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Generic Name: sildenafil 50 mg viagra citrate, dosage Form: tablet, film coated, medically reviewed on November 1, 2017, show On This Page. View All, indications and Usage for Viagra, viagra is indicated for the treatment of erectile dysfunction. Viagra Dosage and Administration. Dosage Information, for most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, Viagra may be taken anywhere from 30 minutes to 4 hours before sexual activity. The maximum recommended dosing frequency is once per day. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or 50 mg viagra decreased to. Use with Food, viagra may be taken with or without food. Dosage Adjustments in Specific Situations, viagra was shown to potentiate the hypotensive 50 mg viagra effects of nitrates and its administration in patients who use nitric oxide donors such as organic nitrates or organic nitrites in any form is therefore contraindicated see. Contraindications (4.1), Drug Interactions 50 mg viagra (7.1), and, clinical Pharmacology (12.2). When Viagra is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating Viagra treatment and Viagra should be initiated at 25 mg see. Warnings and Precautions (5.5), Drug Interactions (7.2), and, clinical Pharmacology (12.2). Dosage Adjustments Due to Drug Interactions. Ritonavir, the recommended dose for ritonavir-treated patients is 25 mg prior to sexual activity and the recommended maximum dose is 25 mg within a 48 hour period because concomitant administration increased the blood levels of sildenafil by 11-fold see. Warnings and Precautions (5.6), Drug Interactions (7.4), and, clinical Pharmacology (12.3). CYP3A4 Inhibitors, consider a starting dose of 25 mg in patients treated with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, or saquinavir) or erythromycin. Clinical data have shown that co-administration with saquinavir or erythromycin increased plasma levels of sildenafil by about 3 fold see. Drug Interactions (7.4) and, clinical Pharmacology (12.3). Dosage Adjustments in Special Populations, consider a starting dose of 25 mg in patients 65 years, patients with hepatic impairment (e.g., cirrhosis and patients with severe renal impairment (creatinine clearance 30 mL/minute) because administration of Viagra in these patients resulted in higher plasma levels. Use in Specific Populations (8.5,.6,.7) and Clinical Pharmacology (12.3). Dosage Forms and Strengths Viagra is supplied as blue, film-coated, rounded-diamond-shaped tablets containing sildenafil citrate equivalent to 25 mg, 50 mg, or 100 mg of sildenafil. Tablets are 50 mg viagra debossed with pfizer on one side and VGR25, VGR50 or VGR100 on the other to indicate the dosage strengths. Contraindications Nitrates Consistent with its known effects on the nitric oxide/cGMP pathway see Clinical Pharmacology (12.1,.2), Viagra was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites. After patients have taken Viagra, it is unknown when nitrates, if necessary, can be safely administered. Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentration, it is unknown whether nitrates can be safely co-administered at this time point see Dosage and Administration (2.3), Drug Interactions (7.1), and Clinical Pharmacology (12.2). Hypersensitivity Reactions Viagra is contraindicated in patients with a known hypersensitivity to sildenafil, as contained in Viagra and revatio, or any component of the tablet. Hypersensitivity reactions have been reported, including rash and urticaria see Adverse Reactions (6.1). Concomitant Guanylate Cyclase (GC) Stimulators Do not use Viagra in patients who are using a GC stimulator, such as riociguat. PDE5 inhibitors, including Viagra, may potentiate the hypotensive effects of GC stimulators. Warnings and Precautions Cardiovascular There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Therefore, treatments for erectile dysfunction, including Viagra, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment. Viagra has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease.4/5.5 mmHg see Clinical Pharmacology (12.2). While this normally would be expected to be of little consequence in most patients, prior to prescribing Viagra, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity. Use with caution in patients with the following underlying conditions which can be particularly sensitive to the actions of vasodilators including Viagra those with left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure.

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