16 HOW SUPPLIED/STORAGE AND HANDLING

If you accidentally take too much sildenafil, call your doctor or go to the nearest hospital emergency room right away.

• Special populations require careful consideration before prescribing.
• In elderly patients (65+), clearance may be reduced; start with a lower dose.
• No dose adjustment is typically needed for patients with mild renal impairment.
• For moderate renal impairment (CrCl 30-80 mL/min), caution is advised.
• In severe renal impairment (CrCl <30 mL/min), a 25mg dose is often recommended.
• For hepatic impairment (Child-Pugh A and B), a 25mg starting dose is advised.
• Sildenafil is not recommended for patients with severe hepatic impairment.
• Safety and efficacy in pediatric patients for ED have not been established.
• Revatio is approved for pediatric PAH patients aged 1 year and older.
• The dose for pediatric PAH is based on body weight and must be carefully calculated.
• Use during pregnancy is only for PAH and requires a careful risk/benefit analysis.

Sildenafil can help you have an erection when sexual stimulation occurs.

What other drugs will affect sildenafil?

Take sildenafil oral tablets exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much to take and when to take it. Your healthcare provider may change your dose if needed. You may take sildenafil between 30 minutes to 4 hours before sexual activity if needed. If you take sildenafil after a high-fat meal (such as a cheeseburger and fries), sildenafil may take a little longer to start working. An erection will not occur just by taking a pill.

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Viagra Generic	25mg	20 Pills	37.74€ 35.94€	Buy
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Viagra Generic	25mg	270 + 8 Pills	184.26€ 175.49€	Buy
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Viagra Generic	50mg	10 Pills	26.87€ 25.59€	Buy
Kamagra Polo	100mg	20 Pills	83.56€ 79.58€	Buy
Kamagra Soft Tabs	100mg	60 + 4 Pills	180.59€ 171.99€	Buy

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.

Aspect	Details	Notes
Active Ingredient	Sildenafil citrate	Used for erectile dysfunction
Dosage Strength	20 mg per tablet	Common dosage for initial treatments
Recommended Use	Oral administration	Taken with water before sexual activity
Availability	Over-the-counter in some countries	Prescription required in others
Onset of Action	Typically 30-60 minutes	Varies by individual

You could be having a serious side effect of sildenafil. Take sildenafil oral film (Vybrique) exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much sildenafil to take and when to take it. Take sildenafil by mouth about 1 hour before sexual activity.

Further information

This survey is being conducted by the WebMD marketing sciences department. Pronunciation: sil-DEN-a-fil Generic name: sildenafil Brand names: Revatio, Viagra, Vybrique Dosage form: tablets (20 mg; 25 mg, 50 mg, 100 mg), injection (10 mg/12.5 mL), oral suspension (10 mg/mL), oral film (25 mg, 50 mg, 75 mg, 100 mg) Drug classes: Agents for pulmonary hypertension, Impotence medications Sildenafil is used to treat erectile dysfunction (ED) in adult men or pulmonary arterial hypertension (PAH) in adults and children, depending on the brand or formulation. Sildenafil tablets (25 mg, 50 mg, 100 mg; Viagra, generic) and sildenafil oral film (25 mg, 50 mg, 75 mg, 100 mg; Vybrique) are used for ED. Sildenafil tablets (20 mg; Revatio, generic), sildenafil oral suspension (Revatio, generic), and sildenafil injection (Revatio, generic) are used for PAH. Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor, which breaks down cyclic GMP and enhances nitric oxide (NO) -mediated smooth muscle relaxation.

7.3 Amlodipine

In erectile dysfunction (ED), this increases blood flow to penile tissue, facilitating an erection. In pulmonary arterial hypertension (PAH), it dilates pulmonary vessels by the same mechanism, reducing pulmonary blood pressure and improving exercise capacity. Sildenafil sildenafil online ireland first gained FDA approval on March 27, 1998. Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

What should I do if I accidentally use too much sildenafil?

Some medicines can cause unwanted or dangerous effects when used with sildenafil. Tell your doctor about all your current medicines, especially riociguat (Adempas). The most common side effects of sildenafil tablets for ED are: Abnormal vision, such as changes in color vision (such as having a blue color tinge) andblurred vision The most common side effects of sildenafil oral film for ED are: Abnormal vision, such as changes in color and blurred vision The most common side effects of sildenafil tablets/ oral suspension, and injection for PAH are: Sildenafil can cause the following serious side effects. If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis. You may take sildenafil between 30 minutes and 4 hours before sexual activity if needed.

Parameter	Description	Typical Value
Absorption Time	Time to reach peak plasma levels	30-120 minutes
Half-life	Time for plasma concentration to reduce by half	4 hours
Bioavailability	Percentage of dose that reaches circulation	40%
Metabolism	Mainly processed in the liver	Cytochrome P450 enzymes
Excretion	Mainly via feces and urine	-

Do not take more than once a day. If you take too much sildenafil, call your healthcare provider or go to the nearest hospital emergency room right away.

13. Nonclinical Toxicology

If you take sildenafil after you eat a high-fat meal, such as a burger and fries, it may take longer to start working. Your healthcare provider may recommend limiting or avoiding grapefruit while taking sildenafil. Grapefruit or grapefruit juice can raise sildenafil levels in your body, which can increase the risk of side effects. There are no known interactions between sildenafil and alcohol. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Warnings and Precautions

In particular, make sure that you discuss if you are using any of the following before taking sildenafil. Tell your healthcare provider about all medicines that you take or have recently taken. This may not be a complete list of medicines that can interact with sildenafil. If you or someone else has used too much sildenafil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222. For this use, sildenafil is used only when needed.

