5 WARNINGS AND PRECAUTIONS

If unable to avoid, monitor or modify substrate dose according to its prescribing information.

What should I do if I forget a dose?

dexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazemdiltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedaronedronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedarone will increase the level or effect chew sildenafil of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

5.4 Hearing Loss

duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. gepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruitgrapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

grapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvingriseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

griseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

8.5 Geriatric Use

cyclosporinecyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazoldanazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. darunavirdarunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Adverse Reactions/Side Effects

Coadministration with PDE-5 inhibitors may result in an increase in PDE-5 inhibitor-associated adverse reactions (eg, hypotension, syncope, visual disturbances and priapism). darunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasiroxdeferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasonedexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisonehydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What Other Drugs Interact with Sildenafil?

etravirineetravirine 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 etravirine 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 fedratinibfedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary. fedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisibidelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of sildenafil with strong CYP3A4 inhibitors is not recommended. If using Viagra, consider decreasing starting dose.

How should this medicine be used?

erythromycin baseerythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider a starting dose of 25 mg in patients treated with erythromycin. erythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin ethylsuccinate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionateerythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Prior authorization

erythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearateerythromycin stearate will increase the level or effect of sildenafil by affecting sildenafil oral strips hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esmololesmolol increases effects of sildenafil by additive vasodilation. esmolol increases effects of sildenafil by additive vasodilation. idelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazidisoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What Are Side Effects Associated with Using Sildenafil?

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels efavirenz 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 elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations.

What’s the difference between sildenafil 50 mg and 100 mg?

Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. enzalutamideenzalutamide 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 enzalutamide 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 epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation. epoprostenol increases effects of sildenafil by additive vasodilation. isoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefyllineistradefylline will increase the level or effect of sildenafil sildenafil from canada by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials.

How should I take sildenafil?

fluconazolefluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavirfosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitantfosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates. istradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

8.6 Patients with Hepatic Impairment

fosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosphenytoinfosphenytoin 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 fosphenytoin 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 gepotidacingepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If possible, avoid with sensitive substrates that are are extensively metabolized by CYP3A4 and have a narrow therapeutic index. itraconazoleitraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension.

• In case of overdose, standard supportive measures should be employed.
• Symptoms of overdose are expected to be an extension of common side effects.
• Severe hypotension could occur and may require active cardiovascular support.
• Hemodialysis is not expected to accelerate clearance of sildenafil.
• The primary metabolite, N-desmethyl sildenafil, is also not significantly dialyzable.
• Management of priapism may require corporal irrigation or surgical intervention.
• There is no specific antidote for sildenafil overdose.
• If an overdose is suspected, contact a poison control center immediately.
• Provide the medical professional with the amount ingested and the time.
• Keep the patient hydrated and monitor vital signs closely.
• Ingestions in children require immediate emergency medical attention.

itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• Common adverse reactions (≥2%) include headache, flushing, and dyspepsia.
• Nasal congestion, back pain, and myalgia are also frequently reported.
• Diarrhea, dizziness, and rash occur in a smaller percentage of users.
• Visual disturbances (color tinge, blurred vision) are dose-related.
• These effects are usually mild to moderate and transient in nature.
• Serious cardiovascular events are rare but possible, especially in at-risk patients.
• Priapism is a urological emergency that requires immediate treatment.
• Sudden hearing loss, often accompanied by tinnitus and dizziness, is rare.
• Allergic reactions, including skin rash and itching, can occur.
• There have been reports of seizures and anxiety in post-marketing experience.
• Most side effects diminish with continued use or dose adjustment.

labetalollabetalol increases effects of sildenafil by additive vasodilation. labetalol increases effects of sildenafil by additive vasodilation.

• Sildenafil may be less effective in men with certain health conditions like diabetes.
• Be aware of potential vision changes, such as blue-tinted vision.
• Discontinue use and consult a doctor if adverse reactions occur.
• Sildenafil can cause priapism, a painful prolonged erection needing urgent care.
• Safe sexual activity depends on your overall cardiovascular health.

lapatiniblapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.