Sildenafil citrate 100 mg starting dose in men with erectile dysfunction in an international, double-blind, placebo-controlled study: effect on the sexual experience and reducing feelings of anxiety about the next intercourse attempt

erythromycin baseerythromycin base will increase the level or

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bisoprololbisoprolol increases effects of sildenafil by additive vasodilation. bisoprolol increases effects of sildenafil by additive vasodilation. bosentanbosentan 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 bosentan 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 butalbitalbutalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Pulmonary Arterial Hypertension

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. 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. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels carvedilolcarvedilol increases effects of sildenafil by additive vasodilation. carvedilol increases effects of sildenafil by additive vasodilation.

Erectile Dysfunction

cenobamatecenobamate will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increase dose of CYP3A4 substrate, as needed, when coadministered sildenafil 50mg tablet with cenobamate. cenobamate will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cimetidinecimetidine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cimetidine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. effect of sildenafil by

affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Why is this medication prescribed?

Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. enzalutamideenzalutamide 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 enzalutamide 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 epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation. epoprostenol increases effects of sildenafil by additive vasodilation. Consider a starting dose of 25 mg in patients treated with erythromycin.

• People with heart problems should consult a doctor before using sildenafil 100 mg.
• Sildenafil is contraindicated in patients with severe liver or kidney impairment.
• Allergic reactions, though rare, may include rash, itching, or swelling.

erythromycin base will increase the level or effect

Ethics declarations

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. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels terazosinsildenafil increases effects of terazosin by pharmacodynamic synergism.

Marketing and sales

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

Alcohol interaction warning

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. acebutololacebutolol increases effects of sildenafil by additive vasodilation. of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• Sildenafil citrate 100 mg should be taken approximately 30-60 minutes before sexual activity.
• Avoid taking sildenafil with a high-fat meal, as it may delay absorption.
• Do not exceed one dose in 24 hours to reduce risk of side effects.

erythromycin ethylsuccinate will increase the level or effect

2.2 Use with Food

duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• Store sildenafil citrate 100 mg at room temperature, away from moisture and heat.
• Keep out of reach of children and pets for safety reasons.
• Check the expiration date before use to ensure medication efficacy.

erythromycin lactobionateerythromycin lactobionate will

8.7 Hepatic Impairment

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels efavirenz 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 elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. increase the level or

effect of sildenafil by

8.6 Renal Impairment

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

Corresponding author

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

Competing interests

artemether/lumefantrine will decrease 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. betaxololbetaxolol increases effects of sildenafil by additive vasodilation. betaxolol increases effects of sildenafil by additive vasodilation. affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionate will increase the level or effect

of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

6.2 Postmarketing Experience

cyclosporinecyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazoldanazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. darunavirdarunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Effets indésirables

Coadministration with PDE-5 inhibitors may result in an increase in PDE-5 inhibitor-associated adverse reactions (eg, hypotension, syncope, visual disturbances and priapism). darunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasiroxdeferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasonedexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

How sildenafil is used

dexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazemdiltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedaronedronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.