Sildenafil Dosage
[1] Inform patients that taking sildenafil with a high-fat meal may cause delayed onset.
- 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.
[1]Advise patient to inform their clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses.
12.3 Pharmacokinetics
[1] Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including possible permanent loss of vision. [1]Advise patients to seek prompt medical attention in the event of sudden decrease or loss of hearing while taking sildenafil. [1] These events may be accompanied by tinnitus and dizziness. [1]Advise patients to seek prompt medical attention for an erection that lasts more than 4 hours. [1] If it is not treated right away, priapism can permanently damage the penis.
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[1]Inform patients taking sildenafil for erectile dysfunction that the drug offers no protection against sexually transmitted diseases and patients should use necessary protective measures to guard against such diseases, including the human immunodeficiency virus (HIV). [1]Instruct the patient to seek medical attention immediately if they take too much sildenafil. [1]Inform 150mg sildenafil for sale patients of the risk of symptomatic low blood pressure (e.g., dizziness, lightheadedness, fainting). [1] Monitor blood pressure when administering sildenafil in combination with blood pressure lowering drugs (e.g., α-adrenergic blocking agents). [1]Advise patients to take sildenafil with or without food 1 hour or, if needed, 30 minutes to 4 hours before sexual activity. [1]Inform patients of other important precautionary information. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
| Dosage | Recommended Use | Onset of Action | Duration of Effect | Typical Frequency |
|---|---|---|---|---|
| 10 mg | Mild to moderate ED cases | 30-60 minutes | Up to 4-6 hours | Once per day, as needed |
| 20 mg | Moderate to severe ED | 30-60 minutes | Up to 4-6 hours | Once per day, as needed |
| 5 mg | For elderly or sensitive users | 30-60 minutes | Up to 4 hours | Once per day, as needed |
\* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name © Copyright, 1959-2026, Selected Revisions April 10, 2024.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra Soft Tabs | 100mg | 272 + 12 Pills | 593.42€ 565.16€ | |
| Kamagra | 100mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Viagra Generic | 25mg | 270 + 8 Pills | 184.26€ 175.49€ | |
| Kamagra Soft Tabs | 100mg | 12 Pills | 57.55€ 54.81€ | |
| Viagra Generic | 50mg | 360 + 10 Pills | 225.33€ 214.60€ | |
| Viagra Generic | 25mg | 10 Pills | 25.19€ 23.99€ | |
| Viagra Generic | 100mg | 20 Pills | 45.58€ 43.41€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Kamagra Soft Tabs | 100mg | 180 + 8 Pills | 425.45€ 405.19€ | |
| Viagra Generic | 50mg | 20 Pills | 40.52€ 38.59€ | |
| Viagra Generic | 150mg | 30 + 2 Pills | 72.32€ 68.88€ | |
| Viagra Generic | 200mg | 10 Pills | 40.96€ 39.01€ | |
| Viagra Generic | 200mg | 270 + 10 Pills | 379.76€ 361.68€ | |
| Kamagra | 100mg | 360 + 6 Pills | 839.95€ 799.95€ | |
| Kamagra Polo | 100mg | 12 Pills | 60.21€ 57.34€ |
American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
- Sildenafil 10mg is commonly used to treat erectile dysfunction.
- It works by relaxing blood vessels in the penis.
- The medication is typically taken about 30-60 minutes before activity.
- Sildenafil 10mg can be prescribed for certain pulmonary conditions.
- Always follow your doctor’s dosage instructions carefully.
The American Society of Health-System Pharmacists, Inc.
- Sildenafil 10mg may be more suitable for older adults with sensitivity.
- Do not take more than one dose in 24 hours.
- Do not mix sildenafil with recreational drugs like poppers.
- Be aware that certain foods and medications can influence its effects.
- Regular medical check-ups are recommended when using sildenafil regularly.
represents that the database provided hereunder as formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty or merchantability and/or fitness for a particular purpose, with respect to such database and specifically disclaims all such warranties and representations.
What Is Silenafil and How Does It Work?
[1][4][56][67][91][116][249] Although studies indicate that more than 90% of an oral sildenafil dose is absorbed from the GI tract, the drug undergoes extensive metabolism in the GI mucosa during absorption and on first pass through the liver, with only about 40% of a dose reaching systemic circulation unchanged. [1][4][56][67][91][116][131][249] Pharmacokinetics of the drug (as determined by peak plasma concentrations or AUC) are dose proportional over the single-dose range of 1.25-200 mg.[1][4][56][91][116][131] Peak plasma concentrations of sildenafil and its active N-desmethyl metabolite are achieved within 30-120 (median: 60) minutes following oral administration in fasting adults. [1][4][91][127][130][249] Administration with a high-fat meal delays GI absorption, with a reduction in peak plasma concentrations of about 29% and a delay in time to peak plasma concentrations of about 60 minutes; the extent of absorption is not affected. Sildenafil appears to be widely distributed in the body. [1][4][67][116][131] Sildenafil and its major circulating N-desmethyl metabolite are each approximately 96% bound to plasma proteins; protein binding reportedly is independent of plasma concentration.
Sildenafil Tablets or Oral Suspension for PAH
[1][67][91][116][131] Sildenafil is distributed to a limited extent in semen following oral administration, with less than 0.001% of a single dose appearing in semen 90 minutes after dosing in healthy individuals. [1][67] Such concentrations are unlikely to cause any effects in sexual partners exposed to the semen. [67] Plasma sildenafil concentrations appear to decline in a biphasic manner following oral administration, with a terminal elimination half-life of about 4 hours (range: 3-5 hours). [1][4][67][91][116][127][130][131] Sildenafil is metabolized principally via hepatic cytochrome P-450 (CYP) microsomal isoenzymes 3A4 (major route) and 2C9 (minor route). [1][26][67][91][131] Plasma concentrations of the active N-desmethyl metabolite are approximately 40% of those observed with sildenafil, and the metabolite reportedly accounts for about 20% of sildenafil's pharmacologic activity. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the database if provided for informational purposes only.
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[1][67][131] The N-demethylated metabolite, the major circulating metabolite, has a phosphodiesterase selectivity profile similar to that of sildenafil and an in vitro potency for PDE type 5 of approximately 50% of the parent drug. [1][116][131] Sildenafil is eliminated mainly in the feces as metabolites following oral administration. [1][67][91][116][131] In healthy adults and those with ED, approximately 80% of an oral dose is excreted as metabolites in feces and 13% is excreted in urine. Importance of instructing patients to read the manufacturer's patient information before starting sildenafil therapy and sildenafil citrate tablets 50mg each time their prescription is refilled. [1]Instruct patients to avoid contraindicated medications such as regular and/or intermittent use of organic nitrates, organic nitrites (e.g., ''poppers''), and riociguat.
Pulmonary Arterial Hypertension
[1]Inform patients that sildenafil is marketed for erectile dysfunction (Viagra) and pulmonary arterial hypertension (Revatio®). [1] Advise patients taking Viagra® not to take Revatio® or other PDE type 5 inhibitors. [1]Advise patients of the potential for sildenafil to augment the blood pressure lowering effect of α-adrenergic blocking agents (e.g., doxazosin) and anti-hypertensive medications (e.g., amlodipine) and concomitant administration may lead to symptomatic hypotension in some patients. [1]Inform patients taking sildenafil for erectile dysfunction and with potential for cardiac risk of sexual activity (e.g., patients with preexisting cardiovascular risk factors) to refrain from further activity and seek medical attention immediately if they experience symptoms (e.g., chest pain, dizziness, nausea) upon initiation of sexual activity. [1]Advise patients to seek immediate medical attention for a sudden loss of vision in one or both eyes while taking sildenafil. The entire monograph for a drug should be reviewed for a throrough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc.
| Condition | Risk Factors | Recommendations |
|---|---|---|
| Use with nitrates | Severe hypotension, risk of significant blood pressure drop | Avoid combining, consult healthcare provider |
| Severe cardiovascular disease | Risk of adverse cardiovascular events | Use only under medical supervision |
| Liver impairment | Altered metabolism, increased side effects | Dose adjustment or avoid use |
| Retinitis pigmentosa | Potential for increased visual side effects | Use with caution, consult ophthalmologist |
does not endorse or recommend the use of any drug in the database. The information contained in the database is not a substitute for medical care or treatment by a licensed health care provider.
- The onset of action for sildenafil 10mg is usually within 30 minutes.
- It is important to follow prescribed intervals between doses.
- Sildenafil is not intended for recreational use.
- Consult your doctor if you experience prolonged erections.
- Women should avoid using sildenafil unless prescribed for pulmonary hypertension.
A PDE5 inhibitor (IC50s = 3.6 and 3 nM for PDE5 activity in isolated rabbit platelets and human corpus cavernosum, respectively); selective for PDE5 over PDE1 and PDE3 (IC50s = 0.26 and 65 μM, respectively); reverses glucose-induced decreases in ANG1 expression and reduction of capillary-like tube formation by mouse dermal endothelial cells in vitro; increases the number of functional blood vessels and regional blood flow in the sciatic nerve in a db/db mouse model of diabetic peripheral neuropathy; increases ICP/MAP ratio in castrated rats at 20 mg/kg per day; reduces cardiac arrest and resuscitation-induced increases in angiotensin II ACE, ACE2, and various angiotensin receptors and increases survival in a porcine model of ischemia/reperfusion injury Sildenafil is used to treat erectile dysfunction (also called sexual impotence).
Overdose/Missed Dose
[1][2][4][5][7][8][10][33][41][42][127][131] During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpora cavernosa. [1][2][4][56][67][91][131] By selectively inhibiting PDE type 5, sildenafil causes accumulation of cGMP in various tissues. [1][2][4][5][31][33][34][41][42][56][57][67][91][131] Because sildenafil potentiates the accumulation of cGMP rather than stimulating its production, the drug is effective only when cGMP production in the penis is increased by sexual arousal. [34][91][131] Sildenafil at recommended doses has no effect on erectile function in the absence of sexual stimulation. [1][4][33][34][91][127][130][131][132] Sildenafil also exhibits some activity against other PDE isoenzymes.
When and How to Take Sildenafil for Best Results
[1][4][5][31][44][57][67][87][88] In vitro, sildenafil is about 10 times more active against PDE type 5 than against PDE type 6, greater than 70-80 times more active against PDE type 5 than against PDE type 1, greater than 1000 times more active against PDE type 5 than against PDE types 2 and 4, and 4000 times more active against PDE type 5 than against PDE type 3. [1][4][27][31][45][52][55][57][67][87][88] The duration of erectile responsiveness (i.e., the time period in which adequate sexual stimulation can produce an erection) with oral sildenafil has been reported to be approximately 2 hours, with some penile responsiveness persisting for up to 4 hours after oral administration. [1] In the largest clinical study published to date, the onset and duration of action of oral sildenafil were not reported. [33][34] In most other placebo-controlled studies in which improvement in erection was determined by penile plethysmography, the erectile effect was determined at a fixed time of 60 minutes after an oral dose of the drug. Sildenafil is rapidly absorbed following oral administration; the mean absolute bioavailability is 41% (range, 25-63%).
