Sildenafil Interactions: Drugs, Diseases, and Other Factors
Sildenafil, commonly known by its brand name Viagra, is a medication primarily used to treat Erectile Dysfunction and Pulmonary Arterial Hypertension. While it can be highly effective in managing these conditions, it is essential to be aware of potential interactions with other drugs, substances, and medical conditions.
These interactions occur because Sildenafil alters the activity of certain enzymes in the body, affecting how other medications are metabolized. Clinically documented instances reveal that various foods and drugs can lead to adverse interactions with Sildenafil, potentially resulting in dangerous side effects or diminishing its effectiveness.
Read on to find out the various Sildenafil interactions to consider and avoid.
Overview of Sildenafil Interactions
Sildenafil interactions can affect how medications work and pose health risks. They include changes in drug potency, potential complications from health conditions, and alterations in how the body processes Sildenafil.
An overview of the interactions of Sildenafil includes:
| Types of interactions of Sildenafil | Numbers |
|---|---|
| Drug interactions | 333 |
| Disease interactions | 10 |
| Alcohol/food interactions | 2 |
Sildenafil drug interaction
Several drugs undergo interactions with Sildenafil in the body when taken together.
Here is a breakdown of Sildenafil drug interactions:
- Total drug interactions: There are 333 drugs known to interact with Sildenafil
- Major interactions: Sildenafil has 38 major drug interactions, which can result in severe adverse effects, some of which include Adagrasib, Ketoconazole, Erythromycin, Avanafil, Saquinavir, Vardenafil, Tadalafil, and Ritonavir
- Moderate interactions: There are 291 moderate drug interactions, indicating the potential for significant effects but less severe than major interactions. Some of them include: Nifedipine, Lisinopril, Metoprolol, Fluconazole, and Morphine
- Minor interactions: Sildenafil has 4 minor drug interactions, including Armodafinil, Dipyridamole, Modafinil, and Theophylline, which may cause mild effects but are still noteworthy
Some of the major drug interactions have been further explained below:
Saxagliptin and Sildenafil
Saxagliptin, used for Type 2 Diabetes, interacts with Sildenafil due to their shared pathway in the body. Both affect Nitric Oxide synthesis, impacting muscle and blood vessel function. This similarity alters their levels in the bloodstream.
Saquinavir and Sildenafil
Formulated as a hard-gel capsule, Saquinavir is an HIV protease inhibitor used in treating HIV patients. Research done by NCBI has shown that Saquinavir significantly inhibits the metabolism of Sildenafil in the body and also affects the systematic clearance mechanism of Sildenafil. These processes result in an increased concentration of free Sildenafil in the blood plasma.
Antihypertensive drugs and Sildenafil
Antihypertensive drugs control high blood pressure. Sildenafil with nitrate medications like Nitroglycerin can lead to dangerous blood pressure drops.
Other antihypertensives (beta-blockers, calcium antagonists, diuretics) cause mild blood pressure decrease, usually not harmful and temporary.
Sildenafil interactions with antibiotics
Sildenafil can interact with certain antibiotics, like Erythromycin and Clarithromycin, increasing its levels in the body. When taken multiple times daily (500 mg twice daily), Erythromycin can raise Sildenafil levels 2- to 3-fold, similar to Ritonavir. Adjusting Sildenafil dosage can manage this risk.
Cimetidine, another drug, slightly raises Sildenafil levels, but it’s not concerning. Azithromycin, however, doesn’t affect Sildenafil levels, so no dosage changes are needed when taking it.
Sildenafil interactions with supplements
When considering interactions with supplements, it’s essential to note that herbal remedies and supplements may be unsafe to take alongside Sildenafil. Unlike pharmacy medications, they are not subjected to the same rigorous testing, leading to variable effects.
However, according to MedlinePlus, some supplements, like Cimetidine (Tagamet HB) and St. John’s wort, can interact with Sildenafil, impacting its efficacy or causing side effects.
Before commencing Sildenafil treatment, it’s crucial to inform your doctor and pharmacist about any supplements, herbs, or vitamins you’re currently using or intend to use.
