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nebivololnebivolol increases effects of sildenafil by additive vasodilation.
| Method | Onset Time | Duration of Effect | Factors Influencing Onset |
|---|---|---|---|
| Oral tablet | 30–60 min | 4–6 hours | Food intake, medication interaction |
| Chewable | 15–30 min | 4–6 hours | Alcohol consumption |
| Sublingual | 15 min | 4–6 hours | Blood flow to oral mucosa |
nebivolol increases effects of pink viagra sildenafil by additive vasodilation. nefazodonenefazodone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nefazodone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nevirapinenevirapine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Country | Legal Classification | Over-the-counter (OTC) | Prescription Required | Notes |
|---|---|---|---|---|
| USA | Prescription-only | No | Yes | Controlled medication |
| UK | Prescription-only | No | Yes | Available at pharmacies with prescription |
| Australia | Prescription-only | No | Yes | Restricted sale |
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels nevirapine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels nifedipinenifedipine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nifedipine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nilotinibnilotinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nilotinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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metoprolol increases effects of sildenafil by additive vasodilation. miconazole vaginal will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mitapivatmitapivat decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic index when coadministered with mitapivat. mitapivat decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. pindololpindolol increases effects of sildenafil by additive vasodilation. pindolol increases effects of sildenafil by additive vasodilation. posaconazoleposaconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. posaconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. propranololpropranolol increases effects of sildenafil by additive vasodilation.
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propranolol increases effects of sildenafil by additive vasodilation.
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fosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosphenytoinfosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels gepotidacingepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If possible, avoid with sensitive substrates that are are extensively metabolized by CYP3A4 and have a narrow therapeutic index.
When to take
If unable to avoid, monitor or modify substrate dose according to its prescribing information. gepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruitgrapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvingriseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ribociclibribociclib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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griseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisonehydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisibidelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of sildenafil with strong CYP3A4 inhibitors is not recommended.
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If using Viagra, consider decreasing starting dose. idelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazidisoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefyllineistradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ribociclib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates. istradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. itraconazoleitraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Dosage adjustments
Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension. itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. labetalollabetalol increases effects of sildenafil by additive vasodilation. labetalol increases effects of sildenafil by additive vasodilation. lapatiniblapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifabutin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Generic versions of 25 mg Viagra are available and usually cheaper.
- Always purchase Viagra from reputable pharmacies to avoid counterfeit products.
- Combining Viagra with other ED medications is not recommended.
- Be aware of potential interactions if taking other prescription drugs.
- The efficacy of 25 mg Viagra can vary based on individual health factors.
- Use Viagra only as directed by a healthcare provider.
- Do not take Viagra if you have been advised against sexual activity for health reasons.
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifampinrifampin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifampin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Individual response varies; some men may not respond to any PDE5 inhibitor.
- The 25 mg tablet is a common choice for men on concomitant alpha-blocker therapy.
- It should not be used by men with severe hepatic impairment (Child-Pugh C).
- Can cause a temporary decrease in blood pressure, leading to dizziness.
- It is not a treatment for low libido or androgen deficiency.
- The medication may improve erectile hardness (tumescence) and maintenance.
- Some studies suggest a potential benefit for Raynaud's phenomenon.
- Off-label use for female sexual arousal disorder is not FDA-approved.
- Proper hydration can help minimize some common side effects.
- It is generally well-tolerated in the healthy elderly population.
- A gradual dose titration may be employed to find the minimal effective dose.
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifapentinerifapentine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifapentine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rilzabrutinibrilzabrutinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Follow substrate recommendations for use with moderate CYP3A inhibitors rilzabrutinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- The drug's action is localized to the penis; systemic effects are generally mild.
- Starting at a low dose allows assessment of individual pharmacokinetics.
- It is not a "party drug" and using it recreationally can be hazardous.
- Men with multiple myeloma or leukemia may have contraindications.
- Can be used by men who have undergone kidney transplantation, with doctor approval.
- The cost-effectiveness of generic sildenafil has increased treatment access.
- Some men may find the side effects diminish with continued use.
- It does not treat underlying vascular disease, a common cause of ED.
- Penile implants or injections are alternatives if oral therapy fails.
- The decision to use medication should be a shared one between patient and doctor.
- Regular check-ups are important to monitor for any new health developments.
Follow substrate recommendations for use with moderate CYP3A inhibitors Either increases effects of the other by pharmacodynamic synergism. Coadministration of sepiapterin with drugs affecting nitric oxide-mediated relaxation may cause additive vasodilation and further reduce blood pressure. sotalolsotalol increases effects of sildenafil by additive vasodilation. sotalol increases effects of sildenafil by additive vasodilation. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects.
Before Using
sildenafil increases levels of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. mavorixaformavorixafor will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor for adverse effects of sensitive CYP3A4 substrates if coadministered with mavorixafor (a weak CYP3A4 inhibitor). mavorixafor will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. metoprololmetoprolol increases effects of sildenafil by additive vasodilation. suzetriginesuzetrigine decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic indexes when coadministered with suzetrigine.
Medical uses
lapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lesinurad (DSC)lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. letermovirletermovir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. letermovir increases levels of sildenafil by cialis or viagra for women affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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When amlodipine and sildenafil were used in combination, each agent independently exerted its own blood pressure lowering effect. lorlatiniblorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mavacamtensildenafil increases levels of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify mavacamten dose if coadministered with weak or moderate CYP2C19 inhibitors.
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