Sildenafil

Status

FDA-approved. FDA-approved labeling exists as Viagra for erectile dysfunction and as Revatio for pulmonary arterial hypertension. Both are contraindicated with organic nitrates in any form and with guanylate cyclase stimulators such as riociguat.

What it is

A short-acting PDE5 inhibitor approved for erectile function.

What published research measured

A phosphodiesterase type 5 inhibitor with one of the largest randomized evidence bases of any drug in this library, establishing efficacy for erectile dysfunction across aetiologies, and separately for pulmonary arterial hypertension at different dosing. The safety issue that matters most is an interaction rather than a toxicity: co-administration with organic nitrates causes profound and potentially fatal hypotension, and this is an absolute contraindication rather than a caution. Alpha-blockers require care for the same reason. Rare but serious reported events include non-arteritic anterior ischaemic optic neuropathy, sudden hearing loss and priapism, all of which appear in approved labeling and all of which warrant immediate medical attention.

Source

FDA labeling for Viagra and Revatio, including the nitrate contraindication

Sources

• Half-life source for Sildenafil