Viagra
trademark for a preparation of sildenafil citrate, a treatment for erectile dysfunction.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
sildenafil citrate
Revatio, Viagra
Pharmacologic class: Phosphodiesterase type 5 (PDE5) inhibitor
Therapeutic class: Anti-erectile dysfunction agent
Pregnancy risk category B
Action
Inhibits PDE5, enhancing the effects of nitric oxide released during sexual stimulation. This action inactivates cyclic guanosine monophosphate (cGMP), which then increases cGMP levels in corpus cavernosum. Resulting smooth muscle relaxation promotes increased blood flow and subsequent erection.
Availability
Tablets: 25 mg, 50 mg, 100 mg
⊘Indications and dosages
➣ Erectile dysfunction
Adults: 50 mg P.O., preferably 1 hour before anticipated sexual activity. Range is 25 to 100 mg taken 30 minutes to 4 hours before sexual activity, not to exceed one dose daily.
Dosage adjustment
• Hepatic or renal impairment
• Concurrent use of hepatic isoenzyme inhibitors (such as cimetidine, erythromycin, itraconazole, ketoconazole)
• Elderly patients
Contraindications
• Hypersensitivity to drug
• Concurrent use of nitrates (nitroglycerin, isosorbide mononitrate or dinitrate)
Precautions
Use cautiously in:
• serious cardiovascular disease (such as history of myocardial infarction, cerebrovascular accident, or serious arrhythmia within past 6 months); coronary artery disease (current or previous) with unstable angina; resting blood pressure below 90/50 mm Hg or above 170/110 mm Hg (current or previous); heart failure (current or previous); renal or hepatic impairment (current or previous); bleeding disorder; active peptic ulcer; anatomic penile deformity; retinitis pigmentosa; conditions associated with priapism (sickle cell anemia, multiple myeloma, leukemia)
• history of uncontrolled hypertension or hypotension
• concurrent use of antihypertensives, erythromycin, ketoconazole, itraconazole, or saquinavir
• patients older than age 65.
Administration
☞ Don't give concurrently with nitrates.
• Administer 30 minutes to 4 hours before sexual activity.
Route Onset Peak Duration
P.O. Within 1 hr Unknown Up to 4 hr
Adverse reactions
CNS: headache, dizziness, anxiety, drowsiness, vertigo, seizures , cerebrovascular hemorrhage, transient ischemic attack
CV: hypertension, myocardial infarction (MI), cardiovascular collapse, ventricular arrhythmias, sudden death
EENT: transient vision loss, blurred or color-tinged vision, increased light sensitivity, ocular redness, retinal bleeding, vitreous detachment or traction, photophobia, nasal congestion
GI: diarrhea, dyspepsia
GU: hematuria, urinary tract infection, priapism
Skin: flushing, rash
Interactions
Drug-drug. Antihypertensives, nitrates: increased risk of hypotension
Enzyme inducers, rifampin: reduced sildenafil blood level
Hepatic isoenzyme inhibitors (such as cimetidine, erythromycin, itraconazole, ketoconazole), protease inhibitors (such as indinavir, nelfinavir, ritonavir, saquinavir): increased sildenafil blood level and effects
Drug-food. High-fat diet: reduced drug absorption, decreased peak level
Patient monitoring
• Monitor cardiovascular status carefully.
• Evaluate patient's vision.
• Assess for drug efficacy.
Patient teaching
• Advise patient to take 30 minutes to 4 hours before sexual activity.
• Tell patient not to exceed prescribed dosage or take more than one dose daily.
☞ Instruct patient to stop sexual activity and contact prescriber immediately if chest pain, dizziness, or nausea occurs.
☞ Teach patient to recognize and immediately report serious cardiac and vision problems.
• Inform patient that drug can cause serious interactions with many common drugs. Instruct him to tell all prescribers he's taking it.
☞ Caution patient never to take drug with nitrates, because of risk of potentially fatal hypotension.
• Instruct patient to report priapism (persistent, painful erection) or erections lasting more than 4 hours.
• Tell patient that high-fat diet may interfere with drug efficacy.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and foods mentioned above.
Trade name of an orally administered drug for erectile failure first cleared for marketing in the United States in March 1998. Its generic name is sildenafil citrate.
