Sildenafil: MedlinePlus Drug Information (2023)

pronounced as (sil den' a fil)

  • Why is this medication prescribed?
  • How should this medicine be used?
  • Other uses for this medicine
  • What special precautions should I follow?
  • What special dietary instructions should I follow?
  • What should I do if I forget a dose?
  • What side effects can this medication cause?
  • What should I know about storage and disposal of this medication?
  • In case of emergency/overdose
  • What other information should I know?
  • Brand names

Why is this medication prescribed?

Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child's condition. Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

How should this medicine be used?

Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

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If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.

If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer's directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.

If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

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What special precautions should I follow?

Before taking sildenafil,

  • tell your doctor and pharmacist if you are allergic to sildenafil, any other medications, or any of the ingredients in sildenafil products. Ask your pharmacist for a list of the ingredients.
  • do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.
  • do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), and terazosin; amlodipine (Norvasc, in Amturnide, in Tekamlo); certain antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain barbiturates such as butalbital (in Butapap, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal LA, InnoPran); bosentan (Tracleer); cimetidine ; efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase; no longer available in the U.S.), atazanavir (Reyataz, in Evotaz), darunavir (Prezista, in Prezcobix), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction; medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol, others), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • tell your doctor what herbal products you are taking or plan to take, especially St. John's wort.
  • tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
  • if you are a woman and you are taking sildenafil to treat PAH, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking sildenafil, call your doctor.
  • if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.
  • if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
  • tell all your healthcare providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the healthcare providers who treat you will need to know when you last took sildenafil.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.

If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

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What side effects can this medication cause?

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache
  • heartburn
  • diarrhea
  • flushing (feeling of warmth)
  • nosebleeds
  • difficulty falling asleep or staying asleep
  • numbness, burning, or tingling in the arms, hands, feet, or legs
  • muscle aches
  • changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
  • sensitivity to light

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • sudden severe loss of vision (see below for more information)
  • blurred vision
  • sudden decrease or loss of hearing
  • ringing in ears
  • dizziness or lightheadedness
  • fainting
  • chest pain
  • worsening shortness of breath
  • erection that is painful or lasts longer than 4 hours
  • itching or burning during urination
  • rash

Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.

Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.

Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension at room temperature or in a refrigerator, but do not freeze it. Dispose of any unused suspension after 60 days.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

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What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

  • Revatio®
  • Viagra®
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FAQs

What are the dangers of sildenafil? ›

Common side effects
  • Headaches. Make sure you rest and drink plenty of fluids. ...
  • Feeling sick (nausea) It may help if you avoid rich or spicy food. ...
  • Flushing including hot flushes. Try cutting down on coffee, tea and alcohol. ...
  • Indigestion. ...
  • Stuffy nose. ...
  • Feeling dizzy.

What should you avoid when taking sildenafil? ›

do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others).

What happens if you take sildenafil without erectile dysfunction? ›

Nothing much would happen if someone without erectile dysfunction took Viagra, although they might think they feel better psychologically. But it would make a difference if you took it along with other drugs.

How good is sildenafil for erectile dysfunction? ›

In controlled studies, Sildenafil 50mg was found to be effective in 74% of men with erectile dysfunction.

Does sildenafil hurt your heart? ›

However, because Viagra is a vasodilator, it helps open up blood vessels and arteries. You might think that this would actually help to reduce the risk of a heart attack, but, there have been reports of heart attack, stroke, arrhythmia and even death in men taking Viagra.

Is sildenafil good for the heart? ›

Researchers analyzed the health records of more than 70,000 men with erectile dysfunction and found that those who were prescribed Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil), or similar drugs called phosphodiesterase type 5 (PDE-5) inhibitors also had: 39 percent lower death rate due to heart disease.

What stops sildenafil from working? ›

1. Avoid taking Viagra with a large meal or high-fat meal. Viagra blood levels peak an hour after you swallow the tablet on an empty stomach. According to Ramin, if you eat a large or high-fat meal and then take Viagra, the medication will lose its effectiveness and may take longer to start working.

