Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Using this medicine with any of the following medicines is not recommended. sildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Use Caution/Monitor. This medicine usually begins to work for erectile dysfunction within 30 minutes after taking it. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. anti-hypertensive channel blocking. Your doctor may adjust your dose if needed. Use Caution/Monitor. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Use Caution/Monitor. PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates. Your doctor may adjust your dose if needed. Mechanism: additive vasodilation. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Monitor Closely (1)levamlodipine, sildenafil. Monitor Closely (1)iloperidone increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)voxelotor will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Use Caution/Monitor. The recommended dosage for tablet and oral suspension formularies is 5 mg or 20 mg three times daily, 4 to 6 hours apart. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. Use only the brand of this medicine that your doctor prescribed. Monitor Closely (1)tazemetostat will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated (1)nitroglycerin translingual, sildenafil. Use Caution/Monitor. Use Caution/Monitor. Properly discard this product when it is expired or no longer needed. Use Caution/Monitor. erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Potentially fatal hypotension. Use Caution/Monitor. nitroglycerin topical, sildenafil. Use Caution/Monitor. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Use Caution/Monitor. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. bosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Slowly pull back the plunger until the required dose. phenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration contraindicated if sildenafil used for pulmonary arterical hypertension. Monitor Closely (1)artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stiripentol is a CYP3A4 inhibitor and inducer. Avoid or Use Alternate Drug. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Contraindicated. Generic name: Sildenafil Tablets (Erectile Dysfunction) [ sil-DEN-a-fil ] Brand name: Viagra Drug classes: Agents for pulmonary hypertension, Impotence agents Medically reviewed by Drugs.com. Please confirm that you would like to log out of Medscape. If unavoidable, reduce CYP3A substrate dose according to product labeling. Without physical action to the penis, such as that occurring during sexual intercourse, sildenafil will not work to cause an erection. Increased risk of priapism, hypotension, and other adverse effects. Avoid or Use Alternate Drug. primidone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Coadministration of vericiguat with PDE-5 inhibitors may result in additive hypotensive effects. Injections are dosed at 2.5 mg or 10 mg three times a day, 4 to 6 hours apart, as an . Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Avoid or Use Alternate Drug. Potentially fatal hypotension. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. sildenafil increases effects of silodosin by pharmacodynamic synergism. Serious - Use Alternative (1)lenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Ask your doctor if you have any questions. Modify Therapy/Monitor Closely. Monitor Closely (1)esmolol increases effects of sildenafil by additive vasodilation. carvedilol increases effects of sildenafil by additive vasodilation. Avoid or Use Alternate Drug. For treatment of pulmonary arterial hypertension: For oral dosage forms (suspension or tablets): Adults20 milligrams (mg) 3 times a day. Portions of this document last updated: June 01, 2023, Original article: https://www.mayoclinic.org/drugs-supplements/sildenafil-oral-route/proper-use/DRG-20066989. Modify Therapy/Monitor Closely. enzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. This medicine usually begins to work for erectile dysfunction within 30 minutes after taking it. Avoid or Use Alternate Drug. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Adults up to 65 years of age50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. nelfinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Injections are dosed at 2.5 mg or 10 mg three times a day, 4 to 6 hours apart, as an . Avoid or Use Alternate Drug. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. Serious - Use Alternative (1)tucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Use Caution/Monitor. Use Caution/Monitor. 1, 6 The dose can be increased . Monitor Closely (1)lorlatinib 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. Avoid or Use Alternate Drug. Although not all of these side effects may occur, if they do occur they may need medical attention. artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Cardiovascular and cerebrovascular: Serious cardiovascular (CV), cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage (most, but not all, of these patients had preexisting CV risk factors), Hemic and lymphatic: vaso-occlusive crisis: In a small, prematurely terminated study of sildenafil in patients with pulmonary arterial hypertension (PAH) secondary to sickle cell disease, vaso-occlusive crises requiring hospitalization were commonly reported, Nervous: Seizure, seizure recurrence, anxiety, and transient global amnesia, Hearing: Cases of sudden decrease or loss of hearing reported postmarketing in temporal association with PDE5 inhibitors, Ocular: Diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal edema, retinal vascular disease or bleeding, and vitreous traction/detachment, Nonarteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision (reported rarely), Urogenital: Prolonged erection, priapism, and hematuria, Soluble guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension, Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure; monitor for hypotension, Use with caution in patients with anatomic deformation of penis (eg, angulation, cavernosal fibrosis, or Peyronie disease), conditions potentially predisposing to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors, Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease, Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness, Stop sildenafil and seek medical care if a sudden loss of vision occurs in 1 or both eyes, which could be a sign of nonarteritic anterior ischemic optic neuropathy (NAION); use with caution, and only when the anticipated benefits outweigh the risks, most patients had underlying anatomic or vascular risk factors for developing NAION, including low cup to disc ratio (crowded disc); advise patients to seek immediate medical attention in the event of a sudden loss of vision, May cause dose-related impairment of color discrimination; use in patients with retinitis pigmentosa not recommended, Limited published data from randomized controlled trials, case-controlled trials, and case series do not report a clear association with sildenafil and major birth defects, miscarriage, or adverse maternal or fetal outcomes when sildenafil is used during pregnancy; there are risks to mother and fetus from untreated pulmonary arterial hypertension, Pregnant women with untreated pulmonary arterial hypertension are at risk for heart failure, stroke, preterm delivery, and maternal and fetal death, Limited published data from a case report describe presence of sildenafil and its active metabolite in human milk; there is insufficient information about effects of sildenafil on breastfed infant and no information on effects of sildenafil on milk production; limited clinical data during lactation preclude a clear determination of risk of drug to an infant during lactation.
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