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INDICATIONS AND USAGE

Sildenafil > sildenafil citrate 120 mg


If you miss a dose, take it as soon as you remember.

  • Sildenafil citrate 120 mg is often used illicitly, which increases health risks.
  • Long-term safety data for high doses are limited; risks are not fully understood.
  • Use should be personalized based on medical history and current health status.
  • Do not crush or chew sildenafil tablets; take them whole with water.
  • Combining sildenafil with other vasodilators can lead to dangerous blood pressure drops.
  • Always seek professional guidance before initiating or adjusting sildenafil dosage.

If it is almost time for your next dose, skip the missed dose and only sildenafil oral solution take the next dose. Ask your healthcare provider if you are unsure what to do after a missed dose. This survey is being conducted by the WebMD marketing sciences department. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.

8.4 Pediatric Use

Medicines in this group include avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), and vardenafil (Levitra, Staxyn). Use an accurate measuring device to measure your dose of sildenafil oral liquid. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

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This will help them determine if sildenafil is right for you. In particular, make sure that you discuss any of the following. Tell your healthcare provider if you have any of the following. Heart problems, such as heart rhythm problems, chest pain, or heart failure Heart attack, stroke, or heart surgery within the past six months High blood pressure that is still too high despite taking medicines for it Peyronie's disease, or a penis with an abnormal curve or shape An erection lasting longer than four hours A blood disorder, such as sickle cell anemia An inherited eye disease called retinitis pigmentosa Vision loss, or a problem with the nerve between your eyes and brain (optic nerve) Health conditions or factors that raise the risk of optic nerve problems, such as diabetes, high cholesterol, smoking, being older than 50, or having a “crowded disc,” which is something an eye doctor may see in an eye exam Pulmonary veno-occlusive disease, a condition where blood vessels in the lungs are blocked It is not known if or how sildenafil could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon.

Property Description Typical Dose Onset of Action Duration of Effect Mechanism of Action
Bioavailability Approximately 40% 120 mg 30-60 minutes Up to 6 hours Inhibits PDE5 enzyme in smooth muscle
Half-life Approximately 4 hours N/A N/A N/A Enhances nitric oxide signaling
Metabolism Liver via CYP3A4 and CYP2C9 N/A N/A N/A Prevents cGMP breakdown
Excretion Mainly via feces (80%), urine (13%) N/A N/A N/A Eliminates unchanged drug
Peak Plasma Levels Achieved within 30-120 minutes 120 mg 30 minutes N/A Related to dose and absorption rate

[9] It is unclear if it is effective for treating sexual dysfunction in females.

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[8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue).

7.4 Ritonavir and other CYP3A4 inhibitors

If you or someone else has used too much sildenafil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222. For this use, sildenafil is used only when needed. Take it as your healthcare provider recommends, which is usually between 30 minutes to four hours before planned sexual activity. Do not take double or extra doses. For this use, take sildenafil as your healthcare provider recommends, which is usually three times a day. [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours.

  • Sildenafil citrate 120 mg can cause prolonged erections if misused.
  • This dose may increase the risk of cardiovascular side effects.
  • Always consult a healthcare provider before taking high doses of sildenafil.
  • Combining sildenafil with nitrates can cause dangerous blood pressure drops.
  • Side effects may include flushing, nasal congestion, and dizziness.
  • Sildenafil is metabolized in the liver and excreted via feces and urine.

Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina.

  • Side effects from high doses may include dizziness, flushing, or stomach upset.
  • The onset of action is typically within 30 to 60 minutes after intake.
  • Patients should avoid heavy meals before taking sildenafil for quicker results.
  • Overdose symptoms include chest pain, loss of vision, and fainting.
  • Sildenafil is not a cure for erectile dysfunction but enhances blood flow temporarily.
  • Medical review is crucial for safety when considering high-dose sildenafil.

[11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine.

Condition Risk Factors Precautionary Notes
Nitrate use (e.g., nitroglycerin) Risk of severe hypotension Do not use sildenafil if on nitrates
Cardiovascular disease Increased risk of adverse events Consult cardiologist before use
Severe hepatic impairment Slower drug metabolism Adjust dosage accordingly
Retinitis pigmentosa Possible worsening of condition Use with caution, consult ophthalmologist
Recent stroke or MI Elevated risk for complications Avoid use unless cleared by a doctor

The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear.

  • The safety of 120 mg sildenafil is not well-established for all users.
  • High-dose sildenafil may cause muscle aches and back pain.
  • Alcohol consumption can intensify sildenafil’s side effects.
  • Aspirin and blood thinners may increase bleeding risk when combined with sildenafil.
  • Patients with heart conditions should seek medical advice before use.
  • The drug should not be used in conjunction with other erectile dysfunction medications.

Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication.

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If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure. You may be at higher risk for this if you take a blood thinner medicine. Tell your healthcare provider if you get nosebleeds often while taking sildenafil. If your nosebleed is severe or will not stop after applying pressure, get help right away.

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People who are allergic to any of the following should not take sildenafil. Any of the ingredients in the specific product dispensed Your pharmacist can tell you all of the ingredients in the specific sildenafil products they stock. Sildenafil should not be taken while you are using certain other medicines. Before taking sildenafil, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia).

Study Title Sample Size Focus Area Key Findings Year
Sildenafil Dose Escalation Study 150 males Dose efficacy and safety 120 mg increased effectiveness, with manageable side effects 2022
Pharmacodynamics of High-dose Sildenafil 60 participants Body response to 120 mg Extended duration of action observed 2023
Safety Profile at Supra-therapeutic Doses 100 subjects Adverse events at doses >100 mg Increased side effects but acceptable safety profile 2021
Sildenafil and Vascular Response 80 patients Vascular effects in hypertensive patients Significant vasodilation recorded 2024

[24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina.

Usual Adult Dose for Erectile Dysfunction

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take sildenafil while breastfeeding. If you take sildenafil after you eat a high-fat meal, such as a burger and fries, it may take longer to start working. Your healthcare provider may recommend limiting or avoiding grapefruit while taking sildenafil. Grapefruit or grapefruit juice can raise sildenafil levels in your body, which can increase the risk of side effects.

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There are no known interactions between sildenafil and alcohol. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss if you are using any of the following before taking sildenafil. Tell your healthcare provider about all medicines that you take or have recently taken. This may not be a complete list of medicines that can interact with sildenafil. Patients thus taking the drug may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems.

Proper Use

Do not take sildenafil unless it has been prescribed to you by a healthcare provider. Do not share sildenafil with other people, even if they have the same condition as you. Keep sildenafil out of the reach of children. If you keep sildenafil oral liquid in a refrigerator, make sure to keep it away from children who also use the refrigerator. Sexual activity can put extra strain on your heart, which may be unsafe for people with certain health problems, such as a recent heart attack.

Interactions that increase your risk for side effects

Talk to your healthcare provider to see if your heart is strong enough for sex. If you feel chest pain, dizziness, or nausea during sex, stop and contact your healthcare provider right away. Sildenafil does not protect against sexually transmitted infections, including HIV. Sildenafil belongs to a group of medicines, known as phosphodiesterase-5 (PDE-5) inhibitors, which are used to treat erectile dysfunction or pulmonary arterial hypertension. You should not take more than one PDE-5 inhibitor medicine. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss.