Sildenafil Citrate Oral Suspension for Managing Erectile Dysfunction: A Systematic Review and a Consensus Report from the Italian Society of Andrology (SIA)
Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement.
| Pharmacy Name | Price per Box (10 tablets) | Availability | Comments |
|---|---|---|---|
| PharmaPlus | $8 | Widely available | Discount for bulk purchase |
| MedExpress | $9 | Usually in stock | Generic options available |
| Local Clinic | $12 | Prescription required | Consultation fee may apply |
| Online Pharmacy | $6 | Varies | Ensure reputable source |
Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function. Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health. Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile.
Author information
She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information. Urology Residency, University of California San Francisco Urology Residency, University of California San Francisco Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill Cowan, B, Walker, K., Rodgers, K., Agyemang, J. Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. Cowan, B, Walker, K., Rodgers, K., Agyemang, J. Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients.
- Sildenafil 12.5 mg should be taken 30-60 minutes before sexual activity.
- It is usually effective for up to 4-6 hours.
- Does not cause an automatic erection; stimulation is needed.
The Journal of Urology, 201(Supplement 4), e680-e681. Feasibility Study of Video Telehealth Clinic Visits women sildenafil in Urology.
- Not suitable for individuals with severe heart or liver conditions.
- Always inform your healthcare provider of all medications being taken.
- Follow-up appointments ensure safe and effective use.
The Journal of Urology, 201(Supplement 4), e545-e545.
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Erectile dysfunction is a condition in which you have trouble getting or keeping an erection firm enough for satisfying sex. Erectile dysfunction affects as many as 30 million men in the United States. Premature ejaculation (PE) is a sexual dysfunction characterized by a short ejaculatory latency, a perceived lack of control about the timing of ejaculation, and distress and interpersonal difficulty related to ejaculating too quickly. Low testosterone or testosterone deficiency, also known as hypogonadism, is a condition in which patients develop symptoms such as low sex drive, erectile dysfunction (ED), and fatigue because the body doesn’t produce enough testosterone. Though many men don’t like to talk about it, ejaculation problems are very common. Some of the most common issues include premature, delayed, or retrograde ejaculation. Your pelvic floor is a lot like plumbing in your home: you never really think about it unless something goes wrong. When you think of male sexual dysfunction, concerns like erectile dysfunction (ED) or premature ejaculation (PE) probably come to mind first. But there’s another sex-related issue that’s more common in men than you might expect: difficulty orgasming. 50 mg PO ~1 hr before sexual activity; however, may be taken anywhere from 30 min to 4 hr before sexual activity Maximum dosing frequency is once per day Based on effectiveness and toleration, may increase dose to maximum of 100 mg or decrease to 25 mg Indicated for treatment of pulmonary arterial hypertension (PAH) (World Health Organization [WHO] Group I) to improve exercise ability and delay clinical worsening Revatio (PO), Liqrev: 20 mg PO TID; may titrate up to 80 mg TID, if required, based on symptoms and tolerability Revatio (IV): 10 mg IV bolus TID 10-mg IV predicted to provide pharmacologic effect equivalent to 10-mg oral dose Do not exceed recommended PO/IV dose Viagra, VibriqueSevere (eg, cirrhosis): Consider initial dose of 25 mg Severe (eg, cirrhosis): Consider initial dose of 25 mg RevatioMild or moderate (Child-Pugh A or B): No dose adjustment requiredSevere (Child-Pugh C): Not studied Mild or moderate (Child-Pugh A or B): No dose adjustment required Viagra, VibriqueMild or moderate (CrCl 30-80 mL/min): No dose adjustment requiredSevere (CrCl <30 mL/min): Consider initial dose of 25 mg Mild or moderate (CrCl 30-80 mL/min): No dose adjustment required Severe (CrCl <30 mL/min): Consider initial dose of 25 mg RevatioAny severity, including severe (CrCl <30 mL/min): No dose adjustment required Any severity, including severe (CrCl <30 mL/min): No dose adjustment required Indicated in children aged 1-17 years for treatment of pulmonary arterial hypertension (PAH) (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underly improvements in exercise 20-45 kg: 20 mg PO TID Maximum dose in pediatric patients not identified Based on experience in adults, dose may be titrated up to 40 mg TID, if required, based on symptoms and tolerability Mild or moderate (Child-Pugh A or B): No dose adjustment required Any severity, including severe (CrCl <30 mL/min): No dose adjustment required ≥65 years: 25 mg PO initially ~1 hr before sexual activity; however, may be taken anywhere from 30 min to 4 hr before sexual activity Maximum dosing frequency is once per day Based on effectiveness and toleration, may increase dose to maximum of 100 mg or decrease to 25 mg Indicated for treatment of pulmonary arterial hypertension (PAH) (World Health Organization [WHO] Group I) to improve exercise ability and delay clinical worsening PO: 20 mg PO TID; may titrate up to 80 mg TID, if required , based on symptoms and tolerability 10-mg IV predicted to provide pharmacologic effect equivalent to 10-mg oral dose Recommended PO/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Clinical trials found no significant difference in response between elderly patients and younger adults; however, cautious dose selection should be considered in elderly because of greater frequency of decreased hepatic, renal, and cardiac function, as well as comorbid conditions and concomitant pharmacotherapy Compared with healthy younger volunteers, healthy elderly volunteers (≥65 years) had reduced clearance of sildenafil, resulting in approximately 84% and 107% higher plasma concentrations of sildenafil and its active N-desmethyl metabolite, respectively atazanaviratazanavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
5.5 Hearing Loss
Coadministration of PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, vardenafil) and guanylate cyclase stimulators (eg, riociguat) is contraindicated due to risk of additive hypotension; do not administer within 24 hr of each other. Either increases effects of the other by pharmacodynamic synergism. Coadministration of vericiguat with PDE-5 inhibitors may result in additive hypotensive effects. alfuzosinsildenafil increases effects of alfuzosin by pharmacodynamic synergism. sildenafil increases effects of alfuzosin by pharmacodynamic synergism.
