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Publication date: 2018-04-21 17:16

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After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the feces (approximately 85% of administered oral dose) and to a lesser extent in the urine (approximately 68% of the administered oral dose). Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.

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Physicians should discuss with patients the contraindication of VIAGRA with use of guanylate cyclase stimulators such as riociguat [see CONTRAINDICATIONS ].

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In addition, N-desmethyl metabolite AUC and Cmax values significantly increased by 755% and 79%, respectively in subjects with severe renal impairment compared to subjects with normal renal function.

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There was no impairment of fertility in rats given sildenafil up to 65 mg/kg/day for 86 days to females and 657 days to males, a dose producing an AUC value of more than 75 times the human male AUC.

The mean profiles of the change from baseline in standing systolic blood pressure in subjects treated with doxazosin in combination with 55 mg VIAGRA or matching placebo are shown in Figure 8.

The mean profiles of the change from baseline in standing systolic blood pressure in subjects treated with doxazosin in combination with 655 mg VIAGRA or matching placebo are shown in Figure 9.

The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

VIAGRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take VIAGRA if you take any other medicines called &ldquo nitrates.&rdquo Nitrates are used to treat chest pain ( angina ). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke.

Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VIAGRA for a condition for which it was not prescribed. Do not give VIAGRA to other people, even if they have the same symptoms that you have. It may harm them.

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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