VIAGRA Tablet

Treatment of erectile dysfunction

Patient with a known hypersensitive to any component of the tablet.

- Patient who are currently using nitric oxide donors, organic nitrate or organic nitrites in any form (Sildenafil was shown to potentiate the hypotensive effects of acute and chronic nitrates)

- Co-administration with guanylate cyclase stimulators, such as riociguat (This may potentially lead to symptomatic hypotension.

- Headache, dizziness, hot flush, nasal congestion, nausea, heart rate increased, hypotension, rhinitis, etc.

- Dosage adjustment are not required in patients with mild to moderate renal impairment(creatinine clearance =30-80mL/min). For patients with severe renal impairment (creatinine clearance <30mL/min), a 25mg dose should be considered.

- Patients with severe renal impairment (e.g. cirrhosis), a 25mg dose should be considered.

- Serious cardiovasucular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage and transient ischemic attack have been reported post-marketing in temporal association with the use of sildenafil. Most, but not all, of these patients had pre-existing cardiovascular risk factors.

- Acute onset of NAION, a rare condition and a cause of decreased vision or loss of vision. In case of sudden visual loss, patients should be advised to stop taking sildenafil and consult a physician immediately.

- Prolonged erections: In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result.

- Decrease or loss of hearing. In case of sudden decrease or loss of hearing, patients should be advised to stop taking sildenafil and consult a physician promptly.

Ritonavir: Patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum single dose of 25mg of sildenafil in a 48-hour period.

- CYP3A4 inhibitor: Patients receiving concomitant therapy with the CYP3A4 inhibitors (e.g. erythromycin, saquinavir, ketoconazole, itraconazole), a starting dose of 25mg should be considered.

- Alpha-blocker: In order to minimize the potential for developing postural hypotension, patients should be stable on alpha-blocker therapy prior to initiating sildenafil treatment, and start with a low dose.

PDE5 inhibitor

- The physiologic mechanism of erection of The penis involves release of nitric oxide (NO) in The corpus cavernosum during sexual stimulation, producing smooth muscle relaxation and allowing inflow of blood to The corpus cavernosum.