Prior authorization
apalutamideapalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
Chronic Obstructive Pulmonary Disease (COPD) (Off-Label Use)
apalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. asenapinesildenafil increases effects of asenapine by pharmacodynamic synergism. sildenafil increases effects of asenapine by pharmacodynamic synergism. ceritinibceritinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Never use combination with chronic sildenafil for PAH cobicistatcobicistat will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When used chronically for PAH, sildenafil is contraindicated for use with cobicistat; if used for erectile dysfunction, do not exceed sildenafil 25 mg q48hr cobicistat will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events; contraindication applies to chronic administration of sildenafil for PAH; for ED, not to exceed 25 mg in 48 hr. nelfinavirnelfinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nelfinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Aspect | Rating (out of 5) | Comments |
|---|---|---|
| Efficacy | 4.2 | Generally effective for most users |
| Side effect profile | 4.0 | Mild side effects, well tolerated |
| Ease of use | 4.5 | Simple dosing regimen |
| Overall satisfaction | 4.3 | Positive feedback from majority of users |
Coadministration contraindicated if sildenafil used for pulmonary arterical hypertension. Reduce sildenafil dose if used for erectile dysfunction.
Summary or Key Points
But there’s another sex-related issue that’s more common in men than you might expect: difficulty orgasming. 50 mg PO ~1 hr before sexual activity; however, may be taken anywhere from 30 min to 4 hr before sexual activity Maximum dosing frequency is once per day Based on effectiveness and toleration, may increase dose to maximum of 100 mg or decrease to 25 mg Indicated for treatment of pulmonary arterial hypertension (PAH) (World Health Organization [WHO] Group I) to improve exercise ability and delay clinical worsening Revatio (PO), Liqrev: 20 mg PO TID; may titrate up to 80 mg TID, if required, based on symptoms and tolerability Revatio (IV): 10 mg IV bolus TID 10-mg IV predicted to provide pharmacologic effect equivalent to 10-mg oral dose Do not exceed recommended PO/IV dose Viagra, VibriqueSevere (eg, cirrhosis): Consider initial dose of 25 mg Severe (eg, cirrhosis): Consider initial dose of 25 mg RevatioMild or moderate (Child-Pugh A or B): No dose adjustment requiredSevere (Child-Pugh C): Not studied Mild or moderate (Child-Pugh A or B): No dose adjustment required Viagra, VibriqueMild or moderate (CrCl 30-80 mL/min): No dose adjustment requiredSevere (CrCl <30 mL/min): Consider initial dose of 25 mg Mild or moderate (CrCl 30-80 mL/min): No dose adjustment required Severe (CrCl <30 mL/min): Consider initial dose of 25 mg RevatioAny severity, including severe (CrCl <30 mL/min): No dose adjustment required Any severity, including severe (CrCl <30 mL/min): No dose adjustment required Indicated in children aged 1-17 years for treatment of pulmonary arterial hypertension (PAH) (WHO Group I) to improve exercise ability and, in pediatric patients too young to perform standard exercise testing, pulmonary hemodynamics thought to underly improvements in exercise 20-45 kg: 20 mg PO TID Maximum dose in pediatric patients not identified Based on experience in adults, dose may be titrated up to 40 mg TID, if required, based on symptoms and tolerability Mild or moderate (Child-Pugh A or B): No dose adjustment required Any severity, including severe (CrCl <30 mL/min): No dose adjustment required ≥65 years: 25 mg PO initially ~1 hr before sexual activity; however, may be taken anywhere from 30 min to 4 hr before sexual activity Maximum dosing frequency is once per day Based on effectiveness and toleration, may increase dose to maximum of 100 mg or decrease to 25 mg Indicated for treatment of pulmonary arterial hypertension (PAH) (World Health Organization [WHO] Group I) to improve exercise ability and delay clinical worsening PO: 20 mg PO TID; may titrate up to 80 mg TID, if required , based on symptoms and tolerability 10-mg IV predicted to provide pharmacologic effect equivalent to 10-mg oral dose Recommended PO/IV dose not to be exceeded Adding Revatio to bosentan does not have any beneficial effect on exercise capacity Clinical trials found no significant difference in response between elderly patients and younger adults; however, cautious dose selection should be considered in elderly because of greater frequency of decreased hepatic, renal, and cardiac function, as well as comorbid conditions and concomitant pharmacotherapy Compared with healthy younger volunteers, healthy elderly volunteers (≥65 years) had reduced clearance of sildenafil, resulting in approximately 84% and 107% higher plasma concentrations of sildenafil and its active N-desmethyl metabolite, respectively atazanaviratazanavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Never use combination with chronic sildenafil for PAH cobicistatcobicistat will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When used chronically for PAH, sildenafil is contraindicated for use with cobicistat; if used for erectile dysfunction, do not exceed sildenafil 25 mg q48hr cobicistat will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events; contraindication applies to chronic administration of sildenafil for PAH; for ED, not to exceed 25 mg in 48 hr.
