Sildenafil Oral Suspension: Package Insert / Prescribing Info

Do not take more than one dose a day. Allow at least 24 hours between doses. For pulmonary arterial hypertension:Take or administer the prescribed dose three times a day, four to six hours apart. Take or administer the prescribed dose three times a day, four to six hours apart. How to take sildenafil oral suspension for pulmonary hypertension:Please read and follow the Instructions for Use.Do not use the medicine if it’s still in powder form, doesn’t have a bottle adapter, or is missing an oral syringe. The pharmacist can provide a bottle adapter or oral syringe.Shake the bottle well for at least 10 seconds.Always measure the dose with the oral syringe provided in the package.Do not mix the dose with other liquids or flavorings.The person getting the medicine should be upright.Place the syringe in the mouth against the cheek.

Push the plunger completely down.Wash the syringe with water and allow it to dry after each use.Store sildenafil oral suspension in the refrigerator.

5. Warnings and Precautions

Please read the Patient Information sheet that comes with this medicine. For erectile dysfunction:Take the prescribed dose about one hour before you have sex.The dose can be taken one-half hour to four hours before sexual activity.Do not take more than one dose a day. Allow at least 24 hours between doses.Store sildenafil tablets at room temperature. Take the prescribed dose about one hour before you have sex. The dose can be taken one-half hour to four hours before sexual activity. Do not freeze.Throw away any unused medicine 60 days after receiving it from the pharmacist or on the expiration date written on the bottle’s label. How to take sildenafil oral suspension for pulmonary hypertension: Please read and follow the Instructions for Use.

Please read and follow the Instructions for Use. Do not use the medicine if it’s still in powder form, doesn’t have a bottle adapter, or is missing an oral syringe.

8. Use In Specific Populations

However, men using higher-dose sildenafil for erectile dysfunction will be started on the lowest possible dose if they have severe kidney or liver impairment, or are over the age of 65. Although the starting dose is lower than normal, the dose can eventually be increased to the maximum dosage if there are no issues with side effects. Patients with renal impairment (creatinine clearance <30 mL/min): Starting dose reduced to 25 mg per day for erectile dysfunction treatment Patients with renal impairment (creatinine clearance <30 mL/min): Starting dose reduced to 25 mg per day for erectile dysfunction treatment Patients with hepatic impairment: Starting dose reduced to 25 mg per day for erectile dysfunction treatment (no dosage adjustment for pulmonary hypertension) Patients with hepatic impairment: Starting dose reduced to 25 mg per day for erectile dysfunction treatment (no dosage adjustment for pulmonary hypertension) Patients over 65 years of age: Starting dose reduced to 25mg per day for erectile dysfunction treatment Patients over 65 years of age: Starting dose reduced to 25mg per day for erectile dysfunction treatment Veterinarians use sildenafil to reduce blood pressure in dogs and cats diagnosed with pulmonary hypertension. They’re more likely to use it when pets are showing symptoms like fainting and other signs of heart failure. Some veterinarians may use it if a pet also has heart disease, heart failure, or lung disease.

Before taking sildenafil,

Dosage guidelines vary, ranging between doses of 0.5 mg to 3 mg/kg given anywhere from once per day to three times per day. Although sildenafil has three dosage forms, erectile dysfunction is treated only with sildenafil tablets. For pulmonary hypertension, pediatric patients and adults who can’t swallow a tablet may be prescribed sildenafil oral suspension. Sildenafil injections are administered by a healthcare provider only. Your healthcare provider will tell you how sildenafil otc much sildenafil to take and how often it can be taken. The pharmacist can provide a bottle adapter or oral syringe. Shake the bottle well for at least 10 seconds. Always measure the dose with the oral syringe provided in the package. Do not mix the dose with other liquids or flavorings. The person getting the medicine should be upright. Place the syringe in the mouth against the cheek. Wash the syringe with water and allow it to dry after each use. Store sildenafil oral suspension in the refrigerator. Throw away any unused medicine 60 days after receiving it from the pharmacist or on the expiration date written on the bottle’s label. In clinical trials, sildenafil showed significant effects on erectile response 60 minutes after the dose was taken, though the effects may be evident within 30 minutes. For pulmonary hypertension, sildenafil lowers blood pressure about one to two hours after a dose is taken. With a half-life of four hours, sildenafil and its active metabolite are completely cleared from the system in about 20 hours, though the effects fade before then.

What side effects can this medication cause?

Sildenafil tablets are the most commonly used. Low-dose tablets (20 mg) are for pulmonary hypertension. Higher-dose tablets are appropriate for erectile dysfunction. Patients with pulmonary hypertension can also take a liquid sildenafil or be given an intravenous injection. Tablets: 20 mg (pulmonary hypertension), 25 mg, 50 mg, 100 mg Tablets: 20 mg (pulmonary hypertension), 25 mg, 50 mg, 100 mg Oral suspension: 10 mg/mL (pulmonary hypertension) Oral suspension: 10 mg/mL (pulmonary hypertension) Injection: 10 mg/12.5 mL (pulmonary hypertension) Injection: 10 mg/12.5 mL (pulmonary hypertension) Sildenafil is FDA-approved for erectile dysfunction and pulmonary hypertension.

