Adult Dosing
Treatment of erectile dysfunction
- Viagra
- 50 mg PO x 1, taken 1 hour before sexual activity (Range: 4 to 0.5 hrs); 25 mg PO x1 if > 65 yrs or if potent CYP3A4 inhibitor use
- Range: 25-100 mg/day
- Max: 100 mg/dose; 1 dose/day
Pulmonary arterial hypertension
- Revatio:
- 5 mg or 20 mg PO tid, administer 4-6 hours apart
- Max: 60 mg/day
Pediatric Dosing
- Not indicated for use in children
[Outline]
Renal Dose Adjustment (Based on CrCl)
- Viagra
- < 30 mL/min: Start 25 mg PO x 1
- Hemodialysis: Not defined
- Revatio: No Dose adjustments
Hepatic Dose Adjustment
- Viagra: Hepatic impairment/ cirrhosis: Start 25 mg PO x 1
- Revatio
- Child pughs A/B (Mild to moderate impairment): No Dose adjustments
- Child Pugh C (Severe impairment): Dose adjustments not defined
- Sexual activity in patients with preexisting cardiovascular disease may pose a risk of cardiac events. Sildenafil should not be used if sexual activity is inadvisable because of their underlying cardiovascular status
- Sildenafil has vasodilatory properties. Prior to starting therapy, carefully consider whether patients with certain underlying conditions (resting hypotension [BP < 90/50], fluid depletion, severe left ventricular outflow obstruction, autonomic dysfunction) could be adversely affected by vasodilatory effects
- Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease (PVOD). Use is not recommended. Consider the possibility of PVOD if signs of pulmonary edema occur with sildenafil administration
- Prolonged erection > 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported
- Use with caution if coadministered with alpha-blockers because of risk of additive reduction in BP. Significant symptomatic hypotension may occur
- Stop all PDE5 inhibitors, including VIAGRA, in the event of a sudden loss of vision in one or both eyes
- Stop all PDE5 inhibitors, including VIAGRA and REVATIO, in the event of sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness
- Use with caution in patients with anatomical deformation of the penis (eg, angulation, cavernosal fibrosis, Peyronies disease) or patients prone to priapism (eg, leukemia, multiple myeloma, sickle cell anemia)
- Safety of sildenafil is unknown in patients with bleeding disorders or active peptic ulceration
- Increased mortality with increasing dose was observed in pediatric patients with PAH. Use of therapy, especially for chronic use is not recommended in children
Cautions: Use cautiously in
- Concurrent ritonavir, ketoconazole and itraconazole (co-administration not recommended)
- MI within 6 months (Safety or efficacy not established)
- Stroke within 6 months (Safety or efficacy not established)
- Life-threatening arrhythmia in last 6 months (Safety or efficacy not established)
- History of severe vision loss, which might reflect a prior episode of NAION
- CAD causing unstable angina (Safety or efficacy not established)
- CHF
- Concurrent treatment with antihypertensives or glipizide
- Hypertension (BP > 170/110) (Safety or efficacy not established)
- Patients currently on bosentan therapy
- Hypotension
- Hypovolemia
- Aortic stenosis
- Anatomical deformation of the penis (e.g angulation, cavernosal fibrosis, or Peyronie’s disease)
- Conditions predisposing to priapism (e.g sickle cell anemia, multiple myeloma, or leukemia)
- Autonomic dysfunction
- Retinitis pigmentosa
- Retinal disorders, degenerative
- Non-arteritic anterior ischemic optic neuropathy
- Bleeding disorder
- PUD, active
- Elderly pts
Pregnancy Category:B
Breastfeeding: It is not known if sildenafil (revatio) or its metabolites are excreted in human breast milk. Manufacturer advises caution
Pricing data from www.DrugStore.com in U.S.A.
- Viagra 50 MG TABS [Bottle] (PFIZER U.S.)
10 mg = $223.99
30 mg = $671.97 - Viagra 100 MG TABS [Bottle] (PFIZER U.S.)
10 mg = $223.99
30 mg = $671.97 - Viagra 25 MG TABS [Bottle] (PFIZER U.S.)
10 mg = $219.99
30 mg = $659.97 - Revatio 20 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $555.98
90 mg = $1528
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
