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Learn about Viagra (Sildenafil Citrate) may treat, uses, dosage, side effects,. (sildenafil citrate) Tablets.Visual disturbances were identified as mild and transient, and were predominately color-tinge to vision, but also increased sensitivity to light or blurred vision.Whether dosages lower than 20 mg t.i.d. are effective is not known.

Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state.In volunteers with hepatic cirrhosis (Child-Pugh class A and B), sildenafil clearance was reduced, resulting in increases in AUC (84%) and C max (47%) compared to age-matched volunteers with no hepatic impairment.Sildenafil Tablets: Sildenafil citrate is formulated as white,.

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The mean steady state volume of distribution (Vss) for sildenafil is 105 L, indicating distribution into the tissues.Sildenafil is an inhibitor of cGMP specific phosphodiesterase type-5 (PDE5) in the smooth muscle of the pulmonary vasculature, where PDE5 is responsible for degradation of cGMP.No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by CYP2C9.Others were reported to have occurred hours to days after use concurrent with sexual activity.Sildenafil acts by inhibiting cGMP-specific phosphodiesterase type 5 (phosphodiesterase 5, PDE 5 ), an enzyme that promotes degradation of cGMP, which regulates blood flow in the penis.

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In the pivotal placebo-controlled trial in pulmonary arterial hypertension, the adverse drug reactions that were reported by at least 3% of REVATIO patients treated at the recommended dosage (20 mg t.i.d.) and were more frequent in REVATIO patients than placebo patients, are shown in Table 2.It was initially studied for use in hypertension (high blood pressure) and angina pectoris (a symptom of ischaemic heart disease ).

Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance.

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Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, but studies did not include sufficient numbers of subjects to determine whether they respond differently from younger subjects.

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Dosage of Sildenafil Citrate for Erectile Dysfunction The recommended starting dosage for treating erectile dysfunction is sildenafil citrate 50 mg one hour prior to.

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Pulmonary vasodilators may significantly worsen the cardiovascular status of patients with pulmonary veno-occlusive disease (PVOD).The most common side effects are nosebleed, headache, upset stomach, getting red or hot in the face (flushing), and trouble sleeping.Sildenafil exposure without concomitant medication is shown to be 5-fold higher at a dose of 80 mg t.i.d. compared to its exposure at a dose of 20 mg t.i.d. This concentration range covers the same increased sildenafil exposure observed in specifically-designed drug interaction studies with CYP3A4 inhibitors (except for potent inhibitors such as ketoconazole, itraconazole, and ritonavir).In patients with pulmonary hypertension, this can lead to vasodilation of the pulmonary vascular bed and, to a lesser degree, vasodilatation in the systemic circulation.

Dosage adjustments may be necessary (see PRECAUTIONS: Drug Interactions ).Sildenafil is only about 10-fold as potent for PDE5 compared to PDE6, an enzyme found in the retina and involved in the phototransduction pathway of the retina.Medications used in the management of pulmonary arterial hypertension ( B01, C02 ).

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Caution is advised when phosphodiesterase type 5 (PDE5) inhibitors are co-administered with alpha-blockers.Other reported clinical experience has not identified differences in response between the elderly and younger pulmonary arterial hypertension patients.It is not possible to determine if these events are related to oral medicines for the treatment of erectile dysfunction, including sildenafil, or to other medical problems, or combination of these factors.In the pivotal study, the incidence of retinal hemorrhage at the recommended sildenafil 20 mg t.i.d. dose was 1.4% versus 0% placebo and for all sildenafil doses studied was 1.9% versus 0% placebo.The overall frequency of discontinuation in REVATIO-treated patients at the recommended dose of 20 mg t.i.d. was low (3%) and the same as placebo (3%).Sildenafil, therefore, increases cGMP within pulmonary vascular smooth muscle cells resulting in relaxation.Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of sildenafil without sexual activity.

More shortness of breath than usual may be due to your underlying medical condition.The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete intercourse).Similar effects on blood pressure were noted with 25 mg, 50 mg and 100 mg doses of sildenafil, therefore the effects are not related to dose or plasma levels within this dosage range.There was no evidence of a difference in effect between sildenafil 20 mg t.i.d. and the higher doses tested.This can happen if you are sick with a fever, vomiting, or diarrhea.In addition to pulmonary vascular smooth muscle and the corpus cavernosum, PDE5 is also found in other tissues including vascular and visceral smooth muscle and in platelets.In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance.

The combination of heparin and sildenafil had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been studied in humans.The major circulating metabolite results from N-desmethylation of sildenafil, and is, itself, further metabolized.Men between the ages of 30 and 65 would be eligible to buy four tablets after a consultation.

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The combination of both drugs did not lead to clinically significant changes in blood pressure (supine or standing).In vivo studies: When sildenafil 100 mg oral was co-administered with amlodipine, 5 mg or 10 mg oral, to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic.REVATIO is a prescription medicine used to treat pulmonary arterial hypertension (PAH).The incidence of epistaxis was also higher in sildenafil-treated patients with concomitant oral vitamin K antagonist (9% versus 2% in those not treated with concomitant vitamin K antagonist).Adverse events were generally transient and mild to moderate in nature.The concomitant administration of the protease inhibitor ritonavir (a highly potent CYP3A4 inhibitor) substantially increases serum concentrations of sildenafil, therefore co-administration with REVATIO is not recommended (see Drug Interactions and DOSAGE AND ADMINISTRATION ).