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In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems.

What special precautions should I follow?

[15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects.

Is Viagra Right for You?

Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss.

[4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss.

Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection.

2.2 Use with Food

In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, sildenafil citrate tablets 200mg indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours.

[4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.

5.8 Effects on Bleeding

[8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, sildenafil 60mg which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal.

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[8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors.

• Sildenafil citrate 100mg tablets can be part of erectile dysfunction treatment plans.
• The medication should be taken approximately 30 minutes to 1 hour before sexual activity.
• Sildenafil does not increase sexual desire but facilitates erection during arousal.
• Patients with heart conditions should seek medical advice before use.
• The medication can cause low blood pressure in some users.
• S sildenafil is not intended for recreational use.
• Do not use sildenafil if you are taking medications for high blood pressure without consulting a doctor.
• The effects depend on individual health and other medications taken concurrently.
• Sildenafil is contraindicated in patients taking certain alpha-blockers.
• Regular follow-up with a healthcare provider is recommended during treatment.
• Alcohol consumption may reduce the effectiveness of sildenafil.
• Read all warnings and instructions provided with the medication.

Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use.

5.4 Hearing Loss

All other trademarks are the property of their respective owners. Viagra® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED). VIAGRA is not for women or children. Please see Full Prescribing Information and Patient Information. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.

How it works

[4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. [34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction.

12.2 Pharmacodynamics

Your blood pressure could drop to an unsafe level are allergic to sildenafil, as contained in VIAGRA and Revatio®, or any of the ingredients in VIAGRA Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help. If it is not treated right away, priapism can permanently damage your penis sudden vision loss in one or both eyes. Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away Before you take VIAGRA, 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 NAION have kidney problems or are having kidney dialysis Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Does Viagra prevent ejaculation?

VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects. In some patients, the use of VIAGRA 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 VIAGRA contains sildenafil, which is the same medicine found in another drug called REVATIO. VIAGRA should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca® [tadalafil]) VIAGRA does not protect against sexually transmitted diseases, including HIV. The most common side effects of VIAGRA: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash. VIAGRA, REVATIO, and CARDURA are registered trademarks of Viatris Specialty LLC, a Viatris Company. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. [35] This study also noted a significant placebo effect in the control group.

• Sildenafil citrate 100mg tablets are FDA-approved for erectile dysfunction.
• It’s important to adhere to the prescribed timetable to ensure safety.
• Not suitable for those with severe heart or liver issues without consulting a doctor.
• Use sildenafil with caution if you have a history of stroke or cardiovascular disease.
• The medication enhances natural erectile responses, not sexual desire.
• Avoid grapefruit or grapefruit juice while taking sildenafil due to interactions.
• Patients should avoid combining sildenafil with recreational drugs.
• Some users may experience back pain or muscle aches as side effects.
• Always read the patient information leaflet before use.
• Report any side effects or unusual symptoms to your healthcare provider.
• Pregnant or breastfeeding women should avoid using sildenafil.
• Sildenafil is only effective when sexual stimulation occurs.

Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs.