Label: SILDENAFIL- sildenafil citrate injection, solution

We design protocols based on your goals, not algorithmic defaults. We provide ongoing physician access for adjustments, not just initial scripts.

Dosing & Uses

For patients dealing with erectile dysfunction (ED), certain drugs that influence the blood flow to pelvic organs can help in restoring and maintaining an erection. Tadalafil and Sildenafil are two such medications typically prescribed for this condition. Both of these work by inhibiting phosphodiesterase type 5 (PDE5), an enzyme found primarily in the vascular smooth muscle of the corpus cavernosum, thus promoting blood flow necessary for achieving an erection. We'll review your health profile, lifestyle patterns, and performance goals—then design a personalized approach using the medication or combination that serves your actual life. Applies to the following strengths: 10 mg/mL; 10 mg/12.5 mL; 20 mg; 25 mg; 50 mg; 100 mg; 75 mg TABLETS (Viagra) Initial dose: 50 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May increase to 100 mg or decrease to 25 mg once a day, based on efficacy and tolerability. Maximum dose: 100 mg orally once a day Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity. TABLETS (Revatio)/ORAL SUSPENSION (Revatio, Liqrev): Initial dose: 20 mg orally 3 times a day Maintenance dose: May titrate up to 80 mg orally 3 times a day, if required, based on symptoms and tolerability. Maximum dose: 80 mg orally 3 times a day IV: 10 mg IV bolus 3 times a day Comments: No adjustment for body weight is required for IV dosing. The 10 mg IV bolus dose is predicted to provide an equivalent pharmacological effect to that of 20 mg orally. Doses up to a maximum of 80 mg orally 3 times a day are supported by delayed clinical worsening with long-term use in clinical studies despite a lack of observed dose-response improvement in exercise ability in short-term clinical studies. In adults 65 years or older, use caution with dose selection due to a higher incidence of compromised renal, cardiac, and/or hepatic function, and of concomitant disease or drug therapy. Use: For the treatment of PAH (WHO Group I) to improve exercise ability and delay clinical worsening TABLETS (Viagra) Initial dose: 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May titrate up to 100 mg orally once a day, based on effectiveness and toleration. Maximum dose: 100 mg orally once a day Comments: This drug may be administered anywhere from 30 minutes to 4 hours before sexual activity. A reduced starting dose is recommended in older adults due to higher systemic exposure as compared to younger adults.

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TABLETS (Revatio)/ORAL SUSPENSION (Revatio) 1 to less than 18 years: Weight 20 kg or less: 10 mg orally 3 times a day Weight greater than 20 kg to 45 kg: 20 mg orally 3 times a day Weight greater than 45 kg: 20 mg orally 3 times a day; dose may be titrated up to a maximum of 40 mg orally 3 times a day, if required, based on symptoms and tolerability Use: For the treatment of pulmonary arterial hypertension (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underlie improvements in exercise ERECTILE DYSFUNCTION: Mild to Moderate Renal Dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended Severe Renal Dysfunction (CrCl less than 30 mL/min): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity Mild, Moderate, or Severe Renal Dysfunction (CrCl 80 to less than 30 mL/min): No adjustment recommended ERECTILE DYSFUNCTION: Mild, Moderate, or Severe Liver Dysfunction (Child-Pugh A, B, or C): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity. Mild or Moderate Liver Dysfunction (Child-Pugh A or B): No adjustment recommended Severe Liver Dysfunction (Child-Pugh C): Data not available in this population. Initiate treatment with 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Patients should be stable on alpha blocker therapy prior initiating treatment with this drug.

• Men on sildenafil should avoid grapefruit or grapefruit juice.
• Sildenafil 10mg is less likely to cause side effects compared to higher doses.
• Regular exercise and healthy lifestyle can improve erectile function.
• Sildenafil has been in use for over two decades with proven safety.
• Patients should consult a healthcare provider if unsure about dosage.

Administration with CYP450 3A4 Inhibitors (e.g., ketoconazole, itraconazole, saquinavir) or Erythromycin: Consider a starting dose of 25 orally once a day, as needed, about 1 hour prior to sexual activity. Recommended dose: 25 mg orally, as needed, about 1 hour prior to sexual activity Maximum dose: 25 mg orally within a 48 hour period Known hypersensitivity to either the active component or to any of the ingredients; hypersensitivity reactions have been reported, including rash and urticaria In patients who are using a guanylate cyclase (GC) stimulators, such as riociguat; phosphodiesterase type 5 inhibitors (PDE5), including this drug, may potentiate the hypotensive effects of GC stimulators. In patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently; this drug has been shown to potentiate the hypotensive effects of nitrates based on its mechanism of action After patients have taken this drug for ED, it is unknown when nitrates, if necessary, can be safely administered.

Further information

For those of you taking Sildenafil (Viagra) to help with ED, I am asking this dosing question. I just got my first script from the online pharmacy my doctor sent it to, and the bottle says "Take two pills daily and 3 more 1 hour before sexual activity." And then on the "appointed day" take 5? Go to the Prostate Cancer Support Group. It seems to be common to do this to try and resolve ED issues. I'm not a medical professional, but here's a document on UCSF that someone on this blog mentioned in another thread.

How do costs compare for vardenafil and sildenafil?

It has a section on Penile Rehabilitation that includes some information related to your question: Best wishes. I would think your doctor would’ve checked up before prescribing it for you though, but you never know. You should at least mention to your doctor, the side effects you have felt from taking the drug. See what he has to say about it. Yes, and I have spoken to her.

IV Administration

The sildenafil is for "lung blood pressure", whatever that means. It has not impacted my pulse rate or my BP. I think I'm just sensitive to it. It can cause problems if you normally have low blood pressure. Listen to the article instead of reading through it. Although plasma levels of this drug at 24 hours post-dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point. Concomitant use of organic nitrates in any form, either regularly or intermittently, because of the greater risk of hypotension Concomitant use of riociguat, a guanylate cyclase stimulator; PDE5 inhibitors, including this drug, may potentiate the hypotensive effects of riociguat. Known hypersensitivity to either the active component or to any of the ingredients of the tablet, injection, or oral suspension; hypersensitivity reactions have been reported, including anaphylactic reaction, anaphylactic shock, and anaphylactoid reaction Safety and efficacy have not been established in patients with ED younger than 18 years. Safety and efficacy have not been established in patients with PAH younger than 1 year. Due to high plasma protein binding and poor elimination in urine, removal via hemodialysis is unlikely. Tablets: Administer orally with or without food. Reconstitute product before oral administration, and shake well before use. An oral syringe is recommended for dose measurement (and delivery).

Advice To Patients

Use within 60 days after reconstitution; discard any sildenafil otc remainder after expiration. The liquid suspension is premixed and may contain flavoring. Shake well before oral administration and use a calibrated measuring device for accurate dosing. IV: Administer as an IV bolus injection; the supplied product is ready for use. Tablets/IV solution: Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (liquid): Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (powder): Store below 30C (86F) in the original package in order to protect from moisture. After reconstitution, store below 30C (86F) or in refrigerator at 2C to 8C (36F to 46F); do not freeze. Oral suspension (powder): Reconstitute with water (total 90 mL) in separate additions; shake vigorously after each addition.

• The medication can improve quality of life for men with ED.
• Sildenafil 10mg is often used as a starting dose.
• If no effect, a doctor may adjust the dose accordingly.
• It is not a cure for ED, but a treatment to manage symptoms.
• Use sildenafil only as directed by a healthcare professional.

Do not mix with other medications or flavoring; insert adaptor into bottle neck. Consult the manufacturer product information for detailed instructions. Cardiovascular: Cardiac status/risk factors (prior to initiation); blood pressure (periodically during treatment in patients with PAH on concomitant anti-hypertensive agents) Drug Interactions: For concomitant use of medications that may be contraindicated or for dose adjustment (at baseline and during treatment) Ocular: NAION risk factors (prior to initiation) Read the US FDA-approved patient labeling (Patient Information and/or Instructions for Use).

Drug Label Information

We design protocols based on your goals, not algorithmic defaults. We provide ongoing physician access for adjustments, not just initial scripts. We'll review your health profile, lifestyle patterns, and performance goals—then design a personalized approach using the medication or combination that serves your actual life. Applies to the following strengths: 10 mg/mL; 10 mg/12.5 mL; 20 mg; 25 mg; 50 mg; 100 mg; 75 mg TABLETS (Viagra) Initial dose: 50 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May increase to 100 mg or decrease to 25 mg once a day, based on efficacy and tolerability. Maximum dose: 100 mg orally once a day Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity.

How the Combination Treatment Works

TABLETS (Revatio)/ORAL SUSPENSION (Revatio, Liqrev): Initial dose: 20 mg orally 3 times a day Maintenance dose: May titrate up to 80 mg orally 3 times a day, if required, based on symptoms and tolerability. Maximum dose: 80 mg orally 3 times a day IV: 10 mg IV bolus 3 times a day Comments: No adjustment for body weight is required for IV dosing. The 10 mg IV bolus dose is predicted to provide an equivalent pharmacological effect to that of 20 mg orally. Doses up to a maximum of 80 mg orally 3 times a day are supported by delayed clinical worsening with long-term use in clinical studies despite a lack of observed dose-response improvement in exercise ability in short-term clinical studies. In adults 65 years or older, use caution with dose selection due to a higher incidence of compromised renal, cardiac, and/or hepatic function, and of concomitant disease or drug therapy.

Special Populations

Use: For the treatment of PAH (WHO Group I) to improve exercise ability and delay clinical worsening TABLETS (Viagra) Initial dose: 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Maintenance dose: May titrate up to 100 mg orally once a day, based on effectiveness and toleration. Maximum dose: 100 mg orally once a day Comments: This drug may be administered anywhere from 30 minutes to 4 hours before sexual activity. A reduced starting dose is recommended in older adults due to higher systemic exposure as compared to younger adults. TABLETS (Revatio)/ORAL SUSPENSION (Revatio) 1 to less than 18 years: Weight 20 kg or less: 10 mg orally 3 times a day Weight greater than 20 kg to 45 kg: 20 mg orally 3 times a day Weight greater than 45 kg: 20 mg orally 3 times a day; dose may be titrated up to a maximum of 40 mg orally 3 times a day, if required, based on symptoms and tolerability Use: For the treatment of pulmonary arterial hypertension (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underlie improvements in exercise ERECTILE DYSFUNCTION: Mild to Moderate Renal Dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended Severe Renal Dysfunction (CrCl less than 30 mL/min): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity Mild, Moderate, or Severe Renal Dysfunction (CrCl 80 to less than 30 mL/min): No adjustment recommended ERECTILE DYSFUNCTION: Mild, Moderate, or Severe Liver Dysfunction (Child-Pugh A, B, or C): Consider a starting dose of 25 mg orally once a day, about 1 hour prior to sexual activity. Mild or Moderate Liver Dysfunction (Child-Pugh A or B): No adjustment recommended Severe Liver Dysfunction (Child-Pugh C): Data not available in this population. Tell your healthcare provider about all of the medicines you (or your child take). Regular and/or intermittent use of nitric oxide donors (e.g., organic nitrates or nitrites) in any form Other PDE5 inhibitors or products containing sildenafil Seek immediate medical attention in the event of: Sudden loss of vision in one or both eyes Sudden decrease or loss of hearing; may be accompanied by tinnitus and dizziness An erection that persists longer than 4 hours. It is not recommended to take this drug more than once a day. This medication can cause your blood pressure to unsafely drop suddenly if it is taken with certain other medicines.

• Medication effectiveness can be impacted by certain health conditions.
• Men should not use sildenafil if they have a history of stroke.
• Sildenafil 10mg can sometimes cause nasal congestion.
• It’s important to report any unusual side effects to your doctor.
• Do not use sildenafil if you are taking other ED medications.

Stop sexual activity and seek medical attention if you experience symptoms such as chest pain, dizziness, or nausea during sex, or if you have any side effect that bothers you or does not go away. Use protective measures to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV). For those of you taking Sildenafil (Viagra) to help with ED, I am asking this dosing question. I just got my first script from the online pharmacy my doctor sent it to, and the bottle says "Take two pills daily and 3 more 1 hour before sexual activity." And then on the "appointed day" take 5?

Dosages of Sildenafil

IV: Administer as an IV bolus injection; the supplied product is ready for use. Tablets/IV solution: Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (liquid): Store at 20C to 25C (68F to 77F); excursions permitted to 15C to 30C (59F to 86F). Oral suspension (powder): Store below 30C (86F) in the original package in order to protect from moisture. After reconstitution, store below 30C (86F) or in refrigerator at 2C to 8C (36F to 46F); do not freeze.

Are vardenafil and sildenafil available over the counter?

Oral suspension (powder): Reconstitute with water (total 90 mL) in separate additions; shake vigorously after each addition. Do not mix with other medications or flavoring; insert adaptor into bottle neck. Consult the manufacturer product information for detailed instructions. Cardiovascular: Cardiac status/risk factors (prior to initiation); blood pressure (periodically during treatment in patients with PAH on concomitant anti-hypertensive agents) Drug Interactions: For concomitant use of medications that may be contraindicated or for dose adjustment (at baseline and during treatment) Ocular: NAION risk factors (prior to initiation) Read the US FDA-approved patient labeling (Patient Information and/or Instructions for Use). Tell your healthcare provider about all of the medicines you (or your child take).

What are the differences between vardenafil and sildenafil?

