Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist

Sildenafil > sildenafil citrate drug


acebutololacebutolol increases effects of sildenafil by additive vasodilation. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications.

Dosing & Uses

ritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. silodosinsildenafil increases effects of silodosin by pharmacodynamic synergism. sildenafil increases effects of silodosin by pharmacodynamic synergism. St John's WortSt John's Wort will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels St John's Wort will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Health News

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels terazosinsildenafil increases effects of terazosin by pharmacodynamic synergism. sildenafil increases effects of terazosin by pharmacodynamic synergism. tovorafenibtovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of tovorafenib (a weak CYP3A4 inducer) with CYP3A substrates where minimal concentration changes may lead to serious therapeutic failures. If unavoidable, monitor patients for loss of efficacy unless otherwise recommended in the CYP3A4 substrate prescribing information. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. acebutolol increases effects of sildenafil by additive vasodilation. amifostineamifostine increases effects of sildenafil by additive vasodilation.

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amifostine increases effects of sildenafil by additive vasodilation. aprepitantaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. aprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What Other Drugs Interact with Sildenafil?

Patients receiving indinavir with ritonavir should receive not more than 25 mg of sildenafil for treatment of erectile dysfunction in a 48-hour period, and patients receiving other protease inhibitors should use a lower initial sildenafil dose of 25 mg. Patient taking sildenafil for PAH with ritonavir is not recommended. pentobarbitalpentobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels pentobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenobarbitalphenobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Missed Dose Instructions

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenobarbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenoxybenzaminesildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. sildenafil increases effects of phenoxybenzamine by pharmacodynamic synergism. phentolaminesildenafil increases effects of phentolamine by pharmacodynamic synergism. sildenafil increases effects of phentolamine by pharmacodynamic synergism. armodafinilarmodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil citrate may cause a drop in blood pressure.
  • Do not consume large quantities of grapefruit juice while on sildenafil.
  • Pregnant or breastfeeding women should not use sildenafil without guidance.
  • The drug does not improve libido, only facilitates blood flow.
  • It is not intended for recreational use or enhancement.
  • Psychological factors can also affect the efficacy of sildenafil.
  • Regular medical check-ups are recommended for long-term users.

armodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Pregnancy & Lactation

ketoconazoleketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with strong CYP3A4 inhibitors and sildenafil (for pulmonary arterial hypertension) is not recommended. When used for erectile dysfunction, consider reducing initial sildenafil dose of 25 mg in patients also taking a strong CYP3A4 inhibitor and monitor for sildenafil toxicities (eg, dyspepsia, headache, hypotension). ketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lenacapavirlenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What else should I know about sildenafil?

Refer to the prescribing information of PDE5 inhibitors for dose recommendations. lenacapavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levoketoconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lonafarniblonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. artemether/lumefantrineartemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

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tovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tucatinibtucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling. tucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. atenololatenolol increases effects of sildenafil by additive vasodilation. atenolol increases effects of sildenafil by additive vasodilation.

MeSH terms

phenytoinphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels phenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels prazosinsildenafil increases effects of prazosin by pharmacodynamic synergism. sildenafil increases effects of prazosin by pharmacodynamic synergism. primidoneprimidone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Warnings for other groups

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels primidone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels relacorilantrelacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid canadian sildenafil citrate coadministration of sildenafil with strong CYP3A4 inhibitors. relacorilant increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ritonavirritonavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. betaxololbetaxolol increases effects of sildenafil by additive vasodilation. betaxolol increases effects of sildenafil by additive vasodilation.

What is Sildenafil Citrate?

lonafarnib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavirlopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lopinavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mifepristonemifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Special Populations

mitotanemitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels. mitotane decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nafcillinnafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels nafcillin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. bisoprololbisoprolol increases effects of sildenafil by additive vasodilation. bisoprolol increases effects of sildenafil by additive vasodilation.

  • Sildenafil is unsuitable for individuals with severe liver disease.
  • Patients should avoid alcohol consumption during treatment.
  • Some side effects may resolve on their own within hours.
  • Persistent side effects should prompt medical consultation.
  • The drug does not cure ED but manages symptoms.
  • Lifestyle changes can also improve erectile function.
  • Follow your healthcare provider’s instructions precisely.

bosentanbosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Parameter Description Typical Value
Absorption Rate Time to reach peak plasma concentration 30-120 minutes
Bioavailability Percentage of dose reaching systemic circulation 40%
Half-life Time to reduce plasma concentration by half 4 hours
Metabolism Primary site of metabolism Liver (CYP3A4 enzyme)
Excretion Main routes of elimination Feces and urine

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels bosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Sildenafil shortens the time to achieve an erection.
  • It does not cause spontaneous erections without sexual stimulation.
  • Overdose signs include vision changes, persistent erections, or hypotension.
  • It is linked to priapism, a sustained and painful erection.
  • Always consult a healthcare provider before starting sildenafil.
  • Store medication in a cool, dry place away from children.
  • Combining with recreational drugs can cause dangerous interactions.

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels butalbitalbutalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. butalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. carbamazepinecarbamazepine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

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Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels carbamazepine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Contraindications include use with nitrates and recent heart attack.
  • Patients with contraindications should avoid sildenafil entirely.
  • Visual disturbances including blue-tinted vision may occur.
  • Use caution in patients with liver or kidney impairment.
  • Sildenafil can interact with certain antibiotics and antifungals.
  • Always inform your doctor about other medications you're taking.
  • It does not protect against sexually transmitted infections.

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