armodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Medical uses
ivosidenib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ketoconazoleketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with strong CYP3A4 inhibitors and sildenafil (for pulmonary arterial hypertension) is not recommended. When used for erectile dysfunction, consider reducing initial sildenafil dose of 25 mg in patients also taking a strong CYP3A4 inhibitor and monitor for sildenafil toxicities (eg, dyspepsia, headache, hypotension). ketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Patient resources
lenacapavirlenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Refer to the prescribing information of PDE5 inhibitors for dose recommendations. lenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levoketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lonafarniblonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Dosage for erectile dysfunction (ED)
If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. lonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavirlopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mifepristonemifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. artemether/lumefantrineartemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Further information
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels St John's Wort 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 terazosinsildenafil increases effects of terazosin by pharmacodynamic synergism. sildenafil increases effects of terazosin by pharmacodynamic synergism. tovorafenibtovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of tovorafenib (a weak CYP3A4 inducer) with CYP3A substrates where minimal concentration changes may lead to serious therapeutic failures.
Mild side effects
If unavoidable, monitor patients for loss sildenafil premature ejaculation of efficacy unless otherwise recommended in the CYP3A4 substrate prescribing information. tovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tucatinibtucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
Drugs you should not use with sildenafil
tucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acebutololacebutolol increases effects of sildenafil by additive vasodilation. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. acebutolol increases effects of sildenafil by additive vasodilation. atenololatenolol increases effects of sildenafil by additive vasodilation.
| Condition | Requirement | Reason |
|---|---|---|
| Temperature | Store below 30°C (86°F) | Maintain tablet stability |
| Humidity | Keep in a dry place | Prevent tablet degradation |
| Light exposure | Store in original container | Protect from light |
| Shelf life | Typically 2-3 years | Ensure efficacy |
atenolol increases effects of sildenafil by additive vasodilation.
- Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor.
- Its primary function is to improve blood flow to the penis.
- The medication does not protect against sexually transmitted infections.
- Use condoms for protection regardless of medication use.
betaxololbetaxolol increases effects of sildenafil by additive vasodilation. betaxolol increases effects of sildenafil by additive vasodilation.
- Long-term safety of sildenafil requires more research.
- Most side effects are mild and resolve on their own.
- Repeated use may cause psychological dependence.
- Regular medical reviews are recommended for ongoing therapy.
bisoprololbisoprolol increases effects of sildenafil by additive vasodilation.
| Drug/Class | Interaction Effect | Clinical Significance | Recommendation |
|---|---|---|---|
| Nitrates | Severe hypotension | Contraindicated | Avoid concomitant use |
| Alpha-blockers | Additive blood pressure lowering | Hypotension risk | Monitor blood pressure closely |
| CYP3A4 inhibitors | Increased sildenafil levels | Increased side effects | Dose adjustment may be necessary |
| Alcohol | Enhanced hypotensive effects | Increased dizziness risk | Use with caution |
bisoprolol increases effects of sildenafil by additive vasodilation.
Usual Geriatric Dose for Erectile Dysfunction
sildenafil increases effects of phentolamine by pharmacodynamic synergism. phenytoinphenytoin 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 phenytoin 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 prazosinsildenafil increases effects of prazosin by pharmacodynamic synergism. sildenafil increases effects of prazosin by pharmacodynamic synergism.
Side effect details
primidoneprimidone 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 primidone 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 relacorilantrelacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of sildenafil with strong CYP3A4 inhibitors. relacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Can I take Viagra by snorting it?
ritonavirritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. silodosinsildenafil increases effects of silodosin by pharmacodynamic synergism. sildenafil increases effects of silodosin by pharmacodynamic synergism. St John's WortSt John's Wort will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. bosentanbosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Health And Lifestyle
mifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mitotanemitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels. mitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nafcillinnafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Who should not take sildenafil?
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels nafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Patients receiving indinavir with ritonavir should receive not more than 25 mg of sildenafil for treatment of erectile dysfunction in a 48-hour period, and patients receiving other protease inhibitors should use a lower initial sildenafil dose of 25 mg. Patient taking sildenafil for PAH with ritonavir is not recommended. pentobarbitalpentobarbital 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 pfizer sildenafil 50 levels pentobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Your expert team
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenobarbitalphenobarbital 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 phenobarbital 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 phenoxybenzaminesildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. sildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. phentolaminesildenafil increases effects of phentolamine by pharmacodynamic synergism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels bosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Stronger erections, better sex
amifostineamifostine increases effects of sildenafil by additive vasodilation. amifostine increases effects of sildenafil by additive vasodilation. aprepitantaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. aprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. armodafinilarmodafinil 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 butalbitalbutalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. butalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. carbamazepinecarbamazepine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Indication | Contraindication | Comments |
|---|---|---|
| Erectile dysfunction | Use of nitrates | Absolute contraindication |
| Pulmonary arterial hypertension | Severe cardiovascular disorders | FDA approved for PAH (Revatio) |
| Raynaud's phenomenon (off-label) | Hypersensitivity to sildenafil | Not FDA approved for this indication |
| Altitude sickness (off-label) | Concomitant use with alpha-blockers | Use cautiously under supervision |