Sildenafil has traditionally been used to treat erectile dysfunction and has the highest penetration efficacy compared to other phosphodiesterase type 5 inhibitors. However, the range of action of this drug is much wider. Therapy of various somatic diseases using sildenafil has shown the effectiveness of this drug. The use of sildenafil in comorbidities is safe.
Indications for use
Erectile dysfunction, characterized by the inability to achieve or maintain an erection of the penis sufficient for sexual intercourse. Sildenafil citrate is effective only in the presence of sexual stimulation.
Hypersensitivity; concomitant use of nitrates or other drugs that release nitric oxide (diazoxide, nebivolol).
Loss of vision in one eye, in patients with anterior ischemic optic neuropathy, of extravascular origin.
Contraindicated in the presence of severe liver failure, arterial hypotension, patients who have recently had a stroke or myocardial infarction.
Erectile dysfunction medications, including Sildenafil, should not be used by people for whom sexual activity is not recommended.
The capsules are intended for oral administration.
For most patients, the recommended dose of Sildenafil, taken as needed approximately 1 hour before sexual activity, is 50 mg. Depending on the effectiveness and tolerability of the drug, the dose may be increased to the maximum recommended dose of 100 mg or reduced to 25 mg. The frequency of taking the maximum recommended dose is 1 time per day. Sildenafil 50 mg and 100 mg capsules cannot be divided into parts. If it is necessary to prescribe a dose of sildenafil 20 mg, another drug should be used.
Use in patients taking other drugs
With the exception of ritonavir, whose concomitant use with pill is contraindicated, an initial dose of 25 mg sildenafil is recommended for patients receiving concomitant inhibitors of the CYP3A4 isoenzyme (eg, erythromycin, ketoconazole , cimetidine ).
In order to minimize the likelihood of developing postural hypotension, patients should be in a stable condition during treatment with α – blockers before starting the use of tablets. In addition, in such cases
From the immune system: rarely – hypersensitivity.
From the nervous system: very often – headache; often – dizziness.
From the side of vision: often – impaired vision, impaired color perception; infrequently – conjunctiva, lacrimation disorder.
From the respiratory system: often – nasal congestion.
Interaction with other drugs
The efficacy and safety of sildenafil has been confirmed in patients with ED of various etiologies. By 2003, over 20 million people worldwide were taking sildenafil 20 mg tablet with excellent results. Despite the fact that ED has been caused by such severe and difficult to treat diseases as radical prostatectomy in patients with prostate cancer, severe diabetes mellitus and spinal cord injury, pills has demonstrated its effectiveness in such patients. The frequency of adverse cardiovascular effects in patients taking sildenafil did not differ from those in the population.
The study of the pharmacological effects of sildenafil on the ischemic myocardium also confirms the safety of this drug. The tablets have been shown to be safe and effective in patients taking a variety of medications, including multiple antihypertensive drugs concomitantly, selective serotonin reuptake inhibitors, cardiovascular and antidiabetic drugs.
Cimetidine, ketoconazole , erythromycin increase the concentration of sildenafil in the blood and slow down its excretion, while an increase in the frequency of side effects was not observed. When combined with these drugs, the initial dose of sildenafil should not exceed 25 mg.
Nicorandil has the potential for a clinically significant interaction with sildenafil.
Grapefruit juice inhibits liver and intestinal enzymes that destroy sildenafil and can increase its concentration in the blood.
Simultaneous administration of sildenafil in patients taking α-blockers may lead to symptomatic hypotension within 4 hours after taking sildenafil.
The tablets (50 mg) did not potentiate the hypotensive effect of alcohol in healthy volunteers.
Analysis of safety data did not reveal differences in the side effect profile in patients taking sildenafil alone and in combination with antihypertensive drugs or drugs such as diuretics, β- blockers, ACE inhibitors, angiotensin II antagonists, antihypertensive drugs (vasodilator and central action).
Doses of 200 mg do not lead to an increase in efficacy, but the frequency of adverse reactions increases.
Symptoms: headache, hot flashes, dizziness, dyspepsia, nasal congestion, blurred vision.
Treatment: standard supportive care.
In a place protected from light and moisture, at a temperature not exceeding 25 ° C. Keep out of the reach of children.