How should I take sildenafil for best results? ›

Swallow tablets whole with a drink of water or juice (but not grapefruit juice). For erectile dysfunction, it's best to take sildenafil on an empty stomach. It may take longer to work if you take it with food.

Does sildenafil increase size? ›

Sildenafil (brand name Viagra, or affectionately nicknamed “the little blue pill”; see Important Safety Information) is a highly effective medication to treat erectile dysfunction. However, there is something it can't do. Viagra does not make your penis bigger. No pill does.

Can you just stop taking sildenafil? ›

The good news is that sildenafil (the active ingredient in Viagra) isn't linked to physical addiction, meaning you won't develop a physical dependence on it or develop withdrawal symptoms if you stop using it suddenly.

Does sildenafil work without stimulation? ›

Viagra works by relaxing muscles in blood vessel walls to help increase blood flow to the penis, making it easier to get and maintain an erection. Viagra is only effective if there is sexual stimulation, such as that occurring during sexual intercourse.

Does sildenafil increase testosterone? ›

Administration of an optimized dose of sildenafil to men with erectile dysfunction and low baseline serum testosterone increases serum testosterone levels likely by a direct action on the testes.

How long does sildenafil last once taken? ›

One of the most common questions associated with sildenafil (Viagra) and other PDE5 inhibitors is how long does it last? The simple answer is usually around 4 hours, with the maximum effect between 30 mins and 2.5 hours after taking – see graph below.

Does sildenafil work better if you take it everyday? ›

Taking a daily dose of Viagra can help stop the intensity of the progression of ED. It also has other benefits, including improving your ability to urinate and improving your quality of life in general. Discuss dosage and frequency with your doctor to determine what works best for you.

How many hours is sildenafil effective? ›

This medicine usually begins to work for erectile dysfunction within 30 minutes after taking it. It continues to work for up to 4 hours, although its action is usually less after 2 hours. Use only the brand of this medicine that your doctor prescribed.

Who should not take sildenafil? ›

have low blood pressure (hypotension) have a rare inherited eye disease, such as retinitis pigmentosa. have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells) or multiple myeloma (cancer of bone marrow) have a deformity of your penis or Peyronie's disease (curved penis)

Does sildenafil affect the kidneys? ›

In a clinical setting, administration of sildenafil improves kidney function, prevents disease progression, reduces proteinuria, and restores GFR in patients with conditions ranging from pulmonary hypertension to diabetic nephropathy (reviewed by Vasquez et al. 14).

Can taking sildenafil cause high blood pressure? ›

Conclusions: The acute, short-term effects of oral sildenafil on blood pressure and heart rate in men with erectile dysfunction were small and not likely to be clinically significant in those taking concomitant antihypertensive medication.

Is it healthy to take sildenafil? ›

Sildenafil is a safe medication when it's used as directed. Tens of millions of men of all ages and backgrounds use it and similar ED medications on a regular basis, with serious side effects very uncommon.

What does sildenafil do in females? ›

There's limited evidence that the drug is somewhat beneficial for women with sexual dysfunction. It should be noted that sildenafil is also available as Revatio, available in 20 milligram (mg) doses (which is less than a Viagra dose). It's used to treat pulmonary hypertension in both men and women.

Can Viagra cause strokes? ›

However, when used as directed and with the recommended precautions, Viagra is not normally associated with heart attacks or strokes. In fact, documented cases of Viagra causing strokes are typically associated with overuse and abuse of Viagra.

Does sildenafil delay climax? ›

Background: Recently, sildenafil has been demonstrated to be effective in treating premature ejaculation (PE).

How do you know if sildenafil is working? ›

Viagra doesn't start working immediately after taking it, as the medication needs time to be absorbed into your blood. For most men, it takes around 30 minutes before you start to feel the effects of Viagra. 12 minutes after – One study has shown that some men got an erection just 12 minutes after taking Viagra.

How long can the average man stay erect? ›

A penile erection can normally last anywhere from a few minutes to about half an hour. On average, men have five erections a night while they're sleeping, each lasting about 25 to 35 minutes (Youn, 2017).

What helps sildenafil work better? ›

Watch what you eat when you take your pill.

