One study found the median time to onset of an erection was 27 minutes, with the shortest time to action at 12 minutes and the longest at 70 minutes.⁸ ⁹ Sildenafil is not suitable for everyone, and some people may need to take additional measures to ensure they can use the drug safely. Inform your doctor if you¹⁰ ¹¹ ¹² Have had an allergic reaction to sildenafil or a similar drug Have had an allergic reaction to sildenafil or a similar drug Are taking nitrate-based drugs for chest pain (Nitrostat, Isordil) or for recreational use (“poppers”) Are taking nitrate-based drugs for chest pain (Nitrostat, Isordil) or for recreational use (“poppers”) Have a history of priapism (a painful, prolonged erection) Have a history of priapism (a painful, prolonged erection) Have had a heart attack or stroke Have had a heart attack or stroke Or if you have any of the following medical conditions: Sickle cell disease, multiple myeloma, and leukemia Sickle cell disease, multiple myeloma, and leukemia Vision loss related to non-arteritic anterior ischemic optic neuropathy (NAION) and other eye conditions Vision loss related to non-arteritic anterior ischemic optic neuropathy (NAION) and other eye conditions These lists may be incomplete, and other conditions may affect your body’s handling of sildenafil.
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Retinal toxicity of long term overdose of sildenafil citrate: A case report. What to discuss with your doctor before starting sildenafil We make it easy to take part. Sildenafil is a prescription drug belonging to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. PDE5 enzymes regulate the signaling pathway in the normal physiological processes related to blood flow. They bind to and activate receptors located in the arteries of the lungs and the corpus cavernosum of the penis. Inform your doctor of all your medical conditions before taking sildenafil. Most are mild and resolve without intervention, but some are severe and demand urgent medical attention.¹³ ¹⁴ The most common side effects associated with sildenafil are: Visual changes, including blurred vision, changes in color perception, and light sensitivity Visual changes, including blurred vision, changes in color perception, and light sensitivity Some of the less common and more severe adverse effects of sildenafil include the following:¹⁵ ¹⁶ Sudden vision loss affecting one or both eyes Sudden vision loss affecting one or both eyes Vaso-occlusive crisis in patients with PAH due to sickle cell disease Vaso-occlusive crisis in patients with PAH due to sickle cell disease Buildup of fluid in the lungs and worsening of condition in people with PVOD Buildup of fluid in the lungs and worsening of condition in people with PVOD Any of the adverse effects outlined above may indicate an overdose. If you suspect you may have taken too much sildenafil, seek medical care immediately, even if you don’t have any symptoms.¹⁷ Some people are allergic to the active or inactive ingredients in sildenafil. Symptoms of a drug allergy may include any of the following: Swelling in the face, lips, mouth, and tongue Swelling in the face, lips, mouth, and tongue If you experience any symptoms of a drug allergy while taking sildenafil, stop taking the drug immediately. Call your doctor or seek emergency medical attention, depending on the severity of your symptoms.
Potential Side Effects and Safety Measures
If you have severe or life-threatening symptoms, get medical help right away by calling 911 or going to the nearest ER. There are ways to save on Revatio, which is available as a brand-name and generic medication. GoodRx can help you navigate between GoodRx coupons, copay savings cards, and patient assistance programs to save money on your prescription. Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of brand-name Revatio at an exclusive cash price of about $850. An equivalent supply of the generic may cost as little as $11.70. As such, it’s commonly prescribed for long-term use.
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PDE5 inhibitors prevent the binding of these enzymes to their target receptors. This inhibition initiates a series of metabolic events resulting in the relaxation of smooth muscle in the blood vessel walls, allowing the vessels to dilate and increasing the flow of blood to those areas.¹ ² Sildenafil is sold under the brand name Viagra for the treatment of erectile dysfunction (ED), while prescriptions for pulmonary arterial hypertension (PAH) are for the brands Revatio and Liqrev. The generic drug sildenafil is available for both indications. Sildenafil has been approved by the US Food and Drug Administration (FDA) for the treatment of ED in adults and PAH in adults and children aged one year and older.³ ⁴ In ED, sildenafil indirectly promotes the activity of nitric oxide, a compound naturally released during sexual stimulation that increases blood flow to the genitalia. Because the drug relies on nitric oxide, it will not trigger spontaneous erections. In a study examining the long-term safety of sildenafil, less than 4% experienced treatment-related adverse effects that led to a change in dosage or discontinuation of treatment.¹⁸ While it’s possible to develop tolerance to many drugs, that’s not the case with sildenafil.