Also Read: To know more about the Side effects of Sildenafil, read Sildenafil Side Effects: What You Need to Know
Sildenafil interactions with diseases
Sildenafil interactions with diseases can pose significant risks beyond drug interactions. Patients with certain physiological conditions may experience complications when using Sildenafil. For instance, individuals with cardiovascular disease may be prone to internal bleeding in the lungs and brain, as well as sudden death when taking Sildenafil.
Moreover, Priapism, a prolonged and painful erection, is a known risk for patients with Sickle Cell Disease who use Sildenafil. Additionally, those with kidney impairment may experience adverse effects due to Sildenafil accumulation in their bodies.
It’s crucial to be aware of the various disease interactions associated with Sildenafil. These include cardiovascular disease, alcoholism, hearing loss, liver disease, seizure disorders, sickle cell disease, bleeding disorders, renal dysfunction, and visual disorders.
Sildenafil interactions with food
Drinking pomelo juice with Sildenafil lowers the drug’s effectiveness by reducing how much of it your body absorbs.
Similarly, green tea is another disruptor that affects the pharmaceutical activity of Sildenafil. Green tea catechins inhibit the enzymes that metabolize Sildenafil in the body, reducing its efficacy.
Drinking grapefruit juice boosts how much Sildenafil gets into your bloodstream. This raises the risk of experiencing side effects like headaches, flushing, and low blood pressure because more of the drug is circulating in your body.
Sildenafil interactions with smoking
Smoking is associated with the increased solubility of Sildenafil in the gastrointestinal tract, consequently enhancing the absorption of the drug. It may be because of the effect of smoking on the metabolism of Sildenafil in the liver, where the enzymes for Sildenafil clearance are located.
Sildenafil interactions with alcohol
Sildenafil can interact with alcohol, potentially lowering blood pressure. While avoiding this mix is generally advised due to potential risks, small alcohol amounts with Sildenafil have shown no major side effects. Still, caution is necessary due to their complex interaction. Symptoms like dizziness and flushing may occur. Limit alcohol use during Sildenafil treatment, and be careful when changing positions.
How to manage Sildenafil interactions
To manage interactions with Sildenafil effectively, follow these steps:
- Consult healthcare provider: Before starting Sildenafil, inform your healthcare provider about all medications, supplements, and health conditions.
- Avoid certain medications: Steer clear of combining Sildenafil with nitrates, alpha-blockers, high blood pressure meds, and grapefruit to prevent complications.
- Monitor symptoms: Stay vigilant for any unusual symptoms or side effects while on Sildenafil, and promptly report them to your healthcare provider.
- Discuss alcohol consumption: If you drink alcohol, discuss with your doctor the safe amount while taking Sildenafil, as it can interact and lower blood pressure.
- Follow the prescribed dosage: Stick to the prescribed dosage of Sildenafil and avoid changing it without consulting your healthcare provider
- Emergency response: In case of severe symptoms or adverse reactions, seek immediate medical attention or contact emergency services
Takeaway
Sildenafil, commonly known as Viagra, treats Erectile Dysfunction and Pulmonary Arterial Hypertension but interacts with many drugs, diseases, and substances. It alters enzyme activity, affecting how medications work. Over 330 drugs, including Saxagliptin and Saquinavir, interact with Sildenafil, impacting its levels and effects, which necessitates careful consideration and monitoring during treatment.
Antihypertensive drugs can lower blood pressure dangerously when combined with Sildenafil. NSAIDs, antibiotics like Erythromycin, and supplements like Cimetidine may also interact, affecting Sildenafil’s effectiveness or causing side effects. Patients with cardiovascular disease, sickle cell disease, or kidney impairment should be cautious.
Avoiding grapefruit juice, green tea, and excessive alcohol while taking Sildenafil is advisable. Smoking can potentially enhance the absorption of Sildenafil, leading to altered effects. Although moderate alcohol intake alongside Sildenafil may be tolerated, caution is essential due to potential interactions. Always consult healthcare providers regarding Sildenafil use and potential interactions.
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