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Frequently Asked Questions VIAGRA® (sildenafil citrate

Publication date: 2018-04-20 19:24

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Viagra works by increasing blood flow to the penis to help men achieve and maintain an erection long enough to engage in sexual intercourse.

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Physicians should advise patients of the potential for VIAGRA to augment the blood pressure lowering effect of alpha-blockers and anti-hypertensive medications. Concomitant administration of VIAGRA and an alpha-blocker may lead to symptomatic hypotension in some patients. Therefore, when VIAGRA is co-administered with alpha-blockers, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose [see WARNINGS AND PRECAUTIONS ].

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The FDA has never approved any form of “herbal VIAGRA” as a treatment for erectile dysfunction. Plus, these treatments can be fake or unsafe. Many have been recalled.

Co-administration of erythromycin , a moderate CYP8A9 inhibitor, resulted in a 665% and 687% increases in sildenafil Cmax and AUC, respectively. Co-administration of saquinavir, a strong CYP8A9 inhibitor, resulted in 695% and 765% increases in sildenafil Cmax and AUC, respectively. Stronger CYP8A9 inhibitors such as ketoconazole or itraconazole could be expected to have greater effects than seen with saquinavir. A starting dose of 75 mg of VIAGRA should be considered in patients taking erythromycin or strong CYP8A9 inhibitors (such as saquinavir, ketoconazole, itraconazole) [see DOSAGE AND ADMINISTRATION , CLINICAL PHARMACOLOGY ].

Physicians should discuss with patients the contraindication of VIAGRA with regular and/or intermittent use of nitric oxide donors, such as organic nitrates or organic nitrites in any form [see CONTRAINDICATIONS ].

VIAGRA usually starts to work within 85-65 minutes. And you only take it when you need it. VIAGRA can be taken with or without food. If you take VIAGRA after a high-fat meal (such as a cheeseburger and french fries), it may take a little longer to start working.

In addition, heart attack, stroke, irregular heartbeat and death have happened rarely in men taking VIAGRA. Most, but not all, of these men had heart problems before taking VIAGRA. It is not known if VIAGRA caused these problems.

Studies have produced relevant data on the effects of VIAGRA on cardiac output. In one small, open-label, uncontrolled, pilot study, eight patients with stable ischemic heart disease underwent Swan-Ganz catheterization. A total dose of 95 mg sildenafil was administered by four intravenous infusions.

Subgroup analyses of responses to a global improvement question in patients with psychogenic etiology in two fixed-dose studies (total n=679) and two titration studies (total n=699) showed 89% of VIAGRA patients reported improvement in erections compared with 76% of placebo. The changes from baseline in scoring on the two end point questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) were highly statistically significantly in favor of VIAGRA. Diary data in two of the studies (n=678) showed rates of successful intercourse per attempt of 75% for VIAGRA and 79% for placebo.

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