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Viagra with other medicines

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Viagra with other medicines

VIAGRA revealed that to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors like as organic nitrates or organic nitrites in any form is therefore contraindicated [see CLINICAL PHARMACOLOGY, CONTRAINDICATION and DRUG INTERACTIONS].

 

When VIAGRA is co-administered with an alpha-blocker, patients should be secured on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at 25 mg [see WARNINGS AND PRECAUTIONS, DRUG INTERACTIONS, and CLINICAL PHARMACOLOGY].

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Viagra’s Drug Interactions and Contraindications

Precise drug interactions can occur when taking Viagra along with other medications and the interactivity can act to either lessen or increase the effects of Viagra, and can cause unanticipated side effects.

 

Cimetidine (brand name Tagamet), classified as a nonspecific CYP inhibitor used to inhibit stomach acid production, has been proclaimed to expand the concentration of sildenafil in patients’ blood. CYP3A4 inhibitors, when taken in conjunction with Viagra, have also been revealed  to increase blood concentration levels of sildenafil.

 

The HIV drug ritonavir, when consumed with Viagra, resulted in a four-fold expansion in the amount of sildenafil present in patients’ blood in clinical studies. This necessitated a suggested dosing adjustment in patients taking Viagra while also being cured with ritonavir. Patients taking both medications should not take Viagra more often than every two days.

 

Moreover,Viagra with other medicines Viagra is not suggested to be taken by patients who:

 

Are also taking medicines called nitrates (such as nitroglycerin), which are used to cure high blood pressure during surgery and specific heart conditions

Use crescent medicines called “poppers” (such as amyl nitrate or amyl nitrite, and butyl nitrate)

Take any medicines called guanylate cyclase stimulators, such as riociguat (Adempas), which are used to cure two types of pulmonary hypertension in adults.

Any other ingredients in Viagra or Viagra with other medicines

Have had allergic reactions to sildenafil, as contained in Viagra and Revatio. Don’t use Sildenafil with any other drugs or devices that cause erections. First tell your doctor about any heart problems you have now or may have had in the past. This medicine can cause serious side effects in patients with cardiovascular problems.

Men whose blood pressure is not under control and those who take alpha-blockers (for high blood pressure or prostate problems) should not take Cialis, Levitra, Staxyn, or Viagra. Also, you may not be able to take these drugs if you: Take nitrate drugs (for chest pain) Had a heart attack or stroke in the past half year.

Do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others).

Viagra with other medicines

In combination with ED drugs, these 56 drugs can cause dangerous falls in blood pressure that could lead to a cardiovascular attack or stroke; a potentially harmful “overdose,” even when taking the suggested amount; and decrease the effectiveness of the ED drugs themselves.

The drugs include the normal suspects, such as nitrates for blood pressure. Taken in combination with Viagra, Cialis or Levitra nitrates can lead to potentially lethal fall in blood pressure.

But the list also includes some surprises — menage name drugs that shouldn’t be taken with ED pills — including Flomax, Provigil and grapefruit juice. Some medicines increase plasma concentrations of ED drugs, potentially leading to toxicity, and others reduce those concentrations, making the drugs unproductive. Some examples:

 

Potential low blood pressure triggers:

Flomax (Boehringer Ingelheim)

Potential toxicity:

Reyataz (Bristol-Myers Squibb)

Grapefruit juice

Diflucan (Pfizer)

Gleevec (Novartis)

Crixivan (Merck)

Tykerb (GlaxoSmithKline)

Mifeprex (Danco Labs)

Viracept (Pfizer)

Ketek (Sanofi-Aventis)

Potential Inhibitors:

Sustiva (BMS)

Provigil (Cephalon)

Viramune (Boehringer)

DRUG INTERACTIONS

Nitrates

Regulation of VIAGRA with nitric oxide donors such as organic nitrates or organic nitrites in any form is contraindicated. Congruous with its known effects on the nitric oxide/cGMP pathway, VIAGRA was shown to potentiate the hypotensive effects of nitrates [see DOSAGE AND ADMINISTRATION, CONTRAINDICATIONS, CLINICAL PHARMACOLOGY].

 

Alpha-blockers

Be aware when co-administering alpha-blockers with VIAGRA because of potential additive blood pressure-lowering conclusion.

Amlodipine

When VIAGRA 100 mg was co-administered with amlodipine (5 mg or 10 mg) to hypertensive patients, the mean additional depletion on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic [see WARNINGS AND PRECAUTIONS OF CLINICAL PHARMACOLOGY].

 

Ritonavir And Other CYP3A4 Inhibitors

Co-administration of ritonavir, a strong CYP3A4 inhibitor, substantially improved the systemic exposure of sildenafil (11-fold increase in AUC). It is therefore suggested not to exceed a maximum single dose of 25 mg of VIAGRA in a 48 hour period [see DOSAGE AND ADMINISTRATION, WARNINGS AND PRECAUTIONS, CLINICAL PHARMACOLOGY].

 

Co-administration of erythromycin, a moderate CYP3A4 inhibitor, resulted in a 160% and 182% increase in sildenafil Cmax and AUC, respectively. Co-administration of saquinavir, a strong CYP3A4 inhibitor, outcomes in 140% and 210% increases in sildenafil Cmax and AUC, respectively. Robust CYP3A4 inhibitors such as ketoconazole or itraconazole could be expected to have prominent effects than seen with saquinavir. The first dose of 25 mg of VIAGRA should be considered in patients taking erythromycin or strong CYP3A4 inhibitors (such as saquinavir, ketoconazole, itraconazole) [see DOSAGE AND ADMINISTRATION, CLINICAL PHARMACOLOGY].

 

Alcohol

In a drug-drug interaction study sildenafil 50 mg given with alcohol 0.5 g/kg in which mean maximum blood alcohol levels of 0.08% was achieved, sildenafil did not potentiate in healthy volunteers  the hypotensive effect of alcohol [see CLINICAL PHARMACOLOGY].

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