Jeffrey Panko NP Psychiatry · Patient education
Sildenafil
Viagra / Generic erectile-dysfunction tablets · Separate PAH formulations
A guide for adults taking sildenafil.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Erectile-dysfunction tablets are usually taken as needed. Pulmonary-hypertension treatment uses a regular schedule and must not be replaced by as-needed instructions.
What it is used for
Sildenafil treats erectile dysfunction and, in different formulations and schedules, pulmonary arterial hypertension. It is sometimes prescribed for antidepressant-associated erectile difficulties. This guide emphasizes adult erectile-dysfunction treatment.
How it works
It inhibits PDE5, helping blood vessels relax through the nitric-oxide pathway. For erections it requires sexual stimulation; it does not directly increase sexual desire.
What to expect over time
An erectile response may be possible after a dose, but timing varies. Review inadequate response, technique, other medicines, and cardiovascular suitability rather than taking extra tablets.
Taking your medication
- Use the prescribed dose and timing. For erectile dysfunction, do not take more than once daily unless a specialist has given different instructions for another indication.
- A high-fat meal can delay onset.
- Do not combine with another sildenafil formulation or another erectile-dysfunction medicine without explicit instructions.
- Never take with nitrates, recreational nitrites (“poppers”), or riociguat.
When to get help
Emergency symptoms. Get emergency care for an erection lasting four hours, chest pain, collapse, or sudden loss of vision or hearing. Do not wait for a prolonged erection to become painful.
Prompt medical advice. Report persistent visual symptoms, marked dizziness, or inadequate benefit before changing the dose.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Headache, flushing, or nasal congestion
- Indigestion
- Dizziness
- Temporary changes in color or brightness perception
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Report dizziness, fainting, vision or hearing changes, and prolonged erections. Review whether sexual activity is safe with your heart condition.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss heart disease, low blood pressure, a recent stroke or heart attack, eye disorders, bleeding disorders, and conditions that increase priapism risk. Discuss kidney or liver impairment.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Nitrates and riociguat can cause dangerous hypotension with sildenafil. If chest pain occurs, call 911 and tell responders when sildenafil was taken; do not take a nitrate yourself.
Alpha blockers and other blood-pressure medicines add dizziness risk. Strong CYP3A inhibitors can substantially raise exposure.
Everyday tips
Keep the exact dose and last-dose time available for emergency care.
Discuss the specific sexual side effect being treated.
Your questions answered
Will it increase desire?
It helps the physical erection response, not necessarily low libido or difficulty reaching orgasm.
What if I take it for pulmonary hypertension?
Follow that specialist’s regular schedule and missed-dose instructions; this as-needed erectile-dysfunction schedule does not apply.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.