Skip to main content

Revatio Side Effects

Generic name: sildenafil

Medically reviewed by Drugs.com. Last updated on Oct 20, 2023.

Note: This document contains side effect information about sildenafil. Some dosage forms listed on this page may not apply to the brand name Revatio.

Applies to sildenafil: oral powder for suspension, oral suspension, oral tablet. Other dosage forms:

Serious side effects of Revatio

Along with its needed effects, sildenafil (the active ingredient contained in Revatio) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking sildenafil:

Less common

  • Bladder pain
  • burning feeling in the chest or stomach
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • cloudy or bloody urine
  • dizziness
  • increased frequency of urination
  • indigestion
  • pain on urination
  • stomach upset
  • tenderness in the stomach area

Rare

  • Abnormal vision
  • anxiety
  • behavior change similar to drunkenness
  • bleeding of the eye
  • blurred vision
  • bone pain
  • breast enlargement
  • chest pain
  • chills
  • cold sweats
  • confusion
  • cool and pale skin
  • deafness or hearing loss
  • decrease in amount of urine or the frequency of urination
  • decreased vision
  • difficulty in concentrating
  • dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position
  • double vision
  • drowsiness
  • dry eyes
  • dry mouth
  • dryness, redness, scaling, or peeling of the skin
  • excessive hunger
  • eye pain
  • fainting or faintness
  • fast, irregular, or pounding heartbeat
  • feeling of something in the eye
  • fever or chills
  • headache (severe or continuing)
  • increase in the size of the pupil
  • increased sweating
  • increased thirst
  • lower back or side pain
  • migraine headache
  • nausea (severe or continuing)
  • nervousness
  • nightmares
  • numbness of the hands
  • painful, swollen joints
  • prolonged, painful erection of penis
  • redness, burning, or swelling of the eyes
  • redness, itching, or tearing of the eyes
  • restless sleep
  • seeing shades of colors differently than before
  • seizures
  • sensitivity to light
  • shakiness
  • skin lesions with swelling
  • skin paleness
  • skin rash, hives, or itching
  • skin ulcers
  • slurred speech
  • sore throat
  • sudden weakness
  • swelling of the face, hands, feet, or lower legs
  • trouble breathing
  • twitching of the muscles
  • unusual feeling of burning or stinging of the skin
  • unusual tiredness or weakness
  • vision changes
  • vision loss, temporary

Incidence not known

  • Blindness

Other side effects of Revatio

Some side effects of sildenafil may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Aches or pains in the muscles
  • bloody nose
  • diarrhea
  • difficult or labored breathing
  • flushing
  • headache
  • pain or tenderness around the eyes and cheekbones
  • redness of the skin
  • sneezing
  • stomach discomfort following meals
  • stuffy or runny nose
  • trouble sleeping
  • unusually warm skin

Rare

  • Abdominal or stomach pain
  • abnormal dreams
  • anxiety
  • clumsiness or unsteadiness
  • cough
  • diarrhea or stomach cramps (severe or continuing)
  • difficulty in swallowing
  • ear pain
  • increased amount of saliva
  • increased skin sensitivity
  • lack of coordination
  • loss of bladder control
  • mental depression
  • nausea
  • numbness or tingling of the hands, legs, or feet
  • rectal bleeding
  • redness or irritation of the tongue
  • redness, soreness, swelling, or bleeding of the gums
  • ringing or buzzing in the ears
  • sensation of motion, usually whirling, either of one's self or of one's surroundings
  • sexual problems in men (continuing), including failure to experience a sexual orgasm
  • sleepiness
  • sores in the mouth and on the lips
  • tense muscles
  • trembling and shaking
  • vomiting
  • waking to urinate at night
  • worsening of asthma

For Healthcare Professionals

Applies to sildenafil: intravenous solution, oral powder for reconstitution, oral tablet.

