16 HOW SUPPLIED/STORAGE AND HANDLING

Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions.

• Legally, sildenafil is classified as a prescription drug in many parts of India.
• Online purchasing should be from licensed pharmacies to avoid scams.
• Always read the patient information leaflet before use.
• Sildenafil 50 mg offers a quick and effective solution for ED.
• The medication has been shown to improve sexual satisfaction for many men.
• Use in combination with counseling can improve overall outcomes.
• Avoid operating machinery or driving after taking sildenafil until effects are known.
• Report any adverse reactions to a healthcare provider promptly.
• Keep track of dosage and response to determine the ideal use pattern.

[13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus.

Myth	Fact	Source
Sildenafil is addictive	No, it is not addictive	Medical authorities
It cures ED permanently	No, it provides temporary relief during use	Health experts
It causes heart attacks	Not directly, but can affect heart in some cases	Clinical studies
Only older men use it	Used by men across various age groups	User surveys

Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction.

5.6 Adverse Reactions with the Concomitant Use of Ritonavir

Sildenafil does not protect against sexually transmitted infections, including HIV. Sildenafil belongs to a group of medicines, known as phosphodiesterase-5 (PDE-5) inhibitors, which are used to treat erectile dysfunction or pulmonary arterial hypertension. You should not take more than one PDE-5 inhibitor medicine. Medicines in this group include avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), and vardenafil (Levitra, Staxyn). Use an accurate measuring device to measure your dose of sildenafil oral liquid.

6. What are common side-effects?

A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if sildenafil is right for you. In particular, make sure that you discuss any of the following. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects.

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	100mg	270 + 10 Pills	270.47€ 257.59€	Buy
Viagra Generic	25mg	360 + 10 Pills	213.68€ 203.50€	Buy
Viagra Generic	25mg	30 + 4 Pills	47.97€ 45.69€	Buy
Viagra Generic	100mg	10 Pills	28.91€ 27.53€	Buy
Viagra Generic	200mg	20 Pills	61.69€ 58.75€	Buy
Viagra Generic	150mg	10 Pills	36.73€ 34.98€	Buy
Kamagra Soft Tabs	100mg	60 + 4 Pills	180.59€ 171.99€	Buy
Kamagra	100mg	360 + 6 Pills	839.95€ 799.95€	Buy
Viagra Generic	200mg	270 + 10 Pills	379.76€ 361.68€	Buy
Kamagra Oral Jelly	100mg	110 + 9 Sachets	334.87€ 318.92€	Buy
Viagra Generic	100mg	180 + 8 Pills	199.37€ 189.88€	Buy
Viagra Generic	25mg	120 + 6 Pills	125.56€ 119.58€	Buy
Viagra Generic	100mg	60 + 4 Pills	96.36€ 91.77€	Buy

Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes.

Before taking this medicine

Ask your healthcare provider if you are unsure what to do after a missed dose. This survey is being conducted by the WebMD marketing sciences department. DescriptionDosage FormTabletIndicationErectile DysfunctionBrand NameViagra®TE CodeABLactoseNoGlutenNoColorGreenShapeOval-shaped beveled edge, biconvex, film-coated tabletMarkingsDebossed with ‘SC’ on one side and ’50’ on other sideStorage ConditionStore at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F). ]Pack Size: 30sNDC#: 27241-068-03Click to View Package Insert Click to View Material Data Safety Sheet Viagra® is a registered trademark of Pfizer Inc. Original price was: ₹525.00.₹446.25Current price is: ₹446.25.

Vardenafil (Levitra) or Avanafil (Stendra)

Manforce Strawberry Vanilla Dotted Ring Cocktail 10NOriginal price was: ₹90.00.₹76.50Current price is: ₹76.50. Manforce Condom Ignite Apple PeachOriginal price was: ₹50.00.₹40.00Current price is: ₹40.00. Manforce Wild Condom Chocolate 3NOriginal price was: ₹30.00.₹24.00Current price is: ₹24.00. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear.

• Sildenafil 50 mg can be purchased online from Indian e-pharmacies.
• Ensure the pharmacy provides a valid prescription if required by law.
• Generic sildenafil is a cost-effective alternative to branded options.
• It is advisable to avoid alcohol when taking sildenafil for better results.
• Use caution if combining sildenafil with other ED medications or supplements.
• People with kidney or liver issues should seek medical advice before use.
• The medication does not protect against sexually transmitted infections.
• Always store sildenafil in a cool, dry place away from light.
• Consult a healthcare professional if adverse reactions occur after taking sildenafil.

Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia).

2.3 Dosage Adjustments in Specific Situations

[8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs. [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina.

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In particular, make sure that you discuss if you are using any of the following before taking sildenafil. Tell your healthcare provider about all medicines that you take or have recently taken. This may not be a complete list of medicines that can interact with sildenafil. If you or someone else has used too much sildenafil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222. For this use, sildenafil is used only when needed.

Recreational use

Take it as your healthcare provider recommends, which is usually between 30 minutes to four hours before planned sexual activity. Do not take double or extra doses. For this use, take sildenafil as your healthcare provider recommends, which is usually three times a day. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Patients thus taking the drug may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use.

How should I take sildenafil?

Tell your healthcare provider if you have any of the following. Heart problems, such as heart rhythm problems, chest pain, or heart failure Heart attack, stroke, or heart surgery within the past six months High blood pressure that is still too high despite taking medicines for it Peyronie's disease, or a penis with an abnormal curve or shape An erection lasting longer than four hours A blood disorder, such as sickle cell anemia An inherited eye disease called retinitis pigmentosa Vision loss, or a problem with the nerve between your eyes and brain (optic nerve) Health conditions or factors that raise the risk of optic nerve problems, such as diabetes, high cholesterol, smoking, being older than 50, or having a “crowded disc,” which is something an eye doctor may see in an eye exam Pulmonary veno-occlusive disease, a condition where blood vessels in the lungs are blocked It is not known if or how sildenafil could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take sildenafil while breastfeeding.

Altitude sickness

If you take sildenafil after you eat a high-fat meal, such as a burger and fries, it may take longer to start working. Your healthcare provider may recommend limiting or avoiding grapefruit while taking sildenafil. Grapefruit or grapefruit juice can raise sildenafil levels in your body, which can increase the risk of side effects. There are no known interactions between sildenafil and alcohol. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. [4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects.

7.5 Alcohol

[9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through sildenafil citrate tablets for female the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours.

Legal Status	Description	Regulatory Authority	Notes
Approved for medical use	Yes, for ED and PAH	Drugs Controller General	Prescription required
Over-the-counter availability	Generally regulated, prescription advised	Not recommended	Some pharmacies may sell without prescription
Import Regulations	Allowed with proper documentation	Indian Customs	Strict import laws for unapproved sources

[4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.

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