7 DRUG INTERACTIONS
phenytoinphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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ketoconazoleketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with strong CYP3A4 inhibitors and sildenafil (for pulmonary arterial hypertension) is not recommended. When used for erectile dysfunction, consider reducing initial sildenafil dose of 25 mg in patients also taking a strong CYP3A4 inhibitor and monitor for sildenafil toxicities (eg, dyspepsia, headache, hypotension). ketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lenacapavirlenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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Refer to the prescribing information of PDE5 inhibitors for dose recommendations. lenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levoketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lonafarniblonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
Dosage Forms and Strengths
lonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavirlopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mifepristonemifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels prazosinsildenafil increases effects of prazosin by pharmacodynamic synergism. sildenafil increases effects of prazosin by pharmacodynamic synergism. primidoneprimidone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels primidone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels relacorilantrelacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of sildenafil with strong CYP3A4 inhibitors.
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Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenoxybenzaminesildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. sildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. phentolaminesildenafil increases effects of phentolamine by pharmacodynamic synergism. sildenafil increases effects of phentolamine by pharmacodynamic synergism. relacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ritonavirritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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If concomitant use of strong CYP3A inhibitors is unavoidable, reduce crizotnib to 250 mg PO qDay. After discontinuation of a strong CYP3A inhibitor, resume crizotinib dose used prior to initiating the strong CYP3A4 inhibitor. crizotinib increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dabrafenibdabrafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels dabrafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
12.2 Pharmacodynamics
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels doxazosinsildenafil increases effects of doxazosin by pharmacodynamic synergism. sildenafil increases effects of doxazosin by pharmacodynamic synergism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels eslicarbazepine acetate will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fexinidazolefexinidazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration may increase risk for adverse effects of CYP3A4 substrates.
Common Side Effects
fexinidazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ivosidenibivosidenib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. ivosidenib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ritonavir will increase the level or effect of sildenafil by sildenafil for women affecting hepatic/intestinal enzyme CYP3A4 metabolism. silodosinsildenafil increases effects of silodosin by pharmacodynamic synergism. sildenafil increases effects of silodosin by pharmacodynamic synergism. St John's WortSt John's Wort will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Dosage Level | Typical Use | Onset Time | Duration of Effect |
|---|---|---|---|
| 25 mg | Mild cases | 30-60 min | 4-6 hours |
| 50 mg | Standard dose | 30-60 min | 4-6 hours |
| 100 mg | Severe erectile dysfunction | 30-60 min | up to 6 hours |
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels St John's Wort will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels terazosinsildenafil increases effects of terazosin by pharmacodynamic synergism. sildenafil increases effects of terazosin by pharmacodynamic synergism. tovorafenibtovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of tovorafenib (a weak CYP3A4 inducer) with CYP3A substrates where minimal concentration changes may lead to serious therapeutic failures. If unavoidable, monitor patients for loss of efficacy unless otherwise recommended in the CYP3A4 substrate prescribing information.
- Possible interactions include medications for HIV, antibiotics, and blood pressure.
- Overdose symptoms include severe headaches and chest pain.
- Seek immediate medical attention if adverse reactions occur.
tovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tucatinibtucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling. tucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Drug Class | Interaction Effect |
|---|---|
| Nitrates | Dangerous drop in blood pressure |
| Alpha-Blockers | Enhanced hypotensive effect |
| CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) | Increased sildenafil levels |
| Other PDE5 inhibitors | Risk of overdose and side effects |
acebutololacebutolol increases effects of sildenafil by additive vasodilation. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. acebutolol increases effects of sildenafil by additive vasodilation.
Medical uses
mitotanemitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 sildenafil pick up inducers are expected to cause substantial decreases in sildenafil plasma levels. mitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nafcillinnafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels nafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Incidence not known
Patients receiving indinavir with ritonavir should receive not more than 25 mg of sildenafil for treatment of erectile dysfunction in a 48-hour period, and patients receiving other protease inhibitors should use a lower initial sildenafil dose of 25 mg. Patient taking sildenafil for PAH with ritonavir is not recommended. pentobarbitalpentobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels pentobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenobarbitalphenobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. amifostineamifostine increases effects of sildenafil by additive vasodilation. amifostine increases effects of sildenafil by additive vasodilation. aprepitantaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Sildenafil film tablets are oral medications used to treat erectile dysfunction.
- These tablets are smooth, coated, and designed for quick swallowing.
- They contain sildenafil citrate as the active ingredient.
- 14 CLINICAL STUDIES
- Label: SILDENAFIL- sildenafil tablet, film coated
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- Sildenafil Pfizer 100 mg Filmtabletten, 24 St
