Sildenafil Dosage: Finding the Perfect Balance for Maximum Results

Manish Choudhary
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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Recommended sildenafil dosage for alleviating various issues

If you are one of the many individuals grappling with Erectile Dysfunction (ED) or Pulmonary Arterial Hypertension (PAH), you’re likely familiar with Sildenafil, commonly known by its brand name Revatio and Viagra. 

This salt, Sildenafil, is widely recognized to enhance blood flow in the human body and deal with issues like PAH and ED. It comes in various dosages, but not every dose is appropriate for you. Understanding the right dosage of Sildenafil is crucial for effective treatment and minimizing potential side effects. In this article, we will delve into the intricacies of recommended dosages, factors influencing dosage selection, and how to handle missed doses or potential overdose.

Available Sildenafil Citrate dosage

Sildenafil comes in various strengths to accommodate different needs and scenarios.

As per doctors, here’s a breakdown of Sildenafil’s common dosages:

Erectile DysfunctionPulmonary Arterial Hypertension
25 mg tablet10 mg/mL: Oral suspension
50 mg tablet10 mg /12.5 mL: Intravenous (IV)
100 mg tablet20 mg tablet

For Erectile Dysfunction

Sildenafil relaxes blood vessels in the penis, increasing blood flow and facilitating erections, helping treat ED. Here’s a description of various dosage recommendations and adjustments of Sildenafil for Erectile Dysfunction:

Usual Sildenafil dosage for ED

For most adults seeking treatment for ED, the typical Sildenafil daily dosage is 50 mg, taken orally approximately 1 hour before sexual activity. Depending on individual response and tolerance, the dose may be adjusted to 25 mg or 100 mg. It’s crucial not to exceed one dose per day.

Although Viagra contains Sildenafil and is approved by the FDA, it is not intended for the treatment of PAH. Viagra is primarily prescribed for Erectile Dysfunction.

Geriatric dose (for older adults)

As stated in an NCBI study, older adults usually have age-related liver, kidney, or heart problems than the general population of ED. Thus, they may be more susceptible to the side effects of Sildenafil

Consequently, starting with the highest dosage of Sildenafil is not recommended, and a lower starting dose, such as 25 mg, is often prescribed. As with any medication, close monitoring for adverse reactions is essential.

Renal dose adjustments

Individuals with renal (kidney) disorders may require dose adjustments to prevent potential complications of severe kidney damage. However, for mild to moderate renal dysfunction (CrCl 30 to 80 mL/min), no adjustment is recommended. An individual with severe renal dysfunction (CrCl less than 30 mL/min) is recommended to start with a lower dose of 25 mg of Sildenafil once a day.

Liver dose adjustments

Similarly, individuals with liver (hepatic) disorders may metabolize Sildenafil differently, necessitating not starting with the maximum dosage for Sildenafil. A lower starting dose of 25 mg, along with careful monitoring for adverse effects, is advisable for patients with mild, moderate, or severe liver dysfunction.

Dose adjustments with other medicines

Here’s a brief description of the recommended Sildenafil dosage as per the Food and Drug Administration (FDA) if you are taking it along with other medications:

  • Alpha-blockers: Initiate treatment with 25 mg Sildenafil
  • Erythromycin or strong CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Saquinavir): Starting dose of 25 mg
  • Ritonavir: Stick to a maximum dosage of 25 mg in 48 hours

Also Read: Take the next step and know how to take Sildenafil. Read our article “How to Take Sildenafil: A Comprehensive Guide” for all the information.

Never combine Sildenafil with other Erectile Dysfunction medications. Doing so can lead to unwanted health risks and complications, such as low blood pressure.

For Pulmonary Arterial Hypertension

Man experiencing chest pain, suggesting possible PAH symptoms
Man experiencing chest pain, suggesting possible PAH symptoms

Sildenafil dilates pulmonary arteries, making it easier for the heart to pump blood through the lungs, reducing blood pressure and improving symptoms of PAH. Here’s a description of various Sildenafil dosages for Pulmonary Hypertension:

Usual adult dose

For adults with Pulmonary Arterial Hypertension, the recommended starting dose of Sildenafil is typically 20 mg, taken three times daily. Depending on response and tolerance, the dose may be adjusted up to 80 mg three times a day. In terms of IV administration, a 10 mg IV injection is given three times a day. 

