Sildenafil

Treatment of erectile dysfunction, characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil is effective only when combined with sexual stimulation.

Take orally. The recommended dose for most adult patients is 50 mg taken approximately 1 hour before sexual activity. Depending on efficacy and tolerability, the dose may be increased to 100 mg or reduced to 25 mg. The maximum recommended dose is 100 mg. The maximum recommended frequency of use is once daily.

Medications for erectile dysfunction should be used with caution in patients with anatomical deformities of the penis (angulation, cavernosal fibrosis, Peyronie’s disease) or in patients with risk factors for priapism (sickle cell anemia, multiple myeloma, leukemia). Medications intended to treat erectile dysfunction should not be prescribed to men for whom sexual activity is undesirable. Sexual activity poses a certain risk for people with heart disease. Sildenafil has a systemic vasodilatory effect, leading to a transient decrease in blood pressure; this is not clinically significant and does not result in any adverse effects in most patients. Nevertheless, before prescribing sildenafil, the physician should carefully assess the risk of potential adverse effects associated with vasodilation in patients with relevant medical conditions, particularly during sexual activity. Increased sensitivity to vasodilators is observed in patients with left ventricular outflow tract obstruction (aortic stenosis, hypertrophic obstructive cardiomyopathy), as well as in patients with the rare multiple system atrophy syndrome, which manifests as severe disruption of blood pressure regulation by the autonomic nervous system. The concomitant use of sildenafil and alpha-blockers may cause symptomatic hypotension in some susceptible patients; sildenafil should be used with caution in patients receiving alpha-blockers. To minimize the risk of postural hypotension in patients taking alpha-blockers, sildenafil should be initiated only after their hemodynamic parameters have stabilized. Consideration should also be given to whether it is appropriate to reduce the initial dose of sildenafil. The doctor should inform patients about what steps to take if symptoms of postural hypotension occur. Rare cases of anterior non-arteritic ischemic optic neuropathy have been reported as a cause of vision loss or deterioration in patients taking any PDE5 inhibitor, including sildenafil. Most of these patients had risk factors such as optic disc cupping, age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia, and smoking. No causal relationship has been identified between the use of PDE5 inhibitors and the development of anterior non-arteritic ischemic optic neuropathy. The physician should inform the patient of the increased risk of developing anterior non-arteritic ischemic optic neuropathy if the patient has a history of this condition. In the event of sudden vision loss, patients should receive immediate medical attention. A small number of patients with hereditary pigmentary retinitis have genetically determined abnormalities in retinal PDE function. There are no data on the safety of sildenafil in patients with pigmentary retinitis; therefore, sildenafil should be used with caution. If you experience a sudden decline in hearing or hearing loss while taking sildenafil, consult your doctor immediately. Sildenafil potentiates the antiplatelet effect of sodium nitroprusside, a nitric oxide donor, on human platelets in vitro. There are no data on the safety of sildenafil in patients with a tendency to bleed or with active gastric or duodenal ulcers; therefore, sildenafil should be used with caution in these patients.

Hypersensitivity to sildenafil; use in patients receiving nitric oxide donors, organic nitrates, or nitrites in any form, either continuously or intermittently, as sildenafil potentiates the hypotensive effects of nitrates; children and adolescents under 18 years of age; according to the approved indication, sildenafil is not intended for use in women; concomitant use of sildenafil with ritonavir or other treatments for erectile dysfunction is not recommended. Use with caution Anatomical deformities of the penis (angulation, cavernosal fibrosis, or Peyronie’s disease); conditions predisposing to the development of priapism (sickle cell anemia, multiple myeloma, leukemia, thrombocythemia); conditions accompanied by bleeding; exacerbation of gastric and duodenal ulcers; hereditary pigmentary retinitis; heart failure, unstable angina, myocardial infarction, stroke, or life-threatening arrhythmias within the last 6 months, hypertension (BP >170/100 mmHg) or hypotension (BP <90/50 mmHg); in patients with a history of episodes of anterior non-arteritic ischemic optic neuropathy.

2 years