How to Take / Dosage Guidelines
Save with a copay savings card: If you have commercial insurance, you may be eligible to pay $0 per month for Revatio 20 mg tablets using a copay savings card from the manufacturer. Save with a patient assistance program: If you’re uninsured or underinsured, you may be eligible for a patient assistance program that offers the medication free of charge. Revatio (sildenafil) is a medication that manages pulmonary arterial hypertension (PAH) in adults and children. Revatio is available as oral tablets, an oral liquid suspension, and an injection. The typical dosage of Revatio for PAH in adults is 20 mg by mouth 3 times a day, with a maximum dosage of 80 mg 3 times a day. In a study on the treatment for radiation-related ED in people with prostate cancer, researchers found that over 90% of participants reported the drug was still effective over the four-year study period.¹⁹ Sildenafil has been designated a category B drug in pregnancy by the US FDA. While animal studies did not demonstrate a risk to the fetus, there are no adequate studies assessing the risk in humans.²⁰ Despite the uncertainty, sildenafil is considered a relatively safe drug during pregnancy.
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Sildenafil - sildenafil citrate injection, solution [package insert]. Sildenafil-associated hepatoxicity: A review of the literature. European Review for Medical and Pharmacological Sciences. FDA approves intravenous formulation of Pfizer’s Revatio (sildenafil) for the treatment of pulmonary arterial hypertension. Revatio - sildenafil citrate tablet, film coated; Revatio - sildenafil citrate injection, solution; Revatio - sildenafil citrate powder, for suspension [package insert]. A 2018 review of literature revealed that some babies whose mothers had taken sildenafil while pregnant had increased birth weights, which was considered a beneficial effect.²¹ Your doctor will weigh the potential risks against the benefits in your case when deciding if you should take the drug while pregnant.
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For children, typical dosages are based on body weight, with dosages ranging from 10 mg to 40 mg by mouth 3 times a day. Revatio dosages do not need to be adjusted for health conditions. But your dosage may be adjusted if you take an interacting medication. But don’t double up on doses to make up for a missed one. There are ways to save on both brand-name Revatio and the lower-cost generic, including with a GoodRx coupon. Limited research indicates that sildenafil does appear in breastmilk but in doses that would not be considered harmful to the infant.²² If you take sildenafil for ED, you’ll take it as needed, so you won’t have to worry about missed doses.
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The drug works similarly in PAH to improve blood flow through the arteries bringing blood from the heart to the lungs. It allows these vessels to dilate, counteracting the high pressures that prevent healthy blood flow to the lungs in PAH. Sildenafil has been used off-label for treating female sexual arousal disorder and high-altitude sickness, but these uses are not US FDA-approved.⁵ Sildenafil is available as a tablet, an oral suspension, and a liquid for intravenous injection.⁶ Tablets are available in the following dosing strengths (generic, Viagra, Revatio): The oral suspension is formulated in one concentration (generic, Revatio, Liqrev): The solution for injection is available in one strength (generic, Revatio): The dosage for sildenafil varies with the indication being treated.⁷ For ED, the recommended adult dosing options for sildenafil (generic, Viagra) are as follows: An initial dose of 50mg once a day as needed, and it can be taken 30 minutes to four hours before sexual activity (recommended one hour prior) An initial dose of 50mg once a day as needed, and it can be taken 30 minutes to four hours before sexual activity (recommended one hour prior) The dose may be adjusted up or down based on effectiveness and tolerance The dose may be adjusted up or down based on effectiveness and tolerance Maximum dosing frequency is once per day Maximum dosing frequency is once per day These are the adult dosing recommendations for the treatment of PAH (generic, Revatio, Liqrev): An initial oral dose of 20mg three times daily, spaced 4–6 hours apart An initial oral dose of 20mg three times daily, spaced 4–6 hours apart A maximum oral dose of 240mg per day A maximum oral dose of 240mg per day Pediatric dosing is based on age and weight Pediatric dosing is based on age and weight Injections are administered by a medical professional in a healthcare setting Injections are administered by a medical professional in a healthcare setting Your prescriber will adjust your sildenafil dose according to the recommendations for your condition and your unique needs. Sildenafil can produce an erection within 30 minutes. Its duration of action can last up to 18 hours.