Label: SILDENAFIL tablet

Sildenafil > sildenafil 20 mg tablets


Avoid concurrent or sequential use to decrease risk for ototoxicity tobramycin inhaled and sildenafil both increase nephrotoxicity and/or ototoxicity. Avoid concurrent or sequential use to decrease risk for ototoxicity verapamilverapamil will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. verapamil will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Medication Type Interaction Effect Risk Level Recommendation
Nitrates Severe hypotension High Do not combine
Alpha-blockers Increased risk of blood pressure drop Moderate Use under medical supervision
CYP3A4 inhibitors Increased sildenafil levels Moderate Adjust dose or avoid
Ritonavir Elevated risk of side effects High Consult healthcare provider

voriconazolevoriconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. voriconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil 20 mg can interact with nitrates used for chest pain.
  • Store tablets at room temperature, away from moisture.
  • Do not crush or split the tablets; swallow whole.
  • It is not recommended for use by women or children.
  • Known for its rapid onset, usually within 30 minutes.

zafirlukastzafirlukast will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil was originally developed as a treatment for hypertension.
  • The 20 mg dose is considered a moderate dosage.
  • It can be part of a comprehensive erectile dysfunction treatment plan.
  • Regular use should be monitored by a healthcare professional.
  • The medication should not be used with other ED drugs simultaneously.

zafirlukast will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil 20 mg tablets are supplied in blister packs or bottles.
  • Always check the expiration date before use.
  • Alcohol may reduce the effectiveness or increase side effects.
  • Avoid taking sildenafil with fatty foods for faster absorption.
  • Keep out of reach of children to prevent accidental ingestion.

acetazolamideacetazolamide will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamide will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Use Case Description Typical Dosage Notes
Treatment of Erectile Dysfunction Improves blood flow to the penis 20 mg as needed Taken 30-60 minutes before sexual activity
Pulmonary Hypertension To reduce blood pressure in lungs 20 mg thrice daily Prescribed by doctor
Off-label Uses Potential treatment for other conditions Varies Under medical supervision

anastrozoleanastrozole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil 20 mg tablets are manufactured by several pharmaceutical companies.
  • Generic versions are usually less expensive than brand-name options.
  • The drug works by inhibiting phosphodiesterase type 5 enzyme.
  • Patients should report any unusual symptoms promptly.
  • It is important to have a proper diagnosis before starting treatment.

cyclophosphamidecyclophosphamide will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclophosphamide will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Parameter Details
Onset of Action 30-60 minutes
Peak Effect About 1 hour
Duration of Effect 4-6 hours
Factors Influencing Food intake, alcohol, metabolism

drospirenonedrospirenone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

6.2 Postmarketing Experience

posaconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. propranololpropranolol increases effects of sildenafil by additive vasodilation. propranolol increases effects of sildenafil by additive vasodilation. ribociclibribociclib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ribociclib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Professional resources

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rifabutin 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 rifampinrifampin 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 rifampin 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 rifapentinerifapentine 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 rifapentine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

How sildenafil is used

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels rilzabrutinibrilzabrutinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Follow substrate recommendations for use with moderate CYP3A inhibitors rilzabrutinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Follow substrate recommendations for use with moderate CYP3A inhibitors Either increases effects of the other by pharmacodynamic synergism. Coadministration of sepiapterin with drugs affecting nitric oxide-mediated relaxation may cause additive vasodilation and further reduce blood pressure. sotalolsotalol increases effects of sildenafil by additive vasodilation. drospirenone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

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labetalolsildenafil increases effects of labetalol by pharmacodynamic synergism. sildenafil increases effects of labetalol by pharmacodynamic synergism.

Brand names

sotalol increases effects of sildenafil by additive vasodilation. Monitor CYP3A4 substrates coadministered over the counter drugs containing sildenafil with stiripentol for increased or decreased effects. suzetriginesuzetrigine decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic indexes when coadministered with suzetrigine. Consider modifying dose of sensitive substrate according to prescribing recommendations.

Alcohol interaction warning

suzetrigine decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tecovirimattecovirimat will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. timololtimolol increases effects of sildenafil by additive vasodilation. larotrectiniblarotrectinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. larotrectinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. macitentanmacitentan increases levels of sildenafil by unspecified interaction mechanism. Systemic exposure of steady-state sildenafil (20 mg TID) increased by 15% during coadministration of macitentan (10 mg/day); this change is not considered clinically relevant.

What Other Drugs Interact with Sildenafil?

Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic index when coadministered with mitapivat. mitapivat decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nebivololnebivolol increases effects of sildenafil by additive vasodilation. nebivolol increases effects of sildenafil by additive vasodilation. nefazodonenefazodone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Warnings for other groups

nefazodone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nevirapinenevirapine 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 nevirapine 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 nifedipinenifedipine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nifedipine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Other Interactions

nilotinibnilotinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nilotinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. pindololpindolol increases effects of sildenafil by additive vasodilation. pindolol increases effects of sildenafil by additive vasodilation. posaconazoleposaconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. macitentan increases levels of sildenafil by unspecified interaction mechanism. Possible additive vasorelaxation, leading to low blood pressure.

12.3 Pharmacokinetics

timolol increases effects of sildenafil by additive vasodilation. tipranavirtipranavir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increased risk of priapism, hypotension, and other adverse effects. tipranavir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tobramycin inhaledtobramycin inhaled and sildenafil both increase nephrotoxicity and/or ototoxicity. 50-mg doseHeadache (21%)Flushing (19%)100-mg dose H5Headache (28%)Flushing (18%)Dyspepsia (17%)Abnormal vision (11%) 25-mg doseFlushing (10%)Nasal congestion (4%)Dyspepsia (3%)Back pain (3%)Dizziness (3%)Myalgia (2%)Nausea (2%)Abnormal vision (1%)Rash (1%) 50-mg doseDyspepsia (9%)Nasal congestion (4%)Back pain (4%)Dizziness (4%)Nausea (3%)Abnormal vision (2%)Myalgia (2%)Rash (2%) 100-mg doseNasal congestion (9%)Back pain (4%)Myalgia (4%)Nausea (3%)Dizziness (3%)Rash (3%) <2% with potential causal relationshipBody as a whole: Face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injuryCardiovascular: Angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathyDigestive: Vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitisHemic and lymphatic: Anemia and leukopeniaMetabolic and nutritional: Thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremiaMusculoskeletal: Arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitisNervous: Ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hypesthesiaRespiratory: Asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increasedSkin and appendages: Urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitisSpecial senses: Sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyesUrogenital: Cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia Body as a whole: Face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury Cardiovascular: Angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy Digestive: Vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis Metabolic and nutritional: Thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremia Musculoskeletal: Arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis Nervous: Ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hypesthesia Respiratory: Asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased Skin and appendages: Urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis Special senses: Sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyes Urogenital: Cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia Cardiovascular and cerebrovascular: Serious cardiovascular (CV), cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage (most, but not all, of these patients had preexisting CV risk factors) Hemic and lymphatic: vaso-occlusive crisis: In a small, prematurely terminated study of sildenafil in patients with pulmonary arterial hypertension (PAH) secondary to sickle cell disease, vaso-occlusive crises requiring hospitalization were commonly reported Nervous: Seizure, seizure recurrence, anxiety, and transient global amnesia Hearing: Cases of sudden decrease or loss of hearing reported postmarketing in temporal association with PDE5 inhibitors Ocular: Diplopia, temporary vision loss/decreased vision, ocular redness