Regular and/or intermittent use of nitric oxide donors (e.g., organic nitrates or nitrites) in any form Other PDE5 inhibitors or products containing sildenafil Seek immediate medical attention in the event of: Sudden loss of vision in one or both eyes Sudden decrease or loss of hearing; may be accompanied by tinnitus and dizziness An erection that persists longer than 4 hours. It is not recommended to take this drug more than once a day. This medication can cause your blood pressure to unsafely drop suddenly if it is taken with certain other medicines. Stop sexual activity and seek medical attention if you experience symptoms such as chest pain, dizziness, or nausea during sex, or if you have any side effect that bothers you or does not go away. Use protective measures to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV). Go to the Prostate Cancer Support Group. It seems to be common to do this to try and resolve ED issues. I'm not a medical professional, but here's a document on UCSF that someone on this blog mentioned in another thread. It has a section on Penile Rehabilitation that includes some information related to your question: Best wishes. I would think your doctor would’ve checked up before prescribing it for you though, but you never know. You should at least mention to your doctor, the side effects you have felt from taking the drug. See what he has to say about it. Yes, and I have spoken to her.

Comparing Which Works Faster

The sildenafil is for "lung blood pressure", whatever that means. It has not impacted my pulse rate or my BP. I think I'm just sensitive to it. It can cause problems if you normally have low blood pressure. Listen to the article instead of reading through it.

More about sildenafil

Initiate treatment with 25 mg orally once a day, as needed, about 1 hour prior to sexual activity Patients should be stable on alpha blocker therapy prior initiating treatment with this drug. Administration with CYP450 3A4 Inhibitors (e.g., ketoconazole, itraconazole, saquinavir) or Erythromycin: Consider a starting dose of 25 orally once a day, as needed, about 1 hour prior to sexual activity. Recommended dose: 25 mg orally, as needed, about 1 hour prior to sexual activity Maximum dose: 25 mg orally within a 48 hour period Known hypersensitivity to either the active component or to any of the ingredients; hypersensitivity reactions have been reported, including rash and urticaria In patients who are using a guanylate cyclase (GC) stimulators, such as riociguat; phosphodiesterase type 5 inhibitors (PDE5), including this drug, may potentiate the hypotensive effects of GC stimulators. In patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently; this drug has been shown to potentiate the hypotensive effects of nitrates based on its mechanism of action After patients have taken this drug for ED, it is unknown when nitrates, if necessary, can be safely administered. Although plasma levels of this drug at 24 hours post-dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point.

Other Medical Problems

Concomitant use of organic nitrates in any form, either regularly or intermittently, because of the greater risk of hypotension Concomitant use of riociguat, a guanylate cyclase stimulator; PDE5 inhibitors, including this drug, may potentiate the hypotensive effects of riociguat. Known hypersensitivity to either the active component or to any of the ingredients of the tablet, injection, or oral suspension; hypersensitivity reactions have been reported, including anaphylactic reaction, anaphylactic shock, and anaphylactoid reaction Safety and efficacy have not been established in patients with ED younger than 18 years. Safety and efficacy have not been established in patients with PAH younger than 1 year. Due to high plasma protein binding and poor elimination in urine, removal via hemodialysis is unlikely. Tablets: Administer orally with or without food.

Does the price of sildenafil vary based on strength or what it is prescribed for?

Reconstitute product before oral administration, and shake well before use. An oral syringe is recommended for dose measurement (and delivery). Use within 60 days after reconstitution; discard any sildenafil otc remainder after expiration. The liquid suspension is premixed and may contain flavoring. Shake well before oral administration and use a calibrated measuring device for accurate dosing. For patients dealing with erectile dysfunction (ED), certain drugs that influence the blood flow to pelvic organs can help in restoring and maintaining an erection.

Parameter	Value	Notes
Absorption Rate	Rapid	Peak plasma levels in ~60 minutes
Bioavailability	Approximately 40%	Due to first-pass metabolism
Half-life	About 4 hours	Time to reduce plasma concentration by half
Metabolism	Liver (primarily via CYP3A4)	Enzymatic breakdown
Excretion	Mainly feces (~80%)	Some via urine (~13%)

Tadalafil and Sildenafil are two such medications typically prescribed for this condition. Both of these work by inhibiting phosphodiesterase type 5 (PDE5), an enzyme found primarily in the vascular smooth muscle of the corpus cavernosum, thus promoting blood flow necessary for achieving an erection.

• Sildenafil 10mg is available by prescription only.
• Do not exceed the recommended dose to prevent adverse effects.
• Alcohol consumption can increase side effects of sildenafil.
• Sildenafil 10mg may interact with certain medications.
• Patients with heart issues should consult a doctor before use.

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