VIAGRA
(sildenafil citrate) tablets

This summary contains important information about VIAGRA® (sildenafil citrate) . It is not meant to take the place of your doctor's instructions. Read this information carefully before you start taking VIAGRA (sildenafil citrate) . Ask your doctor or pharmacist if you do not understand any of this information or if you want to know more about VIAGRA (sildenafil citrate) .

This medicine can help many men when it is used as prescribed by their doctors. However, VIAGRA (sildenafil citrate) is not for everyone. It is intended for use only by men who have a condition called erectile dysfunction. VIAGRA (sildenafil citrate) must never be used by men who are taking medicines that contain nitrates of any kind, at any time. This includes nitroglycerin. If you take VIAGRA (sildenafil citrate) with any nitrate medicine your blood pressure could suddenly drop to an unsafe or life threatening level.

• WHAT IS VIAGRA (sildenafil citrate) ?

VIAGRA (sildenafil citrate) is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).

You will not get an erection just by taking this medicine. VIAGRA (sildenafil citrate) helps a man with erectile dysfunction get an erection only when he is sexually excited.

• HOW SEX AFFECTS THE BODY

When a man is sexually excited, the penis rapidly fills with more blood than usual. The penis then expands and hardens. This is called an erection. After the man is done having sex, this extra blood flows out of the penis back into the body. The erection goes away. If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.

Some conditions and medicines interfere with this natural erection process. The penis cannot fill with enough blood. The man cannot have an erection. This is called erectile dysfunction if it becomes a frequent problem.

During sex, your heart works harder. Therefore sexual activity may not be advisable for people who have heart problems. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem.

• HOW VIAGRA (sildenafil citrate) WORKS

VIAGRA (sildenafil citrate) enables many men with erectile dysfunction to respond to sexual stimulation. When a man is sexually excited, VIAGRA (sildenafil citrate) helps the penis fill with enough blood to cause an erection. After sex is over, the erection goes away.

• VIAGRA (sildenafil citrate) IS NOT FOR EVERYONE

As noted above (How Sex Affects the Body), ask your doctor if your heart is healthy enough for sexual activity.

If you take any medicines that contain nitrates - either regularly or as needed - you should never take VIAGRA (sildenafil citrate) . If you take VIAGRA (sildenafil citrate) with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as:

• nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth)
• isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth)

Nitrates are also found in recreational drugs such as amyl nitrate or nitrite (“poppers”). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.

VIAGRA (sildenafil citrate) is only for patients with erectile dysfunction. VIAGRA (sildenafil citrate) is not for newborns, children, or women. Do not let anyone else take your VIAGRA (sildenafil citrate) . VIAGRA (sildenafil citrate) must be used only under a doctor's supervision.

• WHAT VIAGRA (sildenafil citrate) DOES NOT DO

• VIAGRA (sildenafil citrate) does not cure erectile dysfunction. It is a treatment for erectile dysfunction.
• VIAGRA (sildenafil citrate) does not protect you or your partner from getting sexually transmitted diseases, including HIV—the virus that causes AIDS.
• VIAGRA (sildenafil citrate) is not a hormone or an aphrodisiac.

• WHAT TO TELL YOUR DOCTOR BEFORE YOU BEGIN VIAGRA (sildenafil citrate)

Only your doctor can decide if VIAGRA (sildenafil citrate) is right for you. VIAGRA (sildenafil citrate) can cause mild, temporary lowering of your blood pressure. You will need to have a thorough medical exam to diagnose your erectile dysfunction and to find out if you can safely take VIAGRA (sildenafil citrate) alone or with your other medicines. Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex.

Be sure to tell your doctor if you:

• have ever had any heart problems (e.g., angina, chest pain, heart failure, irregular heart beats, heart attack or narrowing of the aortic valve)
• have ever had a stroke
• have low or high blood pressure
• have ever had severe vision loss
• have a rare inherited eye disease called retinitis pigmentosa
• have ever had any kidney problems
• have ever had any liver problems
• have ever had any blood problems, including sickle cell anemia or leukemia
• are allergic to sildenafil or any of the other ingredients of VIAGRA (sildenafil citrate) tablets
• have a deformed penis, Peyronie's disease, or ever had an erection that lasted more than 4 hours
• have stomach ulcers or any types of bleeding problems
• are taking any other medicines

