8 USE IN SPECIFIC POPULATIONS

Comparing the Mechanism of Action
2.1 Sildenafil Tablets
What Other Drugs Interact with Sildenafil?
6.2 Postmarketing Experience
Side Effects

However, you should never double your dosage. If you completely miss a dose and it’s time for the next dose, skip the one you missed. Are there any safety measures I should take before using this drug? Like most medications, there are precautions you should take before using this drug. Make sure you talk with your doctor about: any other drugs, medications, herbs, or supplements you take or plan to take any medical conditions or surgeries you have or plan to have if you are pregnant or plan to become pregnant There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you. Sildenafil and tadalafil are alike because they both can treat sildenafil citrate tablets 50mg ED and PAH.

Condition	Details
Temperature	Store below 25°C (77°F)
Humidity	Keep in a dry place, away from moisture
Light Exposure	Store in a dark place, protect from light
Child Safety	Keep out of reach of children

However, tadalafil has a few distinctions from sildenafil. Tadalafil is the generic name for the erectile dysfunction drug Cialis.

Country/Region	Approval Status	Prescription Required	Notes
USA	Approved by FDA	Yes	Prescription only
European Union	Approved by EMA	Yes	Prescription required
Canada	Approved by Health Canada	Yes	Prescription needed
Australia	TGA approval	Yes	Prescription mandatory

There are two versions of the drug: a version that can be taken as needed Cialis 5-mg daily dosing is the only PDE5 inhibitor dose approved for treating an enlarged prostate; improving ED symptoms is an added benefit of the daily dose. Because of the “as needed” version of tadalafil, some users may find this option more convenient. The downside, however, is that side effects tend to last longer too. The main difference between generic sildenafil and Viagra is marketing. The main ingredient in Viagra is sildenafil, meaning that the drugs are essentially the same.

Sildenafil 20 mg tablets are manufactured by several pharmaceutical companies.
Generic versions are usually less expensive than brand-name options.
The drug works by inhibiting phosphodiesterase type 5 enzyme.
Patients should report any unusual symptoms promptly.
It is important to have a proper diagnosis before starting treatment.

Comparing the Mechanism of Action

Before taking sildenafil,

Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you. Sildenafil and tadalafil are alike because they both can treat sildenafil citrate tablets 50mg ED and PAH. However, tadalafil has a few distinctions from sildenafil. Tadalafil is the generic name for the erectile dysfunction drug Cialis. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date.

Product	Dosage	Quantity + Bonus	Price
Kamagra	100mg	60 + 4 Pills	201.34€ 191.75€
Kamagra Polo	100mg	60 + 4 Pills	189.39€ 180.37€
Viagra Generic	200mg	360 + 10 Pills	481.98€ 459.03€
Kamagra Soft Tabs	100mg	84 + 4 Pills	233.05€ 221.95€
Kamagra	100mg	120 + 6 Pills	330.74€ 314.99€
Viagra Generic	100mg	30 + 4 Pills	60.91€ 58.01€
Viagra Generic	100mg	180 + 8 Pills	199.37€ 189.88€
Kamagra	100mg	360 + 6 Pills	839.95€ 799.95€
Kamagra Soft Tabs	100mg	60 + 4 Pills	180.59€ 171.99€
Kamagra Polo	100mg	20 Pills	83.56€ 79.58€
Viagra Generic	150mg	60 + 4 Pills	111.25€ 105.95€
Kamagra Polo	100mg	120 + 6 Pills	327.15€ 311.57€
Viagra Generic	200mg	20 Pills	61.69€ 58.75€
Kamagra Soft Tabs	100mg	32 Pills	120.11€ 114.39€

However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.

2.1 Sildenafil Tablets

Dosage for pulmonary arterial hypertension (PAH)

However, Viagra is marketed and prescribed strictly for erectile dysfunction, while generic sildenafil can be prescribed for PAH as well. Viagra is also known as “the little blue pill” because of its blue color, while generic sildenafil tends to be a white color. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or 150mg sildenafil for sale other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Brand Name	Price Range (per tablet)	Availability	Prescription Needed	Notes
Viagra	$2 - $5	Pharmacies	Yes	Brand-name option
Sildenafil generics	$0.50 - $1.50	Online & Local Pharmacies	Yes	Economical choice
Kamagra	Varies	Online (regulated in some countries)	Yes	Check legal status

Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Sildenafil does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice "safe sex" such as using latex condoms.

Sildenafil 20 mg tablets are supplied in blister packs or bottles.
Always check the expiration date before use.
Alcohol may reduce the effectiveness or increase side effects.
Avoid taking sildenafil with fatty foods for faster absorption.
Keep out of reach of children to prevent accidental ingestion.

