Sildenafil (Viagra) – Complete Medication Guide

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What Is Sildenafil?

Sildenafil is a prescription medication used to treat erectile dysfunction (ED) in men. It's more commonly known by its brand name, Viagra. When taken with sexual stimulation, sildenafil works by increasing blood flow to the penis, helping you get and keep an erection firm enough for sex.

Important: This medication does not protect against sexually transmitted diseases (STDs) like HIV, hepatitis B, or syphilis. Always practice safe sex, including using latex condoms. Talk to your doctor or pharmacist for more details.

Other Uses for Sildenafil

Sildenafil is also available in other strengths for treating pulmonary hypertension (high blood pressure in the lungs). However, you should never substitute one form of this medication for another. Always use the specific strength and form prescribed by your doctor.

How to Take Sildenafil

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and every time you get a refill. If you have any questions, ask your doctor or pharmacist.

For erectile dysfunction:

• Take this medication by mouth as directed by your doctor, usually as needed.

• Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity. For best results, take it about 1 hour before.

• Do not take more than once daily.

• A high-fat meal may delay how quickly the medication starts working.

Your dosage depends on:

• Your medical condition

• Your response to treatment

• Other medications you may be taking

Important: Avoid eating grapefruit or drinking grapefruit juice while taking this medication, unless your doctor or pharmacist says it's safe. Grapefruit can increase the risk of side effects.

If your condition does not improve, tell your doctor.

Side Effects of Sildenafil

Like all medications, sildenafil can cause side effects. Many people using this medication do not have serious side effects.

Common side effects may include:

• Dizziness

• Headache

• Flushing (redness or warmth in the face)

• Stomach upset

• Vision changes (increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart)

If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness:

• Get up slowly when rising from a sitting or lying position.

Sexual activity may put extra strain on your heart, especially if you have heart problems. If you experience any of these serious side effects during sex, stop and get medical help right away:

• Severe dizziness

• Fainting

• Chest, jaw, or left arm pain

• Nausea

Serious Side Effects – Get Help Immediately

Rare but serious side effects include:

Sudden vision loss in one or both eyes (NAION):

• If this occurs, stop taking sildenafil and get medical help right away.

• Your risk is slightly higher if you have heart disease, diabetes, high cholesterol, certain eye problems, high blood pressure, are over 50, or smoke.

Sudden hearing loss or decrease:

• Sometimes with ringing in the ears and dizziness.

• Stop taking sildenafil and get medical help right away.

Painful or prolonged erection lasting 4 or more hours (priapism):

• Stop using the drug and get medical help right away. Permanent problems could occur.

Severe allergic reaction (rare):

• Symptoms include rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing. Get medical help right away.

Precautions Before Taking Sildenafil

Before taking sildenafil, tell your doctor or pharmacist:

• If you are allergic to sildenafil or any other medications

• About any other allergies you may have (this product may contain inactive ingredients that can cause allergic reactions)

Before using this medication, tell your doctor about your medical history, especially if you have:

ConditionWhy It MattersHeart problems (heart attack, irregular heartbeat, chest pain, heart failure)Sexual activity may strain your heartStroke in the past 6 monthsMay increase risk of complicationsKidney or liver diseaseMay require dose adjustmentHigh or low blood pressureMay affect how the drug worksDehydrationMay increase risk of side effectsPenis conditions (angulation, fibrosis, Peyronie's disease)May increase risk of priapismHistory of painful/prolonged erection (priapism)Higher risk of recurrenceSickle cell anemia, leukemia, or multiple myelomaIncreased risk of priapismEye problems (retinitis pigmentosa, sudden vision loss, NAION)May increase risk of vision problemsBleeding disorders or active stomach ulcersMay increase risk of bleeding

Driving and Operating Machinery

This medication may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you know how this medication affects you.

Limit alcoholic beverages while taking sildenafil, as alcohol can increase the risk of side effects.

Before Surgery

Before having surgery, tell your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs, and herbal products.

Pregnancy and Breastfeeding

This medication is not usually used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk. Consult your doctor before breastfeeding.

Drug Interactions

Sildenafil can interact with many medications, which may change how they work or increase your risk of serious side effects.

Do not take sildenafil with:

Type of DrugExamplesRiskNitratesNitroglycerin, isosorbideSerious drop in blood pressureRecreational drugs called "poppers"Amyl or butyl nitriteSerious drop in blood pressureAlpha blockersDoxazosin, tamsulosinLow blood pressure, dizziness, fainting

Other medications that may interact:

• Azole antifungals (itraconazole, ketoconazole)

• Macrolide antibiotics (clarithromycin, erythromycin)

• HIV protease inhibitors (ritonavir, saquinavir)

• Hepatitis C protease inhibitors (boceprevir, telaprevir)

• Rifampin

• Other ED medications (tadalafil, vardenafil)

Always provide a complete list of all medications you take to your healthcare provider and pharmacist. Do not start, stop, or change the dosage of any medicine without your doctor's approval.

What to Do in Case of Overdose

If you suspect an overdose, contact a poison control center or emergency room immediately.

US residents: Call the US National Poison Hotline at 1-800-222-1222.
Canada residents: Call a provincial poison control center.

Symptoms of overdose may include:

• Severe dizziness

• Fainting

• Painful or prolonged erection

Storage Instructions

• Store at room temperature, away from light and moisture.

• Do not store in the bathroom.

• Keep all medications away from children and pets.

• Do not flush medications down the toilet or pour them into a drain unless instructed.

• Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.