General

The most common adverse reactions reported in clinical trials are headache, flushing, dyspepsia, abnormal vision, nasal congestion, back pain, myalgia, nausea, dizziness, and rash.[Ref]

Cardiovascular

Very common (10% or more): Flushing (10%)

Uncommon (0.1% to 1%): Heart rate increased, palpitations, tachycardia, hypertension, hypotension

Rare (less than 0.1%): Myocardial infarction, atrial fibrillation, sudden cardiac death, ventricular arrhythmia, unstable angina

Frequency not reported: Ventricular arrhythmia, sudden cardiac death, angina pectoris, AV block, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy, shock

Postmarketing reports: Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction; sudden cardiac death; ventricular arrhythmia; cerebrovascular hemorrhage; transient ischemic attack; hypertension; subarachnoid, intracerebral, and pulmonary hemorrhage have been reported in temporal association with the use of this drug.[Ref]

Gastrointestinal

Very common (10% or more): Dyspepsia (up to 17%), diarrhea

Common (1% to 10%): Nausea, vomiting, dry mouth, gastritis, gastroesophageal reflux disease, hemorrhoids, abdominal distension

Rare (less than 0.1%): Oral hypoesthesia

Frequency not reported: Glossitis, colitis, dysphagia, gastroenteritis, esophagitis, stomatitis, gingivitis[Ref]

Musculoskeletal

Very common (10% or more): Pain in extremity

Common (1% to 10%): Back pain, myalgia

Frequency not reported: Arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis[Ref]

Nervous system

Very common (10% or more): Headache (up to 28%)

Common (1% to 10%): Dizziness, migraine, tremor, paresthesia, burning sensation

Uncommon (0.1% to 1%): Somnolence, hypoesthesia

Rare (less than 0.1%): Cerebrovascular accident, syncope

Frequency not reported: Transient ischemic attack, seizure, seizure recurrence, ataxia, hypertonia, neuralgia, neuropathy, paresthesia, somnolence, reflexes decreased

Postmarketing reports: Transient global amnesia[Ref]

Ocular

This drug has lesser affinity for isoenzyme PDE6, an enzyme found in the retina. This lower selectivity is thought to be the basis for abnormalities related to color vision observed with higher doses or plasma levels.

Nonarteritic anterior ischemic optic neuropathy developed in one eye within minutes to hours after ingestion of sildenafil (the active ingredient contained in Revatio) Four of the five patients had no vascular risk factors for ischemic optic neuropathy.

-Abnormal Vision: Mild to moderate and transient, predominantly color tinge to vision, but also increased sensitivity to light, or blurred vision.

-Visual color distortions: Chloropsia, chromatopsia, cyanopsia, erythropsia and xanthopsia

-Lacrimation disorders: Dry eye, lacrimal disorder and lacrimation increased[Ref]

Very common (10% or more): Abnormal vision (up to 11%)

Common (1% to 10%): Visual color distortion, retinal hemorrhage, visual impairment, vision blurred, photophobia, chromatopsia, cyanopsia, eye irritation, ocular hyperemia

Uncommon (0.1% to 1%): Conjunctival disorders, eye disorders, eye pain, lacrimation disorders, visual acuity reduced, diplopia, abnormal sensation in eye, photopsia, visual brightness, conjunctivitis

Rare (less than 0.1%): Retinal hemorrhage, arteriosclerotic retinopathy, retinal disorder, glaucoma, visual field defect, myopia, asthenopia, vitreous floaters, iris disorder, mydriasis, halo vision, eye edema, eye swelling, eyelid edema, scleral discoloration

Frequency not reported: Non-arteritic anterior ischemic optic neuropathy (NAION), retinal vascular occlusion, visual field defect, cataract[Ref]

Respiratory

Very common (10% or more): Pharyngitis (18%), rhinitis

Common (1% to 10%): Nasal congestion, epistaxis, cough

Uncommon (0.1% to 1%): Sinus congestion

Rare (less than 0.1%): Throat tightness, nasal edema, nasal dryness

Frequency not reported: Asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased[Ref]

Dermatologic

Common (1% to 10%): Rash, alopecia, erythema, night sweats

Frequency not reported: Steven-Johnson syndrome (SJS), toxic epidermal necrolysis(TEN), urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis[Ref]

Hematologic

Common (1% to 10%): Anemia

Frequency not reported: Leukopenia

Postmarketing reports: In patients with pulmonary arterial hypertension (secondary to sickle cell disease) taking Revatio (R), vaso-occlusive crises requiring hospitalization were more commonly reported. The clinical relevance of this finding in male patients treated with sildenafil (the active ingredient contained in Revatio) for erectile dysfunction is unknown.[Ref]

