The following provides information on contraindications to the use of sildenafil in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Sildenafil not be used?
The active substance must not be used with
- Hypersensitivity to sildenafil
- concomitant intake of alpha-sympatholytic agents or nitro-based vasodilators (nitrates), as this may lead to severe hypotension
- concomitant use of active substances such as the fungicides ketoconazole and itraconazole and the anti-vitus agent ritonavir. They can increase the effects and side effects of sildenafil.
- severe cardiovascular disease, such as unstable angina pectoris or severe heart failure, after a stroke less than six months or within three months after a heart attack
- severe pulmonary hypertension (grade IV)
- severe renal or hepatic impairment
- low blood pressure with a systolic value less than 90 mmHg
- Hereditary disease of the retina (retinitis pigmentosa) or with damage to the optic nerve due to a circulatory disorder.
Only after careful medical benefit-risk assessment, the drug may be taken at
- Severe arterial circulatory disorders, especially with a narrowing in the area of the main artery (aortic stenosis)
- a blood pressure control disorder (multisystem atrophy)
- Gastric and duodenal ulcers
- Disorders of blood clotting, sickle cell anemia or certain forms of blood cancer (for example, leukemia, plasmocytoma)
- malformations of the penis
- Painful persistent erections (priapism) already occurred
- Kidney weakness or liver dysfunction (for example cirrhosis of the liver). It is recommended by the doctor to reduce the dose of sildenafil.
What should you watch out for during pregnancy and lactation?
The active substance has only recently been approved for use in women for the treatment of pulmonary hypertension (pulmonary hypertension). There are still no established findings about the risk for the unborn baby during pregnancy. However, animal studies revealed damage that did not develop until after birth. The drug should therefore not be used in pregnant women for the treatment of pulmonary hypertension, unless an application is considered urgent by the doctor.
Sildenafil should also not be taken while breastfeeding.
What should be considered in children?
The active substance is not suitable for children and adolescents below the age of 18.
Warnings and Precautions
- Taking the drug temporarily causes a slight drop in your blood pressure.
- There may be an increased risk of
myocardial infarction, arrhythmia and other life-threatening cardiovascular disorders associated with sexual activity when taking the drug.
- In some cases, irreversible optic nerve damage (nonarterial anterior ischemic optic neuropathy, NAION) has occurred. Whether a connection with the use of the drug is not known. In case of deterioration of vision, consult an ophthalmologist immediately.
- The use of the drug should not be combined with other treatments for erectile dysfunction (prostaglandins).
- The medicine should not be taken with grapefruit juice, as the combination may cause a sharp drop in blood pressure.
- If patients take the drug for sexual intercourse, they should not use nitrates during intercourse or thereafter in cardiac pain. Their combination with the drug can cause severe hypotension.
- The medication may cause dizziness and blurred vision, which may affect your ability to react.
- Reactivity may be altered by the drug to the point of affecting the ability to drive or operate machinery. This applies to a greater extent in conjunction with alcohol.
Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.