DRUG INTERACTIONS

Sildenafil > 20mg sildenafil


lorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

  • Comparing 20mg sildenafil to other PDE5 inhibitors highlights differences.
  • Tadalafil (Cialis) has a longer duration of action (up to 36 hours).
  • Vardenafil (Levitra) has a similar duration to sildenafil but may be less affected by food.
  • Avanafil (Stendra) has a faster onset of action (15-30 minutes).
  • The choice of drug depends on individual patient needs and response.
  • Tadalafil is also approved for daily use at a lower dose (2.5mg, 5mg).
  • Side effect profiles are similar but can vary in frequency between individuals.
  • Cost and insurance coverage often play a significant role in the choice.
  • Some patients may respond better to one medication over another.
  • A doctor can help determine the most appropriate medication and dose.
  • It may take trial and error to find the optimal treatment.

mavacamtensildenafil increases levels of mavacamten

Drug Class Interaction Effect Recommendation
Nitrates Severe hypotension Avoid combination
Alpha-blockers Additive blood pressure lowering effect Use with caution
CYP3A4 inhibitors (e.g., ketoconazole) Increased sildenafil levels Dose adjustment may be necessary
Antihypertensives Enhanced blood pressure reduction Monitor blood pressure
Grapefruit juice Increased plasma concentration Avoid during treatment

by affecting hepatic enzyme CYP2C19 metabolism.

What is sildenafil?

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fedratinibfedratinib will increase the level or effect of sildenafil by canada sildenafil affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary. fedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fluconazolefluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fluconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Oral Administration

fosamprenavirfosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosamprenavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitantfosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. fosphenytoinfosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

7.4 Ritonavir and Other CYP3A4 Inhibitors

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fosphenytoin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels gepotidacingepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If possible, avoid with sensitive substrates that are are extensively metabolized by CYP3A4 and have a narrow therapeutic index. If unable to avoid, monitor or modify substrate dose according to its prescribing information. gepotidacin increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify mavacamten dose if coadministered with weak or moderate CYP2C19 inhibitors.

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sildenafil increases levels of mavacamten

5. Warnings and Precautions

labetalollabetalol increases effects of sildenafil by additive vasodilation. labetalol increases effects of sildenafil by additive vasodilation. lapatiniblapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lapatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. lesinurad (DSC)lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. by affecting hepatic enzyme CYP2C19 metabolism.

Condition Risk Factors Recommendations
Use with Nitrates Risk of severe hypotension Avoid concurrent use
Severe Heart Disease Increased cardiac stress Consult cardiologist before use
Severe Liver or Kidney Impairment Altered drug metabolism Dose adjustment or avoid use
Hypotension Blood pressure too low Use caution, monitor blood pressure
Retinitis Pigmentosa Risk of vision changes Consult eye specialist

mavorixaformavorixafor will increase the level or effect

  • Special populations require careful consideration before prescribing.
  • In elderly patients (65+), clearance may be reduced; start with a lower dose.
  • No dose adjustment is typically needed for patients with mild renal impairment.
  • For moderate renal impairment (CrCl 30-80 mL/min), caution is advised.
  • In severe renal impairment (CrCl <30 mL/min), a 25mg dose is often recommended.
  • For hepatic impairment (Child-Pugh A and B), a 25mg starting dose is advised.
  • Sildenafil is not recommended for patients with severe hepatic impairment.
  • Safety and efficacy in pediatric patients for ED have not been established.
  • Revatio is approved for pediatric PAH patients aged 1 year and older.
  • The dose for pediatric PAH is based on body weight and must be carefully calculated.
  • Use during pregnancy is only for PAH and requires a careful risk/benefit analysis.

of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Other uses for this medicine

lesinurad (DSC) decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. letermovirletermovir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. letermovir increases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. When amlodipine and sildenafil were used in combination, each agent independently exerted its own blood pressure lowering effect. lorlatiniblorlatinib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor for adverse effects of sensitive CYP3A4 substrates

Brand Name Company Formulation Type Price Range
Viagra Pfizer Tablet $10–$25 per pill
Kamagra Ajanta Pharma Generic $2–$7 per pill
Sildenafil RX Various pharmacies Various generics $3–$9 per pill
Revatio Pfizer (for pulmonary hypertension) Same strength, different use Varies

if coadministered with mavorixafor (a weak CYP3A4 inhibitor).

How to take tablets

Consider dose reduction of sensitive CYP3A4 substrates. istradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. itraconazoleitraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Not recommended during and 2 weeks after itraconazole treatment when sildenafil is used for pulmonary arterial hypertension. itraconazole will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. mavorixafor will increase the level or effect

What Are Warnings and Precautions for Sildenafil?

Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels enzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation. epoprostenol increases effects of sildenafil by additive vasodilation. erythromycin baseerythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider a starting dose of 25 mg in patients treated with erythromycin.

Dosage Forms & Strengths

erythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin ethylsuccinate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionateerythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearateerythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What should I tell my healthcare provider before taking sildenafil?

erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esmololesmolol increases effects of sildenafil by additive vasodilation. esmolol increases effects of sildenafil by additive vasodilation. etravirineetravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels etravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Highlights of Prescribing Information

diltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedaronedronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs.

Common side effects of Sildenafil

Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels efavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

8.2 Lactation

Consider increasing CYP3A substrate dose if needed. elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. enzalutamideenzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. metoprololmetoprolol increases effects of sildenafil by additive vasodilation.

12.3 Pharmacokinetics

grapefruitgrapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. grapefruit will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvingriseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. griseofulvin will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hydrocortisonehydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

8.5 Geriatric Use

hydrocortisone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisibidelalisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of sildenafil with strong CYP3A4 inhibitors is not recommended. If using Viagra, consider decreasing starting dose. idelalisib will increase the level or sildenafil citrate tables effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

12.2 Pharmacodynamics

isoniazidisoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isoniazid will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefyllineistradefylline will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day.