USE IN SPECIFIC POPULATIONS

Breastfeeding This drug should be used if the benefits outweigh the risks. Though harm is not expected based on the drug properties, inadequate human data is available to evaluate the risk of infant harm.

Overdose/Missed Dose

This drug is available in 3 packaging options: a box containing a blister of 4 tablets, a box containing 100 tablets, or a bottle of 1000 tablets. AdvaCare Pharma is a global distributor and manufacturer of Sildenafil Citrate Tablets. This medicine is produced in our GMP-certified facilities in China, India, and the USA. Our factories are routinely inspected to ensure they meet the high standards necessary to comply with WHO guidelines and standards. AdvaCare Pharma is a trusted Sildenafil manufacturer committed to providing quality-assured, cost-effective pharmaceuticals for an ever-changing global market.

When to take

Manufacturing a wide range of 200+ pharmaceutical products in tablet form, we ensure that all of our oral solid dosage forms adhere to stringent GMP standards. We operate according to a unique "vested supplier-distributor relationship" business model, in which we tie our success in a market to that of our distributor. Such a model facilitates a closer relationship by working together to achieve pre-defined goals for market entry and expansion. As a Sildenafil manufacturer and global supplier, we implement unique strategies to ensure successful distribution. It is used to treat erectile dysfunction in men. There is no human data available that addresses this drug’s effects on milk production. Children It is advised to avoid high-dose therapy with Sildenafil in pediatric patients, as there is a greater risk of mortality.

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Geriatric When used to treat erectile dysfunction, Sildenafil is typically well tolerated by healthy elderly male patients. Studies have not shown significant differences in response but have reported that healthy elderly patients show a reduced clearance of the drug that could increase the risk of adverse effects. As this population is more likely to have medical conditions, it is advised to use a lower starting dose. This medication should be stored at room temperature between 15-30°C. Keep the tablets out of the reach of children and pets. For patients taking CYP3A4 inhibitors, the starting dose should be not more than 25mg per day.

5.5 Hearing Loss

If it is nearly time for the next scheduled dose, then the missed dose should be skipped. Sildenafil Citrate Tablets can be given to adults and children, but caution is advised for specific groups of patients. Pregnant It is not known whether Sildenafil causes fetal harm. It is important to note that pulmonary hypertension increases the risk of complications during pregnancy, including heart failure or stroke, for both the mother and fetus. Sildenafil should be used if the benefits outweigh the risks under medical discretion. For patients taking ritonavir-boosted HIV inhibitors, the maximum dosage is 25mg in 48 hours. For stable patients taking alpha-blockers, the starting dose should be 25mg.

• Using sildenafil with certain medicines can cause serious interactions.
• Blood pressure medications and alpha-blockers are common concerns.
• Always inform your doctor of all medications you're taking.

It is advised to monitor blood pressure and pulse when this drug is used with hypotensive medications. The combination of Sildenafil with nitrate and nicorandil can lead to a significant drop in blood pressure, which can potentially be fatal.

Warnings & Precautions

Prescription savings vary by prescription and by pharmacy, and may reach up to 80% off cash price. This program offers you the opportunity to locate providers of various types of medical services who will offer their services to you at discounted rates. The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and service received. You are fully responsible for paying for all health care services but will be entitled to receive a discount from those health care providers in accordance with the specific pre-negotiated discounted fee schedule. This program does not guarantee the quality of the services or procedures offered by the providers.

Who can use Sildenafil Citrate Tablets?

Except for prescription drugs which you will pay directly to the pharmacy at the time of purchase, all other services received through a program provider will be charged to the credit card on file in your member account. The charge will include an administrative fee for use of the program. Towers Administrators LLC is the licensed discount medical plan organization with its administrative office located at 4510 Cox Road, Suite 111, Glen Allen, VA 23060. SingleCare Services, LLC is the marketer of the discount medical plan organization including its website, singlecare.com, with its corporate office located at 99 High Street, Suite 2800, Boston, MA 02110. For additional information, including an up-to-date list of providers, or assistance with any issue related to program membership, please contact member support any time at or by calling toll-free 844-234-3057, 24 hours, 7 days a week (except major holidays). As with all pharmaceuticals, some unwanted effects can occur from the use of Sildenafil Citrate Tablets.

Parameter	Value	Notes
Absorption Time	30-120 minutes	Peak plasma levels in approx. 1 hour
Bioavailability	About 40%	Due to first-pass metabolism
T1/2 (Half-life)	4-5 hours	Eliminated mainly via hepatic metabolism
Onset of Action	30-60 minutes	Varies with food intake
Duration of Effect	Up to 4-6 hours	Depending on dose and individual

Common side effects include, but may not be limited to: Seek medical attention if the following symptoms develop: blurred vision or sudden loss of vision ringing in the ears or a sudden decrease or loss of hearing erection that lasts longer than 4 hours For a comprehensive understanding of all potential side effects, consult a medical professional. If any symptoms persist or worsen, or you notice any other symptoms, please call your doctor immediately.

