Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels etravirine 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 fedratinibfedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary.
Dosing & Uses
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider sildenafil citrate tablet increasing CYP3A substrate dose if needed. elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
Other Literature Sources
enzalutamideenzalutamide 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 enzalutamide 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 epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation. epoprostenol increases effects of sildenafil by additive vasodilation. erythromycin baseerythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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fluconazolefluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavirfosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitantfosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosphenytoinfosphenytoin 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 fosphenytoin 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 gepotidacingepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If possible, avoid with sensitive substrates that are are extensively metabolized by CYP3A4 and have a narrow therapeutic index. If unable to avoid, monitor or modify substrate dose according to its prescribing information. gepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Further information
diltiazemdiltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedaronedronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Recreational use
Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz 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 efavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruitgrapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Erratum in
cyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazoldanazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. darunavirdarunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with PDE-5 inhibitors may result in an increase in PDE-5 inhibitor-associated adverse reactions (eg, hypotension, syncope, visual disturbances and priapism).
Patient resources
darunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasiroxdeferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasonedexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvingriseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Medication Type | Potential Interaction | Effect | Notes |
|---|---|---|---|
| Nitrates | Severe hypotension | Dangerous drop in blood pressure | Absolute contraindication |
| Alpha-blockers | Enhanced hypotensive effect | Blood pressure may drop too low | Use with caution, monitor BP |
| CYP3A4 inhibitors | Increased sildenafil levels | Increased risk of side effects | Dose adjustment may be needed |
| Rifampin | Reduced sildenafil effectiveness | Lower plasma levels | May require dose increase |
griseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- Take sildenafil on an empty stomach for faster absorption.
- High-fat meals may delay the effectiveness of the medication.
- Do not crush or chew sildenafil tablets; swallow whole.
hydrocortisonehydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisone will decrease the level or effect buy sildenafil online uk of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisibidelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Condition | Caution / Notes | Risk Factors |
|---|---|---|
| Cardiovascular disease | Use with caution | Heart failure, recent MI |
| Concomitant nitrate use | Absolute contraindication | Risk of severe hypotension |
| Severe hepatic impairment | May require dose adjustment | Reduced clearance |
| Retinitis Pigmentosa | Cautious use | Potential for vision disturbances |
Coadministration of sildenafil with strong CYP3A4 inhibitors is not recommended.
- Sildenafil can improve exercise capacity in pulmonary hypertension patients.
- Regular monitoring may be required for long-term use.
- Be aware of potential side effects related to blood pressure changes.
If using Viagra, consider decreasing starting dose.
- Patients with heart conditions should consult a cardiologist before use.
- Sildenafil may cause a temporary drop in blood pressure.
- Do not use sildenafil if you have a history of stroke or heart attack.
idelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazidisoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefyllineistradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates. istradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
- The medication may cause a sudden decrease in blood pressure in some users.
- Use sildenafil cautiously if you are also taking blood pressure medications.
- Do not share your medication with others to prevent misuse.
itraconazoleitraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension. itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Side Effect | Incidence (%) | Severity | Recommendations |
|---|---|---|---|
| Headache | 16-30 | Mild to moderate | Usually resolves spontaneously |
| Flushing | 10-15 | Mild | Can be reduced with lower doses |
| Dyspepsia | 10-20 | Mild | Take with food to reduce symptoms |
| Nasal Congestion | 10-20 | Mild | Usually transient |
| Visual Disturbances | 2-4 | Mild to moderate | Rare, discontinue if persistent |
labetalollabetalol increases effects of sildenafil by additive vasodilation. labetalol increases effects of sildenafil by additive vasodilation.
Usual Adult Dose for Erectile Dysfunction
Consider a starting dose of 25 mg in patients treated with erythromycin. erythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin ethylsuccinate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionateerythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
What are the most common side effects of sildenafil?
erythromycin stearateerythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esmololesmolol increases effects of sildenafil by additive vasodilation. esmolol increases effects of sildenafil by additive vasodilation. etravirineetravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lapatiniblapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lesinurad (DSC)lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
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