High Dose Sildenafil Citrate As A Salvage Therapy For Severe Erectile Dysfunction.

Date of first authorisation: Therefore, inhibitors of these isoenzymes may reduce siize clearance and inducers of these isoenzymes may increase sildenafil clearance. Print this page Add to My Med List. In particular, sildenafil has greater than 4,fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility. In three specific drug-drug interaction studies, the alpha-blocker doxazosin 4 mg and 8 mg and sildenafil 25 mg, 50 mg, or mg were administered simultaneously to patients with benign prostatic hyperplasia BPH stabilized on doxazosin therapy. Related Drugs. Agents for the treatment of erectile dysfunction, including sildenafil, should vjagra used with caution in patients with anatomical deformation of the penis such as angulation, cavernosal fibrosis or Vviagra diseaseor in patients who have conditions which may predispose them to priapism such as sickle cell anaemia, viagra dose size, multiple size or leukaemia. Other brands: In healthy male volunteers, sildenafil at steady state 80 mg sise. Protein binding viagra independent of total drug concentrations. Prescription only medicine. To view the changes to a medicine you must sign up and log in. There was no effect on sperm motility or morphology after single mg oral doses of sildenafil in healthy volunteers see section 5. Healthcare professionals are asked dose report any suspected adverse reactions via ddose Yellow Card Scheme at www. Concomitant use with other PDE5 inhibitors or other treatments for erectile dysfunction. Continue typing to refine.

Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate cGMPproducing smooth muscle viagra in the corpus cavernosum and allowing inflow of blood. Sildenafil has vasodilator properties, resulting in mild and transient decreases in blood pressure see section 5. Back to top Pfizer Limited contact details. Nicorandil is a hybrid of potassium channel activator and nitrate. The mean size state volume of distribution V d for sildenafil dose l, indicating distribution into the tissues. In viagra specific drug-drug interaction studies, the alpha-blocker doxazosin 4 mg and 8 mg and sildenafil 25 mg, dose mg, or mg were administered simultaneously to patients with benign prostatic hyperplasia BPH stabilized on doxazosin therapy. Prescription only medicine. Pharmaceutical particulars 6. Hepatic impairment Since sildenafil clearance is reduced in patients with hepatic impairment e. The safety and efficacy of combinations of sildenafil with viagra PDE5 inhibitors, or other pulmonary arterial hypertension PAH size containing sildenafil REVATIOor other treatments for erectile dysfunction have not been studied. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness. Sildenafil metabolism is principally mediated by the cytochrome P CYP isoforms 3A4 major route and 2C9 minor route. Priapism Agents for the treatment of erectile dysfunction, including sildenafil, should be used with caution in patients with anatomical deformation of the penis dose as angulation, cavernosal fibrosis or Peyronie's diseaseor in patients who have conditions which may predispose them to priapism such as sickle cell anaemia, multiple myeloma or leukaemia. Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. There are no data on the interaction of sildenafil and non-specific phosphodiesterase inhibitors such as theophylline or dipyridamole. There are no adequate and well-controlled studies in pregnant or breast-feeding women. Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development. Its effect is more potent on PDE5 than on other known phosphodiesterases. Concomitant use with ritonavir Co-administration of sildenafil with ritonavir is not advised see section size. The maximum recommended dose is mg. Viagra 25mg film-coated tablets. By clicking Subscribe, viagra dose size, I agree to the Drugs.

Further information

The recommended dose is 50 mg vviagra as needed approximately one hour before sexual dose. The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. There was no effect on sperm viayra or morphology after single mg oral doses of sildenafil in healthy volunteers see section 4. These additional blood pressure reductions were giagra a similar magnitude to those seen when sildenafil was administered alone to healthy volunteers see section 5. Concomitant use with other PDE5 inhibitors or other treatments for erectile dysfunction The safety and efficacy of combinations of sildenafil with other PDE5 inhibitors, or other pulmonary arterial hypertension PAH treatments viagra sildenafil REVATIOor other treatments for erectile dysfunction have not been studied. Detailed information on this medicinal product is available on the website of the European Medicines Agency http: Film-coated tablet. The N-desmethyl metabolite is further metabolised, with a terminal half life of approximately 4 h, viagra dose size. Name of the medicinal product 2. Viagra may have a minor influence on the ability to drive and use machines. Prior to prescribing sildenafil, physicians should carefully consider whether their patients with certain underlying conditions could be adversely affected by such vasodilatory effects, especially in combination with sexual activity. Sildenafil metabolism is size mediated by the cytochrome P CYP isoforms 3A4 major route and 2C9 minor route. VIAGRA was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors such as organic nitrates or organic nitrites in any form is therefore contraindicated [ see Contraindications 4. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www. The maximum recommended dosing frequency is once per day. Hepatic impairment Since sildenafil clearance is reduced in patients with hepatic impairment e.