If you swallow sildenafil (Viagra) with a high-fat meal, such as a steak dinner, it may take longer for it to work. You can take other ED drugs with or without food, such as: Avanafil (Stendra) Tadalafil (Adcirca, Cialis)

What is the peak time for sildenafil? ›

In healthy volunteers, sildenafil doses are absorbed rapidly, with maximum plasma concentrations achieved within a median time of 1 h (range, 0.5–2 h) after dosing [3].

Should you drink water with sildenafil? ›

Sildenafil can be taken with or without food, but it works faster on an empty stomach. Sildenafil takes longer to start working if you take it with or after a meal. Swallow your sildenafil tablet with a drink of water.

Can I take sildenafil for years? ›

Because sildenafil citrate is a treatment, not a cure, for erectile dysfunction (ED), many men may choose to use it for an extended period.

Can sildenafil cause permanent ED? ›

Taking Viagra doesn't cause new or worsening ED. However, Viagra can sometimes cause priapism, which is a long-lasting and sometimes painful erection. Priapism is a medical emergency that needs to be treated right away.

Can you drink alcohol while taking sildenafil? ›

Alcohol (Ethanol) sildenafil

You may be more likely to experience symptoms such as dizziness, lightheadedness, fainting, flushing, headache, and heart palpitations. You should avoid or limit the use of alcohol while being treated with sildenafil, and use caution when getting up from a sitting or lying position.

How can I increase my erectile sensitivity? ›

Simple lifestyle changes like improving your diet, increasing your daily physical activity, quitting smoking, and limiting alcohol use can improve your overall health and increase blood flow to the penis, which can help with sensitivity.

Does sildenafil lower blood pressure and heart rate? ›

These have shown that sildenafil causes a modest reduction in blood pressure, even when taken with other blood pressure-lowering drugs, providing reassurance on safety when taken as a single dose for erectile dysfunction.

Can sildenafil damage kidneys? ›

Generally, sildenafil is safe, with mild side effects. Here, we report a case of acute kidney injury caused by a sildenafil overdose. A 67-year-old man took 400 mg of sildenafil for erectile dysfunction.

Does sildenafil make you harder? ›

Both brand name Viagra and its generic version sildenafil work by increasing blood flow to your penis. This process, which we've discussed in more detail further down the page, can make it easier to get and maintain an erection when you feel sexual desire and arousal.

Can you take sildenafil for life? ›

The short answer is yes; you can take Viagra or its generic form, sildenafil, every day. Whether you need to or should, depends. Since each person is different, you should consult with a doctor about what's best for you. They can discuss dosage and frequency.

Is sildenafil good for prostate? ›

In men on sildenafil vs placebo significant improvements were observed in International Prostate Symptom Score (-6.32 vs -1.93, p<0.0001), Benign Prostatic Hyperplasia Impact Index (-2.0 vs -0.9, p<0.0001), mean International Prostate Symptom Score quality of life score (-0.97 vs -0.29, p<0.0001) and total Self-Esteem ...

Does sildenafil cause lower back pain? ›

Some Viagra users experience muscle aches after using their medication. These can range in severity from a mild level of muscular pain to more significant, noticeable pain in a certain area, such as the lower back.

Does sildenafil give you energy? ›

We show that chronically inhibiting cGMP hydrolysis with the phosphodiesterase-5 inhibitor sildenafil improves energy balance and enhances in vivo insulin action in a mouse model of diet-induced insulin resistance.

Is it better to take sildenafil daily or as needed? ›

Use sildenafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects is increased.

How long does it take for sildenafil to kick in? ›

Key takeaways: Viagra (sildenafil) is an oral medication that's used to treat erectile dysfunction. You can take Viagra take 30 minutes to 4 hours before sexual activity, but it shouldn't be taken more than once daily. For most men, Viagra begins to work within an hour.

How can I speed up the effects of sildenafil? ›

Is it possible to speed up the effects of Viagra? No, there isn't a way to speed up the effects of Viagra. These tablets need to be processed in your digestive system to take effect and even if you crush or chew the pill, the time it takes for your body to fully process the pill stays about the same.

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