Metabolic

Common (1% to 10%): Fluid retention

Frequency not reported: Thirst, edema, gout, unstable diabetes, hyperglycemia, hyperuricemia, hypoglycemic reaction, hypernatremia[Ref]

Other

Common (1% to 10%): Cellulitis, influenza, bronchitis, sinusitis, rhinitis, gastroenteritis, vertigo, pyrexia

Uncommon (0.1% to 1%): Tinnitus, chest pain, fatigue, gynecomastia

Rare (less than 0.1%): Deafness, irritability

Frequency not reported: Sudden hearing loss, edema, face edema, peripheral edema, pain, chills accidental fall, accidental injury[Ref]

Psychiatric

Common (1% to 10%): Insomnia, anxiety

Frequency not reported: Abnormal dreams, depression[Ref]

Genitourinary

Uncommon (0.1% to 1%): Penile hemorrhage, hematospermia

Frequency not reported: Priapism, prolonged erection, increased erection, cystitis, nocturia, urinary frequency, urinary incontinence, abnormal ejaculation, genital edema, anorgasmia[Ref]

Renal

Uncommon (0.1% to 1%): Hematuria[Ref]

Hypersensitivity

Rare (less than 0.1%): Hypersensitivity reactions, including rash and urticaria[Ref]

Hepatic

Frequency not reported: Liver function tests abnormal[Ref]

Frequently asked questions

References

1. Product Information. Viagra (sildenafil). Pfizer U.S. Pharmaceuticals. 2001.

2. Product Information. Revatio (sildenafil). Pfizer U.S. Pharmaceuticals Group. 2005.

3. Cerner Multum, Inc. UK Summary of Product Characteristics.

4. Cerner Multum, Inc. Australian Product Information.

5. Feenstra J, vanDriePierik RJHM, Lacle CF, Stricker BHC. Acute myocardial infarction associated with sildenafil. Lancet. 1998;352:957-8.

6. Goldenberg MM. Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. Clin Ther. 1998;20:1033-48.

7. Zusman RM. Cardiovascular data on sildenafil citrate - Introduction. Am J Cardiol. 1999;83:c1-2.

8. 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. 1999;83:c29-34.

9. Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. Am J Cardiol. 1999;83:c35-44.

10. 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. 1999;53:1011-8.

11. Kloner RA, Zusman RM. Cardiovascular effects of sildenafil citrate and recommendations for its use. Am J Cardiol. 1999;84:n11-7.

12. 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. 2000;320:69-71.

13. Kloner RA. Cardiovascular risk and sildenafil. Am J Cardiol. 2000;86:f57-61.

14. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED. Side-effect profile of sildenafil citrate (Viagra) in clinical practice. Urology. 2000;56:474-6.

15. McMahon CG, Smali R, Johnson H. Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction. J Urol. 2000;164:1192-6.

16. Malozowski S, Sahlroot JT. Hemodynamic effects of sildenafil. N Engl J Med. 2000;343:967-8.

17. Dunn N. Cardiovascular events in users of sildenafil - Paper does not provide any reassurance. Br Med J. 2001;323:50-1.

18. Arruda-Olson AM, Mahoney DW, Nehra A, Leckel M, Pellikka PA. Cardiovascular effects of sildenafil during exercise in men with known or probable coronary artery disease: a randomized crossover trial. JAMA. 2002;287:719-25.

19. McLeod AL, McKenna CJ, Northridge DB. Myocardial infarction following the combined recreational use of Viagra and cannabis. Clin Cardiol. 2002;25:133-4.

20. Egan RA, Pomeranz H. Transient ischemic attack an stroke associated with sildenafil (Viagra) use. Neurology. 2002;59:293-4.

21. Bocchi EA, Guimaraes G, Mocelin A, Bacal F, Bellotti G, Ramires JF. Sildenafil effects on exercise, neurohormonal activation, and erectile dysfunction in congestive heart failure: a double-blind, placebo-controlled, randomized study followed by a prospective treatment for erectile dysfunction. Circulation. 2002;106:1097-103.

22. Stanopoulos I, Hatzichristou D, Tryfon S, Tzortzis V, Apostolidis A, Argyropoulou P. Effects of sildenafil on cardiopulmonary responses during stress. J Urol. 2003;169:1417-21.

