Take 1 dose as needed about 1hr (½–4hrs) before sexual activity at frequency of up to once daily. Initially 50mg. May reduce dose to 25mg or increase to max of 100mg. Elderly, hepatic impairment, severe renal impairment, or concomitant strong CYP3A4 inhibitors: consider initial dose of 25mg. Concomitant ritonavir: max single sildenafil dose of 25mg in 48hrs. Concomitant α-blockers (patients should be stable on α-blocker therapy before starting): initially 25mg.

Not established.

Concomitant organic nitrates or nitric oxide donors (eg, sodium nitroprusside). Concomitant guanylate cyclase (GC) stimulators (eg, riociguat).

Confirm diagnosis. Cardiovascular disease (eg, MI, stroke, or life-threatening arrhythmia within 6 months; BP170/110; unstable angina, LV outflow obstruction, impaired autonomic regulation of BP). Anatomical penile deformation. Predisposition to priapism. History of non-arteritic anterior ischemic optic neuropathy (NAION) or those with “crowded” optic disc. Retinitis pigmentosa. Advise patients to discontinue if sudden vision or hearing loss occurs. Patients for whom sexual activity is inadvisable or contraindicated. Bleeding disorders. Active peptic ulcer.

See Contraindications. Hypotension with nitrates, GC stimulators. Additive hypotensive effects with concomitant α-blockers (eg, doxazosin), antihypertensives (eg, amlodipine). Potentiated by CYP3A4 (eg, ketoconazole, itraconazole, erythromycin, saquinavir, ritonavir) or CYP2C9 inhibitors, or cimetidine. Antagonized by CYP3A4 inducers (eg, rifampin). Concomitant other erectile dysfunction treatments: not recommended.

Take 1 dose as needed about 1hr (½–4hrs) before sexual activity at frequency of up to once daily. Initially 50mg. May reduce dose to 25mg or increase to max of 100mg. Elderly, hepatic impairment, severe renal impairment, or concomitant strong CYP3A4 inhibitors: consider initial dose of 25mg. Concomitant ritonavir: max single sildenafil dose of 25mg in 48hrs. Concomitant α-blockers (patients should be stable on α-blocker therapy before starting): initially 25mg.

Not established.

Concomitant organic nitrates or nitric oxide donors (eg, sodium nitroprusside). Concomitant guanylate cyclase (GC) stimulators (eg, riociguat).

Confirm diagnosis. Cardiovascular disease (eg, MI, stroke, or life-threatening arrhythmia within 6 months; BP170/110; unstable angina, LV outflow obstruction, impaired autonomic regulation of BP). Anatomical penile deformation. Predisposition to priapism. History of non-arteritic anterior ischemic optic neuropathy (NAION) or those with “crowded” optic disc. Retinitis pigmentosa. Advise patients to discontinue if sudden vision or hearing loss occurs. Patients for whom sexual activity is inadvisable or contraindicated. Bleeding disorders. Active peptic ulcer.

See Contraindications. Hypotension with nitrates, GC stimulators. Additive hypotensive effects with concomitant α-blockers (eg, doxazosin), antihypertensives (eg, amlodipine). Potentiated by CYP3A4 (eg, ketoconazole, itraconazole, erythromycin, saquinavir, ritonavir) or CYP2C9 inhibitors, or cimetidine. Antagonized by CYP3A4 inducers (eg, rifampin). Concomitant other erectile dysfunction treatments: not recommended.