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 is available by prescription only in most countries.
The medication comes in various dosages, typically 25mg, 50mg, and 100mg.
Adjust dosage as directed by your healthcare provider.

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.

Medication Type	Potential Interaction	Effect	Notes
Nitrates	Severe hypotension	Dangerous drop in blood pressure	Absolute contraindication
Alpha-blockers	Enhanced hypotensive effect	Blood pressure may drop too low	Use with caution, monitor BP
CYP3A4 inhibitors	Increased sildenafil levels	Increased risk of side effects	Dose adjustment may be needed
Rifampin	Reduced sildenafil effectiveness	Lower plasma levels	May require dose increase

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.

Medical uses

The associated media frenzy sildenafil syrup has been fuelled by endorsements from prominent individuals. Such reports stoke the already intense public demand for information about and prescriptions for sildenafil. In the midst of these developments, it is crucial to recognise and deal with the potential problems. First, sildenafil is no panacea; not all patients with erectile dysfunction will benefit from it. Second, there is substantial risk that many patients will receive little or no evaluation before treatment; the potential for ill-informed and inappropriate prescribing is high.4 Third, sildenafil is not an aphrodisiac,3,4 nor does it increase sexual desire or libido.1–4 The drug has the potential for abuse by thrill-seekers.

Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction

Fourth, the known side-effects may not be transient, as current data suggest. Sildenafil may also have other, as-yet-unknown, adverse effects that will become evident only over time. In the first few weeks after sildenafil's release, physicians' only information source was the package insert.2 Goldstein's study1 supplied data that physicians should use to make informed decisions in the work-up and treatment of patients with erectile dysfunction. Physicians who prescribe sildenafil should do so only after a comprehensive work-up (history and physical examination, with diagnostic tests if indicated) has been completed. Oral sildenafil in the treatment of erectile dysfunction Research Question: Research Question: Funding: Funding: Year Study Began: Year Study Began: Year Study Published: Year Study Published: Study Location: Study Location: Who Was Studied: Who Was Studied: Who Was Excluded: Who Was Excluded: Patients: Patients: Study Overview: Study Overview: Study Interventions: Study Interventions: Follow-up: Follow-up: Endpoints: Endpoints: Criticism and Limitations: Criticism and Limitations: Other Relevant Studies and Information: Other Relevant Studies and Information: Summary and Implications: Summary and Implications: References References Other Relevant Studies and Information: Other Relevant Studies and Information: This chapter summarizes the results of a landmark trial comparing different doses of oral sildenafil versus placebo to treat erectile dysfunction.

Sildenafil, a novel effective oral therapy for male erectile dysfunction

Patients received either an identical placebo or 25- mg, 50-mg, or 100-mg tablets of sildenafil to be taken approximately one hour before planned sexual activity (but not more than once daily) for 24 weeks. Higher doses of sildenafil resulted in higher mean score for frequency of penetration and maintenance of erection, which were also consistently better than placebo. The most common side effects were headaches, flushing, dyspepsia, rhinitis, and visual disturbances. This study established sildenafil as an effective, reasonably well-tolerated treatment for men with erectile dysfunction of varying etiologies. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. In erectile dysfunction (ED), this increases blood flow to penile tissue, facilitating an erection.

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In pulmonary arterial hypertension (PAH), it dilates pulmonary vessels by the same mechanism, reducing pulmonary blood pressure and improving exercise capacity.

Dose (mg)	Typical Usage Frequency	Time to Onset (minutes)	Duration of Effect (hours)	Notes
50	Once or twice daily	30-60	4-6	Starting dose for most patients
100	Once daily	30-60	4-6	Common for moderate ED
25	As needed	30-60	4-6	For mild ED
10	As needed	30-60	4-6	Lower dose option

Sildenafil first gained FDA approval on March 27, 1998.

Chemical synthesis

Place the medication in a safe location – one that is up and away and out of their sight and reach. Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website for more information.

Other Literature Sources

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking.

Personal account

Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies. Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA DOI: 10.1016/S0140-6736(05)60375-3 External LinkAlso available on ScienceDirect External Link The study by I Goldstein and colleagues1 provides the much needed data for scrutiny by the medical community with regard to the efficacy, mechanism of action, pharmacokinetics, dosing, and side-effects of sildenafil. Since its approval by the Food and Drug Administration on March 27, 1998, sildenafil (marketed by Pfizer as Viagra) has been a pharmaceutical phenomenon. Its appeal stems from the fact that sildenafil is the first effective and safe oral therapy for men with erectile dysfunction.1–4 Pfizer's stock has risen by 50%, primarily because of aggressive marketing and the tremendous expectations for sildenafil.3 New prescriptions have increased almost exponentially—from 546 in the week ending April 3, to 269 842 in the week ending May 1.3 Urologists and nonurologists alike have been swamped with requests for the drug. 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".

Sign in

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions. Click the account icon in the top right to: View your signed in personal account and access account management features. View the institutional accounts sildenafil citrate tables that are providing access. Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access.

Diabetes-related impotence in the elderly

If you believe you should have access to that content, please contact your librarian. For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more. Choose an option Alt text (alternative text) helps when people can’t see the image or when it doesn’t load. Aim for 1-2 sentences that describe the subject, setting, or actions. Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

Sildenafil can improve exercise capacity in pulmonary hypertension patients.
Regular monitoring may be required for long-term use.
Be aware of potential side effects related to blood pressure changes.

Some medicines can cause unwanted or dangerous effects when used with sildenafil.

Study selection

This is used for ornamental images, like borders or watermarks. This alt text was created automatically and may be inaccurate. Downloading alt text AI model (0 of 0 MB) Automatic alt text Create alt text automaticallyDeleteDownload Suggests descriptions to help people who can’t see the image or when the image doesn’t load. Runs locally on your device so your data stays private. Alt text editor Show alt text editor right away when adding an image Helps you make sure all your images have alt text. Tell your doctor about all your current medicines, especially riociguat (Adempas).

Sildenafil's effects typically last for 4-6 hours.
It does not increase sexual desire but enhances response.
Onset of action can be affected by age and health status.

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.

Usual Geriatric Dose for Erectile Dysfunction

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Cardiovascular problems

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Outcomes assessed in the review

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43 Oral Sildenafil in the Treatment of Erectile Dysfunction