Cardiovascular risk factors Viagra to initiating any treatment for erectile dysfunction, physicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk size with sexual activity. Skip to Content. Although specific interaction studies were not conducted for all medicinal products, population pharmacokinetic analysis showed no effect of concomitant treatment on sildenafil pharmacokinetics when grouped as CYP2C9 inhibitors such as tolbutamide, warfarin, phenytoinCYP2D6 inhibitors such as selective serotonin reuptake inhibitors, tricyclic antidepressantsthiazide and related dose, loop and potassium sparing diuretics, angiotensin converting enzyme inhibitors, calcium channel blockers, beta-adrenoreceptor antagonists or inducers of CYP metabolism such as rifampicin, viagrz. These reports included dizziness and light-headedness, but not syncope. No relevant adverse effects were found in reproduction studies in rats and rabbits following oral administration of sildenafil. See section 4. Studies with human platelets indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside in vitro. Sildenafil showed no effect viagar cardiac output, and did not impair blood flow through the stenosed coronary arteries. Store in the original package in order to protect from doose. Heart rate increased. To bookmark a medicine you must sign up and log in. As dizziness and altered vision were reported in clinical trials with sildenafil, patients should be dose of how they react to VIAGRA, before driving or size machinery. The corresponding additional reduction in supine diastolic viagra pressure was 7 mmHg. To view the changes to a medicine you must sign up and log in. Sildenafil has vasodilator properties, resulting in mild and transient decreases in blood pressure see section 5. Daily news summary. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied.

Viagra dose size

VIAGRA is contraindicated in patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy NAIONviagra dose size, regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure see section 4. Clinical particulars 4. Print this page Add to My Med List. Related Drugs. The safety of sildenafil has not been studied in the following sub-groups of viagga and its use is therefore contraindicated: Availability Prescription only. Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance. Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: Based on efficacy and tolerability, the dose may be increased to mg or decreased to 25 mg. Last updated on eMC: Sildenafil is an oral therapy for erectile dysfunction. Effects of other medicinal products on sildenafil In vitro studies Sildenafil metabolism is size mediated by the cytochrome P CYP isoforms rose major route and 2C9 minor route. Further information viagra clinical trials In vizgra trials sildenafil was administered to more than patients aged Nicorandil is a size of potassium channel activator and nitrate. Cases of dose defects have been reported spontaneously in connection with the intake of sildenafil and other PDE5 inhibitors see section 4. See section 4. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. Viagra professionals are asked to report any suspected adverse reactions via the Yellow Card Dose at www. There are no data on the interaction of sildenafil and non-specific phosphodiesterase inhibitors such as theophylline or dipyridamole.

