VIAGRA® (sildenafil citrate)

To make sure Viagra is safe for you, tell your doctor if you have ever had:

Further information

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis. Stop using Viagra and get emergency medical help if you have sudden vision loss. heart disease or heart rhythm problems, coronary artery

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disease; heart disease or heart rhythm problems, coronary

See also:

You should not use Viagra if you are allergic to sildenafil, or: if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). artery disease; a heart attack, stroke, or congestive

• Viagra is sometimes used recreationally, raising health concerns.
• The World Health Organization recognizes ED as a common health issue.
• Education about safe Viagra use has improved over the years.
• Pfizer continues research into new uses and formulations of sildenafil.
• Viagra has helped destigmatize male sexual health issues.
• The drug's cost can vary based on region and insurance coverage.
• Pfizer's earnings from Viagra significantly contributed to its revenues.
• Viagra's side effects can sometimes include dizziness and visual disturbances.
• The development of Viagra helped shift perceptions of sexual health medication.

heart failure; a heart attack, stroke, or congestive

Dosage Form	Strengths (mg)	Available Packaging	Typical Use Cases
Tablets	25	Blister packs of 4, 8	Mild to moderate ED
Tablets	50	Blister packs of 4, 8	Common dose, initial use
Tablets	100	Blister packs of 4, 8	Severe ED issues

heart failure; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; a

Condition	Warning Level	Reason
Uncontrolled hypertension	High	Risk of severe hypotension
Cardiovascular disease	High	Increased cardiac risk
Use of nitrate medications	High	Dangerous drop in blood pressure
Retinitis pigmentosa	Moderate	Potential retinal complications

blood cell disorder such as sickle cell anemia,

• Viagra's mechanism involves inhibiting the enzyme PDE5.
• The drug requires sexual stimulation to be effective.
• Pfizer's research on sildenafil was crucial for Viagra's development.
• The medication is designed to last for about 4-6 hours.
• Viagra has been linked to minor vision changes such as blue tinting.
• It is essential to follow medical advice when using Viagra.
• Viagra's international approval varied, with some countries restricting its use.
• Pfizer invested heavily in marketing Viagra to physicians and consumers.
• The medication's popularity saw a rise alongside increased awareness of ED.

multiple myeloma, or leukemia; retinitis pigmentosa (an inherited condition of the eye); retinitis pigmentosa (an inherited

What is Viagra?

Subgroup analyses of responses to a global improvement question in patients with psychogenic etiology in two fixed-dose studies (total n=179) and two titration studies (total n=149) showed 84% of VIAGRA patients reported improvement in erections compared with 26% of placebo. Diary data in two of the studies (n=178) showed rates of successful intercourse per attempt of 70% for VIAGRA and 29% for placebo. Efficacy Results in Subpopulations in Controlled Clinical Studies A review of population viagra 100mg subgroups demonstrated efficacy regardless of baseline severity, etiology, race and age. VIAGRA was effective in a broad range of ED patients, including those with a history of coronary artery disease, hypertension, other cardiac disease, peripheral vascular disease, diabetes mellitus, depression, coronary artery bypass graft (CABG), radical prostatectomy, transurethral resection of the prostate (TURP) and spinal cord injury, and in patients taking antidepressants/antipsychotics and anti-hypertensives/diuretics. VIAGRA (sildenafil citrate) is supplied as blue, film-coated, rounded-diamond-shaped tablets containing sildenafil citrate equivalent to the nominally indicated amount of sildenafil and debossed on the obverse and reverse sides as follows: Advise the patient to read the FDA-approved patient labeling (Patient Information) Physicians should discuss with patients the contraindication of VIAGRA with regular and/or intermittent use of nitric oxide donors, such as organic nitrates or organic nitrites in any form [see Contraindications (4.1)].

Lactation Precautions

Physicians should discuss with patients the contraindication of VIAGRA with use of guanylate cyclase stimulators such as riociguat [see Contraindications (4.3)]. Concomitant Use with Drugs Which Lower Blood Pressure 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 (5.5)]. Physicians should discuss with patients the potential cardiac risk of sexual activity in patients with preexisting cardiovascular risk factors.

What are the typical dosages of Viagra?

