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Sildenafil Citrate is an oral drug for male impotence, also known as erectile dysfunction (ED). It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.

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Sildenafil Citrate causes erections only during sexual excitement. It does not work in the absence of arousal.

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Taking Sildenafil Citrate approximately 1 hour before sexual activity works best for most men. Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.

If you miss a dose of Sildenafil Citrate

Sildenafil Citrate is not for regular use. Take it only before sexual activity.

Storage instructions for Sildenafil Citrate

Store at room temperature.

What side effects may occur when taking Sildenafil Citrate?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Sildenafil Citrate.

More common side effects of Sildenafil Citrate may include:

Abnormal vision (color tinge, blurring, sensitivity to light), acid indigestion, diarrhea, flushing, headache, nasal congestion, urinary tract infection
Heart attack, stroke, heart irregularities, dangerous surges in blood pressure, and sudden death have all been reported after use of Sildenafil Citrate, usually in men with existing cardiac risk factors, and typically during or shortly after sex.

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Do not take Sildenafil Citrate if you are taking any nitrate-based drug, including nitroglycerin patches (Nitro-Dur, Transderm-Nitro), nitroglycerin ointment (Nitro-Bid, Nitrol), nitroglycerin pills (Nitro-Bid, Nitrostat), and isosorbide pills (Dilatrate-SR, Isordil, Sorbitrate). Combining Sildenafil Citrate with these drugs can cause a severe drop in blood pressure.

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If you have heart problems severe enough to make sexual activity a danger, you should avoid using Sildenafil Citrate. Use it cautiously--if at all--if you've had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months. Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time).

If you take Sildenafil Citrate and develop cardiac symptoms (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue. Alert your doctor to the problem as soon as possible.

If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Sildenafil Citrate with caution. Also use cautiously if you have a genital problem or deformity such as Peyronie's disease. If an erection lasts more than 4 hours, seek treatment immediately. Permanent damage and impotence could result.

If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use this medication with caution. Its safety under these circumstances has not yet been studied.

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Sildenafil Citrate within 4 hours of taking an alpha-blocking drug such as Cardura.

Remember that Sildenafil Citrate offers no protection from transmission of sexually transmitted diseases, such as HIV, the virus that causes AIDS.

Possible food and drug interactions when taking Sildenafil Citrate

If Sildenafil Citrate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Sildenafil Citrate with the following:

Other impotence remedies including Caverject and Muse
Alpha-blockers such as doxazosin (Cardura)
Amlodipine (Norvasc)
Cimetidine (Tagamet)
Erythromycin (E-Mycin, Ery-Tab, PCE)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nitrates such as Isordil, Nitro-Bid, and Nitro-Dur
Rifampin (Rifadin, Rimactane)
Ritonavir (Norvir)
Saquinavir (Fortovase, Invirase)

Special information on Sildenafil Citrate if you are pregnant or breastfeeding

Sildenafil Citrate should not be used by women. Its affects during pregnancy and breastfeeding have not been studied.

Recommended dosage of Sildenafil Citrate

Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect. The usual dose is 50 milligrams. If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoconazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient. Your doctor will adjust the dosage if the drug is not working properly for you.

Take Sildenafil Citrate only before sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Sildenafil Citrate within 4 hours of taking an alpha-blocking drug such as Cardura.

Overdosage when taking Sildenafil Citrate

No overdose of Sildenafil Citrate has been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

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