Sildenafil Citrate: Brands, Price & Uses in Bangladesh

Sildenafil Citrate is indicated for the following uses:

Established / FDA-approved uses

• Erectile dysfunction (ED): Treatment of erectile dysfunction in men, to help achieve and maintain an erection sufficient for sexual activity. Sexual stimulation is required for Sildenafil Citrate to be effective.
• Pulmonary arterial hypertension (PAH): Treatment of PAH (WHO Group I) in adults, to improve exercise ability and delay clinical worsening. This use employs a separate formulation and dosing schedule from the erectile dysfunction indication (see Dosage and Administration).

Sildenafil Citrate is not indicated for use in women, and it is not a treatment for HIV or other sexually transmitted infections. It does not increase sexual desire on its own and has no effect in the absence of sexual stimulation.

Dosing by indication

Dose adjustment for erectile dysfunction

Starting dose is usually 50 mg; the dose may be increased to 100 mg or decreased to 25 mg depending on response and tolerability. In patients taking potent CYP3A4 inhibitors (e.g. ritonavir, ketoconazole, itraconazole) or alpha-blockers, or in those with hepatic or severe renal impairment, a lower starting dose (25 mg) is recommended (see Interactions and Use in Special Populations).

Renal impairment

No dose adjustment is generally needed in mild-to-moderate renal impairment; in severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 25 mg should be considered for erectile dysfunction.

Hepatic impairment

In hepatic impairment (e.g. cirrhosis), a starting dose of 25 mg is recommended for erectile dysfunction, as clearance of Sildenafil Citrate is reduced.

Common and serious side effects associated with Sildenafil Citrate include:

Common

• Headache
• Flushing
• Dyspepsia (indigestion)
• Nasal congestion
• Dizziness
• Visual disturbances (e.g. altered color perception, blurred vision, light sensitivity)
• Back pain and myalgia (more often reported with the PAH dosing regimen)

Uncommon to rare but serious

• Priapism — a prolonged, painful erection lasting more than 4 hours; a medical emergency requiring immediate attention (see Precautions and Warnings).
• Sudden decreased or loss of vision in one or both eyes, including non-arteritic anterior ischemic optic neuropathy (NAION) (see Precautions and Warnings).
• Sudden decreased or loss of hearing, sometimes with tinnitus and dizziness (see Precautions and Warnings).
• Cardiovascular events (e.g. myocardial infarction, chest pain, palpitations, tachycardia, and rarely sudden cardiac death) reported in temporal association with sexual activity in men with underlying cardiovascular risk (see Precautions and Warnings).
• Hypotension, particularly when combined with interacting medicines (see Interactions).
• Hypersensitivity reactions, including rash and, rarely, angioedema.