Usual pediatric dose

Pediatric (1 to less than 18 years) patients with Pulmonary Hypertension may require lower doses of Sildenafil. The appropriate dosage is determined based on weight. So here’s a breakdown of pediatric Sildenafil dosage by weight:

WeightSildenafil dosage
Weight 20 kg or less10 mg three times daily
Weight greater than 20 kg to 45 kg20 mg three times daily
Weight greater than 45 kg20 mg three times a day; dose may be titrated up to a maximum of 40 mg orally three times a day
    No Sildenafil adjustments for PAH are required in the cases of:

  • Mild, moderate, or severe (CrCl 80 to less than 30 mL/min) renal dysfunction
  • Mild or moderate (Child-Pugh A or B) liver dysfunction

There’s not much data available for Sildenafil dosage adjustments in accordance with severe (Child-Pugh C) liver dysfunctions and other medicines’ effects. Consult your doctor for appropriate guidance.

How to deal with missing a dose

Life happens, and occasionally, a dose of Sildenafil may be missed, but remember, consistency is essential when taking Sildenafil to ensure its effectiveness. However, if you happen to miss a dose, here are some steps to consider:

  • Take it as soon as you remember: If you realize you’ve missed a dose, take it as soon as you remember. If you’re nearing the time for your next prescribed dose, it’s best to skip the missed dose and start following your usual dosing routine
  • Do not double dose: Avoid doubling your dose to make up for a missed one. Doubling your dosage can increase the risk of side effects and complications
  • Consult your healthcare provider: If you frequently miss doses or are unsure about the best course of action, consult your healthcare provider. They can provide guidance on managing missed doses and potentially adjusting your dosage regimen

Dealing with a potential overdose

Sildenafil overdose is a serious concern and can lead to severe side effects. If you suspect you or someone else has taken more Sildenafil than prescribed, seek immediate medical attention. Common symptoms of a Sildenafil overdose can include:

  • Severe headache
  • Dizziness
  • Flushing
  • Blurred vision
  • Priapism (painful, prolonged erection)
  • Nausea and vomiting
  • Fainting

It’s crucial not to ignore these symptoms, as priapism, in particular, can lead to permanent damage if left untreated.


In navigating the complexities of Sildenafil dosage, the journey toward effective treatment and minimized risks begins with understanding your unique needs. Whether combating Erectile Dysfunction or Pulmonary Arterial Hypertension, the selection of Sildenafil dosage is pivotal. It is available in varying dosages from 10 to 100 mg.

From recommended starting doses to adjustments for specific conditions like renal or hepatic impairment, each aspect plays a crucial role in treatment efficacy and safety. Remember, consistency is vital, but if a dose is missed, caution and consultation with healthcare providers are imperative. Vigilance against potential overdose symptoms is crucial for prompt intervention. 

Frequently Asked Questions

Is it ok to take Sildenafil 100mg dosage?

Taking Sildenafil 100mg dosage is generally safe for adults with Erectile Dysfunction (ED), but it’s crucial to consult a healthcare provider. They’ll assess your medical history, potential risk factors, and suitability for this dosage. Starting with a lower dose and adjusting as needed is often recommended for safety and efficacy.

Is there a Sildenafil 20 mg dosage for Erectile Dysfunction?

While Sildenafil is typically available in 25mg, 50mg, and 100mg doses for Erectile Dysfunction (ED), a 20mg dosage is not standard. However, a healthcare provider may prescribe a lower dose, such as 20mg, as part of a tailored treatment plan based on individual factors like age, health status, and response to the medication.

How much Sildenafil is too much?

Taking more than the prescribed dosage of Sildenafil increases the risk of adverse effects and overdose. The maximum recommended dose is 100mg per day for Erectile Dysfunction. Exceeding this limit significantly raises the likelihood of severe side effects requiring immediate medical attention.

How much Sildenafil should I take?

The appropriate dosage of Sildenafil depends on various factors such as your medical condition, age, and response to the medication. Generally, for Erectile Dysfunction, a typical starting dose is 50mg, taken about 1 hour before sexual activity. However, it’s crucial to consult your healthcare provider for personalized guidance and adjustment if needed.

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