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Sildenafil Disease Interactions

There are 8 disease interactions with sildenafil.

Major

PDE5 inhibitors (applies to sildenafil) cardiovascular disease

Major Potential Hazard, High plausibility. Applicable conditions: Hypotension, History - Cerebrovascular Disease, Cerebral Vascular Disorder, History - Myocardial Infarction

The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
  2. Feenstra J, vanDriePierik RJHM, Lacle CF, Stricker BHC "Acute myocardial infarction associated with sildenafil." Lancet 352 (1998): 957-8
  3. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
  4. Zusman RM "Cardiovascular data on sildenafil citrate - Introduction." Am J Cardiol 83 (1999): c1-2
  5. Conti CR, Pepine CJ, Sweeney M "Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease." Am J Cardiol 83 (1999): c29-34
  6. Zusman RM, Morales A, Glasser DB, Osterloh IH "Overall cardiovascular profile of sildenafil citrate." Am J Cardiol 83 (1999): c35-44
  7. Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8
  8. Kloner RA, Zusman RM "Cardiovascular effects of sildenafil citrate and recommendations for its use." Am J Cardiol 84 (1999): n11-7
  9. Awan GM, Calderon E, Dawood G, Alpert MA "Acute, symptomatic atrial fibrillation after sildenafil citrate therapy in a patient with hypertrophic obstructive cardiomyopathy." Am J Med Sci 320 (2000): 69-71
  10. Kloner RA "Cardiovascular risk and sildenafil." Am J Cardiol 86 (2000): f57-61
  11. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED "Side-effect profile of sildenafil citrate (Viagra) in clinical practice." Urology 56 (2000): 474-6
  12. McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6
  13. Malozowski S, Sahlroot JT "Hemodynamic effects of sildenafil." N Engl J Med 343 (2000): 967-8
  14. Dunn N "Cardiovascular events in users of sildenafil - Paper does not provide any reassurance." Br Med J 323 (2001): 50-1
  15. "Product Information. Levitra (vardenafil)." Bayer (2003):
  16. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  17. Curran M, Keating G "Tadalafil." Drugs 63 (2003): 2203-12; discussion 2213-4
  18. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  19. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  20. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  21. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
  22. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
View all 22 references
Major

PDE5 inhibitors (applies to sildenafil) renal dysfunction

Major Potential Hazard, High plausibility.

The plasma clearance of phosphodiesterase-5 (PDE5) inhibitors may be decreased in patients with severe renal impairment, resulting in drug accumulation. Therapy with these agents should be avoided in patients with severe renal disease or on renal dialysis. Dose adjustments might be needed based on individual renal assessment and tolerability if used in these patients.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
  2. "Product Information. Levitra (vardenafil)." Bayer (2003):
  3. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  4. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2005):
  5. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  6. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  7. "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
View all 7 references
Major

Sildenafil (applies to sildenafil) pulmonary disease

Major Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Heart or Vascular Disease, Pulmonary Edema

Sildenafil injection for the treatment of pulmonary arterial hypertension (PAH) should not be used in patients with pulmonary veno-occlusive disease (PVOD) as it may significantly worsen the cardiovascular status of these patients. If signs of pulmonary edema develop during therapy, the possibility of associated PVOD should be considered.

References

  1. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  2. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
Moderate

PDE 5 inhibitors (applies to sildenafil) priapism

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Myeloproliferative Disorder, Sickle Cell Anemia, Peyronie's Disease, Cavernosal/Penile Tissue Abnormalities

Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.

References

  1. Kassim AA, Fabry ME, Nagel RL "Acute priapism associated with the use of sildenafil in a patient with sickle cell trait." Blood 95 (2000): 1878-9
  2. "Product Information. Levitra (vardenafil)." Bayer (2003):
  3. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  4. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  5. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  6. "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
  7. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  8. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
  9. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
View all 9 references
Moderate

PDE5 inhibitors (applies to sildenafil) alcoholism

Moderate Potential Hazard, Moderate plausibility.

Alcohol consumption may intensify the pressure-lowering effects of mild vasodilators, such as phosphodiesterase 5 (PDE5) inhibitors. Therefore, patients that consume alcohol should be warned to limit alcohol intake while receiving these agents.

References

  1. "Product Information. Levitra (vardenafil)." Bayer (2003):
  2. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  3. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  4. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  5. "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
  6. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  7. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
  8. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
View all 8 references
Moderate

PDE5 inhibitors (applies to sildenafil) hearing loss

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Tinnitus

Use of phosphodiesterase-5 (PDE5) inhibitors has been associated with sudden decrease or loss of hearing, which may be accompanied by tinnitus or dizziness. Patients with hearing problems should stop taking these agents and seek prompt medical care.

References

  1. "Product Information. Levitra (vardenafil)." Bayer (2003):
  2. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  3. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  4. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  5. "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
  6. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  7. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
  8. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
View all 8 references
Moderate

PDE5 inhibitors (applies to sildenafil) liver disease

Moderate Potential Hazard, High plausibility.

Phosphodiesterase 5 (PDE-5) inhibitors are cleared predominantly by hepatic metabolism. The pharmacokinetic disposition of these agents has not been assessed in patients with severe hepatic impairment. No dosage modification is recommended for patients with mild to moderate hepatic impairment, however, therapy with these agents should not be administered to patients with severe hepatic impairment. In patients with mild hepatic impairment a lower dose of these agents should be used as initial therapy.

References

  1. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  2. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  3. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  4. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group SUPPL-25 (2023):
  5. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2017):
  6. "Product Information. Liqrev (sildenafil)." Carolina Medical Products Company (2023):
View all 6 references
Moderate

PDE5 inhibitors (applies to sildenafil) seizure disorders

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures

The use of phosphodiesterase 5 (PDE-5) inhibitors has been associated with seizures. Therapy with these agents should be administered cautiously in patients with preexisting seizure disorders.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer U.S. Pharmaceuticals PROD (2001):
  2. "Product Information. Levitra (vardenafil)." Bayer (2003):
  3. "Product Information. Cialis (tadalafil)." Lilly, Eli and Company (2003):
  4. "Product Information. Revatio (sildenafil)." Pfizer U.S. Pharmaceuticals Group (2005):
  5. "Product Information. Adcirca (tadalafil)." United Therapeutics Corporation (2009):
  6. "Product Information. Stendra (avanafil)." Vivus Inc (2012):
  7. "Product Information. Staxyn (vardenafil)." Merck & Co., Inc (2014):
View all 7 references

Sildenafil drug interactions

There are 332 drug interactions with sildenafil.

Sildenafil alcohol/food interactions

There are 2 alcohol/food interactions with sildenafil.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.