23. Tran D, Howes LG. Cardiovascular safety of sildenafil. Drug Saf. 2003;26:453-60.

24. Brindis RG, Kloner RA. Sildenafil in patients with cardiovascular disease. Am J Cardiol. 2003;92(9 Suppl):26-36.

25. Khandheria BK. Erection, erectile dysfunction: what has heart got to do with it? Herz. 2003;28:275-6.

26. Arruda-Olson AM, Pellikka PA. Appropriate use of exercise testing prior to administration of drugs for treatment of erectile dysfunction. Herz. 2003;28:291-7.

27. Webster LJ, Michelakis ED, Davis T, Archer SL. Use of sildenafil for safe improvement of erectile function and quality of life in men with New York Heart Association classes II and III congestive heart failure: a prospective, placebo-controlled, double-blind crossover trial. Arch Intern Med. 2004;164:514-20.

28. Israilov S, Baniel J, Shmueli J, et al. Treatment program for erectile dysfunction in patients with cardiovascular diseases. Am J Cardiol. 2004;93:689-93.

29. Jackson G. Treatment of erectile dysfunction in patients with cardiovascular disease : guide to drug selection. Drugs. 2004;64:1533-45.

30. Boolell M, Gepi-Attee S, Gingell JC, Allen MJ. Sildenafil, a novel effective oral therapy for male erectile dysfunction. Br J Urol. 1996;78:257-61.

31. PadmaNathan H, Steers WD, Wicker PA. Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: A double-blind, placebo-controlled study of 329 patients. Int J Clin Pract. 1998;52:375-9.

32. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998;338:1397-404.

33. Bortolotti M, Mari C, Lopilato C, Porrazzo G, Miglioli M. Effects of sildenafil on esophageal motility of patients with idiopathic achalasia. Gastroenterology. 2000;118:253-7.

34. Bosch X. Sildenafil's effects extended to additional organs. Lancet. 2000;355:631.

35. Savitz SA, Caplan LR. Transient global amnesia after sildenafil (Viagra) use. Neurology. 2002;59:778.

36. Gilad R, Lampl Y, Eshel Y, Sadeh M. Tonic-clonic seizures in patients taking sildenafil. BMJ. 2002;325:869.

37. Zrenner E. No cause for alarm over retinal side-effects of sildenafil. Lancet. 1999;353:340-1.

38. Vobig MA, Klotz T, Staak M, BartzSchmidt KU, Engelmann U, Walter P. Retinal side-effects of sildenafil. Lancet. 1999;353:375.

39. Marmor MF. Sildenafil (Viagra) and ophthalmology. Arch Ophthalmol. 1999;117:518-9.

40. Vobig MA. Retinal side-effects of sildenafil. Lancet. 1999;353:1442.

41. Egan R, Pomeranz H. Sildenafil (Viagra) associated anterior ischemic optic neuropathy. Arch Ophthalmol. 2000;118:291-2.

42. Jagle H, Jagle C, Serey L, et al. Visual short-term effects of viagra: double-blind study in healthy young subjects. Am J Ophthalmol. 2004;137:842-9.

43. Gandhi JS. Sildenafil-associated NAION. Ophthalmology. 2003;110:1860-1; author reply 1861.

44. Boshier A, Pambakian N, Shakir SA. A case of nonarteritic ischemic optic neuropathy (NAION) in a male patient taking sildenafil. Int J Clin Pharmacol Ther. 2002;40:422-3.

45. Pomeranz HD, Smith KH, Hart WM Jr, Egan RA. Sildenafil-associated nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2002;109:584-7.

46. Viagra and loss of vision. Med Lett Drugs Ther. 2005;47:49.

47. Milman HA, Arnold SB. Neurologic, psychological, and aggressive disturbances with sildenafil. Ann Pharmacother. 2002;36:1129-34.

48. Kassim AA, Fabry ME, Nagel RL. Acute priapism associated with the use of sildenafil in a patient with sickle cell trait. Blood. 2000;95:1878-9.

49. Goldmeier D, Lamba H. Prolonged erections produced by dihydrocodeine and sildenafil. BMJ. 2002;324:1555.

Further information

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

Some side effects may not be reported. You may report them to the FDA.