is 100mg per day. Studies show that moving from 25mg to 50mg and then to 100mg doses produces better results and that going above that threshold has no benefit and only increases the risk of side effects. Tadalafil and sildenafil come in different doses, and this is because the different dosages have different results. Sildenafil is available in 25, 50, and 100 mg doses because it is taken as needed and generally lasts 4-6 hours. Tadalafil comes in 2.5mg and 5mg versions for daily use, and 10mg and 20mg doses for taking as needed.

• The usual starting dose of sildenafil for ED is 50 mg, but 20 mg may be prescribed for some patients.
• Prescription requirements ensure safe usage and proper dosing based on health conditions.
• Always follow a doctor’s instructions when taking sildenafil 20 mg.

The daily use doses (2.5mg and 5mg) should be taken daily in the morning, or at bedtime, while the as needed doses (10mg and 20mg) are generally taken about 30-60 minutes before sexual activity.

13. Nonclinical Toxicology

Drinking alcohol with sildenafil can cause side effects. Grapefruit juice and products may interact with sildenafil, leading to unwanted side effects. Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor. Tell your healthcare provider about all the medicines you take, including prescription and over-the-countermedicines, vitamins, and herbal supplements. Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects.

Warnings for other groups

Especially tell your healthcare provider if you take: Nitrates for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure Alpha-blockers are sometimes prescribed for prostate problems orhigh blood pressure. In some patients, the use of sildenafil with alpha-blockers can lead to a drop in blood pressure or fainting Other drugs to treat high blood pressure or a prostate disorder Medicines to treat HIV, such as protease inhibitors, such as ritonavir and saquinavir Some types of oral antifungal medicines, such as ketoconazole and itraconazole Some types of antibiotics, such as erythromycin Other medicines that treat high blood pressure Medicines or treatments for ED, such as avanafil (Stendra), tadalafil (Cialis), or vardenafil (Levitra). Tadalafil is often referred to as “the weekend pill” as when taken even as needed,, will be effective for up to 36 hours. For best results men should take sildenafil 30-60 minutes before sexual activity. However it can be effective when taken up to 4 hours before, but its effectiveness peaks at about an hour after use.

12.3 Pharmacokinetics

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Factors That Influence the Right Dosage for You

Is generic Viagra available in the U.S.? Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The proper dosage for sildenafil (Viagra) will vary between 25mg and 100mg once daily, with the most prescribed dosage being 50mg. Patients generally start with a lower dosage of 25mg to 50mg and depending on how the starting dosage works including how well it interacts with the body, may move to a higher dosage for a better experience. (1) For treating erectile dysfunction (or ED), sildenafil is normally only taken on an as needed basis, 30-60 minutes before sexual activity but can be dosed between 30 minutes and 4 hours before sexual activity. To maximize the effectiveness of the medication, it’s best to take it on an empty stomach. A high fat meal can delay absorption by up to an hour and reduce the peak concentration of the medication by almost 30%. There are many factors that your doctor will evaluate when deciding on your ideal sildenafil dosage. Your age is an important factor and men over 65 for example, will likely start at a 25mg dosage before testing 50mg. Weight is generally not a direct factor in how well sildenafil will work, but low fitness levels or more severe ED may require patients to try a higher dose. Anyone with liver or kidney issues will also likely be started at the lower 25mg dose. You should discuss starting dose with your doctor as various factors may play into the choice of dosage. If you have stable heart disease, you can generally still take sildenafil, but your blood pressure should be monitored and in some cases, an exercise stress test might be administered prior to starting sildenafil. Men with significant coronary artery disease or with valvular narrowing's in the heart caused by aortic valve stenosis or hypertrophic obstructive cardiomyopathy (or HOCM) should not use sildenafil.

5.3 Epistaxis

Sildenafil treats erectile dysfunction by selectively inhibiting an enzyme known as phosphodiesterase type 5, which allows corpus cavernosum smooth muscle to relax, making erections during sexual stimulation more satisfactory. (2) An erection is achieved in a response cycle that begins with sildenafil producing arteriolar dilatation and increased blood flow to the erectile tissue of the penis. (3) In a study on different dosages for treating erectile dysfunction with sildenafil, it was found that both 50 mg and 100 mg doses of sildenafil improved erectile function, sexual satisfaction, and enjoyment in patients, however the 100 mg dose had slightly better results. Higher doses led to improved sexual frequency and enjoyment, especially for patients with more severe cases of ED or if the patient had any additional health conditions. The overall findings suggest that adjusting the sildenafil dosage can optimize treatment for an improved outcome and many patients who start at 50mg, request a higher dosage later on.

Interactions that increase your risk for side effects

The common tablet dosages for sildenafil when treating erectile dysfunction are 25mg, 50mg, and 100mg with 50mg being the dosage most often initially prescribed and with dosages designed for once daily dosing. (4) Professor Irwin Goldstein noted in a presentation on sildenafil in 2003 that taking a quarter pill of sildenafil every night was effective in preventing erectile dysfunction. “If you would like to be sexually active in five years' time, take a quarter of a pill a night, we have data to show that will facilitate and prolong nocturnal erections.” Speak with your doctor if you have been taking sildenafil as needed and want to try switching to a daily micro dose. Sildenafil is considered generally a low-risk drug (although there are some important adverse effects and some contra-indications to taking sildenafil) and has been approved by the FDA (Food and Drug Administration) since 1998 for treating erectile dysfunction. Sildenafil prescriptions for erectile dysfunction typically start at 50mg and should be taken no more than once per day.