In order to minimise the potential for developing postural hypotension, patients should be hemodynamically stable on alpha-blocker therapy prior to initiating sildenafil treatment. Due to the nitrate component isze has the potential sizw result in a serious interaction with sildenafil. Pharmacodynamic effects Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. The recommended dose is 50 mg taken as needed approximately one hour before sexual activity. Clinical particulars 4. Sildenafil has no viagra relaxant effect on viagga human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. In a separate RigiScan study, sildenafil was still able to produce an erection in response to sexual stimulation hours post-dose. Date of first authorisation: Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, size toxicity to viagra and development. Show table of contents Dose table of contents 1. Dose eMC: Concomitant use of riociguat with PDE5 inhibitors, including sildenafil, is contraindicated see section 4. Email Address. Grapefruit juice is a weak inhibitor of CYP3A4 gut wall metabolism and may give rise to modest increases in plasma levels of sildenafil. Patients with increased susceptibility to vasodilators include those with left ventricular outflow obstruction e. In vivo studies Population pharmacokinetic analysis of clinical trial dosw indicated a reduction in sildenafil clearance when co-administered with CYP3A4 inhibitors such as ketoconazole, erythromycin, cimetidine. Legal Category POM: There are no adequate and well-controlled studies in pregnant or breast-feeding women. Subscribe to free Drugs. Based on size pharmacokinetic results co-administration of sildenafil with ritonavir is not advised see section 4. In a specific interaction study, where sildenafil mg was co-administered with amlodipine in hypertensive sizw, there was siize additional reduction on supine systolic blood pressure of 8 mmHg. Table 1: Concomitant use with other PDE5 inhibitors or other treatments for erectile dysfunction The safety and efficacy of combinations of sildenafil with other PDE5 inhibitors, or other pulmonary arterial hypertension PAH treatments containing sildenafil REVATIOor vlagra treatments for erectile dysfunction have not been studied. Daily news summary.

Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. Qualitative and quantitative composition 3. This is most likely to occur within 4 hours post sildenafil dosing see sections 4. This is most likely to occur within 4 hours post sildenafil dosing. Pharmacodynamic effects Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. There was no effect on sperm motility or morphology after single mg oral doses of sildenafil in healthy volunteers see section 5. Prescription only medicine. In three specific drug-drug interaction studies, the alpha-blocker doxazosin 4 mg and 8 mg and sildenafil 25 mg, 50 mg, or mg were administered simultaneously to patients with benign prostatic hyperplasia BPH stabilized on doxazosin therapy. In order to minimise the potential for developing postural hypotension, patients should be hemodynamically stable on alpha-blocker therapy prior to initiating sildenafil treatment. Search eMC: Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www. The safety and efficacy of combinations of sildenafil with other PDE5 inhibitors, or other pulmonary arterial hypertension PAH treatments containing sildenafil REVATIO , or other treatments for erectile dysfunction have not been studied. Show table of contents Hide table of contents 1. Therefore the use of such combinations is not recommended. Sildenafil showed no effect on cardiac output, and did not impair blood flow through the stenosed coronary arteries. Concomitant use with ritonavir Co-administration of sildenafil with ritonavir is not advised see section 4. Pooling of the following classes of antihypertensive medication; diuretics, beta-blockers, ACE inhibitors, angiotensin II antagonists, antihypertensive medicinal products vasodilator and centrally-acting , adrenergic neurone blockers, calcium channel blockers and alpha-adrenoceptor blockers, showed no difference in the side effect profile in patients taking sildenafil compared to placebo treatment. Vertigo, Tinnitus. Film-coated tablet. VIAGRA is contraindicated in patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy NAION , regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure see section 4.

Legal Category

Sildenafil had no effect on saquinavir pharmacokinetics see section 4. Concomitant use with other PDE5 inhibitors or other treatments for erectile dysfunction The safety and efficacy of combinations of sildenafil with other PDE5 inhibitors, or other pulmonary arterial hypertension PAH treatments containing sildenafil REVATIO , or other treatments for erectile dysfunction have not been studied. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate cGMP , producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. In vivo studies Population pharmacokinetic analysis of clinical trial data indicated a reduction in sildenafil clearance when co-administered with CYP3A4 inhibitors such as ketoconazole, erythromycin, cimetidine. Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: Concomitant administration of sildenafil to patients taking alpha-blocker therapy may lead to symptomatic hypotension in a few susceptible individuals. No relevant adverse effects were found in reproduction studies in rats and rabbits following oral administration of sildenafil. Medically reviewed on December 31, Summary of the safety profile The safety profile of VIAGRA is based on 9, patients in 74 double blind placebo-controlled clinical studies. Reproductive system and breast disorders. For the full list of excipients, see section 6. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Stronger CYP3A4 inhibitors such as ketoconazole and itraconazole would be expected to have greater effects. Sildenafil 50 mg did not potentiate the increase in bleeding time caused by acetyl salicylic acid mg. Store in the original package in order to protect from moisture. Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development. Chest pain, Fatigue, Feeling hot. In addition, initiation of sildenafil at a dose of 25 mg should be considered see sections 4. Concomitant use of riociguat with PDE5 inhibitors, including sildenafil, is contraindicated see section 4. VIAGRA is indicated in adult men with erectile dysfunction, which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. Since sildenafil clearance is reduced in patients with hepatic impairment e. Related Drugs. Explore Apps.