Sildenafil Tablets Dosage and Administration

Take it as your healthcare provider recommends, which is usually between 30 minutes to four hours before planned sexual activity. Do not take double or extra doses. For this use, take sildenafil as your healthcare provider recommends, which is usually three times a day. If it is almost time for your next dose, skip the missed dose and only take the next dose. Ask your healthcare provider if you are unsure what to do after a missed dose. Do not remove the film from the pouch unless ready for immediate use.

• The medication should be stored at room temperature between 15-30°C (59-86°F).
• Keep the tablets in their original container, tightly closed.
• Protect from light and moisture; avoid storing in bathrooms or near sinks.
• Do not use the medication if the packaging is torn or shows signs of tampering.
• Check the expiration date printed on the bottle or blister pack before use.
• Properly discard any medication that is outdated or no longer needed.
• Do not flush medications down the toilet or pour them into a drain.
• Consult a pharmacist or local waste disposal company for proper disposal methods.
• Many communities have drug take-back programs for safe disposal.
• Keeping old medication increases the risk of accidental ingestion or misuse.
• Safe storage and disposal protect children, pets, and the environment.

Do not handle the oral film with wet hands.

Usual Geriatric Dose for Erectile Dysfunction

Sildenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking sildenafil and call your healthcare provider right away if you havesudden vision loss in one or both eyes. Some people may also have ringing in their ears (tinnitus) or dizziness.

2.5 Dosage Adjustments in Special Populations

If you have these symptoms, stop taking sildenafil and contact a doctor right away. In addition, heart attack, stroke, irregular heartbeats, and death have happened rarely in people taking sildenafil. Most, but not all, of these people had heart problems before taking this medicine. It is not known if sildenafil caused these problems. Tell all your healthcare providers that you take sildenafil.

Looking for a Different Strength?

If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took sildenafil. Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Sildenafil does not protect you or your partner from getting sexually transmitted diseases, including Human Immunodeficiency Virus (HIV). Sildenafil may cause low blood pressure, which may cause you to feel faint or dizzy. See the Vybrique Prescribing Information for more information about how to take sildenafil oral film.

• Patient support resources are available for those taking sildenafil.
• Many pharmaceutical manufacturers offer patient assistance programs.
• Non-profit organizations provide information and support for ED and PAH.
• The Pulmonary Hypertension Association offers resources for PAH patients.
• Urology care foundations provide educational materials on ED treatments.
• Online forums and support groups can offer peer support and shared experiences.
• Healthcare providers are the primary source for personalized medical advice.
• Pharmacists are an excellent resource for information on dosing and side effects.
• Mental health professionals can help address psychological aspects of ED.
• Cardiac rehabilitation may be recommended for some PAH patients.
• A multidisciplinary approach often yields the best patient outcomes.

Take sildenafil exactly as it was prescribed for you.

Usual Adult Dose for Pulmonary Hypertension

Lie down if you feel faint or dizzy. Tell your doctor if you get more short of breath after you start sildenafil. More shortness of breath than usual may be due to your underlying medical condition. Do not take Viagra while also taking Revatio. Tell your healthcare provider if you have any side effect that bothers you or does not go away.

Why it’s used

These are not all of the possible side effects of sildenafil. Have allergies to sildenafil, Viagra, Revatio, Vybrique, or any of the ingredients in the sildenafil formulation you are taking Take other medicines for pulmonary arterial hypertension, such as riociguat (Adempas) Take other medicines for pulmonary arterial hypertension, such as riociguat (Adempas) Take other medicines that lower your blood pressure, such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs that also contain nitrates, such as "poppers". To make sure sildenafil is safe for you, tell your healthcare provider about all your medical conditions, including if you have: Or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure Had heart surgery within the last 6 months Low blood pressure, or high blood pressure that is not controlled A physical deformity of the penis (such as Peyronie's disease) Been told you should not have sexual intercourse for health reasons and you are a male Had an erection that lasted for more than 4 hours Problems with your blood cells, such as sickle cell anemia, multiple myeloma, or leukemia Retinitis pigmentosa, a rare genetic (runs in families) eye disease Ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION) Kidney problems or are having kidney dialysis Are pregnant or intending to become pregnant (for patients with PAH) Are breastfeeding or intending to breastfeed (for patients with PAH). Sildenafil for ED is not approved for males <18 years old. Sildenafil is not expected to harm an unborn baby.

How is sildenafil supplied (dosage forms)?

Tell your doctor if you are pregnant or plan to become pregnant. Women with pulmonary arterial hypertension should not stop taking sildenafil without talking to their doctor if they discover they are pregnant. It is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. Tell your doctor sildenafil citrate tables if you are breastfeeding a baby. Women with pulmonary arterial hypertension should not stop taking sildenafil without talking to their doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Do not change your dose or stop taking this medicine on your own.

Condition	Risk Factors	Recommendations
Use with Nitrates	Risk of severe hypotension	Avoid concurrent use
Severe Heart Disease	Increased cardiac stress	Consult cardiologist before use
Severe Liver or Kidney Impairment	Altered drug metabolism	Dose adjustment or avoid use
Hypotension	Blood pressure too low	Use caution, monitor blood pressure
Retinitis Pigmentosa	Risk of vision changes	Consult eye specialist

Take sildenafil tablet or oral suspension 3 times a day, about 4 to 6 hours apart.