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- Hypersensitivity to the active substance or any of the excipients of the drug
- simultaneous use with nitric oxide donors (such as amyl nitrite) or nitrates in any form is contraindicated, since it is known that sildenafil affects the pathways of nitric oxide / cyclic guanosine monophosphate (cGMP) metabolism and potentiates the hypotensive effect of nitrates
- conditions for which sexual activity is discouraged (eg, severe cardiovascular disorders such as unstable angina or severe heart failure)
- loss of vision in one eye due to non-arterial and anterior ischemic neuropathy of the optic nerve, regardless of whether this pathology is associated with previous use of PDE-5 inhibitors or not
The drug is administered orally.
Adults. The recommended dose is 50 mg and is applied as needed about an hour before sexual activity. Depending on the effectiveness and tolerability of the drug, the dose can be increased to 100 mg or reduced to 25 mg (the drug is used in the appropriate dosage). The maximum recommended dose is 100 mg. The frequency of application of the maximum recommended dose of the drug is 1 time per day. When using the drug Silagra during a meal, the effect may occur later than when it is used on an empty stomach.
Patients with hepatic impairment. Since the clearance of sildenafil is reduced in patients with hepatic impairment (eg cirrhosis), a dose of 25 mg should be considered. Depending on the effectiveness and tolerability of the drug, if necessary, the dose can be gradually increased to 50 mg and to 100 mg.
In clinical trials involving volunteers, when using a single dose of sildenafil up to 800 mg, adverse reactions were similar to those observed with sildenafil at lower doses, but were more frequent and more severe. The use of sildenafil at a dose of 200 mg did not lead to an increase in efficacy, but caused an increase in the number of cases of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, visual disturbances).
In case of overdose, if necessary, resort to the usual supportive measures. An acceleration of the clearance of sildenafil during hemodialysis is unlikely due to the high degree of binding of the drug to blood plasma proteins and the lack of elimination of sildenafil in the urine.
According to the literature, the most commonly reported adverse reactions were headache, hot flushes, dyspepsia, nasal congestion, back pain, dizziness, nausea, hot flashes, visual disturbances, cyanopsia, and blurred vision.
- Infectious and invasive diseases.
- Rhinitis infrequently.
- From the immune system.
- Hypersensitivity infrequently.
- From the nervous system.
- Headache very often.
- Dizziness often.
- Infrequently, drowsiness, hypesthesia.
- Rarely stroke, transient ischemic attack, convulsions *, relapses in court *, syncope.
- On the part of the organs of vision.