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Usual Adult Dose for Pulmonary Hypertension

Tell your healthcare provider about all the medicines you take, including prescription and over-the-countermedicines, vitamins, and herbal supplements. Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects. Especially tell your healthcare provider if you take: Nitrates for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers").

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Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure Alpha-blockers are sometimes prescribed for prostate problems orhigh blood pressure. In some patients, the use of sildenafil with alpha-blockers can lead to a drop in blood pressure or fainting Other drugs to treat high blood pressure or a prostate disorder Medicines to treat HIV, such as protease inhibitors, such as ritonavir and saquinavir Some types of oral antifungal medicines, such as ketoconazole and itraconazole Some types of antibiotics, such as erythromycin Other medicines that treat high blood pressure Medicines or treatments for ED, such as avanafil (Stendra), tadalafil (Cialis), or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction. Ask your healthcare provider or pharmacist for a list of these medicines if you are not sure. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

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Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. Store sildenafil tablets and oral film at room temperature, between 20°C and 25°C (68°F and 77°F). Store sildenafil reconstituted oral suspension below 30°C (86°F) or in a refrigerator between 2°C to 8°C (36°F to 46°F). Throw away the reconstituted oral suspension after 60 days. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. SILDENAFIL CITRATE- sildenafil citrate tablet, film coated Greenstone LLC What is the most important information I should know about SILDENAFIL CITRATE TABLETS? SILDENAFIL CITRATE TABLETS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take SILDENAFIL CITRATE TABLETS if you take any other medicines called "nitrates." Nitrates are used to treat chest pain (angina). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke. Do not take sildenafil tables SILDENAFIL CITRATE TABLETS if you take medicines called guanylate cyclase stimulators which include: Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronic-thromboembolic pulmonary hypertension.

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Tell all your healthcare providers that you take SILDENAFIL CITRATE TABLETS. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took SILDENAFIL CITRATE TABLETS.

5.5 Hypotension when Co-administered with Alpha-blockers or Anti-hypertensives

If you accidentally take too much sildenafil, call your doctor or go to the nearest hospital emergency room right away. Sildenafil can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Before taking sildenafil,

Take sildenafil oral film (Vybrique) exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much sildenafil to take and when to take it. Take sildenafil by mouth about 1 hour before sexual activity. You may take sildenafil between 30 minutes and 4 hours before sexual activity if needed. Do not take more than once a day.

Clinical monitoring

If you take too much sildenafil, call your healthcare provider or go to the nearest hospital emergency room right away. Do not remove the film from the pouch unless ready for immediate use. Do not handle the oral film with wet hands. See the Vybrique Prescribing Information for more information tablet sildenafil 50 mg about how to take sildenafil oral film. Take sildenafil exactly as it was prescribed for you. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

Drug/Class Interaction Effect Clinical Significance Recommendation
Nitrates Severe hypotension Contraindicated Avoid concomitant use
Alpha-blockers Additive blood pressure lowering Hypotension risk Monitor blood pressure closely
CYP3A4 inhibitors Increased sildenafil levels Increased side effects Dose adjustment may be necessary
Alcohol Enhanced hypotensive effects Increased dizziness risk Use with caution

SILDENAFIL CITRATE TABLETS does not protect you or your partner from getting sexually transmitted diseases, including HIV—the virus that causes AIDS. SILDENAFIL CITRATE TABLETS is a prescription medicine used to treat erectile dysfunction (ED). You will not get an erection just by taking this medicine. SILDENAFIL CITRATE TABLETS helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated). SILDENAFIL CITRATE TABLETS is not for use in women or children. It is not known if SILDENAFIL CITRATE TABLETS is safe and effective in women or children under 18 years of age.

