What is the most important information I should know about sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart
problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur,
Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate
(Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO,
Monoket). Nitrates are also found in some recreational drugs such as amyl
nitrate or nitrite ("poppers").
Contact your doctor or seek emergency medical attention for any erection that
lasts longer than 4 hours. A sustained erection can damage the penis.
Refrain from further sexual activity and notify your doctor it you develop
dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or
tingling in the chest, arms, neck, or jaw) during sexual activity.
Do not take sildenafil more than once a day.
What is sildenafil?
Sildenafil relaxes muscles within the penis. This allows increased blood flow
into the penis, necessary to achieve and maintain an erection.
Sildenafil is used to treat erectile dysfunction (impotence).
Sildenafil may also be used for purposes other than those listed in this
medication guide.
What should I discuss with my healthcare provider before taking sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart
problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur,
Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate
(Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO,
Monoket). Nitrates are also found in some recreational drugs such as amyl
nitrate or nitrite ("poppers").
Before taking sildenafil, tell your doctor if you
- have had a heart attack, stroke, or life-threatening irregular
heartbeats within the last six months;
- have a history of heart failure;
- have coronary artery disease;
- have angina;
- have high or low blood pressure;
- have liver problems;
- have kidney problems;
- have ever had blood problems, including sickle cell anemia or leukemia;
- have a bleeding disorder;
- have a stomach ulcer;
- have retinitis pigmentosa (an inherited condition of the eye);
- have a physical deformity of the penis such as Peyronie's disease;
- have a condition that could lead to prolonged and painful erections,
such as a tumor of the bone marrow, sickle cell anemia, or leukemia; or
- are taking another medicine to treat impotence, such as alprostadil
(Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others).
You may not be able to take sildenafil, or you may require a dosage
adjustment or special monitoring during treatment if you have any of the
conditions listed above.
Although sildenafil is not indicated for use by women, it is in the FDA
pregnancy category B. This means that sildenafil is not expected to be harmful
to an unborn baby. Sildenafil should not be taken by women.
It is not known whether sildenafil passes into breast milk. Sildenafil should
not be taken by women.
If you are over 65 years of age, you may be more likely to experience side
effects from sildenafil. Your doctor may prescribe a lower dose of this
medication.
How should I take sildenafil?
Take sildenafil exactly as directed by your doctor. If you do not understand
these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
Sildenafil is usually taken when needed. It can be taken anywhere from 4
hours to one-half hour before sexual activity. Generally, it is taken 1 hour
before sexual activity. The medication can help achieve an erection when
sexual stimulation occurs. An erection will not occur just by taking a pill.
Follow your doctor's instructions.
Taking sildenafil after eating a high-fat meal (such as a cheeseburger and
french fries) may cause the medication to take a little longer to start working.
Do not take sildenafil more than once a day.
If you develop dizziness, nausea, or angina (pain, tightness, discomfort,
numbness, or tingling in the chest, arms, neck, or jaw) during sexual
activity, refrain from further sexual activity and notify your doctor.
Contact your doctor or seek emergency medical attention for any erection that
lasts longer than 4 hours. A sustained erection can damage the penis.
Grapefruit and grapefruit juice may interact with sildenafil. The
interaction could lead to potentially adverse effects. You should discuss
the use of grapefruit and grapefruit juice with your doctor. Do not increase
or decrease the amount of grapefruit products in your diet without first
talking to your doctor.
Store this medication at room temperature away from moisture and heat.
What happens if I miss a dose?
Sildenafil is used as needed, so you are not likely to miss a dose.
What happens if I overdose?
Seek emergency medical attention.
Symptoms of a sildenafil overdose are not known, but are likely to include
chest pain, dizziness, an irregular heartbeat, and swelling of the ankles or
legs.
What should I avoid while taking sildenafil?
Do not take any other drug used to treat impotence, such as alprostadil
(Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first
talking to your doctor.
Grapefruit and grapefruit juice may interact with sildenafil. The
interaction could lead to potentially adverse effects. You should discuss
the use of grapefruit and grapefruit juice with your doctor. Do not increase
or decrease the amount of grapefruit products in your diet without first
talking to your doctor.
What are the possible side effects of sildenafil?
If you experience any of the following serious side effects, stop taking
sildenafil and seek emergency medical attention or notify your doctor
immediately:
- an allergic reaction (difficulty breathing; closing of the throat;
swelling of the lips, tongue, or face; or hives);
- chest pain or an irregular heartbeat;
- swelling of the ankles or legs;
- shortness of breath;
- prolonged or severe dizziness;
- a prolonged (lasting longer than 4 hours) or painful erection; or
- dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or
tingling in the chest, arms, neck, or jaw).
Other, less serious side effects may be more likely to occur. Continue to
take sildenafil and talk to your doctor if you experience
- flushing;
- mild dizziness;
- headache;
- nasal congestion;
- diarrhea;
- temporary blue tint in vision or other vision abnormalities; or
- itching or a rash.
Side effects other than those listed here may also occur. Talk to your doctor
about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart
problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur,
Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate
(Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO,
Monoket). Nitrates are also found in some recreational drugs such as amyl
nitrate or nitrite ("poppers").
Before taking sildenafil, tell your doctor if you are taking any of the
following medications:
- any other drug used to treat impotence, such as alprostadil (Caverject,
Muse, Edex) or yohimbine (Yocon, Yodoxin, others);
- the antibiotic drugs clarithromycin (Biaxin), erythromycin (E-Mycin,
Eryc, Ery-Tab, others), or troleandomycin (TAO);
- an antifungal medication such as itraconazole (Sporanox) or ketoconazole
(Nizoral);
- the HIV medications amprenavir (Agenerase), delavirdine (Rescriptor),
indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), or
saquinavir (Fortovase, Invirase);
- cimetidine (Tagamet, Tagamet HB);
- phenobarbital (Luminal);
- carbamazepine (Tegretol) or phenytoin (Dilantin); or
- rifampin (Rifadin, Rifamate) or rifabutin (Mycobutin).
You may not be able to take sildenafil, or you may require a dosage
adjustment or special monitoring during treatment if you are taking any of the
medicines listed above.
Drugs other than those listed here may also interact with sildenafil or
affect your condition. Talk to your doctor or pharmacist before taking any
prescription or over-the-counter medicines, including herbal products.
Where can I get more information?
Your pharmacist has additional information about sildenafil written for
health professionals that you may read.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the
indication prescribed.
Every effort has been made to ensure that the information provided by Cerner
Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee
is made to that effect. Drug information contained herein may be time sensitive.
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. Multum's drug information does not endorse drugs, diagnose patients
or recommend therapy. Multum's drug information is an informational resource
designed to assist licensed healthcare practitioners in caring for their
patients and/or to serve consumers viewing this service as a supplement to, and
not a substitute for, the expertise, skill, knowledge and judgment of healthcare
practitioners. The absence of a warning for a given drug or drug combination in
no way should be construed to indicate that the drug or drug combination is
safe, effective or appropriate for any given patient. Multum does not assume any
responsibility for any aspect of healthcare administered with the aid of
information Multum provides. The information contained herein is not intended to
cover all possible uses, directions, precautions, warnings, drug interactions,
allergic reactions, or adverse effects. If you have questions about the drugs
you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2003 Cerner Multum, Inc. Version: 4.05. Revision date: 9/9/04.
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