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Uses

Primary indications include erectile dysfunction in adult men and pulmonary arterial hypertension in both sexes. In ED, it facilitates penile erection in response to sexual stimulation. For PAH, it reduces pulmonary vascular resistance, improving exercise capacity. Off-label research has explored benefits for Raynaud’s phenomenon and high-altitude pulmonary edema, though routine use is not established.

Dosage & Administration

For ED, the typical starting dose is 50 mg taken as needed 30 to 60 minutes before sexual activity, not more than once daily. Adjustments range from 25 to 100 mg based on efficacy and tolerability. For PAH (Revatio), the recommended dose is 20 mg three times daily. Tablets should be swallowed with water; grapefruit products and heavy meals may delay absorption.

Side Effects & Warnings

Common reactions include headache, flushing, nasal congestion, dizziness, and dyspepsia. Visual disturbances such as tinted vision or blurred focus can occur from PDE6 inhibition in the retina. Serious but rare effects include priapism, sudden hearing loss, and cardiac events in susceptible patients. Contraindicated with nitrate therapy or severe hypotension. Use with alpha-blockers requires medical supervision.

Patient Considerations

Patients with cardiovascular disease, retinal degeneration, or hepatic/renal impairment should consult a doctor before use. Alcohol may worsen hypotension. Sildenafil does not protect against sexually transmitted infections and is not an aphrodisiac. Women and children should use it only for approved PAH indications.