Sildenafil

For erectile dysfunction, sildenafil supports the blood-flow response to sexual stimulation. It does not increase sexual desire or establish why erections have changed. Product labels for pulmonary arterial hypertension describe a separate use and must not be treated as an ED self-treatment guide. ¹

Sildenafil must not be used with nitrates, recreational nitrites or riociguat because of dangerous blood-pressure effects. Headache, flushing and indigestion can occur. A prolonged erection, sudden vision or hearing changes, or chest symptoms need urgent clinical assessment. The emergency team should know which erectile-dysfunction medicine was used. ^{1, 2}

Bring all prescription and nonprescription medicines, any prior ED treatment, and a description of when symptoms occur. Ask whether heart symptoms or another underlying condition need assessment before medication selection. The discussion should also cover what to do if the prescribed option is ineffective.

Sexual activity itself can add cardiovascular demand, so chest pain, fainting, severe breathlessness or an unstable heart condition changes the conversation. Sildenafil lowers blood pressure and can interact with alpha blockers and other antihypertensives as well as nitrates and riociguat. The prescriber needs the exact names and timing of heart medicines, not simply a statement that blood pressure is controlled. Never use someone else's nitrate or erectile-dysfunction medicine during a symptom episode. ^{1, 2}

Sildenafil appears in products for erectile dysfunction and pulmonary arterial hypertension. The indication affects how it is prescribed and monitored. A compounded troche or combination is a separate formulation and is not established by the Viagra label. Check for duplicate PDE5 inhibitors when tadalafil, vardenafil or branded pulmonary-hypertension products appear elsewhere on the list. If a dose seems ineffective, do not take extra tablets or add another product without the prescriber's instructions. ^{1, 2}

An erection lasting more than four hours requires emergency care to reduce the risk of permanent injury. Sudden loss of vision or hearing also needs urgent assessment. For chest pain after sildenafil, call emergency services and say when the medicine was taken; do not take a nitrate unless the emergency team specifically directs care with full knowledge of the sildenafil exposure. Severe dizziness, fainting, breathing difficulty or facial swelling should be treated as urgent. ^{1, 2}

Sildenafil supports an erection only with sexual stimulation; it does not create desire or treat every cause of erectile difficulty. A high-fat meal can delay the effect of some sildenafil products, while pulmonary-hypertension regimens follow different schedules. Agree on when to assess response before changing the plan. Persistent difficulty can be a clue to vascular disease, diabetes, medication effects, low testosterone or another condition requiring evaluation. ^{1, 2}