Before taking this medicine

Active ingredient: sildenafil 100g sildenafil citrateInactive ingredients: dextrose and water for injection. Contains no ingredients made from gluten-containing grain (eg, wheat, barley, or rye). Revatio is distributed by Pfizer Labs, Division of Pfizer Inc., NY, NY 10017. Viagra is distributed by Pfizer Labs, Division of Pfizer Inc., NY, NY 10017. It is distributed by: IBSA Pharma Inc, Parsippany, NJ 07054 USA. Who should not take SILDENAFIL CITRATE TABLETS? Do not take SILDENAFIL CITRATE TABLETS if you: take medicines called nitrates (such as nitroglycerin) use street drugs called "poppers" such as amyl nitrate or amyl nitrite, and butyl nitrate take any medicines called guanylate cyclase stimulators such as riociguat (Adempas) are allergic to sildenafil, as contained in SILDENAFIL CITRATE TABLETS and REVATIO, or any of the ingredients in SILDENAFIL CITRATE TABLETS. See the end of this leaflet for a complete list of ingredients in SILDENAFIL CITRATE TABLETS. What should I tell my healthcare provider before taking SILDENAFIL CITRATE TABLETS?

  • Sildenafil is sometimes used off-label for pulmonary arterial hypertension.
  • Its use in this condition requires medical supervision.
  • The medication may interact with certain antifungal or antibiotic drugs.
  • Always inform your healthcare provider about all medications taken.

Before you take SILDENAFIL CITRATE TABLETS, tell your healthcare provider if you: have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve or heart failure have had heart surgery within the last 6 months have low blood pressure, or high blood pressure that is not controlled have had an erection that lasted for more than 4 hours have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia have retinitis pigmentosa, a rare genetic (runs in families) eye disease have ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION) have kidney problems or are having kidney dialysis Tell your healthcare provider about all the medicines you take1, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

  • Long-term safety of sildenafil requires more research.
  • Most side effects are mild and resolve on their own.
  • Repeated use may cause psychological dependence.
  • Regular medical reviews are recommended for ongoing therapy.

SILDENAFIL CITRATE TABLETS may affect the way other medicines work, and other medicines may affect the way SILDENAFIL CITRATE TABLETS works causing side effects. Especially tell your healthcare provider if you take any of the following: medicines called nitrates (see "What is the most important information I should know about SILDENAFIL CITRATE TABLETS?") medicines called guanylate cyclase stimulators, such as riociguat (Adempas) medicines called alpha blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure.

What to avoid

Follow all directions on your prescription label and read all medication guides or instruction sheets. Do not change your dose or stop taking this medicine on your own. Take sildenafil tablet or oral suspension 3 times a day, about 4 to 6 hours apart. Take at approximately the same times every day. Sildenafil oral suspension will be mixed for you by your pharmacist.

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Do not mix with other medicines or flavorings. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). When sildenafil is used for ED, it is used as needed, so you are not likely to miss a dose. If you are taking sildenafil for PAH and you miss a dose, take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose.

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Do not take two doses at one time. If you take too much sildenafil, call your doctor or go to the nearest hospital emergency room. Drinking alcohol with sildenafil can cause side effects. Grapefruit juice and products may interact with sildenafil, leading to unwanted side effects. Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor. In some patients, the use of SILDENAFIL CITRATE TABLETS with alpha-blockers can lead to a drop in blood pressure or to fainting. medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase) or atazanavir sulfate (Reyataz) some types of oral antifungal medicines, such as ketoconazole (Nizoral), and itraconazole (Sporanox) some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin other medicines that treat high blood pressure SILDENAFIL CITRATE TABLETS contains sildenafil, which is the same medicine found in another drug called SILDENAFIL TABLETS. SILDENAFIL TABLETS is used to treat a rare disease called pulmonary arterial hypertension (PAH).

  • Sildenafil was originally developed for hypertension and angina.
  • It was repurposed for erectile dysfunction after unintended effects were observed.
  • The medication is marketed under various brand names like Viagra.
  • Generic sildenafil citrate became available after patent expiration.

SILDENAFIL CITRATE TABLETS should not be used with SILDENAFIL TABLETS or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil]).