• VIAGRA (sildenafil citrate) AND OTHER MEDICINES

Some medicines can change the way VIAGRA (sildenafil citrate) works. Tell your doctor about any medicines you are taking. Do not start or stop taking any medicines before checking with your doctor or pharmacist. This includes prescription and nonprescription medicines or remedies:

• Remember, VIAGRA (sildenafil citrate) should never be used with medicines that contain nitrates (see VIAGRA (sildenafil citrate) Is Not for Everyone).
• If you are taking medicines called alpha-blockers for the treatment of high blood pressure or prostate problems, your blood pressure could suddenly drop. You could get dizzy or faint.
• If you are taking a protease inhibitor, your dose may be adjusted (please see Finding the Right Dose for You).
• VIAGRA (sildenafil citrate) should not be used with any other medical treatments that cause erections. These treatments include pills, medicines that are injected or inserted into the penis, implants or vacuum pumps.
• VIAGRA (sildenafil citrate) contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension. VIAGRA (sildenafil citrate) should not be used with REVATIO.

• FINDING THE RIGHT DOSE FOR YOU

VIAGRA (sildenafil citrate) comes in different doses (25 mg, 50 mg and 100 mg). If you do not get the results you expect, talk with your doctor. You and your doctor can determine the dose that works best for you.

• Do not take more VIAGRA (sildenafil citrate) than your doctor prescribes.
• If you think you need a larger dose of VIAGRA (sildenafil citrate) , check with your doctor.
• VIAGRA (sildenafil citrate) should not be taken more than once a day.

Your doctor may prescribe a lower dose of VIAGRA (sildenafil citrate) in certain circumstances. For example:

• If you are older than age 65, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg) of VIAGRA (sildenafil citrate) .
• If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25 mg of VIAGRA (sildenafil citrate) in a 48 hour period.
• If you have prostate problems or high blood pressure for which you take medicines called alpha blockers, your doctor may start you on a lower dose of VIAGRA (sildenafil citrate) .

• HOW TO TAKE VIAGRA (sildenafil citrate)

Take VIAGRA (sildenafil citrate) about one hour before you plan to have sex. Beginning in about 30 minutes and for up to 4 hours, VIAGRA (sildenafil citrate) can help you get an erection if you are sexually excited. If you take VIAGRA (sildenafil citrate) after a high-fat meal (such as a cheeseburger and french fries), the medicine may take a little longer to start working. VIAGRA (sildenafil citrate) can help you get an erection when you are sexually excited. You will not get an erection just by taking the pill.

• POSSIBLE SIDE EFFECTS

Like all medicines, VIAGRA (sildenafil citrate) can cause some side effects. These effects are usually mild to moderate and usually don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses. The most common side effects of VIAGRA (sildenafil citrate) are headache, flushing of the face, and upset stomach. Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light, or blurred vision.

In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including VIAGRA (sildenafil citrate) ) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including VIAGRA (sildenafil citrate) , and call a doctor right away.

In rare instances, men have reported an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours. If not treated right away, permanent damage to your penis could occur (see How Sex Affects the Body).

Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including VIAGRA (sildenafil citrate) . It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking VIAGRA (sildenafil citrate) and contact a doctor right away.

Heart attack, stroke, irregular heart beats, and death have been reported rarely in men taking VIAGRA (sildenafil citrate) . Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to VIAGRA (sildenafil citrate) .

VIAGRA (sildenafil citrate) may cause other side effects besides those listed on this sheet. If you want more information or develop any side effects or symptoms you are concerned about, call your doctor.

• ACCIDENTAL OVERDOSE

In case of accidental overdose, call your doctor right away.

• STORING VIAGRA (sildenafil citrate)

Keep VIAGRA (sildenafil citrate) out of the reach of children. Keep VIAGRA (sildenafil citrate) in its original container. Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature].

• FOR MORE INFORMATION ON VIAGRA (sildenafil citrate)

VIAGRA (sildenafil citrate) is a prescription medicine used to treat erectile dysfunction. Only your doctor can decide if it is right for you. This sheet is only a summary. If you have any questions or want more information about VIAGRA (sildenafil citrate) , talk with your doctor or pharmacist, visit www.viagra (sildenafil citrate) .com, or call 1-888-4VIAGRA (sildenafil citrate) .

Last reviewed on RxList: 1/3/2011
This monograph has been modified to include the generic and brand name in many instances.