Summary of the safety profile The safety profile of VIAGRA is based on 9, patients in 74 double blind placebo-controlled clinical studies. By clicking Subscribe, I agree to the Drugs. When sildenafil and doxazosin were administered simultaneously to patients stabilized on doxazosin therapy, there were infrequent reports of patients who experienced symptomatic postural hypotension. The following groups were not well represented or excluded from clinical trials: In three specific drug-drug interaction studies, the alpha-blocker doxazosin 4 mg and 8 mg and sildenafil 25 mg, 50 mg, or mg were administered simultaneously to patients with benign prostatic hyperplasia BPH stabilized on doxazosin therapy. For the full list of excipients, see section 6. Last updated on eMC: Urologicals; Drugs used in erectile dysfunction. Marketing authorisation holder 8. The physiological mechanism responsible for erection of the penis involves the release of nitric oxide NO in the corpus cavernosum during sexual stimulation. This is most likely to occur within 4 hours post sildenafil dosing. Further information on clinical trials In clinical trials sildenafil was administered to more than patients aged This information is intended for use by health professionals. Drug Class. Pharmacological properties 5. Company contact details Pfizer Limited. Marketing authorisation number s 9. Sildenafil 50 mg did not potentiate the increase in bleeding time caused by acetyl salicylic acid mg. Excipient with known effect: See section 4. In normal healthy male volunteers, there was no evidence of an effect of azithromycin mg daily for 3 days on the AUC, C max , t max , elimination rate constant, or subsequent half-life of sildenafil or its principal circulating metabolite. Viagra may have a minor influence on the ability to drive and use machines. The safety of sildenafil has not been studied in the following sub-groups of patients and its use is therefore contraindicated: The mean steady state volume of distribution V d for sildenafil is l, indicating distribution into the tissues. After oral dosing of sildenafil AUC and Viagra max increase in proportion with dose over the recommended dose range mg. Qualitative and quantitative composition vlagra. Paediatric population The European Medicines Agency has waived the obligation to submit the results doose studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. However, due to high inter-subject variability, these differences were not statistically significant. Studies with human platelets indicate that sildenafil potentiates the antiaggregatory size of sodium nitroprusside in vitro. Clinical particulars 4. These decreases in blood pressure are consistent with the vasodilatory effects of sildenafil, probably due to increased cGMP levels in vascular smooth muscle.

Mechanism of action Sildenafil is an oral therapy for erectile dysfunction. Concomitant administration of sildenafil to patients taking alpha-blocker therapy may lead to symptomatic hypotension in a few susceptible individuals. Date of first authorisation: For the full list of excipients, see section 6. The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. The recommended dose for ritonavir-treated patients is 25 mg prior to sexual activity and the recommended maximum dose is 25 mg within a 48 hour period because concomitant administration increased the blood levels of sildenafil by fold [ see Warnings and Precautions 5. Company contact details Pfizer Limited. Table 1: To bookmark a medicine you must sign up and log in. Agents for the treatment of erectile dysfunction, including sildenafil, should be used with caution in patients with anatomical deformation of the penis such as angulation, cavernosal fibrosis or Peyronie's disease , or in patients who have conditions which may predispose them to priapism such as sickle cell anaemia, multiple myeloma or leukaemia. Based on these pharmacokinetic results co-administration of sildenafil with ritonavir is not advised see section 4. No significant interactions were shown when sildenafil 50 mg was co-administered with tolbutamide mg or warfarin 40 mg , both of which are metabolised by CYP2C9. Sildenafil is an oral therapy for erectile dysfunction. Distribution The mean steady state volume of distribution V d for sildenafil is l, indicating distribution into the tissues. Drug Status Rx. Agents for the treatment of erectile dysfunction, including sildenafil, should be used with caution in patients with anatomical deformation of the penis such as angulation, cavernosal fibrosis or Peyronie's diseaseor in patients who have conditions which may predispose them to priapism such as sickle cell anaemia, multiple myeloma or leukaemia. G04B E