Consult your doctor or pharmacist for more details. Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension). Do not take sildenafil with any other product that contains sildenafil or sildenafil pricing other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil). Sildenafil is available under the following different brand names: Revatio, and Viagra. Dosage Considerations – Should be Given as Follows: 50 mg orally 1 hour before sexual activity may be increased to 100 mg or reduced to 25 mg, depending on effectiveness and tolerance Oral: 5 mg or 20 mg 3 times daily, administered 4-6 hours apart Intravenous (IV): 2.5-mg or 10-mg bolus 3 times daily if patient is temporarily unable to take orally Recommended oral/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Hepatic impairment or severe renal impairment: Use initial dose of 25 mg Older than 65 years: 25 mg orally initially 1 hour before sexual activity Oral: 5 mg or 20 mg 3 times daily, administered 4-6 hours apart Intravenous (IV): 2.5-mg or 10-mg bolus 3 times daily if patient is temporarily unable to take orally Recommended oral/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Clinical trials found no significant difference in response between elderly patients and younger adults; however, cautious dose selection should be considered in elderly because of greater frequency of decreased hepatic, renal, and cardiac function, as well as comorbid conditions and concomitant pharmacotherapy Compared with healthy younger volunteers, healthy elderly volunteers (65 years and older) had reduced clearance of sildenafil, resulting in approximately 84% and 107% higher plasma concentrations of sildenafil and its active N-desmethyl metabolite, respectively Not to be prescribed to children (1-17 years) for pulmonary arterial hypertension (PAH); this recommendation against use is based on long-term clinical pediatric trial showing that children taking high doses had higher risk of death than children taking low doses and that low doses were not effective in improving exercise ability Side effects associated with use of Sildenafil, include the following: Postmarketing side effects of sildenafil reported include: Vaso-occlusive crisis (PAH secondary to sickle-cell anemia) This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects. If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first. Sildenafil has serious interactions with at least 48 different drugs.

Sildenafil 20 mg tablets are sometimes used off-label for pulmonary hypertension.
The medication can cause priapism, a painful, prolonged erection.
Wait at least 24 hours before taking another dose.
Avoid grapefruit juice, which can increase drug levels.
Report any allergic reactions such as rash or difficulty breathing.

Sildenafil has moderate interactions with at least 72 different drugs.

What Other Drugs Interact with Sildenafil?

The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or 150mg sildenafil for sale other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Sildenafil does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis).

Marketing and sales

Practice "safe sex" such as using latex condoms. Consult your doctor or pharmacist for more details. Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension). Do not take sildenafil with any other product that contains sildenafil or sildenafil pricing other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil). Sildenafil is available under the following different brand names: Revatio, and Viagra. This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.

6.2 Postmarketing Experience

Dosage Considerations – Should be Given as Follows: 50 mg orally 1 hour before sexual activity may be increased to 100 mg or reduced to 25 mg, depending on effectiveness and tolerance Oral: 5 mg or 20 mg 3 times daily, administered 4-6 hours apart Intravenous (IV): 2.5-mg or 10-mg bolus 3 times daily if patient is temporarily unable to take orally Recommended oral/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Hepatic impairment or severe renal impairment: Use initial dose of 25 mg Older than 65 years: 25 mg orally initially 1 hour before sexual activity Oral: 5 mg or 20 mg 3 times daily, administered 4-6 hours apart Intravenous (IV): 2.5-mg or 10-mg bolus 3 times daily if patient is temporarily unable to take orally Recommended oral/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Clinical trials found no significant difference in response between elderly patients and younger adults; however, cautious dose selection should be considered in elderly because of greater frequency of decreased hepatic, renal, and cardiac function, as well as comorbid conditions and concomitant pharmacotherapy Compared with healthy younger volunteers, healthy elderly volunteers (65 years and older) had reduced clearance of sildenafil, resulting in approximately 84% and 107% higher plasma concentrations of sildenafil and its active N-desmethyl metabolite, respectively Not to be prescribed to children (1-17 years) for pulmonary arterial hypertension (PAH); this recommendation against use is based on long-term clinical pediatric trial showing that children taking high doses had higher risk of death than children taking low doses and that low doses were not effective in improving exercise ability Side effects associated with use of Sildenafil, include the following: Postmarketing side effects of sildenafil reported include: Vaso-occlusive crisis (PAH secondary to sickle-cell anemia) This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects. If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first. Sildenafil has serious interactions with at least 48 different drugs.

