Sildenafil 50 mg Precautions and Contraindications

[104][127] Pooled data from various clinical trials indicate that sildenafil improved the erections of 43% of patients with ED secondary to radical prostatectomy compared with 15% of those receiving placebo.

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Select the format you want to export the citation of this publication. Multi-view semi-supervised adversarial attention network for drug repurposing, Computer Methods and Programs in Biomedicine, 282, (109406), (2026). Multi‐Target Mechanisms of Moroccan Aphrodisiac Plants: An Integrative Computational and Phytochemical Investigation, Food Science & Nutrition, 14, 5, (2026). Artificial intelligence in drug research and sildenafil 25 mg tablets development: a review of methods and applications in drug repurposing, Briefings in Bioinformatics, 27, 3, (2026). Endocrine-metabolic crosstalk in erectile dysfunction: mechanistic insights and therapeutic implications, International Journal of Impotence Research, (2026).

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Therapeutic applications of phosphodiesterase inhibitors in male reproductive health: narrative review, Sexual Medicine Reviews, 14, 2, (2026). Oral suspension versus tablet sildenafil for erectile dysfunction: a prospective multicenter comparative study on patient satisfaction, International Journal of Impotence Research, (2026). Low‐intensity shockwave therapy for erectile dysfunction: An abridged Cochrane review, BJU International, 137, 6, (949-957), (2026). Current state of the problem, Andrology and Genital Surgery, 25, 4, (33-40), (2026). Emerging Trends and Research Focus in Erectile Dysfunction Treatment: A 1993–2023 Bibliometric Analysis, Andrologia, 2026, 1, (2026). [1][104] A pooled analysis of 10 placebo-controlled studies of men with severe ED (organic etiology in 60%, psychogenic

Attribute	Description	Notes
Active Ingredient	Sildenafil citrate	50 mg per tablet
Mechanism of Action	PDE5 enzyme inhibition to promote vasodilation	Enhances blood flow for erectile function
Onset of Action	30-60 minutes	Varies with food intake
Duration of Effect	Up to 4-6 hours	Effect duration can vary
Metabolism	Primarily processed in the liver through CYP3A4 and CYP2C9 enzymes	Potential drug interactions
Contraindications	Use with nitrates or contraindicated in severe cardiovascular conditions	Precautions required

in 15%, and mixed in 25% of patients) treated with sildenafil (50-100 mg in fixed- or flexible-dose studies)

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indicated that 48% of the patients usually had erections sufficient for intercourse (score of 4, with 0 being

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Br J Urol 1996;78:257-261 Rosen, RC, Riley, A, Wagner, G, Osterloh, IH, Kirkpatrick, J, Mishra, A. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Riley, AJ, Athanasiadis, L. Impotence and its non-surgical management. Br J Clin Pract 1997;51:99-103 Any commercial reuse of NEJM Group content requires permission.

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From the Department of Urology, Boston University Medical Center, Boston (I.G. ); the Department of Urology, University of California, San Francisco (T.F.L. ); the Department of Urology, University of Southern California, Los Angeles, and the Male Clinic, Santa Monica, Calif. (H.P.-N.); the Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, N.J. ); the Department of Urology, University of Virginia, Charlottesville (W.D.S. unsuccessful and 5 being almost always successful) after treatment with sildenafil, compared with 8% of those receiving placebo.

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[1][2][4][5][7][8][10][24][27][33][41][56][57][67][91][131] Brand Name: Vybrique, ViagraClasses: Phosphodiesterase Type 5 Inhibitors (24:08.12), Phosphodiesterase type 5 inhibitors (48:48.24) Sildenafil citrate (Viagra® and generic equivalents) is used orally for the treatment of erectile dysfunction (ED, impotence). [1][4][6][7][8][9][10][25][33][34][67][81][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][142][143][144][189] A thorough medical, sexual and psychosocial history, physical examination, and selective laboratory testing should be undertaken to diagnose ED, determine potential underlying causes, exclude potentially reversible or treatable causes (e.g., hypogonadism with inadequate testosterone replacement, hyperprolactinemia, drug-induced dysfunction, dyslipidemias, alcoholism, other substance abuse, hypertension, thyroid disease, cardiovascular or cerebrovascular disease, neurologic disease, adrenal dysfunction, psychologic dysfunction, marital discord, smoking), and identify appropriate treatment in conjunction with or prior to initiating vasoactive therapy (e.g., PDE 5 type inhibitor). [12][28][30][31][57][65][66][70][78][83][94][144][145][160][161][189][601][602][603] A review of the patient's current drug regimens should be conducted to detect possible drug-induced ED (e.g., certain antihypertensive, antidepressant, antipsychotic, or antiarrhythmic agents); it may be possible to substitute alternative drug(s) that lessen the risk of such dysfunction. [12][28][70][81][118][144][161][602][603] In instances where substitution therapy is not feasible, concomitant vasoactive therapy with a PDE 5 type inhibitor may promote patient compliance by counteracting ED as an adverse effect. [12][28][70][81][118][144][161][602][603] Efficacy of sildenafil is variable in patients with ED, in part depending on the underlying etiology, severity, and dose employed, but the drug generally appears to be effective in restoring sexual function to an acceptable level in the majority of treated men.