CRediT authorship contribution statement

Healthcare professionals may use the drug off-label for other conditions, such as Raynaud’s syndrome or altitude sickness, but these are not approved uses. For pulmonary hypertension, low-dose sildenafil is administered daily for as long as necessary. For erectile dysfunction, men take a pill when needed, but no more than one dose per day. No one who has had an allergic reaction to sildenafil will be prescribed this medicine. Popularly known as brand-name Viagra, sildenafil is widely used to treat erectile dysfunction (ED).

2.1 Recommended Dosage in Adults

Defined as an inability to achieve or maintain an erection, clinical erectile dysfunction affects more than thirty million men in the United States. This enzyme cGMP is needed because it causes smooth muscle relaxation and increased blood flow to the penis. By blocking PDE-5, cGMP increases, and erections can occur. Tablets are taken at least one hour before anticipated sexual activity, but men could take their dose a half hour to four hours before sexual activity. However, a dose starts to lose its potency about two hours after a dose is taken. For erectile dysfunction, sildenafil produces its maximum effects for about two hours and can still produce an erectile response four hours after a dose is taken. For pulmonary hypertension, sildenafil’s benefits in lowering blood pressure were the same as a placebo (inert pill) after eight hours.

• During use, note the onset time and duration of the liquid sildenafil's effect.
• Use with caution if you have heart, kidney, or liver issues.
• Always inform your healthcare provider of other ongoing treatments.
• Potential side effects can include nasal congestion or stomach upset.
• Avoid driving or operating machinery until you know how sildenafil affects you.
• Use only as directed; misuse can cause serious health issues.
• Liquid sildenafil citrate is sometimes compounded into topical gels.
• It’s crucial to maintain a record of dose and timing.
• Be aware that alcohol can impair the effectiveness of sildenafil.
• The medication does not protect against sexually transmitted infections.
• Seek emergency medical help if you experience symptoms like chest pain.

For treatment of erectile dysfunction, take only one dose per day. If a dose has been forgotten, take it when remembered but wait at least 30 minutes before attempting sexual activity. For pulmonary hypertension, take a missed dose as soon as you remember it.

• Liquid sildenafil citrate is a water-based solution of the erectile dysfunction medication.
• It is often used for faster absorption compared to pills.
• This liquid form allows adjustable dosing for precise treatment.
• It is typically stored in a sealed bottle to prevent spoilage.
• The liquid is usually flavored to improve taste and ease consumption.
• It must be measured accurately with a dosing syringe or dropper.
• Not all brands are FDA approved; verify quality before use.
• Liquid sildenafil citrate may have a shorter shelf life than tablet forms.
• It’s important to consult a healthcare provider before use.
• Possible side effects include headaches, flushing, and dizziness.
• Store the liquid in a cool, dry place away from sunlight.

If it’s almost time for the next dose, skip the missed dose and take the next dose as scheduled.

What should I do if I forget a dose?

Sexual stimulation is required for the drug to work. Men will start on a 50 mg dose which can rise to 100 mg if necessary. Standard sildenafil dosage for erectile dysfunction: 25–100 mg tablet taken only once daily at least one hour before sexual activity Standard sildenafil dosage for erectile dysfunction: 25–100 mg tablet taken only once daily at least one hour before sexual activity Maximum sildenafil dosage for erectile dysfunction: 100 mg daily Maximum sildenafil dosage for erectile dysfunction: 100 mg daily Pulmonary hypertension is when the blood pressure in the arteries of the lungs is higher than normal. This makes the heart work harder to pump blood through the lungs. This can lead to heart damage and cause symptoms such as shortness of breath, chest pain, and lightheadedness.

8.7 Patients with Renal Impairment

Pulmonary hypertension affects about 1% of the population. Pulmonary hypertension has many potential causes, including heart disease, lung disease, medications, and other health conditions. Physicians will focus on treating those problems, but they will also use drugs like sildenafil to lower blood pressure. Sildenafil is taken orally three times daily and can range from 60 mg to 240 mg. Sildenafil injections are limited to 30 mg per day.

Oxygen radicals and nitric oxide in rat mesenteric ischemia-reperfusion: modulation by L-arginine and N-nitro-L-arginine methyl ester

For pulmonary hypertension, people may be prescribed generic sildenafil or a brand-name version called Revatio. Standard sildenafil dosage for pulmonary hypertension: 20–80 mg taken orally three times daily OR 10 mg intravenous injection three times daily Standard sildenafil dosage for pulmonary hypertension: 20–80 mg taken orally three times daily OR 10 mg intravenous injection three times daily Maximum sildenafil dosage for pulmonary hypertension: 240 mg taken orally OR 30 mg daily administered as intravenous injections Maximum sildenafil dosage for pulmonary hypertension: 240 mg taken orally OR 30 mg daily administered as intravenous injections Healthcare professionals use sildenafil to treat pulmonary hypertension in children as young as 1 year old. Children can take tablets or an oral suspension. Healthcare professionals do not use sildenafil injections in pediatric patients. When sildenafil is used for pulmonary hypertension, no dosage reductions are required for people with kidney disease or liver problems. If too much sildenafil is taken, get immediate medical attention.

Side effects of sildenafil, such as headache, flushing, stomach upset, nasal congestion, back pain, low blood pressure, or painful erections (priapism), are more likely and could be worse than normal. Serious side effects are also possible such as heart rate problems, chest pain (angina), and heart attack.

Do not take sildenafil if you are using medications called nitrates, such as nitroglycerin, or over-the-counter nitrites (“poppers”), such as amyl nitrite.