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- Precautions and Interactions
- Side effects
- Exclusions from supply
- Erectile dysfunction Medicines
Sildenafil ( Viagra) is a prescription drug and whilst it is very tolerable, it may not be suitable for every man, especially with certain medical conditions. If you are allergic to the ingredients, or have a serious condition such as heart disease, a stroke or uncontrolled blood pressure, you should not take Sildenafil. If you use nitrates either medically, for example if you have angina, or you use recreational nitrate-based drugs, Sildenafil is not suitable. This is because PDE-5 inhibitors increase the effect of nitrates and may lower your blood pressure.
Your doctor will decide if Sildenafil is compatible with any other medical conditions or current medications.
One of the effects of Sildenafil is a lowering of the blood pressure which is compounded by alcohol intake, therefore large quantities of alcohol should be avoided while using Sildenafil. Otherwise light-headedness, fainting and heart palpitations are possible. Alcohol can also make it more difficult to achieve an erection.
Caution should be taken if you are suffering from cardiovascular disease. Dizziness and altered vision were reported in clinical trials hence take care if driving or operating machinery .
Grapefruit and grapefruit juice decreases the ability of the body to process the medication, which can increase the risk of dangerous side effects.
All simultaneously used medications should be discussed with your doctor or pharmacist before first usage of Sildenafil, to avoid interactions.
How does Sildenafil work? Sildenafil (Viagra) works by inhibiting the action of a chemical called Phosphodiesterase type-5 (PDE5). When released by the body, PDE5 contributes to the loss of an erection by causing a reduction in blood flow to the penis. Sildenafil (Viagra) works by blocking the effect of PDE5 to increase blood flow, helping the patient to achieve an erection and maintain it for longer.
How do I take Sildenafil? The recommended starting dose is 50mg of the treatment once a day maximum (24 hours). For optimal effectiveness, consume Sildenafil whole with water on an empty stomach, one hour before engaging in sexual activity. Consuming food before taking the medication can delay absorption, resulting in it taking longer to work. Eating an hour after taking the pill will not affect its activity.
Other Interactions:
• Co-administration with potent CYP3A4 inhibitors (such as ketoconazole, erythromycin, cimetidine, ritonavir)
• Co-administration with nitric oxide donors (such as amyl nitrite) or nitrates .
• Co-administration with guanylate cyclase stimulators, such as riociguat
• Patients should be stable on alpha-blocker therapy prior to initiating ED treatment.
How long does Sildenafil take to work? Sildenafil takes approximately 1 hour to work. It will not work without sexual stimulation.
How long does Sildenafil last? Sildenafil works with sexual stimulation and its effects can last about four hours. This does not mean that you will have an erection for four hours, but rather that you have the potential for an improved erection as long as the drug lasts in your body.
Sildenafil Patient information leaflet
Before our pharmacists can this medicine, you will need to complete a short online questionnaire, which will determine if the product is suitable for you.
For most patients Sildenafil (Viagra) is highly tolerable and side effects are infrequent or minimal.
If you suffers from any of the following side effects you should see your GP as soon as possible :
• Loss of vision or hearing
• Chest pain
• Continuous painful erection lasting 4 or more hours
• The most common side effects of Sildenafil include headache, flushed face and chest, indigestion, nausea and congestion. Muscle or back ache are also possible. Less common side effects are, among others, palpitations, stomach pain, insomnia and abnormal vision.
We are unable to supply this medicine to you if you:
•have hypersensitivity to the active substance(s) or to any of the excipients or trace residuals in selected oral phosphodiesterase type-5 inhibitor (PDE5).
•are under 18 years.
•are Female.
•are a man who has severe or mild erectile dysfunction as defined by scoring outside the 8-16 point SHIM score range.
• are taking concomitantly other PDE5 inhibitors or other treatments for erectile dysfunction or concomitant use with other treatments that are contraindicated (see Product Interactions).
Patients who suffer from any of the following conditions are also excluded:
• Severe renal impairment (creatinine clearance < 30 mL/min).
• Hepatic impairment
•Where vasodilation or sexual activity are inadvisable (e.g. patients with severe cardiovascular disorders such as unstable angina or severe cardiac failure [New York Heart Association Class 2 or greater heart failure in the last 6 months]).
• History of non-arteritic ischaemic optic neuropathy (NAION).
• Uncontrolled blood pressure.
• Hypotension (blood pressure < 90/50 mmHg)
• Hypertension (blood pressure > 170/100 mmHg).
N.B. If it is suspected that you have hypertension or hypotension, it is recommended to have your blood pressure checked and consult one of our pharmacists or your doctor
• Recent history of stroke or myocardial infarction (within the last 6 months).
• Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases)
• Uncontrolled arrhythmias. • Left ventricular outflow obstruction, e.g., aortic stenosis and idiopathic hypertrophic subaortic stenosis
.• Anatomical deformation of the penis (e.g. angulation, cavernosal fibrosis, Peyronie’s disease)
.• Pre-disposition to priapism (e.g. sickle cell disease, multiple myeloma or leukaemia)
.• Bleeding disorders (such as haemophilia).
• Active peptic ulceration
Please Note - Erectile dysfunction medicines can be supplied on The NHS . If you have to any of the following conditions you may be eligible:
Multiple sclerosis, Parkinson’s disease, polio, prostate cancer, severe pelvic or spinal injury, spina bifida certain genetic conditions, such as Huntington's disease.
You can also get ED medication on the NHS if you have had any of the following treatments: pelvic surgery, surgical removal of the prostate gland (prostatectomy), dialysis for kidney failure and kidney transplant.
All erectile dysfunction medicines supplied by Numark Pharmacy are exclusively for oral administration and require sexual stimulation in order to facilitate erection
• Swallow tablets whole with water.
• The onset of action may be delayed in some ED medication when taken with food
• Combinations of sildenafil citrate, vardenafil hydrochloride, tadalafil and avanafil should not be taken in combination without a break of at least 36 hours between one medication and another .
•Lifestyle advice - Changes and risk factor modification that may be required before or accompanying treatment with a phosphodiesterase-5 (PDE-5) inhibitor, include : • regular exercise, • reduction in body mass index, • smoking cessation, • reduced alcohol consumption
Need some assistance?
Give one of our friendly team members a call on 01509 506564 or email us at mail@numark-chemist.com