Drugs you should not use with sildenafil
nelfinavirnelfinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nelfinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration contraindicated if sildenafil used for pulmonary arterical hypertension. Reduce sildenafil dose if used for erectile dysfunction. nirmatrelvir/ritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Other Interactions
nitroglycerin rectalsildenafil increases 50 mg sildenafil price effects of nitroglycerin rectal by additive vasodilation. Use of nitroglycerin within a few days of PDE5 inhibitors is contraindicated. PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates. sildenafil increases effects of nitroglycerin rectal by additive vasodilation. Either increases effects of the other by additive vasodilation. nirmatrelvir/ritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nitroglycerin rectalsildenafil increases 50 mg sildenafil price effects of nitroglycerin rectal by additive vasodilation. Use of nitroglycerin within a few days of PDE5 inhibitors is contraindicated. PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates. sildenafil increases effects of nitroglycerin rectal by additive vasodilation. Either increases effects of the other by additive vasodilation.
- Sildenafil 12.5 mg is a lower dose used for mild erectile dysfunction.
- It helps relax blood vessels to increase blood flow.
- Often prescribed when starting treatment or for lighter symptoms.
Coadministration of PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, vardenafil) and guanylate cyclase stimulators (eg, riociguat) is contraindicated due to risk of additive hypotension; do not administer within 24 hr of each other. Either increases effects of the other by pharmacodynamic synergism.
Contraindications for Sildenafil Use
Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. Cowan, B, Walker, K., Rodgers, K., Agyemang, J. Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681.
Pregnancy Categories
Feasibility Study of Video Telehealth Clinic Visits women sildenafil in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. Erectile dysfunction is a condition in which you have trouble getting or keeping an erection firm enough for satisfying sex. Erectile dysfunction affects as many as 30 million men in the United States. Premature ejaculation (PE) is a sexual dysfunction characterized by a short ejaculatory latency, a perceived lack of control about the timing of ejaculation, and distress and interpersonal difficulty related to ejaculating too quickly.
Corresponding author
Low testosterone or testosterone deficiency, also known as hypogonadism, is a condition in which patients develop symptoms such as low sex drive, erectile dysfunction (ED), and fatigue because the body doesn’t produce enough testosterone. Though many men don’t like to talk about it, ejaculation problems are very common. Some of the most common issues include premature, delayed, or retrograde ejaculation. Your pelvic floor is a lot like plumbing in your home: you never really think about it unless something goes wrong. When you think of male sexual dysfunction, concerns like erectile dysfunction (ED) or premature ejaculation (PE) probably come to mind first. Coadministration of vericiguat with PDE-5 inhibitors may result in additive hypotensive effects.
Further information
alfuzosinsildenafil increases effects of alfuzosin by pharmacodynamic synergism. sildenafil increases effects of alfuzosin by pharmacodynamic synergism. apalutamideapalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.
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Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function. Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician.
Sildenafil for Pulmonary Arterial Hypertension (PAH)
In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health. Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog.
Can I take sildenafil every day?
You can find Dr. Brown on LinkedIn for more information. Urology Residency, University of California San Francisco Urology Residency, University of California San Francisco Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill Cowan, B, Walker, K., Rodgers, K., Agyemang, J. Adjust dose according to prescribing information if needed. apalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. asenapinesildenafil increases effects of asenapine by pharmacodynamic synergism. sildenafil increases effects of asenapine by pharmacodynamic synergism. ceritinibceritinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.