sildenafil (oral)
Pronunciation: sil DEN a fil
Brand: Viagra


What is the most important information I should know about sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket).
Contact your doctor or seek emergency medical attention for any erection that lasts 4 hours. A sustained erection can damage the penis.
Refrain from further sexual activity and notify your doctor it you develop dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw) at the start of sexual activity.
Do not take sildenafil more than once a day.


What is sildenafil?
Sildenafil relaxes muscles within the penis. This increases the flow of blood into the penis and helps you achieve and maintain erections.
Sildenafil is used to treat erectile dysfunction (impotence).
Sildenafil may also be used for purposes other than those listed in this medication guide.


Who should not take sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket).
Before taking sildenafil, tell your doctor if you
     · have had a heart attack, stroke, or life-threatening irregular heartbeats within the last six months;
     · have a history of heart failure;
     · have coronary artery disease;
     · have angina;
     · have high or low blood pressure;
     · have liver disease;
     · have kidney disease;
     · have a bleeding disorder;
     · have a stomach ulcer;
     · have retinitis pigmentosa (an inherited condition of the eye);
     · have a physical deformity of the penis such as Peyronie's disease;
     · have a condition that could lead to prolonged and painful erections, such as a tumor of the bone marrow, sickle cell anemia, or leukemia; or
     · are taking another medicine to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others).
You may not be able to take sildenafil, or you may require a lower dose or special monitoring during therapy if you have any of the conditions listed above.
Although sildenafil is not indicated for use by women, it is in the FDA pregnancy category B. This means that sildenafil is not expected to harm an unborn baby. Do not take sildenafil without first talking to your doctor if you are pregnant.
Sildenafil is not indicated for use by women, and it is not known whether this medication passes into breast milk. Do not take sildenafil without first talking to your doctor if you are breast-feeding a baby.
If you are over 65 years of age, you may be more likely to experience side effects from sildenafil. You may require a lower dose of this medication.


How should I take sildenafil?
Take sildenafil exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
Sildenafil is usually taken when needed. It can be taken anywhere from 4 hours to one-half hour before sexual activity. Generally, it is taken 1 hour before sexual activity. Follow your doctor's instructions.
Do not take sildenafil more than once a day.
If you develop dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw) at the start of sexual activity, refrain from further sexual activity and notify your doctor.
Contact your doctor or seek emergency medical attention for any erection that lasts 4 hours. A sustained erection can damage the penis.
Store this medication at room temperature away from moisture and heat.


What happens if I miss a dose?
Sildenafil is used as needed, so you are not likely to miss a dose.


What happens if I overdose?
Seek emergency medical attention.
Symptoms of a sildenafil overdose are not known, but are likely to include chest pain, dizziness, an irregular heartbeat, and swelling of the ankles or legs.


What should I avoid while taking sildenafil?
Do not take any other drug used to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.


What are the possible side effects of sildenafil?
If you experience any of the following serious side effects, stop taking sildenafil and seek emergency medical attention or notify your doctor immediately:
     · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
     · chest pain or an irregular heartbeat;
     · swelling of the ankles or legs;
     · shortness of breath;
     · prolonged or severe dizziness;
     · a prolonged erection (4 hours); or
     · dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw).
Other, less serious side effects may be more likely to occur. Continue to take sildenafil and talk to your doctor if you experience
     · flushing,
     · mild dizziness,
     · headache,
     · nasal congestion,
     · diarrhea,
     · temporary blue tint in vision or other vision abnormalities, or
     · itching or a rash.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


What other drugs will affect sildenafil?
Do not take sildenafil if you are using a nitrate drug for chest pain or heart problems. Nitrates include nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket).
Before taking sildenafil, tell your doctor if you are taking any of the following medications:
     · any other drug used to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others);
     · the antibiotic drugs clarithromycin (Biaxin), erythromycin (E-Mycin, Eryc, Ery-Tab, others), metronidazole (Flagyl, Metrogel), sulfamethoxazole (Bactrim, Septra, Gantanol, others), or troleandomycin (TAO);
     · an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral);
     · the HIV medications amprenavir (Agenerase), delavirdine (Rescriptor), indinavir (Crixivan), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Fortovase, Invirase);
     · the stomach medications cimetidine (Tagamet, Tagamet HB), ranitidine (Zantac, Zantac 75), or omeprazole (Prilosec);
     · the heart medications amiodarone (Cordarone) or quinidine (Quinidex, Quinaglute);
     · the steroid medications dexamethasone (Decadron, others) or prednisolone (Prelone, others);
     · carbamazepine (Tegretol);
     · phenobarbital (Luminal, Solfoton);
     · phenytoin (Dilantin);
     · primidone (Mysoline);
     · zafirlukast (Accolate);
     · disulfiram (Antabuse);
     · fluvastatin (Lescol);
     · rifampin (Rifadin, Rifamate) or rifabutin (Mycobutin);
     · troglitazone (Rezulin) or pioglitazone (Actos);
     · danazol (Danocrine);
     · anastrozole (Arimidex); or
     · sulfinpyrazone (Anturane).
You may not be able to take sildenafil, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with sildenafil or affect your condition. Talk to your doctor or pharmacist before taking any prescription or over-the-counter medicines.


Where can I get more information?
Your pharmacist has additional information about sildenafil written for health professionals that you may read.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

The information in this leaflet is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.
© Multum Information Services 1999. Version: 3.01. Revision date: 10/15/99.