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In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to sildenafil.

Immediate action required: Call 999 or go to A&E if: you get a skin rash that may include itchy, red, swollen, blistered or peeling skin you're wheezing you get tightness in the chest or throat you have trouble breathing or talking your mouth, face, lips, tongue or throat start swelling. You could be having a serious allergic reaction and may need immediate treatment in hospital.

For a full list, see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme. Sildenafil is not recommended in pregnancy and while breastfeeding. Non-urgent advice: Tell your doctor if you're: trying to get pregnant pregnant breastfeeding.

Tell your doctor if you're taking these medicines before you start sildenafil : nitrates for chest pain riociguat for pulmonary hypertension recreational drugs called poppers, such as amyl nitrite.

Mixing sildenafil with herbal remedies and supplements.

Some

complementary

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

Sildenafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. It works if you have erection problems by temporarily increasing blood flow to the penis when you get sexually excited.

It works in pulmonary hypertension by relaxing blood vessels in the chest.

This increases the blood supply to the lungs and reduces the workload of the heart. In general, at least two-thirds of men say they have harder erections after taking it. If sildenafil does not work for you, it may be because: you have not waited long enough after taking it before trying to have sex you have waited too long after taking it to have sex the dose is not high enough you're not sexually aroused enough.

Sildenafil usually starts to work within 30 to 60 minutes.

It's triggered by sexual stimulation, so you need to be aroused for it to work. You should be able to get an erection at any time between 1 and 4 hours after taking sildenafil.

Your erection should go away after you have had sex.

If you're taking sildenafil for erectile dysfunction, do not take it more than once a day. If you're taking sildenafil (Revatio) for pulmonary hypertension, do not take it more than 3 times a day. There do not seem to be any lasting harmful effects from taking it for many months and years. If sildenafil does not work, there are other tablets you could try that work in a similar way, such as: tadalafil (Cialis) - can be taken up to 36 hours before sex avanafil (Spedra) - can be taken up to around 4 hours before sex vardenafil (Levitra) - can be taken up to around 4 hours before sex. This is a man-made hormone that helps to stimulate blood flow to the penis.

Alprostadil comes as: an injection directly into your penis a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) If you cannot get erections because of a hormonal problem, your GP may refer you to an endocrinologist (who specialises in the treatment of hormonal problems).

You may benefit from treatment using injections of man-made hormones to restore your hormone levels to normal. Other treatments for erectile dysfunction include: a vacuum pump psychological treatments penile implants pelvic floor muscle exercises. Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. There are lots of treatments that claim to be a "herbal Viagra". A herbal Viagra has never been approved as a treatment for erectile dysfunction.

Women can use sildenafil for pulmonary hypertension.

There's no good evidence that sildenafil works for women with sexual problems.

There's no firm evidence to suggest that taking sildenafil will reduce fertility in either women or men.

But speak to a pharmacist or your doctor before taking it if you're trying to get pregnant. Sildenafil does not affect any type of contraception, including the contraceptive pill and emergency contraception. A beer or a couple of glasses of wine are not likely to stop or delay sildenafil working. But drinking lots of alcohol can make it more difficult to get an erection. To get the most benefit from sildenafil, do not drink heavily before taking it.

Taking poppers (amyl nitrite) with sildenafil can have a dangerous effect on your heart. It

can

Sildenafil has not been properly tested with recreational drugs. Talk to your doctor if you think you might use any recreational drugs with sildenafil.

Do not drink grapefruit juice if you're taking sildenafil (Revatio) for pulmonary hypertension. You can eat and drink normally while taking sildenafil (Viagra) to get an erection.

Erectile dysfunction can often be improved if you make changes to your lifestyle, such as: Related conditions.

Ejaculation problems Erectile dysfunction (impotence) Male sexual problems Priapism (painful erections) Pulmonary hypertension.

Relate (sex therapy): charity Sexual Advice Association: charity Sildenafil: forum Viagra: forum.

Page last reviewed: 22 January 2019 Next review due: 22 January 2022. Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men.

Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child's condition. Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV). Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often.

However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work. If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food.

Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer's directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication. If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication.

Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it.

Do not stop taking sildenafil without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Before taking sildenafil, tell your doctor and pharmacist if you are allergic to sildenafil, any other medications, or any of the ingredients in sildenafil products. do not take sildenafil if you are taking or have recently taken purchase viagra no prescription riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.

do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), and terazosin; amlodipine (Norvasc, in Amturnide, in Tekamlo); certain antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain barbiturates such as butalbital (in Butapap, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal LA, InnoPran); bosentan (Tracleer); cimetidine ; efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase; no longer available in the U.S.), atazanavir (Reyataz, in Evotaz), darunavir (Prezista, in Prezcobix), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction; medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol, others), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

tell your doctor what herbal products you are taking or plan to take, especially St.

tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration).

This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids.

Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see. if you are a woman and you are taking sildenafil to treat PAH, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking sildenafil, call your doctor.

if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.

if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity.

Sexual activity may be a strain on your heart, especially if you have heart disease.

If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.

tell all your healthcare providers that you are taking sildenafil.

If you ever need emergency medical treatment for a heart problem, the healthcare providers who treat you will need to know when you last took sildenafil.

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.

If you are taking sildenafil for PAH, take the missed dose as soon as you remember it.

However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Tell your doctor if any of these symptoms are severe or do not go away: headache heartburn diarrhea flushing (feeling of warmth) nosebleeds difficulty falling asleep or staying asleep numbness, burning, or tingling in the arms, hands, feet, or legs muscle aches changes in color vision (seeing a blue tinge on

objects

It is not known if the vision loss was caused by the medication.

If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil.

It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.

Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped.

It is not known if the hearing loss was caused by the medication.

If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately.

If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children.

Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the

suspension

To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.

Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222.

Information is also available online at https://www.poisonhelp.org/help.

If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Ask your pharmacist any questions you

have