Generic Name: Sildenafil Citrate

Brand Name: Viagra

Classification of Drug:

Chemical Class: Pyrazolopyrimidinone

Derivative

Therapeutic Class: Antihypertensive (pulmonary arterial), Anti-impotence

Mechanism of Action:  It provides relief to the patient by dilating the narrow
arteries which will allow blood to pass fluidly from the heart to the lungs. This will
now give the lungs proper amounts of oxygen, making the patient stronger.

Dose and Route:

For treatment of Pulmonary Hypertension

Adults. 20 mg three times a day, P.O.

Adults. 10 mg administered as bolus three times a day, I.V.

For Childhood Primary and Secondary Pulmonary Hypertension

Children and Adolescents weighing more than 20 kg

20 mg three times a day, P.O.

Children weighing 20 kg or less

10 mg three times a day, P.O.

Infants

0.5 to 1 mg/kg/dose PO every 8 hours

Indications: To treat pulmonary arterial hypertension in order to improve

exercise ability and delay clinical worsening of condition in patients classified as
group 1 by the World Health Organization.
Contraindications: Continuous or intermittent nitrate therapy, hypersensitivity to
sildenafil or components

Side Effects: CNS: Headache, flushing, dizziness

GI: Stomach pain, diarrhea

RESP: Difficult or labored breathing, runny nose

MS: Aches or pain in muscles

Skin: Redness, unusually warm skin

Adverse Reactions: CNS: Headache, dizziness, migraine, tremor, paresthesia,

burning sensation, somnolence, hypoesthesia, cerebrovascular
accident, syncope

CV: Flushing, heart rate increased, palpitations, tachycardia, hypertension,

hypotension, myocardial infarction, atrial fibrillation, sudden cardiac death,
ventricular arrhythmia, unstable angina

GI: Dyspepsia, diarrhea, nausea, vomiting, dry mouth, gastritis,

gastroesophageal reflux disease, hemorrhoids, abdominal distension, oral
hypoesthesia

MS: Pain in extremity, back pain, myalgia

OPTIC: Abnormal vision, visual color distortion, retinal hemorrhage, visual

impairment, vision blurred, photophobia, chromatopsia, cyanopsia, eye irritation,
ocular hyperemia

RESP: Pharyngitis, rhinitis, nasal congestion, epistaxis, cough, sinus congestion,

throat tightness, nasal edema, nasal dryness

DERMATOLOGIC: Rash, alopecia, erythema, night sweats

Drug Interactions: Drug: antiarrhythmics, anticonvulsants, digoxin,

levothyroxine, liothyronine, quinolones, tetracyclines, theophylline, warfarin:
Possibly altered absorption of these drugs 1078 sildenafil citrate phosphate salts,
phosphorus salts: Neutralized therapeutic effects of sevelamer ciprofloxacin:
Decreased ciprofloxacin effectiveness

Food: High-fat diet: reduced drug absorption, decreased peak level

Nursing Responsibilities:

1. Determine if the patient is hypersensitive to Sildenafil citrate or to any

components of the product.
2. Monitor cardiovascular status carefully.
3. Monitor serum phosphorus level to determine drug’s effectiveness;
monitor other serum electrolyte levels, especially bicarbonate and
chloride, to detect imbalances.
4. Instruct patient to take drug with meals and to swallow capsules or
tablets whole with water and not to open, break, or chew them.
5. Evaluate patient’s vision and hearing.
6. Instruct patient to notify prescriber immediately if serious cardiac and
vision problems and sudden decrease in or loss of hearing occur.
7. Instruct patient to report severe or prolonged constipation to prescriber
because additional treatment may be needed to prevent serious
complications.
8. Review symptoms of thrombosis, and advise patient to report them
immediately
9. Inform patient that drug can cause serious interactions with many
common drugs. Instruct the patient to tell all prescribers he is taking it.
10. Inform patient that high-fat diet may interfere with drug efficacy.