Sildenafil

Sildenafil is a phosphodiesterase type 5 (pde5) inhibitor medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Erectile dysfunction in adult men.
• Pulmonary arterial hypertension, when a sildenafil product and dose are specifically prescribed for this condition.

For erectile dysfunction, sildenafil is usually taken only when needed before sexual activity, and not more often than directed by the doctor. For pulmonary arterial hypertension, it is taken on a regular schedule as prescribed. The correct dose and timing depend on the indication, age, other illnesses, and other medicines being used; follow the prescribing doctor’s instructions and do not change the dose without medical advice.

• Common side effects may include headache, flushing, indigestion, nasal congestion, dizziness, nausea, and visual disturbances such as a blue tinge or blurred vision.
• Serious effects needing urgent medical help include chest pain, fainting, severe dizziness, sudden loss of vision, sudden decrease or loss of hearing, allergic reaction, or an erection lasting more than 4 hours.

Use sildenafil with caution in people with heart disease, low or uncontrolled high blood pressure, a history of stroke or heart attack, liver or severe kidney disease, bleeding disorders, stomach ulcer, penile deformity, conditions predisposing to priapism such as sickle cell disease, leukemia or multiple myeloma, or eye conditions such as retinitis pigmentosa or previous non-arteritic anterior ischemic optic neuropathy. Sexual activity may not be advisable for some heart patients; medical assessment is important. Use this medicine only under the guidance of a registered doctor or pharmacist.

• Nitrates such as nitroglycerin, isosorbide dinitrate, or isosorbide mononitrate: contraindicated due to risk of severe hypotension.
• Riociguat: contraindicated due to risk of severe hypotension.
• Alpha-blockers and other blood pressure-lowering medicines: may increase dizziness or low blood pressure.
• Strong CYP3A4 inhibitors such as ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin, and some other HIV or antifungal medicines can increase sildenafil levels and side effects.
• CYP3A4 inducers such as rifampicin may reduce sildenafil effect.
• Grapefruit or grapefruit juice may increase sildenafil exposure and side effects.
• Alcohol can worsen dizziness, low blood pressure, and erectile dysfunction.
• Do not combine with other PDE5 inhibitors or other erectile dysfunction medicines unless specifically advised by a doctor.

• Known hypersensitivity to sildenafil or any component of the product.
• Use with any nitrate medicine or nitric oxide donor, whether regular or intermittent.
• Use with riociguat.
• Use in patients for whom sexual activity is medically inadvisable because of significant cardiovascular risk, unless cleared by a doctor.

Sildenafil for erectile dysfunction is not intended for use in women. For pulmonary arterial hypertension, use during pregnancy or breastfeeding only if clearly prescribed by a specialist after weighing benefits and risks. Small amounts may pass into breast milk; breastfeeding patients should seek medical advice before use.

Store tablets at room temperature, away from excess heat, moisture, and direct light. Keep in the original packaging, out of the reach of children, and do not use after the expiry date.