5.1 Cardiovascular

The dose can be increased up to 80mg taken 3 times per day. Renal Dosing For erectile dysfunction, a starting dose of 25mg should be considered for patients with severe renal impairment (CrCl < 30). Dosing adjustment guidelines have not been defined for patients with HD/PD. For pulmonary arterial hypertension, no adjustment is needed for patients with renal impairment. Hepatic Dosing For erectile dysfunction, a starting dose of 25mg should be considered for patients with hepatic impairment or cirrhosis.

Drugs Affecting Gastric Acidity

For pulmonary arterial hypertension, no adjustment is needed for patients with Child-Pugh Class A or B. Dosing adjustment guidelines have not been defined for patients with Child-Pugh Class C. Pediatric Dosing For pulmonary arterial hypertension, doses for pediatric patients from 1 to 17 years old are based on body weight. body weight < 20kg: 10mg taken 3 times per day. body weight 20-45kg: 20mg taken 3 times per day. Do NOT use Sildenafil Citrate Tablets if: You are allergic to sildenafil or any of the other ingredients.

Condition	Details	Notes
Temperature	Store below 25°C	Keep in a dry place
Light	Protect from light	Use opaque container
Humidity	Keep away from moisture	Avoid bathroom storage
Shelf Life	Usually 2-3 years	Check expiration date

You are taking a nitrate drug, such as nitroglycerin, isosorbide dinitrate, or or isosorbide mononitrate.

Medication Class	Interaction Type	Effect	Clinical Significance
Nitrates	Additive hypotensive effect	Severe hypotension	Contraindicated
Alpha-blockers	Enhanced hypotension	Blood pressure drop	Use with caution
CYP3A4 inhibitors	Increased sildenafil levels	Prolonged or intensified side effects	Dose adjustment may be needed
Protease inhibitors	Elevated sildenafil levels	Increased adverse effects	Monitoring required

You have been advised to currently refrain from sexual activity.

5.8 Effects on Bleeding

Pharmacy names, logos, brands, and other trademarks are the property of their respective owners. They are intended for general informational purposes and are not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911. Sildenafil Citrate Tablets are a drug used in the treatment of sexual function problems (erectile dysfunction, impotence) in males.

Who should not take sildenafil?

This medication is not a cure for erectile dysfunction. Sildenafil Citrate is also used to improve exercise capacity in patients with pulmonary arterial hypertension. The active ingredient works by preventing the enzyme phosphodiesterase type-5 from working. This relaxes the muscles and blood vessels and allows the flow of blood to increase to the penis during sexual stimulation. Sildenafil Citrate Tablets are produced with a dosage of 50mg or 100mg. You have vision loss due to non-arteritic anterior ischaemic optic neuropathy.

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

body weight > sildenafil citrate 100mg tablets 45kg: 20mg taken 3 times per day. The maximum dosage is 120mg per day. Renal Dosing for pediatrics No adjustment is needed for children with renal impairment. Dosing adjustment guidelines have not been defined for pediatric patients with HD/PD. Hepatic Dosing for pediatrics No adjustment is needed for children with Child-Pugh Class A or B.

Pharmacokinetics in Special Populations

Dosing adjustment guidelines have been defined for pediatric patients with Child-Pugh Class C. The dosage is based on medical condition, response to treatment, age, and weight. Refer to a doctor or pharmacist for guidelines on dosage. When taken for erectile dysfunction, this drug is used as needed so it is unlikely to be forgotten. When taken for pulmonary arterial hypertension, the forgotten dose should be taken as soon as it is remembered. You have a history of heart attack or stroke in the past six months.

Usual Adult Dose for Pulmonary Hypertension

Sildenafil Citrate is also used to improve exercise ability and slow down the progression of pulmonary arterial hypertension in children and adults. This medication is intended to be taken orally. It can be taken with or without food, but a high-fat meal may delay the drug's activity. Adult Dosing For erectile dysfunction, the usual dose is 25-100mg taken 30 minutes to 4 hours before sexual activity. It is recommended to consider a starting dose of 25mg in patients over 65 years old.

Are you currently using Sildenafil (Viagra, Revatio)?

For pulmonary arterial hypertension, the usual dose is 20mg taken 3 times per day. Doses should be taken 4-6 hours apart. Geriatric Dosing For erectile dysfunction in patients 65 years or older, the usual starting dose is 25mg 30 minutes to 4 hours before sexual activity. The dose can be increased based on tolerance and effectiveness. The maximum dosage is 100mg per day. You have known hereditary degenerative retinal disorders such as retinitis pigmentosa. Drug interactions may increase your risk for serious side effects or change how your medications work.

• Common side effects include headache and flushing.
• Some may experience nasal congestion or dizziness.
• Serious side effects require immediate medical attention.

Consult with your doctor about any vitamins, supplements, or medications you are taking before treatment with sildenafil citrate.

• Physical activity might improve erectile response when combined with medication.
• Maintain a healthy weight for better sexual function.
• Lifestyle changes can enhance sildenafil efficacy over time.

This drug is known to interact with medications for hypertension or prostate problems, antifungals (e.g. This is not a complete list of possible interactions.

• Overdose symptoms may include dizziness, nausea, or prolonged erections.
• Seek emergency help if an erection lasts over 4 hours.
• Avoid excessive dosing to prevent adverse events.