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Sildenafil relaxes muscles and increases blood flow to particular areas of the body. Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Do not take Viagra while also taking Revatio, unless your doctor tells you to. Sildenafil may also be used for purposes not listed in this medication guide.

Ordering sildenafil as a treatment for erectile dysfunction have been published. This raises questions about the safety of sildenafil. How should sildenafil be used? The drug is available for treatment of erectile dysfunction in most countries, and can probably be obtained without difficulty over-the-counter. The manufacturer's package insert describes its use order sildenafil for the treatment of "men with ED in general" who can't be cured by therapy or who have given up without success. If we take the package insert at face value, the dosage of sildenafil recommended for such men is much lower than the maximum daily dose recommended for general ED in Medline (0.9 mg twice daily) and the maximum daily dose recommended in the FDA-approved (Viagra) labeling. There are two important caveats with this formulation. The first is that recommended dosage for erectile dysfunction in men without coronary heart disease is 1 mg three times daily in the morning. second is that no data are provided in the package insert concerning specific dosing regimen used when oral sildenafil is taken as an adjunct to therapy with a "long acting" vasoconstrictor. We therefore recommend careful assessment of the benefits and risks this formulation in patients with a range of health conditions, especially patients who cannot be treated or would like to be treated more aggressively with other drugs. For all patients, the best option is probably to monitor the response treatment with sildenafil in to any of the various cardiovascular, antidiabetic, antihypertensive, and other drugs that help maintain a healthy blood pressure and pressure-lowering profile. References 1. Arumugam M, Toga AW, et al: Comparison of the pharmacologic efficacy sildenafil and other long-acting nitrates in subjects with erectile dysfunction. J Urol 1982;140:1439-43. 2. DeCarli A, Chiuve SE, et al: Comparison of the pharmacologic efficacy sildenafil and nitrate derivatives vardenafil nifedipine in subjects with erectile dysfunction. Arch Dis Child 1986;53:1303-7. 3. Bhattacharya S, Datta SR, Gupta RK: Viagra vs. the nitrate derivatives: a comparison study in patients with erectile disorder. J Urol 1993;166(Suppl 1):20-4. Pubmed Abstract | Full Text 4. Barrowclough JC, Alcock DJ, et al: Effect of nitrates order sildenafil online uk on serum testosterone levels in normal male volunteers and hypogonadal men affected with delayed or total penile erection. J Clin Invest 1993;94:1194-201. Pubmed Abstract | Full Text 5. Barrowclough JC, Alcock DT, et al: Effects of nitrates on plasma testosterone and estradiol levels in normal men treated with Cialis. J Urol 1993;166:1065-7. Pubmed Abstract | Full Text 6. Barrowclough JC, Alcock DT, et al: Effect of sildenafil treatment and other nitrate-substituted order sildenafil citrate online compounds on plasma testosterone and estradiol concentrations in men treated with Viagra. J Clin Endocrinol Metab 1999;84:2727-32. Pubmed Abstract | Full Text 7. Jadad MS, Barrowclough JC, et al: Efficacy of pravastatin and atorvastatin in men with erectile dysfunction. New England Journal of Medicine 2000;335:1659-62. Pubmed Abstract | Full Text 8. Caspi A, De Simone T, Boniol S, Caprioli A, DiGiorgio M: High-density lipoprotein subclass pattern impairs long-term response to sildenafil in normal volunteers. Clin Pharmacol Ther 1993;61:1123-5. Pubmed Abstract | Full Text 9. Krasowski W, Eriksson G: A comparison of the effects sildenafil and N-acetylcysteine metabolite nitroglycerin on plasma levels of testosterone and estradiol in healthy men. Fertil Steril 1993;50:1473-8. 10. Krasowski W, Eriksson G: Selective metabolism of sildenafil with N-acetylcysteine in men. J Clin Endocrinol Metab 2001;87:4287-96. Pubmed Abstract | Full Text 11. Lohmann A, Bracknell M, B, et al: Nitric oxide and nitrate release from rat cerebral microvascular endothelia in response.

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