Patients who experience symptoms (e.g., angina pectoris, dizziness, nausea) upon initiation of sexual activity should be advised to refrain from further activity and should discuss the episode with their physician [see Warnings and Precautions (5.1)]. Physicians should advise patients to stop use of all PDE5 inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including possible permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors. Physicians should discuss with patients the increased risk of NAION in individuals who have already experienced NAION in one eye. Physicians should also discuss with patients the increased risk of NAION among the general population in patients with a "crowded" optic disc, although evidence is insufficient to support screening of prospective users of PDE5 inhibitor, including VIAGRA, for this uncommon condition [see Warnings and Precautions (5.3) and Adverse Reactions (6.2)]. condition of the eye); a physical deformity of

• Viagra was initially a surprise success after initial clinical trials.
• Pfizer's marketing included educational campaigns for healthcare professionals.
• The drug's availability increased global discussions on sexual wellness.
• Viagra is often mentioned in discussions about aging and vitality.
• Pfizer has continued to innovate within the sildenafil portfolio.
• The efficacy of Viagra can depend on individual health factors.
• Viagra's popularity has prompted discussions on sexual performance enhancement.
• Pfizer faced challenges in differentiating Viagra in competitive markets.
• The medication plays a significant role in sexual health treatment options.

the penis (such as Peyronie's disease); or a physical deformity of the penis (such as Peyronie's

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In these studies, involving about 1600 patients, analyses of patient diaries showed no effect of VIAGRA on rates of attempted intercourse (about 2 per week), but there was clear treatment-related improvement in sexual function: per patient weekly success rates averaged 1.3 on 50–100 mg of VIAGRA vs 0.4 on placebo; similarly, group mean success rates (total successes divided by total attempts) were about 66% on VIAGRA vs about 20% on placebo. During 3 to 6 months of double-blind treatment or longer-term (1 year), open-label studies, few patients withdrew from active treatment for any reason, including lack of effectiveness. At the end of the long-term study, 88% of patients reported that VIAGRA improved their erections. Men with untreated ED had relatively low baseline scores for all aspects of sexual function measured (again using a 5-point scale) in the IIEF. VIAGRA improved these aspects of sexual function: frequency, firmness and maintenance of erections; frequency of orgasm; frequency and level of desire; frequency, satisfaction and enjoyment of intercourse; and overall relationship satisfaction.

Patient resources

One randomized, double-blind, flexible-dose, placebo-controlled study included only patients with erectile dysfunction attributed to complications of diabetes mellitus (n=268). As in the other titration studies, patients were started on 50 mg and allowed to adjust the dose up to 100 mg or down to 25 mg of VIAGRA; all patients, however, were receiving 50 mg or 100 mg at the end of the study. There were highly statistically significant improvements on the two principal IIEF questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) on VIAGRA compared to placebo. On a global improvement question, 57% of VIAGRA patients reported improved erections versus 10% on placebo. Diary data indicated that on VIAGRA, 48% of intercourse attempts were successful versus 12% on placebo.

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One randomized, double-blind, placebo-controlled, crossover, flexible-dose (up to 100 mg) study of patients with erectile dysfunction resulting from spinal cord injury (n=178) was conducted. The changes from baseline in scoring on the two end point questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) were highly statistically significantly in favor of VIAGRA. On a global improvement question, 83% of patients reported improved erections on VIAGRA versus 12% on placebo. Diary data indicated that on VIAGRA, 59% of attempts at sexual intercourse were successful compared to 13% on placebo. Across all trials, VIAGRA improved the erections of 43% of radical prostatectomy patients compared to 15% on placebo. disease); or if you have been told you should not have sexual intercourse for health reasons.

What other drugs will affect Viagra?

It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors [see Warnings and Precautions (5.4) and Adverse Reactions (6.2)]. Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result [see Warnings and Precautions (5.2)]. Physicians should inform patients not to take VIAGRA with other PDE5 inhibitors including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil. Sildenafil is also marketed as REVATIO for the treatment of PAH.

Does Viagra affect fertility?

The safety and efficacy of VIAGRA with other PDE5 inhibitors, including REVATIO, have not been studied [see Warnings and Precautions (5.7)]. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), may be considered [see Warnings and Precautions (5.9)]. What is the most important information I should know about VIAGRA? Generic name: sildenafil (oral) [ sil-DEN-a-fil ] Other brand names of sildenafil (oral) include: Revatio, Viagra, Vybrique Drug class: Impotence medications Viagra relaxes muscles liquid viagra found in the walls of blood vessels and increases blood flow to particular areas of the body. Viagra is used to treat erectile dysfunction (impotence) in men.

Marketing and sales

Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. This page contains specific information for Viagra, not Revatio. Do not take Viagra while also taking Revatio, unless your doctor tells you to. Some medicines can cause unwanted or dangerous effects when used with Viagra. Tell your doctor about all your current medicines, especially riociguat (Adempas) and nitrates.