Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of sildenafil in children younger than 1 year of age. Safety and efficacy have not been established.

Sildenafil should never be used in children for erectile dysfunction. In general, sildenafil should not be used for pulmonary arterial hypertension in children, especially for chronic use.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sildenafil in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving sildenafil.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amprenavir
  • Amyl Nitrite
  • Atazanavir
  • Boceprevir
  • Cobicistat
  • Darunavir
  • Erythrityl Tetranitrate
  • Fosamprenavir
  • Indinavir
  • Isosorbide Dinitrate
  • Isosorbide Mononitrate
  • Levoketoconazole
  • Lopinavir
  • Molsidomine
  • Nelfinavir
  • Nirmatrelvir
  • Nitroglycerin
  • Nitroprusside
  • Pentaerythritol Tetranitrate
  • Propatyl Nitrate
  • Riociguat
  • Ritonavir
  • Saquinavir
  • Telaprevir
  • Tipranavir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adagrasib
  • Bosentan
  • Cannabis
  • Carbamazepine
  • Cenobamate
  • Ceritinib
  • Clarithromycin
  • Conivaptan
  • Dabrafenib
  • Dihydrocodeine
  • Duvelisib
  • Efavirenz
  • Enzalutamide
  • Etravirine
  • Fedratinib
  • Fexinidazole
  • Fluconazole
  • Fosnetupitant
  • Fosphenytoin
  • Idelalisib
  • Itraconazole
  • Ivosidenib
  • Ketoconazole
  • Larotrectinib
  • Lefamulin
  • Lenacapavir
  • Lorlatinib
  • Lumacaftor
  • Mavacamten
  • Mitotane
  • Modafinil
  • Nafcillin
  • Nefazodone
  • Netupitant
  • Olutasidenib
  • Omaveloxolone
  • Pacritinib
  • Phenobarbital
  • Phenytoin
  • Pirtobrutinib
  • Posaconazole
  • Primidone
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritlecitinib
  • Simeprevir
  • St John's Wort
  • Telithromycin
  • Trofinetide
  • Vericiguat
  • Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Bunazosin
  • Ciprofloxacin
  • Delavirdine
  • Doxazosin
  • Erythromycin
  • Moxisylyte
  • Nebivolol
  • Prazosin
  • Silodosin
  • Tamsulosin
  • Terazosin
  • Trimazosin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice
  • Pomelo Juice

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abnormal penis, including a curved penis or birth defects of the penis—Chance of problems occurring may be increased and this medicine should be used with caution in these patients.
  • Angina (severe chest pain), unstable or
  • Arrhythmia (irregular heartbeat, within the last 6 months) or
  • Blood vessel problems (eg, aortic stenosis, idiopathic subaortic stenosis) or
  • Heart attack (within the last 6 months) or
  • Heart failure or
  • Hypertension (high blood pressure) or
  • Hypotension (low blood pressure) or
  • Retinal disorders (eye problem) or
  • Retinitis pigmentosa (an inherited eye disorder) or
  • Stroke (within the last 6 months)—Should not be used in patients with these conditions.
  • Age greater than 50 years or
  • Coronary artery disease or
  • Crowded disc or low cup to disc ratio in the eye (an eye disorder) or
  • Diabetes or
  • Heart disease or
  • Hyperlipidemia (high fats in the blood) or
  • Hypertension (high blood pressure) or
  • Non-arteritic anterior ischemic optic neuropathy or NAION (serious eye condition), history of or
  • Smoking—May increase the chance for a serious side effect in the eye called NAION.
  • Bleeding disorders, history of or
  • Stomach ulcer, or history of or—Chance of problems occurring may be increased. It is not known if the medicine is safe for use in these patients.
  • Kidney disease, severe or
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Leukemia (blood related cancer) or
  • Multiple myeloma (blood related cancer) or
  • Sickle-cell anemia (blood disorder)—Sildenafil should be used with caution in these patients as problems with prolonged erection of the penis may occur.
  • Pulmonary veno-occlusive disease or PVOD (a type of lung disease)—Use with caution. May make this condition worse.

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