Mentioned in: Impotence
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.
trademark for a preparation of sildenafil citrate, a treatment for erectile dysfunction.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
sildenafil citrate
Revatio, Viagra
Pharmacologic class: Phosphodiesterase type 5 (PDE5) inhibitor
Therapeutic class: Anti-erectile dysfunction agent
Pregnancy risk category B
Action
Inhibits PDE5, enhancing the effects of nitric oxide released during sexual stimulation. This action inactivates cyclic guanosine monophosphate (cGMP), which then increases cGMP levels in corpus cavernosum. Resulting smooth muscle relaxation promotes increased blood flow and subsequent erection.
Availability
Tablets: 25 mg, 50 mg, 100 mg
⊘Indications and dosages
➣ Erectile dysfunction
Adults: 50 mg P.O., preferably 1 hour before anticipated sexual activity. Range is 25 to 100 mg taken 30 minutes to 4 hours before sexual activity, not to exceed one dose daily.
Dosage adjustment
• Hepatic or renal impairment
• Concurrent use of hepatic isoenzyme inhibitors (such as cimetidine, erythromycin, itraconazole, ketoconazole)
• Elderly patients
Contraindications
• Hypersensitivity to drug
• Concurrent use of nitrates (nitroglycerin, isosorbide mononitrate or dinitrate)
Precautions
Use cautiously in:
• serious cardiovascular disease (such as history of myocardial infarction, cerebrovascular accident, or serious arrhythmia within past 6 months); coronary artery disease (current or previous) with unstable angina; resting blood pressure below 90/50 mm Hg or above 170/110 mm Hg (current or previous); heart failure (current or previous); renal or hepatic impairment (current or previous); bleeding disorder; active peptic ulcer; anatomic penile deformity; retinitis pigmentosa; conditions associated with priapism (sickle cell anemia, multiple myeloma, leukemia)
• history of uncontrolled hypertension or hypotension
• concurrent use of antihypertensives, erythromycin, ketoconazole, itraconazole, or saquinavir
• patients older than age 65.
Administration
☞ Don't give concurrently with nitrates.
• Administer 30 minutes to 4 hours before sexual activity.
Route Onset Peak Duration
P.O. Within 1 hr Unknown Up to 4 hr
Adverse reactions
CNS: headache, dizziness, anxiety, drowsiness, vertigo, seizures , cerebrovascular hemorrhage, transient ischemic attack
CV: hypertension, myocardial infarction (MI), cardiovascular collapse, ventricular arrhythmias, sudden death
EENT: transient vision loss, blurred or color-tinged vision, increased light sensitivity, ocular redness, retinal bleeding, vitreous detachment or traction, photophobia, nasal congestion
GI: diarrhea, dyspepsia
GU: hematuria, urinary tract infection, priapism
Skin: flushing, rash
Interactions
Drug-drug. Antihypertensives, nitrates: increased risk of hypotension
Enzyme inducers, rifampin: reduced sildenafil blood level
Hepatic isoenzyme inhibitors (such as cimetidine, erythromycin, itraconazole, ketoconazole), protease inhibitors (such as indinavir, nelfinavir, ritonavir, saquinavir): increased sildenafil blood level and effects
Drug-food. High-fat diet: reduced drug absorption, decreased peak level
Patient monitoring
• Monitor cardiovascular status carefully.
• Evaluate patient's vision.
• Assess for drug efficacy.
Patient teaching
• Advise patient to take 30 minutes to 4 hours before sexual activity.
• Tell patient not to exceed prescribed dosage or take more than one dose daily.
☞ Instruct patient to stop sexual activity and contact prescriber immediately if chest pain, dizziness, or nausea occurs.
☞ Teach patient to recognize and immediately report serious cardiac and vision problems.
• Inform patient that drug can cause serious interactions with many common drugs. Instruct him to tell all prescribers he's taking it.
☞ Caution patient never to take drug with nitrates, because of risk of potentially fatal hypotension.
• Instruct patient to report priapism (persistent, painful erection) or erections lasting more than 4 hours.
• Tell patient that high-fat diet may interfere with drug efficacy.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and foods mentioned above.
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