Sildenafil
Brand Names: Revatio
Methodology & AI Transparency ⓘ
Sildenafil Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Sildenafil citrate is indicated for the treatment of erectile dysfunction.
- 2 Real-world patient consensus: 74% patient "Worth It" rating across 4 anonymous logs for Sildenafil (RxNorm 314229).
- 3 Typical cash cost range: Uninsured 30-day outlay compares $5.84 wholesale mail-order against $34.50 retail pharmacy pricing.
- 4 Top reported side effects / signs: Most commonly reported Sildenafil tolerability events: nausea (12.6%), headache (11.2%), dizziness (6.9%).
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Sildenafil Mechanism, CYP450 Pathways & DailyMed Monograph
Sildenafil citrate is indicated for the treatment of erectile dysfunction. Sildenafil citrate is a phosphodiesterase-5 (PDE5) inhibitor indicated for the treatment of erectile dysfunction (ED) ( 1 )
12.1 Mechanism of Action The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. Sildenafil enhances the effect of NO by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum.
Following administration (50 mg/1 Tablet, Film Coated), Sildenafil achieves ~41% systemic bioavailability (Sildenafil) bioavailability and peak plasma concentration (tmax) reached 1–2 hours post-dose for sildenafil onset, governed by a Approximately 3–10 hours terminal plasma half-life for Sildenafil terminal half-life through hepatic oxidation via cyp3a4 followed by renal and biliary excretion of sildenafil metabolites.
Before initiating Sildenafil at 50 mg/1 Tablet, Film Coated, clinical safety checklists rule out administration of sildenafil tablets to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form.; prior anaphylaxis, angioedema, or severe hypersensitivity to sildenafil or sildenafil excipients. Logged tolerability patterns center on nausea (12.6% of reports), headache (11.2% of reports), dizziness (6.9% of reports).
Strong CYP3A4 blockade slows first-pass metabolism of Sildenafil, elevating systemic AUC exposure.
Potent CYP3A4 modulators alter hepatic clearance of Sildenafil, shifting steady-state plasma concentrations.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- Administration of sildenafil tablets to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form.
- Prior anaphylaxis, angioedema, or severe hypersensitivity to Sildenafil or Sildenafil excipients
Logged Side-Effect Incidence (4 Reports)
Sildenafil Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Sildenafil)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Effect of sildenafil citrate on treatment of infertility in women with a thin: What a 1,452-Participant Study Found Sildenafil citrate is effective in improving endometrial thickness, the clinical pregnancy rate, and the biochemical pregnancy rate in women who have a thin endometrium. The Journal of international medical research • 2020-11-15 • Meta-Analysis | N = 1,452 | 99/100 | PMID 33176524 ↗ |
| New Insights on Sildenafil for congenital heart diseases induced lung high blood pressure, a: What a 849-Participant Study Found Sildenafil is a well-tolerated treatment in congenital heart diseases induced lung high blood pressure, as it has proven its efficacy not only in lowering both PAP mean and systolic but also in reducing the ventilation time,... BMC pediatrics • 2023-07-20 • Meta-Analysis | N = 849 | 97/100 | PMID 37474896 ↗ |
| Check Your Medicine Cabinet: Tonight We Ride, LLC Issues Voluntary Recall of Ultimate Forza Male Supplement Due to Pr Indexed from FDA Drug Recalls (2026-10-24) by DotMD's 2-hour clinical surveillance pipeline. FDA Drug Recalls • 2026-10-24 • FDA Recall | Multi-cohort | 95/100 | PMID FDA_RECALLS-743098658 ↗ |
| New Insights on Effect of Oral Phosphodiesterase-5 Inhibitors on Sperm: What a 1,317-Participant Study Found Oral PDE5 inhibitors treatment could modestly increase the sperm motility and morphology in infertile men. Urology • 2017-07-15 • Meta-Analysis | N = 1,317 | 94/100 | PMID 28259808 ↗ |
| New Insights on Emotional changes in men treated with sildenafil citrate for erectile: What a 841-Participant Study Found The physiologic and emotional benefits of sildenafil in the treatment of ED were confirmed, overall and in men with comorbid high blood pressure, high cholesterol, benign prostatic hypertrophy, and/or depression. The journal of sexual medicine • 2009-12-15 • Randomized Controlled Trial | N = 841 | 93/100 | PMID 19796051 ↗ |
Sildenafil Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $0.1029/unit (~$3.09/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $5.84 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $34.50 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 4 Anonymous DotMD Community Micro-Logs | $7.50 / mo | View logs ↓ |
| Ro Body & Metabolic Clinic (Licensed Telehealth Cash Program) | State-licensed clinician review • ~2d mail fulfillment | $45.00 consult | Program details |
| Hone Health Hormone & At-Home Biomarker Lab (Licensed Telehealth Cash Program) | State-licensed clinician review • ~3d mail fulfillment | $65.00 consult | Program details |
Sildenafil Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Sildenafil RxNorm Concept ID | 314229 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.1029 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.50 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $5.84 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 74.00% Worth It (4 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Sildenafil Patient Community, Cohort Filters & Dosage Logs
Cross-verified Sildenafil (phosphodiesterase 5 inhibitor) monograph synthesizing RxNorm 314229, openFDA FAERS signals, and $5.84–$34.50 cash benchmarks.
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Filter Sildenafil community threads and patient logs by age, biological sex, dosage, and treatment duration.