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Alpha-blockers Use caution when co-administering alpha-blockers with Viagra because of potential additive blood pressure-lowering effects. When Viagra is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating Viagra treatment and Viagra should be initiated at the lowest dose [see Dosage and Administration 2.
Amlodipine When Viagra mg was co-administered with amlodipine 5 mg or 10 mg to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic [see Warnings and Precautions 5.
It is therefore recommended not to exceed a maximum single dose of 25 mg of Viagra in a 48 hour period [see Dosage and Administration 2. Stronger CYP3A4 inhibitors such as ketoconazole or itraconazole could be expected to have greater effects than seen with saquinavir. A starting dose of 25 mg of Viagra should be considered in patients taking erythromycin or strong CYP3A4 inhibitors such as saquinavir, ketoconazole, itraconazole [see Dosage and Administration 2.
Alcohol In a drug-drug interaction study sildenafil 50 mg given with alcohol 0. There are no data with the use of Viagra in pregnant women to inform any drug-associated risks for adverse developmental outcomes.
Lactation Risk Summary Viagra is not indicated for use in females. Limited data indicate that sildenafil and its active metabolite are present in human milk. There is no information on the effects on the breastfed child, or the effects on milk production. Pediatric Use Viagra is not indicated for use in pediatric patients. Safety and effectiveness have not been established in pediatric patients. However, since higher plasma levels may increase the incidence of adverse reactions, a starting dose of 25 mg should be considered in older subjects due to the higher systemic exposure [see Dosage and Administration 2.
A starting dose of 25 mg should be considered in patients with severe renal impairment [see Dosage and Administration 2. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function Child-Pugh Class C have not been studied. A starting dose of 25 mg should be considered in patients with any degree of hepatic impairment [see Dosage and Administration 2. Overdosage In studies with healthy volunteers of single doses up to mg, adverse reactions were similar to those seen at lower doses but incidence rates and severities were increased.
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Viagra Description Viagra sildenafil citrate , an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate cGMP -specific phosphodiesterase type 5 PDE5. Sildenafil citrate is designated chemically as 1-[[3- 6,7-dihydromethyloxopropyl-1H-pyrazolo[4,3-d]pyrimidinyl ethoxyphenyl]sulfonyl]methylpiperazine citrate and has the following structural formula: Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.
Viagra is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and mg of sildenafil for oral administration. Viagra - Clinical Pharmacology Mechanism of Action The physiologic mechanism of erection of the penis involves release of nitric oxide NO in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate cGMP , producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.
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