Viagra Dosage Guide. Sildenafil Dosage Guide with Precautions.

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Viagra Dosage

Generic name: SILDENAFIL CITRATE 25mg

Dosage form: tablet, film coated

Dosage Information

For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, VIAGRA may be taken anywhere from 30 minutes to 4 hours before sexual activity.
The maximum recommended dosing frequency is once per day.
Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.

Use with Food

VIAGRA may be taken with or without food.

Dosage Adjustments in Specific Situations

VIAGRA was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors such as organic nitrates or organic nitrites in any form is therefore contraindicated.
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 25 mg.

Dosage Adjustments Due to Drug Interactions

Ritonavir

The recommended dose for ritonavir-treated patients is 25 mg prior to sexual activity and the recommended maximum dose is 25 mg within a 48 hour period because concomitant administration increased the blood levels of sildenafil by 11-fold.

CYP3A4 Inhibitors

Consider a starting dose of 25 mg in patients treated with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, or saquinavir) or erythromycin. Clinical data have shown that co-administration with saquinavir or erythromycin increased plasma levels of sildenafil by about 3 fold.

Dosage Adjustments in Special Populations

Consider a starting dose of 25 mg in patients > 65 years, patients with hepatic impairment (e.g., cirrhosis), and patients with severe renal impairment (creatinine clearance <30 mL/minute) because administration of VIAGRA in these patients resulted in higher plasma levels of sildenafil.


Information by https://www.drugs.com/dosage/viagra.html


Sildenafil Dosage

Usual Adult Dose for:
  • Erectile Dysfunction
  • Pulmonary Hypertension

Usual Geriatric Dose for:
  • Erectile Dysfunction

Additional dosage information:
  • Renal Dose Adjustments
  • Liver Dose Adjustments
  • Dose Adjustments
  • Precautions
  • Dialysis
  • Other Comments

Usual Adult Dose for Erectile Dysfunction

Initial dose: 50 mg orally once a day, as needed, 1 hour prior to sexual activity
Maintenance: 25 to 100 mg orally once a day, as needed, 1 hour prior to sexual activity

Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity.

Use: Treatment of erectile dysfunction

Usual Adult Dose for Pulmonary Hypertension

Revatio (R):

Oral:
-Initial dose: 5 or 20 mg orally three times a day, 4 to 6 hours apart
-Maximum dose: 20 mg orally three times a day

Injection:
-Initial dose: 2.5 or 10 mg IV bolus three times a day

Comments:
-No greater efficacy was achieved with oral doses higher than the maximum recommended dose.
-A 10 mg injection dose is predicted to provide pharmacological effect equivalent to the 20 mg oral dose.

Use: Treatment of PAH (WHO Group I) in adults to improve exercise ability and delay clinical worsening

Usual Geriatric Dose for Erectile Dysfunction

Initial dose: 25 mg orally once a day 1 hour prior to sexual activity

Use: Treatment of erectile dysfunction

Renal Dose Adjustments

Erectile dysfunction:
-Mild to moderate renal dysfunction (CrCl 30 to less than 80 mL/min): No adjustment recommended.
-Severe renal dysfunction (CrCl less than 30 mL/min): 25 mg orally once a day 1 hour prior to sexual activity

Pulmonary Arterial Hypertension:
Revatio (R):
-No adjustment recommended.

Liver Dose Adjustments

Erectile dysfunction:
-Initial dose: 25 mg orally should be considered in patients with any degree of hepatic impairment

Pulmonary Arterial Hypertension:
Revatio (R):
-Mild to moderate hepatic dysfunction (Child-Pugh Class A and B): No adjustment recommended.
-Severe hepatic dysfunction (Child-Pugh Class C): Has not been studied

Dose Adjustments

Concomitant administration with alpha blockers:
-Initial dose: 25 mg orally 1 hour prior to sexual activity
-Patients should be stable on alpha blocker therapy prior initiating treatment with this drug.

Concomitant administration with ritonavir:
-Initial dose: 25 mg orally 1 hour prior to sexual activity
-Maximum dose: 25 mg within a 48 hour period

Concomitant administration with CYP450 3A4 inhibitors (ketoconazole, itraconazole, saquinavir) or erythromycin:
-Initial dose: 25 mg orally 1 hour prior to sexual activity

Revatio (R) for the treatment of pulmonary arterial hypertension in elderly patients: Caution is recommended when selecting or adjusting dose in this population.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-This drug may be taken with or without food.
-Revatio (R) IV injection is for the continued treatment of patients with pulmonary arterial hypertension (PAH) currently taking oral Revatio (R) and temporarily unable to take oral medication.

General:
-This drug is indicated for treatment of erectile dysfunction in male adult patients, and is also marketed as Revatio (R) to treat PAH in children and adults.
-Limitation of use: Adding Revatio (R) to bosentan therapy does not result in any beneficial effect on exercise capacity.

Monitoring:
-Cardiovascular: Blood pressure

Patient advice:
-This drug offers no protection against sexually transmitted diseases. Consider protective measures against sexually transmitted diseases.
-Patients should seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking this drug.
-Patients should seek immediate medical attention in the event of sudden decrease or loss of hearing while taking this drug.
-Patients taking Revatio (R) should not take sildenafil for erectile dysfunction or other PDE-5 inhibitors.


Information by https://www.drugs.com/dosage/sildenafil.html

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