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[1][7][8][9][10][25][33][34][65][76][81][101][104][105][126][127][131][142][143][144] The erectile response generally increases with increasing sildenafil dose and plasma drug concentration, with response becoming greater at 50- and 100-mg doses than at 25 mg.[1][8][9][33][126][130][131][155] Analyses of subgroups of patients with ED indicate that efficacy of sildenafil is not affected by race or age, duration of ED, or sildenafil pills duration of select underlying disease states (e.g., diabetes mellitus), and the drug has been effective in a broad range of patients with ED, including those with a history of coronary artery disease (e.g., coronary artery bypass graft [CABG]), hypertension, other cardiac disease (including ischemic heart disease), peripheral vascular disease, type 1 or 2 diabetes mellitus, depression, radical prostatectomy, prostate brachytherapy, transurethral resection of the prostate (TURP), spina bifida, spinal cord injury, and in patients taking antidepressants, antipsychotics, diuretics, and antihypertensive agents. [1][25][30][33][34][93][101][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][144] Pooled data from numerous fixed-dose and flexible-dose studies in men with ED secondary to a broad spectrum of organic and psychogenic causes showed increases in mean rates of successful intercourse (total successes divided by total attempts) to about 66-69% in those receiving sildenafil compared with about 20-22% for placebo. Erectile response to sildenafil is better in patients whose erectile function is less impaired at treatment initiation (e.g., those with some spontaneous successful intercourse, with partial erections, with erections during sleep, or with psychogenic causes). [1][33][105][145] In one flexible-dose study (dosage titration and maintenance up to 100 mg), mean scores for number of successful penetrations returned to normal in a subgroup of patients with psychogenic causes of ED; however, mean scores for maintenance of erections during intercourse in these men were lower than in untreated healthy men. [33][34] In a study in men with ED secondary to radical prostatectomy receiving fixed-dose sildenafil (100 mg), response to therapy was greatest in those who had undergone bilateral-nerve-sparing surgery than in those who had undergone unilateral or non-nerve-sparing procedures. [76][127] In several randomized, double-blind, placebo-controlled studies in patients receiving sildenafil (flexible doses up to 100 mg

Aspect	Details	Notes
Absorption	Rapid, peak plasma levels in ~30-120 minutes	Food can delay absorption
Distribution	Binds extensively to plasma proteins	Bioavailability approximately 40%
Metabolism	Liver via CYP3A4, CYP2C9	Metabolites excreted primarily in feces
Elimination	Half-life ~4 hours, mostly excreted in feces	Dosage adjustments possible in hepatic impairment

or fixed doses ranging from 10-100 mg for 12 weeks) for the treatment of ED attributed to complications

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Fitch III, San Antonio, Tex. ; T. Garland, Lawrence, N.J.; M. Gittelman, North Miami, Fla.; D. Gleason, Tucson, Ariz.; F.

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

Govier, Seattle; L. Hoffman, Gurnee, Ill.; J.M. Kaufman, Aurora, Colo.; I. Klimberg, Ocala, Fla.; V. Longo, New London, Conn.; T. of diabetes mellitus, complications of spinal cord injury, or psychogenic causes, 48, 59, or 70% of all attempts

• Sildenafil 50 mg can be used occasionally or regularly.
• Chewing or breaking the tablet may reduce effectiveness.
• Patient fasting is not necessary but avoid heavy meals.
• Avoid grapefruit juice while taking this medication.
• Keep out of reach of children and pets.
• Emergency: seek medical help if an erection lasts over 4 hours.
• Inform your doctor about any pre-existing health conditions.
• Use caution if you're on any other medication.

at intercourse were successful, respectively, compared with 12, 13, or 29% of all attempts in those receiving placebo.

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Sex-ual behavior in the human male. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. Treatment of men with erectile dysfunction with transurethral alprostadil. Clinical Guidelines Panel on Erectile Dysfunction: summary report on the treatment of organic erectile dysfunction. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission.

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N Engl J Med 1992;326:90-94 Andersson, K-E, Wagner, G. Physiology of penile erection. The role of nitric oxide in the physiology of erection. Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Sildenafil, a sildenafil 12 5 mg novel effective oral therapy for male erectile dysfunction. [1][7][8][9][10][25][33][93] In these studies, sildenafil improved several aspects of sexual function including frequency, firmness, and

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Malloy, Philadelphia; A. McCullough, New York; J. McMurray, Huntsville, Ala.; D.F. ; J Susset, Providence, R.I.; J. Tuttle, Lexington, Ky.; G.

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Wells, Birmingham, Ala.; C. White, Mobile, Ala.; J. Young, Laguna Hills, Calif.; and N. Zinner, Torrance, Calif. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. maintenance of erection; frequency of orgasm; satisfaction and enjoyment of intercourse; and overall relationship satisfaction.

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Michael Smith of Pfizer for their assistance with data analysis; and to Dr. Patricia Leinen and Dr. Michael Sweeney for aid in the preparation of the manuscript. The other members of the Sildenafil Study Group are S. Auerbach, Newport Beach, Calif.; A.L.

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Burnett, Baltimore; R. Castellanos, Fort Myers, Fla.; L. Charles, Stratford, N.J.; F. Eid, New York; R. Feldman, Waterbury, Conn.; W. [1][8][9][33][94][107][130][131][142] Pooled data from fixed- and flexible-dose studies indicate that sildenafil (50 or 100 mg) has no effect on sexual desire (i.e., rates of attempted intercourse, which averaged about 2 per week), but the rate of success increased to an average of 1.3 events per patient per week from 0.4 events per week with placebo.

• Always take sildenafil with a full glass of water.
• Use the medication responsibly to avoid dependency.
• Do not share your medication with others.
• Regular check-ups are recommended during use.
• Report any vision or hearing disturbances immediately.
• Use caution if combining with antihypertensive drugs.
• It is not intended for use in erectile enhancement alone.
• Follow legal and medical guidelines for purchase.