Recreational use

Sildenafil has moderate interactions with at least 72 different drugs. This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

Side Effects

Do not take Revatio or Viagra if you are allergic to sildenafil or any ingredients contained in this drug. In case of overdose, get medical help or contact a Poison Control Center immediately Soluble guanylate cyclase (sGC) stimulators (e.g., riociguat); concomitant use can cause hypotension Co-administration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure. See "What Are Side Effects Associated with Using Sildenafil?" Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi See "What Are Side Effects Associated with Using Sildenafil?” Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure Use with caution in patients with anatomic deformation of penis (e.g., angulation, cavernosal fibrosis, or Peyronie disease), conditions potentially predisposing to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease Patients taking alpha blocker should be stabilized before starting phosphodiesterase (PDE)-5 inhibitor, which should be initiated at lowest dose; if patient is already taking optimized dose of PDE-5 inhibitor, alpha blocker should be initiated at lowest dose to avoid hypotension Not to be taken with other PDE-5 inhibitors Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness Viagra: Patients should stop sildenafil and seek medical care if a sudden loss of vision occurs in 1 or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION); use with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION; patients with a ”crowded” optic disc may also be at an increased risk of NAION Viagra: Potential for cardiac risk with sexual activity in patients with preexisting cardiovascular disease; therefore, treatment for erectile dysfunction generally should not be instituted in men for whom sexual activity is inadvisable because of their underlying cardiovascular status May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy Revatio: In small, prematurely terminated study of patients with PAH secondary to sickle-cell disease, vaso-occlusive crises requiring hospitalization were more commonly reported by patients who received sildenafil than by those randomized to placebo; effectiveness of sildenafil in PAH secondary to sickle-cell anemia has not been established; the clinical relevance to men treated for erectile dysfunction with sildenafil is not known Revatio: Not for use in children with PAH; increased mortality with increasing doses (hazard ratio 3.5) was observed in randomized, double-blind, placebo-controlled clinical trial of 234 children (1-17 years) with PAH who had mild-to-moderate symptoms at baseline Revatio: Epistaxis occurred in 13% of patients with PAH secondary to connective tissue disease (e.g., scleroderma); this effect was not seen in idiopathic PAH; incidence was also higher in those receiving concomitant PO vitamin K antagonist therapy (9%) than in those not receiving such therapy (2%) Sildenafil may be acceptable for use during pregnancy Either animal studies show no risk but human studies are not available, or animal studies showed minor risks and human studies were done and showed no risk It is unknown whether sildenafil is distributed into breast milk. Do not take Revatio or Viagra if you are allergic to sildenafil or any ingredients contained in this drug. In case of overdose, get medical help or contact a Poison Control Center immediately Soluble guanylate cyclase (sGC) stimulators (e.g., riociguat); concomitant use can cause hypotension Co-administration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure.

Safe use of sildenafil requires assessment of heart conditions.
It may cause temporary visual disturbances like blurred vision.
Do not drive or operate machinery until effects are known.
Use with caution if you have high or low blood pressure.
Discuss any other medications with your healthcare provider.

See "What Are Side Effects Associated with Using Sildenafil?" Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi See "What Are Side Effects Associated with Using Sildenafil?” Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure Use with caution in patients with anatomic deformation of penis (e.g., angulation, cavernosal fibrosis, or Peyronie disease), conditions potentially predisposing to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease Patients taking alpha blocker should be stabilized before starting phosphodiesterase (PDE)-5 inhibitor, which should be initiated at lowest dose; if patient is already taking optimized dose of PDE-5 inhibitor, alpha blocker should be initiated at lowest dose to avoid hypotension Not to be taken with other PDE-5 inhibitors Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness Viagra: Patients should stop sildenafil and seek medical care if a sudden loss of vision occurs in 1 or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION); use with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION; patients with a ”crowded” optic disc may also be at an increased risk of NAION Viagra: Potential for cardiac risk with sexual activity in patients with preexisting cardiovascular disease; therefore, treatment for erectile dysfunction generally should not be instituted in men for whom sexual activity is inadvisable because of their underlying cardiovascular status May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy Revatio: In small, prematurely terminated study of patients with PAH secondary to sickle-cell disease, vaso-occlusive crises requiring hospitalization were more commonly reported by patients who received sildenafil than by those randomized to placebo; effectiveness of sildenafil in PAH secondary to sickle-cell anemia has not been established; the clinical relevance to men treated for erectile dysfunction with sildenafil is not known Revatio: Not for use in children with PAH; increased mortality with increasing doses (hazard ratio 3.5) was observed in randomized, double-blind, placebo-controlled clinical trial of 234 children (1-17 years) with PAH who had mild-to-moderate symptoms at baseline Revatio: Epistaxis occurred in 13% of patients with PAH secondary to connective tissue disease (e.g., scleroderma); this effect was not seen in idiopathic PAH; incidence was also higher in those receiving concomitant PO vitamin K antagonist therapy (9%) than in those not receiving such therapy (2%) Sildenafil may be acceptable for use during pregnancy Either animal studies show no risk but human studies are not available, or animal studies showed minor risks and human studies were done and showed no risk It is unknown whether sildenafil is distributed into breast milk.